Pub Date : 2021-07-01DOI: 10.21037/shc-2019-amp-07
M. Al-Sahaf
Fortunately, the incidence of postoperative chylothorax is low. Postoperative chylothorax can result from iatrogenic injury to either the thoracic duct or its tributaries during thoracic procedures. Thoracic duct injury has been reported following several thoracic procedures including oesophagectomy, pulmonary resections, mediastinal lymph node dissection and aortic surgery. Knowledge of the anatomical course and variations in ductal anatomy reduces the risks of injury during surgery. Chylothorax results in metabolic derangement, hypovolaemia, acidosis, malnutrition and immunosuppression. Undiagnosed, postoperative chylothorax could have devastating effects with significant morbidity and a mortality of up to 30%. Early diagnosis is therefore imperative to enable prompt and aggressive management. If postoperative chylothorax is suspected, it should be immediately investigated to confirm the diagnosis. Familiarity with the diagnostic and management procedures are therefore important to help reduce the complications of postoperative chylothorax. There are several options for managing postoperative chylothorax. These include conservative treatment, interventional procedures and surgical re-exploration for the closure of leak or duct ligation. Successful management is often achieved using a combination of these approaches. Intraoperative prophylactic thoracic duct ligation has been suggested to reduce the incidence of chylothorax following high-
{"title":"Postoperative chylothorax","authors":"M. Al-Sahaf","doi":"10.21037/shc-2019-amp-07","DOIUrl":"https://doi.org/10.21037/shc-2019-amp-07","url":null,"abstract":"Fortunately, the incidence of postoperative chylothorax is low. Postoperative chylothorax can result from iatrogenic injury to either the thoracic duct or its tributaries during thoracic procedures. Thoracic duct injury has been reported following several thoracic procedures including oesophagectomy, pulmonary resections, mediastinal lymph node dissection and aortic surgery. Knowledge of the anatomical course and variations in ductal anatomy reduces the risks of injury during surgery. Chylothorax results in metabolic derangement, hypovolaemia, acidosis, malnutrition and immunosuppression. Undiagnosed, postoperative chylothorax could have devastating effects with significant morbidity and a mortality of up to 30%. Early diagnosis is therefore imperative to enable prompt and aggressive management. If postoperative chylothorax is suspected, it should be immediately investigated to confirm the diagnosis. Familiarity with the diagnostic and management procedures are therefore important to help reduce the complications of postoperative chylothorax. There are several options for managing postoperative chylothorax. These include conservative treatment, interventional procedures and surgical re-exploration for the closure of leak or duct ligation. Successful management is often achieved using a combination of these approaches. Intraoperative prophylactic thoracic duct ligation has been suggested to reduce the incidence of chylothorax following high-","PeriodicalId":74794,"journal":{"name":"Shanghai chest","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43554388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Narrative review of the psychological impacts of lung cancer screening—consequences and how to address them?","authors":"Paloma Diab Garcia, G. Hal","doi":"10.21037/shc-21-6","DOIUrl":"https://doi.org/10.21037/shc-21-6","url":null,"abstract":"","PeriodicalId":74794,"journal":{"name":"Shanghai chest","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46736409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D. Sanchez, Francisco A. Tarrazzi, S. Harter, M. Block, S. Razi
