PS01.130: VIDEO-ASSISTED THORACOSCOPE 3D AND 2D MODE COMPARATIVE ANALYSIS FOR ESOPHAGEAL CHEST SURGERY

Abstract Background To study the advantages and disadvantages of 3D and 2D thoracoscope in the thoracic surgery of esophageal carcinoma. Methods Retrospectively analyze esophageal cancer cases between July 2013 and July 2017 of the first affiliated hospital to Xiamen University, depending on the different mode of Video-Assisted Thoracoscopic, which can be divided into 3D-VATS group 353 cases (observation group) and 2D-VATS group 351 cases (control group). Comparing the difference in operation time, intraoperative bleeding, lymph node transmission, volume of the drain by the first 24 hours, total volume of the drain, chest tube time and postoperative complications. Results All the 704 patients with esophageal cancer were performed under the video-assisted thoracoscope. In terms of surgery time, 3D-VATS group (51.4 ± 13.3min) was shorter than 2D-VATS group (65.7 ± 9.1min), with statistical significance (t = -9.751, P = 0.013); on blood loss, 3D-VATS group (34.1 ± 10.5ml) was less than 2D-VATS group (50.2 ± 9.4ml) with statistical significance (t = -9.274, P = 0.009); about lymph nodes transmission, 3D-VATS group (16.8 ± 3.2) was more than 2D-VATS group (13.1 ± 3.7), with statistical significance (t = 5.213, P = 0.007); in volume of the drain by the first 24 hours, 3D-VATS group (171.2.15 ± 20.2ml) was less slightly than 2D-VATS group (180.3 ± 35.2ml), no statistical difference (t = -1.347, P = 0.281); about total volume of the drain, 3D-VATS group (530.2 ± 53.4ml) was less slightly than 2D-VATS group (553.8 ± 57.5ml), no statistical difference (t = -1.911, P = 0.093); on chest tube time, 3D-VATS group (4.2 ± 0.7d) was less slightly than 2D-VATS group (4.9 ± 1.1d), no statistical difference (t = -1.806, P = 0.069); Postoperative complications in two groups including the incidence of arrhythmia, pulmonary infection, anastomotic leakage and recurrent laryngeal nerve injury has no obvious difference (P > 0.05). Conclusion Video-assisted thoracoscopic surgery of esophagectomy under 3D-mode has certain advantages in operation time, intraoperative bleeding and lymph nodes transmission over 2D-mode. While in the item of volume of the drain by 24 hours, total volume of the drain, chest tube time and postoperative complications, they have no obvious difference. Disclosure All authors have declared no conflicts of interest.

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Curative Effect Observation and Prognosis Analysis of Video-Assisted Thoracic Surgery and Thoracotomy in Patients with Hemopneumothorax

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2021/3937420 ◽

2021 ◽

Vol 2021 ◽

pp. 1-7

Author(s):

Honglei Zhang ◽

Qian Yang ◽

Tao Liu ◽

Yu Liu

Keyword(s):

