Is it time to optimize thoracoscope instruments package of lobectomy in patients with lung cancer?_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

TU Xuehua ¹ , ZHANG Xiangrong ¹ , HAO Miao ¹ , XU Ninghui ¹ , WANG Wenping ² ,  CHE Guowei ²

1. Department of Operation Room, West China Hospital, Sichuan University, Chengdu, 610041, P.R.China;
2. Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, 610041, P.R.China;

Corresponding author：

CHE Guowei, Email: guowei_che@yahoo.com

Keywords：

Thoracoscopic surgery; surgical instruments package; lung cancer

DOI：

10.7507/1007-4848.201802027

Video：

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Objective To evaluate the advantages about video-assisted thoracoscopic surgery (VATS) lobectomy with optimized management of surgical instruments package. Methods A total of 200 patients with lung cancer were enrolled, which included 78 males and 122 females, aged 24-83 years at median age of 56.8 years. All of them were divided into 2 groups including a routine group (n=100) and an optimized management of surgical instruments group (n=100). The total operation time, bleeding, instrument weights, utilization rate of instruments, counted and cleaning time in 2 groups were recorded and analyzed. Results The average operation time and average lost blood of the routine group was 117.62±42.52 min and 53.14±50.69 ml, respectively, and the one of the optimized instruments group was 120.48±40.62 min, 56.10±49.87 ml, respectively, with no significant difference between the two groups (P=0.112, P=0.231, respectively). The utilization rate of instruments in the routine group (58.02%±2.39%) was significantly lower than that of the optimized instruments group (94.00%±1.48%, P=0.014). The counted time, the loading and unloading time and the cleaning time of instruments in the routine group was 112.00±26.00 s, 70.00±15.00 s, 1 010.00±130.00 s, respectively, much longer than the time of the optimized instruments group, which was 65.00±23.00 s, 20.00±4.00 s, 665.00±69.00 s, respectively. There was a statistical difference between the two groups (P=0.028, P=0.011, P=0.039, respectively). The value of instruments in the routine group (177 574.00±14 438.00 yuan) was apparently higher than that of the optimized instruments group(132 027.00±10 311.00 yuan), with a statistical difference (P=0.032). Conclusion It is demonstrated that optimized management of surgical instruments package in VATS lobectomy can greatly improve the utilization rate of instruments and work efficiency, with no effects on the operation time and amount of bleeding in lobectomy.

Citation： TU Xuehua, ZHANG Xiangrong, HAO Miao, XU Ninghui, WANG Wenping, CHE Guowei. Is it time to optimize thoracoscope instruments package of lobectomy in patients with lung cancer?. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2018, 25(11): 967-970. doi: 10.7507/1007-4848.201802027 Copy

1.	车国卫, 刘伦旭. 单操作孔电视胸腔镜手术临床应用的现状与进展. 中国胸心血管外科临床杂志, 2012, 9(2): 175-178.
2.	车国卫, 李为民, 刘伦旭. 快速肺康复需要围手术期流程优化. 中国胸心血管外科临床杂志, 2016, 23(3): 216-220.
3.	何惠芬, 赖英桃, 黄秀玲, 等. 手术器械包模块化分类管理的效果评价. 解放军护理杂志, 2012, 29(24): 63-64.
4.	车国卫. 肺癌患者加速肺康复外科体系的建立与优化. 中国肺癌杂志, 2017, 20(12): 795-799.
5.	Liu L, Che G, Pu Q, et al. A new concept of endoscopic lung cancer resection: Single -direction thoracoscopic lobectomy. Surg Oncol, 2010, 19(2): e71-e77.
6.	Zhi XY, Yu JM, Shi YK. Chinese guidelines on the diagnosis and treatment of primary lung cancer (2015 version). Cancer, 2015, 121(Suppl 17): 3165-3181.
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8.	周洪霞, 杨梅, 廖虎, 等. 胸腔镜肺叶切除术后 16F 尿管胸腔引流可行性的前瞻性队列研究. 中国胸心血管外科临床杂志, 2016, 23(4): 334-340.
9.	杨梅, 樊骏, 周红霞, 等. 胸腔镜肺癌肺叶切除术后 16F 较 28F 胸腔引流管应用的临床优势. 中国肺癌杂志, 2015, 18(8): 512-517.
10.	林琳戢, 艳丽, 车国卫, 等. 肺癌胸腔镜肺叶切除术后不同药物镇痛效果的随机对照试验. 中国胸心血管外科临床杂志, 2017, 24(11): 830-834.
11.	杜恒, 廖虎, 宋志芳, 等. 胸腔镜手术在中国地市级医院胸外科应用现状的问卷调查. 中国胸心血管外科临床杂志, 2013, 20(3): 347-351.
12.	He HF, Lai YT, Huang XL, et al. Effect evaluation of modular category management of surgical instrument package. Nur J Chin People's Liber Arm, 2012, 29(24): 63-64.
13.	王子豪, 廖虎, 张含露, 等. 胸腔镜前纵隔肿瘤手术中超声刀与电凝钩应用的对照研究. 中国胸心血管外科临床杂志, 2018, 25(1): 9-11.
14.	刘伦旭. 胸腔镜手术超声刀规范使用专家共识 (2017 版). 中国胸心血管外科临床杂志, 2017, 24(6): 407-412.
15.	杨思悦, 苏兰, 龚仁蓉, 等. 胸腔镜肺叶切除术:器械包模块化应用的临床评价. 生物医学工程与临床, 2014, 18(3): 255-258.
16.	朱云柯, 蒲强, 车国卫, 等. 单向式胸腔镜肺叶切除术的于术时间. 四川大学学报: 医学版, 2013, 44(1): 119-121.

