ObjectiveTo compare postoperative efficacy of thoracoscopic partial pneumonectomy with or without thoracic drainage tube postoperatively.MethodsThe PubMed, Wanfang database, CNKI and Web of Science from January 2000 to August 2020 were searched by computer to collect randomized controlled studies (RCT), cohort studies and case-control studies on the efficacy of chest drainage tube placement versus no placement after thoracoscopic partial pneumonectomy. Two reviewers independently screened articles and extracted data to evaluate the risk of literature bias. Meta-analysis was performed with RevMan software.ResultsA total of 15 articles were included, including 1 RCT and 14 cohort studies. A total of 1 524 patients were enrolled, including 819 patients in the test group (no postoperative chest drainage tube group) and 705 patients in the control group (postoperative chest drainage tube group). Compared with the control group, the length of hospital stay in the test group was shorter (MD=–1.3, 95%CI –1.23 to –0.17, P<0.000 01) and the incidence of postoperative pneumothorax was higher (RD=0.06, 95%CI 0.01 to 0.10, P=0.01). There was no significant difference between the two groups in operation time (MD=–2.37, 95%CI –7.04 to 2.30, P=0.32), the incidence of postoperative complications (RR=2.43, 95%CI 0.79 to 1.80, P=0.39), the reintervention rate of postoperative complications (RD=0.02, 95%CI=–0.00 to 0.04, P=0.05), postoperative subcutaneous emphysema (RD=0.02, 95%CI –0.01 to 0.06, P=0.20) and the incidence of postoperative pleural effusion (RD=0.04, 95%CI –0.00 to 0.09, P=0.10) .ConclusionCompared with the patients with chest drainage tube placement after thoracoscopic partial pneumonectomy (the control group), the test group can shorten the hospital stay. Although the incidence of postoperative pneumothorax is higher than that of the control group, the operation time, incidence of postoperative subcutaneous emphysema and in-hospital complications, and reintervention rate of in-hospital complications are not statistically significant between the two groups. Therefore no chest drainage tube may be placed after partial pneumonectomy.
ObjectiveTo explore effect of rapid rehabilitation management measures by multidisciplinary cooperation on hospital stay and complications after liver transplantation. MethodsThe convenience sampling method was used to collect the liver transplant patients in the Department of Liver Surgery of West China Hospital of Sichuan University. The patients underwent the rapid rehabilitation management measures by multidisciplinary cooperation from January 2017 to December 2017 as the study group and the patients underwent the routine management measures from January 2015 to December 2016 as the control group. The postoperative intensive care unit (ICU) stay time and postoperative hospitalization time were recorded and the postoperative complications were observed. ResultsA total of 175 patients with liver transplantation were included, including 78 cases in the study group and 97 cases in the control group. There were no significant differences in the age, gender, hemoglobin, leukocyte count, platelet count, total bilirubin, aspartate aminotransferase, alanine aminotransferase, albumin, prothrombin time, acute liver failure, model for end-stage liver disease score, liver transplantation mode, operation time, and intraoperative bleeding between the two groups (P>0.05). The postoperative ICU stay time and postoperative hospitalization time were shorter and the incidences of total postoperative complications and gade of complications were lower in the study group as compared with the control group (P<0.05). ConclusionFrom preliminary results of this study, rapid rehabilitation management measures by multidisciplinary cooperation could shorten postoperative ICU stay time and postoperative hospitalization time, reduce incidence of postoperative complications, and be more conducive to postoperative rehabilitation.