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find Keyword "电视胸腔镜手术" 67 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
  • 电视胸腔镜手术中控制出血的技术方法

    目的 探讨电视胸腔镜手术术中出血的控制方法,总结其止血经验。 方法 2004年11月至2011年3月内蒙古赤峰学院附属医院行电视胸腔镜手术387例,术中需特殊止血93例(24.03%),其中男56例,女37例;年龄15~63岁。全胸腔镜下肺叶切除术中肺动脉出血14例,扩张的支气管动脉出血3例、肺癌清扫淋巴结术中上腔静脉出血1例、肺隔离症变异血管出血1例,肺楔形切除术中肺静脉出血1例;穿刺戳卡处出血35例,胸膜滋养血管出血30例,肋间血管出血4例,胸顶粘连带滋养血管出血2例;胸腺瘤全胸腺扩大切除术中发生乳内动脉出血1例,无名静脉出血1例。术中采用自制套管引线钩跨肋缝合、压迫控制、镜下缝合、超声刀、电凝、Hem-o-lok、钛夹、直线切割闭合器等方法进行有效止血。 结果 全组患者均手术顺利,无死亡。其中1例出血量超过1 200 ml而中转开胸,1例缝合器故障出血中转开胸,因出血而中转开胸率2.15% (2/93);平均手术时间175 min,术中平均出血量230 ml,术后平均带管时间6.7 d,平均住院时间11.5 d。 围手术期全组未发生再次胸腔出血,均痊愈出院。全组随访6~12个月,均恢复良好。 结论 止血方法应根据自身水平选择适宜的患者,加强镜下缝合打结的基础训练,合理组合应用各种止血方法,根据肿瘤大小、淋巴结、血管长短及粘连变异、肺裂发育程度,采取合理的解剖顺序,对出血部位的血管意外要有一定的预判性及必要的提前阻断血管。

    Release date:2016-08-30 05:45 Export PDF Favorites Scan
  • Clinical Research on the Combined Video-assisted Thoracic Surgery with Two Trocars and Endoscopic Ultrasonography in the Treatment of Esophageal Leiomyoma

    Objective To explore the minimal invasiveness and practability of combined video-assisted thoracic surgery (VATS) with two trocars and endoscopic ultrasonography (EUS) in the treatment of esophageal leiomyoma. Methods Between February 2007 and February 2012, we retrospectively analysed the clinical data of 166 patients who underwent various surgeries for the treatment of esophageal leiomyoma. Among them, 62 received routine thoracotomy (group A), 49 accepted conventional VATS surgery with three trocars (group B), and 55 underwent combined VATS surgery with two trocars and EUS (group C). Then, we summarized the clinical indexes of patients in all the three groups for further comparative analysis. Results There was no significant difference among the three groups in age, gender, and lesion location, origin level and size (P > 0.05). There were significant differences between group A and C in blood loss, surgery time, intraoperative localization, postoperative incision pain, hospitalization expenses, length of hospital stay, fasting time, pulmonary infection, and the complications during the follow-up (P < 0.05). There were significant differences between group C and B in blood loss, surgery time, intraoperative localization, fasting time and pulmonary infection (P < 0.05). Conclusion Combined VATS surgery with two trocars and EUS is safe, minimally invasive, thorough with few complications, which is worthy of clinical promotion.

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  • 关注细节,提高手术质量

    Release date:2023-12-10 04:52 Export PDF Favorites Scan
  • 电视胸腔镜手术治疗巨型肺大泡的临床分析

    目的探讨电视胸腔镜手术(VATS)治疗巨型肺大泡的安全性及可行性,总结手术方法及临床经验。 方法回顾性分析2007年1月至2012年12月宝鸡市中心医院19例有临床症状、巨型肺大泡患者的临床资料,其中男15例、女4例,年龄38~77岁。所有患者均采用VATS肺大泡切除+机械性胸膜固定术治疗。 结果12例(63.2%)患者行VATS肺大泡切除+胸膜固定术,7例(36.8%)中转开胸。围术期无死亡及严重并发症发生。手术时间35~75 min。4例出现持续性肺漏气>7 d,1例伤口感染,2例出现皮下气肿,3例术后因肺部感染发生急性呼吸衰竭行机械通气,经保守治疗后治愈。术后5~11 d成功拔除胸腔引流管。术后住院时间5~15 d。术后近期症状缓解。术后随访19例,随访时间3个月至3年。随访期间患者的临床症状明显缓解,呼吸困难分级降级,术后肺功能明显改善。复查胸部CT无肺大泡复发,残留的肺大泡无增大。 结论VATS肺大泡切除联合胸膜固定术治疗巨型肺大泡是安全、有效的,残端补片及加强缝合能减少术后肺漏气的发生。

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  • 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
  • Surgical Treatment for Primary Spontaneous Pneumothorax without Bullae: A Comparative Study of Three Procedures