1. 车国卫, 刘伦旭. 单操作孔电视胸腔镜手术临床应用的现状与进展. 中国胸心血管外科临床杂志, 2012, 9(2): 175-178.
2. 车国卫, 李为民, 刘伦旭. 快速肺康复需要围手术期流程优化. 中国胸心血管外科临床杂志, 2016, 23(3): 216-220.
3. 何惠芬, 赖英桃, 黄秀玲, 等. 手术器械包模块化分类管理的效果评价. 解放军护理杂志, 2012, 29(24): 63-64.
4. 车国卫. 肺癌患者加速肺康复外科体系的建立与优化. 中国肺癌杂志, 2017, 20(12): 795-799.
5. Liu L, Che G, Pu Q, et al. A new concept of endoscopic lung cancer resection: Single -direction thoracoscopic lobectomy. Surg Oncol, 2010, 19(2): e71-e77.
6. Zhi XY, Yu JM, Shi YK. Chinese guidelines on the diagnosis and treatment of primary lung cancer (2015 version). Cancer, 2015, 121(Suppl 17): 3165-3181.
7. 韩兆杰, 宋志芳, 苏建华, 等. 单胸腔引流管在肺癌术后快速康复中的应用. 中国胸心血管外科临床杂志, 2014, 21(1): 17-20.
8. 周洪霞, 杨梅, 廖虎, 等. 胸腔镜肺叶切除术后 16F 尿管胸腔引流可行性的前瞻性队列研究. 中国胸心血管外科临床杂志, 2016, 23(4): 334-340.
9. 杨梅, 樊骏, 周红霞, 等. 胸腔镜肺癌肺叶切除术后 16F 较 28F 胸腔引流管应用的临床优势. 中国肺癌杂志, 2015, 18(8): 512-517.
10. 林琳戢, 艳丽, 车国卫, 等. 肺癌胸腔镜肺叶切除术后不同药物镇痛效果的随机对照试验. 中国胸心血管外科临床杂志, 2017, 24(11): 830-834.
11. 杜恒, 廖虎, 宋志芳, 等. 胸腔镜手术在中国地市级医院胸外科应用现状的问卷调查. 中国胸心血管外科临床杂志, 2013, 20(3): 347-351.
12. He HF, Lai YT, Huang XL, et al. Effect evaluation of modular category management of surgical instrument package. Nur J Chin People's Liber Arm, 2012, 29(24): 63-64.
13. 王子豪, 廖虎, 张含露, 等. 胸腔镜前纵隔肿瘤手术中超声刀与电凝钩应用的对照研究. 中国胸心血管外科临床杂志, 2018, 25(1): 9-11.
14. 刘伦旭. 胸腔镜手术超声刀规范使用专家共识 (2017 版). 中国胸心血管外科临床杂志, 2017, 24(6): 407-412.
15. 杨思悦, 苏兰, 龚仁蓉, 等. 胸腔镜肺叶切除术:器械包模块化应用的临床评价. 生物医学工程与临床, 2014, 18(3): 255-258.
16. 朱云柯, 蒲强, 车国卫, 等. 单向式胸腔镜肺叶切除术的于术时间. 四川大学学报: 医学版, 2013, 44(1): 119-121.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Is it time to optimize thoracoscope instruments package of lobectomy in patients with lung cancer?

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