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吉林大学学报（医学版） 2006年第4期32卷 711-713页

作者：李志军张影付彤张彬吉林大学第一医院胸外科吉林长春130021 吉林大学中日联谊医院内科吉林长春130033 内蒙古民族大学附属医院胸外科内蒙古通辽028000

目的:探讨胸腔镜与腋下小切口治疗自发性气胸的疗效。方法:143例患者按手术时间和患者自身对手术的选择性分为腋下小切口治疗组(n=96)和胸腔镜治疗组(n=47)。所有病例均为外科治疗适应证。二组均采用肺大泡切除及壁层胸膜机械性磨擦。... 详细信息

目的:探讨胸腔镜与腋下小切口治疗自发性气胸的疗效。方法:143例患者按手术时间和患者自身对手术的选择性分为腋下小切口治疗组(n=96)和胸腔镜治疗组(n=47)。所有病例均为外科治疗适应证。二组均采用肺大泡切除及壁层胸膜机械性磨擦。腋下小切口组加胸顶部胸膜切除术。疗效评价指标包括:术中及术后失血量、术后疼痛及止痛药物用量、术后并发症、住院时间,正常生理功能的恢复、自发性气胸的复发及治疗费用。结果:术中及术后失血量、术后疼痛、止痛药物用量、正常生理功能的恢复、自发性气胸的复发在两组间比较差异无显著性(P>0.05),但在治疗费用方面腋下小切口组低于胸腔镜组(P<0.05)。结论:胸腔镜和腋下小切口对于治疗自发性气胸有着相似的治疗结果,安全、可靠、创伤小、疼痛轻,术后并发症少、复发率低。

关键词：气胸/外科学胸外科手术电视辅助/方法腋下小切口对比研究

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Perioperative nurse training in cardiothoracic surgical robotics.

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AORN journal 2001年第6期74卷 851-852页

作者： Connor, M.A. Reinbolt, J.A. Handley, P.J. Center for Advanced Surgery Sarasota Memorial Hospital Sarasota Fla. USA.

The exponential growth of OR technology during the past 10 years has placed increased demands on perioperative nurses. Proficiency is required not only in patient care but also in the understanding, operating, and troubleshooting of video systems, computers, and cutting edge medical devices. The formation of a surgical team dedicated to robotically assisted cardiac surgery requires careful selection, education, and hands-on practice. This article details the six-week training process undertaken at Sarasota Memorial Hospital, Sarasota, Fla, which enabled staff members to deliver excellent patient care with a high degree of confidence in themselves and the robotic technology.

关键词：冠状动脉分流术/仪器和设备冠状动脉分流术/方法冠状动脉分流术/护理佛罗里达在职培训/方法围手术期护理/教育规划制订机器人/教育技术转让胸外科手术电视辅助/仪器和设备胸外科手术电视辅助/方法胸外科手术电视辅助/护理美国人类

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Video-assisted thoracoscopic treatment for spontaneous pneumothorax as two-day surgery

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AMERICAN JOURNAL OF SURGERY 2000年第3期180卷 171-173页

作者： Maruyama, R Oka, T Anai, H Oita Natl Hosp Dept Thorac Surg Oita Japan Saiseikai Fukuoka Gen Hosp Dept Thorac Surg Fukuoka Japan

BACKGROUND: TO see whether video-assisted thoracoscopic surgery (VATS) for spontaneous pneumothorax (SP) as 2-day surgery is a safe and cost-effective procedure, we retrospectively compared VATS as 2-day surgery with standard VATS. METHODS: From April 1994 to March 2000, 139 SP patients were operated on: 115 patients were operated on by means of standard VATS and 24 were treated by 2-day surgery. The parameters we compared were the postoperative complications, hospitalization cost, and relapses. RESULTS: Excepting that 2 of those selected for 2-day surgery required another hospitalization, short-term complications were considered to be similar for the two groups. The median economic cost of 2-day surgery was about $5,822 US dollars and was lower than that of standard VATS. The difference in the recurrence rate between the two groups was not significant. CONCLUSIONS: We conclude that VATS as 2-day surgery is a safe and cost-effective procedure. Am J Surg. 2000;180:171-173. (C) 2000 by Excerpta Medica, Inc.