Atrio-esophageal fistula (AEF) is a rare but fatal complication of cardiac ablation procedures. Approaches to management have focused on prompt diagnosis and surgical correction, as there is a high risk of patient decompensation and death from cerebrovascular morbidity and mortality. Esophageal stenting is not a standard approach and has been used exclusively for palliation in select cases with limited outcomes data. We report a case of a 61-year-old male presenting in critical condition due to AEF 4 weeks after cardiac ablation for persistent atrial fibrillation. The patient presented in septic shock, multisystem organ failure and was not a candidate for definitive surgical repair. Therefore, he underwent treatment with covered esophageal stent placement. The post-operative course was complicated by septic shock and cranial emboli. Despite the complex presentation and clinical progression, the patient made a meaningful neurologic and physiologic recovery. At 8 weeks he was discharged and at 10 weeks the stent was removed with demonstration of complete healing of the AEF. While surgical repair remains the standard of care for treatment of AEF as a result of cardiac ablation, in high-risk patients, esophageal stenting may provide a means for effective palliation. Stenting may allow for spontaneous healing of AEF in these select high-risk
{"title":"Successful management of atrio-esophageal fistula using a fully covered esophageal stent case report","authors":"D. Sanchez, Francisco A. Tarrazzi, S. Harter, M. Block, S. Razi","doi":"10.21037/SHC-20-70","DOIUrl":"https://doi.org/10.21037/SHC-20-70","url":null,"abstract":"Atrio-esophageal fistula (AEF) is a rare but fatal complication of cardiac ablation procedures. Approaches to management have focused on prompt diagnosis and surgical correction, as there is a high risk of patient decompensation and death from cerebrovascular morbidity and mortality. Esophageal stenting is not a standard approach and has been used exclusively for palliation in select cases with limited outcomes data. We report a case of a 61-year-old male presenting in critical condition due to AEF 4 weeks after cardiac ablation for persistent atrial fibrillation. The patient presented in septic shock, multisystem organ failure and was not a candidate for definitive surgical repair. Therefore, he underwent treatment with covered esophageal stent placement. The post-operative course was complicated by septic shock and cranial emboli. Despite the complex presentation and clinical progression, the patient made a meaningful neurologic and physiologic recovery. At 8 weeks he was discharged and at 10 weeks the stent was removed with demonstration of complete healing of the AEF. While surgical repair remains the standard of care for treatment of AEF as a result of cardiac ablation, in high-risk patients, esophageal stenting may provide a means for effective palliation. Stenting may allow for spontaneous healing of AEF in these select high-risk","PeriodicalId":74794,"journal":{"name":"Shanghai chest","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41436688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Roman V Petrov, Romulo A Fajardo, Charles T Bakhos, Abbas E Abbas
Achalasia is progressive neurodegenerative disorder of the esophagus, resulting in uncoordinated esophageal motility and failure of lower esophageal sphincter relaxation, leading to impaired swallowing. Surgical myotomy of the lower esophageal sphincter, either open or minimally invasive, has been a standard of care for the past several decades. Recently, new procedure-peroral endoscopic myotomy (POEM) has been introduced into clinical practice. This procedure accomplishes the same objective of controlled myotomy only via endoscopic approach. In the current chapter authors review the present state, clinical applications, outcomes and future directions of the POEM procedure.
{"title":"Peroral endoscopic myotomy: techniques and outcomes.","authors":"Roman V Petrov, Romulo A Fajardo, Charles T Bakhos, Abbas E Abbas","doi":"10.21037/shc.2020.02.02","DOIUrl":"https://doi.org/10.21037/shc.2020.02.02","url":null,"abstract":"<p><p>Achalasia is progressive neurodegenerative disorder of the esophagus, resulting in uncoordinated esophageal motility and failure of lower esophageal sphincter relaxation, leading to impaired swallowing. Surgical myotomy of the lower esophageal sphincter, either open or minimally invasive, has been a standard of care for the past several decades. Recently, new procedure-peroral endoscopic myotomy (POEM) has been introduced into clinical practice. This procedure accomplishes the same objective of controlled myotomy only via endoscopic approach. In the current chapter authors review the present state, clinical applications, outcomes and future directions of the POEM procedure.</p>","PeriodicalId":74794,"journal":{"name":"Shanghai chest","volume":"5 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8130836/pdf/nihms-1640573.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39000717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yiyang Wang, Z. Gu, F. Yao, T. Mao, Rui Wang, Yifeng Sun, Zhigang Li, Jun Yang, Q. Tan, Q. Luo, W. Fang
