Objective: This study aims to investigate the drainage effect and clinical outcomes of negative pressure chest drainage in patients after two-port thoracoscopic valve surgery, comparing the differences in postoperativ...Objective: This study aims to investigate the drainage effect and clinical outcomes of negative pressure chest drainage in patients after two-port thoracoscopic valve surgery, comparing the differences in postoperative pain, hospital stay, and other factors between the negative pressure group and the control group. Methods: This study is a prospective controlled trial that selected patients undergoing two-port thoracoscopic valve surgery at a certain hospital from January 2019 to December 2024. Patients were randomly assigned to the control group and the negative pressure group using a random number table method. The control group consisted of 30 patients (20 males, 10 females, mean age 42.03 ± 12.89 years), and the negative pressure group consisted of 35 patients (26 males, 9 females, mean age 41.84 ± 11.83 years). The control group received traditional chest drainage, while the negative pressure group received negative pressure chest drainage. Postoperative pain scores, hospital stay, drainage time, number of tube blockages, and incidences of pneumothorax or subcutaneous emphysema were recorded and statistically analyzed. Results: The negative pressure group had a significantly shorter postoperative drainage time compared to the control group (49.09 ± 11.99 hours vs. 79.10 ± 7.32 hours, P < 0.001). The postoperative pain score was lower in the negative pressure group (4.49 ± 1.27 vs. 7.03 ± 0.85, P < 0.001), and the hospital stay was significantly shorter (9.83 ± 1.69 days vs. 14.73 ± 2.32 days, P < 0.001). The incidence of pneumothorax or subcutaneous emphysema was significantly lower in the negative pressure group than in the control group (14.29% vs. 56.67%, P = 0.0003). Conclusion: The application of negative pressure chest drainage in patients after two-port thoracoscopic valve surgery can effectively reduce postoperative pain, shorten hospital stay, and lower the incidence of tube blockage and pneumothorax, demonstrating good clinical outcomes.展开更多
BACKGROUND Esophageal cancer is a prevalent solid malignancy of the gastrointestinal tract.Surgical resection remains an effective intervention for prolonging patient survival.While conventional open surgery demonstra...BACKGROUND Esophageal cancer is a prevalent solid malignancy of the gastrointestinal tract.Surgical resection remains an effective intervention for prolonging patient survival.While conventional open surgery demonstrates therapeutic efficacy,it is often associated with significant tissue trauma,high complication rates,and prolonged recovery period.Advances in imaging technology and refined minimally invasive techniques have led to an increasing adoption of total thoracoscopy-assisted resection among patients.However,the efficacy of total thoracoscopic ultrasonic scalpel resection specifically for esophageal cancer patients remains unclear.AIM To evaluate the efficacy of total thoracoscopic ultrasonic scalpel resection in esophageal cancer patients.METHODS We retrospectively analyzed clinical data from 127 esophageal cancer patients undergoing total thoracoscopy-assisted resection in our hospital from January 2022 to January 2025.Based on surgical technique,61 patients subjected to total thoracoscopic electrosurgical scalpel esophagectomy were included in the control group,while 66 patients receiving total thoracoscopic ultrasonic scalpel esophagectomy were assigned to the observation group.Perioperative outcomes were compared between the two groups,including pain mediators[5-hydroxytryptamine(5-HT),potassium ions(K^(+)),norepinephrine(NE)],immune indices(CD4^(+),CD8^(+),CD4^(+)/CD8^(+)),inflammatory markers[interleukin-6(IL-6),interleukin-8(IL-8),tumor necrosis factor alpha(TNF-α)],as well as pulmonary function parameters[forced vital capacity(FVC),forced expiratory volume in one second(FEV1),maximal voluntary ventilation(MVV)].Besides,complication rates were also assessed.RESULTS Operative time was significantly shorter in the observation group compared to the control group.The observation group demonstrated reduced intraoperative blood loss and lower postoperative chest drainage volume and increased number of dissected lymph nodes(P<0.05 for all).Preoperatively,no significant differences were observed between the two groups in terms of 5-HT,K^(+),NE,CD4^(+),CD8^(+),CD4^(+)/CD8^(+),IL-6,IL-8,TNF-α,FVC,FEV1,and MVV(P>0.05).Postoperatively,both groups showed improvement in measured parameters,with the observation group