Résumé
Chest trauma is one of the most common injuries. Venous thromboembolism (VTE) as a common complication of chest trauma seriously affects the quality of patients′ life and even leads to death. Although there are some consensus and guidelines on the prevention and treatment of VTE at home and abroad, the current literatures lack specificity considering the diagnosis, treatment and prevention of VTE in patients with chest trauma have their own characteristics, especially for those with blunt trauma. Accordingly, China Chest Injury Research Society and editorial board of Chinese Journal of Traumatology organized relevant domestic experts to jointly formulate the Chinese expert consensus on the diagnosis, treatment and prevention of chest trauma venous thromboembolism associated with chest trauma (2022 version). This consensus provides expert recommendations of different levels as academic guidance in terms of the characteristics, clinical manifestations, risk assessment, diagnosis, treatment, and prevention of chest trauma-related VTE, so as to offer a reference for clinical application.
Résumé
Objective To find a new operation based on the themy of NOTES,through the way of mouth floor-pretracheal space-retrosternal space,instead of through esophagus or the trachea.Methods We anesthetized six mongrel dogs with endotracheal intubation,then cut the tissue between the incisors and the glossodesmus.The retrosternal space was separated slowly by the balloon expander,and cut the right mediastinal fascia,and went through thorax,then cut a small piece of lung tissue,which would be used to biopsied.Results All of the 6 operations were successfully completed,without any arrhythmia,serious bleeding,airway obstruction and death.Conclusion It doesn't need the soft endoscope in the new operation,which will have bigger operating space and to be safer,just with pin type thoracoscope and related apparatus.
Résumé
Objective To evaluate the role of thoracoscopy-assisted mini-incision in surgical treatment of lung tuberculosis.Methods From 1999 to 2004,pulmonary lobectomy was performed with thoracoscopy-assisted mini-incision(5-7 cm) on 42 patients with lung tuberculosis(right superior lobectomy in 16,right middle lobectomy in 4,right inferior lobectomy in 4,left superior lobectomy in 10,left lingular lobectomy in 4,and left inferior lobectomy in 4).Results None of the patients were converted to open surgery.The mean operation time was 105 min(35-170 min);blood loss ranged 100-800 ml(mean,150 ml).In the patients,thoracic drainage lasted for 1-5 d(mean,2.8 d) after the operation,and the hospital stay was 4-11 d(mean,6.7 d).During a 2-to 13-month follow-up(mean,8.2),no patient showed positive sputum,bronchopleural fistula,or diffusion of tuberculosis.Conclusions Since thoracoscopy-assisted mini-incision is assosiated with minimal tissue injury,few blood loss,quick postoperative recovery,short hospital stay,and few complications after the surgical treatment of lung tuberculosis,it is worth being widely used.For surgeons,it is important to remember the indications for the procedure.