ObjectiveTo evaluate the impact of video-assisted thoracoscopic surgery (VATS) esophagectomy and routine operation on the short-term quality of life in patients with esophageal cancer. MethodsFrom January 2012 through January 2014, 157 esophageal cancer patients were classified into a VATS group (n=42) and a routine operation group (n=115) in our hospital. All patients in the two groups completed the Chinese versions of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (QLQ)-C30 and QLQ-OES18 at one, six and 12 months after operation separately. ResultsAt the end of 6, 12 months after operation, the evaluation on global health status was higher in the VATS group(68.8±12.3 vs. 62.7±13.7, P<0.05; 76.2±10.4 vs. 68.6±8.8, P<0.05). At the end of 1, 6, 12 months after operation, the scores of symptom pain were less significantly in the VATS group than those in the routine operation group (P<0.05). One month after operation, the score of active ability in the VATS group was higher (P<0.05). At the end of 6, 12 months after operation, the score of emotional function and social role in the VATS group was higher (P<0.05). At the end of 12 months after operation, the score of role function and cognitive function in the VATS group was also higher (P<0.05). ConclusionVATS is of better effect on improving short-term quality of life of esophageal cancer patients compared with routine operation.
Objective To investigate clinical outcomes of complete video-assisted thoracoscopic lobectomy and summarize our preliminary experience. Methods Clinical data of 60 consecutive patients who underwent complete video-assisted thoracoscopic lobectomy in General Hospital of Chengdu Military Command from March 2010 to August 2011 were retrospectively reviewed. There were 37 male patients and 23 female patients with their median age of 52.1 （17-77） years. There were 7 patients undergoing left upper lobectomy， 19 patients undergoing left lower lobectomy， 12 patients undergoing right upper lobectomy， 3 patients undergoing right middle lobectomy， 17 patients undergoing right lower lobectomy， and 2 patients undergoing combined right middle and lower lobectomy. Results The average operation time was 161 （50-270） minutes， average intra-operative blood loss was 310 （50-800） ml， average number of lymph node dissection was 13.4 （6-29）， average postoperative thoracic drainage was 950 （250-2 800） ml， average duration of thoracic drainage was 4.6 （3-11） days， average intensive care unit stay was 1.2 （1-3） days， and average postoperative hospital stay was 7.7（4-14） days. None of the patients had any severe postoperative complication. Fifty-two patients were followed up for 7 to 24 months， and 8 patients were lost during follow-up. During follow-up， 5 patients had lung cancer metastases， including 2 patients with mediastinal lymph node metastases and 3 patients with distant metastases. After chemoradiotherapy，3 patients lived well but 2 patients died. None of the other patients had any severe complication during follow-up. Conclusion Complete video-assisted thoracoscopic lobectomy is a safe and effective surgical strategy for patients with benign or malignantpulmonary disease.
Objective To investigate the impact of complete video-assisted thoracoscopic lobectomy and open lobectomy on perioperative heart rate （HR） and blood oxygen saturation （SO2） of lung cancer patients，and explore whether minimally invasive surgery can enhance postoperative recovery of lung cancer patients. Methods A total of 138 lung cancer patients were chosen from 161 consecutive patients with pulmonary diseases who were admitted to West China Hospital of Sichuan University between September 2010 and December 2011. According to different surgical approach，all the 138 lung cancer patients were divided into routine thoracotomy group （thoracotomy group，70 patients including 53 males and 17 females with their average age of 56.1±9.7 years） and complete video-assisted thoracoscopic lobectomy group （VATS group，68 patients including 46 males and 22 females with their average age of 53.4±6.5 years）. There was no statistical difference in preoperative clinical characteristics between the 2 groups. Preoperative and postoperative （1st，3rd，7th and 30th day） numeric pain rating scale （NPRS），HR and SO2 were compared between the 2 groups. Results （1） There was no statistical difference in NPRS on the 1st and 3rd postoperative day between the 2 groups （3.83±0.79 vs. 3.93±0.67， 2.88±0.59 vs. 3.03±0.71，P＞0.05），but on the 7th and 30th postoperative day，NPRS of the thoracotomy group was signi- ficantly higher than that of VAST group （1.61±0.33 vs. 1.22±0.12，1.58±0.26 vs. 1.19±0.31，P＜0.05）. （2） Postop- erative sedentary HR of both VATS group and thoracotomy group were significantly higher than preoperative levels ［（84.13±17.21） / minute vs. （73.67±10.32）/minute， （86.13 ±19.67） / minute vs. （72.24±14.21） / minute， P＜0.05］. Postoperative HR of VATS group decreased to preoperative level on the 3rd postoperative day，while postoperative HR of the thoracotomy group decreased to preoperative level on the 7th postoperative day. （3） There was no statistical difference between preoperative and postoperative （all the time points） sedentary SO2 of both VATS group and thoracotomy group （96.34 %±2.11% vs. 97.12%±2.31%，95.33%±4.13% vs. 94.93% ±4.31%，P＞0.05）.（4） The changes of HR and SO2 before and after exercise of VATS group were significantly smaller than those of the thoracotomy group on the 3rd postoperative day ［（11.11±4.81）/minute vs. （18.23±6.17）/minute，3.1%±1.2% vs. 7.4 %±2.7%，P＜0.05］ . Conclusion The impact of complete video-assisted thoracoscopic lobectomy on cardiopulmonary function is comparatively smaller，which is helpful for postoperative fast-track recovery of lung cancer patients.