Postoperative Complications ◽

Hospital Stay ◽

Retention Time ◽

Chest Tube ◽

Operation Time ◽

Postoperative Recovery ◽

Inflammatory Factor ◽

Intraoperative Bleeding ◽

Video Assisted

Currently, the incidence of hemopneumothorax is high in China, and with the continuous improvement of modern medical standards, video-assisted thoracoscopic surgery (VATS) has gradually become the main method of clinical treatment of hemopneumothorax. The aim of this study was to investigate the minimally invasive mechanism and the clinical value of television thoracoscopy in the diagnosis and treatment of traumatic hemopneumothorax and to provide a relevant theoretical basis for the superiority of television thoracoscopy. In this study, total of 98 patients with traumatic hemopneumothorax admitted to three hospitals from January 2017 to December 2019 were selected and divided into 49 cases each in the thoracotomy group and VATS group according to the differences of the surgical method. The surgical situation such as operation time, intraoperative bleeding, and incision length, postoperative recovery such as duration of painkiller use, chest tube retention time, volume of drainage, and hospital stay, levels of C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and other inflammatory factors at different times after admission to hospital, postoperative complications such as pulmonary infection, enveloped effusion, incisional infection, and pressureulcers, and recurrence rate at 12-month follow-up were used as the evaluation indexes to analyze the effect of different surgical treatment modalities in patients with hemopneumothorax and the impact on patient prognosis. The results showed that the operative time, intraoperative bleeding, duration of painkiller use, chest tube retention time, and hospital stay were shorter in the VATS group than in the thoracotomy group. The length of the surgical incision, volume of drainage, and inflammatory factor levels at different postoperative periods were lower in the VATS group than in the thoracotomy group. The incidence of postoperative complications was lower in both groups, and the difference was not statistically significant. The follow-up results showed that there were no recurrent cases in both groups 12 months after discharge. This indicates that VATS is an effective treatment option for hemopneumothorax, which can achieve the same exploration and treatment effect as thoracotomy, and has the advantages of less trauma, less bleeding, shorter operation time, and faster postoperative recovery compared with thoracotomy. The prognosis of patients treated by VTAS is good, which provides a new treatment route for patients who cannot tolerate thoracotomy and are poorly tolerated.

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Surgical Benefits of Prone Position Thoracoscopic Esophagectomy Over Open Thoracic and Thoracoscopic Esophagectomy in Left Lateral Decubitus Position: A Literature Review

Journal of Surgical Oncology ◽

10.31487/j.jso.2020.02.02 ◽

2020 ◽

pp. 1-8

Author(s):

Kazuo Koyanagi ◽

Kentaro Yatabe ◽

Miho Yamamoto ◽

Soji Ozawa ◽

...

Keyword(s):

Esophageal Cancer ◽

Lymph Node ◽

Postoperative Complications ◽

Lymph Nodes ◽

Mediastinal Lymph Node ◽

Minimally Invasive Esophagectomy ◽

Node Dissection ◽

Invasive Esophagectomy ◽

Left Lateral Decubitus Position ◽

Lateral Decubitus

Objective: We reviewed the surgical outcomes of minimally invasive esophagectomy (MIE), especially the number of lymph nodes retrieved, for the patients with esophageal cancer to clarify the surgical benefits of MIE in patients with esophageal cancer. Material and Methods: A systematic literature search was performed, and articles that fully described the surgical results of MIE were selected. Parameters such as operative time, blood loss, the number of lymph nodes retrieved, and postoperative complications were compared among patients undergoing minimally invasive esophagectomy (MIE) in the left lateral decubitus position (MIE-LP), MIE in the prone position (MIE-PP), and open thoracic esophagectomy (OE). Results: The conversion rate from MIE to OE was very low. MIE-PP was associated with lower blood loss than OE and MIE-LP. Results of a multicenter randomized controlled trial demonstrated that pneumonia and recurrent laryngeal nerve paralysis in MIE-PP significantly reduced compared with OE. Although postoperative complications were not different between MIE-PP and MIE-LP, the number of lymph nodes retrieved in MIE-PP was higher than that in MIE-LP. Conclusion: MIE-PP has potential benefits in terms of less surgical invasiveness and improvement of mediastinal lymph node dissection. A prospective randomized control trial using a large number of cases and long-term follow-up is recommended for analyses of appropriate mediastinal lymph node dissection and its impact on oncological benefit.

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Management of Pleural Empyema with Single-Port Video-Assisted Thoracoscopy

Innovations Technology and Techniques in Cardiothoracic and Vascular Surgery ◽

10.1097/imi.0b013e31827e26d6 ◽

2012 ◽

Vol 7 (5) ◽

pp. 338-345 ◽

Cited By ~ 7

Author(s):

Alessandro Marra ◽

Christoph Huenermann ◽

Bernd Ross ◽

Ludger Hillejan

Keyword(s):