exhibiting significantly better outcomes,that is,lower 5-HT,K^(+),and NE levels,higher CD4^(+)levels,lower CD8^(+)levels,and higher CD4^(+)/CD8^(+)levels(P<0.05);reduced IL-6,IL-8,and TNF-α(P<0.05);superior FVC,FEV1,and MVV measurements(P<0.05).The total complication rate was significantly lower in the observation group(7.58%vs 21.31%;P<0.05).CONCLUSION Total thoracoscopic ultrasonic scalpel resection demonstrates superior surgical outcomes in esophageal cancer patients compared to electrosurgical techniques.This approach significantly improves perioperative indicators,ameliorates postoperative pain,enhances immune function,alleviates inflammatory responses,and preserves pulmonary function,demonstrating the safety and reliability of this technique in esophageal cancer patients.展开更多
目的探讨胸腔镜肺段切除术后根据连续8 h胸腔引流量(PDV)拔除胸腔引流管的可行性和安全性。方法回顾性分析2022年7月1日-2024年6月30日于该院接受胸腔镜肺段切除术的360例肺结节患者的临床资料。根据8 h PDV拔除胸腔引流管的患者设为8 h...目的探讨胸腔镜肺段切除术后根据连续8 h胸腔引流量(PDV)拔除胸腔引流管的可行性和安全性。方法回顾性分析2022年7月1日-2024年6月30日于该院接受胸腔镜肺段切除术的360例肺结节患者的临床资料。根据8 h PDV拔除胸腔引流管的患者设为8 h组(173例),根据24 h PDV拔除胸腔引流管的患者设为24 h组(187例)。比较两组患者手术相关情况和术后并发症。结果两组患者手术肺叶、手术时间、术中出血量、清扫淋巴结站数、清扫淋巴数量和术后病理比较,差异均无统计学意义(P>0.05)。8 h组术后胸腔引流管留置时间和术后住院时间明显短于24 h组,差异均有统计学意义(P<0.05)。两组患者再次引流率和切口愈合不良率比较,差异均无统计学意义(P>0.05)。结论胸腔镜肺段切除术后,根据8 h PDV拔除胸腔引流管是安全的,具有一定可行性。与传统的根据24 h PDV拔除胸腔引流管方案相比,该方法可更早地拔除胸腔引流管,缩短住院时间。值得临床推广应用。展开更多
A 47-year-old woman presented to our hospital with complaints of dysphagia. Esophagogastroduodenoscopy identified a submucosal tumor in the left wall of the esophagus that was diagnosed as a benign schwannoma on biops...A 47-year-old woman presented to our hospital with complaints of dysphagia. Esophagogastroduodenoscopy identified a submucosal tumor in the left wall of the esophagus that was diagnosed as a benign schwannoma on biopsy. Computed tomography revealed a tumor of length 60 mm in the thoracic esophagus, with its cranial edge at the level of the aortic arch. On endoscopy, a submucosal tunnel was created 40 mm proximal to the cranial edge of the tumor, and its oral end was dissected from the mucosal and muscular layers. This was followed by the resection of the entire tumor by left-sided thoracoscopy. The esophageal defect was closed in layer by continuous suture from the thoracic side. Endoscopic closure was achieved by using clips. No postoperative complications were observed. Oral diet was resumed from postoperative day 7 and the patient was discharged on postoperative day 9. This combined approach has not been described for similar tumors. Our experience demonstrated that large esophageal tumors can be safely excised with minimally invasive surgery by using a combination of thoracoscopy and endoscopy.展开更多
文摘Objective: This study aims to investigate the drainage effect and clinical outcomes of negative pressure chest drainage in patients after two-port thoracoscopic valve surgery, comparing the differences in postoperative pain, hospital stay, and other factors between the negative pressure group and the control group. Methods: This study is a prospective controlled trial that selected patients undergoing two-port thoracoscopic valve surgery at a certain hospital from January 2019 to December 2024. Patients were randomly assigned to the control group and the negative pressure group using a random number table method. The control group consisted of 30 patients (20 males, 10 females, mean age 42.03 ± 12.89 years), and the negative pressure group consisted of 35 patients (26 males, 9 females, mean age 41.84 ± 11.83 years). The control group received traditional chest drainage, while the negative pressure group received negative pressure chest drainage. Postoperative pain scores, hospital stay, drainage time, number of tube blockages, and incidences of pneumothorax or subcutaneous emphysema were recorded and statistically analyzed. Results: The negative pressure group had a significantly shorter postoperative drainage time compared to the control group (49.09 ± 11.99 hours vs. 79.10 ± 7.32 hours, P < 0.001). The postoperative pain score was lower in the negative pressure group (4.49 ± 1.27 vs. 7.03 ± 0.85, P < 0.001), and the hospital stay was significantly shorter (9.83 ± 1.69 days vs. 14.73 ± 2.32 days, P < 0.001). The incidence of pneumothorax or subcutaneous emphysema was significantly lower in the negative pressure group than in the control group (14.29% vs. 56.67%, P = 0.0003). Conclusion: The application of negative pressure chest drainage in patients after two-port thoracoscopic valve surgery can effectively reduce postoperative pain, shorten hospital stay, and lower the incidence of tube blockage and pneumothorax, demonstrating good clinical outcomes.
