Report of 15 cases of single-port video-assisted thoracoscopic surgery for pulmonary sequestration / 上海交通大学学报（医学版）

Objective: To investigate the feasibility of single-port video-assisted thoracoscopic surgery (VATS) for pulmonary sequestration. Methods: Fifteen cases with intralobar pulmonary sequestration in Renji Hospital, Shanghai Jiao Tong University School of Medicine from January 2014 to December 2018 were reviewed. All the cases had underwent lobectomy by single-port VATS, including 13 cases of left lower lobectomy and 2 cases of right lower lobectomy. Results: Pleural adhesion was found in 11 of the 15 cases. Lobectomy was successfully performed by single-port VATS in 12 cases. Three cases were transferred to multi-port VATS because of severe pleural adhesion. There was no case conversed to thoracotomy in the study. There was no mortality and complication during the perioperative period. For the 15 cases, the operation time was (96.7±27.8) min, the bleeding volume was (75.3±45.5) mL, the postoperative intubation was (5.2±2.0) d and the postoperative hospital stay was (6.2±2.2) d. Conclusion: Single-port VATS treatment for pulmonary sequestration is safe, effective and feasible.

Clinical analysis of single-and multiple-port thoracoscopic lobectomy for lung cancer / 中国肿瘤临床

Objective:The clinical factors of single-port video-assisted thoracoscopic surgery (SP-VATS) were compared with those of multi-port video-assisted thoracoscopic surgery (MP-VATS). The differences between the two surgical methods and their respective postoperative recoveries were also discussed. Methods:A total of 522 patients who underwent surgical treatment for lung cancer in Tianjin Medical University Cancer Institate and Hospital from January, 2014 to December, 2015 were retrospectively reviewed. Of these cases, 83 underwent SP-VATS and 439 underwent MP-VATS. The two surgical methods were then compared in terms of opera-tive time, operative bleeding, number of lymph node and lymph node cleaning station, pain degree, 24 h postoperative chest drain-age, and in-hospital time after operation. Results:The differences between the patients who underwent SP-VATs and those who under-went MP-VATS in term of gender, age, smoking, tumor diameter, TNM stage, pathological type, and tumor location were not statistical-ly significant. The operative time in SP-VATS group was longer than that in the MP-VATS group (P<0.01), whereas in-hospital time after operation in the former group was shorter than that in the latter (P=0.011). Furthermore, pain degree in the SP-VATS group is lower than that in the MP-VATS group (P=0.041). The differences between the two groups in terms of operative bleeding, number of lymph node and lymph node cleaning station, and 24 h postoperative chest drainage were not statistically significant. Conclusion:SP-VATS can achieve a surgical effect similar to that of MP-VATS but has a prolonged operation time. SP-VATS is beneficial to postoperative re-covery and reduces the degree of pain. Thus, it has great potential for development.

Comparison of thoracic drainage by two kinds of devices after single-port video-assisted thoracoscopic surgery in treatment of primary spontaneous pneumothorax / 中国内镜杂志

Objective To explore the clinical values of the modified thoracic drainage devices that were applied in treatment of primary spontaneous pneumothorax patients who underwent single-port video-assisted thoracoscopic surgery. Methods Clinical data of 82 primary spontaneous pneumothorax patients who underwent single-port video-assisted thoracoscopic lung wedge resection and pleurodesis from January 1st, 2015 to August 31st, 2016 was analyzed retrospectively. These patients, according to the thoracic drainage devices, were divided into traditional group (Group A, n = 42) or modified group (Group B, n = 40). These statistical data, including duration of thoracic drainage, lengths of hospital stay, duration of using antibiotic, amounts of pleural drainage, scales of pain, and complications of the two groups of patients in postoperative stage, were compared. Results There was no significant differences (P > 0.05) in volumes of thoracic drainage while there were significant differences (P < 0.05) in duration of thoracic drainage, lengths of hospital stay, duration of using antibiotic, scales of pain, and complications in postoperative stage between the two groups. And patients in group B had shorter time of thoracic drainage, hospital stay, and using antibiotic, lower scales of pain and rates of complications when compared with group A. Conclusion There are some clinical values of application of modified thoracic drainage devices in treatment of primary spontaneous pneumothorax underwent single-port video-assisted thoracoscopic surgery, because of it could give the patients fast recovery and made the operations simpler.

Effects of general anesthesia combined thoracic paravertebral block on postoperative pain and fast track in single-port video-assisted thoracoscopic surgery / 临床麻醉学杂志

Objective To explore the effects of general anesthesia combined thoracic paraverte-bral block on postoperative pain and fast track single-port video-assisted thoracoscopic surgery (VATS).Methods Thirty patients,including male 20 and female 10,received single-port VATS were randomly and equally divided into two groups:group C received general anesthesia only,and group T received ultrasound-guided thoracic paravertebral nerve block combined with general anesthe-sia.Both groups did not use the patient-controlled analgesia,if insufficient analgesia happened (rest-ing VAS scores>4),than used dezocine intravenously as additional analgesia (a single-dose 5-20 mg, no more than 120 mg per day).The Ramsay scores at 1,4,8,12 h after the surgery and the mechani-cal withdrawal threshold on the day before the surgery,at 4,8,12,24 h after the surgery were recor-ded.The first time of post-operation pain feedback,the consumption of dezocine in the first 24 h after surgery,the incidence rates of side effects,the first time off-bed and the hospital stays were also re-corded.Results Compared with group C,the Ramsay scores at 8,12 h postoperatively in group T significantly decreased (P <0.05),and the mechanical withdrawal threshold at 4,8 h postoperatively significantly increased (P <0.05).The first time of post-operation pain feedback in group T was sig-nificantly longer than group C (P <0.05).The consumption of dezocine in the first 24 h after surgery significantly decreased in group T (P <0.05).The first time off-bed and the hospital stays in group T were shorter than group C (P <0.05).Also,the incidence rates of nausea,vomiting in the first 24 h postoperatively were lower in group T (P < 0.05 ).Conclusion General anesthesia combined with single-injected thoracic paravertebral nerve block can effectively relieve the postoperative pain in pa-tients undergoing single-port VATS,reduce the consumption of opioids in the first 24 h postopera-tively,cutting down the occurring rates of adverse reactions,which was beneficial to early ambulate and shortened the hospital stays.