    ObjectiveTo explore the surgical procedures for primary spontaneous pneumothorax without bullae. MethodsWe retrospectively analyzed the clinical data of 52 patients with primary spontaneous pneumothorax without bullae, who underwent surgical treatment in Second Affiliated Hospital of Kunming Medical University between January 2008 and January 2013. There were 46 males and 6 females, with mean average age of 23.2±4.3 years (ranged from 16 to 34 years). According to the different methods of intraoperative surgery, all patients were divided into three groups. The patients in a group Ⅰ (n=20) underwent video-assisted thoracoscope (VATS) selective apex of low energy electric coagulation treatment. The patients in a group Ⅱ (n=21) underwent VATS lung tip part of lung resection. The patients in a group Ⅲ (n=11) received VATS resection of the pleura. The clinical effectiveness among the three groups was compared. ResultsCompared with other two kinds of operation schemes,the leak duration(2.61±1.89 d vs. 4.90±3.20 d vs. 5.36±2.57 d, P=0.012), postoperative chest tube drainage time (3.67±2.13 d vs. 6.00±3.73 d vs. 7.03±2.58 d, P=0.003), postoperative length of hospital stay (4.95±2.16 d vs. 7.35±3.03 d vs. 8.61±2.67 d, P=0.002) and the recurrence rate (0.0% vs. 23.1% vs. 12.5%, P=0.021) of the patients with lung tip part resection of lung tissue by VATS were significantly lower. There were no statistically significant differences in the indicators of the patients with selective apex of low energy electric coagulation by VATS and those with pleural resection by VATS (P>0.05). ConclusionLung tip part of the lung tissue resection by VATS for primary spontaneous pneumothorax without bullae is better than VATS selective apical low energy coagulation treatment and VATS resection of the pleura both in the short and long-term efficacy.

    Release date:2016-10-02 04:56 Export PDF Favorites Scan
  • Comparison of postoperative immune function between da Vinci robot-assisted and video-assisted thoracoscopic surgery in patients with non-small cell lung cancer

    ObjectiveTo compare the effect on postoperative immune function between da Vinci robot-assisted thoracoscopic surgery (RATS) and video-assisted thoracoscopic surgery (VATS) , and to provide clinical support for more effective surgical procedures.MethodsA total of 90 patients undergoing radical resection of pulmonary carcinoma in our hospital from June to November 2019 were included. There were 49 males and 41 females with an average age of 62.67 (37-84) years. Among them, 50 patients underwent da Vinci robot-assisted thoracoscopic surgery (a RATS group) and 40 patients underwent video-assisted thoracoscopic surgery (a VATS group). The perioperative indexes as well as postoperative inflammatory factors and immune level effects between the two groups were compared.ResultsCompared with the VATS, RATS could significantly shorten the operation time and decrease intraoperative blood loss (P<0.05). RATS also effectively reduced the increase of postoperative inflammatory factor level (P<0.05). But there was no significant difference in postoperative immune function between the RATS group and the VATS group (P>0.05).ConclusionRATS is superior to VATS in the treatment of non-small cell lung cancer in perioperative indicators and inflammatory factors.

    Release date:2021-06-07 02:03 Export PDF Favorites Scan
  • 电视胸腔镜诊治12例儿童支气管囊肿临床分析

    Release date:2016-12-06 05:27 Export PDF Favorites Scan
  • Single-direction video-assisted thoracoscopic surgery anatomic basal segmentectomy in 352 patients: A retrospective study in a single center

    Objective To share the clinical experience of video-assisted thoracoscopic surgery (VATS) anatomic basal segmentectomy by single-direction method. Methods The clinical data of 352 patients who underwent VATS anatomic basal segmentectomy in West China Hospital between April 2015 and April 2021 were retrospectively reviewed, including 96 males and 256 females with a median age of 50 (range, 26-81) years. All basal segmentectomies were performed under thoracoscopy, through the interlobar fissure or inferior pulmonary ligament approach, and following the strategy of single-direction and the method of "stem-branch". ResultsAll patients underwent basal segmentectomy successfully (49 patients of uniportal procedure, 3 patients of biportal procedure and 300 patients of triportal procedure) without addition of incisions or conversion to thoracotomy and lobectomy. The median operation time was 118 (range, 45-340) min, median intraoperative blood loss was 20 (range, 5-500) mL, median drainage time was 2 (range, 1-22) d and median postoperative hospital stay was 4 (range, 2-24) d. The postoperative complications included pneumonia in 6 patients, prolonged drainage (air leakage duration>5 d or drainage duration>7 d) in 18 patients, cerebral infarction in 1 patient and other complications in 2 patients. All patients were treated well and discharged without main complaints. No perioperative death happened. ConclusionVATS anatomic basal segmentectomy is feasible and safe. It can be performed in a simple manner following the strategy of single-direction.

    Release date:2022-10-26 01:37 Export PDF Favorites Scan
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