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Partial removal of the pulmonary artery in video-assisted thoracic surgery for non-small cell lung cancer 被引量:2
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作者 Keping Xu Zhi Zhang +3 位作者 Jianqiang Zhao Jianfeng Huang Rong Yin Lin Xu 《The Journal of Biomedical Research》 CAS 2013年第4期310-317,共8页
Lobectomy with partial removal of the pulmonary artery in video-assisted thoracic surgery (VATS) currently remains a challenge for thoracic surgeons. We were interested in introducing pulmonary vessel blocking techn... Lobectomy with partial removal of the pulmonary artery in video-assisted thoracic surgery (VATS) currently remains a challenge for thoracic surgeons. We were interested in introducing pulmonary vessel blocking techniques in open thoracic surgery into video-assisted thoracic surgery (VATS) procedures. In this study, we reported a surgical technique simultaneously blocking the pulmonary artery and the pulmonary vein for partial removal of the pulmonary artery under VATS. Seven patients with non-small-cell lung cancer (NSCLC) received lobectomy with partial removal of the pulmonary artery using the technique between December 2007 and March 2012. Briefly, rather than using a small clamp on the distal pulmonary artery to the area of invading cancer, we replaced a vascular clamp with a ribbon and Hem-o-lock clip to block the preserved pulmonary veins so as to prevent back bleeding and yield a better view for surgeons. The mean occlusion time of the pulmonary artery and pulmonary veins were 44.0±10.0 and 41.3±9.7 minutes, respectively. The mean repair time of the pulmonary artery was 25.3±13.7 minutes. No complications occurred. No patients showed abnormal blood flow through the reconstructed vessel. There were no local recurrences on the pulmonary artery. In conclusion, the technique for blocking the pulmonary artery and veins is feasible and safe in VATS and reduces the risk of abrupt intraoperative bleeding and the chance of converting to open thoracotomy, and extends the indications of VATS lobectomy. 展开更多
关键词 video-assisted thoracic surgery (VATS) non-small-cell lung cancer (NSCLC) LOBECTOMY pulmonary artery reconstruction
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Video-Assisted Thoracic Surgery for Residual Aneurysm after Total Arch Replacement
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作者 Kayo Sugiyama Hirotaka Watanuki +5 位作者 Yasuhiro Futamura Masaho Okada Hiroki Numanami Masayuki Yamaji Satoshi Makino Katsuhiko Matsuyama 《Open Journal of Thoracic Surgery》 2021年第1期25-30,共6页
<strong>Background</strong>: Residual aneurysms after graft replacement are rare, but they can be detrimental if they are saccular and large. The etiology of residual aneurysms remains unknown, and their m... <strong>Background</strong>: Residual aneurysms after graft replacement are rare, but they can be detrimental if they are saccular and large. The etiology of residual aneurysms remains unknown, and their management is controversial. One treatment option is late open surgical conversion;however, postoperative respiratory complications resulting from the dissection of pleural adhesions, which is frequently necessary with this approach, are often unavoidable. <strong>Case presentation</strong>: Herein, we report a case of open surgical repair of a residual distal aortic arch aneurysm that occurred after total arch replacement and thoracic endovascular aortic repair. Contrast-enhanced magnetic resonance imaging was not possible in this case due to the patient’s severe renal dysfunction;however, contrast-enhanced computed tomography using minimal contrast did not detect remarkable leakage through the graft or stent graft into the aneurysm. Late open surgical conversion using video-assisted thoracic surgery was performed by thoracic surgeons, and the adhesion between the aortic wall and the lung was safely and effectively dissected. Because there was no significant pulsation or evidence of feeding arteries in the aortic wall, the aortic wall was opened carefully. No bleeding or backflow from any branch arteries into the aneurysm was noted, so the aortic wall was ligated with continuous sutures. The patient recovered without experiencing any major complications. <strong>Conclusions</strong>: This case report demonstrates that video-assisted thoracic surgery is safe and effective for late open conversion in cases of residual aneurysm;furthermore, this case suggests that video-assisted thoracic surgery may be particularly beneficial for the dissection of adhesions between the aortic wall and lung in these cases. 展开更多
