Background The present research is designed to evaluate the short-term outcome of robot-assisted thoracoscopic surgery (RATS) for the treatment of posterior mediastinal neurogenic tumors. Methods We retrospectively analyzed clinical data on 39 consecutive patients with mediastinal neurogenic tumors after RATS treatment completed by the same operator in the Department of Thoracic Surgery, Gansu Provincial People's Hospital from January 2016 to September 2022. There were 22 males and 17 females with a mean age of (35.1 ± 6.9) years in this analysis report. The tumors of the patients were localized and evaluated preoperatively using magnetic resonance imaging (MRI) or enhanced CT. Results All 39 patients successfully underwent the resection of posterior mediastinal neurogenic tumors under RATS, and no conversion to thoracotomy occurred during the operations. The average operative time was (62.1 ± 17.2) min, the average docking time was (10.1 ± 2.5) min, the average intraoperative bleeding was (32.8 ± 19.5) ml, the average 24-h postoperative chest drainage was (67.4 ± 27.9) ml, the average postoperative chest drainage time was (2.2 ± 1.3) days and the average post-operative hospital stay was (3.2 ± 1.3) days. Postoperative complications occurred in 3 patients, including 2 patients with transient Horner's syndrome after surgery and 1 patient with transient anhidrosis of the affected upper limb after surgery. Conclusion RATS for posterior mediastinal neurogenic tumors is safe, effective, feasible and bring the superiority of robotic surgical system into full play.
Objective To assess the impact of da Vinci robot versus thoracoscopic surgery on body trauma and lymphocyte subsets in lung cancer patients. Methods Retrospective analysis of 352 patients with lung cancer treated by minimally invasive surgery completed by the same operator in the Department of Thoracic Surgery, Gansu Provincial People's Hospital from October 2019 to October 2022. The patients were divided into a robotic-assisted thoracic surgery(RATS) group (n = 159) and a video-assisted thoracoscopic surgery group(VATS) (n = 193) according to the surgical procedure. Propensity score matching analysis (PSM) was performed in both groups, and perioperative indicators were recorded. Levels of inflammatory markers (C-reactive protein, CRP; interleukin-6, IL-6) and lymphocyte subsets (CD3+, CD4+, CD8+, CD4+/CD8+) were measured 1 day before surgery, 1, 3 and 5 days after surgery, respectively. To compare the effects of the two surgical procedures on the trauma and lymphocyte subsets of the patient's organism. Results 138 patients in each group after PSM. The operative time, intraoperative bleeding, postoperative drainage time, and drainage flow were all lower in the RATS group than in the VATS group, with statistically significant differences (P < 0.05). The levels of CRP and IL-6 increased in both groups after surgery compared with those before surgery, and the increase was less in the RATS group than in the VATS group. Postoperative T-lymphocyte levels were lower in both groups compared with preoperative levels, and T-lymphocyte levels were significantly lower in the VATS group compared with the RATS group (P < 0.05). Conclusion Compared with thoracoscopic radical lung cancer surgery, robotic radical lung cancer surgery is clinically superior because it is less invasive, induces less inflammatory response in the body, has faster recovery, and has less suppressive effects on lymphocyte subpopulations.
perioperative deaths. After PSM, 79 patients were successfully matched in each of the two groups. Two cases of pneumothorax, three cases of hemothorax and four cases of decoupling occurred in the Hook-wire group; no complications of pneumothorax, hemothorax and decoupling occurred in the 3D reconstruction group. Compared with the Hook-wire group, the 3D reconstruction group had shorter operative time Objective: To analyze and compare the clinical application value of three-dimensional reconstruction and CT-guided Hook-wire localization row lung segment resection for pulmonary nodules. Methods: Retrospective analysis of the clinical data of 204 patients with pulmonary nodules admitted to the Department of Thoracic Surgery of Gansu Provincial People's Hospital from June 2016 to December 2022. The group was divided into a 3D reconstruction group (98 cases) and a Hook-wire group (106 cases) according to the preoperative positioning method. The two groups of patients were propensity score matching(PSM) to compare the perioperative outcomes of patients in both groups. Results: All patients in both groups completed the surgery successfully with no perioperative deaths. After PSM, 79 patients were successfully matched in each of the two groups. Two cases of pneumothorax, three cases of hemothorax and four cases of decoupling occurred in the Hook-wire group; no complications of pneumothorax, hemothorax and decoupling occurred in the 3D reconstruction group. Compared with the Hook-wire group, the 3D reconstruction group had shorter operative time (P=0.001), less intraoperative bleeding (P<0.001), and shorter postoperative hospital stay (P=0.026), and there was no statistically significant difference between the two groups in terms of pathological type and TNM staging (P=0.316). Conclusion: Pulmonary nodules are based on three-dimensional reconstruction and localization, and individualized thoracoscopic anatomical lung segment resection is safe and effective with a low complication rate, which has good clinical application value.
