八十岁非小细胞肺癌患者的自发通风视频辅助胸腔镜手术:一个非劣势性研究
Yulin Zhao1,2, Xuanzhuang Lu1,2, Runchen Wang1
1Department of Thoracic Surgery and Oncology, the First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China.
Translational lung cancer research
|January 20, 2025
概括
自发通风 (SV) - 视频辅助胸腔镜手术 (VATS) 是八十多岁的非小细胞肺癌 (NSCLC) 患者的安全和可行的选择. 这种方法为机械通风 (MV) -VATS提供了与机械通风 (MV) 相似的生存结果,恢复时间更短.
科学领域:
- 胸部外科手术 胸部外科手术
- 在瘤学瘤学.
- 麻醉学 麻醉学
背景情况:
- 视频辅助胸腔镜手术 (VATS) 是一种对非小细胞肺癌 (NSCLC) 的微创方法.
- 八十岁以上 (80岁以上) 的患者在胸部手术方面面临着独特的挑战.
- 在这个老年人群中,自发通风 (SV) -VATS的好处没有得到充分的证据.
研究的目的:
- 评估SV-VATS在患有NSCLC的八十岁患者中的安全性和可行性.
- 为了比较SV-VATS和机械通风 (MV) -VATS之间的术后结果和生存率.
主要方法:
- 在80岁以上的NSCLC患者中 (2017-2022) 进行了回顾性研究,比较了SV-VATS和MV-VATS.
- 倾向性得分匹配 (PSM) 用于平衡基线特征 (1:2比).
- 分析的结果包括手术内和手术后的参数,整体存活率 (OS) 和无病存活率 (DFS).
主要成果:
- 在PSM之后,SV-VATS组中有22名患者,MV-VATS组中有44名患者.
- 在SV-VATS组,麻醉后护理单位 (PACU) 停留和复苏时间显著缩短.
- 没有观察到手术/麻醉时间,胸管持续时间,血液流失,住院或并发症的显著差异. OS和DFS是可以比较的.
结论:
- 对于八十岁的NSCLC患者来说,SV-VATS是一种安全且可行的手术选择.
- 它在减少PACU停留和复苏时间方面提供了潜在的好处.
- 需要进一步的大规模前性研究来证实这些发现.
相关概念视频
Mechanical Ventilation III: Noninvasive Ventilation
76
Noninvasive positive-pressure ventilation (NIPPV), continuous positive airway pressure (CPAP), and bilevel positive airway pressure (BiPAP) are essential methods in respiratory care. These ventilation techniques offer unique benefits for patients with various respiratory conditions, providing adequate support without requiring intubation. Let's explore how each method is crucial in improving patient outcomes and enhancing respiratory therapy.
Noninvasive Positive-Pressure Ventilation...
Noninvasive Positive-Pressure Ventilation...
76
Endoscopic Studies II: Thoracocentesis
196
Thoracentesis(Thoracocentesis), commonly known as pleural tap, is a medical procedure where a 22 gauge needle is inserted into the pleural space, the area between the lung and chest wall. This procedure is commonly performed to diagnose or treat various respiratory disorders.
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
196
Tracheostomy Decannulation
107
Tracheostomy decannulation is a significant milestone in the liberation of mechanically ventilated patients. Despite its importance, there is no universally accepted protocol for this procedure. This demands an evidence-based, individualized approach.
Description of the Procedure
Decannulation refers to the permanent removal of the tracheostomy tube, signaling the resolution of the condition that initially necessitated the tracheostomy. The process requires a well-coordinated interplay between...
Description of the Procedure
Decannulation refers to the permanent removal of the tracheostomy tube, signaling the resolution of the condition that initially necessitated the tracheostomy. The process requires a well-coordinated interplay between...
107
Endoscopic Studies I: Bronchoscopy and Thoracoscopy
173
Endoscopy is a non-surgical medical technique used to examine a person's internal organs and vessels. This lesson will focus on two types of endoscopic studies: bronchoscopy and thoracoscopy.
Bronchoscopy
Description
Bronchoscopy is a procedure that involves direct visualization of the larynx, trachea, and bronchi for diagnostic and therapeutic purposes. A flexible fiber optic or rigid bronchoscope is used to carry out the procedure. The fiber-optic bronchoscope is more frequently used due...
Bronchoscopy
Description
Bronchoscopy is a procedure that involves direct visualization of the larynx, trachea, and bronchi for diagnostic and therapeutic purposes. A flexible fiber optic or rigid bronchoscope is used to carry out the procedure. The fiber-optic bronchoscope is more frequently used due...
173
Mechanical Ventilation II: Invasive Ventilation
107
Ventilators are essential medical equipment used to aid patients with respiratory difficulties. Their primary function is to assist or replace spontaneous breathing by providing mechanical ventilation. There are two general classes of mechanical ventilators: negative-pressure and positive-pressure ventilators.
Negative-Pressure Ventilators
Negative-pressure ventilators create a vacuum around the chest or body to draw air into the lungs, simulating breathing. This method does not require an...
Negative-Pressure Ventilators
Negative-pressure ventilators create a vacuum around the chest or body to draw air into the lungs, simulating breathing. This method does not require an...
107
Tracheostomy Care II: Procedure
114
Tracheostomy care is an essential nursing skill that involves cleaning and maintaining a tracheostomy tube to prevent infection and other complications. Here's a step-by-step guide explaining each procedure with its rationale. Note that disposable gloves are to be worn at all times and changed as often as needed to maintain a sterile work environment, and to protect both patient and healthcare worker.
Step 1: Perform hand hygiene, and put on personal protective equipment: gown, gloves, mask...
Step 1: Perform hand hygiene, and put on personal protective equipment: gown, gloves, mask...
114


