Humans ; Sympathectomy ; adverse effects ; methods ; Thoracoscopy ; adverse effects ; methods

Esophageal surgery has developed for almost 100 years. Esophagectomy can be performed via left, right thoracotomy, even via hiatus without thoracotomy due to its unique anatomic characteristics. Left thoracotomy was the initial approach in the world, and has still been performed by Chinese colleagues, but Ivor Lewis (right side thoracotomy) procedure is popular in western countries. Currently, esophagectomy by right thoracotomy has been accepted worldwide since its radical dissection for tumor. Therefore, video-assisted thoracoscopic esophagectomy based on right thoracotomy will be the mainstream surgery for esophageal cancer in the future since its minimal invasion and tumor dissection.
Esophageal Neoplasms ; surgery ; Esophagectomy ; methods ; Humans ; Thoracoscopy ; methods

OBJECTIVETo evaluate the outcomes of thoraco laparoscopic esophagectomy venus open esophagectomy for esophageal cancer.

METHODSLiterature search was performed using PubMed, Embase, Cochrane Library, and Google Scholar databases, CBM, and CNKI from inception to July 2011 for comparative studies assessing thoraco laparoscopic esophagectomy and open esophagectomy. Data were extracted and evaluated by two reviewers independently according to the Cochrane Handbook for Systematic Reviews. Meta-analyses were conducted using RevMan 5.1.

RESULTSA total of 10 studies involving 1017 patients were included for the analysis. Four hundred and fifty-five patients underwent thoraco laparoscopic esophagectomy and 562 patients underwent open esophagectomy. There were no significant differences between the two groups in anastomotic leak, 30-day mortality, and number of lymph node retrieved(P>0.05). However, thoraco laparoscopic esophagectomy had lower blood loss, less operative time, and reduced respiratory complications(P<0.05). There were no significant differences between the two groups in overall complications, cardiac complications, anastomotic stricture, recurrent laryngeal nerve injury, length of stay, ICU stay, and 3-year survival(all P>0.05).

CONCLUSIONThoraco laparoscopic esophagectomy for esophageal cancer is feasible and safe as open esophagectomy.

Esophageal Neoplasms ; surgery ; Esophagectomy ; methods ; Humans ; Laparoscopy ; Thoracoscopy ; Treatment Outcome

Minimally invasive surgery is now rapidly developing and becoming a standard surgical option in some fields. In the past, many thoracic surgeons were reluctant to adopt minimally invasive techniques in esophageal cancer surgery due to concern over the oncologic perspectives and technical difficulties. However, over the last few years, thoracic surgeons have progressively embraced the technical advancements and now many experienced centers have adopt minimally invasive surgery as a primary option for non-advanced esophageal cancer operations. In esophageal cancer surgery, the volume of operation performed in some hospital is closely related to the outcome of patients, and the experiences of surgical team play an important role in minimally invasive surgery. Minimally invasive esophageal surgery (MIES) has steep learning curves, also. The merits of MIES are as follows. The conventional esophageal cancer operation has two or triple incisions, resulting in high postoperative morbidity and mortality. However, postoperative complication in MIES became less frequent than conventional surgery. The patient's satisfaction is high. Mid-term outcomes of MIES have been reported that it is safe and feasible in esophageal cancer and survival curves are similar to those of conventional surgery. Therefore, MIES is a valuable therapeutic modality for both esophageal cancer patients and thoracic surgeons.
Esophageal Neoplasms/*surgery ; Humans ; Laparoscopy/methods ; Surgical Procedures, Minimally Invasive/methods ; Thoracoscopy/methods

OBJECTIVETo study the feasibility and early results of radical resection of esophageal carcinoma using single-port thoracoscopy combined with laparoscopy.

METHODSFrom March 2010 to December 2010, 6 patients with esophageal carcinoma underwent radical resection by single-port thoracoscopy combined with laparoscopy in the General Hospital of People's Liberation Army. With the patients at a supine position, laparoscopy was performed to complete stomach mobilization and abdominal lymph node dissection. Thoracoscopy was then carried out with the patients lying on the left to mobilize the esophagus and dissect thoracic lymph nodes. Finally, the stomach was pulled into the thoracic cavity via the hiatus of the diaphragm to construct a tube-like stomach, which was then anastomosed to the esophagus using the OrVil system.

RESULTSNo patient was converted to open surgery during the operation. The total operative time ranged from 200 to 320 min. The mean laparoscopic time was 75(range, 45-90) min, and the mean thoracoscopic time 160(120-240) min. The mean intraoperative blood loss was 220(160-300) ml. The mean lymph node retrieval was 12(9-18). No anastomotic fistula, chylothorax, lung infection were found postoperatively.

