Abstract:
BACKGROUND:The aim of this study was to reveal the short-term outcomes of video-assisted thoracoscopic surgery (VATS) segmentectomy without tracheal intubation compared with intubated general anesthesia with one-lung ventilation (OLV). METHODS:We performed a retrospective review of our institutional database of consecutive 140 patients undergoing VATS anatomical segmentectomy from July 2011 to June 2015. Among them, 48 patients were treated without tracheal intubation using a combination of thoracic epidural anesthesia (TEA), intrathoracic vagal blockade, and sedation (non-intubated group). The other 92 patients were treated with intubated general anesthesia (intubated group). Safety and feasibility was evaluated by comparing the perioperative profiles and short-term outcomes of these two groups. RESULTS:Two groups had comparable surgical durations, intraoperative blood loss, postoperative chest tube drainage volume, and numbers of dissected lymph nodes (P>0.05). Patients who underwent non-intubated segmentectomy had higher peak end-tidal carbon dioxide (EtCO2) during operation (44.81 vs. 33.15 mmHg, P<0.001), less white blood cell changes before and after surgery (△WBC) (6.08×10(9) vs. 7.75×10(9), P=0.004), earlier resumption of oral intake (6.76 vs. 17.58 hours, P<0.001), shorter duration of postoperative chest tube drainage (2.25 vs. 3.16 days, P=0.047), less cost of anesthesia (¥5,757.19 vs. ¥7,401.85, P<0.001), and a trend toward shorter postoperative hospital stay (6.04 vs. 7.83 days, P=0.057). One patient (2.1%) in the non-intubated group required conversion to intubated OLV since a significant mediastinal movement. In the intubated group, there was one patient (1.1%) required conversion to thoracotomy due to uncontrolled bleeding. The incidence difference of postoperative complications between groups was not significant (P=0.248). There was no in-hospital death in either group. CONCLUSIONS:Compared with intubated general anesthesia, non-intubated thoracoscopic segmentectomy is a safe, technically feasible and economical alternative with comparable short-term outcomes. Patients underwent non-intubated thoracoscopic segmentectomy could gain a prompt recovery.
journal_name
J Thorac Disjournal_title
Journal of thoracic diseaseauthors
Guo Z,Yin W,Pan H,Zhang X,Xu X,Shao W,Chen H,He Jdoi
10.21037/jtd.2016.02.50subject
Has Abstractpub_date
2016-03-01 00:00:00pages
359-68issue
3eissn
2072-1439issn
2077-6624pii
jtd-08-03-359journal_volume
8pub_type
杂志文章abstract:BACKGROUND:To assess the correlation of WHO histological classification of thymomas and thymic carcinomas (TCs) with prognosis in recently treated patient cohort compared to a historical one from a single institution. METHODS:Retrospective review of clinical charts and histological sections of 241 patients treated dur...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2016.03.24
更新日期:2016-04-01 00:00:00
abstract::The bidirectional interaction between sleep-disordered breathing (SDB) and stroke has been the subject of many studies. On the one hand, different forms of SDB, and especially obstructive sleep apnea, increase the risk of stroke either directly or indirectly by influencing other known cardiovascular risk factors such ...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2018.12.66
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:A clinical trial of extracorporeal membrane oxygenation (ECMO) as an alternative ventilator tool is being performed as a new indication for ECMO. The purpose of this study was to evaluate the feasibility of awake ECMO to increase the success rate of weaning patients from ECMO and ventilator care during treat...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.3978/j.issn.2072-1439.2016.01.32
更新日期:2016-01-01 00:00:00
abstract::This review provides an update on the current role of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) and mediastinoscopy (Med) in assessment of patients with non-small cell lung cancer (NSCLC). Invasive mediastinal lymph node (LN) staging is the major application for both of these techniq...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2017.03.102
更新日期:2017-03-01 00:00:00
abstract::Histological characteristics and clinical behaviour define lung neuroendocrine tumors (NETs), which are classified into four groups: typical (TC) and atypical carcinoids (AC), large-cell neuroendocrine carcinomas (LCNCs) and small-cell lung cancers (SCLCs). Historically, outcome and treatment of these rare neoplasms h...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2018.04.104
更新日期:2018-10-01 00:00:00
abstract::China offers great opportunities for Europe in thoracic surgery training and research. Thoracic surgeons from Europe might profit from intense collaborations and on the other hand provide assist in academic structures, creating guidelines and patient follow-up strategies. With an observership award the AME Publishing ...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2016.09.27
更新日期:2016-09-01 00:00:00
abstract:Background:Although morphological abnormalities of the heart appear to be remarkable, most patients with tako-tsubo cardiomyopathy (TTC) remain clinically stable. We investigate real time changes in the left ventricular (LV) and right ventricular (RV) mechanics and function to explore the mechanism to preserve hemodyna...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2018.04.143
