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find Keyword "电视胸腔镜手术" 68 results
  • The diagnosis and video-assisted thoracic surgery for mediastinal bronchogenic cysts

    ObjectiveTo emphasize the important role of video-assisted thoracoscopic surgery (VATS) in treatment of mediastinal bronchogenic cysts (MBCs).MethodsWe retrospectively reviewed the clinical data of 112 patients (53 males and 59 females) of mediastinal bronchogenic cysts who underwent VATS in our institution between April 2001 and Aprial 2016. Median age was 4–75 (45.6±15.0) years. All patients underwent chest CT preoperatively. The patients were divided into two groups: an anterior mediastinum group, 47 patients; a middle and posterior mediastinum group, 65 patients including 35 patients in the middle mediastinum, 30 patients in the posterior mediastinum. The average diameter was 0.5–22.0 (3.50±2.33) cm. The average CT attenuation was 0–67 (35.5±15.3) Hu on unenhanced CT. We began each operation with the VATS technique.ResultsThe CT diagnostic accuracy for group middle and posterior mediastinum with CT value≤20 Hu was higher than others (61.5% vs. 13.1%, χ2=17.675, P<0.001). A total of 111 patients underwent VATS, only one patient converted to open thoracotomy. Cyst resection and thymectomy were conducted in 45 patients, cyst resection and extended thymectomy were conducted in 2 patients in the anterior mediastinum group. Simply cyst resection were performed in the middle and posterior mediastinum group (n=65). The average operative time was 40–360 (104.5±43.1) min. The average intraoperative blood loss was 5–600 (57.9±88.9) mL. The intraoperative complication rate was 3.6% and the incomplete resection rate was 6.3%. The main reason for these was severe adhesion between the cyst and mediastinal structure. No serious postoperative complication was found. Follow-up was done in 99 patients, and the mean follow-up time was 42 (12–191) months. There was no local recurrence.ConclusionVATS resection of MBCs is a safe and efficacious procedure, and minimally invasive and surgical resection should be performed as early as possible for MBCs.

    Release date:2019-08-12 03:01 Export PDF Favorites Scan
  • 胸腔引流管拔除后急性大面积皮下气肿二例

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  • Application of Completely Videoassisted Thoracoscopic Lobectomy in Pulmonary Diseases Treatment

    Abstract: Objective To summarize the clinical experiences of applying completely videoassisted thoracoscopic lobectomy in pulmonary diseases treatment, and evaluate its safety, indication and efficacy. Methods We retrospectively analyzed the clinical data of 47 patients with pulmonary diseases undergoing completely videoassisted thoracoscopic lobectomy at the First People’s Hospital of Yunnan Province between October 2008 and November 2010. Among the patients, there were 35 males and 12 females with their age ranged from 30 to 72 years averaging at 61.5 years. Adenocarcinoma was present in 27 patients, squamous carcinoma in 9 patients, small cell carcinoma in 1 patient, tuberculosis in 3 patients, bronchiectasis in 3 patients, pulmonary inflammatory pseudotumor in 2 patients, hamartoma in 1 patient, and giant bulla in 1 patient. All patients underwent completely videoassisted thoracoscopic lobectomy which was carried out through three miniinvasive incisions without the use of rib spreader. Systemic lymph node dissection was performed for patients with malignancies. Blood loss, operation time, the rate of conversion to thoracotomy, postoperative hospital stay, and complications were observed. Results Completely videoassisted thoracoscopic lobectomy was successfully performed in 44 patients, and the other 3 patients were changed to open thoracotomy due to bleeding in one patient, T3 tumor in one patient and accidentally injured bronchus in one patient. The overall conversion rate was 6.4% (3/47). The mean operation time, blood loss and postoperative hospital stay were respectively 120±45 minutes, 150±80 ml, and 7±2 days. No perioperative death occurred. There were 9 patients of complications including lymphatic fistula, air leak, atrial fibrillation and atelectasis, and they all recovered after conservative treatment. Fortyfour- patients were followed up for -1 to 23 months with 3 patients missing. One-patient had bloody sputum during the followup, but recovered spontaneously later. Brain metastasis occurred to a stage Ⅲa patient with primary lung cancer 9 months after operation, and the patient survived after treatment with gamma knife. No recurrence happened to the other patients and their quality of life was good. Conclusion Completely videoassisted thoracoscopic lobectomy is a safe and feasible surgical procedure for patients with earlystage lung cancer and benign pulmonary lesions which need lobectomy. However, it is necessary to select the patients carefully in the early period of practising.