Objective: Systematic evaluation of the efficacy and safetyof robotic-assisted laparoscopic myomectomy (RALM)versus laparoscopic myomectomy (LM). Methods: PubMed, Embase, The Cochrane Library and Web of Science database were searched by computer to seek relevant literatures in order to compare the efficacy and safety of RALM with that of LM from the establishment of the databases to January 2023, and Review Manager5.4 software was utilized to perform a meta-analysis of the literatures. Results: A total of 15 retrospective clinical controlled studies were included. There exists a total of 45702 patients, among 11618 patients in the RALM group and the remaining 34084 patients in the LM group. Meta-analysis results revealed that RALM was associated with less intraoperative bleeding(MD=-32.03, 95%CI -57.24 to -6.83, P=0.01), lower incidence of blood transfusions(OR=0.86, 95%CI 0.77 to 0.97, P=0.01), shorter postoperative hospital stay(MD=-0.11, 95%CI -0.21 to -0.01, P=0.03), fewer transitions to open stomach(OR=0.82, 95%CI 0.73 to 0.92, P=0.0006) and lower incidence of post-operative complications(OR=0.58, 95%CI 0.40 to 0.86, P=0.006) than LM; whereas, LM is more advantageous in terms of operating time(MD=38.61, 95%CI 19.36 to 57.86, P<0.0001); no statistically significant difference between the two surgical approaches in terms of maximum myoma diameter(MD=0.26, 95%CI -0.17 to 0.70, P=0.24). Conclusion In the aspects of intraoperative bleeding, lower incidence of blood transfusions, postoperative hospital stay, transit open stomach rate and post-operative complications, RALM has unique advantage than that of LM; while LM has advantages over RALM in terms of operating time.
Objective: To compare the efficacy and safety of robotic-assisted thoracoscopic surgery (RATS) with video-assisted thoracoscopic surgery (VATS) in the treatment of mediastinal cysts. Methods: Retrospective analysis on clinical data of 70 cases of minimally invasive surgery for mediastinal cysts completed in the Department of Thoracic Surgery, Gansu Provincial People's Hospital from April 2014 to December 2022. There were 34 cases in the RATS group with a cyst diameter of (3.70±1.16) cm and 36 cases in the VATS group with a cyst diameter of (4.07±1.20) cm. All cysts were evaluated preoperatively using MRI or chest CT localization. Surgery-related indices were compared among the two groups. Results: All patients in both two groups successfully completed resection of mediastinal cysts without perioperative deaths. Compared with the VATS group, the RATS group possessed shorter operative time [(75.32±17.80) min vs. (102.22±19.80) min, P<0.001], lesser intraoperative bleeding [(10.29±6.39) ml vs. ±1.37) ml vs. (3.08±1.08) ml, P=0.004], and shorter postoperative hospital stay [(3.26±1.36) d vs. (4.64±1.13) d, P=0.001]. There was no statistically significant discrepancy in intermediate openings and complications in both two groups (P>0.05). Conclusion: Compared with VATS, RATS is safer and more effective in the treatment of mediastinal cysts and thus has advantages in operative time, intraoperative bleeding, postoperative chest drainage time and postoperative hospital stay.
Objective A meta-analysis was conducted to assess the impact of miRNAs in circulation on diagnosing benign and malignant pulmonary nodules (BPNs and MPNs). Methods Electronic databases such as Embase, PubMed, Web of Science, and The Cochrane Library were utilized for diagnostic tests of circulating miRNAs to diagnose BPNs and MPNs from the library creation to February 2023. Meta-analysis of the included literature was performed using Stata 16, Meta-Disc 1.4, and Review Manager 5.4 software. This study determined the combined sensitivity, specificity, diagnostic ratio (DOR), positive/negative likelihood ratios (PLR/NLR), as well as value of area under the receiver operating characteristic (ROC) curve. Results This meta-analysis included 14 publications and 17 studies. According to our findings, the pooled sensitivity for miRNA in diagnosing benign and malignant pulmonary nodules was 0.82 [95% CI (0.74, 0.88)], specificity was 0.84 [95% CI (0.79, 0.88)], whereas the DOR was 22.69 [95% CI (13.87, 37.13)], PLR was 5.00 [95% CI (3.87, 6.46)], NLR was 0.22 [95% CI (0.15, 0.32)], and an area under the subject working characteristic curve (AUC) of 0.89 [95% CI (0.86, 0.91)]. Conclusion Circulating miRNAs could be used with sensitivity, specificity, DOR, PLR, NLR, and AUC as biomarkers to diagnose pulmonary nodules (PNs). However, because of the significant heterogeneity of the studies included, more research is needed to determine the optimum miRNA combinations for diagnosing PNs.
Background To compare the difference of short-term curative effect between the use of Maryland forceps (MF) and electrocoagulation hooks (EH) in da Vinci robot-assisted thoracoscopic mediastinal tumor resection. Methods Analyze retrospectively 84 patients with mediastinal tumors treated with robot-assisted thoracoscopic surgery (RATS) at the Department of Thoracic Surgery of Gansu Provincial Hospital from February 2019 to February 2023. Two groups were divided according to the intraoperative use of energy devices, including 41 cases in the MF group and 43 cases in the EH group. Perioperative clinical data were collected to compare the recent outcomes of patients in both groups. Results There were no statistically significant differences between the two groups in terms of baseline indicators such as sex, age, and tumor size. Compared with the EH group, patients in the MF group have lower operative time, intraoperative bleeding, postoperative hospital stay and the levels of IL-6, IL-8, TNF-α, and cortisol were lower in the MF group than that in the EH patients, with statistically significant differences (P < 0.05). Conclusion RATS for mediastinal tumors using MF is safe and effective, which can reduce the amount of bleeding and reduce the degree of inflammatory reaction.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
334 Leonard St
Brooklyn, NY 11211
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.