Detecting Oropharyngeal and Esophageal Emptying by Submental Ultrasonography and High-Resolution Impedance Manometry: Intubated vs. Non-Intubated Video-Assisted Thoracoscopic Surgery.

Postoperative swallowing, affected by general anesthesia and intubation, plays an important part in airway and oral intake safety regarding effective oropharyngeal and esophageal emptying. However, objective evidence is limited. This study aimed to determine the time required from emergence to effective oropharyngeal and esophageal emptying in patients undergoing non-intubated (N) or tracheal-intubated (I) video-assisted thoracoscopic surgery (VATS). Hyoid bone displacement (HBD) by submental ultrasonography and high-resolution impedance manometry (HRIM) measurements were used to assess oropharyngeal and esophageal emptying. HRIM was performed every 10 min after emergence, up to 10 times. The primary outcome was to determine whether intubation affects the time required from effective oropharyngeal to esophageal emptying. The secondary outcome was to verify if HBD is comparable to preoperative data indicating effective oropharyngeal emptying. Thirty-two patients suitable for non-intubated VATS were recruited. Our results showed that comparable HBDs were achieved in all patients after emergence. Effective esophageal emptying was achieved at the first HRIM measurement in 11 N group patients and 2 I group patients (p = 0.002) and was achieved in all N (100%) and 13 I group patients (81%) within 100 min (p = 0.23). HBD and HRIM are warranted for detecting postoperative oropharyngeal and esophageal emptying.

Unusual complication of endostapler use in video-assisted thoracoscopic surgery.

Video-assisted thoracoscopic surgery is becoming more popular in thoracic surgery practice. Use of endostaplers is mandatory for anatomical video-assisted thoracoscopic surgery resections. In this article, we present an unusual complication related to use of endostapler, which, to our knowledge, may be the first reported in the literature.

Clinical analysis of dual-port video-assisted thoracic surgery for secondary spontaneous pneumo-thorax / 临床外科杂志

Objective To evaluated clinical effects and effectiveness of dual-port video-assisted thoracic surgery(VATS)for secondary spontaneous pneumothorax.Methods The clinical data of 48 pa-tients with secondary spontaneous pneumothorax who underwent open thoracotomy(n =18)or dual-port VATS(n =30)were reviewed retrospectively.Mean operation time,mean postoperative drainage period and mean postoperative hospital stay between the two groups were compared.Results All surgeries were suc-cessfully performed without reoperation and severe complications.No patient was converted to thoracotomy in the VATS group.There were significant differences in mean operation time [(67.9 ±7.2)min vs (73.3 ±6.4)min],mean postoperative drainage period [(3.2 ±0.9)d vs(5.0 ±1.3)d],and mean postoperative hospital stay [(7.2 ±1.4)d vs(8.7 ±1.5)d]between the dual-port VATS and open thora-cotomy(P <0.05 ).Conclusion Dual-port video-assisted thoracic surgery can reduce postoperative drainage period and postoperative hospital stay and increase satisfaction.It has little influence on upper limb movement and improves postoperative recovery.