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【文摘发布】经剑突手辅助电视胸腔镜手术
Title:
Transxiphoid Hand-Assisted Videothoracoscopic Surgery
Background: We have performed transxiphoid hand-assisted videothoracoscopy since 1995 to allow manual palpation in bilateral lung metastasectomy. This approach was extended to other thoracoscopic procedures requiring a handport. No extensive report about early and late results has yet been published.
Methods: We retrospectively reviewed the first 100 consecutive patients undergoing transxiphoid hand-assisted videothoracoscopy. Acute and chronic postoperative pain, respiratory function, patient’s satisfaction score (1 to 5), quality of life (Short Form-36), and survival rate were evaluated.
Results: Seventy-four patients had lung metastases, 5 had primary lung cancers, 16 had benign nodules, and 5 had Morgani’s hernia. Five patients needed conversion to thoracotomy, whereas 7 successfully underwent a second transxiphoid operation. Sixty-five metastatic patients were bilaterally explored, 44 were without radiologic evidence of controlateral lesions, discovering 23 occult metastases and 10 patients with occult controlateral disease. A total of 207 minimal resections and 11 lobectomies were performed. Mean operative time was 103 ± 35 minutes. We had no intraoperative mortality or major complications. Thirty-day postoperative morbidity documented arrhythmia (n = 4) and acute pneumonia (n = 4). Visual Analogue Scale pain, C-reactive protein, fibrinogen, and serum interleukin-6, -8, and -10 normalized within 72 hours. Respiratory function and most of the Short Form-36 domains recovered within 3 months. Six-month mean patient satisfaction score was 4.0 ± 0.8. Three- and 5-year survival rates for metastatic patients were 52% and 43%, respectively. Mean disease-free interval was 12 ± 5.8 months.
Conclusions: Transxiphoid hand-assisted videothoracoscopy proved a good alternative to conventional approaches, and provided rapid recovery without affecting the survival rate in those patients with metastatic lesions. We recommend it whenever a handport during video-assisted procedure is required.
链接：
http://ats.ctsnetjournals.org/cgi/content/abstract/83/6/1978 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领。 [标签:content1][标签:content2]
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作者:admin@医学,生命科学 2011-03-12 23:56
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