ObjectiveTo discuss the advantage and disadvantage of uniport video-assisted thoracic surgery (VATS) versus single utility port VATS in the surgical treatment of benign thoracic diseases. MethodsFrom January 2012 to December 2014, 125 patients with benign thoracic diseases who underwent VATS by the same performer were divided randomly into two groups including a uniport VATS group or a single utility port VATS group. There were 41 males and 24 females with a mean age of 47.5±16.6 years in the uniport VATS group. There were 39 males and 21 females with a mean age of 45.1±15.7 years in the single utility port VATS group. Then the patients were followed up. The perioperative data and follow-up results were compared between two groups. ResultsThe total 125 patients of operations were performed successfully according the established plan, without increasing incisions or transferring to thoracotomy. There were no statistical differences between two groups in operative time (48.9±11.3 min vs. 47.1±11.0 min), intraoperative bleeding volume (26.9±15.4 ml vs. 23.8±13.2 ml), postoperative 24 h chest tube drainage volume (81.5±36.9 ml vs. 77.3±31.2 ml), postoperative chest tube drainage time (2.8±2.0 d vs. 3.4±2.2 d), the pain score on the 3rd postoperative day (2.6±1.2 points vs. 2.6±1.3 points), average in-hospital stay (4.9±2.1 d vs. 5.1±2.2 d) or postoperative complications (P > 0.05). The patients were followed up for 3-24 months. All patients achieved satisfactory results with no recurrence. ConclusionsCompared with single utility port VATS, uniport VATS does not prolong operation time or consume more materials, and has advantages of minimally invasion and higher acceptance. It is a safe and feasible approach in surgical treatment of benign thoracic diseases and worthy of popularization and application.
ObjectiveTo explore the advantages and disadvantages of duodenum-preserving pancreatic head resection (DPPHR) in the clinical application of pancreatic surgical diseases, and to summarize the progress of minimally invasive application of DPPHR combined with the current application of laparoscopy and robot surgery in pancreatic surgery. MethodThe related research literatures about DPPHR at home and abroad in recent years were searched and reviewed. ResultsThe effect of DPPHR compared with traditional pancreaticoduodenectomy (PD) for treatment of benign pancreatic diseases was still controversial, and the postoperative remission effect, perioperative period, occurrence of long-term complications and improvement of quality of life were not very advantageous compared with PD, and the prognosis of minimally invasive surgery was poor. ConclusionDPPHR remains highly controversial for surgical intervention in benign pancreatic disease and has enormous scope for advances in minimally invasive surgical applications in pancreatic surgery, but more clinical studies are needed to verify its clinical efficacy.
Abstract: Objective To investigate the role of video-assisted thoracoscopic surgery (VATS) in treatment of benign pulmonary disease, in order to promo te the mini-invasive way of operation. Methods From May 2001 to M ay 2006, 128 patients with benign pulmonary diseases were treated by VATS. The diseases included 17 kinds of different lesions, such as tuberculosis, bronchiectasis, inflammatory pseudotumor, giant bullae of lung, hamartoma,lymphangiomyomatosis, etc. 53 cases had definite diagnosis before operation, the others had final diagnosis by pathology. Limited resection were performed in 66 cases, single lobectomy in 56 cases, bilobectomy in 2 cases, and concomitant bilateral lobectomy in 4 cases. Limited resections were carried out by pure thoracoscopic procedure with three ports, lobectomies were carried out by video-assisted minithoracotomy with 7-10cm incision. Results For lim ited resect ion, the average operat ive durat ion w as 110m in (30-180m in) , blood loss was 60m l (10-300m l) , none had intraoperative blood transfusion needed. Conversion to minithoracotomy occurred in 2 patients. Postoperative bleeding happened in one case, which was controlled by medicine. Average length of stay was 6. 5 days. For lobectomy, the average operation time was 145 min (80-260min) , blood loss was 190ml (50-500m l) , no intraoperative blood tansfusion needed. Conversion to tranditional thoracotomy occurred in 3 patients, pneumonia occurred in 2 patients, delayed healing of mini-incision occurred in 2 patients. One diaphragmat ic hernia and one active bleeding after operat ion underwent second thoracotomy. Average length of postoperative stay was 7. 4 days (4-13d). For bilateral lobectomies, the average operative duration was 330min (270-415m in) , postoperative length of hospital stay was 10.7days (8-16d). No perioperative death occurred. Conclusion VATS for benign pulmonary disease is miniinvasive and safe, the pat ients recover quickly. It could be the choice of operation for selected patients in equipped center.
【Abstract】Objective To investigate the safety and clinical significance of total thyroidectomy performed for benign thyroid disease. Methods Eighty-eight patients with benign thyroid disease were treated with total thyroidectomy. The postoperative complications were analyzed. Results With primary total thyroidectomy, the incidences of transient hypocalcemia and transient recurrent laryngeal nerve paralysis were 2.5% and 1.2% respectively. The incidences after reoperation were 28.6%（P＜0.05）and 28.6%（P＜0.01）respectively. No patients had permanent hypoparathyroidism and permanent recurrent laryngeal nerve injury. Conclusion Total thyroidectomy can be performed safely. It can avoid reoperation for the recurrence caused by the remainder thyroid.
