Comparison of hemodynamic and inflammatory changes between transoral and transthoracic thoracoscopic surgery.
Comparison of hemodynamic and inflammatory changes between transoral and transthoracic thoracoscopic surgery.
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DOI：
10.1371/journal.pone.0050338
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Liu HP
中科院分区：
文献类型：
--
作者：
Chu Y;Liu CY;Wu YC;Hsieh MJ;Chen TP;Chao YK;Wu CY;Yuan HC;Ko PJ;Liu YH;Liu HP
自然孔腔内窥镜已发展为腹部外科手术。本研究的目的是比较新型经口入路和标准经胸入路对犬模型胸腔的手术效果。28只狗被分配到经口（n = 14）或标准胸腔镜（n = 14）。每组均行胸部探查、预先确定的手术肺活检和心包窗创建。术前及术后第1、3、7、14天抽血。比较两种手术的手术时间、并发症、实验室参数、血流动力学参数和炎症参数。对动物进行两周的监测，并进行尸检以评估手术结果。除了经口组的一只动物外，所有的狗都成功地进行了胸部手术。无与手术相关的严重急性或延迟并发症。两个手术组的血流动力学参数均无差异。关于手术的免疫学影响，经口胸腔镜与标准胸腔镜相比，分别在术后第1天和第3天白细胞介素6和c反应蛋白水平显著升高。所有的狗恢复良好，没有纵隔炎或胸部感染的迹象。尸检显示没有感染，重要器官没有损伤，证实了新手术的成功。这项研究表明，两种技术在手术成功率、血流动力学影响和炎症变化方面具有可比性。此外，两组术后不适发生率无差异。
Natural orifice transluminal endoscopy has been developed for abdominal surgical procedures. The aim of this study was to compare the surgical outcome between a novel transoral approach and a standard transthoracic approach for the thoracic cavity in a canine model. Twenty-eight dogs were assigned to transoral (n = 14) or standard thoracoscopy (n = 14). Each group underwent thoracic exploration, pre-determined surgical lung biopsy, and pericardial window creation. Blood draws were obtained before surgery and at postoperative days 1, 3, 7, and 14. Operative time, complications, laboratory parameters, hemodynamic parameters, and inflammatory parameters were compared between the two procedures. The animals were monitored for two weeks and necropsy were performed for surgical outcome evaluation. The thoracic procedures were successfully performed in all of the dogs, with the exception of one animal in the transoral group. There were no serious acute or delayed complications related to surgery. There was no difference between the two surgical groups for each of the hemodynamic parameters that were evaluated. Regarding the immunological impact of the surgeries, transoral thoracoscopy was associated with significant elevations in interleukin 6 and c-reactive protein levels on postoperative days 1 and 3, respectively, when compared with the standard thoracoscopy. All dogs recovered well, without signs of mediastinitis or thoracic infection. Necropsy revealed absence of infection, no injury to vital organs, and confirmed the success of the novel procedure. This study suggests that both techniques were comparable with respect to procedure success rate, hemodynamic impact, and inflammatory changes. Furthermore, there was no difference in the incidence of postoperative discomfort between groups.
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影响因子：
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