Chest Tube ◽

Pleural Cavity ◽

Single Port ◽

Intraoperative Complications ◽

Operation Time ◽

Pleural Empyema ◽

Metastatic Colon Cancer ◽

Invasive Treatment ◽

Female Ratio ◽

Video Assisted

Objective The aim of this study was to evaluate the safety and efficacy of an original technique of single-port video-assisted thoracoscopy (S-VATS) for the minimally invasive treatment of pleural empyema in fibrinopurulent stage. Methods Single-port video-assisted thoracoscopy was performed under general anesthesia and single-lung ventilation using a 2-cm incision after ultrasound localization of the projected midpoint of the pleural effusion. Through the single access, a video scope and standard thoracoscopy instruments were simultaneously introduced to perform debridement and lavage of the pleural cavity. Postoperatively, patients underwent continuous or intermittent pleural irrigation through the chest tube until microbiological confirmation of sterility of the pleural fluid. Results Between November 2004 and December 2009, a total of 61 patients underwent S-VATS for pleural empyema in stage I(7%) or II (93%). Median age was 63.5 years (range, 22–94 years). Male-to-female ratio was 4.2. Surgery was performed 3 to 60 days after the onset of symptoms. Macroscopically complete debridement of the pleural cavity was achieved in most (98%) cases. Median operation time was 53 minutes (range, 29–90 minutes). No intraoperative complications occurred. In-hospital mortality and morbidity rates were 3% and 16%, respectively. Deaths were caused by diffuse metastatic colon cancer in one case and severe apoplectic insult in the other. Chest tube was removed after a median time of 12 days (range, 4–64 days). Four (6.5%) patients experienced a relapse of empyema; this was caused by complicated residual pleural space (two cases), persistent pleuropulmonary fistula (one case), or both (one case). Conclusions It seems that S-VATS is a safe and effective procedure for the treatment of pleural empyema in fibrinopurulent stage.

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The Application of Rigid and Flexible Mediastinoscopy in Esophagectomy: Our Experience and a New Technology

10.21203/rs.3.rs-525371/v1 ◽

2021 ◽

Author(s):

chunli wu ◽

Bo Dong ◽

Bin Wu ◽

Shihao Li ◽

Yu Qi

Keyword(s):

Esophageal Cancer ◽

Lymph Nodes ◽

New Technology ◽

Operation Time ◽

Flexible Endoscopy ◽

New Technique ◽

Thoracic Esophagus ◽

Early Esophageal Cancer ◽

Cervical Incision

Abstract Background: To avoid the inconvenience of triangulation among various rigid operating instruments in Mediastinoscopy-Assisted Esophagectomy，we invent a new technique: Using a flexible endoscope to mobilize thoracic esophagus and dissect mediastinal lymph nodes through the left cervical incision. In this study, we introduce our long-term experience and demonstrate this new technique.Methods: 29 patients with early esophageal cancer underwent Mediastinoscopy-Assisted Esophagectomy in our hospital from June 2018 to September 2020. Among them, 12 patients used flexible mediastinoscopy, and 17 patients used conventional rigid mediastinoscopy and instruments to observe their therapeutic effect. Results: There were no significant differences between the two groups in gender, average age, body mass index, incidence of adverse reactions, bleeding volume and postoperative hospital stay. The operation time of flexible mediastinoscopy group was significantly shorter than that of rigid mediastinoscopy group (192.9±13.0 vs 246.8±6.9 min, p<0.01). The number of lymph nodes removed by flexible endoscopy was significantly more than that of rigid endoscopy (8.5±0.6 vs 6.0±0.3, P<0.01). Postoperative follow-up was completed for all patients, and the average follow-up time was 11.6±7.2 months. During the follow-up period, no recurrence or death was observed. Conclusions: Mediastinoscopy-Assisted Esophagectomy is an effective way to treat early esophageal cancer. The application of flexible mediastinoscopy provides more convenience and better stability. It can facilitate the operation of the surgeon and lymph node dissection, which proved to be a feasible technology.

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Impact of retrieved lymph nodes count on short-term complications in patients with gastric cancer: a retrospective study

10.21203/rs.3.rs-17793/v1 ◽

2020 ◽

Author(s):

Feng Sun ◽

Song Liu ◽

Peng Song ◽

Chen Zhang ◽

Zhijian Liu ◽

...