    Release date:2016-08-30 05:57 Export PDF Favorites Scan
  • 电视胸腔镜手术与开胸手术治疗创伤性血气胸的疗效分析

    目的 比较电视胸腔镜手术(VATS)与开胸手术治疗创伤性血气胸的效果,探讨VATS治疗胸部创伤性血气胸的可行性。 方法 回顾性分析2004年6月至2011年9月三峡大学仁和医院60例创伤性血气胸患者经VATS [VATS组,n=31,男24例,女7例,年龄(31.5±5.5)岁]和开胸手术治疗[开胸组,n=29,男26例,女3例,年龄(32.1±5.6)岁] 的临床资料,术后观察VATS组和开胸组患者的手术时间、住院时间、胸腔引流时间、止痛药应用时间和出血量等。 结果 围术期无死亡。VATS组住院时间[(10.3±2.4) d vs. (15.8±2.6) d]、胸腔引流时间[(3.2±1.4) d vs. (5.3±1.2) d]和止痛药应用时间[(5.1±0.8) d vs. (9.0±1.2) d]均较开胸组明显缩短,手术时间[(64.6±20.5) min vs. (118.1±20.9) min]和出血量[(538.5±32.5) ml vs. (862.6±68.5) ml]明显减少(P<0.05)。VATS组随访29例,失访2例;开胸组随访24例,失访5例;随访时间2~8个月,均无严重并发症发生和死亡病例。 结论 对胸部创伤性血气胸患者采用VATS和开胸手术治疗均有较好的疗效,但采用VATS治疗可显著缩短手术和住院时间,减少创伤后出血,且患者痛苦小,是一种安全、有效、微创和可行的手术方法。

    Release date:2016-08-30 05:28 Export PDF Favorites Scan
  • 单孔与单向式胸腔镜肺癌切除术的结合—单孔单向式胸腔镜肺癌切除术 Combinating the concepts of single-port and single-direction in video-assisted thoracic surgery (VATS) lung cancer resection—Uniportal single-direction VATS lung cancer resection

    Release date:2017-12-04 10:31 Export PDF Favorites Scan
  • Video-assisted thoracoscopic lung resection in tuberculosis treatment: A retrospective cohort study

    ObjectiveTo investigate the feasibility of video-assisted thoracoscopic surgery (VATS) lung resection in the treatment of tuberculosis.MethodsWe retrospectively analyzed the clinical data of 164 tuberculosis patients who underwent lung resection in Xi'an Chest Hospital from 2013 to 2017. Patients were divided into two groups according to the surgical procedure: a VATS group (85 patients, 56 males and29 females) and a thoracotomy group (79 patients, 52 males and 27 females). The clinical effect of the two groups was compared.Results Compared to the thoracotomy group, the VATS group had less operation time (151.59±76.75 min vs. 233.48±93.89 min, P<0.001), amount of intraoperative blood loss (200.00 ml vs. 600.00 ml, P<0.001), the postoperative drainage (575.00 ml vs. 1 110.00 ml, P=0.001), extubation time (4 d vs. 6 d, P<0.001) and hospital stay (13.00 d vs. 17.00 d, P<0.001). There was no statistical difference in postoperative complications (10 patients vs.17 patients, P=0.092) between the two groups. A total of 97 patients underwent lobectomy, including 36 of the VATS group and 61 of the thoracotomy group. The operation time (211.39±70.88 min vs. 258.20±87.16 min, P=0.008), the intraoperative blood loss (400.00 ml vs. 700 ml, P<0.010), the postoperative drainage (800.00 ml vs. 1 250.00 ml, P=0.001), extubation time (5.00 d vs. 8.00 d, P=0.002) and hospital stay (13.11±4.45 d vs. 19.46±7.74 d, P<0.010) in the VATS group were significantly better than those in the thoracotomy group. There was no statistical difference in postoperative complication rate (4 patients vs. 14 patients, P=0.147) between the two[1], groups.ConclusionCompared with conventional thoracotomy, VATS lung resection has obvious advantages in treatment of tuberculosis, which may be the preferred technique.

    Release date:2019-06-18 10:20 Export PDF Favorites Scan
  • Lobectomy for Pulmonary Diseases by Complete Videoassisted Thoracoscopic Surgery

