For the middle and lower thoracic esophageal cancer patients, whether or not who has suspected lymph node metastasis in the upper mediastinum based on preoperative CT and EUS, the surgical treatment through right thoracic approach can achieve better but not significantly better overall survival than that through left thoracic approach. Further prospective randomized clinical trials are still needed to verify this disputed issue on approach selection.

Unilateral absence of a pulmonary artery (UAPA) is a rare congenital cardiac malformation that is often associated with other cardiovascular deformities. Surgical repair of this rare condition is usually performed only on the abnormal lung. The occurrence of lung cancer in association with UAPA is even rarer and clinical experience is very limited. This report aims to describe a case of unilateral absence of right pulmonary artery that was complicated by primary carcinoma of the contralateral lung. A left lower lobectomy was performed despite the absence of the right pulmonary artery and repeated decreases in the arterial oxygen saturation (SaO) were encountered intraoperatively. The current case provides insights into the operative tolerability and the foreseeable ominous prognosis after excision of the normal lung in patients with UAPA and highlights the importance of the clinical awareness of this potentially lethal congenital anomaly in light of its extreme rarity, which may facilitate better diagnosis and treatment of such patients.

Many cytogenetic studies have been carried out on human lung cancer. However the chromosomal alterations in human lung cancers are often complex, making it difficult to identify some abnormal chromosomes by routine cytogenetic studies. Using FISH (fluorescence in situ hybridization), we studied the alterations of chromosome 2, 3, and 17 in four human bronchial epithelial cell lines, two human non-small-cell lung cancer (NSCLC) cell lines, and 12 primary NSCLC specimens. 2q- was found in three out of four human bronchial epithelial cell lines, two NSCLC cell lines, and three out of seven primary NSCLC specimens tested. 3p- was noted in five cases of twelve primary NSCLC patients examined. 3p- was the first cytogenetic discovery and the most prominent abnormality in lung cancer. 2q- has rarely been reported in human lung cancer but loss of heterozygosity by RFLP analysis for 2q had been reported in human NSCLC. Our results indicate that 2q- was also a non-random chromosomal abnormality in the early stage of the development of human NSCLC. There would be one or more putative tumor suppressor gene(s) on the long arm of chromosome 2. Loss of the gene(s) presumably contributes to the carcinogenesis of human non-small-cell lung cancer.

OBJECTIVE To evaluate the indication and short-term outcomes of video assisted thoracic surgery (VATS) for lung tumors. METHODS Data of 306 consecutive patients undergoing VATS pulmonary resection between were retrospectively reviewed. RESULTSThere were 7 patients who underwent open thoracotomy, accounting for 2.29% (7/306). The overall morbidity rate of complications and the mortality rate induced by VATS was 1.63% (5/306) and 0.33% (1/306), respectively. There were no significant differences in morbidity and mortality rate between the patients receiving the VATS and the patients receiving the OT. The overall hospitalization, postoperative length of stay (LOS) and chest tube duration in the VATS lobectomy group (n = 167) were shorter than those in the open thoracotomy (OT), but the operative time in the VATS group was longer than that in the OT group (n = 124). There were no signifi cant diff erences in the number of station of lymph nodal dissection (LND) and number of LND in pathological stage I between VATS group and OT group, but signifi cant diff erences were found in the number of station of LND and the number of LND in pathological stage II and stage IIIA between the 2 groups. Compared with those who underwent OT wedge resection (n = 72), the patients who underwent VATS wedge resection (n = 108) had shorter operative time, chest tube duration and hospital LOS, and there were no significant differences in morbidity of the complications and mortality between the 2 groups. CONCLUSION VATS lobectomy can be performed for patients with clinical stage I lung cancer (with tumor diameter smaller than 5 cm, without hilar and mediastinal lymph node enlargement). VATS lobectomy is superior to OT lobectomy in short-term outcomes, although further studies exploring long-term outcomes through longer follow-up is needed to determine the oncologic equivalency between the VATS and the open lobectomy. VATS is also superior to OT in pulmonary wedge resection.