Keyword(s):

Gastric Cancer ◽

Lymph Node ◽

Postoperative Complications ◽

Lymph Node Metastasis ◽

Lymph Nodes ◽

Operation Time ◽

Short Term ◽

Node Metastasis ◽

Significant Difference ◽

Univariate Analyses

Abstract Background: It is well established that retrieved lymph nodes (RLNs) count were positively correlated with better overall survival in gastric cancer (GC). But little is known about the relationship between RLNs count and short-term complications after radical surgery. Methods: A total of 1487 consecutive GC patients between January 2016 and December 2018 at Nanjing Drum Tower Hospital were retrospectively analyzed. Univariate analyses were performed to elucidate the association between RLNs count and postoperative complications. We further identified clinical factors that might affect the RLNs count.Results: Among all of the patients, postoperative complications occurred in 435 (29.3%) patients. The mean RLNs count was 25.1 and 864 (58.1%) patients were diagnosed with lymph node metastasis. Univariate analyses showed no significant difference between RLNs count and postoperative complications (both overall and stratified by CDC grade). We further explored that preoperative serum albumin, type of resection, operation time, tumor invasion, lymph node metastasis, and pTNM stage were associated with RLNs count. Conclusions: The current study demonstrated that RLNs count was not associated with postoperative short-term complications following gastrectomy of GC, which provided a rationale for the determination of a proper RLNs count of curative gastrectomy.

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Two-port versus three-port video-assisted thoracoscopic surgery for primary spontaneous pneumothorax: feasibility, postoperative outcome and long-term recurrence rates

BMC Surgery ◽

10.1186/s12893-021-01426-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Stephen Fung ◽

Hany Ashmawy ◽

Sami Safi ◽

Anja Schauer ◽

Alexander Rehders ◽

...

Keyword(s):

Postoperative Complications ◽

Hospital Stay ◽

Chest Tube ◽

Spontaneous Pneumothorax ◽

Thoracoscopic Surgery ◽

Length Of Hospital Stay ◽

Operation Time ◽

Postoperative Outcome ◽

Primary Spontaneous Pneumothorax ◽

Recurrence Rates

Abstract Background Two-port VATS (2-P-VATS) and three-port VATS (3-P-VATS) are well-established techniques for surgical therapy of primary spontaneous pneumothorax (PSP). However, comparisons of both techniques in terms of postoperative outcome and recurrence are limited. Methods From January 2010 to March 2020, we retrospectively reviewed data of 58 PSP patients who underwent VATS in our institution. For statistical analysis, categorical and continuous variables were compared by chi-square test or Fisher’s exact test and the Student´s t-test, respectively. Twenty-eight patients underwent 2-P-VATS and 30 were treated with 3-P-VATS. Operation time, length of hospital stay (LOS), total dose of analgesics per stay (opioids and non-opioids), duration of chest tube drainage, pleurectomy volume (PV), postoperative complications and recurrence rates were compared between both groups. Results Clinical and surgical characteristics including mean age, gender, Body-Mass-Index (BMI), pneumothorax size, smoking behaviour, history of contralateral pneumothorax, side of pneumothorax, pleurectomy volume and number of resected segments were similar in both groups. The mean operation time, LOS and total postoperative opioid and non-opioid dose was significantly higher in the 3-P-VATS group compared with the 2-P-VATS group. Despite not being statistically significant, duration of chest tube was longer in the 3-P-VATS group compared with the 2-P-VATS group. In terms of postoperative complications, the occurrence of hemothorax was significantly higher in the 3-P-VATS group (3-P-VATS vs. 2-P-VATS; p = 0.001). During a median follow-up period of 61.6 months, there was no significant statistical difference in recurrence rates in both groups (2/28 (16.7%) vs. 5/30 (7.1%); p = 0.274). Conclusion Our data demonstrate that 2-P-VATS is safer and effective. It is associated with reduced length of hospital stay and decreased postoperative pain resulting in less analgesic use.

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Impact of Retrieved Lymph Nodes Count on Short-Term Complications in Patients with Gastric Cancer

10.21203/rs.3.rs-34560/v1 ◽

2020 ◽

Author(s):

Feng Sun ◽

Song Liu ◽

Peng Song ◽

Chen Zhang ◽

Zhijian Liu ◽

...

