ABSTRACT
Introduction@#The introduction of minimally invasive surgery has revolutionized multiple disciplines of surgical practice. @*Objectives@#This meta-analysis of matched case control studies aimed to compare the perioperative outcomes of video-assisted thoracic surgery (VATS) with open thoracotomy for patients with early-stage non-small cell lung cancer (NSCLC).@*Methods@#We searched from PubMed and Embase electronic database and revealed seven relevant studies. Endpoints included perioperative mortality and morbidity, postoperative complications and duration of hospitalization. Two investigators (L.S and D.N) independently reviewed each retrieved article. The values of RR and 95% CI were estimated. We used the fixed and random-effects models to estimate the size of the treatment benefit.@*Results@#Results indicate that perioperative mortality was similar between VATS and open thoracotomy (RR-0.62(95%CI 0.39-0.98). However, patients who underwent VATS were found to have fewer overall complications (RR-0.68(95%CI 0.59-0.78), and patients who underwent VATS had a significantly shorter length of hospitalization compared with those who underwent open thoracotomy (MD= -2.98(95%CI-4.09:-1.87)).@*Conclusions@#The present meta-analysis demonstrated superior perioperative outcomes for patients who underwent VATS, including overall complication rates and duration of hospitalization. Therefore, our study suggests that VATS should be performed widely to treat patients with lung cancer in the future.
ABSTRACT
@#BACKGROUND The study was based on the facts that high patient satisfaction and good health indicators are common in countries where quality of nursing care and organization has reached high level and skill level of these professionals is the main factor for the improvement of health care service quality. OBJECTIVE Evaluate practical skill levels of nurses who are responsible for pre- and post-operative care in the National First Central Hospital (NFCH). METHOD Using cross-sectional design, we have conducted 120 questions questionnaire, which was developed by Canadian Nursing Association and Kwantlen Polytechnic University in 2008, to determine 4 levels of skill (never done – did independently) among 41 nurses who work in the Department of Surgery of NFCH. Data was analyzed using social studies statistics software SPSS 21. RESULT Average age and average work years of the 41 nurses who work in the Department of Surgery were 29.9±8.6 and 7.7±9.1, respectively. In terms of specialty, 4 were anesthesiology and intensive care nurse (9.8%) and 17 were surgical nurse (41.5%) while almost half of them (20, 48.8%) did not have specialty certification. During the evaluation of practical skill levels of participants in regards to pre- and post-operative care, for checking readiness of respiratory apparatus, there were 9 (22%) nurses who had never done it, 11 (27%) nurses who did it with assistance, 9 (22%) nurses who did it under guidance, and 12 (29%) nurses who did it independently, for checking neurologic function, there were 4 (11%) nurses who had never done it, 3 (7%) nurses who did it with assistance, 7 (17%) nurses who did it under guidance, and 27 (65%) nurses who did it independently, for operation wound care, there were 5 (12%) nurses who had never done it, 2 (5%) nurses who did it with assistance, 11 (27%) nurses who did it under guidance, and 23 (56%) nurses who did it independently, for using nasal and tracheal intubation, there were 10 (24%) nurses who had never done it, 4 (10%) nurses who did it with assistance, 10 (24%) nurses who did it under guidance, and 17 (42%) nurses who did it independently. There was correlation between average work years and skill level (p<0.001). CONCLUSION Varying skill levels (never done it 17.25%, with assistance 12.25%, under guidance 22.5%, and independently 48%) of surgical nurses who are responsible for pre- and post-operative care show that there is a need for improving practical skills of nurses in the Department of Surgery of NFCH.