关键词：费用效益分析日本住院时间气胸/外科学手术后并发症回顾性研究胸外科手术电视辅助/经济学胸外科手术电视辅助/方法时间因素治疗结果青少年成年人老年人儿童女(雌)性人类男(雄)性中年人

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Video-assisted thoracoscopic lobectomy achieves a satisfactory long-term prognosis in patients with clinical stage IA lung cancer

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WORLD JOURNAL OF SURGERY 2000年第1期24卷 27-31页

作者： Sugi, K Kaneda, Y Esato, K Natl Sanyo Hosp Dept Clin Res Ube Yamaguchi 7550241 Japan Yamaguchi Univ Sch Med Dept Surg 1 Ube Yamaguchi 7558505 Japan

We designed a prospective trial to determine the long-term prognosis of video-assisted thoracoscopic (VATS) lobectomy versus conventional lobectomy for patients with clinical stage IA (T1N0M0) lung cancer. Between January 1993 and June 1994, 100 consecutive patients with clinical stage IA non-small cell lung carcinoma underwent either conventional lobectomy through an open thoracotomy (open group;n = it) or VATS lobectomy (VATS group;a = 48). Lymph node dissections were performed in a similar manner in both groups. No significant differences were observed in the number of dissected lymph nodes between the 2 groups. Pathologic N1 and N2 disease was found in 3 and 1 patients, respectively, from the open group, and in 2 and 1 patients, respectively, from the VATS group. During the follow-up period, distant metastases and focal or regional recurrences developed in 7 and 3 of the open group patients, respectively, and in 2 and 3 of the VATS group patients, respectively. Two and one of the open and VATS group patients developed second primary cancers, respectively. The overall survival rates 5 years after surgery were 85% and 90% in the open and VATS groups, respectively (log-rank test, p = 0.74;generalized Wilcoxon test, p = 0.91). VATS lobectomy with lymph node dissection achieved an excellent 5-year survival, similar to that achieved by the conventional approach.

关键词：癌非小细胞肺/死亡率癌非小细胞肺/病理学癌非小细胞肺/外科学随访研究肺肿瘤/死亡率肺肿瘤/病理学肺肿瘤/外科学淋巴转移肿瘤复发局部/流行病学肿瘤分期肺切除术/方法预后前瞻性研究胸外科手术电视辅助/方法时间因素老年人女(雌)性人类男(雄)性中年人

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Video-assisted thoracoscopic surgery for children with stage II empyema

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AMERICAN SURGEON 2000年第6期66卷 569-572页

作者： Rodriguez, JA Hill, CB Loe, WA Kirsch, DS Liu, DC Childrens Hosp New Orleans Div Pediat Surg New Orleans LA 70118 USA Louisiana State Univ Sch Med New Orleans LA USA

Children with stage II empyema often fail traditional medical management, frequently succumbing to the effective albeit morbid clutches of thoracotomy. Video-assisted thoracoscopic surgery (VATS) has been recently introduced as a viable and potentially less morbid alternative to open thoracotomy, We review our VATS experience in children with empyema, assessing surgical outcome. Between August 1996 and March 1999, 13 patients at our institution with stage II empyema that did not respond to conventional medical management underwent a modified VATS with decortication, Data from retrospective chart review reflects intraoperative findings and postoperative course, including average time to defervescence, removal of thoracostomy tube, and hospital discharge. VATS was completed in all 13 patients. All intraoperative cultures of pleural fluid and fibrinopurulent debris obtained at VATS showed no growth, The average time to defervescence was 2.2 days (range, 0-4 days) and to removal of thoracostomy tube 3.6 days (range, 2-5 days). Average total chest tube days in patients with pre-VATS thoracostomy (n = 6) was 14.5 days (range, 8-37 days) versus 3.1 days (range, 2-5 days) in patients (n = 7) who underwent primary VATS (t test, p < 0.05). The average time to surgical discharge after VATS was 5.8 days (range, 3 to 19 days). All patients were well on follow-up clinic visits without delayed complications. VATS can be performed safely and effectively in children with stage II empyema, thus avoiding the morbidity of open thoracotomy and decortication. Importantly, early application of VATS significantly relieves patients of unnecessary days of thoracostomy drainage.