关键词 Late Open Surgical Conversion Total Arch Replacement video-assisted thoracic surgery
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Video-assisted thoracic surgery―the past, present status and the future 被引量:26
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作者 LUH Shi-ping LIU Hui-ping 《Journal of Zhejiang University-Science B(Biomedicine & Biotechnology)》 SCIE CAS CSCD 2006年第2期118-128,共11页
Video-assisted thoracic surgery (VATS) has developed very rapidly in these two decades, and has replaced conven-tional open thoracotomy as a standard procedure for some simple thoracic operations as well as an option ... Video-assisted thoracic surgery (VATS) has developed very rapidly in these two decades, and has replaced conven-tional open thoracotomy as a standard procedure for some simple thoracic operations as well as an option or a complementary procedure for some other more complex operations. In this paper we will review its development history, the present status and the future perspectives. 展开更多
关键词 胸外科 可视的 气胸 积脓症 VATS
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Application of video-assisted thoracic surgery in the standard operation for thoracic tumors 被引量:9
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作者 Ju-Wei Mu Gui-Yu Chen +22 位作者 Ke-Lin Sun Da-Wei Wang Bai-Hua Zhang Ning Li Fang Lv You-Sheng Mao Qi Xue Shu-Geng Gao Jun Zhao Da-Li Wang Zhi-Shan Li Wen-Dong Lei Yu-Shun Gao Liangze Zhang Jin-Feng Huang Kang Shao Kai Su Kun Yang Liang Zhao Fei-Yue Feng Yong-Gang Wang Jian Li Jie He 《Cancer Biology & Medicine》 SCIE CAS CSCD 2013年第1期28-35,共8页
Objective: To evaluate the short-term outcomes of video-assisted thoracic surgery (VATS) for thoracic tumors. Methods: The data of 1,790 consecutive patients were retrospectively reviewed. These patients underwent VAT... Objective: To evaluate the short-term outcomes of video-assisted thoracic surgery (VATS) for thoracic tumors. Methods: The data of 1,790 consecutive patients were retrospectively reviewed. These patients underwent VATS pulmonary resections, VATS esophagectomies, and VATS resections of mediastinal tumors or biopsies at the Cancer Institute & Hospital, Chinese Academy of Medical Sciences between January 2009 and January 2012. Results: There were 33 patients converted to open thoracotomy (OT, 1.84%). The overall morbidity and mortality rate was 2.79% (50/1790) and 0.28% (5/1790), respectively. The overall hospitalization and chest tube duration were shorter in the VATS lobectomy group (n=949) than in the open thoracotomy (OT) lobectomy group (n=753). There were no significant differences in morbidity rate, mortality rate and operation time between the two groups. In the esophageal cancer patients, no significant difference was found in the number of nodal dissection, chest tube duration, morbidity rate, mortality rate, and hospital length of stay between the VATS esophagectomy group (n=81) and open esophagectomy group (n=81). However, the operation time was longer in the VATS esophagectomy group. In the thymoma patients, there was no significant difference in the chest tube duration, morbidity rate, mortality rate, and hospital length of stay between the VATS thymectomy group (n=41) and open thymectomy group (n=41). However, the operation time was longer in the VATS group. The median tumor size in the VATS thymectomy group was comparable with that in the OT group. Conclusions: In early-stage (I/II) non-small cell lung cancer patients who underwent lobectomies, VATS is comparable with the OT approach with similar short-term outcomes. In patients with resectable esophageal cancer, VATS esophagectomy is comparable with OT esophagectomy with similar morbidity and mortality. VATS thymectomy for Masaoka stage I and II thymoma is feasible and safe, and tumor size is not contraindicated. Longer follow-ups are needed to determine the oncologic equivalency of VATS lobectomy, esophagectomy, and thymectomy for thymoma vs. OT. 展开更多
关键词 腔镜 肿瘤 手术 标准操作 胸部 电视 非小细胞肺癌 胸腺切除
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Application of Video-Assisted Thoracic Surgery in the Standard Operation for Lung Tumors 被引量:1
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作者 Ju-wei MU Ning LI Fang LU You-sheng MAO Qi XUE Shu-geng GAO Jun ZHAO Da-li WANG Zhi-shan LI Wen-dong LEI Yu-shu GAO Liang-ze ZHANG Jin-feng HUANG Kang SHAO Kai SU Kun YANG Jian LI Gui-yu CHENG Ke-lin SUN Jie HE 《Clinical oncology and cancer resexreh》 CAS CSCD 2010年第5期310-316,共7页
