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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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Uniportal versus biportal video-assisted thoracoscopic sympathectomy for palmar hyperhidrosis 被引量:15
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作者 CHEN Yong-bing YE Wu YANG Wen-tao SHI Li GUO Xu-feng XU Zhong-hua QIAN Yong-yue 《Chinese Medical Journal》 SCIE CAS CSCD 2009年第13期1525-1528,共4页
Background Video-assisted thoracoscopic sympathectomy had replaced open surgery. The aim of this study was to compare the outcomes of using a single port and two ports to perform video-assisted thoracoscopic sympathec... Background Video-assisted thoracoscopic sympathectomy had replaced open surgery. The aim of this study was to compare the outcomes of using a single port and two ports to perform video-assisted thoracoscopic sympathectomy for palmar hyperhidrosis. Methods Between April 2006 and February 2008, 20 cases underwent video-assisted thoracoscopic sympathectomy through one port (uniportal group) and 25 cases through two ports (biportal group). The variables including the operating time, hospital stay, pain scores, postoperative complications, incidence of symptom recurrence and patient satisfaction were compared. The mean postoperative follow-up period was 11.5 months (range, 3-25 months). Results The hands of all patients were warm and dry after operation. No conversion to open surgery was necessary, and no operative mortality was recorded in either group. The mean inpatient pain scores were significantly higher in the biportal group (1.2±0.6) than that in the uniportal group (0.8±0.5, P=0.025). For the first three weeks after operation, four out of 20 (20%) patients in the uniportal group constantly suffered from mild or moderate residual pain while eight out of 25 (32%) cases in the biportal group (P=0.366). Among them, two cases in the uniportal group and five cases in the biportal group need to take analgesics. Our mean operative time (bilateral sympathectomy) in the uniportal group ((39.5±10.0) minutes) was shorter than that in biportal group ((49.7±10.6) minutes, P=0.02). There were no significant differences between two groups in terms of the mean hospital stay, compensatory sweating, and patient satisfaction. Two patients in the biportal group and three in the uniportal group experienced a unilateral pneumothorax. None of them required chest drainage. No patient experienced Homer's syndrome, and no recurrent symptoms were observed in either groups Conclusions Both uniportal and biportal video-assisted thoracoscopic sympathectomy are effective, safe, and minimally invasive for palmar hyperhidrosis. Comparing with the biportal approach, the uniportal approach causes less postoperative pain and less operative time, and is a more reasonable procedure in treatment of palmar hyperhidrosis. 展开更多
关键词 uniportal HYPERHIDROSIS thoracic surgery video-assisted SYMPATHECTOMY
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剑突下单孔胸腔镜与传统外科术治疗前纵隔肿瘤的疗效比较
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作者 王士猛 孙晨 陈博汉 《当代医学》 2023年第10期105-107,共3页
目的比较剑突下单孔胸腔镜技术与传统外科手术治疗前纵隔肿瘤的效果。方法选取2014年1月至2016年1月本院收治的48例前纵隔肿瘤患者作为研究对象,按照随机数字表法分为胸腔镜组与开胸组,每组24例。开胸组予以传统外科手术治疗,胸腔镜组... 目的比较剑突下单孔胸腔镜技术与传统外科手术治疗前纵隔肿瘤的效果。方法选取2014年1月至2016年1月本院收治的48例前纵隔肿瘤患者作为研究对象,按照随机数字表法分为胸腔镜组与开胸组,每组24例。开胸组予以传统外科手术治疗,胸腔镜组予以剑突下单孔胸腔镜技术治疗,比较两组围术期情况、疼痛情况、并发症发生情况及1、5年生存情况。结果胸腔镜组切口长度、手术时间、住院时间均短于开胸组,差异有统计学意义(P<0.05)。胸腔镜组视觉疼痛模拟评分法(VAS)低于开胸组,疼痛持续时间短于开胸组,差异有统计学意义(P<0.05)。两组并发症发生率和1、5年生存率比较差异均无统计学意义。结论与传统外科手术相比,剑突下单孔胸腔镜技术治疗前纵隔肿瘤患者,可缩短切口长度、手术时间、患者住院时间,减轻疼痛度,预防并发症的发生,并能改善预后效果。 展开更多
