ABSTRACT
Introduction: To date, totally 3D-endoscopy has primarily been employed in mitral, tricuspid, and aortic valve surgeries. Herein, we describe the first case of a pulmonary valve surgery using totally 3D-endoscopy. To the best of our knowledge, this is the first case of a totally endoscopic pulmonary valve surgery. Case report: A 56-year-old woman was provisionally diagnosed with a tumor arising from the left cusp of the pulmonary valve. Totally 3D-endoscopy was planned for tumor resection. The patient was placed in a modified right lateral decubitus position and underwent mild hypothermic cardiopulmonary bypass using the left femoral artery, right jugular vein, and right femoral vein. An on-pump beating-heart technique was used during this surgery. Trocars for the 3D-endoscopic system and surgical instruments were inserted through the third and fourth intercostal spaces. Upon incision of the pulmonary artery, the suspected tumor was revealed to be a hyperplastic left pulmonary cusp; therefore surgical resection was abandoned. The patient was discharged without any complications. Conclusion: This case demonstrates that a totally 3D-endoscopic approach may provide optimal views of the pulmonary valve. Moreover, this procedure would be a novelty in MICS.
ABSTRACT
Objective:To study the effect of totally endoscopic surgery and Miccoli surgery for papillary thyroid microcarcinoma. Methods Totally 64 patients with papillary thyroid microcarcinoma from April 2013 to April 2014 in our hospital were divided into the ob-servation group and the control group according to a random number table.And the intraoperative and postoperative situation of the two groups were compared.Results The number of lymph node dissection,postoperative hospital stay,hospital costs of the two groups had no sig-nificant difference (P >0.05).The blood loss,operative time,drainage time,amount of drainage,incision length,time of postoperative recov-ery of the observation group were significantly less than those of the control group with statistical significance (P <0.05).But the cosmetic score of observation group after operation was lower than that of the control group,and there was a significant difference (P <0.05).Postop-erative pain grade of the observation group was better than the control group with statistical significance (P <0.05).The complication rate of control group was significantly higher than the observation group (P <0.05).Conclusion Miccoli surgery for papillary thyroid microcarci-noma has more advantages compared with totally endoscopic surgery in terms of blood loss,operative time,drainage time,amount of drainage, incision length,time of postoperative recovery,and degree of pain.Moreover,it has a lower complication rate and high security,which should be the first choice in clinic surgery.