BACKGROUNDThymokidney has been reported as an approach for a vascularized thymus for transplantation to induce donor specific tolerance. A completely thymectomized model which ensures that the obtained thymus is not injured has not been developed yet and it would be useful for evaluating autologous thymokidney function in rats.

METHODSAdult Sprague-Dawley male rats weighing 150 - 300 g (n = 30) underwent non-invasive intubation with the assistance of an improved self-made wedge-shaped cannula made from a 2-ml plastic syringe and transillumination from the anterior tracheal area by an operation spotlight. The rats then received a thoracotomy while their breathing was supported by a small animal ventilator, and both lobes of the thymus were entirely extirpated under a 10× microscope. The postoperative survival rate of the rats was recorded, and changes in the T-cell reservoir from 9 of 30 rats within 21 days after surgery were monitored using flow cytometry. The complete thymectomy rate was confirmed by autopsy and histological examination on 21 days post-operation.

RESULTSThe postoperative survival rate of rats was 100%. The exsected thymus was free of injury and the rate of complete thymectomy was 100%.

CONCLUSIONSThis model has a stable survival rate and complete thymectomy is able to be achieved. The obtained thymus tissue is free of injury and can be used for transplantation.

Animals ; Intubation, Intratracheal ; methods ; Male ; Rats ; Rats, Sprague-Dawley ; Thoracotomy ; methods ; Thymectomy ; methods ; Thymus Gland ; surgery

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 retrospective study was designed to compare the contribution of the video-assisted thoracoscopic surgery (VATS) and open thoracotomy in the management of spontaneous pneumothorax (SP). The medical records of 100 patients with recurring or persisting (SP) treated were reviewed. The patients were divided into two groups: group I treated by thoracotomy while in group II (VATS) was used. There were 96 men and 6 women aged from 16 to 75 years. Indications for operation and sex distribution were comparable. The mean age for group I was 35 years and for group II was 45 years. Hospital stay was identical in both groups. The amount of narcotic requirements was lesser in group II than in group I as well as the postoperative respiratory dysfunction. There have been no recurrence to date (mean follow-up 6 years for the group I and 3 years for the group II). VATS have been shown to produce results comparable to those obtained following open thoracotomy with reduction of postoperative pain, respiratory dysfunction, catabolic response to trauma and decrease in wound related complications. VATS is a valid alternative to open thoracotomy for primary (SP) but it should be used with caution for the management of secondary pneumothorax.
Adolescence ; Adult ; Aged ; Female ; Human ; Male ; Middle Age ; Pneumothorax/surgery* ; Retrospective Studies ; Thoracoscopy/methods ; Thoracotomy/methods* ; Video Recording/methods*

OBJECTIVETo observe the effects that shape memory alloy (SMA) staples implanted to the lateral aspect of the thoracic vertebrae on spinal growth in goats.

METHODSSixteen goats (age 2 - 3 months) were divided into 3 groups: six in single staple group; six in double staples group and four in control group. Single staples group underwent right-side thoracotomy for exposing the thoracic spine through the eighth rib. Five SMA staples were placed laterally into vertebral bodies of T(6 - 11) spanning discs. Double staples group underwent the same operation. Laterally directed 10 SMA staples were placed into vertebrae of T(6 - 11) spanning discs and two staple spanning each disc. The last four goats in control groups just only underwent right-side thoracotomy. In the next 4 months after operation, radiographs were taken to observe the spinal growth every month.

RESULTSThe radiographic analysis demonstrated scoliosis of 12.83 degrees +/- 12.17 degrees in single staple group and 12.00 degrees +/- 3.22 degrees in double staple group after 2 months of the operation. Cobb angle of 6.00 degrees +/- 4.94 degrees and 25.17 degrees +/- 3.71 degrees were observed in the two groups respectively after 4 months of operation, as compared with 0 degrees in the control groups. Only 2 goats developed kyphosis.