更新日期:2018-05-01 00:00:00
abstract:Background:Pulmonary nocardiosis often occurs among immunocompromised patients, especially in those with impaired cell immunity related to AIDS and transplant. As the number of patients receiving transplant, the occurrence of pulmonary nocardiosis may also increase. Radiologic characteristics of this entity have not be...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2017.09.122
更新日期:2017-11-01 00:00:00
abstract::Post pneumonectomy bronchopleural fistula (BPF) is a life-threatening complication requiring pleural cavity drainage to avoid acute mediastinal shift and contralateral aspiration pneumonia. Chest drain insertion in this situation may be technically difficult because of drastic anatomical changes such as mediastinal di...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2017.11.145
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:Paired basic amino acid-cleaving enzyme 4 (PACE4) was shown to enhance tumor cells proliferation and invasive. This study provides the first investigation of PACE4 expression in non-small cell lung cancer (NSCLC) and the correlation with clinicopathologic features, prognostic indicators of 172 cases. METHOD...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.3978/j.issn.2072-1439.2015.05.09
更新日期:2015-05-01 00:00:00
abstract:Background:Pacing parameters may influence pacing lead life and pacemaker life. This study sought to determine whether different right atrial active-fixation lead implantation parameters are associated with chronic pacing performance. Methods:A retrospective observational study was conducted on all consecutive patient...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2019.04.04
更新日期:2019-04-01 00:00:00
abstract::Obstructive sleep apnea (OSA) is a disorder which afflicts a large number of individuals around the world. OSA causes sleepiness and is a major cardiovascular risk factor. Since its inception in the early 1980's, continuous positive airway pressure (CPAP) has emerged as the major treatment of OSA, and it has been show...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.3978/j.issn.2072-1439.2015.07.30
更新日期:2015-08-01 00:00:00
abstract:Background:The novel HeartMate 3 (Abbott, Chicago, IL, USA) left ventricular assist device (LVAD) was worldwide first implanted by Prof. Schmitto and his team in 2014 at the Hannover Medical School, Germany and received CE Mark approval in October, 2015 following completion of a clinical trial. Methods:Although HeartM...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2018.01.26
更新日期:2018-06-01 00:00:00
abstract::The incidence of pulmonary nodules and lung cancer is rising. Some of this increase in incidence is due to improved pick up by newer imaging modalities. However, the goal is to diagnose these lesion, many of which are located in the periphery, by safe and relatively non-invasive methods. This has led to the emergence ...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2016.02.73
更新日期:2016-07-01 00:00:00
abstract::We reported the case of a 70-year-old man who was admitted to neurologic wards for recurrent syncope for 3 years. Unfortunately, just 2 hours after his admission, he suddenly collapsed and failed to return of spontaneous circulation (ROSC) after a 100-minute standard cardiopulmonary resuscitation (CPR). Fortunately, h...
journal_title:Journal of thoracic disease
pub_type:
doi:10.3978/j.issn.2072-1439.2014.12.23
更新日期:2014-12-01 00:00:00
abstract::A 22-year-old young man with a history of idiopathic dilated cardiomyopathy (IDC) was admitted to our hospital due to difficult-to-control heart failure. A thoracic X-ray showed multiple nodules at the both pulmonary hilus and upper lobe of the right lung. Computed tomography (CT) angiography of the thorax confirmed a...
journal_title:Journal of thoracic disease
pub_type:
doi:10.3978/j.issn.2072-1439.2014.07.39
更新日期:2014-09-01 00:00:00
abstract:BACKGROUND:(18)F-FDG PET/CT is increasingly used in evaluation of treatment response for patients with non-small cell lung cancer (NSCLC). There is a need for an accurate criterion to evaluate the effect and predict the prognosis. The aim of this study is to evaluate therapeutic response in NSCLC with comparing PET res...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.3978/j.issn.2072-1439.2014.05.10
更新日期:2014-06-01 00:00:00
abstract::Analyses of cell-free tumor DNA (ctDNA) have provided a non-invasive strategy for cancer diagnosis, the identification of molecular aberrations for treatment identification, and evaluation of tumor response. Sensitive and specific ctDNA sequencing strategies have allowed for implementation into clinical practice for t...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2020.01.66
更新日期:2020-05-01 00:00:00
abstract::We present an unusual case of partial anomalous venous drainage in which the vein of the right upper lobe drains into the superior vena cava, together with the azygos vein. This was discovered during surgery for a lung tumor of the right upper lobe. We present the embryological background, functional consequences and ...
