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Objective To compare the short-term perioperative outcomes of video-assisted mini-thoracotomy(VAMT),multiple port-video-assisted thoracoscopic surgery(MP-VATS)and single utility port-VATS(SP-VATS)in treatment of early stage non-small cell lung cancer(NSCLC).Methods A total of 157 cases of early stage NSCLC patients were collected and divided into three groups:66 cases received VAMT treatment as group VAMT;45 cases received MP-VATS treatment as group MP-VATS;46 cases received SP-VATS treatment as group SP-VATS.The intraoperative and postoperative conditions,lung function indexes including forced expiratory volume in one second(FEV1),forced vital capacity(FVC)and maximal voluntary ventilation(MVV)among the groups were compared.Results There were no significant differences in the operation time and the number of lymph node dissection among the SP-VATS group,MP-VATS group and group VAMT[(154.89±32.34)min vs(158.43±36.78)min vs(161.21±40.02)min,(12.34±4.55)pieces vs(12.47±3.81)pieces vs(11.78±3.32)pieces,P>0.05];the incision length,blood loss,amount and time of postoperative drainage and the postoperative ambulation in groupSP-VATS were significantly lower than group MP-VATS and VAMT[(4.11±0.65)cm vs(6.42±0.65)cm vs(12.14±2.23)cm;(170.31±45.68)ml vs(166.23±43.21)ml vs(228.96±63.21)ml;(623.42±231.56)ml vs(681.23±278.54)ml vs(924.54±324.51)ml;(5.27±1.32)d vs(7.43±2.27)d vs(7.66±2.89)d;(3.36±0.78)d vs(4.62±1.26)d vs(4.78±1.43)d,all P0.05);After surgery,the lung function(FEV1,FVC,MVV)among the three groups were significantly decreased,and the group SP-VATS was significantly higher than VAMT group(P0.05).Conclusion The SP-VATS for early stage NSCLC has similar short-term efficacy with VAMT and MP-VATS,but SP-VATS has faster recovery and maller postoperative pulmonary dysfunction.
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Objective To compare the effect of video-assisted minithoracotomy(VAMT)and video-assisted thoracoscopic surgery(VATS)for spontaneous pneumothorax.Methods 98 patiens with spontaneous pneumothorax allocated to VAMT or VATS were selected.The operation time,blood loss during operation,score of postoperative pain,time of postoperative drainage,postoperative hospital stay,surgery cost,rate of complication and recurrence were compared between the two groups.Results All patients were cured.The operation time,postoperative hospital stay and surgery cost were significantly different between VAMT and VATS groups(all P ＜0.05).The parameters of two groups were similar in score of postoperative pain,time of post-operative drainage,blood loss during operation,rate of complication and recurrence(all P ＞ 0.05).Conclusion VAMT was as effective as VATS,but the operation time,postoperative hospital stay and surgery cost was significantly better than VATS.
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Objective To assess the value of lobectomy by video-assisted mini-thoracotomy(VAMT) for the treatment of peripheral pulmonary carcinoma.Methods From January 2004 to December 2007,56 cases of peripheral pulmonary carcinoma underwent VAMT lobectomy under general anaesthesia in our hospital.Of the patients,5 had the tumor in the upper lobe of the right lung,2 in the middle lobe of the right lung,19 in the superior lobe of the right lung,8 in the upper lobe of the left lung,and 22 in the superior lobe of the left lung.All the tumors were no more than 5 cm in diameter.All the cases were intubated with double-lumen tubes and then one-lung ventilation was performed.With the patients being placed in a lateral position,a mini-incision(6.0-8.0 cm in length) was made at the fourth or fifth intercostal space.And another 1.5-cm incision was made at the sixth intercostal space along the midaxillary line for introducing the video-thoracoscope.The resected pulmonary lobe was removed though the mini-incision.Afterwards,enlarged lymph nodes were dissected as routine.Results During the operation,no incision was prolonged in the cases.A mean of 14 lymph nodes were removed(ranged from 9 to 31).The mean operation time was(145?35) min(range,120 to 220 min),and the intraoperative hemorrhage was 100 to 450 ml [(210?48) ml].The patients were discharged from hospital in 5 to 11 days(mean,7 days).Seven of the patients developed complications including thoracic effusion in 5 and atelectasis in 2.The patients were followed up for 1 year,3 of them died during the period(1 year survival rate:94.6%).Conclusion VAMT lobectomy is feasible and safe for peripheral lung cancer.
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Objective To study the reliability and feasibility of video-assisted thorascopic lymphadenectomy for complete resection of non-small cell lung cancer(NSCLC).Methods From May 2007 to October 2008,31 patients with NSCLC underwent video-assisted thorascopic radical lobectomy combined with systemic lymphadenectomy in our hospital.The patients were divided into video-assisted thorascopic surgery(VATS) group(n=14) and video-assisted mini-thoracotomy(VAMT) group(n=17).The numbers of removed and metastatic lymph nodes were counted.The results and the follow-up outcomes were compared between the two groups.Results No patient dead or showed serious perioperative complications in both the groups.No significant differences were found between the VATS and VAMT groups in the operation time [(193?92) min vs(188?101) min,t=0.143,P=0.887],blood loss [(592?123) ml vs(648?120) ml,t=-1.297,P=0.211],number of removed lymph nodes [(14.6?7.5) vs(15.2?4.5),t=0.262,P=0.795],or 1-year rate of recurrence or metastasis [21.4%(3/14) vs 13.3%(2/15),P=0.651].Conclusion For patients with NSCLC,no significant difference exists between the outcomes of video-assisted thorascopic surgery and video-assisted mini-thoracotomy.
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0.05).Conclusion VAMT is as effective as VATS,whereas it can achieve a shorter operation time.
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Objective To inverstigte the feasibility of video-assisted thoracoscopic surgery(VATS) be used in grass-roots hospital. Methods 46 patients were treated with video-assisted thoracoscopic surgery or video-assisted minithoracotomy surgery (VAMT) including bullectomy, lobectomy or wedge resection of lung, lung volume reduction surgery, esophageal tumor resection, clearance of hemathorax,partial pericardial,et al. Results There was no operative mortality. Complications occurred in 2 cases(4.3%). All patients were perfectly recovered by treatment. The overall follow-up was 6 months. Conclusion VATS is a safe,effective and new technique of thoracic surgery. More attentions must be payed to prevent and reduce complication in order to generalize the use of grass-roots hospital.