关键词 手术治疗 应用电视 肺肿瘤 肺部 胸腔 淋巴结肿大 标准 催产素
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Long-term survival outcomes of video-assisted thoracic surgery for patients with non-small cell lung cancer 被引量:5
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作者 Wenlong Shao Xinguo Xiong +6 位作者 Hanzhang Chen Jun Liu Weiqiang Yin Shuben Li Xin Xu Xin Zhang Jianxing He 《Chinese Journal of Cancer Research》 SCIE CAS CSCD 2014年第4期391-398,共8页
Background: Video-assisted thoracic surgery (VATS) has been shown to be a safe alternative to conventional thoracotomy for patients with non-small cell lung cancer (NSCLC). However, popularization of this relativ... Background: Video-assisted thoracic surgery (VATS) has been shown to be a safe alternative to conventional thoracotomy for patients with non-small cell lung cancer (NSCLC). However, popularization of this relatively novel technique has been slow, partly due to concerns about its long-term outcomes. The present study aimed to evaluate the long-term survival outcomes of patients with NSCLC after VATS, and to determine the significant prognostic factors on overall survival. Methods: Consecutive patients diagnosed with NSCLC referred to one institution for VATS were identified from a central database. Patients were treated by either complete-VATS or assisted-VATS, as described in previous studies. A number of baseline patient characteristics, clinicopathologic data and treatment-related factors were analyzed as potential prognostic factors on overall survival. Results: Between January 2000 and December 2007, 1,139 patients with NSCLC who underwent VATS and fulfilled a set of predetermined inclusion criteria were included for analysis. The median age of the entire group was 60 years, with 791 male patients (69%). The median 5-year overall survival for Stage Ⅰ, Ⅱ, Ⅲ and Ⅳ disease according to the recently updated TNM classification system were 72.2%, 47.5%, 29.8% and 28.6%, respectively. Female gender, TNM stage, pT status, and type of resection were found to be significant prognostic factors on multivariate analysis. Conclusions: VATS offers a viable alternative to conventional open thoracotomy for selected patients with clinically resectableNSCLC 展开更多
关键词 Non-small cell lung cancer (NSCLC) video-assisted thoracoscopic surgery (VATS) overall survival
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Video-Assisted Thoracic Surgery as a Less-Invasive Management for Acute Hemothorax in Blunt Trauma 被引量:1
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作者 Yoshihiko Kurimoto Atsushi Watanabe +5 位作者 Tetsuya Koyanagi Toshiro Ito Tetsuya Higami Kunihiko Maekawa Katsutoshi Tanno Yasufumi Asai 《Surgical Science》 2012年第3期136-140,共5页
Purpose: We report our experience of Video-assisted thoracic surgery (VATS) to treat acute blunt traumatic hemothorax using mini-thoracotomy. Methods: We designed a prospective study to determine if VATS with mini-tho... Purpose: We report our experience of Video-assisted thoracic surgery (VATS) to treat acute blunt traumatic hemothorax using mini-thoracotomy. Methods: We designed a prospective study to determine if VATS with mini-thoracotomy benefits for patients with blunt traumatic hemothorax compared with conventional repair through full thoracotomy. Twenty-five patients underwent emergency operation for acute hemothorax from 2000. Five patients with less than 5% probability of survival (PS) were excluded, leaving 20 as the subjects. Results: Ten patients underwent conventional thoracotomy (conventional group) and the other 10 patients underwent VATS with mini-thoracotomy (VATS group). There was no difference between conventional group and VATS group in injury severity score (29.1 and 27.0) or PS (81.2% and 80.7%). Hospital mortality rates were 10% in conventional group and 0% in VATS group (N.S). Total amounts of intra-operative bleeding and post-operative transfusion until day 7 were 735 ml and 19.3 units in conventional group and 303 ml and 9.2 units in VATS group respectively (N.S). The length of ICU stay was 9.7 days in conventional group and 5.9 days in VATS group (N.S). Conclusion: VATS with mini-thoracotomy can be alternative for patients with blunt traumatic hemothorax in most emergency operations. 展开更多
关键词 HEMOTHORAX TRAUMA video-assisted thoracic surgery Emergency surgery Critical Care
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Video-assisted Thoracoscopic Surgery for the Treatment of Mediastinal Lymph Node Tuberculous Abscesses 被引量:3
