Résumé
Objective:To explore the application of 3D printing technology in anatomy teaching of radical resection of lung cancer in the department of thoracic surgery.Methods:Forty young doctors who took turns in the routine training of thoracic surgery department of The First Affiliated Hospital of Guangzhou Medical University from September 2018 to September 2020 were selected as the research objects. They were randomly divided into the experimental group and the control group by envelope lottery, with 20 doctors in each group. They were respectively trained with traditional teaching and 3D printing technology. After one month of training, objective teaching content test and subjective teaching effect questionnaire were used to evaluate the effect. SPSS 24.0 was used for t-test, Chi-square test or Fisher exact probability test. Results:Under plain CT scan and video-assisted thoracoscopy during operation, all the students identified five groups of anatomical structures: pulmonary artery, pulmonary bronchus, pulmonary vein, mediastinal lymph nodes in group 7, lymph nodes in groups 2 and 4 (right) or lymph nodes in groups 5 and 6 (left). The accuracy of CT and video-assisted thoracoscopy in the experimental group [(84.00±11.42) points and (74.00±13.14) points] were higher than those in the control group [(71.00±10.71) points and (56.50±9.88) points]. The subjective evaluation of the students in the experimental group was higher than those in the control group in the recognition of teaching methods, the improvement of teaching interest, the familiarity with CT images and the familiarity with intraoperative anatomy.Conclusion:Compared with the traditional teaching, 3D printing technology can improve the students' scores of objective teaching content test, and can improve the students' recognition of teaching methods, teaching interest, CT image familiarity and intraoperative anatomy familiarity.
Résumé
Objective To report the results of lung transplantation using graft lungs from donation after citizens death.Methods The clinical data of lung transplantation between January 2016 and June 2016 were analyzed retrospectively.Results Totally 20 patients with end stage lung diseases underwent lung transplantation.Of the 20 patients,11 cases (55％) underwent single lung transplantation and 9 cases (45 ％) underwent bilateral lung transplantation.The top two diseases for lung transplantation were pulmonary fibrosis in 11 cases (55％) and emphysema in 6 cases (30％).Four cases (20％) were given intraoperative ECMO support.Median duration of postoperative intubation was 2 days:1 day for single lung transplantation and 4 days for bilateral lung transplantation,respectively.Acute rejections were diagnosed in 9 patients (45％) who were successfully treated with high-dose intravenous methylprednisolone or methylprednisolone combined with anti-human thymocyte globulin.Postoperative pneumonia episodes occurred in 16 cases (80％)and 4 of them were associated fungal pneumonia.Preoperative sputum culture showed positive bacteria in 16 donors (80％) and 17 kinds of strains were identified.Postoperative sputum culture showed positive bacteria in 19 recipients and 4 of them had the same strains as compared with the corresponding donors.One recipient died of primary graft dysfunction in early term (＜ 1 month)postoperatively,two recipients abandoned treatments and died in 1 week after the discharge,and the remaining 17 cases successfully recovered.Median hospital duration was 55 days:35 days for single lung transplantation and 67 days for bilateral lung transplantation,respectively.Conclusion LLung transplantation is an effective treatment for end-stage lung diseases.Carefully selecting donors,well protecting graft lung and proper peri-operative treatment are the key steps leading to successful lung transplantation using grafts from organ procurement organization.
Résumé
Objective To report the results of lung transplantation using graft lungs from donation after citizens death.Methods The clinical data of lung transplantation between January 2016 and June 2016 were analyzed retrospectively.Results Totally 20 patients with end stage lung diseases underwent lung transplantation.Of the 20 patients,11 cases (55％) underwent single lung transplantation and 9 cases (45 ％) underwent bilateral lung transplantation.The top two diseases for lung transplantation were pulmonary fibrosis in 11 cases (55％) and emphysema in 6 cases (30％).Four cases (20％) were given intraoperative ECMO support.Median duration of postoperative intubation was 2 days:1 day for single lung transplantation and 4 days for bilateral lung transplantation,respectively.Acute rejections were diagnosed in 9 patients (45％) who were successfully treated with high-dose intravenous methylprednisolone or methylprednisolone combined with anti-human thymocyte globulin.Postoperative pneumonia episodes occurred in 16 cases (80％)and 4 of them were associated fungal pneumonia.Preoperative sputum culture showed positive bacteria in 16 donors (80％) and 17 kinds of strains were identified.Postoperative sputum culture showed positive bacteria in 19 recipients and 4 of them had the same strains as compared with the corresponding donors.One recipient died of primary graft dysfunction in early term (＜ 1 month)postoperatively,two recipients abandoned treatments and died in 1 week after the discharge,and the remaining 17 cases successfully recovered.Median hospital duration was 55 days:35 days for single lung transplantation and 67 days for bilateral lung transplantation,respectively.Conclusion LLung transplantation is an effective treatment for end-stage lung diseases.Carefully selecting donors,well protecting graft lung and proper peri-operative treatment are the key steps leading to successful lung transplantation using grafts from organ procurement organization.