CONCLUSIONSCompression between vertebral bodies by SMA staples can depress spinal growth in the same side and greater compression result in larger curves.

Alloys ; Animals ; Bone Nails ; Female ; Goats ; Spine ; growth & development ; Thoracic Vertebrae ; surgery ; Thoracotomy ; instrumentation ; methods

Adult ; Extracorporeal Circulation ; Female ; Humans ; Pregnancy ; Pregnancy Complications, Cardiovascular ; surgery ; Pregnancy Trimesters ; Thoracotomy ; methods

BACKGROUNDThe advantages of video assisted thoracoscopic anterior correction for scoliosis are minimal invasion and relatively short-time instrumentation; however the relatively steep learning curve cannot be ignored. Small incision, thoracotomic anterior correction for idiopathic thoracic scoliosis could be another choice because of less demanding technique. We compared the outcomes of these two techniques.

METHODSForty-nine patients with idiopathic right thoracic scoliosis were randomly divided into two groups. Group A was 12 girls with mean age 14.9 years, mean Cobb angle 52 degrees and Risser signs "+++" to "++++". Ten patients received video assisted thoracoscopic anterior correction with Eclipse rectification and two with Frontier instrumentation. Group B was 4 boys and 33 girls with mean age 14.1 years, mean Cobb angle of 56 degrees and Risser signs "++" to "++++". These patients underwent small incision, thoracotomic anterior instrumentation. The operation time, blood loss, postoperative drainage, instrumented levels, curve correction and early loss of correction of both groups were analyzed.

RESULTSGroup A had average operation time of (390+/-82) minutes, intraoperative blood loss of (600+/-155) ml, instrumented level of 7.4+/-1.3, postoperative drainage of (500+/-160) ml, correction rate of (65+/-16)% and loss of correction during the 18-36 month followup of (8.6+/-2.9)%. Group B had average operative time of (220+/-80) minutes, intraoperative blood loss of (320+/-120) ml, instrumented level of 7.8+/-0.9, postoperative drainage of (210+/-90) ml, curve correction rate of (70+/-12)% and loss of correction during the 18-36-month followup of (4.6+/-3.9)%. The curve correction rates of the two groups were not statistically significant (P>0.05). However, the operative time, blood loss, postoperative drainage, and early loss of correction showed statistical significance (P<0.05).

CONCLUSIONBoth video assisted thoracoscopic anterior correction and small incision thoracotomic anterior correction are safe and effective in correcting the idiopathic thoracic scoliosis.

Adolescent ; Adult ; Child ; Female ; Humans ; Kyphosis ; surgery ; Male ; Scoliosis ; surgery ; Thoracic Surgery, Video-Assisted ; methods ; Thoracic Vertebrae ; surgery ; Thoracotomy ; methods

The levels of pain, duration of approaching and closure, and surgical exposure associated with intercostal thoracotomy were compared between muscle-sparing and traditional techniques in 20 dogs. Postoperative pain was assessed based on numerical pain scores using behavioral observation, heart rate, respiratory rate, and wound palpation. Time for approaching and closure were measured, and the extent of intrathoracic organ exposure for the surgical procedures was described for each technique. There were significant differences in numerical pain scores at 2 h as well as 1, 2, 3, 4, 5, 6, and 7 days after surgery between the two groups (p < 0.0001). There was no significant (p = 0.725) difference in times for approaching and closure between the two groups. Compared to the traditional method, the muscle-sparing technique also achieved the desired exposure without compromising exposure of the target organs. Our results suggest that the muscle-sparing technique is more effective than the traditional method for providing a less painful recovery during the first 7 days after intercostal thoracotomy. Additionally, the muscle-sparing technique is as effective as the traditional modality for providing an appropriate time for approaching and closure during intercostal thoracotomy as well as adequate organ exposure for the surgical procedures.
Animals ; Dog Diseases/*etiology ; Dogs ; Pain Measurement/veterinary ; Pain, Postoperative/etiology/*veterinary ; Thoracotomy/adverse effects/methods/*veterinary

