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Video-assisted thoracoscopic surgery (VATS) for thoracic surgery is practical, has been shown to reduce postoperative discomfort, and has improved cosmetic results when compare to open thoracotomy. The specific aims of this project are: to clarify the physiologic and immunologic effects of different approaches for minimally invasive thoracic surgery: (1) multiple-port VATS; (2) single-port VATS
Video-assisted thoracoscopic surgery (VATS) was first reported in the early 1990s. Since then, the safety and efficacy of thoracoscopy for diagnosing and treating pleural, pulmonary, and mediastinal disease has been demonstrated with similar oncological results, which were confirmed by multiple clinical studies. Although VATS for thoracic surgery is practical, has been shown to reduce postoperative discomfort, and has improved cosmetic results when compare to open thoracotomy, unfortunately chronic thoracic wound discomfort and postoperative neuralgia were found in a significant portion of patients .
Recently, a minimally invasive approach that is different from the conventional multiport thoracoscopic technique is gradually becoming of great interest in the diagnosis and treatment of thoracic surgical disease. Single-port VATS is one of the most promising emerging surgical techniques which allows the surgeon to perform a majority of thoracic surgeries and with similar perioperative outcomes that are comparable with the conventional multiport technique. However, a very limited number of clinical studies have demonstrated the advantages of single port VATS in postoperative pain reduction, when comparing to the traditional multiport thoracoscopic approach.
To clarify the physiologic and immunologic effects of different approaches for minimally invasive thoracic surgery, investigators aim to compare the perioperative physiological changes, immunological responses, and postoperative pain between standard (multi-port) transthoracic thoracoscopic and single-port transthoracic thoracoscopic surgery for thoracic disease.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| multi-port VATS | Other | Multi-port VATS is an operative method |
|
| single-port VATS | Other | Single-port VATS is an operative method |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| multi-port VATS | Procedure | Patients with thoracic surgical diseases who underwent VATS will be recruited into this study to investigate the postoperative pain , physiologic and immunologic impacts of two different approaches for minimally invasive thoracic surgery. |
| Measure | Description | Time Frame |
|---|---|---|
| Pain score | Numerical Rating Scale (NRS) or Wong-Baker Face Pain Rating Scale | beginning at 3 hours after surgery until 5 days |
| Measure | Description | Time Frame |
|---|---|---|
| Complication | Yes/No | beginning at 3 hours after surgery until 30 days |
| Mean arterial pressure | MAP; mmHg | beginning 20 min before the start of surgery until 20 min after the surgery. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Yun-Hen Liu | Chang Gung Memorial Hospital | Principal Investigator |
| Hung-Pin Liu | Chang Gung Memorial Hospital | Principal Investigator |
| Yi-Cheng Wu | Chang Gung Memorial Hospital | Principal Investigator |
| Ming-Ju Hsieh | Chang Gung Memorial Hospital | Principal Investigator |
| Wei-Hsun Chen | Chang Gung Memorial Hospital | Principal Investigator |
| Yen Chu | Chang Gung Memorial Hospital | Principal Investigator |
| Chien-Ying Liu | Chang Gung Memorial Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Chang Gung Memorial Hospital | Taoyuan | 333 | Taiwan |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 11515867 | Background | Nagahiro I, Andou A, Aoe M, Sano Y, Date H, Shimizu N. Pulmonary function, postoperative pain, and serum cytokine level after lobectomy: a comparison of VATS and conventional procedure. Ann Thorac Surg. 2001 Aug;72(2):362-5. doi: 10.1016/s0003-4975(01)02804-1. | |
| 19577048 | Background | Flores RM, Park BJ, Dycoco J, Aronova A, Hirth Y, Rizk NP, Bains M, Downey RJ, Rusch VW. Lobectomy by video-assisted thoracic surgery (VATS) versus thoracotomy for lung cancer. J Thorac Cardiovasc Surg. 2009 Jul;138(1):11-8. doi: 10.1016/j.jtcvs.2009.03.030. |
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All collected IPD, all IPD that underlie results in a publication
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Starting 6 months after publication
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| single-port VATS | Procedure | Patients with thoracic surgical diseases who underwent VATS will be recruited into this study to investigate the postoperative pain , physiologic and immunologic impacts of two different approaches for minimally invasive thoracic surgery. |
|
| Heart rate | HR; beats per min [bpm] | beginning 20 min before the start of surgery until 20 min after the surgery. |
| Cardiac index | CI; L/[min·m2] | beginning 20 min before the start of surgery until 20 min after the surgery. |
| Systemic vascular resistance index | SVRI; [dyn·s]/[cm-5·m2] | beginning 20 min before the start of surgery until 20 min after the surgery. |
| Global end-diastolic volume index | GEDVI; mL/m2 | beginning 20 min before the start of surgery until 20 min after the surgery. |
| Leukocyte subset analysis | 10^3/ul | preoperation till 5 days after surgery |
| Intracellular oxidative activity of neutrophils | ratio compared with preoperation | preoperation till 5 days after surgery |
| Inducible nitric oxide synthase expression in monocytes | Arbitrary intensity | preoperation till 5 days after surgery |
| Interleukin-6 | pg/ml | preoperation till 5 days after surgery |
| C-reactive protein | ng/ml | preoperation till 5 days after surgery |
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