Part 1 Analysis Of Clinical Factors In Primary Achalasia Complicated With Esophageal Cancer Part 2 Short-term Efficacy Of Thoracoscopic Anatomical Segmentectomy In The Treatment Of Stage IA Non-small Cell Lung Cancer

Objective To analyze the clinical effect of primary achalasia complicated with esophageal cancer.Methods The data of patients in Cancer Hospital of Chinese Academy of Medical Sciences from January 1980 to March 2019 were collected and analyzed retrospectively.SPSS 25.0 was used for statistical analysis.Results Among the 38 patients with primary achalasia,the number of male cases was 26 and the number of female cases was 12.There were 10 cases(26.3%)with esophageal cancer.The number of male cases was 9 and the number of female cases was 1.The average age of diagnosis of esophageal cancer was 54.5 9.23 years old,and the time from the diagnosis of primary achalasia to the diagnosis of esophageal cancer was 18.7 9.8 years based on the statistics of relevant data.The number of patients undergoing balloon dilatation or Heller operation is the same as that of patients without operation for primary achalasia,which is 50.00%(5/10).Esophageal cancer occurred in the upper middle segment(50.00%,5/10),lower middle segment(10.00%,1/10)and lower segment(40.00%,4/10).The most common site was middle and upper esophagus(50.00%,5/10).Pathological types were squamous cell carcinoma(90.00%,9/10)and small cell carcinoma(10.00%,1/10).50.00%(5/10)patients received regular endoscopy in early stage,50.00%(5/10)had advanced tumor(stage Ⅲ-Ⅳ),and 10.00%(1/10)had distant metastasis(right supraclavicular lymph node).70.00%(7/10)patients underwent radical esophagectomy,with 3 patients taking radical esophagectomy alone,1 patient taking postoperative chemotherapy,1 patient taking postoperative concurrent chemoradiotherapy as treatment,1 patient taking postoperative sequential chemoradiotherapy as treatment,and 1 patient taking neoadjuvant concurrent chemoradiotherapy and postoperative chemotherapy as treatment.The average survival time of patients with esophageal cancer was 26.924.68 months.Eight patients were monitored regularly by upper gastrointestinal endoscopy.Two patients received radiotherapy for advanced tumor,and their survival time was 8 months and 4 months respectively.For upper gastrointestinal endoscopy monitoring,in stage Ⅳ patients,the monitoring frequency is every 5 years or never.In stage Ⅲ patients,the monitoring frequency is 2-4 years/time.In stage Ⅱ patients,the monitoring frequency is 1-3 years/time.In stage I patients,the monitoring frequency is 1-2 years/time.Conclusion For patients with achalasia who have a medical history of more than 10 years or have received surgical treatment,endoscopic monitoring of upper digestive tract should be carried out once a year.Esophageal cancer must be detected early and intervened in time,so that the prognosis of patients can be effectively improved.Objective To analyze the correlation of patients with stage IA non-small cell lung cancer,and to determine the short-term effect of thoracoscopic anatomical lobectomy and thoracoscopic lobectomy in actual treatment.Methods The clinical and pathological data of patients with stage IA NSCLC who underwent thoracoscopic anatomical lobectomy and thoracoscopic lobectomy in Cancer Hospital of Chinese Academy of Medical Sciences from January 2015 to March 2016 were collected,and were followed up through the medical record system and telephone conversation of Cancer Hospital of Chinese Academy of Medical Sciences.The data were collected and analyzed retrospectively.SPSS 25.0 was used for statistical description and analysis.Results A total of 284 patients with stage IA NSCLC were included,and 190 patients underwent thoracoscopic lobectomy and 94 patients underwent thoracoscopic anatomical lobectomy.There were no statistical differences in age,hypertension,diabetes,coronary heart disease and preoperative lung function between the lung segment group and the lung leaf group(P>0.05),but there were statistical differences in gender,smoking history,lymph node dissection,number of lymph node dissection and average tumor diameter(P<0.05).The indexes of total drainage volume,postoperative tube taking time and postoperative hospital stay in the lung segment group were significantly better than those in the lung lobe group,and the difference between them could reach the statistical significant standard(P<0.05).The operation time in the lung segment group was longer than that in the lung lobe group,and the difference between the two groups could reach the statistically significant standard[(124.30 27.45)min vs.(131.32 22.58)min,P=0.033].There was no significant difference in blood loss and complication rate(P>0.05).The hazard ratio(HR)between the lobe group and the segment group was 1.642(0.648-4.162),P=0.296.There was no significant difference in prognosis(P>0.05).Conclusion For patients with stage IA NSCLC,the actual curative effects of the two types of surgery are basically the same,and both of them have high safety in practice.