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作者 左涛 龚凤云 +2 位作者 陈宝钧 倪正义 张定宇 《Journal of Huazhong University of Science and Technology(Medical Sciences)》 SCIE CAS 2017年第6期849-854,共6页
The mediastinal lymph node tuberculous abscesses(MLNTAs) are secondary to mediastinal tuberculous lymphadenitis. Surgical excision is often required when cold abscesses form. This study was aimed to examine video-as... The mediastinal lymph node tuberculous abscesses(MLNTAs) are secondary to mediastinal tuberculous lymphadenitis. Surgical excision is often required when cold abscesses form. This study was aimed to examine video-assisted thoracoscopic surgery(VATS) for the treatment of MLNTA. Clinical data of 16 MLNTA patients who were treated in our hospital between December 1, 2013 and December 1, 2015 were retrospectively analyzed. All of the patients underwent the radical debridement and drainage of abscesses, and intrathoracic lesions were removed by VATS. They were also administered the intensified anti-tuberculosis treatment(ATT), and engaged in normal physical activity and follow-up for 3 to 6 months. The results showed that VATS was successfully attempted in all of the 16 MLNTA patients and they all had good recovery. Two patients developed complications after surgery, with one patient developing recurrent laryngeal nerve injury, and the other reporting poor wound healing. It was concluded that VATS is easy to perform, and safe, and has high rates of success and relatively few side-effects when used to treat MLNTA. 展开更多
关键词 mediastinal diseases thoracic surgery video-assisted tuberculosis lymph node
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Video-assisted thoracoscopic surgery (VATS) for bilateral primary spontaneous pneumothorax 被引量:21
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作者 Yi-jen CHEN Shi-ping LUH +3 位作者 Kun-yen HSU Cheng-ren CHEN Thomas Chang-yao TSAO Jia-yuh CHEN 《Journal of Zhejiang University-Science B(Biomedicine & Biotechnology)》 SCIE CAS CSCD 2008年第4期335-340,共6页
目的将由帮助录像的 thoracoscopic 外科(大桶) 考察我们双边的主要自发的气胸(PSP ) 的治疗的经验。回顾的图表评论被在诊所上或电话会见跟随的材料和方法。病人们被在乎为由在四个医学中心的一位胸的外科医生或在北、中央的台湾的社... 目的将由帮助录像的 thoracoscopic 外科(大桶) 考察我们双边的主要自发的气胸(PSP ) 的治疗的经验。回顾的图表评论被在诊所上或电话会见跟随的材料和方法。病人们被在乎为由在四个医学中心的一位胸的外科医生或在北、中央的台湾的社区医院。有双边的 PSP 的 13 个病人从 1994 年 7 月同时或顺序经历了双边的大桶到 2005 年 12 月。结果与从 15 ~ 36 年(平均数 23.1 年)的年龄, 12 男性和男性女性同时为双边的 PSP 与大桶被对待,在双边的 pneumothoracis 的指示下面(n=4 ) 或顺序(n=9 ) 。在为非同时的 PSP 病人的第一和第二个相反地侧面的大桶过程之间的间隔从 7 d 到 6 年。13 个病人(84.6%) 中的十一个有突出的肺的 bullae/blebs,并且与机械或化学的 pleurodesis 经历了 bullae 切除术。吝啬的起作用的时间是( 45.6 ±1 8.3 ) min (范围 25 ~9 6 min )并且( 120.6 ±2 8.7 ) min (范围 84 ~1 66 min )分别地为非同时(为在第一个大桶以后的相反地侧面的方面的复发的第二个大桶)并且同时(双边的大桶在里面一操作)过程。没有手术后的死亡。然而,延长了漏气(】7 d ) 在在保守治疗以后恢复了的一个病人(7.7%) 发生了。胸试管排水的吝啬的持续时间是 3.1 d 并且中部在时期上面列在后面是 3.4 年。结论大桶是在双边的 PSP 的治疗的一个安全、有效的过程。因为甚至与可见 bullae,复发的发生不在我的组并且在某以前的文学那么高,双边的大桶仅仅与同时双边的 PSP 为病人被推荐。在一个仰卧的位置的双边的大桶应该仅仅在选择情况中被使用,因为可能的肋膜的粘附或在以后的方面上隐藏 bullae。 展开更多
关键词 呼吸系统 手术治疗 自发性气胸 临床表现
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Nonintubated uniportal video-assisted thoracoscopic surgery for primary spontaneous pneumothorax 被引量:15
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作者 Shuben Li Fei Cui +5 位作者 Jun Liu Xin Xu Wenlong Shao Weiqiang Yin Hanzhang Chen Jianxing He 《Chinese Journal of Cancer Research》 SCIE CAS CSCD 2015年第2期197-202,共6页
Objective: The objective of the current study was to evaluate the feasibility and safety of nonintubated nniportal video-assisted thoracoscopic surgery (VATS) for the management of primary spontaneous pneumothorax ... Objective: The objective of the current study was to evaluate the feasibility and safety of nonintubated nniportal video-assisted thoracoscopic surgery (VATS) for the management of primary spontaneous pneumothorax (PSP). Methods: From November 2011 to June 2013, 32 consecutive patients with PSP were treated by nonintubated uniportal thoracoscopic bullectomy using epidnral anaesthesia and sedation without endotracheal intubation. An incision 2 cm in length was made at the 6th intercostal space in the median axillary line. The pleural space was entered by blunt dissection for placement of a soft incision protector. Instruments were then inserted through the incision protector to perform thoracoscopic bullectomy. Data were collected within a minimum follow-up period of 10 months. Results: The average time of surgery was 49.0 rain (range, 33-65 rain). No complications were recorded. The postoperative feeding time was 6 