RESUMO
Objective:To investigate the efficacy of Da Vinci robot-assisted surgery for mediastinal tumor, and summarize the value of Da Vinci system in mediastinal surgery.Methods:The clinical data of 339 cases of robot-assisted mediastinal mass in Shanghai Chest Hospital from April 2015 to September 2020 were retrospectively analyzed, to compare perioperative outcomes of robotic surgery and conventional video-assisted thoracoscopic surgery 2 949 cases.Results:All the operations were successfully completed as planned. No residual lesions, conversion or second operation was observed in the consecutive cohort. The operating time[(81.8±36.8)min vs.(95.6±58.3)min, P=0.015]and post-operation stay[(3.1±1.9)days vs.(3.8±2.3)days, P=0.002] were statistically shorter in robotic group than those inconventional thoracoscopic group. Intraoperative blood loss in two groups was similar[(43.2±22.6)ml vs.(44.0±33.4)ml, P>0.05]. Conclusion:The Da Vinci robot system in mediastinal surgery is safe and feasible with great perspective in the new age of minimally invasive thoracic surgery. Compared with thoracoscopic surgery, it can shorten the operation time and reduce the postoperative hospital stay. It has certain advantages in operator experience and patient recovery.
RESUMO
Objective To evaluate the clinical significance of video-assisted thoracic surgery ( VATS) in localization of pulmonary ground-glass opacities( GGOs) by intraoperative ultrasound ( IU ) . Methods An intraoperative ultrasonographic procedure was prospectively performed on 14 patients harboring GGOs of no more than 3 cm in diameter to localize these lesions and achieve adequate margins . Patients were excluded with both asthma and chronic obstructive pulmonary disease from this study inasmuch as the intraoperative ultrasonographic procedure was more difficult to interpret when residual air is present in the lung . The sonographic characteristics of nodules were compared with those from CT and pathology . Results A total of 18 GGOs were successfully identified by intraoperative ultrasonography without any complications .In all instances 13 GGOs were localized in the lung of complet collapse ,and high-quality echo images were obtained . Additionally ,the IU showed that the nodule sizes were similar to those of CT and postoperative pathological specimens( P < 0 .05) . There was significant difference in lung collapse degree , the maximum diameter of CT and the distance from the lesion to the pleura between echo types ( P <0 .05) . The mean operation time was ( 4 .2 ± 2 .7) min . Conclusions Intraoperative ultrasonography can both safely and effectively localize pulmonary GGO in a completely deflated lung . Hence ,ultrasonography may assist surgeons to perform minimally invasive lung resections with clear surgical margins during the treatment of lung GGO .
RESUMO
[Objective]To find a better minimally invasive surgical operation in teenagers suffered from spontaneous hematopneumothorax caused by pulmonary bullae.[Methods]To analyse 86 cases of patients with pulmonary bullous through transaxilary minithoracotomy from February 2001 to February 2007.[Results]It was observed from 6 months to 6 years after operation with few recrudescence,more curative effects.[Conclusions]Compared with traditional methods,it was a perfect technique for its small traumatism,rapid resume,scarce syndrome and approving curative effect.