journal_title:Journal of thoracic disease
pub_type:
doi:10.3978/j.issn.2072-1439.2015.10.02
更新日期:2015-10-01 00:00:00
abstract::Increased recognition of advantages, over the last decade, of minimizing surgical trauma by operating through smaller incisions and its direct impact on reduced postoperative pain, quicker recovery, improved cosmesis and earlier return to work has spurred the minimally invasive cardiac surgical revolution. This transi...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.3978/j.issn.2072-1439.2013.11.01
更新日期:2013-11-01 00:00:00
abstract::Chronic obstructive pulmonary disease (COPD) associates with several extra-pulmonary effects. Muscle dysfunction and wasting is one of the most prominent extra-pulmonary effects and contributes to exercise limitation and health related quality of life (HRQoL), morbidity as well as mortality. The loss of muscle mass is...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2018.05.81
更新日期:2018-05-01 00:00:00
abstract::We present a case involving alveolar adenoma (AA) comprising a malignant component. An 83-year-old man was referred with a solitary pulmonary nodule, which was diagnosed as adenocarcinoma (AC) by transbronchial biopsy. Resected specimen after left S1+2 segmentectomy revealed that the tumor comprised two histologically...
journal_title:Journal of thoracic disease
pub_type:
doi:10.21037/jtd.2016.03.37
更新日期:2016-05-01 00:00:00
abstract::Patients with locally advanced esophageal cancer are treated with definitive chemoradiation (dCXRT) for a number of reasons. Some patients are never referred to a surgeon for a con-versation about surgery, others decline surgery, and some are not candidates for surgery due to a sag in performance status secondary to t...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.3978/j.issn.2072-1439.2014.03.29
更新日期:2014-05-01 00:00:00
abstract::Liquid biopsy refers to the use of various body fluids to test for circulating biological elements derived from the tumor. Liquid biopsy has taken on an increasingly important role in lung cancer diagnosis, molecular characterization, surveillance, monitoring, and determining mechanisms of resistance. These assays can...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2020.04.20
更新日期:2020-11-01 00:00:00
abstract:Background:Multimorbidity is increasing common in Brazilian adults. Comorbid chronic lung disease, cardiovascular disease and diabetes are often inaccurately diagnosed or ineffectively treated. The Global Alliance against Chronic Respiratory Diseases (GARD) aims to strengthen health systems to prevent and control non-c...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2018.07.34
更新日期:2018-07-01 00:00:00
abstract:Background:Pulmonary complications (PCs) may influence long-term survivor. We sought to determine the long-term impacts of major pulmonary complications (MPCs) and identify the independent risk factors in non-small cell lung cancer (NSCLC) patients. Methods:A retrospective study was conducted to analyze the PCs of 828...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2017.10.144
更新日期:2017-12-01 00:00:00
abstract::Idiopathic pulmonary fibrosis (IPF) is the most common cause of interstitial lung disease (ILD) and carries a worse prognosis than many cancers. Until recently, there were no active treatment options available for patients with IPF, meaning palliation or lung transplantation in selected patients were the only options....
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2017.10.111
更新日期:2017-11-01 00:00:00
abstract:Background:There is a lack of data regarding the incidence and associated factors of pneumothorax following thoracentesis conducted in emergency department (ED) settings. The present study aims to determine the incidence of pneumothorax following thoracentesis in ED settings and evaluate the association of specific dem...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2017.08.127
更新日期:2017-10-01 00:00:00
abstract:BACKGROUND:Metachronous malignancy is also found in the lung cancer population and may be identified before or after diagnosis of lung cancer. No prior studies have documented lung cancer patients with metachronous malignancy and its survival impact in this population. The aim of this study was to try to clarify the su...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2016.04.45
更新日期:2016-06-01 00:00:00
abstract::As indications for heart-lung transplant (HLT) have changed to some degree in the past 30 years, this treatment is being used less frequently in children due to more advanced care of severe heart and lung disease. This is fortunate as the outcomes for HLT are poor compared to other solid organ transplants and this is ...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.3978/j.issn.2072-1439.2014.07.05
更新日期:2014-08-01 00:00:00