文摘BACKGROUND Esophageal cancer is a prevalent solid malignancy of the gastrointestinal tract.Surgical resection remains an effective intervention for prolonging patient survival.While conventional open surgery demonstrates therapeutic efficacy,it is often associated with significant tissue trauma,high complication rates,and prolonged recovery period.Advances in imaging technology and refined minimally invasive techniques have led to an increasing adoption of total thoracoscopy-assisted resection among patients.However,the efficacy of total thoracoscopic ultrasonic scalpel resection specifically for esophageal cancer patients remains unclear.AIM To evaluate the efficacy of total thoracoscopic ultrasonic scalpel resection in esophageal cancer patients.METHODS We retrospectively analyzed clinical data from 127 esophageal cancer patients undergoing total thoracoscopy-assisted resection in our hospital from January 2022 to January 2025.Based on surgical technique,61 patients subjected to total thoracoscopic electrosurgical scalpel esophagectomy were included in the control group,while 66 patients receiving total thoracoscopic ultrasonic scalpel esophagectomy were assigned to the observation group.Perioperative outcomes were compared between the two groups,including pain mediators[5-hydroxytryptamine(5-HT),potassium ions(K^(+)),norepinephrine(NE)],immune indices(CD4^(+),CD8^(+),CD4^(+)/CD8^(+)),inflammatory markers[interleukin-6(IL-6),interleukin-8(IL-8),tumor necrosis factor alpha(TNF-α)],as well as pulmonary function parameters[forced vital capacity(FVC),forced expiratory volume in one second(FEV1),maximal voluntary ventilation(MVV)].Besides,complication rates were also assessed.RESULTS Operative time was significantly shorter in the observation group compared to the control group.The observation group demonstrated reduced intraoperative blood loss and lower postoperative chest drainage volume and increased number of dissected lymph nodes(P<0.05 for all).Preoperatively,no significant differences were observed between the two groups in terms of 5-HT,K^(+),NE,CD4^(+),CD8^(+),CD4^(+)/CD8^(+),IL-6,IL-8,TNF-α,FVC,FEV1,and MVV(P>0.05).Postoperatively,both groups showed improvement in measured parameters,with the observation group exhibiting significantly better outcomes,that is,lower 5-HT,K^(+),and NE levels,higher CD4^(+)levels,lower CD8^(+)levels,and higher CD4^(+)/CD8^(+)levels(P<0.05);reduced IL-6,IL-8,and TNF-α(P<0.05);superior FVC,FEV1,and MVV measurements(P<0.05).The total complication rate was significantly lower in the observation group(7.58%vs 21.31%;P<0.05).CONCLUSION Total thoracoscopic ultrasonic scalpel resection demonstrates superior surgical outcomes in esophageal cancer patients compared to electrosurgical techniques.This approach significantly improves perioperative indicators,ameliorates postoperative pain,enhances immune function,alleviates inflammatory responses,and preserves pulmonary function,demonstrating the safety and reliability of this technique in esophageal cancer patients.
文摘目的探讨胸腔镜肺段切除术后根据连续8 h胸腔引流量(PDV)拔除胸腔引流管的可行性和安全性。方法回顾性分析2022年7月1日-2024年6月30日于该院接受胸腔镜肺段切除术的360例肺结节患者的临床资料。根据8 h PDV拔除胸腔引流管的患者设为8 h组(173例),根据24 h PDV拔除胸腔引流管的患者设为24 h组(187例)。比较两组患者手术相关情况和术后并发症。结果两组患者手术肺叶、手术时间、术中出血量、清扫淋巴结站数、清扫淋巴数量和术后病理比较,差异均无统计学意义(P>0.05)。8 h组术后胸腔引流管留置时间和术后住院时间明显短于24 h组,差异均有统计学意义(P<0.05)。两组患者再次引流率和切口愈合不良率比较,差异均无统计学意义(P>0.05)。结论胸腔镜肺段切除术后,根据8 h PDV拔除胸腔引流管是安全的,具有一定可行性。与传统的根据24 h PDV拔除胸腔引流管方案相比,该方法可更早地拔除胸腔引流管,缩短住院时间。值得临床推广应用。
文摘A 47-year-old woman presented to our hospital with complaints of dysphagia. Esophagogastroduodenoscopy identified a submucosal tumor in the left wall of the esophagus that was diagnosed as a benign schwannoma on biopsy. Computed tomography revealed a tumor of length 60 mm in the thoracic esophagus, with its cranial edge at the level of the aortic arch. On endoscopy, a submucosal tunnel was created 40 mm proximal to the cranial edge of the tumor, and its oral end was dissected from the mucosal and muscular layers. This was followed by the resection of the entire tumor by left-sided thoracoscopy. The esophageal defect was closed in layer by continuous suture from the thoracic side. Endoscopic closure was achieved by using clips. No postoperative complications were observed. Oral diet was resumed from postoperative day 7 and the patient was discharged on postoperative day 9. This combined approach has not been described for similar tumors. Our experience demonstrated that large esophageal tumors can be safely excised with minimally invasive surgery by using a combination of thoracoscopy and endoscopy.
