Background Large (≥3 cm) benign thyroid nodules usually cause clinical symptoms or cosmetic concerns and therefore require treatment. Microwave ablation (MWA) is a potential valid non‐surgical treatment alternative, but there is a lack of evidence. Thus, this study is to evaluate the safety and efficacy of MWA in the treatment of large benign thyroid nodules. Methods A retrospective study was conducted on 42 large benign thyroid nodules in 40 patients treated with MWA. We used the trans‐isthmic approach and moving‐shot technique to perform the procedure under ultrasound (US) guidance. Patients were followed by clinical and US examinations at 1, 3, 6, and 12 months after the MWA. Study outcomes were complications, volume reduction ratio (VRR), symptom and cosmetic scores, and the requirement of multiple MWA sessions. Results There were 31 females and 9 males, with a median age of 46 years. The medians of largest diameter and volume of the nodules were 40 mm and 22 ml. Four (10%) minor complications were observed. The mean VRR was 75.1, 85.2, and 96.4% after 3, 6, and 12 months. The mean symptom and cosmetic scores dropped from 8.0 and 3.8 (before treatment) to 2.8 and 2.3 (at 12 months), respectively. Thirteen nodules (31%) required two MWA sessions. Conclusions MWA is safe, effective, and can be a good option to treat large benign thyroid nodules. More studies with large dataset and long follow‐up are required to improve its safety and efficacy.

Background Congenital tracheal malformations are less common than congenital cardiac diseases and surgical repair of these anomalies is complex. We sought to examine the surgical treatment and outcomes in cases of tracheal anomalies presenting with or without associated congenital malformations. Methods We retrospectively reviewed the demographic, clinical, and imaging data of 49 children who underwent surgery for congenital tracheal malformations between August 2013 and September 2017. Data were collected from the hospital records. Results In all, 49 patients (male, 30; female, 19) underwent surgeries at our center. The children were of ages between 3 and 36 months (average: 9.7 months). Associated congenital lesions included sling in31/49 (63%), vascularring: in 2/49; ventriculoseptaldefectin5/49; Fallot’s tetraology in 2/49 (4.1%), and imperforate anus in 3/49 (6.1%). The outcomes of surgery were excellent in 42(85.7%) cases, good in 3 cases, while mortality occurred in 4(8.1%) cases. All cases of tracheal stenosis without any change in tracheobronchial arborization, 10/12 cases of bridge carina, and all cases of tripod carina were reconstructed using the slide tracheoplasty technique. Antetracheal translocation was performed for correction of associated pulmonary sling, without reimplantation of the pulmonary artery. Conclusions Reconstructive surgery is a feasible treatment option for congenital tracheal malformations. Slide tracheoplasty can be safely applied in all cases for the correction of tracheal stenosis. Segment resection was not required for any portion of the trachea. Pulmonary artery translocation is safe and effective for patients with pulmonary artery sling, rather than reimplantation. Mortality was associated with severe cardiac complications.

Aim Post-tuberculosis tracheobronchial stenosis is rare but one of the most dangerous complications of tracheobronchial tuberculosis. Balloon dilatation, stent insertion, laser photoresection, argon plasma coagulation, and cryotherapy are some of the initial treatments recommended for mild to moderate cases. Here, we report a case series of patients who underwent segmental resection and end-to-end anastomosis for bronchial stenosis and a sliding technique for severe and long-segment tracheal stenosis. Methods We retrospectively reviewed the medical records of patients with post-tuberculosis tracheobronchial stenosis operated on in our thoracic surgery department. Of the 7 cases that were treated, two had severe tracheal stenosis stretching over 50% of the tracheal length, one was operated on using resection and end-to-end anastomosis, and the other had sliding tracheoplasty. The other 5 cases of bronchial stem stenosis were treated with segmental resection and end-to-end anastomosis. Results All five patients with bronchial stenosis had a good outcome; the ipsilateral lung was well ventilated and respiratory function was good. One patient with tracheal stenosis, treated with segmental resection and end-to-end anastomosis, died after the surgery, and the other patient, treated with slide tracheoplasty, had a good recovery. Conclusion The treatment plan for patients with post-tuberculosis tracheobronchial stenosis should be on a patient-by-patient basis. Sliding tracheoplasty can be a treatment option in patients with long-segment tracheal stenosis.

Background Mechanical injury to the trachea and bronchi may cause mild to severe stenosis requiring surgical intervention for reconstructing the damaged trachea. The location, length, and cause of injury are important factors affecting the surgical outcome. Method We conducted a retrospective study to evaluate the results of reconstructive surgery on noncancerous tracheobronchial lesions in 75 patients aged 5–55 years who had undergone reconstructive tracheobronchial surgery in our hospital from 2009 to 2018. Results The causes of tracheobronchial injury included blunt trauma in 38 patients, sharp penetrating trauma in 24, a postintubation lesion in 6, a post-tracheotomy lesion in 3, tuberculosis in 3, and an adult congenital lesion in one. In 59 cases of a lesion in the trachea, the length of missing segment before reconnection was 1–2 cm in 6 cases, 3 cm in 22, 4 cm in 18, 5 cm in 13, and >5.5 cm in 1 case. The length of the resected segment was <5.5 cm in all survivors, whereas one death occurred when the resected length was approximately 6 cm. Conclusions The length of the resected segment and precision of the surgery are crucial for determining the outcome of surgery.

