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Objective:To evaluate the clinical efficacy of endoscope assisted supraclavicular thyroidectomy and lymph node dissection through the sternocleidomastoid muscular approach (ELDS) .Methods:Clinical data of 40 patients undergoing ELDS and 40 patients who had open surgery (open group) by same team admitted to Ningbo Medical Center Lihuili Hospital from Jan. 2021 to Jan. 2022 were retrospectively analyzed. The intraoperative and postoperative outcomes and follow-up were observed situation. The intraoperative situation, the number of lymph nodes dissected, postoperative outcomes and scar healing satisfaction were observed. SPSS 20.0 software was employed to carry out statistical analysis, the measurement date were compared with t-test, and the counting date were analyzed by χ2 test. Results:There was no significant differences in the two groups with respect to the number of lymph nodes dissected (ELDS group: 30.5±9.8, open group: 29.9±9.0) . The surgical injury in ELDS group were significantly smaller than those in open group, and the operation time was significantly higher in open group (ELDS group: 95.2±12.0min, open group: 82.3±13.9min, P<0.05) . In postoperative follow-up, there were significant differences between the two groups in swallowing impairment, anterior cervical pressure and scar satisfaction (ELDS group: 4.45±1.82, open group: 6.03±1.47, P<0.05) , and the lateral approach group was superior to open group, but there were no significant differences in parathyroidism or recurrent laryngeal nerve injury ( P>0.05) . Conclusions:ELDS has the advantages of good cosmetic effect, less postoperative anterior cervical discomfort, less postoperative complications, and good lymph node dissection effect. The operation is safe and feasible, and has obvious advantages over traditional operation.
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Objective To observe the clinical application effects of Disposcope endoscope in Univent tube intubation and positioning.Methods Eighty patients underwent scheduled thoracic sur gery (51 males,29 females,aged 18-77 years,ASA Ⅰ-Ⅲ) under one-lung ventilation (OLV) were randomly grouped into two groups:Disposcope endoscope group (group D) and laryngoscope group (group L),40 patients in each group.Group D used Disposcope endoscope for intubation and positio ning while group L used laryngoscope for intubation and auscultation positioning.Patients with difficult intubation,severe ventilation dysfunction and large sputum volume,such as pulmonary hemoptysis and bronchiectasis,were excluded.Intubation and positioning time,airway pressure and arterial carbon dioxide partial pressure (PaCO2) were recorded during double-lung ventilation and OLV,lung collapse effect,and one-time successful intubation ratio,positionging adjustment ratio and the incidence of intubation complications were calculated.Results Intubation and positioning time were significantly longer in group L than in group D [(169.98±52.65)s vs.(102.38±44.45)s](P＜0.05),one-time successful intubation ratio in group L was lower than that in group D (80％ vs.97.5％) (P ＜0.05).The difference of airway pressure and PaCO2 during double-lung ventilation and OLV between the two groups were not statistically significant.The blocker positioning adjust ratio of Univent tube in group L was significantly higher than that in group D (22.5％ vs.7.5％)(P＜0.05).The incidence of bleeding and sore throat after operation in group L were significantly higher than those in group D (27.5％ vs.7.5％,37.5％ vs.15％) (P＜0.05).Conclusion Compare with laryngoscope for intubation and auscultation positioning,Disposcope endoscope used for Univent tube intubation and positioning needs shorter time for intubation and positioning,higher successful one-time intubation ratio,less positioning adjustment.It also reduces the incidence of intubation complications.
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Objective To explore the feasibility of minimally invasive video-assisted thyroidectomy (M IVAT). Methods Clinical data of 8 consecutive patients with ben ign thyroid nodules treated by MIVAT in this hospital from September 2002 to Sep tember 2004 were retrospectively reviewed. Results All the pro cedures were successfully completed. The operative time was 90~150 min (mean, 12 0 min), and the hemorrhage volume, 10~30 ml (mean, 20 ml). No complications happ ened and no conversions to open surgery were needed. All the patients were compl etely recovered and discharged from hospital 3~4 days after the surgery. Follow- up checkups for 6~12 months (mean, 9 months) in the 8 patients found normally he aled wounds and no paraesthesia. Conclusions MIVAT is safe and effective, with excellent cosmetic outcomes.
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The field of cardiovascular surgery has been relatively stable from 1964 to 1990 where primary advances were in improvements of existing procedures from a morbidity and mortality reduction standpoint. New procedures were introduced but not wholly embraced during this time. The mid 1990's brought an initiation of adoption of new procedures such as "off pump" coronary surgery, robotic, and endoscopic advances. The breadth and depth of the new technologies continue to advance at an ever rapid pace with ever accelerating adoption rates worldwide which in turn then generates even faster technological advancement. This article will strive to give an overview of the technologies and future currently facing the leading cardiovascular surgeons.
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The field of cardiovascular surgery has been relatively stable from 1964 to 1990 where primary advances were in improvements of existing procedures from a morbidity and mortality reduction standpoint. New procedures were introduced but not wholly embraced during this time. The mid 1990's brought an initiation of adoption of new procedures such as "off pump" coronary surgery, robotic, and endoscopic advances. The breadth and depth of the new technologies continue to advance at an ever rapid pace with ever accelerating adoption rates worldwide which in turn then generates even faster technological advancement. This article will strive to give an overview of the technologies and future currently facing the leading cardiovascular surgeons.
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The field of cardiovascular surgery has been relatively stable from 1964 to 1990 where primary advances were in improvements of existing procedures from a morbidity and mortality reduction standpoint. New procedures were introduced but not wholly embraced during this time. The mid 1990's brought an initiation of adoption of new procedures such as "off pump" coronary surgery, robotic, and endoscopic advances. The breadth and depth of the new technologies continue to advance at an ever rapid pace with ever accelerating adoption rates worldwide which in turn then generates even faster technological advancement. This article will strive to give an overview of the technologies and future currently facing the leading cardiovascular surgeons.
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0. 05). There were no complications during EEVL. During a follow-up of 3 to 30 months in 76 patients with cirrhosis, the mortality was 14. 5% and 2 patients rebled in the near future. Conclusion It is concluded that EEVL is safe, effective, reliable and fast measure in treating esophageal varices bleeding.
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Objective The clinical and endoscopic characteristics of ischemic colitis (IC) were retrospectively reviewed. Methods 23 aged patients with IC were included; their symptoms,signs,laboratory findings and endoscopic appearances analysed. Results IC occurred most frequently in mid-aged and elders with predominant presentations as acute onset of lower abdominal pains and bloody stools.Endoscopic lesions located mainly in left colon with segmental distribution.Mucosal edema,erosion and submucosal bleeding were common pathological features.Most lesions (91％ ) looked to be nongangrenous, transient and reversible.Only 9 percent of cases turned into chronic stage. Conclusion IC should be suspected in all eldly patients with acute onset of lower abdominal pain and bloody stools.Early colonoscopy is of diagnostic significance.