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Objective To study the safety,feasibility and efficacy of thoracoscopic hepatectomy for liver carcinoma. Methods Thoracoscopic hepatectomy was performed in 3 cases with single liver neoplasm from 2007 to 2011,including hepatocellular carcinoma ( HCC ) in one case and metastatic liver cancer in 2 cases.By preoperative imaging the tumor was located accurately to simulate the port position in operation.Patients were placed in a left lateral decubitus position,and 3 ports were inserted into the chest wall surrounding the tumor. Through the use of intra-operative thoracoscopic uhrasonography (IOTU),the diaphragm just above the tumor was opened.IOTU was performed on the liver surface and the resection line was marked.Throughout the course of parenchymal transection,IOTU was performed repeatedly to guide the resection line,and ensure the complete removal of the tumor.After meticulous hemostasis of the resection surface,the diaphragm was closed. A thoracic drain was left. Results Thoracoscopic hepatectomy succeeded in all 3 cases,the median total operating time was 150 min (110 -210 min),and the medianblood loss was 297 ml (130 -600 ml). Patients recovered quickly and had no major post-operative complications.During 9 to 42 months' follow-up,one patients died of other cause,no relapse of the diseases was found. Conclusions Thoracoscopic hepatectomy is a safe and feasible operation in selected patients and has advantages in post-operative morbidity and in hospital time.
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Objective To explore the application of video-assisted thoracic surgery (VATS) in the diagnosis and treatment of mediastinal tumors. Methods Thirty-four patients with mediastinal tumors underwent VATS from June 1995 to December 2002. The patients comprised 9 men and 25 women, with a mean age 43 9 years (16～74 years). Entered into the study there were 14 cases of thymoma (9 benign thymomas and 5 malignant), 6 cases of neurogenic benign tumors, 5 bronchogenic cysts, 4 teratomas, 2 pericardial cysts and 3 other conditions (metastatic carcinoma, lymphoma and hemangioma racemosum, respectively). Maximum diameter of the tumors ranged 3 5 cm to 6 cm, mean 4 5 cm. Operations were performed under general anesthesia, double lumen endotracheal tube placement and single lung ventilation. The patients were maintained in the lateral decubitus position. Camera port was placed at the sixth or the seventh intercostals space on the midaxillary line. Sites of the other two ports depended upon the location of the tumors. Results Out of the 34 patients with mediastinal tumors, 25 patients underwent tumor removal by VATS alone and 6 patients received VATS combined with mini-thoracotomy, while the remaining 3 patients only underwent biopsy by VATS. Postoperatively, all patients recovered uneventfully, without severe complications or mortality. Conclusions VATS is the first choice for benign mediastinal tumors, typically those in the middle and posterior mediastinum.
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0.05), respectively; 10 cases out of 12 cases performed SAMT and 26 cases out of 33 cases per- formed VATS were operated bullaectomy; the number of recurrence after operation was 2 in VATS and none in SAMT; the average operative cost was ￥ 806 ? 78 in SAMT and ￥ l808 + 447 in VATS(t = 7 .6,P
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Objective To study the feasibility of Video-assisted thoracoscopic thymectomy and the long term result of thoracoscopic thymectomy for myasthenia gravis. Methods 9 cases of thymus related disease were selected to undergo thymectomy though thoracoscopic approach from August 1996 to April 2001.Patients were followed up through outpatient service and telephone consultation. Results Of the 9 cases 2 cases were diagnosed as thymus cysts,1 cases thymoma,1 case malignant thymoma,1cases thymus carcinoma and 4 cases myasthenia gravis.Of the 4 cases of myasthenia gravis,3 cases were typeⅠ and 1 case was typeⅡb according to the modified Osserman classification.After thoracoscopic thymectomy 75% of patients had long-term good responses to surgery.The operation of one case of malignant thymoma was converted to lateral thoracotomy.One case of malignant thymoma with myasthenia gravis relapsed and reoperated through open thoracotomy . Conclusions video-assisted thoracoscopy can be usd to treat seleted thymic diseases .The results of video-assisted thoracoscopic thymectomy for mysthenia gravis is almost comparable with traditional open thoracotomy