关键词：积脓胸腔/分类积脓胸腔/外科学回顾性研究胸外科手术电视辅助/方法青少年儿童儿童学龄前人类婴儿婴儿新生

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Videothoracoscopic surgery in the year 2000

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MEDICINA CLINICA 2000年第9期114卷 336-338页

作者： Molins, L Hosp Sagrado Corazon Serv Cirugia Torac Barcelona Spain

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Minimal damage during endoscopic latissimus dorsi muscle mobilization with the harmonic scalpel

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ANNALS OF THORACIC SURGERY 2000年第5期69卷 1399-1401页

作者： Inaba, H Kaneko, Y Ohtsuka, T Ezure, M Tanaka, K Ueno, K Takamoto, S Univ Tokyo Fac Med Dept Cardiothorac Surg Bunkyo Ku Tokyo 11386255 Japan

Background. To reduce wound-related complications, a video-assisted surgical technique has been adopted for the mobilization of the latissimus dorsi muscle. We postulated that thermal damage to the muscle might be minimized by using a Harmonic Scalpel instead of electrocautery during this procedure. Methods. Canine latissimus dorsi muscles were mobilized through a small incision, assisted by a videoscope. In 6 dogs, dissection with electrocautery was used to mobilize the latissimus dorsi muscle. In 6 other dogs, the Harmonic Scalpel was used. We compared operation times, wound infection rates, histologic changes in the muscles, and ease of handling between these groups. Results. The operation time was significantly shorter in the Harmonic Scalpel group Wan in the electrocautery group (61.5 versus 106.5 minutes, p = 0.00014). The Harmonic Scalpel caused less histologic damage to the mobilized muscles and produced less vision-obscuring smoke. Conclusions. The Harmonic Scalpel shortens the operation, minimizes muscle damage, and facilitates the performance of video-assisted latissimus dorsi muscle mobilization. (C) 2000 by The Society of Thoracic Surgeons.

关键词：电凝术肌骨骼/损伤肌骨骼/外科学外科器械胸外科手术电视辅助/方法动物狗

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Thoracoscopic lung biopsy - Five commonly asked questions about video-assisted thoracic surgery

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POSTGRADUATE MEDICINE 1999年第4期106卷 139-+页

作者： Shrager, JB Kaiser, LR Univ Penn Sch Med Dept Surg Div Cardiothorac Surg Philadelphia PA 19104 USA

Video-assisted thoracic surgery has changed the way in which many lung diseases are diagnosed and treated. With this innovative procedure, the discomfort and morbidity of more invasive means of obtaining biopsy specimens can often be avoided. Drs Shrager and Kaiser answer same of the most commonly asked questions about this exciting advance in thoracic medicine.

关键词：活组织检查/方法硬币病变肺/诊断胸部疾病/诊断胸外科手术电视辅助/方法人类

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Clinical experience with video-assisted thoracic sympathectomy through the retrosternal pulmonary junction

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ANNALS OF THORACIC SURGERY 1999年第6期68卷 2361-2363页

作者： Yamamoto, H Okada, M Kanehira, A Yamada, A Kawamura, M Kyowa Hosp Dept Surg Kobe Hyogo Japan Kobe Univ Sch Med Dept SurgHyougo Hosp Div 2 Kobe Hyogo 6500017 Japan

A new technique of video-assisted thoracic sympathectomy through retrosternal pulmonary junction can be done safely using a scope guide and a flexible scope. Bilateral thoracic sympathectomy was performed, employing a single skin incision, in 18 patients with palmar hyperhidrosis. The advantages include minimal neuralgia and superior cosmesis. (C) 1999 by The Society of Thoracic Surgeons.

关键词：手多汗症/外科学交感神经切除术/方法胸外科手术电视辅助/方法胸部/神经支配青少年成年人人类

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Thymic cystectomy through subxyphoid by video-assisted thoracic surgery

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ANNALS OF THORACIC SURGERY 1999年第6期68卷 2339-2341页

作者： Akamine, S Takahashi, T Oka, T Kishimoto, K Ayabe, H Nagasaki Univ Sch Med Dept Surg 1 Nagasaki 8528501 Japan

In this paper we present a new technique for thymic cystectomy by video-assisted thoracic surgery. The thoracoscope was inserted using a Vein Harvest (Ethicon Endo-Surgery Co, Ltd, Cincinnati, OH) through a 5-cm subxyphoid incision. A Harmonic Scalpel (Ethicon Endo-Surgery) and Cherry Dissector (Ethicon Endo-Surgery) were used for dissection. The thymic cyst was successfully removed through the incision without thoracotomy. The advantage of this technique is that it is less invasive than video-assisted thoracic surgery through the thorax, removing the need for a thoracotomy. (C) 1999 by The Society of Thoracic Surgeons.

关键词：纵隔囊肿/外科学胸外科手术电视辅助/方法老年人女(雌)性人类

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