h. The mean postoperative chest tube drainage and hospital stay were 19.3 h and 41.6 h, respectively. The postoperative pain was mild for 30 patients (93.75%) and moderate for two patients (6.25%). No recurrences ofpneumothorax were observed at follow-up. Conclusions: The initial results indicated that nonintubated uniportal video-assisted thoracoscopic operations are not only technically feasible, but may also be a safe and less invasive alternative for select patients in the management of PSP. This is the first report to include the use of a nonintubated uniportal technique in VATS for such a large number of PSP cases. Further work and development of instruments are needed to define the applications and advantages of this technique. 展开更多
关键词 Uniportal video-assisted thoracoscopic surgery (VATS) spontaneous pneumothorax
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Surgical approaches for stage Ⅰ and Ⅱ thymoma-associated myasthenia gravis:feasibility of complete video-assisted thoracoscopic surgery (VATS) thymectomy in comparison with trans-sternal resection 被引量:16
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作者 Zhicheng He Quan Zhu +3 位作者 Wei Wen Liang Chen Hai Xu Hai Li 《The Journal of Biomedical Research》 CAS 2013年第1期62-70,共9页
Complete resection could be achieved in virtually all myasthenic patients with Masaoka stage I and II thymoma us- ing the trans-sternal technique. Whether this is appropriate for minimally invasive approach is not yet... Complete resection could be achieved in virtually all myasthenic patients with Masaoka stage I and II thymoma us- ing the trans-sternal technique. Whether this is appropriate for minimally invasive approach is not yet clear. We evalu- ated the feasibility of complete video-assisted thoracoscopic surgery (VATS) thymectomy for the treatment of Ma- saoka stage I and Ⅱ thymoma-associated myasthenia gravis, compared to conventional trans-sternal thymectomy. We summarized 33 patients with Masaoka stage I and II thymoma-associated myasthenia gravis between April 2006 and September 2011. Of these, 15 patients underwent right-sided complete VATS (the VATS group) by us- ing adjuvant pneuomomediastinum, comparing with 18 patients using the trans-sternal approach (the T3b group). No intraoperative death was found and no VATS case required conversion to median sternotomy. Significant differences between the two groups regarding duration of surgery and volume of intraoperative blood loss (P = 0.001 and P 〈 0.001, respectively) were observed. Postoperative morbidities were 26.7% and 33.3% for the VATS and T3b groups, respectively. All 33 patients were followed up for 12 to 61 months in the study. The cumulative probabilities of reaching complete stable remission and effective rate were 26.7% (4/15) and 93.3% (14/15) in the VATS group, which had a significantly higher complete stable remission and effective rate than those in the T3b group (P = 0.026 and P = 0.000, respectively). We conclude that VATS thymectomy utilizing adjuvant pneuomo- mediastinum for the treatment of stage I and II thymoma-associated myasthenia gravis is technically feasible but deserves further investigation in a large series with long-term follow-up. 展开更多
关键词 video-assisted thoracoscopic surgery (VATS) THYMOMA THYMECTOMY myasthenia gravis adjuvantpneuomomediastinum
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Safety and feasibility of video-assisted thoracoscopic surgery for stage IIIA lung cancer 被引量:12
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作者 Wenlong Shao Jun Liu +5 位作者 Wehua Liang Hanzhang Chen Shuben Li Weiqiang Yin Xin Zhang Jianxing He 《Chinese Journal of Cancer Research》 SCIE CAS CSCD 2014年第4期418-422,共5页
Objective: The current study was prospectively designed to explore the application of video-assisted thoracoscopic surgery (VATS) radical treatment for patients with stage ⅢA lung cancer, with the primary endpoint... Objective: The current study was prospectively designed to explore the application of video-assisted thoracoscopic surgery (VATS) radical treatment for patients with stage ⅢA lung cancer, with the primary endpoints being the safety and feasibility of this operation and the second endpoints being the survival and complications after the surgery. Methods: A total of 51 patients with radiologically or mediastinoscopically confirmed stage ⅢA lung cancer underwent VATS radical treatment, during which the standard pulmonary lobectomy and mediastinal lymph node dissection were performed after pre-operative