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Application of Video-Assisted Thoracoscopic Surgery for Thoracic Diseases

Author: HuangChaoRong
Tutor: SongZuoFeng
School: Lanzhou University
Course: Human Anatomy,Histology and Embryology
Keywords: Video-assisted thoracoscopic surgery Chest Diseases Minimally Invasive Surgery
CLC: R655
Type: Master's thesis
Year: 2008
Downloads: 30
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Abstract


Objective: To evaluate and summarize the video-assisted thoracoscopic surgery (VATS) in certain of chest disease diagnosis and treatment, as well as the specific application of different chest diseases. Method: August 2003 to June 2008, 63 cases of thoracic surgical patients using video-assisted thoracoscopic surgical treatment, including 48 cases of male and 15 were female, age 34 to 82 (average 67.6 years). Repeated episodes of spontaneous pneumothorax bulla resection of 30 cases, emphysema bullae resection in 6 cases, 13 cases of pulmonary benign and malignant disease surgery, the traumatic hemopneumothorax 6, two cases of esophageal disease surgery, two cases of palmar hyperhidrosis, trauma two cases of anterior mediastinal hematoma surgery, two cases of chronic empyema surgery. Seven cases of secondary chest wall small incision surgery. Than injury accident and emergency outside the rest of the patients 3 months to 34 years duration, with an average of 23.4 months. To extract the conventional thoracotomy over the same period 57 cases of the control group, 46 male and 11 female patients, aged 19 to 76 (mean 59.6) years old. Penetrating injury to the eight cases in which left chest, right chest, penetrating wounds four cases, 14 patients (Ⅰ five cases, Ⅱ of eight cases, Ⅲ a period of 1 case), benign tumors of the lung in 5 cases, 2 cases of achalasia two cases of esophageal disturbing noise chamber, esophageal leiomyoma, emphysema and lung bullae spontaneous pneumothorax in 21 cases, in addition to acute trauma the rest of the patient's course of 2 months to 41 years, with an average of 17.6 months. Complete the appropriate surgical treatment of the disease to take the traditional surgical practices. All patients who had no history of thoracic surgery. The surgeon completed in all cases by the same surgeon, anesthesia with double-lumen tube intubation single lung ventilation, observe the two treatment methods impact the patient anatomy and physiology indicators, intraoperative and postoperative complications and postoperative recovery conducted Comparison of statistical treatment. Specifically explore the application of skills and experience in a variety of VATS surgery. Results: All patients were all successful, no operative mortality and conversion to thoracotomy. VATS surgery is open, closed chest for no more than 15min, significantly shorter than conventional incision surgery (P <0.05). Length of the incision, intraoperative blood loss, postoperative chest lead pipe pull out time, postoperative incisional pain, chest pain, the degree of application of analgesics, surgery side shoulder and upper limb activities affect the ability to cough and deep breathing, postoperative forced postoperative reaction the observation of a number of indicators of the resistance low-grade fever and body temperature returned to normal time, postoperative complications, perioperative mortality after 3 days, 7 days lung function, postoperative oxygen time, ambulation time, post-operative hospitalization time VATS group was significantly better than conventional thoracotomy group (P <0.05, intraoperative blood loss, after 3 days and 7 days the lung function MVVP <0.01). The bulla of spontaneous pneumothorax single disease are two ways indicators comparison, single-lung ventilation surgery no difference (P> 0.05). Incision length, switch chest, blood loss, operative time, postoperative bed time and postoperative hospital stay VATS group was significantly superior to conventional thoracotomy group (P <0.05). Successfully applied to the diagnosis and treatment of diseases of Thoracic Surgery. In all cases in addition to the first three days of the thoracotomy group 1 patients due to acute left ventricular failure to rescue died, the rest were cured and complete follow-up of 3 months to 58 months (thoracotomy group lost 3 cases of traumatic hemopneumothorax patients), the results were satisfactory. Conclusions: Video-assisted thoracoscopic surgery (VATS) compared to traditional open-chest surgery with less trauma, high security, fewer perioperative complications, rapid postoperative recovery and many other advantages; With the improvement of surgical techniques, surgical equipment and devices constantly improve the video-assisted thoracoscopic technique in the diagnosis and treatment of certain pleural disease in applications will be more and more extensive and broad prospects.

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