Transoral endoscopic surgery versus conventional thoracoscopic surgery for thoracic intervention: safety and efficacy in a canine survival model

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• 作者：Chien-Ying Liu (1)
  Yen Chu (2)
  Yi-Cheng Wu (2)
  Hsu-Chia Yuan (2)
  Po-Jen Ko (2)
  Yun-Hen Liu (2)
  Hui-Ping Liu (3)
  
• 关键词：Surgical ; Technical ; Endoscopy ; Thoracoscopy
• 刊名：Surgical Endoscopy
• 出版年：2013
• 出版时间：July 2013
• 年：2013
• 卷：27
• 期：7
• 页码：2428-2435
• 全文大小：586KB
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• 作者单位：Chien-Ying Liu (1)
  Yen Chu (2)
  Yi-Cheng Wu (2)
  Hsu-Chia Yuan (2)
  Po-Jen Ko (2)
  Yun-Hen Liu (2)
  Hui-Ping Liu (3)
  
  1. Department of Thoracic Medicine, Chang Gung University, 5, Fushing Street, Gueishan Shiang, Taoyuan, 333, Taiwan, ROC
  2. Laboratory Animal Center, Department of Surgery, Chang Gung Memorial Hospital at linko, Chang Gung University, 5, Fushing Street, Gueishan Shiang, Taoyuan, 333, Taiwan, ROC
  3. Department of Surgery, Benq Medical Center, 71 Hexi Avenue, Jianye District, Nanjing, China
  
• ISSN：1432-2218

文摘

Purpose Transoral endoscopic surgery has been shown to be feasible and safe in both humans and animal models. The purpose of this study was to evaluate the safety and efficacy of transoral and conventional thoracoscopy for thoracic exploration, surgical lung biopsy, and pericardial window creation. Methods The animals (n?=?20) were randomly assigned to the transoral endoscopic approach group (n?=?10) or conventional thoracoscopic approach group (n?=?10). Transoral thoracoscopy was performed with a flexible bronchoscope via an incision over the vestibulum oris. In conventional thoracoscopy, access to the thoracic cavity was obtained through a thoracic incision. Surgical outcomes (body weight, operating time, operative complications, and time to resumption of normal diet), physiologic parameters (respiratory rate, body temperature), inflammatory parameters [white blood cell (WBC) counts and C-reactive protein (CRP)], and pulmonary parameters (arterial blood gases) were compared for both procedures. Results The surgical lung biopsy and pericardial window creation were successfully performed in all animals except one animal in the transoral group. There was no significant difference in operating times between the groups. The increase in WBC in the transoral thoracoscopy group was significantly smaller on postoperative day 1 than in the conventional thoracoscopy group (p?=?0.0029). The transoral group had an earlier return to preoperative body temperature (p?=?0.041) and respiratory rate (p?=?0.045) on day 7. With respect to pulmonary parameters, there was no significant difference in blood pH, pCO2, or PaCO2 between the transoral and transthoracic groups. All animals survived without complications 14?days after surgery. Conclusions This study demonstrated that the transoral approach was comparable to conventional thoracoscopic surgery for lung biopsy and pericardial window creation in terms of safety and efficacy.