assessment. The operative time, intraoperative blood loss/ complications, postoperative recovery, postoperative complications, and lymph node dissection were recorded and analyzed. This study was regarded as successful if the surgical success rate reached 90% or higher. Results: A total of 51 patients with non-small cell lung cancer (NSCLC) were enrolled in this study from March 2009 to February 2010. The median post-operative follow-up duration was 50.5 months. Of these 51 patients, 41 (80.4%) had N2 lymph node metastases. All patients underwent the thoracoscopic surgeries, among whom 50 (98%) received pulmonary lobectomy and mediastinal lymph node dissection completely under the thoracoscope, 6 had their incisions extended to about 6 cm due to larger tumor sizes, and 1 had his surgery performed using a 12 cm small incision for handling the adhesions between lymph nodes and blood vessels. No patient was converted to conventional open thoracotomy. No perioperative death was noted. One patient received a second surgery on the second post-operative day due to large drainage (〉1,000 mL), and the postoperative recovery was satisfactory. Up to 45 patients (88.2%) did not suffer from any perioperative complication, and 6 (11.8%) experienced one or more complications. Conclusions: VATS radical treatment is a safe and feasible treatment for stage ⅢA lung cancer. 展开更多
关键词 Lung cancer video-assisted thoracoscopic surgery (VATS) systematic node dissection (SND)
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A single institution experience using the LigaSure vessel sealing system in video-assisted thoracoscopic surgery for primary spontaneous pneumothorax 被引量:6
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作者 Zhi Li Liang Chen +4 位作者 Jun Wang Jianwei Qin Quan Zhu Bin Zhang Yijiang Chen 《The Journal of Biomedical Research》 CAS 2014年第6期494-497,共4页
This study sought to report our 6-year experience with the LigaSure vessel sealing system(LVSS) in videoassisted thoracoscopic surgery(VATS) for primary spontaneous pneumothorax.A series of 180 consecutive patient... This study sought to report our 6-year experience with the LigaSure vessel sealing system(LVSS) in videoassisted thoracoscopic surgery(VATS) for primary spontaneous pneumothorax.A series of 180 consecutive patients with primary spontaneous pneumothorax were operated on in our institution from May 2005 to December 2010.Intraoperatively,large lesions(bullae or blebs) with a diameter more than 2 cm were resected by staplers,and the residual lesions were treated by LVSS.LVSS was also used to ablate the apical area when no lesions were found.Conventional apical pleural abrasion was done in all cases.All patients were successfully treated using VATS with minimal perioperative bleeding.The mean operating time was 76 minutes(range,43-160 minutes) for single-side procedures and 169 minutes(range,135-195 minutes) for bilateral procedures,the mean number of applied staples was 1.93 per patient(range,0-8 days),the duration of drainage was 3.8 days(range,2-15 days),and the duration of hospital stay was 5.8 days(range,3-16 days).Postoperative complications included persistent air leak(〉 5 days) in 11 cases(6.1%) and residual pneumothorax in 6(3.3%).None required reoperation.The mean duration of follow-up was 57 months(range,24-105 months).Recurrence was seen in three cases(1.7%),and all underwent another operation thereafter.None of the lesions in the relapse cases received ablation with LVSS in the first operation.LVSS can optimize VATS for primary spontaneous pneumothorax and reduces the use of single-use staples.The method is safe,easy to use,and cost-effective and produces satisfactory results. 展开更多
关键词 LigaSure vessel sealing system video-assisted thoracoscopic surgery(VATS) primary spontaneous pneumothorax
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Uniportal Video-Assisted Thoracoscopic Surgery and Outcomes for Recurrent Primary Spontaneous Pneumothorax: Single-Institution Experience 被引量:2
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作者 Iskander Al-Githmi 《Surgical Science》 2018年第3期122-127,共6页