关键词 前纵隔肿瘤 传统外科手术 剑突下单孔胸腔镜技术 生存率
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经剑突下单孔胸腔镜肺切除术93例 被引量:21
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作者 宋楠 赵德平 +5 位作者 蒋雷 鲍熠 戴洁 姜格宁 朱余明 丁嘉安 《中华胸心血管外科杂志》 CSCD 2016年第3期129-131,共3页
目的探讨经剑突下单孔VATS肺切除手术的可行性及优势。方法回顾性分析2014年8月至今,93例经剑突下单孔VATS肺切除术的临床资料。结果单侧手术83例,双侧手术10例,手术顺利。无术中及术后严重并发症,术后8h、第1、2、3天及出院前的平... 目的探讨经剑突下单孔VATS肺切除手术的可行性及优势。方法回顾性分析2014年8月至今,93例经剑突下单孔VATS肺切除术的临床资料。结果单侧手术83例,双侧手术10例,手术顺利。无术中及术后严重并发症,术后8h、第1、2、3天及出院前的平均疼痛指数分别为2.37±0.94、2.03±0.86、1.66±0.84、1.20±0.80和0.46±0.51,相比对照组(侧胸单孔VATS)各时间点疼痛指数显著降低(P〈0.001)。结论经剑突下单孔胸腔镜肺切除术,手术安全可靠,更适用于双侧肺部病变,明显减轻了患者术后切口的疼痛。 展开更多
关键词 肺切除术 胸外科手术 胸腔镜辅助 剑突下 单孔
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剑突下单孔胸腔镜手术治疗早期肺癌的手术操作质量控制 被引量:8
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作者 蔡昊旻 谢冬 +5 位作者 赵德平 蒋雷 何文新 陈昶 姜格宁 朱余明 《中国胸心血管外科临床杂志》 CAS CSCD 2020年第9期1001-1004,共4页
剑突下单孔胸腔镜手术是近年来微创胸外科领域重要的创新之一。由于其避免了损伤肋间神经,以往研究表明可明显降低围术期和远期切口疼痛。该手术操作难度较高,所以在患者选择上相较于传统肋间胸腔镜手术更为严格,术中需要某些特殊的手... 剑突下单孔胸腔镜手术是近年来微创胸外科领域重要的创新之一。由于其避免了损伤肋间神经,以往研究表明可明显降低围术期和远期切口疼痛。该手术操作难度较高,所以在患者选择上相较于传统肋间胸腔镜手术更为严格,术中需要某些特殊的手术技巧,并配合以特制的加长器械。希望本文所述的临床经验和操作规范,随着该术式的进一步普及不断补充完善,产生更大的借鉴价值。 展开更多
关键词 剑突下 电视辅助胸腔镜手术 单孔 外科手术
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剑突下与肋间入路胸腔镜胸腺扩大切除术的临床体会 被引量:10
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作者 张淼 武文斌 +3 位作者 杨敦鹏 刘冬 张辉 胡正群 《中华腔镜外科杂志(电子版)》 2019年第3期166-170,共5页
目的探讨经剑突下入路与肋间入路胸腔镜(video-assisted thoracoscopic surgery, VATS)胸腺扩大切除术的特点。方法回顾性分析2015年1月至2018年12月徐州市中心医院胸外科VATS胸腺扩大切除术的病例资料113例,依据术式不同分为经肋间多孔... 目的探讨经剑突下入路与肋间入路胸腔镜(video-assisted thoracoscopic surgery, VATS)胸腺扩大切除术的特点。方法回顾性分析2015年1月至2018年12月徐州市中心医院胸外科VATS胸腺扩大切除术的病例资料113例,依据术式不同分为经肋间多孔VATS (multiple-port VATS,MVATS)组46例(肋间MVATS组)、剑突下MVATS组40例与剑突下单孔VATS (uniportal VATS,UVATS)组27例(剑突下UVATS组)。比较手术相关参数的差异。结果肋间入路组5例、剑突下入路组7例术前合并重症肌无力(myasthenia gravis, MG)。患者无中转开胸手术或死亡。剑突下UVATS组3例中转剑突下MVATS。肋间MVATS组与剑突下MVATS组、剑突下UVATS组比较,手术时间短[(64.0±15.1) min比(71.4±18.1) min比(87.4±18.7) min, P<0.05],胸腔引流时间短[(1.5±0.7) d比(2.3±1.1) d比(2.9±1.3) d, P< 0.05]、胸腔引流量少[(131.4±66.5) ml比(169.9±110.6) ml比(231.5±111.9) ml, P< 0.05]、术后住院时间短[(1.9±1.1) d比(3.1±2.0) d比(3.7±2.8) d, P< 0.05],而术后1 d视觉模拟评分高[(4.2±1.3)分比(3.7±1.1)分比(3.5±1.2)分,P< 0.05]。剑突下UVATS组2例术后出现MG危象。CT提示剑突下MVATS组1例、剑突下UVATS组5例术后前纵隔脂肪影残留。结论剑突下入路VATS胸腺扩大切除术是可行的,但与肋间入路MVATS比较无显著优势。 展开更多
关键词 剑突下 单孔 胸腔镜 胸腺切除术
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不插管麻醉在剑突下单孔胸腔镜手术中的临床实践 被引量:4
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作者 陈志刚 施佳敏 +5 位作者 施哲 蔡剑桥 朱余明 戴丽华 吕欣 蒋雷 《中华腔镜外科杂志(电子版)》 2020年第6期342-346,共5页
目的探讨不插管麻醉在剑突下单孔胸腔镜手术中的可行性和安全性。方法收集同济大学附属上海市肺科医院2019年4月至2020年4月完成的60例不插管麻醉在经剑突下单孔胸腔镜手术中的病例资料。对围手术期并发症及处理措施、术后恢复和住院时... 目的探讨不插管麻醉在剑突下单孔胸腔镜手术中的可行性和安全性。方法收集同济大学附属上海市肺科医院2019年4月至2020年4月完成的60例不插管麻醉在经剑突下单孔胸腔镜手术中的病例资料。对围手术期并发症及处理措施、术后恢复和住院时间等情况进行分析总结,对不插管麻醉在剑突下单孔胸腔镜手术中的安全性和可行性进行评估。结果60例患者均在不插管麻醉下行剑突下单孔胸腔镜手术,包括肺叶切除术21例、肺段切除术7例、肺楔形切除术24例、胸腺切除术8例;肺叶切除术、肺段切除术、肺楔形切除术、胸腺切除术的手术时间分别为(71.8±25.7)min、(68.9±27.3)min、(41.5±11.1)min、(103.9±22.3)min,术中出血量分别为(47.6±18.4)ml、(45.6±16.8)ml、(26.5±13.3)ml、(65.8±24.5)ml;其中29例(48.3%)术中需要放置口咽通气道、17例(28.3%)出现术中低血压、9例(15.0%)发生心律失常,无术中知晓事件发生,4例(6.7%)发生术后并发症,无严重不良事件发生;平均住院时间(7±4.0)d。结论不插管麻醉在经剑突下入路单孔胸腔镜手术中具有可行性和一定优势,更多支持证据尚需大规模临床对照研究。 展开更多
关键词 不插管麻醉 剑突下单孔胸腔镜 普胸手术
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