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Objective To explore the feasibility and safety of uniportal video-assisted thoracoscopic surgery under non-intubated anesthesia with spontaneous respiration.Methods The clinical data in 35 cases of uniportal video-assisted thoracoscopic surgery under non-intubated anesthesia with spontaneous respiration implemented by same doctor and team in the Affiliated Nanjing Chest Hospital of Medical College,Southeast University from June 2016 to January 2017 were retrospectively analyzed.Results The operations were successfully completed in 35 cases,including 23 cases of lung bullae resection,6 cases of lung wedge resection,5 cases of pulmonary lobectomy and lymph nodes clearance,and 1 case of bilateral sympathectomy.The operative time was 20-106min,average(38.79 ± 26.45) min,intraoperative bleeding volume was 20-350 mL,average(57.14 ± 56.50) mL.No perioperative serious complications or death occurred.Conclusion Uniportal video-assisted thoracoscopic surgery technique under non-intubated anesthesia with spontaneous respiration is safe and feasible,and can be selectively used in partial patients.
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Objective To discuss the feasibility of single hole thoracoscopy of pleural fibreboard endarterectomy surgical treatment on chronic tuberculous empyema. Methods Retrospective analysis of minimally invasive treatment of 52 cases of chronic tuberculous empyema form January 2013 to May 2016, 50 cases applied single hole thoracoscopy surgery, video-assisted mini-thoracoscopy for another 2 cases. Results There was no death, operation time 60 ~ 240 min, average 160 min, bleeding 150 ~ 2000 ml, average 350 ml, postoperative chest tube drainage time 3 ~ 21 d, average 7 d, postoperative persistent leakage in 3 patients, 3 cases of atelectasis, incisional infection in 1 case, pleural effusion in 1 case, 3 cases of arrhythmia. All the cured patients are received the corresponding treatment, the follow-up of 3 ~ 36 m, the chest CT scan show no atelectasis. Conclusion Under the condition of strict selection of indication, single hole thoracoscopy of pleural fibreboard endarterectomy in treatment of chronic tuberculous empyema is safe and feasible, so it is worthy of making further clinical promotion and application.
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Objective: To analyze the effect of single-hole thoracoscopic surgical treatment on elderly spontaneous pneumothorax patients’ postoperative assessment and serological markers and explore single-hole thoracoscopic surgery application. Methods:78 cases of elderly patients with spontaneous pneumothorax were retrospectively analyzed, and divided into single-hole thoracoscopy group with 35 patients and conventional thoracoscopic group with 43 patients. Then the surgery indicators, postoperative pain scores and perioperative serum target level differences were compared between the two groups. Results: The operative time, postoperative drainage time and total hospital stays of single-hole thoracoscopic surgery patients were shorter than that of conventional thoracoscopic group. The differences were statistically significant (t=7.183, t=5.294, t=6.938;P<0.05). The blood loss and postoperative drainage were less. The differences were statistically significant (t=6.883, t=8.735; P<0.05). The postoperative pain scores within one week was less than conventional thoracoscopic group. The differences were also statistically significant (t=6.882, t=5.724, t=5.284;P<0.05). The serological indicators, CRP, IL-1, TNF-α,α1-AT levels of patients in the single-hole thoracoscopy group were lower than the conventional group (t=8.293, t=7.274, t=9.284, t=7.183;P<0.05). Conclusion:VATS and conventional hole thoracoscopic surgery can be used for treatment of spontaneous pneumothorax in elderly, but single-hole thoracoscopy has more advantages in reducing surgical trauma and postoperative pain and optimize systemic inflammation associated factors.