目的 報道10例血清CA19-9明顯升高的膽管良性疾病病例。方法 回顧性分析2004年1月至2006年3月期間我院收治并經手術證實的10例血清CA19-9明顯升高（gt;500 U/ml）的膽管良性病變病例。結果 患者中男4例，女6例，年齡30~85歲，CA19-9為532.32~12 000.00 U/ml，除1例患者CA125輕度升高外，其他患者血清CEA、CA125及AFP均正常。膽總管結石8例，肝內膽管結石1例，原發性硬化性膽管炎1例； 除1例外均存在不同程度阻塞性黃疸。經治療后8例CA19-9水平在30 d內降至正常，另2例分別于術后2個月和3個月內降至正常。結論 CA19-9在膽管惡性腫瘤診斷方面的意義仍需進一步研究。
ObjectiveTo investigate the efficacy of total thoracoscopy (VATS) lobectomy and the thoracotomy for the treatment of benign lung disease. MethodsWe retrospectively analyzed the clinical data of 70 patients with benign lung diseases in the First People's Hospital of Qujing between January 2012 and September 2013. According to the surgical way, the patients were divided into two groups including a total VATS group involved in 35 patients with 25 males and 10 females, aged 18 to 71 years, mean age of 41.3±6.4 years and a thoracotomy group involved in 35 patients with 26 males and 9 females, aged 19 to 72 years, mean age of 42.4±5.6 years. Then we compared the efficacy of the two groups. ResultsThere was no statistical difference (P > 0.05) in operative time and postoperative survival rate comparison. While in the total VATS group, the total thoracoscopic incision length, bleeding volume or pain time, postoperative day time of analgesia, thoracic drainage volume, postoperative drainage tube pulling time and hospitalization time were all lower than those in the thoracotomy group with statistical differeces (P < 0.05). ConclusionThe thoracoscopic lobectomy for treatment of benign pulmonary lesions is superior to the conventional thoracotomy with much less bleeding and pain, more faster postoperative recovery and less impact on the patient's body. It's suitable for clinical application in normal hospital.
目的 初步探討容易誤診為乳腺癌的乳腺良性疾病的病理類型和臨床特征，提高診斷準確率。方法 回顧性分析了1998年9月至2000年1月收治的50例術前診斷為乳腺癌的乳腺良性疾病。 結果 乳腺炎性疾病、纖維囊性增生或／和積乳囊腫、纖維腺病或／和某些纖維腺瘤均易誤診為乳腺癌；此類乳腺良性疾病捫診的準確性顯著低于乳腺鉬靶攝片和彩超檢查(P＜0.005)。 結論 乳腺良性疾病臨床診斷的準確性有賴于病史、乳腺捫診及乳腺X線攝片和彩超的綜合分析。
目的 介紹胸部良性疾病經單孔胸腔鏡切除術后免胸腔引流管的臨床經驗。 方法 回顧性分析 2015 年 10 月至 2016 年 10 月我院胸外科 17 例行單孔胸腔鏡手術患者的臨床資料，其中男 9 例、女 8 例，年齡 33.8（17～58）歲。行肺大皰切除術 7 例，肺楔形切除術 9 例，交感神經烙斷術 1 例。 結果 所有患者均經單孔胸腔鏡手術有效切除，期間無中轉開胸或再次開操作孔，術后不放置胸腔引流管，手術時間為（60.3±8.2）min，術中出血量為（15.2±5.1）ml，術后第 1 d、2 d、3 d 疼痛視覺模擬評分（VAS） 為 6.5±2.2，5.8±2.1，3.5±1.3，術后舒適度評分分別為 8.6±1.3，術后早期下床活動時間為（1.0±0.3）d，切口甲級愈合率 100.0%。17 例患者均無心律失常、肺部感染等并發癥，術后隨訪 6 個月氣胸均無復發。 結論 合理選擇及嚴格基線評估，胸部良性疾病經單孔胸腔鏡切除術后免胸腔引流管是安全可行的，可能有利于患者術后快速康復。
ObjectiveTo discuss the causes of esophageal benign diseases and how to prevent, diagnose and treat such diseases. MethodsWe reviewed and analyzed the clinical data of 162 patients with esophageal benign diseases treated in our hospital from March 1994 to July 2011. Causes, diagnosis, treatment and prognosis of this kind of diseases were analyzed and summarized. ResultsEighty-five patients had definite inducements. All patients were diagnosed through barium swallow radiography, CT, and gastroscopic inspection and underwent operation. A total of 155 patients were cured by positive treatment, but 7 patients died because of severe infection. ConclusionMost patients suffering from esophageal benign diseases have definite inducements. Therefore, many such diseases can be prevented. Once being confirmed, active surgery is the main treatment. Most patients can be cured if treatment is performed in time.