肺切除加左心房部分切除治疗局部晚期肺癌的手术配合

对39例局部晚期肺癌患者施行肺和左心房部分切除术,结果均顺利完成手术,无手术死亡及术中并发症.认为术前做好患者心理准备、物品准备,术中密切配合医生操作是保证手术顺利完成的重要环节.     

腹腔镜下广泛性子宫切除加盆腔淋巴结清扫术的手术配合

对81例子宫癌患者行腹腔镜下广泛性子宫切除及盆腔淋巴结清扫术。结果均顺利完成手术，手术时间2．5～3．0h，术中出血100～200ml；无并发症发生，术后恢复良好，切口一期愈合。提出认真做好术前准备和术前访视，熟练掌握手术步骤，术中与医生密切配合是保证手术顺利完成的关键。     

2例门静脉低温灌注联合血管重建法行胰十二指肠切除的手术配合

总结2例门静脉低温灌注联合血管重建法行胰十二指肠切除的手术配合经验，包括：术前访视患者，检查备齐特殊用物；术中严格控制液体输入的速度和量，加强全身保温措施，防止术中大出血，严格无菌操作、预防感染等。结果患者手术顺利完成，术后恢复好。     

腹腔镜下广泛性子宫切除加盆腔淋巴结清扫术的手术配合

对81例子宫癌患者行腹腔镜下广泛性子宫切除及盆腔淋巴结清扫术.结果 均顺利完成手术,手术时间2.5～3.0 h,术中出血100～200 ml;无并发症发生,术后恢复良好,切口一期愈合.提出认真做好术前准备和术前访视,熟练掌握手术步骤,术中与医生密切配合是保证手术顺利完成的关键.     

气管隆凸切除与重建术的手术配合

对23例进行气管隆凸切除术和重建术的患者进行手术配合。主要内容为术前访视时了解患者手术相关知识知晓情况，对患者进行健康教育，缓解紧张、焦虑等心理；检查并备齐与气管隆凸切除术和重建术有关的特殊物品。入手术室后配合麻醉师进行麻醉诱导，巡回护士术中注意保持呼吸道通畅并配合麻醉师调节好高频通气机。本组患者均顺利完成手术，未发生护理并发症。     

舌癌切除及游离股外侧皮瓣行舌再造术的手术配合

对25例舌癌患者施行舌切除及游离股前外侧皮瓣移植舌重建术。结果25例游离皮瓣全部成活，其中1例术后发生静脉危象，经探查并重新吻合后皮瓣成活。提出护士认真做好术前准备和患者的心理护理，熟练掌握手术步骤及专用器械的使用方法，术中密切与医生配合是保证手术顺利完成的关键。     

腹腔镜阑尾切除术与开腹阑尾切除术治疗急性阑尾炎效果分析

目的比较腹腔镜阑尾切除术与开腹阑尾切除术治疗急性阑尾炎的效果。方法将120例接受阑尾切除术的急性阑尾炎患者根据手术方法不同分成2组,每组60例。对照组实施开腹手术,观察组实施腹腔镜手术。结果 2组均顺利完成手术。2组手术时间差异无统计学意义(P0.05)。观察组患者术中出血量及术后下床活动时间、镇痛药物使用率、并发症发生率、住院时间均优于对照组,差异具有统计学意义(P0.05)。结论腹腔镜阑尾切除术治疗急性阑尾炎,创伤小、术后恢复快,并发症发生率低,安全性高。     

腹腔镜胃间质瘤切除56例体会

目的：总结腹腔镜胃间质瘤切除术的治疗体会。方法：回顾分析56例腹腔镜胃间质瘤切除术的手术方法、术中处理要点及术后治疗效果。结果：56例手术均顺利完成,平均手术时间1.5h,平均出血60ml,术后平均住院5d,术后复发1例。结论：腹腔镜胃间质瘤切除术患者创伤小,术后康复快,是治疗胃间质瘤最佳的手术方式。     

2例门静脉低温灌注联合血管重建法行胰十二指肠切除的手术配合

总结2例门静脉低温灌注联合血管重建法行胰十二指肠切除的手术配合经验,包括:术前访视患者,检查备齐特殊用物;术中严格控制液体输入的速度和量,加强全身保温措施,防止术中大出血,严格无菌操作、预防感染等.结果患者手术顺利完成,术后恢复好.     

巨大甲状腺肿的手术切除体会

目的 探讨影响巨大甲状腺肿手术成功的因素.方法 对24例巨大甲状腺肿患者术前进行多学科讨论,手术方式为甲状腺全切除术或近全切除术,并对大部分病例随访1年余.结果 24例患者均顺利完成手术治疗.手术时间60～120min,平均85min.术中出血20～60ml,4例给予气管悬吊术,3例术中行气管切开术,2例出现暂时性喉返神经麻痹,2例出现口唇麻木感,术后住院时间5～14d,平均7d.结论 完善的术前检查,必要的术前准备,多学科讨论,正确的手术方式,术中良好的暴露以及细致的操作,是切除巨大甲状腺肿,减少术中出血,控制术后并发症的重要保证.     

Pulmonary Resection for Lung Trauma

Background. Pulmonary resection is rarely required for trauma, and its mortality is reportedly high.

Methods. A 10-year retrospective review of pulmonary resections for trauma was done.

Results. Of 2,455 patients with chest trauma, 183 (7.4%) underwent thoracotomy and 32 (1.3%) required pulmonary resection. Mean age was 28.4 years and mean injury severity score was 24.5. Mechanism of injury was stab wound in 14 patients, gunshot wound in 6, and blunt trauma in 12. Blunt trauma patients had a higher injury severity score (29.6) than penetrating trauma patients (21.4), but this was not significant (p < 0.07). Indications for thoracotomy were hemorrhage in 24 patients, airway disruption in 4, and other indications in 4. Operations consisted of wedge resection (19 patients), lobectomy (9), and pneumonectomy (4). Four (12.5%) patients (pneumonectomy, 2; lobectomy, 1; wedge, 1) died. Mortality for pneumonectomy was 50%, but this was not significantly higher than for lesser resections. Blunt trauma had a higher mortality (33%) than penetrating trauma (0%) (p < 0.02). Nonsurvivors had higher injury severity scores (44.2) than survivors (21.6) (p < 0.001).

Conclusions. Pulmonary resection is infrequently required for lung injury. Overall mortality is lower than previously reported, but pneumonectomy has a high mortality. Blunt trauma has a higher mortality than penetrating trauma. Injury severity scores are higher for nonsurvivors than survivors; this shows the importance of associated injuries on outcome.     

Open versus Thoracoscopic RFA-Assisted Lung Resection

The purpose of this study was to evaluate Radio Frequency Ablation (RFA)-assisted lung parenchymal transection through thoracotomy and thoracoscopy. Twelve domestic pigs underwent RFA-assisted lingulectomy: six through thoracotomy (group A), and six with thoracoscopy (group B). There was no mortality, no bleeding, or air leak intra- or postoperatively in either of the groups, and no conversion to open thoracotomy in group B. Group A had longer operating period and more pleural adhesions. A barotrauma, a skin burn, and a localized infection were observed in this group. Histopathology confirmed a sharply demarcated area of coagulation necrosis without damage to adjacent structures. RFA-assisted lung resection through thoracotomy bears the inherent problems of an open approach, and the use of RFA device does not add to morbidity. The thoracoscopic use of RFA probe by experienced surgeons is considered safe, maintaining the advantages of key-hole surgery.