ABSTRACT
Objective To investigate the feasibility and safety of Bean Bag in lateral position placing during pulmonary operations,evaluate its effects by comparing with the routine placing of lateral position by sandbags and side shields, and to provide scientific evidences to solve the existing clinical problems in lateral position placing. Methods One hundred patients with pulmonary surgeries who needed lateral position placing were divided into Bean Bag group and routine method group randomly according to random digit table,50 patients in each group.Bean bag was used in lateral position placing in Bean Bag group,while sandbags and side shields were used in routine lateral position placing in routine method group. The required time for positioning and skin pressing condition, the activity of both upper limbs during postoperative follow-up were recorded.The satisfaction of operating surgeons on this position was acquired by self-designed questionnaire when operation was finished. Results The required time for positioning in Bean Bag group was(178.36±24.27)seconds,and that for positioning in routine method group was (282.06 ± 29.34) seconds, there was statistically significant difference between two groups (t=19.254,P<0.01).There were 14 patients who appeared skin injury and press red in Bean Bag group and 27 patients who appeared skin injury and press red in routine method group, and there was statistically significant difference between two groups(χ2=6.986,P=0.008).In Bean Bag group,the total score of seven items in satisfaction questionnaire of operating surgeons on patient's position was 38.34±1.36,while that in routine method group was 29.34±1.29,there was statistically significant difference between two groups(Z=33.924,all P<0.01). Conclusions Our study indicated that it was feasible and safe to use Bean Bag to place lateral position.The exposure of operating field was good and the stability of position was strong. Compared with routine position placing method, lateral position placing by using Bean Bag could save time, the operating procedures were more simple and convenient, and it could protect the physiological function of all aspects in patient's body more effectively, the satisfaction of surgeons for this method in lateral position placing was higher. It might deserve to popularize this method in the clinical practice in the future.
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Objective To summarize the nursing experience in patients with CT-assisted thoracoscopic surgery for small indeterminate pulmonary nodules.Method The data of 26 patients having undergone CT-assisted thoracoscopic surgery for small indeterminate pulmonary nodules were analyzed retrospectively for summarizing the nursing experience.Result The CT-assisted locations of nodules and the thoracoscopic resection of the pulmonary nodules in all the patients were successfully performed,without pneumatothorax,haematothorax and pneumorrhagia.Conclusion Such measures as setting the right time for locating,enhanced management of body position,accurate and safe punctuation and well performance of surgical cooperation are all critical for the success of the resection.
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Objective To introduce the application and the surgical cooperation of the transanal endoscopic microsurgery in resection of rectal neoplasms and summarize the nursing points.Method The clinical histories of 135 patients undergoing resection of rectal neoplasms with transanal endoscopic microsurgery were reviewed and analyzed.Results All the surgeries were successful. Four patients developed with wound infections,three of them getting better after treatment and one of them diagnosed with poorly differentiated adenocarcinoma and selected another operation.Conclusion Well-prepared、pre-operation,skillful operation and instrument procedure and postoperative nursing were critical to the success of operations.
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Objective To explore the experience of operative cooperation of trans-sternocostal triangle hand-assisted double lung metastatic tumor resection.Method The clinical data of 54 patients undergoing trans-sternocostal triangle hand-assisted double lung metastatic tumor resection were retrospectively analyzed from January 2005 to December 2005.Results The operations were all successful,with blood loss of 10~700 mL,operation time of 40~300 min,averaged(130.3+43.0)mins.One hundred and seventy eight malignant tumor lesions were removed.No serious complications occurred.Conclusion The key points to ensure thesuccessful operation were as follows:preoperation of special equipment,reasonable position,intraoperative strict aseptic operation,fixing of endoscopic incision suturing instrument,and accurate cooperation at all procedures.