CONCLUSIONAfter esophageal resection using single-port thoracoscopic and laparoscopy, reconstruction using OrVil system is safe and feasible.

Aged ; Esophageal Neoplasms ; surgery ; Esophagectomy ; methods ; Female ; Humans ; Laparoscopy ; methods ; Male ; Middle Aged ; Thoracoscopy ; methods

The use of anterior surgical techniques for the treatment of adolescent idiopathic scoliosis (AIS) has increased recently and anterior discectomy, anterior release and fusion, instrumentation of the thoracic scoliosis can be performed through a thoracoscopic approach. The thoracoscopic approach has several advantages: small surgical trauma, early return to work, reduced postoperative pain and improved postoperative respiratory functions. Although the thoracoscopic approach still has some shortcomings currently, it will be widely accepted with further development of this technique and instrumentations in the future.
Adolescent ; Animals ; Diskectomy ; methods ; Humans ; Internal Fixators ; Scoliosis ; surgery ; Spinal Fusion ; methods ; Thoracic Vertebrae ; surgery ; Thoracoscopy ; methods ; Thoracotomy ; methods

This paper introduces the recent study and development of an aided endoscopic surgical robot system, and discusses its future trends--teleoperative robot system and telesurgery system. In addition, their key technologies are analyzed here in the paper.
Angioscopy ; Endoscopy ; methods ; trends ; Humans ; Laparoscopy ; Robotics ; instrumentation ; trends ; Surgery, Computer-Assisted ; instrumentation ; Telemedicine ; instrumentation ; Thoracoscopy

From January 2013 to January 2015, 19 patients of traumatic hemothorax with hemorrhagic shock were treated in our department by thoracoscopic surgery combined with autologous blood transfusion. This study retrospectively analyzed the therapeutic effect and shared our experience. The average amount of blood transfused back was 662.41 ml ± 269.15 ml. None of the patients developed transfusion reaction and were all discharged uneventfully. Thoracoscopic surgery combined with autologous blood trans- fusion is effective in the rescue of patients with progressive hemothorax and hemorrhagic shock. When corresponding indications are well managed, treatment for these patients is quicker, safer, and more effective.
Blood Transfusion, Autologous ; Female ; Hemothorax ; surgery ; Humans ; Male ; Retrospective Studies ; Thoracic Injuries ; surgery ; Thoracoscopy ; methods

Along with continuous improvement of clinical staging modalities and endoscopic instrument and skills, the staging-based minimally invasive treatment for esophageal carcinoma has been firmly guaranteed, because of more accurate pretreatment staging and more mature minimally invasive technique. Different minimally invasive treatment should be provided to patients with different stage. On the premise of assurance of treatment, it would minimize trauma, accelerate rehabilitation, and improve quality of life.
Endosonography ; Esophageal Neoplasms ; pathology ; surgery ; Humans ; Minimally Invasive Surgical Procedures ; methods ; Neoplasm Staging ; Thoracoscopy

INTRODUCTIONMinimally invasive surgical ablation is an emerging alternative method to catheter ablation and the full surgical maze procedure for nonpharmacologic treatment of atrial fibrillation (AF). We present a totally thoracoscopic "box lesion" radiofrequency ablation procedure in patients with paroxysmal or persistent AF.

MATERIALS AND METHODSFrom June 2011 to October 2012, 14 patients with lone paroxysmal (n = 7) or persistent AF (n = 7) were enrolled in this study. Procedures were performed through 3 5-12 mm holes on each side of the chest wall. A bipolar ablation device was used to create a box lesion in the posterior wall of the left atrium that encircled the 4 pulmonary veins (achieving bilateral pulmonary vein/posterior left atrial wall isolation). Perioperative complications were recorded for all patients. Freedom from AF was assessed by 24-hour Holter monitoring every 3 months or during symptoms of arrhythmia.

RESULTSThe ablation was successfully performed in all patients, with median operation time of 128 minutes (range, 45 to 180 minutes). No operative mortality or morbidity were noted during the study period. Freedom from AF was achieved in 12 patients (85.7%) during follow-up (median follow-up 9 months). One patient with persistent AF was shifted to paroxysmal AF. No atrial flutter or atrial tachycardia was noted during the follow-up.

CONCLUSIONThese early results show that totally thoracoscopic surgical ablation using a unique "box lesion" procedure for persistent or paroxysmal AF is a feasible and effective method with good short-term results. Further study is necessary to validate this result.

Adult ; Aged ; Atrial Fibrillation ; surgery ; Catheter Ablation ; methods ; Female ; Humans ; Male ; Middle Aged ; Thoracoscopy