RÉSUMÉ
@#Objective To compare the subaxillary small incision thoracotomy (SSIT) with video-assisted thoracic surgery (VATS) for patients with lung cancer. Methods Retrospective analysis of 142 patients with lung cancer in Department of Thoracic Surgery, The First People's Hospital of Neijiang from January 2014 to April 2016 was conducted. There were 86 males and 56 females, aged 40-77 years. Patients were divided into a VATS group (n=72) and a SSIT group (n=70). The following postoperative data were evaluated: operation time, number of dissected lymph nodes, intraoperative bleeding, postoperative chest drainage volume, drainage duration, postoperative ambulation time, average hospital stay, postoperative complications, hospitalization cost, early postoperative incision pain (visual analogue scale, VAS) and other indicators. Results There were no statistically significant differences between the two groups in the operation time (120.8±20.4 min vs. 126.2±21.6 min, P=0.124), the dissected lymph node (11.1±2.0 vs. 11.4±1.9, P=0.333) and the postoperative complications rate (13.9% vs. 15.7%, P=0.759). Laparoscopic intraoperative bleeding and postoperative drainage volume were significantly less in the VATS group than those in the SSIT group (123.2±26.9 ml vs. 156.4±24.0 ml, P<0.001; 227.0±75.5 ml vs. 334.3±89.1 ml, P<0.001). Postoperative drainage duration, postoperative ambulation time and hospital stay were shorter in the VATS group than those in the SSIT group (2.5±0.5 d vs. 3.1±0.6 d, 1.5±0.5 d vs. 2.2±0.6 d, 6.5±0.5 d vs. 7.4±0.6 d, all P<0.001). The average hospitalization cost of the VATS group was significantly higher than that of the SSIT group (42 338.9±8 855.7 yuan vs. 32 043.7±7 178.1 yuan, P<0.001). There was no significant difference in the operation cost and anesthesia cost between the two groups (P>0.05). The early postoperative pain of laparoscopic group was less, but the difference was not statistically significant (P>0.05). Conclusion The hospitalization cost of the SSIT is lower than that of thoracic surgery, which may be beneficial to the appilication in primary hospitals.
RÉSUMÉ
@#Objective To explore the safety, feasibility and learning curve of video-assisted thoracoscopic surgery(VATS) in treatment of thoracic diseases. Method We retrospectively analyzed the clinical data of 591 patients of thoracic surgery in our hospital between September 2009 and September 2016. There were 378 males and 213 females at age of 14–82 years. Result All patients were successfully completed surgery. Twelve patients converted to open chest with conversion rate of 2.0%. Postoperative complications occurred in 24 patients (4.1%). Four patients died during the perioperative period, and mortality rate was 0.7%. The learning curve of VATS for lung cancer was about 25 patients. And the learning curve of video-assisted laparoscopy for resection of esophageal cancer was about 15 patients. Conclusion VATS is safety and feasible for the chest disease patients in municipal hospital, and is worthy to popularize.
RÉSUMÉ
Objective:To investigate the clinical effects of dezocine combined with flurbiprofen anesthesia for thoracotomy patients and the influence on postoperative irritability status. Methods:Totally 98 cases of patients with thoracotomy were selected and randomly divided into the control group and the research group with 49 ones in each. The control group was given fentanyl and dezocine patient-controlled intravenous analgesia at the end of surgery, and the research group was given dezocine combined with flurbiprofen instead. The clinical anesthesia effects and postoperative irritability status of the two groups were observed and statistically analyzed. Results:The VAS scores in 2 h and 4 h after the surgery in the research group were significantly lower than those in the control group ( P<0. 05). The Ramsay sedation scores at the extubation and in 5min after the extubation in the research group were significantly better than those in the control group (P<0. 05). Furthermore, the postoperative irritability rate and the probability of adverse reactions were significantly lower in the research group (P<0. 01). Conclusion:The implementation of dezocine combined with flurbiprofen anesthe-sia for thoracotomy patients can fully ensure analgesic effect and relieve postoperative restlessness with good clinical application value.