ABSTRACT
@#Objective To summarize the experience of minimally invasive anterior mediastinal tumor resection in our center, and compare the Da Vinci robotic and video-assisted thoracoscopic approaches in the treatment of mediastinal tumor. Methods A retrospective cohort study was conducted to continuously enroll 102 patients who underwent minimally invasive mediastinal tumor resection between September 2014 and November 2019 by the single medical group in our department. They were divided into two groups: a robotic group (n=47, 23 males and 24 females, average age of 52 years) and a thoracoscopic group (n=55, 29 males and 26 females, average age of 53 years). The operation time, intraoperative blood loss, postoperative thoracic drainage volume, postoperative thoracic drainage time, postoperative hospital stay, hospitalization expense and other clinical data of two groups were compared and analyzed. Results All the patients successfully completed the surgery and recovered from hospital, with no perioperative death. Myasthenia gravis occurred in 4 patients of the robotic group and 5 of the thoracoscopic group. The tumor size was 2.5 (0.8-8.7) cm in the robotic group and 3.0 (0.8-7.7) cm in the thoracoscopic group. Operation time was 62 (30-132) min in the robotic group and 60 (29-118) min in the thoracoscopic group. Intraoperative bleeding volume was 20 (2-50) mL in the robotic group and 20 (5-100) mL in the thoracoscopic group. The postoperative drainage volume was 240 (20-14 130) mL in the robotic group and 295 (20-1 070) mL in the thoracoscopic group. The postoperative drainage time was 2 (1-15) days in the robotic group and 2 (1-5) days in the thoracoscopic group. There was no significant difference between the two groups in the above parameters and postoperative complications (P>0.05). The postoperative hospital stay were 3 (2-18) days in the robotic group and 4 (2-14) in the thoracoscopic group (P=0.014). The hospitalization cost was 67 489 (26 486-89 570) yuan in the robotic group and 27 917 (16 817-67 603) yuan in the thoracoscopic group (P=0.000). Conclusion Compared with the video-assisted thoracoscopic surgery, Da Vinci robot-assisted surgery owns the same efficacy and safety in the treatment of mediastinal tumor, with shorter postoperative hospital stay, but higher cost.
ABSTRACT
Previous studies have shown that the commonly used statin lipid lowering drugs can delay the progression of atherosclerotic plaque. Atorvastatin can stabilize atherosclerotic plaque, but it can not reverse atheromatous plaque. This
study will compare the efficacy of rosuvastatin and atorvastatin in the treatment of atherosclerosis and try to prove that the use of statins can improve peripheral atherosclerosis and reverse atherosclerotic plaque. The results showed that 10 mg rosuvastatin was more effective than 20 mg atorvastatin in lowering serum lipid level and elevating ABI index, ABI as rosuvastatin group[0.782+/-0.236] and atorvastatin group[0.541+/-0.196]. After 6 months of treatment, the carotid artery IMT in rosuvastatin group and atorvastatin group decreased compared with before treatment, and the difference was statistically significant [P<0.05]. The TC/mmol·L[-1] is 2.83+/-0.56 in rosuvastatin group and 3.24+/-0.71 in atorvastatin group. In addition, rosuvastatin did not increase the risk of adverse reactions compared with atorvastatin. The results confirm that statin therapy can improve peripheral atherosclerosis and reverse atherosclerotic plaques