Introduction: Primary spontaneous pneumothorax is relatively common condition in young adults. Uniportal video-assisted thoracoscopic surgery (uniportal VATS) has been accepted as a less invasive technique for the tre... Introduction: Primary spontaneous pneumothorax is relatively common condition in young adults. Uniportal video-assisted thoracoscopic surgery (uniportal VATS) has been accepted as a less invasive technique for the treatment of primary spontaneous pneumothorax. Strong evidence suggests that Uniportal VATS procedures are technically feasible and safe with excellent outcomes comparable to conventional VATS approach. Objectives: This article aims to discuss our experience with uniportal thoracoscopic approach as a valuable option in patients with recurrent spontaneous pneumothorax. Study Design: A retrospective study analysis between January 2014 and December 2016. Materials and Methods: From January 2014 to December 2016, 22 consecutive patients with unilateral recurrent spontaneous pneumothorax were to undergo uniportal video-assisted thoracic surgery (uniportal VATS). Their chronic residual postoperative pain, hospital stay and recurrence rate were analyzed. Results: Twenty-two patients with unilateral recurrent spontaneous pneumothorax were included;all received uniportal video-assisted thoracic surgery (uniportal VATS) and mechanical pleurodesis. Conclusions: We conclude that uniportal video-assisted thoracic surgery (uniportal VATS) demonstrated benefits to patients with primary spontaneous pneumothorax a safe, effective and also faster recovery, and decreased postoperative pain and short hospital stay. 展开更多
关键词 Primary PNEUMOTHORAX Uniportal video-assisted thoracic surgery
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Experiences and benefits of positron emitted tomography-computed tomography (PET-CT) combined with video-assisted thoracoscopic surgery (VATS) in the diagnosis of Stage 1 sarcoidosis 被引量:3
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作者 LUH Shi-ping WU Tzu-chin +2 位作者 WANG Yao-tung TSAO Thomas Chang-yao CHEN Jia-yuh 《Journal of Zhejiang University-Science B(Biomedicine & Biotechnology)》 SCIE CAS CSCD 2007年第6期410-415,共6页
Background: The purpose of this study was to describe our experiences and analyze the benefits of video-assisted thoracoscopic surgery (VATS) combined with positron emitted tomography (PET)-computed tomography (CT) in... Background: The purpose of this study was to describe our experiences and analyze the benefits of video-assisted thoracoscopic surgery (VATS) combined with positron emitted tomography (PET)-computed tomography (CT) in the diagnosis of patients with early (Stage 1) sarcoidosis. Methods: From 1995 to 2006, seven patients (two males, five females), with ages ranging from 26 to 58 years, were impressed with Stage 1 sarcoidosis (mediastinal or hilar lymph nodes involvements without lung in- volvement) by histological examination of intrathoracic lymph nodes (LNs) and/or lung parenchyma taken from VATS biopsy. Three of them received PET or PET-CT evaluation. VATS was approached from the right and left side in one and six patients, respectively, according to the locations of their lesions. Results: All the VATS biopsied LNs or lung specimens were adequate for establishing diagnosis. Mediastinal LNs were taken from Groups 3, 4 in four, Group 7 in two, and Groups 5, 6 in one of them. Hilar LNs biopsies were performed in four cases. Lung biopsy was performed in all but two cases. All of them were expressed pathologically or radiologically as Stage 1 sarcoidosis. PET-CT revealed high emission signals over these affected LNs. These patients received oral steroid treatment or follow up only. All of them were followed up from 5 months to 11 years with satis- factory results. Conclusion: VATS biopsy is a minimally invasive, safe and effective procedure. It can be used as a diagnostic alternative of transbronchial lung biopsy (TBLB), and can harvest larger and more areas of specimens than mediastinoscopy for staging patients with sarcoidosis. PET-CT can provide us more accurate information about the characteristics and localization of these lesions before biopsy. VATS combined with PET-CT can provide more accurate and earlier diagnosis of patients with unknown intrathoracic lesions, including the sarcoidosis. 展开更多
关键词 1期类肉状瘤病 PET-CT 视频辅助胸腔镜手术 联合诊断 肺脏 淋巴结
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Middle lobe torsion after right upper and lower lobectomy:repositioning of lobar torsion using a3-cm uniportal video-assisted thoracoscopic surgery 被引量:1
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作者 Ruijie Zhang Yixin Cai +2 位作者 Shengling Fu Xiangning Fu Ni Zhang 《Oncology and Translational Medicine》 2017年第1期38-40,共3页