Keyword(s):

Gastric Cancer ◽

Lymph Node ◽

Postoperative Complications ◽

Lymph Node Metastasis ◽

Lymph Nodes ◽

Operation Time ◽

Short Term ◽

Node Metastasis ◽

Significant Difference ◽

Univariate Analyses

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Influence of different kinds of surgical resection on operation-related clinical indexes, inflammatory cytokines and complications in elderly patients with esophageal cancer

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.36.3.1465 ◽

2020 ◽

Vol 36 (3) ◽

Author(s):

Tao Zhang ◽

Hai Jiang ◽

Chen Yu Ming ◽

Yan Wang ◽

Deng Mao ◽

...

Keyword(s):

Esophageal Cancer ◽

Elderly Patients ◽

Lymph Nodes ◽

Inflammatory Cytokines ◽

Operation Time ◽

Control Group ◽

Observation Group ◽

Incision Length ◽

Sf 36

Objective: To investigate the effects of two kinds of surgical resection schemes, a conventional open surgical scheme and a thoracolaparoscopic esophagectomy surgical scheme, on operation-related clinical indexes, inflammatory cytokines and complications in elderly patients with esophageal cancer. Methods: A total of 100 elderly patients with esophageal cancer seen in the Department of Cardiothoracic Vascular Surgery, Renmin Hospital, Hubei University of Medicine, from June 2014 to June 2016 were enrolled and randomly divided into two groups, including a control group (50 patients) with a conventional open surgical scheme and an observation group (50 patients) with a thoracolaparoscopic esophagectomy surgical scheme. The operation time, the amount of bleeding during the operation, the incision length, the number of lymph nodes dissected, the hospitalization time, the HAMA scores and HAMD scores before and after the operation, the PSQI scores, SF-36 scores and levels of PCT, CRP and IL-6 after the operation, the recurrence and metastasis rates and the mortality at follow-up and the incidence of related complications of both groups were compared. Results: The operation time, the amount of bleeding during the operation, the incision length and the hospitalization time in the observation group were significantly less than those in the control group (p<0.05). The number of lymph nodes dissected in the observation group was significantly higher than that in the control group (p<0.05). The HAMA scores and HAMD scores after the operation in the observation group were significantly lower than those in the control group and those before the operation (p<0.05). The PSQI scores and SF-36 scores after the operation in the observation group were significantly better than those in the control group and those before the operation (p<0.05). The levels of PCT, CRP and IL-6 after the operation in the observation group were significantly lower than those in the control group (p<0.05). The recurrence and metastasis rates at follow-up in the observation group were significantly lower than those in the control group (p<0.05). There was no significant difference in mortality at follow-up between the two groups (p>0.05). The complication incidence after the operation in the observation group was significantly lower than that in the control group (p<0.05). Conclusion: Compared with a conventional open surgical scheme, the thoracolaparoscopic esophagectomy surgical scheme possesses advantages in the treatment of elderly patients with esophageal cancer, including being a minimally invasive, simple operation, having a shorter recovery time, effectively relieving negative emotions, improving the quality of life, reducing the levels of inflammatory molecules and reducing the risk of related complications. doi: https://doi.org/10.12669/pjms.36.3.1465 How to cite this:Mahjoubi F, Hashemipour M, Moshiri F, Iranpour R, Amini M, . Genetic analysis of TTF2 gene in congenital hypothyroid infants with thyroid dysgenesis. Pak J Med Sci. 2020;36(3):---------. doi: https://doi.org/10.12669/pjms.36.3.1465 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Impact of Retrieved Lymph Nodes Count on Short-term Complications in Patients With Gastric Cancer: A Retrospective Study

10.21203/rs.3.rs-27768/v1 ◽

2020 ◽

Author(s):

Feng Sun ◽

Song Liu ◽

Peng Song ◽

Chen Zhang ◽

Zhijian Liu ◽

...

