Actinomycosis is an uncommon disease, which is usually manifested as cervicofacial infection; related to poor oral hygiene or compromised immune function. Pulmonary actinomycosis is rare, but its diagnosis is changing...Actinomycosis is an uncommon disease, which is usually manifested as cervicofacial infection; related to poor oral hygiene or compromised immune function. Pulmonary actinomycosis is rare, but its diagnosis is changing due to its variable presentation; the similarity in appearance to other intrapulmonary diseases. Here we report an 80-year-old man with a solitary pulmonary nodule over the left upper lobe. Pulmonary neoplasm was highly suspected in this patient; thus resection of the mass was undertaken through video-assisted thoracic surgery (VATS). Histopathological examination demonstrated this patient had an Actinomyeces infection. While the application of VATS in patients with pulmonary actinomycosis has rarely been reported in literature, we conclude that VATS is valuable for the diagnosis; treatment of patients with undetermined pulmonary nodule(s).展开更多
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
Thoracic Surgery is a continuous evolving specialty. In the past, thoracic surgeons had to make large incisions in order to operate any pathology inside the chest. This often meant big, painful and ugly scars and long...Thoracic Surgery is a continuous evolving specialty. In the past, thoracic surgeons had to make large incisions in order to operate any pathology inside the chest. This often meant big, painful and ugly scars and long recovery times after surgery. But he history of thoracic surgery changed since the begining of video-assisted thoracoscoDic surgery （VATg3展开更多
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...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=8 1） 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
Nonintubated video-assisted thoracic surgery （VATS） that is also defined awake VATS entails thoracoscopic procedures performed by regional anesthesia in spontaneously ventilating,mildly sedated or fully awake patients.
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
Objective: The aim was to evaluate the best intra-thoracoscopic surgery technique between video-assisted thoracic surgery (VATS) combined with laparoscopy and right open transthoracic esophagectomy, in patients with e...Objective: The aim was to evaluate the best intra-thoracoscopic surgery technique between video-assisted thoracic surgery (VATS) combined with laparoscopy and right open transthoracic esophagectomy, in patients with esophageal cancer. Methods: From November 2006 to May 2008, 221 patients with esophageal cancer were enrolled in this study, prospective randomized in two groups. 111 patients were performed the VATS technique (Experimental group), whereas in the other 110 patients esophagectomy was adopted by thoracotomy (Control group). Results: The time consuming of Experimental group was 272.3 min in average with a standard deviation(std) of 57.9, and it was 218.7 min in average with std of 91.0 in the control group (P=0.000). The operative blood loss was 219.7±194.4 mL in the Experimental group, compared with 590.0±324.4 mL in the control group, with significant difference (P=0.000). Postoperative hospital stay of Experimental group was 9.6±1.7d, and it was 11.4±2.3d in the control group (P=0.000). There was no-delayed union of incision in the Experimental group, but 6.36% in the control group (P=0.007). The disorder of gastric emptying occurred 0.9% in the Experimental group, whereas 6.4% in the Control group. There was no significant difference in survival curves and rates (P=0.555). Conclusion: There were several advantages of VATS technique, such as reduced hemorrhage, better recovery, few complications, and great number of lymph node dissection, although there was no significant difference in long-term survival rate. Thus the VATS combined with laparoscopy technique was worthy of generalization in esophageal surgery with good prospects.展开更多
Objective： The purpose of this study was to summarize and discuss the application of video-assisted thoracoscopic surgery （VATS） in the treatment of 58 chest cancers. Methods： The clinical data of 58 patients with...Objective： The purpose of this study was to summarize and discuss the application of video-assisted thoracoscopic surgery （VATS） in the treatment of 58 chest cancers. Methods： The clinical data of 58 patients with thoracic tumor were analyzed retrospectively in treatment with VATS from July 2005 to June 2007. The surgery treatments included pulmonary wedge resection, enucleation of esophageal leiomyoma, bronchogenic cyst excision, mediastinal cyst excision, etc. Results： All patients were treated with VATS. Three patients of those with lung cancer underwent open-chest Iobectomy resection. All patients had no death and few complications, and all discharged. Conclusion： VATS has advantages of less trauma, suffering light, quick recovery and small postoperative complications and has a great advantage in the treatment of chest benign tumors. But in the treatment of chest malignant tumors we should strictly control indications.展开更多
目的探讨老年肺癌患者行单孔胸腔镜下肺叶或肺段切除术后并发症发生的危险因素。方法纳入2020年1月至2021年12月首都医科大学宣武医院胸外科行单孔胸腔镜肺叶或肺段切除手术的≥60岁的387例老年肺癌患者作为研究对象,中位年龄67(60~87)...目的探讨老年肺癌患者行单孔胸腔镜下肺叶或肺段切除术后并发症发生的危险因素。方法纳入2020年1月至2021年12月首都医科大学宣武医院胸外科行单孔胸腔镜肺叶或肺段切除手术的≥60岁的387例老年肺癌患者作为研究对象,中位年龄67(60~87)岁,其中男性171例(44.2%),女性216例(55.8%)。对老年肺癌患者的术后并发症进行分析,评估老年肺癌患者行单孔胸腔镜肺段或肺叶切除术后并发症发生的危险因素。结果387例患者中共有66例(17.1%)术后出现并发症,其中1例(0.3%)患者死亡。单因素及多因素分析显示:男性(P=0.020)、第1秒用力呼气容积(forced expiratory volume in the first second,FEV1)<1.5 L(P=0.017)、一氧化碳弥散量占预计值百分比(diffusion capacity of the lungs for carbon monoxide as a percentage of the predicted value,DLCO%pred)<80%(P=0.016)、伴有肺部合并症病史(P<0.001)、脑卒中病史(P<0.001)、手术时长≥3 h(P=0.018)为术后出现并发症的独立预测因素。而伴有肺部合并症病史(P<0.001)及手术时长≥3 h(P=0.002)是术后出现肺部并发症的独立危险因素(P<0.05)。结论老年肺癌患者可能因肺部合并症、低肺功能、手术时间等出现术后并发症,因此术前应充分评估老年肺癌患者的生理情况。通过加强围术期管理降低术后并发症的发生率,降低术后并发症对老年肺癌患者行单孔胸腔镜手术治疗效果的影响。展开更多
文摘Actinomycosis is an uncommon disease, which is usually manifested as cervicofacial infection; related to poor oral hygiene or compromised immune function. Pulmonary actinomycosis is rare, but its diagnosis is changing due to its variable presentation; the similarity in appearance to other intrapulmonary diseases. Here we report an 80-year-old man with a solitary pulmonary nodule over the left upper lobe. Pulmonary neoplasm was highly suspected in this patient; thus resection of the mass was undertaken through video-assisted thoracic surgery (VATS). Histopathological examination demonstrated this patient had an Actinomyeces infection. While the application of VATS in patients with pulmonary actinomycosis has rarely been reported in literature, we conclude that VATS is valuable for the diagnosis; treatment of patients with undetermined pulmonary nodule(s).