We aimed to describe a method for repositioning of right middle lobar torsion by using a 3-cm uniportal video-assisted thoracoscopic surgery(VATS) approach. Middle lobe torsion occurred after right upper and lower lob... We aimed to describe a method for repositioning of right middle lobar torsion by using a 3-cm uniportal video-assisted thoracoscopic surgery(VATS) approach. Middle lobe torsion occurred after right upper and lower lobectomy in a 74-year-old man. Immediate re-exploratory thoracotomy using the 3-cm uniportal VATS approach was performed. The torsion was corrected, and the lobe was anchored to the anterior chest wall with Prolene stitches. The patient recovered well postoperatively with daily improvements in chest radiographic findings. Follow-up examination was performed using fiberbronchoscopy, which revealed an unobstructed right middle lobe bronchus and sticky yellow sputum. Follow-up chest computed tomography was performed 3 months after the primary surgery and revealed increased expansion of the right middle lobe. We repositioned the right middle lobe successfully by using the 3-cm uniportal VATS approach, but more cases are needed to confirm the feasibility of the approach. Lobectomy remains the primary treatment option for such cases. 展开更多
关键词 LOBE TORSION 3-cm uniportal video-assisted thoracoscopic surgery (VATS)
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机器人与胸腔镜肺段切除术治疗早期非小细胞肺癌疗效的对比研究
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作者 贾卓奇 王绩钊 +4 位作者 王哲 张勇 吴齐飞 张广健 付军科 《现代肿瘤医学》 CAS 2024年第9期1648-1652,共5页
目的:对比分析达芬奇机器人与胸腔镜肺段切除术治疗早期非小细胞肺癌(non-small cell lung cancer,NSCLC)的临床疗效。方法:回顾性分析2016年06月至2020年12月,于我院胸外科行微创肺段切除术的早期非小细胞肺癌患者,共纳入134例,分为机... 目的:对比分析达芬奇机器人与胸腔镜肺段切除术治疗早期非小细胞肺癌(non-small cell lung cancer,NSCLC)的临床疗效。方法:回顾性分析2016年06月至2020年12月,于我院胸外科行微创肺段切除术的早期非小细胞肺癌患者,共纳入134例,分为机器人组(robot-assisted thoracic surgery,RATS)47例,胸腔镜组(video-assisted thoracic surgery,VATS)87组,对比分析两组临床特征及手术指标、术后主要并发症情况及费用。结果:手术时间、术中出血、平均住院日、术后引流时间等,RATS组优于VATS组,但两组差异无统计学意义(P>0.05)。术后并发症如肺炎、胸腔积液、心律失常、肺不张发生率,两组间差异无统计学意义(P>0.05)。超过5天漏气率RATS组为6.3%,低于VATS组的10.3%,差异有统计学意义(P<0.05)。两组术后NRS疼痛评分差异无统计学意义(P>0.05)。RATS组住院费用明显高于胸腔镜组,差异有统计学意义(P<0.05)。两组1年生存率和2年生存率差异均无统计学意义(P>0.05)。结论:机器人肺段切除术治疗早期非小细胞肺癌安全可行,与胸腔镜相比,术后长期漏气发生较少,值得推广应用。 展开更多
关键词 非小细胞肺癌 达芬奇机器人手术 电视胸腔镜手术 肺段切除术
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加速肺萎陷技术在胸腔镜手术中的应用进展
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作者 杭黎华 费叶晟 李玉琳 《临床麻醉学杂志》 CAS CSCD 北大核心 2024年第1期97-100,共4页
视频辅助胸腔镜手术(VATS)具有视野清晰、对呼吸生理影响小、术后疼痛轻和加速康复等优点,在临床上日渐普及。非通气侧肺萎陷是胸科手术重要环节,萎陷不良将影响手术视野并延缓手术进程,因此高质量肺萎陷是手术成功的基础。如何短时间... 视频辅助胸腔镜手术(VATS)具有视野清晰、对呼吸生理影响小、术后疼痛轻和加速康复等优点,在临床上日渐普及。非通气侧肺萎陷是胸科手术重要环节,萎陷不良将影响手术视野并延缓手术进程,因此高质量肺萎陷是手术成功的基础。如何短时间内获得良好的肺萎陷质量已成为麻醉科医师关注的焦点。近年来,已有多种加速肺萎陷技术应用于临床,本文就非通气侧加速肺萎陷技术的应用进展进行综述,并介绍适用临床技术及其注意事项,旨在为临床实践提供参考。 展开更多
关键词 视频辅助胸腔镜手术 肺萎陷 术后加速康复
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电视胸腔镜与传统开胸手术治疗创伤性血胸的效果比较
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作者 赵巍 《中国卫生标准管理》 2024年第12期117-120,共4页
目的探讨电视胸腔镜与传统开胸手术治疗创伤性血胸的效果与安全性。方法选取2021年3月—2023年8月武警山西总队医院确诊为创伤性血胸的82例患者,依据入院时间顺序分为2组,各41例。对照组行传统开胸手术处理,观察组行电视胸腔镜手术治疗... 目的探讨电视胸腔镜与传统开胸手术治疗创伤性血胸的效果与安全性。方法选取2021年3月—2023年8月武警山西总队医院确诊为创伤性血胸的82例患者,依据入院时间顺序分为2组,各41例。对照组行传统开胸手术处理,观察组行电视胸腔镜手术治疗。比较2组手术处理效果及安全性。结果观察组手术时间、术后胸腔引流时间、术后镇痛用药时间以及住院时间短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05);术后24 h,观察组皮质醇(cortisol,Cor)、神经肽Y(neuropeptideY,NPY)以及P物质(substance P,SP)的检测值均低于对照组,差异有统计学意义(P<0.05);观察组患者术后12 h以及术后第1、2、3天的疼痛程度评分均低于对照组,差异有统计学意义(P<0.05);观察组术后并发症总发生率为7.32%,低于对照组的24.39%,差异有统计学意义(P<0.05)。结论电视胸腔镜手术用于创伤性血胸的治疗效果确切,并可减轻创伤应激反应及术后疼痛程度,减少并发症发生,效果优于传统开胸手术。 展开更多
关键词 创伤性血胸 电视胸腔镜 传统开胸手术 创伤应激指标 术后疼痛程度 安全性
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不同剂量艾司氯胺酮联合罗哌卡因前锯肌平面阻滞对胸腔镜手术病人术后镇痛的影响 被引量:1
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作者 丁冰 寇清晏 +3 位作者 王艳婷 王羽 李琳 牛泽军 《青岛大学学报(医学版)》 CAS 2024年第2期279-283,共5页
目的评价不同剂量艾司氯胺酮联合罗哌卡因前锯肌平面阻滞(SAPB)对胸腔镜手术病人术后镇痛的影响。方法选择择期行胸腔镜手术病人96例,随机分为单纯罗哌卡因组(A组,SAPB局麻药为5 g/L罗哌卡因30 mL)、0.25 mg/kg艾司氯胺酮组(B组,在5 g/... 目的评价不同剂量艾司氯胺酮联合罗哌卡因前锯肌平面阻滞(SAPB)对胸腔镜手术病人术后镇痛的影响。方法选择择期行胸腔镜手术病人96例,随机分为单纯罗哌卡因组(A组,SAPB局麻药为5 g/L罗哌卡因30 mL)、0.25 mg/kg艾司氯胺酮组(B组,在5 g/L罗哌卡因的基础上加用0.25 mg/kg艾司氯胺酮)、0.50 mg/kg艾司氯胺酮组(C组,在5 g/L罗哌卡因的基础上加用0.50 mg/kg艾司氯胺酮)。记录术后2、6、12、24、48 h时的数字等级评定量表(NRS)评分,术后48 h吗啡用量,术后首次按压静脉自控镇痛(PCIA)装置时间,术后需要PCIA病人比例,术中舒芬太尼的用量及不良反应发生情况。结果与A组相比较,C组术后12、24 h NRS评分均显著降低(H=9.006、8.785,P<0.05),术后48 h吗啡用量减少(H=7.400,P<0.05),首次按压PCIA时间明显延长(P<0.05)。3组需要PCIA病人比例和术中舒芬太尼用量差异无统计学意义(P>0.05)。3组不良反应发生率差异无统计学意义(P>0.05)。结论与单纯应用罗哌卡因相比,0.50 mg/kg艾司氯胺酮联合罗哌卡因SAPB用于胸腔镜手术病人可增强术后镇痛效果,减少术后48 h吗啡用量,延长SAPB镇痛持续时间,且无明显不良反应。 展开更多
关键词 氯胺酮 罗哌卡因 神经肌肉阻滞 胸外科手术 电视辅助 疼痛 手术后
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