In running one of the largest thoracic surgery centers in China, the thoracic surgery team of the Shanghai Chest Hospital has exerted continuous effort in the surgical treatment of thoracic diseases. In 2019, a total 17,021 patients received thoracic surgeries at the hospital, including 14,591 pulmonary resections, 1,017 esophageal procedures, 1,089 mediastinal procedures, 59 tracheal procedures, and 9 lung transplantations. The total case volume increased by 21.1% compared to that of the year before, while the percentage of minimally invasive surgery (MIS) was as high as 89.8%, and included both videoassisted thoracic surgery (VATS) and robotic-assisted thoracic surgery (RATS) (Figure 1). The indication for minimally invasive surgery was no longer reserved solely for early-stage thoracic diseases, but was extended to those patients with locally advanced tumors, those who had received neoadjuvant therapy, and those needing complex reconstructions after extensive resection. Furthermore, the rate of major complications has remained low over the past years, with the in-hospital mortality rate being only 0.18% Original Article
{"title":"Annual report of thoracic surgery service at Shanghai Chest Hospital in 2019","authors":"Yiyang Wang, Z. Gu, F. Yao, T. Mao, Rui Wang, Yifeng Sun, Zhigang Li, Jun Yang, Q. Tan, Q. Luo, W. Fang","doi":"10.21037/SHC-2021-01","DOIUrl":"https://doi.org/10.21037/SHC-2021-01","url":null,"abstract":"In running one of the largest thoracic surgery centers in China, the thoracic surgery team of the Shanghai Chest Hospital has exerted continuous effort in the surgical treatment of thoracic diseases. In 2019, a total 17,021 patients received thoracic surgeries at the hospital, including 14,591 pulmonary resections, 1,017 esophageal procedures, 1,089 mediastinal procedures, 59 tracheal procedures, and 9 lung transplantations. The total case volume increased by 21.1% compared to that of the year before, while the percentage of minimally invasive surgery (MIS) was as high as 89.8%, and included both videoassisted thoracic surgery (VATS) and robotic-assisted thoracic surgery (RATS) (Figure 1). The indication for minimally invasive surgery was no longer reserved solely for early-stage thoracic diseases, but was extended to those patients with locally advanced tumors, those who had received neoadjuvant therapy, and those needing complex reconstructions after extensive resection. Furthermore, the rate of major complications has remained low over the past years, with the in-hospital mortality rate being only 0.18% Original Article","PeriodicalId":74794,"journal":{"name":"Shanghai chest","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46281064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gastroesophageal reflux disease along with its end stage manifestations such as intestinal metaplasia, dysplasia, and neoplasia have become increasingly prevalent in the United States and Western countries. Intestinal metaplasia, or Barrett’s Esophagus (BE), is a well described pre-malignant entity that can progress to esophageal adenocarcinoma. While esophageal adenocarcinoma is challenging to treat, early stage disease can still be cured with esophagectomy and perioperative chemoradiation therapy. Despite multimodality therapy, recurrence rates remain high even for early stage disease. Surveillance endoscopy of patients with BE may identify dysplastic changes or carcinoma in-situ prior to the development of invasive cancer. Endoscopic eradication therapies are a low-risk approach to treat dysplastic lesions and non-dysplastic lesions in high-risk patients to subvert progression to adenocarcinoma. Endoscopic mucosal resection (EMR), radiofrequency ablation (RFA), and cryotherapy are current endoscopic therapies that are safe and effective in the management of BE.
