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find Keyword "电视胸腔镜手术" 67 results
  • 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
  • 胸腔引流管拔除后急性大面积皮下气肿二例

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  • Short- and Long-term Outcomes of 231 Consecutive Patients Undergoing Complete Video-assisted Thoracoscopic Surgery Lobectomy for Non-Small Cell Lung Cancer

    Objective To evaluate the safety,efficacy,short- and long-term clinical outcomes of complete video-assisted thoracoscopic surgery (VATS) lobectomy for non-small cell lung cancer (NSCLC). Methods Clinical data of231 consecutive patients with NSCLC who underwent complete VATS lobectomy in the First Affiliated Hospital of NanjingMedical University between June 2006 and March 2011 were retrospective analyzed. There were 132 male and 99 femalepatients with their age of 15-81 (59.51±11.90) years. Preoperative cancer staging wasⅠa in 149 patients,Ⅰb in 50 patients,Ⅱa in 14 patients,Ⅱb in 13 patients and Ⅲa in 5 patients. There were 152 patients with adenocarcinoma,41 patients with squamous carcinoma,23 patients with bronchioalveolar carcinoma,5 patients with adenosquamous carcinoma,4 patients with large cell carcinoma,and 6 patients with other carcinoma. Follow-up data were statistically analyzed,and short-and long-term survival rates were calculated. Results No perioperative mortality was observed. Operation time was 60-370(199.14±51.04) minutes,and intraoperative blood loss was 10-2 300 (168.19±176.39) ml. Thirty-seven patients had postoperative complications including air leak,pulmonary infection,atelectasis,arrhythmia,subcutaneous emphysema andothers,who were all cured after conservative treatment. Mean number of dissected lymph nodes was 11.14±5.49,and meannumber of explored nodal stations was 3.66±1.52. There were 51 patients (22.08%) whose postoperative cancer staging wasmore advanced than preoperative cancer staging. Postoperative hospital stay was 3-36 (10.79±5.13) days. Primary causesof prolonged postoperative hospitalization included pulmonary air leak,pulmonary infection,preoperative concomitant chronic pulmonary diseases (COPD,asthma),and moderate to severe pulmonary dysfunction. A total of 228 patients werefollowed up for a mean duration of 40.83 months (22-82 months),and 3 patients were lost during follow-up. Overall 5-yearsurvival rates were 85.78%,52.54% and 32.70% for stageⅠ,stageⅡand stageⅢ-Ⅳpatients respectively. Five-year cancerfreesurvival rates were 80.00%,45.37% and 20.99% for stageⅠ,stageⅡand stageⅢ-Ⅳpatients respectively. ConclusionThe advantages of VATS lobectomy include smaller surgical incision,less injury and postoperative pain,quicker postoperative recovery and shorter hospital stay. Long-term survival rate is comparable to previous international and Chinese studies. VATS lobectomy can anatomically achieve complete tumor resection and systematic lymph node dissection. VATS lobectomy will become a standard surgical procedure for NSCLC patients.

    Release date:2016-08-30 05:47 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
  • 肺减容术治疗慢性阻塞性肺气肿

    目的 为了提高肺气肿患者生存质量,探讨肺减容手术治疗慢性阻塞性肺气肿的可行性. 方法 本组肺减容手术16例,其中同期双侧肺减容手术9例,胸腔镜辅助小切口肺减容术4例,标准后外侧切口单侧肺减容术3例.术前根据计算机体层摄影术(CT)和同位素肺通气肺灌注扫描选择肺气肿手术"靶区",术中使用带牛心包垫的直线型切割缝合器切除病变,防止肺泡漏. 结果 手术时间90~250分钟,平均146分钟;主要并发症有肺泡漏≥7天6例,心房颤动2例,呼吸衰竭1例,术后胸腔内出血1例.13例手术结束即拔出气管内插管,3例带管回病房需要机械通气.随访2~40个月,14例健在,术后患者呼吸困难指数上升为Ⅰ级1例,Ⅱ级10例,Ⅲ级3例. 结论 慢性阻塞性肺气肿选择性手术能改善患者肺功能,长期效果尚需要观察.