BACKGROUND: Ischemic preconditioning(a prior short period of coronary artery occlusion) has been known to have protective effects on ischemia-induced myocardial injury. The purpose of this study was to investigate the effects of hypoxic preconditioning or ischemic preconditioning on the
Animals ; Anoxia ; Arrhythmias, Cardiac* ; Cats* ; Coronary Vessels ; Heart* ; Hypoventilation ; Ischemic Preconditioning ; Methods ; Reperfusion ; Tachycardia, Ventricular ; Thoracotomy ; Ventilation ; Ventricular Fibrillation

BACKGROUND AND OBJECTIVEAtelectasis is a common complication after thoracotomy, and it may threaten patients' life if it was not treated correctly and properly. The aim of this article is to explore and discuss the prevention and treatment for atelectasis during the perioperative period, and also to explore new methods for reducing the perioperative mortality due to atelectasis after thoracotomy.

METHODSWe retrospectively reviewed the medical records of 374 lung cancer patients who underwent thoracotomy in our department between Jan 2007 and Nov 2009.

RESULTSAtelectasis occurred in 14 patients among all the 374 lung cancer patients who underwent thoracotomy. All the atelectasis returned to reexpansion after treatment.

CONCLUSIONThe incidence of atelectasis in these series is relatively low compared with the reports in literatures. Good perioperative preparation and perioperative treatment can remarkably decrease the incidence and mortality of atelectasis after thoracotomy in the treatment of lung cancer.

Female ; Humans ; Lung Neoplasms ; surgery ; Male ; Middle Aged ; Pulmonary Atelectasis ; prevention & control ; Retrospective Studies ; Thoracotomy ; adverse effects ; methods

BACKGROUND: Immunoneoadjuvant therapy opens a new prospect for local advanced lung cancer. The aim of our study was to explore the safety and feasibility of robotic-assisted bronchial sleeve resection in patients with locally advanced non-small cell lung cancer (NSCLC) after neoadjuvant chemoimmunotherapy. METHODS: Data of 13 patients with locally advanced NSCLC that underwent bronchial sleeve resection after neoadjuvant chemoimmunotherapy during August 2020 and February 2021 were retrospectively included. According to the surgical methods, patients were divided into thoracotomy bronchial sleeve resection (TBSR) group and robot-assisted bronchial sleeve resection (RABSR) group. Oncology, intraoperative, and postoperative data in the two groups were compared. RESULTS: The two groups of patients operated smoothly, the postoperative pathology confirmed that all the tumor lesions achieved R0 resection, and RABSR group no patient was transferred to thoracotomy during surgery. Partial remission (PR) rate and major pathological remissions (MPR) rate of patients in the TBSR group were 71.43% and 42.86%, respectively. Complete pathological response (pCR) was 28.57%. They were 66.67%, 50.00% and 33.33% in RABSR group, respectively. There were no significant differences in operative duration, number of lymph nodes dissected, intraoperative blood loss, postoperative drainage time and postoperative hospital stay between the two groups, but the bronchial anastomosis time of RABSR group was relatively short. Both groups of patients had a good prognosis. Successfully discharged from the hospital and post-operative 90-d mortality rate was 0. CONCLUSIONS In patients with locally advanced central NSCLC after neoadjuvant chemoimmunotherapy can achieve the tumor reduction, tumor stage decline and increase the R0 resection rate, bronchial sleeve resection is safe and feasible. Under the premise of following the two principles of surgical safety and realizing the tumor R0 resection, robot-assisted bronchial sleeve resection can be preferred.
Carcinoma, Non-Small-Cell Lung/surgery* ; Humans ; Lung Neoplasms/surgery* ; Neoadjuvant Therapy ; Pneumonectomy/methods* ; Retrospective Studies ; Robotics ; Thoracotomy ; Treatment Outcome