Keyword(s):

Gastric Cancer ◽

Lymph Node ◽

Postoperative Complications ◽

Lymph Node Metastasis ◽

Lymph Nodes ◽

Operation Time ◽

Short Term ◽

Node Metastasis ◽

Significant Difference ◽

Univariate Analyses

Abstract Background:It is well established thatretrieved lymph nodes (RLNs) count were positively correlated with better overall survival in gastric cancer (GC). But little is known about the relationship between RLNs count and short-term complications after radical surgery.Methods: A total of 1487 consecutive GC patients between January 2016 and December 2018 at Nanjing Drum Tower Hospital were retrospectively analyzed. Univariate analyses were performed to elucidate the association between RLNs count and postoperative complications. We further identified clinical factors that might affect the RLNs count.Results: Among all of the patients, postoperative complications occurred in 435 (29.3%) patients. The mean RLNs count was 25.1 and 864 (58.1%) patients were diagnosed with lymph node metastasis. Univariate analyses showed no significant difference between RLNscount and postoperative complications (both overall and stratified by CDC grade). We further explored that preoperative serum albumin, type of resection, operation time, tumor invasion, lymph node metastasis, and pTNM stage were associated with RLNs count.Conclusions: The current study demonstrated that RLNs count was not associated with postoperative short-term complications following gastrectomy of GC, which provided a rationale for the determination of a proper RLNs count of curative gastrectomy.

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Proximal femoral nail anti-rotation versus cementless bipolar hemiarthroplasty for unstable femoral intertrochanteric fracture in the elderly: a retrospective study

BMC Musculoskeletal Disorders ◽

10.1186/s12891-019-2793-8 ◽

2019 ◽

Vol 20 (1) ◽

Cited By ~ 4

Author(s):

Shenghu Zhou ◽

Jun Liu ◽

Ping Zhen ◽

Weiwei Shen ◽

Yanfeng Chang ◽

...

Keyword(s):

Postoperative Complications ◽

Elderly Patients ◽

Intertrochanteric Fracture ◽

Operation Time ◽

The Elderly ◽

Proximal Femoral Nail ◽

Bipolar Hemiarthroplasty ◽

Intertrochanteric Fractures ◽

Intraoperative Bleeding ◽

Femoral Intertrochanteric Fracture

Abstract Background The treatment for unstable intertrochanteric fractures in the elderly has always been a controversial issue. The aim in this study was to compare the curative effects of proximal femoral nail anti-rotation (PFNA) and cementless bipolar hemiarthroplasty (CPH) on femoral intertrochanteric fracture in the elderly. Methods From March 2008 to December 2012, 108 elderly patients with femoral intertrochanteric fractures were treated by PFNA or CPH. There were 63 males and 45 females, aged 75.3–99.1 years [(83.7 ± 5.6) years]. The patients’ bone mineral density was routinely measured, and the fractures were classified according to Evans-Jensen. The patients were divided into CPH group and PFNA group. The differences in operation time, intraoperative bleeding, immobilization duration, hospitalization time, Harris scores and postoperative complications including deep venous thrombosis, lung and urinary infection were analyzed. Results All patients were followed for 12.5–36.2 months [(28.0 ± 6.3) months)]. The operation time was (53.7 ± 15.2) min and (77.5 ± 16.8) min in PFNA group and CPH group, respectively (P < 0.05); intraoperative bleeding was (132.5 ± 33.2) mL and (286.3 ± 43.2) mL, respectively (P < 0.05); immobilization duration was (28.2 ± 3.7) days and (3.1 ± 1.2) days, respectively (P < 0.05); hospitalization time was (7.6 ± 1.8) days and (6.9 ± 2.2) days, respectively (P > 0.05); and the Harris scores after 1 year were (87.7 ± 7.9) points and (88.3 ± 9.2) points, respectively (P > 0.05). There was no significant difference in postoperative complications between the two groups (P > 0.05). Conclusion Both PFNA and CPH are safe and effective treatments for femoral intertrochanteric fracture in elderly patients. Nonetheless, CPH allows faster mobilization and recovery. Trial registration Registration Number: ChiCTR1900022846. Reg Date:2019-04-26 00:27:33 Retrospective registration

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