ObjectiveTo evaluate the efficacy and safety of robot-assisted thoracoscopic esophagectomy in the treatment of esophageal carcinoma. MethodsWe retrospectively analyzed the clinical data of 79 patients with robotassisted thoracoscopic esophagectomy in our hospital from August 2010 to June 2015. There were 43 males and 36 females at average age of 62 years. The clinical effect was analyzed. ResultsThe mean operation time was 245 min (range 170 min to 330 min). The mean blood loss was 75 ml (range 20 ml to 310 ml). The mean hospital stay was 10.2 days (range 7 days to 26 days). Two perioperative deaths occurred. A total of 14 (17.7%) patients with complication were reported. Mean lymph node harvest was 20.7 nodes with 10.9 in chest, 9.6 in abdomen. ConclusionRobot-assisted thoracoscopic esophagectomy is technically feasible and safe. It is expected to reduce surgical trauma and reduce the incidence of pulmonary complications.
Objective To evaluate the effects of emergency coronary artery bypass grafting (ECABG) in the treatment of emergent patients, and to summarize our experience. Methods We retrospectively analyzed the clinical data of 160 patients who underwent coronary artery bypass grafting (CABG) in Nanjing General Hospital of Nanjing Command from January 2010 through December 2013. The patients were divided into an ECABG group (operation underwent on the day diagnosed, n=27, 22 males and 5 females, at age of 70.2±10.2 years) and a conventional group (CABG operation underwent on 5 days after diagnosed, n=133, 104 males and 29 females, at age of 66.3±8.9 years). Results Statistical differences were found between the ECABG group and the conventional group in EuroSCORE (5.8±3.2 versus 3.4±2.1, P=0.001), acute myocardial infarction (33.3% vs. 11.3%, P=0.007), rate of application of IABP (29.6% versus 12.0%, P=0.034), pericardium and mediastinal tube drainage (533.4±132.8 ml versus 414.8±124.3 ml, P=0.018). There was no statistical difference in continuous renal replacement therapy (P=0.677), postoperative sternal wound complication (P=1.000), the length of hospital stay (P=0.589), or 30-day-mortality (P=0.198) between the two groups. We followed up 24 patients(88.89%) for 3-36 months in the ECABG group. One patient occurred angina symptoms at the end of 1 year follow-up. The symptoms disappeared after treatment. The other patients had no symptoms of angina pectoris and myocardial ischemia. Conclusion ECABG as a lifesaving therapy is an effective procedure in the treatment of severe and acute patients. Sufficient preoperative assessment, good myocardial protection, full revascularization, and comprehensive treatment plays an important role in the success of ECABG.