文摘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.
文摘Thoracic Surgery is a continuous evolving specialty. In the past, thoracic surgeons had to make large incisions in order to operate any pathology inside the chest. This often meant big, painful and ugly scars and long recovery times after surgery. But he history of thoracic surgery changed since the begining of video-assisted thoracoscoDic surgery （VATg3
文摘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=8 1） 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.
文摘Nonintubated video-assisted thoracic surgery （VATS） that is also defined awake VATS entails thoracoscopic procedures performed by regional anesthesia in spontaneously ventilating,mildly sedated or fully awake patients.
文摘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.
文摘Objective: The aim was to evaluate the best intra-thoracoscopic surgery technique between video-assisted thoracic surgery (VATS) combined with laparoscopy and right open transthoracic esophagectomy, in patients with esophageal cancer. Methods: From November 2006 to May 2008, 221 patients with esophageal cancer were enrolled in this study, prospective randomized in two groups. 111 patients were performed the VATS technique (Experimental group), whereas in the other 110 patients esophagectomy was adopted by thoracotomy (Control group). Results: The time consuming of Experimental group was 272.3 min in average with a standard deviation(std) of 57.9, and it was 218.7 min in average with std of 91.0 in the control group (P=0.000). The operative blood loss was 219.7±194.4 mL in the Experimental group, compared with 590.0±324.4 mL in the control group, with significant difference (P=0.000). Postoperative hospital stay of Experimental group was 9.6±1.7d, and it was 11.4±2.3d in the control group (P=0.000). There was no-delayed union of incision in the Experimental group, but 6.36% in the control group (P=0.007). The disorder of gastric emptying occurred 0.9% in the Experimental group, whereas 6.4% in the Control group. There was no significant difference in survival curves and rates (P=0.555). Conclusion: There were several advantages of VATS technique, such as reduced hemorrhage, better recovery, few complications, and great number of lymph node dissection, although there was no significant difference in long-term survival rate. Thus the VATS combined with laparoscopy technique was worthy of generalization in esophageal surgery with good prospects.
文摘Objective： The purpose of this study was to summarize and discuss the application of video-assisted thoracoscopic surgery （VATS） in the treatment of 58 chest cancers. Methods： The clinical data of 58 patients with thoracic tumor were analyzed retrospectively in treatment with VATS from July 2005 to June 2007. The surgery treatments included pulmonary wedge resection, enucleation of esophageal leiomyoma, bronchogenic cyst excision, mediastinal cyst excision, etc. Results： All patients were treated with VATS. Three patients of those with lung cancer underwent open-chest Iobectomy resection. All patients had no death and few complications, and all discharged. Conclusion： VATS has advantages of less trauma, suffering light, quick recovery and small postoperative complications and has a great advantage in the treatment of chest benign tumors. But in the treatment of chest malignant tumors we should strictly control indications.
文摘目的探讨老年肺癌患者行单孔胸腔镜下肺叶或肺段切除术后并发症发生的危险因素。方法纳入2020年1月至2021年12月首都医科大学宣武医院胸外科行单孔胸腔镜肺叶或肺段切除手术的≥60岁的387例老年肺癌患者作为研究对象,中位年龄67(60~87)岁,其中男性171例(44.2%),女性216例(55.8%)。对老年肺癌患者的术后并发症进行分析,评估老年肺癌患者行单孔胸腔镜肺段或肺叶切除术后并发症发生的危险因素。结果387例患者中共有66例(17.1%)术后出现并发症,其中1例(0.3%)患者死亡。单因素及多因素分析显示:男性(P=0.020)、第1秒用力呼气容积(forced expiratory volume in the first second,FEV1)<1.5 L(P=0.017)、一氧化碳弥散量占预计值百分比(diffusion capacity of the lungs for carbon monoxide as a percentage of the predicted value,DLCO%pred)<80%(P=0.016)、伴有肺部合并症病史(P<0.001)、脑卒中病史(P<0.001)、手术时长≥3 h(P=0.018)为术后出现并发症的独立预测因素。而伴有肺部合并症病史(P<0.001)及手术时长≥3 h(P=0.002)是术后出现肺部并发症的独立危险因素(P<0.05)。结论老年肺癌患者可能因肺部合并症、低肺功能、手术时间等出现术后并发症,因此术前应充分评估老年肺癌患者的生理情况。通过加强围术期管理降低术后并发症的发生率,降低术后并发症对老年肺癌患者行单孔胸腔镜手术治疗效果的影响。
