Minimal Invasive Thoracoscopic Mitral Valve Surgery.

INTRODUCTION: The totally thoracoscopic approach for mitral valve (MV) disease is a minimally invasive method. We investigated the procedure's feasibility, safety and effectiveness when it was performed by an experienced operator. METHODS: We retrospectively analysed 96 consecutive patients with MV disease treated between March 2016 and November 2019 by minimally invasive procedures. The procedures were performed on a femoral artery-vein bypass through two ports, including a main operation port and a thoracoscopic port. The clinical data of patients were collected, including preoperative cardiac function, operative data, postoperative complications, and follow-up. RESULTS: A total of 96 patients (57 male patients; average age, 49.7±14.5 years; left ventricular ejection fraction, 65.6±7.7%) were enrolled in this study. No intraoperative conversion incision or death occurred. The cardiopulmonary bypass and aortic cross-clamp times were 163.8±50.6 minutes and 119.7±38.9 minutes, respectively. Postoperative chest tube drainage in the first 24 hours was 232.8±108.1 ml. The ventilation time and length of intensive care unit stay were 13.2±6.2 hours and 2.9±2.2 days, respectively. One patient died of disseminated intravascular coagulation and prosthesis thrombosis 3 days after the operation, fearing anticoagulant-related hemorrhage. The overall success rate of valve repair during 1-year follow-up was 97.9%. CONCLUSION: The totally thoracoscopic procedure on mitral valves by an experienced surgeon is technically feasible, safe, effective and worthy of widespread adoption in clinical practice.

Minimal Invasive Thoracoscopic Mitral Valve Surgery

ABSTRACT Introduction: The totally thoracoscopic approach for mitral valve (MV) disease is a minimally invasive method. We investigated the procedure's feasibility, safety and effectiveness when it was performed by an experienced operator. Methods: We retrospectively analysed 96 consecutive patients with MV disease treated between March 2016 and November 2019 by minimally invasive procedures. The procedures were performed on a femoral artery-vein bypass through two ports, including a main operation port and a thoracoscopic port. The clinical data of patients were collected, including preoperative cardiac function, operative data, postoperative complications, and follow-up. Results: A total of 96 patients (57 male patients; average age, 49.7±14.5 years; left ventricular ejection fraction, 65.6±7.7%) were enrolled in this study. No intraoperative conversion incision or death occurred. The cardiopulmonary bypass and aortic cross-clamp times were 163.8±50.6 minutes and 119.7±38.9 minutes, respectively. Postoperative chest tube drainage in the first 24 hours was 232.8±108.1 ml. The ventilation time and length of intensive care unit stay were 13.2±6.2 hours and 2.9±2.2 days, respectively. One patient died of disseminated intravascular coagulation and prosthesis thrombosis 3 days after the operation, fearing anticoagulant-related hemorrhage. The overall success rate of valve repair during 1-year follow-up was 97.9%. Conclusion: The totally thoracoscopic procedure on mitral valves by an experienced surgeon is technically feasible, safe, effective and worthy of widespread adoption in clinical practice.

The effect of operating room nursing intervention on the psychological status and incidence of emergence agitation in the recovery period of general anesthesia: A protocol for systematic review and meta-analysis.

BACKGROUND: During the recovery period of general anesthesia, patients are disturbed by residual anesthetic drugs, manifesting as clinical signs of confusion, drowsiness and disorientation, and even abnormal psychology and limb agitation at varying degrees in severe cases. These stress reactions are detrimental to the postoperative recovery, which can be life-threatening. Operating room nursing intervention (ORNI) is a novel nursing model that prevents stress reactions during the recovery period of general anesthesia. However, whether ORNI can improve the psychological condition and reduce the incidence of emergence agitation in the recovery period of general anesthesia remains controversial. Therefore, this study aims to evaluate the effect of ORNI on the psychological status and incidence of emergence agitation in the recovery period of general anesthesia through a systematic review and meta-analysis, thus providing clinical evidence to support it. METHODS: Randomized controlled trials reporting the effect of ORNI on the recovery period of general anesthesia published before October 2021 will be searched in the Chinese Scientific Journal Database, China National Knowledge Infrastructure Database, Wanfang, China Biomedical Literature Database, PubMed, Embase, the Cochrane Library, and Web of Science. Eligible literatures will be screened out according to inclusion and exclusion criteria, and their quality will be assessed using the Cochrane Risk of Bias Assessment Tool. Meta-analysis will be performed using Revman 5.4 software. RESULTS: This study will evaluate the effect of the ORNI on the recovery period of general anesthesia by calculating the incidence of emergence agitation, and grading the self-rating anxiety scale and self-rating depression scale scores. CONCLUSION: This study will provide a reliable evidence-based basis for the application of ORNI in the recovery period of general anesthesia. OSF REGISTRATION NUMBER: DOI 10.17605/OSF.IO/P3A4T.

Correlation between monoamine neurotransmitter and cytokine levels and the occurrence of post-traumatic stress disorder among operating room nurses.

BACKGROUND: The aim of the present study was to investigate the correlation between monoamine neurotransmitter and cytokine levels and the occurrence of post-traumatic stress disorder (PTSD) among operating room nurses. METHODS: A total of 131 nursing staff were selected and assigned into the PTSD, non-PTSD, and control group. Enzyme-linked immunosorbent assay was applied to determine the monoamine neurotransmitters in plasma and serum cytokines. Receiver-operating characteristic curve analysis was conducted to assess the sensitivity and specificity of neurotransmitters and cytokines in the clinical detection of PTSD among operating room nurses. Addenbrooke's Cognitive Examination-Revised and the Connor-Davidson Resilience Scale were used to evaluate the correlation between neurotransmitter and cytokine levels and the clinical characteristics of operating room nurses with PTSD. RESULTS: Our study found that the monoamine neurotransmitters and cytokines among nurses in the PTSD group were significantly higher than those in the non-PTSD and control group. Neurotransmitter and cytokine levels as clinical predictors of PTSD among operating room nurses have good sensitivity and specificity, and were negatively correlated with cognitive function and resilience. CONCLUSIONS: The findings of the present study confirm that monoamine neurotransmitter and cytokine levels are correlated with the occurrence of PTSD among operating room nurses.