    Objective To investigate the feasibility, curative effect and perioperative treatments of lobectomy for pulmonary diseases by complete videoassisted thoracoscopic surgery (VATS). Methods Fiftysix patients of pulmonary diseases were treated with thoracoscopic lobectomy (including mediastinal and hilar lymph node dissection for malignant diseases) from March 2006 to November 2007 in our Department. Twelve right upper lobectomy, three right middle lobectomy, fifteen right lower lobectomy, nine left upper lobectomy, fourteen left lower lobectomy and three bilobectomy were carried out. The bilobectomy included one right upper and middle lobectomy, two right middle and lower lobectomy. Mediastinal and hilar lymph node dissection was simultaneously performed in the malignant cases. The feasibility, safety and postoperative complications were retrospectively analyzed. Results Fiftytwo patients (92.8%) were performed successfully by complete VATS. The median operative duration and blood loss were respectively 107±29min(from 45min to 168min) and 121±32 ml(from 50ml to 310ml). The incision in two cases (3.6%) were elongated to around 8 cm, the ribs were retracted, and the operations were completed by the help of VATS. Another two patients (3.6%) were changed to conventional thoracotomy for pneumonectomy or hemostasis. The postoperative pathology diagnosis was lung cancer in thirty nine, tuberculoma in seven, inflammatory pseudotumor in four, indurative angioma in four, bronchiectasis in one and metastasic chondrosarcoma in one. There was no surgical mortality. One case suffered from atelectasis in the middle lobe postoperatively and was cured by phlegm suction with bronchoscopy. Two air leakage healed automatically in three days. No other severe complications was observed. The average postoperative hospitalization was 8.9±3.1 d(from 8 d to 14 d). Conclusion Lobectomy for pulmonary diseases by complete VATS is technically fieasible, safe, minimally invasive with less complications and fast rehabilitation.

    Release date:2016-08-30 06:08 Export PDF Favorites Scan
  • 电视胸腔镜心脏手术对肺功能的影响

    目的 探讨电视胸腔镜心脏手术对呼吸指数的影响。 方法 回顾性分析2011年12月至2012年12月钦州市第二人民医院70例先天性膜周部室间隔缺损(VSD)患者采用电视胸腔镜手术/开胸手术治疗的临床资料。将70例患者按手术方法不同分为两组,电视胸腔镜组:35例,男17例,女18例;年龄(12.70±6. 30)岁; 开胸手术组:35例,男18例,女17例;年龄(13.10±7.50)岁。电视胸腔镜组采取股动静脉插管,建立体外循环,右胸胸壁打3个小孔后在电视胸腔镜下施行手术;开胸手术组行常规体外循环开胸手术。两组患者于术后1 h、3 h、4 h、1 d、2 d、3 d、7 d分别采桡动脉血进行血气分析,计算呼吸指数(respiratory index,RI),并进行比较。 结果 术后1 h、3 h、4 h、1 d、2 d,电视胸腔镜组RI较开胸手术组均增高(术后1 h:0.41±0.03 vs. 0.31±0.13,P=0.021;术后1 d:0.81±0.23 vs. 0.61±0.14,P=0.042);而术后3 d、7 d 两组RI比较差异无统计学意义(P>0.05)。随访62例,随访时间3个月,两组RI比较差异无统计学意义(P>0.05)。 结论 在电视胸腔镜下行VSD修补术后早期对肺功能有损伤,而术后远期对肺功能无影响。

    Release date:2016-08-30 05:46 Export PDF Favorites Scan
  • Advances in Preoperative Localization of Solitary Pulmonary Nodules for Video-assisted Thracoscopic Surgery

    Recently, the frequency of lung disease appears higher and more precise than previously estimated. Small pulmonary nodules (SPNs) are frequently detected on high-resolution computed tomography (CT) scans. For the reason of high rate of false positives by fine needle aspirate biopsy, small lung nodules often can not be confirmed by monitor or palpation with forceps. How to precisely locate and mark the nodule before the surgery is one of the most important things for video-assisted thoracoscopic surgery (VATS). We reviews the methods of location the pulmonary nodules before the surgery and analyzes the advantages and disadvantages of various methods.

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  • Clinical Significance of Lymph Node inside Lung Dissection of Non-small Cell Lung Cancer in Stage T1

    Objective To investigate the feasibility and safety of uniportal video-assisted thoracic surgery (VATS) for primary lung cancer. Methods We retrospectively analyzed the clinical data of 95 primary lung cancer patients in our hospital between January 2014 and January 2015. The patients were divided into an observation group (45 patients) and a control group (50 patients). Standard thoracoscopy lobectomy was used in the control group. Uniportal thoracoscopy lobectomy was used in the trial group. The parameters of the two groups were observed. Results The surgeries of the two groups were successfully completed. There was no statistical difference in operative time, intraoperative transit rate, blood loss, number of lymph node dissection, thoracic drainage and pathology Ⅰ, Ⅱ period (P>0.05). Postoperative drainage tube time, postoperative hospital stay, postoperative pain in the observation group were better than those in the control group (P<0.05). But postoperative drainage time in the observation group was longer than that in the control group (P<0.05). Also, the total hospital costs, especially on the use of expensive consumables, during surgery in the observation group was higher. And there was a higher risk of delayed incision healing or airway injury (P<0.05) in the observation group. One death in the control group during perioperative period occurred. Conclusion Uniportal VATS operation applied in radical operation for lung cancer is safe and feasible. It accelerates postoperative turnover, reduces postoperative pain. But there is a higher risk for airway injury or delayed wound healing, and an increase in use of medical consumptive stuff.

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