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find Keyword "电视胸腔镜手术" 68 results
  • Current status of video-assisted thoracoscopic surgery for spontaneous pneumothorax

    Surgical treatment is an important treatment for spontaneous pneumothorax, which can remove the gas in the pleural cavity, relieve symptoms, promote lung recruitment, moreover, prevent future recurrence. The surgical modalities included video-assisted thoracoscopic surgery (VATS) and non VATS treatment. Nowadays, the treatment of spontaneous pneumothorax has entered a minimally invasive era. With the development of minimally invasive techniques in recent years, as the representative of minimally invasive surgery, the surgeon techniques of VATS has developed to diversity, including three-port VATS, two-port VATS, uniportal VATS, subxiphoid uniportal VATS, 3D VATS, robotic-assisted VAT and cervical uniportal VATS. Each technique has its own advantages and limitations, and individual choices should be made.

    Release date:2018-07-27 02:40 Export PDF Favorites Scan
  • Comparative Study between Videoassisted Thoracoscopic Surgery and Percutaneous Catheter Occlusion in Interruption of Patent Ductus Arteriosus

    Abstract: Objective To investigate videoassisted thoracoscopic surgery (VATS) and percutaneous catheter occlusion (PCO) in interruption of patent ductus arteriosus (PDA), in order to achieve minimally invasive surgical injuries and better clinical results. Methods From November 1995 to September 2009, 312 cases of PDA were treated in Fujian provincial hospital, among whom 252 patients were interrupted with VATS(VATS group) and 60 patients with PCO technique(PCO group). For the VATS group, there were 78 males and 174 females aged from 7 d to 31 years old (9.16±8.91 years), while there were 17 males and 43 females aged from 4 to 57 years old (25.55±14.10 years) in the PCO group. We used titanium clip to interrupt PDA under videoassisted thoracoscope for patients in the VATS group, and adopted Amplatzer method for patients in the PCO group. The clinical results, complications and hospital cost in the two groups were compared in this study. Results In the VATS group, all the PDA were successfully interrupted with no residual shunt. In the PCO group, 5% (3/60) of the patients had minor residual shunt after the procedure. No mortality occurred in both groups. Time of the procedure and hospital stay in the PCO group were shorter than that in the VATS group (70.20±31.20 min vs. 112.50±16.30 min, t=6.344,P=0.002; and 4.70±2.20 d vs. 6.50±2.80 d, t=3.241, P=0.022, respectively). However, the hospital cost for each patient in the PCO group was much higher than that in the VATS group (23 222.00±4 333.40 yuan RMB vs. 8 904.50±2 634.60 yuan RMB,t=25.360, P=0.000). Conclusion Compared with PCO, VATS in interrupting PDA can achieved not only excellent clinical results, especially in the newborn and baby cases, but also very satisfying cost which is just a little more than one third of the PCO cost.

    Release date:2016-08-30 06:02 Export PDF Favorites Scan
  • 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
  • VideoAssisted Thoracoscopic Surgery for Posterior Mediastinal Tumors

    Abstract: Objective To discuss the security, effectiveness and risk factors of videoassisted thoracoscopic surgery for posterior mediastinal tumors. Methods We retrospectively analyzed the data of 59 patients including 36 men and 23 women who underwent thoracoscopic resection of posterior mediastinal tumors in People’s Hospital of Peking University from May 2001 to July 2009. Their age ranged from 6 to 73 years old with an average age of 40.6 years old. The average maximum diameter of the tumors was 4.86 cm. All procedures were performed under general anesthesia and tumors were cut out with three ports. The anterior port was extended to 6 to 10 cm when conversion to thoracotomy was needed. After mediastinal pleura were opened, the tumor was stripped out along the outside of peplos and the vascular pedicle nerves were managed respectively. Results All surgeries were carried out successfully. The surgical duration, perioperative blood loss, postoperative chest tube duration and postoperative stay in hospital were respectively 45-300 min(125.80±57.40 min), 10-1 000 ml(168.10±157.70 ml), 1-10 d(2.50±1.74 d), and 2-14 d(5.24±2.24 d). There were 6 cases of conversion to open thoracotomy with a conversion rate of 10.2%. Postoperative pathology showed that there were 46 cases of neurogenic tumors, 10 cases of cyst, 2 cases of teratoma, and 1 case of lipoma. Follow-up was done on 51 cases for a period of 7-108 months(55.0±24.0 months) and 8(13.6%) cases were missed out during the period. No recurrence or death occurred during the followup. Logistic multivariable analysis showed that maximum diameter of the tumor ≥6 cm was the independent risk factor for extending operative time (OR=1.932,P=0.004), increasing perioperative blood loss (OR=2.267,P=0.002), increasing conversion rate to thoracotomy (OR=3.123,P=0.004) and increasing postoperative complication rate (OR=1.778,P=0.013). Conclusion Videoassisted thoracoscopic surgery for posterior mediastinal tumor is safe and effective. Maximum diameter of the tumor ≥6 cm is an independent risk factor for increasing operation difficulty and risk.

