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剑突下电视辅助胸腔镜手术(VATS)治疗前纵隔肿瘤患者24小时出院的可行性。

Feasibility of twenty-four-hour discharge of patients with anterior mediastinal tumors after subxiphoid video-assisted thoracoscopic surgery (VATS) procedure.

作者信息

Zhou Jiayu, Yu Hao, Tani Kengo, He Zhengfu, Li Zhijun

机构信息

Department of Thoracic Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China.

Department of Thoracic and Cardiovascular Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.

出版信息

J Thorac Dis. 2024 Sep 30;16(9):6229-6236. doi: 10.21037/jtd-24-1277. Epub 2024 Sep 26.

Abstract

BACKGROUND

A wide variety of surgical procedures are administrated in day-surgery unit and are able to be discharged within 24 hours with high efficiency, safety and economy. This study sought to evaluate the safety and feasibility of 24-hour discharge of patients with anterior mediastinal tumors after subxiphoid video-assisted thoracoscopic surgery (VATS) and describe our surgery procedure experiences.

METHODS

A total of 70 selected patients with anterior mediastinal tumors undergoing subxiphoid VATS were included in this prospective study. The patients' clinical features, intraoperative and postoperative complications were assessed, and postoperative pain scale and satisfaction scores were also evaluated.

RESULTS

The subxiphoid VATS was completed with no conversion to open surgery in all included patients and were all discharged within 24 hours after surgery. The mean operative time ± standard deviation (SD) was 70.50±18.98 min, and the mean operative blood loss volume ± SD was 45.50±15.25 mL. In addition, 80% of the patients reported a postoperative pain scale score less than 3 by the day before discharge, and all patients expressed satisfaction with receiving VATS in the day-surgery unit at 2 weeks after discharge.

CONCLUSIONS

The use of subxiphoid VATS is a safe, efficient and feasible surgical approach for patients with anterior mediastinal tumors discharged within 24 hours.

摘要

背景

日间手术单元开展了各种各样的外科手术,患者能够在24小时内高效、安全且经济地出院。本研究旨在评估剑突下电视辅助胸腔镜手术(VATS)治疗前纵隔肿瘤患者24小时出院的安全性和可行性,并描述我们的手术操作经验。

方法

本前瞻性研究纳入了70例经选择的接受剑突下VATS的前纵隔肿瘤患者。评估患者的临床特征、术中及术后并发症,并评估术后疼痛量表评分和满意度评分。

结果

所有纳入患者均成功完成剑突下VATS,无一例转为开放手术,且均在术后24小时内出院。平均手术时间±标准差(SD)为70.50±18.98分钟,平均术中失血量±SD为45.50±15.25毫升。此外,80%的患者在出院前一天报告术后疼痛量表评分低于3分,所有患者在出院后2周对在日间手术单元接受VATS表示满意。

结论

对于前纵隔肿瘤患者,采用剑突下VATS是一种安全、高效且可行的手术方法,可实现24小时出院。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/becd/11494595/d9d5d21a7eae/jtd-16-09-6229-f1.jpg

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