Abstract： Objective To investigate the clinicopathological characteristics, improve the accuracy of clinical diagnosis， and reduce postoperative complications of thoracic hemangioma. Methods Clinical records of 9 patients with thoracic hemangioma who underwent surgical resection in West China Hospital of Sichuan University from January 2006 to August 2012 were retrospectively analyzed. There were 2 males and 7 females with their average age of 47.9±19.3 （18-71）years. Six patients underwent thoracotomy， 1 patient underwent complete video-assisted thoracoscopic surgery （VATS）， 1 patient underwent video-assisted mini-thoracotomy， and 1 patient underwent staged operations which were performed by neurological surgeons and thoracic surgeons separately. Imaging characteristics, intraoperative gross tumor features, and pathological characteristics of resected hemangioma specimens were analyzed. Clinical outcomes of different surgical strategies for the treatment of hemangioma were compared. Results Nine patients with thoracic hemangioma were included in this study. Imaging studies showed the tumor as a round-shaped mass in 66.7% （6/9） of these patients and a lobulated mass in the remaining 33.3% （3/9） patients. Magnetic resonance imaging （MRI） assessment was helpful for preoperative diagnosis of hemangioma， with T2 weighted imaging tumor enhancement as the main MRI feature. Thoracic operation time was 106.3±60.1 （60-192） min， and intraoperative blood loss was 91.1±43.7 （30-150） ml. All the patients were followed up for 3-6 years except 1 patient who was followed up for 1 month. None of the patients had hemangioma-related death， recurrence or metastasis during follow-up. Conclusions Thoracic hemangiomas are usually benign entities and often locate in the mediastinum. Surgical strategies should be determined by the size and location of the tumor as well as the surgeon’s technique level. VATS has the advantages of being minimal invasive, causing less intraoperative blood loss and shorter length of hospital stay for the treatment of hemangioma. Resection of a dumbbell-type hemangioma may need cooperation between neurological and thoracic surgeons.
Objective?To summarize our experience of surgical treatment of Boerhaave’s Syndrome. Methods We retrospectively analyzed clinical records of 14 patients with Boerhaave’s syndrome in West China Hospital between January 1998 and December 2011. There were 11 male patients and 3 female patients with a mean age of 55.2±14.4 years and mean time interval between onset and admission of 49.6±21.2 h. Primary repair was performed in 11 patients.Esophagectomy and reconstruction of digestive track was performed in 1 patient and intra-luminal stent implantation was applied in 1 patient. Intercostal catheter insertion was performed in 1 patient.?Results?Thirteen patients underwent surgical therapy, and their survival rate was 84.6% (11/13). Among the eleven patients who underwent primary repair, 8 patients (72.7%)were cured and 3 patients experienced postoperative leakage resulting 2 deaths. The other one patient was cured with in-hospital time of 22.3±7.0 d. Two patients underwent digestive track reconstruction and intra-luminal stent implantation respectively and all survived with in-hospital time 39.0±5.7 d. Another patient underwent bedside chest drainage and died 10 d after admission.?Conclusion?Aggressive surgical management is an effective way to treat Boerhaave’s syndrome, and primary repair can lead to ideal prognosis in delayed patients whose time interval between onset and admission is beyond 24 h. Digestive track reconstruction and intra-luminal stent implantation are alternative methods on condition that primary repair can not be accomplished.