ObjectiveTo investigate the perioperative safety of patients with myasthenia gravis who take high doses of oral corticosteroids. MethodsA retrospective analysis was conducted on the clinical data of patients with myasthenia gravis who received oral corticosteroids and underwent thoracoscopic thymectomy at the Department of Thoracic Surgery, the University of Hong Kong-Shenzhen Hospital from April 2013 to October 2019. Patients were divided into a high-dose steroid group and a medium-to-low dose steroid group based on the dosage of oral steroids, and the clinical data of the two groups were compared. ResultsA total of 102 patients were included, including 19 (18.62%) males and 83 (81.37%) females, with an average age of (32.25±9.83) years. All patients in both groups successfully completed the surgery without major intraoperative bleeding, conversion to open chest surgery, delayed extubation, severe infection, or perioperative death. The daily oral steroid dose for the high-dose steroid group was (35.81±4.29) mg, and for the medium-to-low dose steroid group it was (15.29±2.17) mg. There was no statistical difference in the operation time [(124.69±23.51) min vs. (117.89±21.46) min, P=0.172] and intraoperative blood loss [(21.19±3.48) mL vs. (20.56±3.41) mL, P=0.419] between the two groups. Postoperatively, 12 (11.76%) patients developed complications: one patient of myasthenic crisis (medium-to-low dose steroid group), which was improved after short-term respiratory support and intravenous immunoglobulin treatment; 11 patients of respiratory/swallowing difficulties (9 in the low-dose steroid group and 2 in the high-dose steroid group), which were improved after anticholinergic treatment to reduce oral secretions and sputum suction, and the patients were discharged smoothly. There was no statistical difference in the incidence of postoperative complications between the two groups (P=0.637). ConclusionOn the basis of good perioperative management, it is safe and feasible for patients with myasthenia gravis who take high dose of oral steroids to undergo thymectomy, and they have the same perioperative safety as patients with medium-to-low dose steroids.
Objective To investigate the feasibility and effectiveness of a comprehensive minimally invasive approach for pulmonary nodule day surgery, utilizing non-invasive localization techniques. Methods A retrospective analysis was conducted on the clinical data of patients diagnosed with peripheral pulmonary nodules and undergoing video-assisted thoracoscopic wedge resection at the Department of Thoracic Surgery, the University of Hong Kong-Shenzhen Hospital, from January 2020 to May 2024. Patients were divided into a conventional surgery group and a day surgery group based on different treatment approaches. The perioperative data between the two patient groups were compared. Results A total of 40 patients were included, comprising 19 males and 21 females, with an average age of (47.4±12.5) years. The day surgery group consisted of 20 patients, and the conventional surgery group consisted of 20 patients. There were no statistically significant differences in baseline demographic characteristics between the two groups (P>0.05). All patients successfully completed the surgery without any deaths or serious complications. The two groups showed statistically significant differences (P<0.05) in key indicators such as pulmonary nodule localization time, incidence of localization-related complications, operative time, blood loss, duration of postoperative chest tube placement, total length of hospital stay, and patient satisfaction on the day of discharge. Conclusion Pulmonary nodule day surgery based on a comprehensive minimally invasive approach with non-invasive localization techniques can maximize the reduction of hospital stay and operative time, reduce surgery-related complications, and improve patient satisfaction and recovery speed while ensuring safety and effectiveness. The implementation of this model not only meets the needs of patients but also optimizes the allocation of medical resources, demonstrating significant clinical application value and broad potential for promotion.