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find Author "林文梁" 2 results
  • 胸腔镜微创术后不留置胸腔引流管在快速康复外科中的应用

    目的探讨患者接受胸腔镜微创手术后不留置胸腔引流管的安全性和可行性。 方法回顾性分析2013年1~9月广东省人民医院胸外科20例行胸腔镜微创手术后不留置胸腔引流管患者的临床资料,其中男14例、女6例,年龄36.7(17~68)岁,分析患者术后恢复情况。 结果全组20例患者均顺利完成手术,无围手术期死亡,无二次手术;术后均未出现严重并发症,均不需有创性操作;术后平均住院时间3.5 d,出院后1周复查胸部X线片均无异常。 结论部分患者接受胸腔镜微创手术后不留置胸腔引流管是安全可行的,符合快速康复外科理念。

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  • Video-assisted Thoracic Surgery Sympathectomy under Monitored Anesthesia Care and Local Analgesia for the Treatment of Palmar Hyperhidrosis without Endotracheal Intubation: A Randomized Controlled Trial

    ObjectiveTo investigate the feasibility, safety and effectiveness of video-assisted thoracic surgery (VATS) sympathectomy under monitored anesthesia care (MAC) and local anesthesia (LA) without endotracheal intubation as a new fast track recovery surgical strategy for the treatment of palmar hyperhidrosis. MethodsA total of 124 patients with intermediate or severe hyperhidrosis who were admitted to Guangdong General Hospital were enrolled in this study. With SPSS18 random number generator, all the patients were divided into MAC+LA group and general anesthesia (GA) group with 62 patients in each group. There were 43 males and 19 females in MAC+LA group with their age of 22.25±6.22 years, and 42 males and 20 females in GA group with their age of 23.98±6.67 years. During the surgery, MAC+LA group patients received MAC and oxygen via nasal tube or face mask instead of endotracheal intubation, and GA group patients received GA, endotracheal intubation and controlled ventilation. Clinical outcomes were compared between the 2 groups. ResultsAll the patients received their operations safely. None of MAC+LA group patients received conversion to GA and controlled ventilation. There was statistical difference in operation time (47.18±12.06 minutes vs. 39.33±13.21 minutes, P=0.002) and length of theatre stay 84.52±22.56 minutes vs. 134.68±26.12 minutes, P=0.000) between MAC+LA and GA group patients. There was no statistical difference in blood loss, incidence of intraoperative SpO2 lower than 95% (2 patients vs. 0 patient), postoperative hospital stay, incidence of postoperative compensatory sweating (86.5% vs. 89.0%) and patient satisfaction rate (94.59% vs.95.12%) between the 2 groups. No intraoperative pain, postoperative complication or symptom recurrence was observed in either group. There was statistical difference in anesthetic preparation time (20.52±10.55 minutes vs. 36.47±12.16 minutes), duration between operation finish and returning to ward (11.26±7.09 minutes vs. 59.39±19.89) minutes and hospitalization cost (RMB 6 376.86±746.00 yuan vs. RMB 8 812.04±867.93 yuan) between the 2 groups. The incidence of postoperative sore throat (0% vs. 100%), monitor time (4 hours vs. 12 hours) and time to resume oral intake (2 hours vs. 6 hours) of MAC+LA group were significantly lower or shorter than those of GA group. ConclusionVATS sympathectomy under MAC and LA can avoid complications of GA and endotracheal intubation, and provide a safe, feasible, effective and more minimally invasive fast track alternative for the treatment of palmar hyperhidrosis.

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