Background. MicroRNA-1246 (miR-1246), an oncomiR that regulates the expression of multiple cancer-related genes, has been attracted and studied as a promising indicator of various tumors. However, diverse conclusions on diagnostic accuracy have been shown due to the small sample size and limited studies included. This meta-analysis is aimed at systematically assessing the performance of extracellular circulating miR-1246 in screening common cancers. Methods. We searched the PubMed/MEDLINE, Web of Science, Cochrane Library, and Google Scholar databases for relevant studies until November 28, 2022. Then, the summary receiver operating characteristic (SROC) curves were drawn and calculated area under the curve (AUC), diagnostic odds ratio (DOR), sensitivity, and specificity values of circulating miR-1246 in the cancer surveillance. Results. After selection and quality assessment, 29 eligible studies with 5914 samples (3232 cases and 2682 controls) enrolled in the final analysis. The pooled AUC, DOR, sensitivity, and specificity of circulating miR-1246 in screening cancers were 0.885 (95% confidence interval (CI): 0.827-0.892), 27.7 (95% CI: 17.1-45.0), 84.2% (95% CI: 79.4-88.1), and 85.3% (95% CI: 80.5-89.2), respectively. Among cancer types, superior performance was noted for breast cancer ( AUC = 0.950 , DOR = 98.5 ) compared to colorectal cancer ( AUC = 0.905 , DOR = 47.6 ), esophageal squamous cell carcinoma ( AUC = 0.757 , DOR = 8.0 ), hepatocellular carcinoma ( AUC = 0.872 , DOR = 18.6 ), pancreatic cancer ( AUC = 0.767 , DOR = 12.3 ), and others ( AUC = 0.887 , DOR = 27.5 , P = 0.007 ). No significant publication bias in DOR was observed in the meta-analysis (funnel plot asymmetry test with P = 0.652 ; skewness   value = 0.672 , P = 0.071 ). Conclusion. Extracellular circulating miR-1246 may serve as a reliable biomarker with good sensitivity and specificity in screening cancers, especially breast cancer.

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ĐẶT VẤN ĐỀ: Một số nghiên cứu chỉ ra rằng 33% bệnh nhân bướu giáp có triệu chứng chèn ép. Bệnh lý bướu giáp chèn ép gây hẹp đường thở là một trong những chỉ định ngoại khoa của bệnh lý bướu giáp. Triệu chứng chèn ép không chỉ ảnh hưởng về lâm sàng đối vối bệnh nhân mà còn là một vấn đề đối với gây mê và hồi sức chu phẫu. PHƯƠNG PHÁP NGHIÊN CỨU: Hồi cứu mô tả cắt ngang. Chúng tôi thu nhận được 52 bệnh nhân được chẩn đoán bướu giáp chèn ép khí quản đến khám và có điều trị phẫu thuật tại khoa Ngoại Lồng Ngực bệnh viện Chợ Rẫy từ tháng 01/2015 đến hết tháng 03/2019. Tiêu chuẩn loại trừ: BN có u phối hợp vùng cổ gây chèn ép khí quản, Ung thư tuyến giáp có hình ảnh xâm lấn khí quản trên CT scan. KẾT QUẢ NGHIÊN CỨU: Tuổi trung bình nhóm nghiên cứu 62.15 ± 12.71, tỉ lệ nam/nữ xấp xỉ 1:4. Tại thời điểm nhập viện, có 3 trường hợp đang điều trị viêm phổi, 4 trường hợp đang đặt NKQ và 1 trường hợp đã được mở khí quản trong tổng số 52 ca, như vậy có 15.38% bệnh nhân có vấn đề hô hấp tại thời điểm nhập viện. Đặc điểm của bướu giáp chèn ép khí quản thường là bướu có kích thước lớn, phân độ từ độ II trở lên, trên 80% có thòng trung thất. Đường kính khí quản nhỏ nhất đo được là 3 mm. Đường kính khí quản nhỏ nhất trung bình tính ra là 8.15 ± 3.40. Phân nhóm khí quản hẹp đa số bệnh nhân thuộc nhóm kích thước từ 5 – 10 mm, chiếm 73.1% Tỉ lệ bệnh nhân đặt nội khí quản khó là 61.5%. Kết quả tốt của phẫu thuật là 86.54%, tỉ lệ biến chứng sau phẫu thuật là 13.46% bao gồm các biến chứng suy hô hấp, tê tay, liệt dây thanh và tụ dịch trung thất, ngoài ra không có trường hợp nào tử vong. Tỉ lệ suy hô hấp sau mổ là 3.8%. Tỉ lệ đặt lại nội khí quản là 1.9%. Ghi nhận chỉ có 2 trường hợp mềm sụn khí quản được đánh giá trong mổ và cả hai trường hợp đều được xử lý bằng cách khâu treo khí quản. KẾT LUẬN: Phẫu thuật điều trị bệnh lý bướu giáp chèn ép khí quản cho kết quả sớm tốt. Phẫu thuật ở thời điểm sớm giúp bệnh nhân nhanh chóng hồi phục hô hấp nhanh chóng sau phẫu thuật. Trong phẫu thuật, cần chú ý các vấn đề: gây mê đặt NKQ, nhuyễn sụn khí quản và liệt dây thanh sau mổ.

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