ABSTRACT
Objective To present the technique of super-minimally invasive bilateral thoracoscopic extended thymectomy,and evaluate the early clinical results by using of this technique.Methods Twenty-three patients with myasthenia gravis (MG) with thymoma underwent with super-minimally invasive bilateral thoracoscopic extended thymectomy in our institution between July 2014 and January 2016.Two operate-poles are 5mm trocar,one is three intercostal space at the anterior axillary line,and the other is four intercostal space at the midclavicular line.A 10 mm trocar is inserted through the 6th intercostal space in the mid axillary line.The perioperative variables and outcomes were collected and analysed retrospectively.Results In the 23 patients who underwent Super-Minimally invasive bilateral thoracoscopic extended thymectomy,the mean operation time was (163.2 ± 14.4) min and the average blood loss was (148.2 ± 39.5) ml.The chest tube duration was (4.14 ± 0.27) days.There were no mortalities.Conclusion Our preliminary report showed that Super-Minimally invasive bilateral thoracoscopic extended thymectomy for mediastinal tumour resection was a promising and safe technique with regard to short-term clinical outcome.
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Objective To explore the feasibility and short-term efficacy of combined use of thoracoscopy and laparoscopy for the treatment of esophageal carcinoma. Methods The study included 2 patients.The operation was conducted under general anesthesia.The esophagus was disconnected and the diaphragm was opened under a 4-port thoracoscopy.Then the stomach was dissociated under a 4-port laparoscopy.The esophagus was mobilized outside the thorax through a!cervical incision after the imple mentation of laparoscopic performance.Under direct vision,the lesion was removed and an anastomosis was made.A naso-intestinal tube and a naso-gastric tube were placed,respectively.Results The operation time was 450 and 470 min,and the intraoperative blood loss was 150 and 200 ml,respectively.The lesion was thoroughly removed with negative cutting edges.Postoperative pathological reports showed well-differentiated squamous cell carcinoma(stage T_1N_0M_0) in both of patients.Follow-up for 4 months in two cases found no recurrence.Conclusions Combined use of thoracoscopy and laparoscopy for the treatment of esophageal carcinoma ensures the feasibility and safety of esophagectomy,with minimal invasion and low postoperative complication incidence.
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Objective: Enteral nutrition was used to correct the malnutrition in the patients suffered from esophageal rupture postoperatively. Methods: The naso intestinal tube was placed during operation and the enteral nutrition was used postoperatively. The albumin, prealbumin and transferrin were measured before and day1, 5, 8 and 12 after operation. Results: All 27 patients were discharged with no death. Albumin, prealbumin and transferrin decreased on the 1st day postoperatively and reached the preoperative level on the fifth postoperativeday. Conclusion: Enteral nutrition plays an important role in the postoperative treatment for esophageal rupture.
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Objective: To evaluate the effect of nutritional support for lung transplantation patients.Methods: The lung transplantation patient received perioperative enteral nutrition(EN) .Exogenous glutamine(Gln) and recombinant human growth hormone(rhGH) were postoperatively used for 7-14 days.Results: The patients weight increased from 53 kg to 55 kg. No respiratory failure and acute rejection occurred postoperatively. The patient recovered fluently.Conclusion: Appropriate perioperative nutritional support and postoperative metabolic intervention can facilitate the recovery of lung transplant patient.