ObjectiveTo investigate the effect of changing of body posture on video-assisted thoracoscopic surgery for pulmonary bullae. MethodsFrom January 2011 to October 2012, 28 patients with pulmonary bullae including 21 males and 7 females were admitted to our department. The median age of these patients was 18 years old, ranging from 16 to 61. All patients were divided into two groups:video-assisted pulmonary bullae resection with changing of body posture (n=14) and without changing of body posture (n=14). Surgery time, blood loss during operation, drainage, duration of drainage, length of stay in hospital, incidence of complications and recurrence rate were observed and compared between the two groups. ResultsSurgery time in the non-change group was shorter than that in the change group (P<0.05). Blood loss during operation in the non-change group was less than that in the change group (P<0.05). There were no significant difference in drainage, duration of drainage, length of stay in hospital and recurrence rate between the two groups (P>0.05). No complications occurred. ConclusionFor patients with bilateral bullae having tolerated cardiopulmonary function and not-heavy pleural adhesions, non-changing of body posture is safe and effective, not only to avoid a second surgery, but also to avoid turning over and second surgical disinfection, which is more beneficial to the patients.
ObjectiveTo explore the learning curve of single pore video-assisted thoracoscopic surgery (VATS) for the treatment of pulmonary bullae. MethodsFrom July 2010 to October 2011, sixty consecutive patients with pulmo-nary bulla undergoing single pore VATS by the same group of surgeons in the Department of Thoracic and Cardiovascular Surgery, Songgang People's Hospital. According to the sequence of the operations, all the patients were divided into group A, B, and C with 20 patients in each group. Operation time, intraoperative blood loss, postoperative hospital stay and thoracic drainage duration were compared between the 3 groups to evaluate surgical outcomes in different stages. Operation time and postoperative hospital stay were the main indexes of the learning curve. ResultsThere was no statistical difference in age, gender or incidence of pneumothorax between the 3 groups (P > 0.05). Operation time of group A (42.7±9.4 minutes) was significantly longer than those of group B (21.3±6.7 minutes) and group C (20.8±7.5 minutes) (P < 0.01). Postoperative hospital stay of group A (10.6±2.2 days) was significantly longer than those of group B (7.6±1.2 days) and group C (7.4±1.2 days) (P < 0.05). There was no statistical difference in other indexes among the 3 groups (P > 0.05). ConclusionThe learning curve of single pore VATS for the treatment of pulmonary bullae is approximately 20 cases.