    Release date:2016-08-30 06:03 Export PDF Favorites Scan
  • 电视胸腔镜辅助食管癌切除术

    目的 探讨电视胸腔镜辅助食管癌切除术的方法。方法 2000年12月-2001年5月我科用胸腔镜辅助施行食管癌切除术5例,均为食管中段癌,0期1例。Ⅰ期2例,Ⅱa期1例,Ⅱb期1例。结果 手术经过均顺利,无1例中转开胸手术,手术时间平均180min,术中出血量平均210ml,无严重术后并发症发生,无手术死亡,均治愈出院。结论 随着胸腔手术设备和器械的改进,手术操作技术的熟练,选择适当的患者采用电视胸腔镜辅助食管癌切除术是可行的,且手术效果良好。

    Release date:2016-08-30 06:18 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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  • Subxiphoid and subcostal arch thoracoscopic versus unilateral thoracoscopic thymectomy for the treatment of thymic abnormalities with myasthenia gravis: A propensity-score matching study

    ObjectiveTo compare clinical effects of extended thymectomy for the treatment of thymic abnormalities with myasthenia gravis (MG) between subxiphoid and subcostal arch thoracoscopic resection (SR) and the unilateral thoracoscopic resection (UR) by a propensity-score matching analysis.MethodsWe retrospectively analyzed the clinical data of 612 patients who presented with MG and were admitted to Tangdu Hospital of Air Force Military Medical University between December 2011 and December 2018. Of these patients, 520 patients underwent subxiphoid and subcostal arch thoracoscopic extended thymectomy (a SR group) and 92 unilateral thoracoscopic extended thymectomy (a UR group). Ninety-two patients in the SR group were matched with the UR group by propensity-score matching analysis. There were 52 males and 40 females with an average age of 26-70 (50.2±10.3) years in the SR group, and 47 males and 45 females with an average age of 20-73 (51.5±12.1) years in the UR group. The operation time, intraoperative blood loss, thoracic drainage time, postoperative hospital stay, thorough adipose tissue removal, postoperative remission of MG, patients’ satisfaction score, pain and complications were compared and analyzed between the two groups.ResultsAll operations were accomplished successfully, without conversion to thoracotomy of the two groups. There were statistical differences between the two groups in operation time (46.2±19.5 min vs. 53.4±23.5 min), chest drainage duration (0 d vs. 3.4±1.2 d), hospital stay (2.9±1.9 d vs. 3.6±1.7 d), patients’ satisfaction score (7.9±2.1 points vs. 6.7±1.2 points) and pain scores (all P<0.05). There were no statistical differences between the two groups in intraoperative blood loss (52.2±12.7 mL vs. 51.2±10.3 mL), peripheral adipose tissue removal (8.1±0.6 vs. 7.9±0.9), remission rate of MG (89.1% vs. 85.9%) and rate of postoperative complications (10.9% vs. 6.5%) (all P>0.05). ConclusionSubxiphoid and subcostal arch thoracoscopic extended thymectomy is a safe and feasible minimally invasive procedure for the management of MG with thymic abnormalities.

