ABSTRACT
@#Objective To summarize the experience of robot-assisted lung basal segmentectomy, and analyze the clinical application value of intersegmental tunneling and pulmonary ligament approach for S9 and/or S10 segmentectomy. Methods The clinical data of 78 patients who underwent robotic lung basal segmentectomy in our hospital between January 2020 to May 2022 were retrospectively reviewed. There were 32 males and 46 females with a median age of 50 (33-72) years. The patients who underwent S9 and/or S10 segmentectomy were divided into a single-direction group (pulmonary ligament approach, n=19) and a bi-direction group (intersegmental tunneling, n=19) according to different approaches, and the perioperative outcomes between the two groups were compared. Results All patients successfully completed the operation, without conversion to thoracotomy and lobectomy, serious complications, or perioperative death. The median operation time was 100 (40-185) min, the blood loss was 50 (10-210) mL, and the median number of dissected lymph nodes was 3 (1-14). There were 4 (5.1%) patients with postoperative air leakage, and 4 (5.1%) patients with hydropneumothorax. No patient showed localized atelectasis or lung congestion at 6 months after the operation. Further analysis showed that there was no significant difference in the operation time, blood loss, thoracic drainage time, complications or postoperative hospital stay between the single-direction and bi-direction groups (P>0.05). However, the number of dissected lymph nodes of the bi-direction group was more than that of the single-direction group [6 (1-13) vs. 5 (1-9), P=0.040]. Conclusion The robotic lung basal segmentectomy for pulmonary nodules is safe and effective. The perioperative results of robotic S9 and/or S10 complex segmentectomy using intersegmental tunneling and pulmonary ligament approach are similar.
ABSTRACT
@#Objective To compare the perioperative outcomes of atypical segmentectomy between robotic-assisted thoracoscopic surgery (RATS) and conventional video-assisted thoracoscopic surgery (VATS) in early-stage non-small cell lung cancer (NSCLC). Methods The data of patients who underwent minimally invasive anatomic atypical segmentectomy in our hospital from October 2016 to December 2021 were collected. These patients were divided into a RATS group and a VATS group according to the operation method. Propensity score (PS) matching was used to select patients with close clinical baseline characteristics, and the perioperative results of the two groups were compared. Results A total of 1 048 patients were enrolled, including 320 males and 728 females, with a mean age of 53.51±11.13 years. There were 277 patients in the RATS group and 771 patients in the VATS group. After 1∶1 PS matching, 277 pairs were selected. Both groups were well balanced for age, sex, smoking history, body mass index, Charlson comorbidity index, pulmonary function, tumor size, tumor location, and histological type. All patients were R0 resection, and there were no deaths within 30 days after surgery. The RATS group had shorter operative time [85 (75, 105) min vs. 115 (95, 140) min, P<0.001] and less blood loss [50 (30, 100) mL vs. 60 (50, 100) mL, P=0.001]. There were no statistical differences between the two groups in lymph node resection, conversion to thoracotomy, thoracic drainage time, total amount of thoracic drainage or postoperative complications (P>0.05). Conclusion Both RATS and VATS atypical segment-ectomies are safe and feasible for early-stage NSCLC. RATS can effectively shorten the operative time, and reduce blood loss.
ABSTRACT
@#Abstract: Objective To analyze the distribution characteristics of new occupational disease cases in Guangxi Zhuang “ ” Methods Autonomous Region (hereinafter referred to as Guangxi ) from 2016 to 2021. Through the Occupational Disease Report Card of Occupational Disease and Occupational Health Monitoring Information System, a subsystem of China Disease Prevention and Control Information System, the data of occupational disease reported in Guangxi from 2016 to 2021 were Results collected and analyzed by routine data analytic method. A total of 633 new cases of occupational diseases were diagnosed in Guangxi from 2016 to 2021. Most of the cases occurred in males that account for 96.5% (611/633). Among them, 85.8% of cases were occupational pneumoconiosis, 6.3% occupational otoaryngological and stomaological diseases, 3.0% chemical poisoning and 4.9% other five types of occupational diseases. The geographical distribution was dominated in Hechi Citythataccountsfor51.7%.Theindustrialdistributionwasconcentratedinbituminouscoalminingandwashing,tinminingand dressing, lead and zinc mining and dressing (43.1% of the total). Private enterprises account for 47.3%. The enterprise was - mainlysmall sizedenterprises,accountingfor50.0%.Themaintypesofworkwererockdrillsandmaincoalminer,accountingConclusion for18.8%and17.5%,respectively. Occupationalpneumoconiosiswasthemostimportantoccupationaldiseasein Guangxi. It is necessary to strengthen the occupational hazard exposure control and protection of bituminous coal mining and - - washing,tinmininganddressing,leadandzincmininganddressingindustries,privateenterprises,andsmall andmedium sized enterprises,rockdrillsandmaincoalminerinHechiCity.
ABSTRACT
Objective To evaluate the influence of fast track surgery on the early outcomes of thoracoscopic and laparoscopic minimally invasive esophageal cancer operation for thoracic segment esophageal cancer.Methods The inpatients with thoracic segment esophageal squamous cancer in this hospital from January 2012 to June 2016 were retrospectively analyzed,who in the same operation group performed thoracoscopic and laparoscopic minimally invasive esophageal cancer resection,gastroesophageal left neck anastomosis and two-field lymphadenectomy.Among them,the conventional group had 156 cases from January 2012 to December 2014 and the fast track surgery group had 93 cases from January 2015 to June 2016.Their perioperative related indicators were recorded and analyzed.Results The age,sex,BMI,complications index,ASA score,tumor segment,pathological stage had no statistical difference between the fast track surgery group and conventional group;the postoperative pain score in the fast track surgery group was significantly lower than that in the conventional group(on 1 d:5.13±1.16 vs.5.69±1.17,P=0.000;on 3 d:2.63±0.76 vs.2.86±0.78,P=0.032;on 7 d:1.82±0.71 vs.2.56±0.47,P=0.005);the pneumonia occurrence rate in the fast track surgery group was much lower(7.5％ vs.17.3％,P=0.030) and sacrococcygeal skin injury was much less(4.3％ vs.12.2％,P=0.038);the occurrence rates of pulmonary atelectasi,ARDS,re-tracheal intubation,neck anastomosis fistula,atrial fibrillation and re-operation had no statistical difference between the two groups;the hospitalization stay time in the fast track surgery was shorter than that in the conventional group[(13.89 ±7.36)d vs.(17.41±6.77)d,P=0.000].Conclusion Implementing fast-track surgery measure intervention during perioperative period in the patients with thoracic segment esophageal cancer resection can alleviative postoperative pain,decreases postoperative complications and shortens the hospitalization length.