{"title":"Endoscopic eradication therapies for Barrett’s esophagus","authors":"P. Sridhar, V. Litle","doi":"10.21037/SHC.2020.02.08","DOIUrl":"https://doi.org/10.21037/SHC.2020.02.08","url":null,"abstract":"Gastroesophageal reflux disease along with its end stage manifestations such as intestinal metaplasia, dysplasia, and neoplasia have become increasingly prevalent in the United States and Western countries. Intestinal metaplasia, or Barrett’s Esophagus (BE), is a well described pre-malignant entity that can progress to esophageal adenocarcinoma. While esophageal adenocarcinoma is challenging to treat, early stage disease can still be cured with esophagectomy and perioperative chemoradiation therapy. Despite multimodality therapy, recurrence rates remain high even for early stage disease. Surveillance endoscopy of patients with BE may identify dysplastic changes or carcinoma in-situ prior to the development of invasive cancer. Endoscopic eradication therapies are a low-risk approach to treat dysplastic lesions and non-dysplastic lesions in high-risk patients to subvert progression to adenocarcinoma. Endoscopic mucosal resection (EMR), radiofrequency ablation (RFA), and cryotherapy are current endoscopic therapies that are safe and effective in the management of BE.","PeriodicalId":74794,"journal":{"name":"Shanghai chest","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44175955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Migliore, Ibrahem Albalkhi, Abdullah AlShammari, Hamsa Aldebakey, Omniyah Alashgar, J. C. Gastardi, N. Santana-Rodríguez
{"title":"A glimpse into the role of debulking surgery and hyperthermic intrathoracic chemotherapy (HITHOC) in the management of malignant pleural mesothelioma","authors":"M. Migliore, Ibrahem Albalkhi, Abdullah AlShammari, Hamsa Aldebakey, Omniyah Alashgar, J. C. Gastardi, N. Santana-Rodríguez","doi":"10.21037/shc-22-22","DOIUrl":"https://doi.org/10.21037/shc-22-22","url":null,"abstract":"","PeriodicalId":74794,"journal":{"name":"Shanghai chest","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48763522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background and Objective: Thoracic surgical patients provide unique challenges which can make maintaining adequate ventilation difficult or impossible. Despite advances in anaesthetic technique there are situations where other methods must be employed. The aim of this review is to provide an overview of extracorporeal membrane oxygenation (ECMO) and how it can be utilised in thoracic surgical patients. Methods: Library searches of PubMed ® and EMBASE databases were carried out to identify literature for inclusion in this review. Timeframe for consideration was from origin to 5/1/22. No restrictions were made on the basis of language. Content and Findings: ECMO has traditionally been used in emergency settings to manage severe respiratory or haemodynamic failure refractory to conventional medical therapy. In recent years there has been an expansion in the use of this technology beyond these settings, and it is increasingly being used in a range of emergency and elective thoracic surgical patients. The configuration of the ECMO circuit, and it’s duration of use are determined by the clinical need. The use of ECMO is associated with significant complications therefore its use requires careful consideration by an experienced multidisciplinary team. Complications can be related to the underlying pathology and patient related factors, or due to circuit related factors and the duration of use. Conclusions: The use of ECMO in thoracic surgery is rare and thus the evidence base is limited. As its use in thoracic surgical patients continues to increase, there is clear need for randomised trials to demonstrate the benefit of this technology in this complex group of patients.
{"title":"The role of extracorporeal membrane oxygenation in thoracic surgery—a narrative review","authors":"T. Eadington, Korah Oommen","doi":"10.21037/shc-22-21","DOIUrl":"https://doi.org/10.21037/shc-22-21","url":null,"abstract":"Background and Objective: Thoracic surgical patients provide unique challenges which can make maintaining adequate ventilation difficult or impossible. Despite advances in anaesthetic technique there are situations where other methods must be employed. The aim of this review is to provide an overview of extracorporeal membrane oxygenation (ECMO) and how it can be utilised in thoracic surgical patients. Methods: Library searches of PubMed ® and EMBASE databases were carried out to identify literature for inclusion in this review. Timeframe for consideration was from origin to 5/1/22. No restrictions were made on the basis of language. Content and Findings: ECMO has traditionally been used in emergency settings to manage severe respiratory or haemodynamic failure refractory to conventional medical therapy. In recent years there has been an expansion in the use of this technology beyond these settings, and it is increasingly being used in a range of emergency and