    Release date:2021-04-25 09:57 Export PDF Favorites Scan
  • 电视胸腔镜与开胸手术治疗复发性自发性气胸的疗效观察

    目的 对比分析电视胸腔镜手术(VATS)与开胸手术治疗复发性自发性气胸的疗效,以提高近、远期治疗效果。 方法 将124例复发性自发性气胸患者按手术方式不同分为两组,VATS组(n=73):采用VATS治疗;对照组(n=51):采用常规开胸手术。比较两种术式的复发率、手术时间、住院时间、术后胸痛等。 结果 两组均无手术死亡。VATS组患者手术成功率为97.26%(71/73),其中 1例因胸腔严重粘连,1例因术中出血转为开胸手术。VATS组复发率与对照组比较差异无统计学意义(8.22% vs.5.88%;χ2=0.034,Pgt;0.05);VATS组手术时间、住院时间均较对照组短(41.13±12.60 min vs. 88.09±41.13 min; 5.96±1.21 d vs. 8.25±1.48 d,u=13.30,9.16;Plt;0.05);慢性切口疼痛发生率低于对照组(2.74% vs.15.69%;χ2=4.93,Plt;0.05)。所有患者均得到随访,随访时间12~54个月。VATS组术后5个月内复发6例,行开胸手术治疗4例,VATS 2例;对照组术后3个月复发3例,经再次手术治疗治愈。 结论 VATS治疗复发性自发性气胸复发率与开胸手术相近,但住院时间短、美观、微创,近、远期疗效均较好。

    Release date:2016-08-30 06:05 Export PDF Favorites Scan
  • Comparative study of pulmonary function retention after video-assisted thoracic surgery and robot-assisted thoracic surgery

    ObjectiveTo investigate the changes in pulmonary function after video-assisted thoracic surgery (VATS) and robot-assisted thoracic surgery (RATS) segmentectomy.MethodsA total of 59 patients (30 males and 29 females) who underwent segmentectomy in the Affiliated Hospital of Qingdao University from July to October 2017 were included. There were 33 patients (18 males and 15 females) in the VATS group and 26 patients (12 males and 14 females) in the RATS group. Lung function tests were performed before surgery, 1 month, 6 months, and 12 months after surgery. Intra- and inter-group comparisons of lung function retention values were performed between the two groups of patients to analyze differences in lung function retention after VATS and RATS segmentectomy.ResultsThe forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) in the VATS group and the RATS group were significantly lower than those before surgery (P<0.05), and they increased significantly within 6 months after surgery (P<0.05). The recovery was not obvious after 6 months (P>0.05), and they were still lower than those before surgery. In addition, the retentions of FEV1 and FVC in the VATS group and the RATS group were similar in 1 month, 6 months, and 12 months after operation with no statistical difference(P>0.05). ConclusionPulmonary function decreases significantly in 1 month after minimally invasive segmentectomy, and the recovery is obvious in 6 months after the operation, then the pulmonary function recovery gradually stabilizes 12 months after surgery. FEV1 of the patients in the two groups recovers to 93% and 94%, respectively. There is no statistical difference in pulmonary function retention after VATS and RATS segmentectomy.

    Release date:2020-07-30 02:32 Export PDF Favorites Scan
  • Quality of Life after Video-assisted Thoracoscopic Surgery or Minimal Incision Thoracotomy for Early Stage Non small Cell Lung Cancer : A Prospective, Randomized Controlled Trial

    Abstract: Objective To evaluate video-assisted thoracic surgery(VATS)and minimal incision thoracotomy(MIT)lobectomy for early stage non-small cell lung cancer patients and the impact upon postoperative quality of life(QOL). Methods A prospective randomized controlled trial was conducted. From January 1, 2008 to December 10, 2011, the qualified patients with early stage NSCLC were recruited and randomized to VATS group (57 patients)and MIT group(49 patients), totally 106 patients,57 males and 49 females, aged 57.60 years. The quality of life was assessed using Lung Cancer Symptom Scale (LCSS) before operation and at 1,3,6,9,12 months after operation. Results There were no significant differences between the 2 groups in age, sex, the location of tumor, tumor pathologic stage, pathological types, postoperative complications, tumor size, operative time, operative bleeding and air leak days. There were no symptoms after operation at the VATS group worse than the leve before operation. Five major symptoms, including appetit(1.04±0.71 vs.2.00±0.83, F=6.357,P=0.021), fatigue (4.55±1.17 vs.10.19±2.10, F=4.721,P=0.043), dyspnea(2.18±0.86 vs.10.26±2.05, F=10.020,P=0.005), normal activity(5.16±1.70 vs.17.60±3.17, F=12.319,P=0.002)at the MIT group were deteriorated significantly at 1 month after the operation (P<0.05). Conclusion The VATS will lead to better quality of life for the patients with early stage NSCLC after surgery and lead to a smooth postoperative recovery.

    Release date:2016-08-30 05:49 Export PDF Favorites Scan
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