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.
To compare the cl inical effect of total hi p arthroplasty (THA) using posterolateral conventional or minimally invasive incision. Methods From January 2007 to November 2007, 38 patients (41 hi ps) were treated with minimally invasive THA (mini-incision group), and 15 patients (15 hi ps) underwent conventional THA (conventional incision group). Mini-incision group: 23 males (25 hi ps) and 15 females (16 hi ps) aged (53.2 ± 15.5) years old; body mass index (BMI) was 23.4 ± 3.3; there were 20 cases (20 hips) of femoral neck fracture, 2 cases (2 hips) of primary osteoarthritis, 14 cases (16 hips) of stage III or IV aseptic necrosis of the femoral head, 2 cases (3 hips) of ankylosing spondyl itis involving hip joint; Harris hip score was 47.7 ± 5.5 and the course of disease was (4.5 ± 4.3) years. Conventional incision group: 7 males (7 hips) and 8 females (8 hips) aged (54.8 ± 10.8) years old; BMI was 26.1 ± 5.1; there were 8 cases (8 hips) of femoralneck fracture, 1 case (1 hip) of primary osteoarthritis, 5 cases (5 hips) of stage III or IV aseptic necrosis of the femoral head, 1 case (1 hip) of ankylosing spondyl itis involving hip joint; Harris hip score was 51.2 ± 4.3 and the course of disease was (3.8 ± 3.7) years. There were no statistically significant differences between two groups in the general information (P gt; 0.05). Results There were statistical differences between two groups in terms of incision length, perioperative blood loss, drainage volume and blood transfusion volume (P lt; 0.05), and no statistical differences were evident in operative time, abduction angle and the anteversion angle of acetabular cup (P gt; 0.05). All incisions healed by first intention and no early postoperative compl ications occurred. Two groups were followed for 12-22 months (average 18.3 months). All patients walked without the crutch at 2-3 months after operation. The Harris score of the mini-incision group and the conventional incision group 6 months after operation was 88.6 ± 3.6 and 85.8 ± 3.3, respectively, indicating there was no significant difference between two groups (P gt; 0.05), but there was significant difference between before and after operation (P lt; 0.05). Conclusion Compared with conventional THA, the minimaly incisive using posteroplateral approach THA has the merits of mini invasion, sl ight hemorrage, short hospital stay, minor compl ication, convenient management of femoral head and accurate prosthesis location. However, strict attention should be paid to operative indications.
Objective To discuss the differences of the effects on open colorectal cancer operation between using ultracision harmonic scalpel (UHS) and monopolar electrosurgery. Methods Fifty-nine patients from April to December in 2007, suffering colorectal cancer in the same treatment group, underwent open radical operation, 29 by GEN300 UHS (UHS group) and 30 by monopolar electrosurgery as control group. There was no significant difference between two groups among the factors of age, gender, tumor location, Dukes staging, gross morphology and degree of histological differentiation (Pgt;0.05). Results Shorter incision was applied in UHS group than in the control group. The mean operation time of UHS group and control group were 126 and 119 min, respectively (Pgt;0.05). The mean operative blood loss was 50 (20-140) ml in UHS group and 90 (40-200) ml in control group (Pgt;0.05). There were no significant differences among factors of bowel function recovery, mean hospitalization and incidence of complications between two groups (Pgt;0.05). The mean time for postoperative drainage fluid changing from bloody to serous was 8 (2-20) h in UHS group, however, 48 (16-80) h in control group (Plt;0.05). Conclusion In open colorectal cancer operation, benefits of using UHS are shorter incision and minimally invasiveness.