RÉSUMÉ
@#Objective To discuss the safety, feasibility and advantages of tubeless trans-subxiphoid thoracoscopic surgery in anterior mediastinal tumor resection. Methods A total of 32 patients suffering anterior mediastinal tumor were enrolled, including 17 patients (8 males and 9 females) with average age of 31.8±8.4 years who had been performed tubeless trans-subxipohoid tharcoscopic surgery and 15 patients (8 males and 7 females) with average age of 31.1±9.2 years who had been performed traditional trans-subxipohoid tharcoscopic surgery. The differences of surgical duration, the lowest intraoperative arterial oxygen saturation (SaO2), postoperative awaking time, postoperative pain visual analogue score (VAS), postoperative pulmonary recruitment time, duration of postoperative hospital stay and hospitalization cost were analyzed. Results Postoperative awaking time (18.5±1.8 min vs. 28.9±4.2 min, P=0.000), postoperative VAS (1.6±0.6 vs. 3.5±7.4, P=0.000), duration of postoperative hospital stay (2.5±7.2 d vs. 4.3±1.1 d, P=0.000) and hospitalization cost (3.2±1.1 ten thousand RMB vs. 4.9±1.1 10 ten thousand RMB, P=0.000) in the tubeless group were better than those in the control group. There was no significant difference in surgical duration (51.7±6.5 min vs. 55.1±8.5 min), the lowest intraoperative SaO2 (98.5%±0.9% vs. 98.1%±0.8%), postoperative pulmonary recruitment time (33.9±12.2 d vs. 38.4±15.2 d, P>0.05) between the two groups. Conclusion Tubeless trans-subxiphoid thoracoscopic surgery is safe, feasible and advanced in anterior mediastinal tumor resection.
RÉSUMÉ
@#Objective To evaluate the efficacy of tubless therapy for pulmonary bulla resection under the concept of fast track surgery. Methods We retrospectively analyzed the clinical data of 45 patients (29 males and 16 females at an average age of 26.1 years) with pulmonary bullae in our hospital between January 2015 and December 2017. These patients were divided into two groups. Among them, 25 patients were treated with preoperative gastric tubes and catheters, tracheal intubation anesthesia and postoperative drainage tubes (a tube group). And 20 patients were treated with no preoperative gastric tube or catheter, sublaryngeal anesthesia and no postoperative drainage tube (a tubless group). Results There was a statistical difference in postoperative pain index (2.60±1.14 vs. 5.16±1.24, P<0.001) and larynx complication (P=0.00) between the two groups. Shorter period of epidural analgesic tubes (1.40±0.50 d vs. 2.84±0.75 d, P<0.001), shorter operation and anesthesia time (15.00±2.59 min vs. 18.56±2.10 min, P<0.001; 95.30±4.38 min vs. 105.50±4.59 min, P<0.001), shorter hospital stay (9.45±1.66 d vs. 12.80±1.87 d, P<0.001), and less expense (20 245.96±1 113.02 yuan vs. 22 147.06±1 735.01 yuan, P<0.001) in the tubless group were found compared with the tube group. But there was no statistical difference in incidence of complication of lung (P=0.43) between the two groups. Conclusion Tubless therapy in the treatment of pulmonary bulla resection can accelerate the postoperative recovery with shorter hospital stay and less expense, and is an advantageous treatment.