Objective To evaluate the feasibility of video-assisted minimal access surgery for lobectomy and pneumonectomy. Methods Under general anesthesia, via a video-assisted minimal access approach, anatomical lobectomy or pneumonectomy was performed through a 6- to 8-cm incision. A total of 42 patients, including 33 patients with lung cancer and 9 with benign tumor, received lobectomy (39 cases) or pneumonectomy (3 cases), which were performed under a video vision and a direct vision through the small incision. Results The average operation time was 2.5 h (1.5-4.5 h),and average blood loss was 200 ml (100-500 ml). In one patient, the incision was extended to a length of 12 cm because of tight adhesion between the tumor and the arch of azygos vein. Traditional open surgery was performed on one patient owning to the injury of the pulmonary artery trunk, which was due to the tight adhesion between the lung cancer at the left upper lobe and the pulmonary artery. Eight days after lobectomy, a 72-year-old patient with lung cancer died of respiratory failure caused by infection of the lungs. No operation-related complications occurred in the other 41 patients during a 6- to 47-month follow-up (mean, 18). Among the 32 patients with lung cancer, who were followed up for 8-47 months, 3 died of liver and bilateral lungs metastasis 8, 11, or 17 months after the opearation. Conclusion Video-assisted minimal access surgery is feasible for lobectomy and pneumonectomy.

Objective To investigate curative effects of video-assisted thoracoscopic sympathectomy for the treatment of palmar hyperhidrosis. Methods Under general anesthesia with double-lumen endotracheal intubation,the patient was maintained at a 45? semi-sitting position with two upper limbs fixed on 90? abduction.An incision 0.5~1.5 cm in length was made on the midaxillary line at the fifth intercostal space to introduce the thoracoscope.Another incision 0.3~0.5 cm in length was made on the anterior axillary line at the third intercostal space as manipulation hole.Under video-assisted thoracoscopy,the sympathetic trunk on the T_2~T_4 level was amputated for treating palmar hyperhidrosis.Results The patient's palms became dry and warm immediately after surgery in all 50 patients.The temperature of the palm was increased by 0.2~4.6 ℃.Slight pneumothorax was encountered in 3 patients(lung compression,10%~20%).Compensated hyperhidrosis occurred in 31 patients within 3~15 days after operation,including mild hyperhidrosis in 11 patients and moderate hyperhidrosis in 20 patients.The hyperhidrosis was located at the chest in 13 patients,back in 11 patients,abdomen in 2 patients,thigh in 4 patients,and shank in 1,respectively.There were no Horner's syndrome and other severe complications after operation.None of patients recurred in follow-up observations.Conclusions(Video-assisted) thoracoscopic sympathectomy is a safe and reliable approach for the treatment of palmar hyperhidrosis.