Application of three-dimensional thoracoscope system in minimally invasive thoracic surgery / 中国癌症杂志

Background and purpose:With the development of the three-dimensional (3D) science, minimally invasive technology is going into the 3D period. While 3D laparoscope system has been widely accepted by surgeons because of its better visual effect and safer operations compared to traditional laparoscope system, this study aimed to evaluate the feasibility of 3D thoracoscope system in minimally invasive surgery for the treatment of thoracic diseases. Methods: A total of 96 cases of thoracic diseases were accomplished with KARL STORZ 3D thoracoscope during Mar. 2014 to Oct. 2014, including 33 cases of lobectomy, 2 cases of segmentectomy, and 10 cases of wedge resection of pulmonary tumor, 27 cases of mediastinal tumor, 20 cases of esophageal tumor and 4 case of esophageal achalasia. The data of operative time, bleeding volume, postoperative chest tube drainage and hospital time and postoperative complications were counted. Results: All the operations were completed successfully, without conversion to open surgery. All the operations cost 30 to 237 min. The operation of local resection lasted 30 to 120 min, with an average of 52 min, the operation of pulmonary lobectomy lasted 63 to 122 min, with an average of 75 min;the operation of mediastinal tumor resection lasted 35 to 125 min, with an average of 77 min;and the operation of esophageal diseases lasted 57 to 237 min, with an average of 189 min. The bleeding volumes were 2 to 85 mL, 15 to 72 mL, 30 to 186 mL and with the average of 50 mL, 47 mL, 118 mL in pulmonary, mediastinal and esophageal operations respectively. The time of postoperative chest tube drainage of each surgery was 1 to 5 days after pulmonary operations, 1 to 3 days after mediastinal operations, and 2 to 6 days after esophageal operations. The postoperative hospital time of pulmonary operation was 2 to 10 days, with an average of 6.3 days;the time of mediastinal operation was 3 to 6 days, with an average of 4.2 days;and the time of esophageal operation was 4 to 19 days, with an average of 13.3 days. No complications and tumor recurrence or metastasis were observed during the followed 3 months. Conclusion: 3D thoracoscope system not only preserves the minimally invasive advantage of video-assisted thoracoscopic surgery (VATS), it can also provide high-definition and stereoscopic vision and better sense of depth which facilitate the operation more precise and safer, thus operation time becomes shorter. Besides, 3D system possesses the advantage of natural vision similar to open surgery, thus it has an easier and shorter learning curve.

A comparison of the perioperative application of fast track surgery and traditional surgery for fractured ribs / 临床外科杂志

Objective To compare the perioperative application of fast track surgery(FTS)andtraditional surgery for fractured fibs.Methods Eighty four perioperative patients with fractured fibs wereenrolled,including 42 cases treated by FTS philosophy(FTS Group)and 42 cases treated by traditional surgery(Tradition Group).The results of postoperative VAS score,serum albumin,recovery time of gurglingsound,exhaust time of intestinal tract,postoperative complications,hospital stay,total hospital cost and patient satisfaction were investigated and compared between the two groups.Results Patients in FTS grouphad lower VAS scores,higher level serum albumin,earlier time of gurgling sound recovery and intestinalexhaust,lower rates of postoperative complication,shorter time of hospital stay,lower hospital costs andhigher levels of satisfaction(P <0.05).Conclusion For perioperative patients with fractured fibs,FTShas advantages in low VAS score,good nutrition condition,short intestinal tract convalescence,low postoperative complication rate,short hospital stay,low host costs and high level of satisfaction,which is worthy ofbeing spread.