Abstract: Objective To investigate the feasibility of the diagnosis and treatment of pleurallung diseases by minithoracotomy and videoassisted thoracic surgery(VATS) under local anesthesia. Methods From February 2002 to March 2005,30 cases were performed by thoracotomy under local anesthesia,which were divided into two groups including minithoracotomy group and VATS group according to the different approaches; inithoracotomy group was used just for the biopsy of thicken pleura and diffuse pulmonary diseases on the state of open pneumothorax, and VATS group was for the diagnosis and treatment of malignant effusion and recurrent pneumothorax on the state of closed pneumothorax,all of them were ompleted under local anesthesia. Results Minithoracotomy group: biopsy of pleura were performed on 13 cases, 10 cases of which has been diagnosed with metastasis, one case was amyloidosis of pleura, two cases were proliferation of pleura.Three cases on diffuse pulmonary diseases were done for biopsy, 2 of which were pulmonary interstitial fibrosis, 1 of which was pulmonary tuberculosis (type Ⅱ). VATS group: Except one was converted to general anesthesia and minithoracotomy to resect the lesion due to heavy pleural adhesion, other patients who had thicken pleura and diffuse pulmonary diseases were performed operation for biopsy, bullarectomy was done on recurrent pneumothorax,and pleurodesis was done on ntractable pleuaral effusion under local anesthesia. 4 cases on pleural effusion were done by diagnostic thoracoscope under local anesthesia, 1 of which was liverrelated pleural effusion. 14 cases has been done by remedial thoracoscope, 8 cases of which malignant pleural effusion were done for pleurodesis, the other cases which have recurrent pneumothorax were given bullaectomy and pleurodesis. Spontaneous breathing and hemodynamics was maintained well during the operation. There was neither severe complication nor mortality in two groups. Conclusion Videoassisted thoracoscopic resection of peripheral pulmonary nodule and biopsy of pleura through minithoracotomy can be performed safely under local anesthesia. The novel approach will be the cost-effective procedure for management of pulmonary nodules in the present time.
Objective To discuss the way and management of cardiopulmonary bypass （CPB） through intubation of femoral artery and femoral vein for completely video assisted cardiac operations, Methods CPB were set up through femoral artery and femoral vein in 85 patients on heart surgery by video assisted thoracotomy. Thirtyeight patients were diagnosed as atrial septal defect （ASD）, forty-three patients were diagnosed as ventricular septal defect （VSD）, and four patients were mitral valve stenosis and mitral incompetence （MS＋MI）,The video assisted thoracotomy was used to repair ASD, VSD and mitral valve replacement （MVR）. Results For all patients the durations of CPB and aortic cross-clamping time was 30-179 min（91.7±27.4 min）, 6-103 min（37.2±6. 1 min）. In one patient, the CPB was set up again for repairing of residual leak. The endothelium of femoral artery was lacerated during withdrawing the cannula in 2 patients. Conclusion The video assisted thoracic operation with CPB and by intubation of femoral artery and femoral vein to perform heart operation are feasible and safe. All patients are recovered well.
Objective\ To investigate the surgical technique and clinical results of interruption of patent ductus arteriosus (PDA) with video assisted thoracic operation (VATO).\ Methods\ Fifty PDA cases were divided into two groups, 25 cases treated with VATO(VATO group) as compared to other 25 cases with conventional surgical interruption(conventional surgical interruption group). In the VATO group, the PDA was interrupted by 2 3 hemoclips under VATO technique, and PDA interrupted by suture ligation with the techni...