    Release date:2016-08-30 06:31 Export PDF Favorites Scan
  • Application of Silk Ligation for Pulmonary Artery in Video-assisted Thoracoscopic Lobectomy

    Objective To investigate the security and feasibility of silk ligating for pulmonary artery in video-assisted thoracoscopic lobectomy, and to summarize the clinical skills. Methods We retrospectively analyzed the clinical data of 68 patients underwent the video-assisted thoracoscopic lobectomy from April 2013 to March 2015. There were 49 males and 19 females with the mean age of 59.6±10.3 years, ranging from 38 to 76 years. We divided the patients into an ECR60W cut-up group (31 patients) and a silk ligation group (37 patients). There were 22 males and 9 females patients with the average age of 59.3±9.9 years with ECR60W. There were 27 males and 10 females patients with the average age of 59.9±10.5 years with silk ligation. We observed the effect of hemostasis, and analyzed the amount of bleeding loss during operation, postoperative suction drainage and the cost of operation material between the two groups. Results There were 4 patients out of 68 converted to the open lobectomy, and all of them used ECR60W. The application of silk ligation for pulmo-nary artery could effectively control bleeding loss and avoid massive amount of bleeding due to the vascular tear in opera-tions. Furthermore, the application can reduce the rate of severe complications such as massive bleeding resulting from postoperative silk ligation slippage. There was a statistical difference between the two groups on the cost of operation mate-rials (P < 0.01). Conclusions Silk ligation for pulmonary artery in video-assisted thoracoscopic lobectomy is simple and prac-tical to apply. Compared with the ECR60W, it can significantly reduce the cost of operation material. It's worth to popularize in clinic.

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  • 电视胸腔镜经右胸前侧径路胸腺切除治疗重症肌无力

    目的 探讨电视胸腔镜手术(VATS)胸腺切除治疗重症肌无力的效果. 方法 10例重症肌无力患者采用VATS经右胸前侧径路行胸腺切除及纵隔脂肪清扫(VATS组),并与20例胸骨劈开胸腺切除(胸骨劈开组)相对照. 结果 VATS组中9例顺利完成手术,1例因电凝钩伤及头臂静脉干而中转开胸止血;全组无术后死亡及危象发生;手术时间、术后住院时间均较胸骨劈开组明显缩短. 结论 VATS经右胸前侧径路行完全胸腺切除是可行的,且具有创伤小、恢复快等优点,可在临床进一步应用.

    Release date:2016-08-30 06:32 Export PDF Favorites Scan
  • 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
  • Comparison of efficacy between robot-assisted and uniportal video-assisted thoracoscopic lobectomy

    ObjectiveTo compare the perioperative efficacy and safety of robot-assisted thoracoscopic surgery (RATS) and uniportal video-assisted thoracoscopic surgery (UVATS) in the lobectomy for early lung adenocarcinoma.MethodsClinical data of 70 early lung adenocarcinoma patients, receiving RATS or UVATS lobectomy by the same surgical team in our hospital from November 2018 to May 2020 were retrospectively analyzed. There were 24 males and 46 females with an average age of 59.3±8.9 years. According to different surgical methods, the patients were divided into a RATS group (31 patients) and a UVATS group (39 patients). The operation time, intraoperative blood loss, postoperative hospital stay, indwelling time, drainage volume, number of lymph node dissected, stations of lymph node dissected and perioperative complications were compared between the two groups.ResultsThere was no conversion to thoracotomy or perioperative death in both groups. There was no significant difference in intraoperative blood loss, postoperative hospital stay, indwelling time of thoracic drainage tube, thoracic drainage volume or stations of lymph node dissected between the two groups (P>0.05). There was no significant difference in the incidence of pulmonary infection, persistent lung leakage, chylothorax, arrhythmia or overall complications between the two groups (P>0.05). The operation time of the RATS group was longer than that of the UVATS group (195.8±52.8 min vs. 154.0±43.1 min, P=0.001). The number of lymph node dissected in the RATS group was more than that of the UVATS group (P=0.016).ConclusionBoth RATS and UVATS are safe and feasible in the treatment of lung cancer. The number of lymph nodes removed by RATS is significantly more than that of UVATS.

    Release date:2021-06-07 02:03 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
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