elective thoracic surgical patients. The configuration of the ECMO circuit, and it’s duration of use are determined by the clinical need. The use of ECMO is associated with significant complications therefore its use requires careful consideration by an experienced multidisciplinary team. Complications can be related to the underlying pathology and patient related factors, or due to circuit related factors and the duration of use. Conclusions: The use of ECMO in thoracic surgery is rare and thus the evidence base is limited. As its use in thoracic surgical patients continues to increase, there is clear need for randomised trials to demonstrate the benefit of this technology in this complex group of patients.","PeriodicalId":74794,"journal":{"name":"Shanghai chest","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46179141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ding-pei Han, Xiaoqing Yang, Lianggang Zhu, Hecheng Li
Background: Accurate intraoperative localization of the nodules was the key point of sub-lobectomy resection. Percutaneous computed tomography (CT)-guided hook-wire was the most widely used method to locate pulmonary nodules, however, it was associated with high rates of pneumothorax and parenchymal hemorrhage. In recent years, surgeons were continuously seeking innovative approaches to cover the limitations of CT-guided hook-wire. In this article, we introduced an innovative approach that based on topographic anatomy of pulmonary segments. Case Description: After identifying and blocking the target arteries with the guide of three-dimensional (3D) reconstruction based on the CT images, indocyanine green (ICG) fluorescence was injected via peripheral vein, the fluorescence was invisible in the watershed of the target arteries by using infrared thoracoscopy. Then, a wedge resection along the border of fluorescence was completed. We demonstrated a case underwent wedge resection of a pulmonary nodule in left lower lobe, the 3D reconstruction revealed the 2 cm margin involved the subsegment a of LS8 (LS8a) and subsegment b of LS6 (LS6b). the nodule was successfully resected along the border of LS8a and LS6b displayed by this method after blocking the arteries of LS8a and LS6b. Conclusions: wedge resection guided by negative fluorography based on pre-block of watershed pulmonary arteries is a safe and flexible alternative method for nodules localization in video-assisted thoracic surgery (VATS).
{"title":"A case report of uniportal video-assisted thoracic surgery left lower lobe wedge resection: guided by negative fluorography based on pre-block of watershed pulmonary arteries","authors":"Ding-pei Han, Xiaoqing Yang, Lianggang Zhu, Hecheng Li","doi":"10.21037/shc-22-3","DOIUrl":"https://doi.org/10.21037/shc-22-3","url":null,"abstract":"Background: Accurate intraoperative localization of the nodules was the key point of sub-lobectomy resection. Percutaneous computed tomography (CT)-guided hook-wire was the most widely used method to locate pulmonary nodules, however, it was associated with high rates of pneumothorax and parenchymal hemorrhage. In recent years, surgeons were continuously seeking innovative approaches to cover the limitations of CT-guided hook-wire. In this article, we introduced an innovative approach that based on topographic anatomy of pulmonary segments. Case Description: After identifying and blocking the target arteries with the guide of three-dimensional (3D) reconstruction based on the CT images, indocyanine green (ICG) fluorescence was injected via peripheral vein, the fluorescence was invisible in the watershed of the target arteries by using infrared thoracoscopy. Then, a wedge resection along the border of fluorescence was completed. We demonstrated a case underwent wedge resection of a pulmonary nodule in left lower lobe, the 3D reconstruction revealed the 2 cm margin involved the subsegment a of LS8 (LS8a) and subsegment b of LS6 (LS6b). the nodule was successfully resected along the border of LS8a and LS6b displayed by this method after blocking the arteries of LS8a and LS6b. Conclusions: wedge resection guided by negative fluorography based on pre-block of watershed pulmonary arteries is a safe and flexible alternative method for nodules localization in video-assisted thoracic surgery (VATS).","PeriodicalId":74794,"journal":{"name":"Shanghai chest","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47806096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Brunswicker, M. Z. Y. Tan, M. Garner, K. Rammohan
{"title":"A realist (re)view on surgical lung biopsy in interstitial lung disease: who, how, when and at what risk?","authors":"A. Brunswicker, M. Z. Y. Tan, M. Garner, K. Rammohan","doi":"10.21037/shc-22-28","DOIUrl":"https://doi.org/10.21037/shc-22-28","url":null,"abstract":"","PeriodicalId":74794,"journal":{"name":"Shanghai chest","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46945583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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