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The purpose of this study is to compare the advantages and disadvantages of video-assisted rib planting and traditional internal fixation of rib fractures in chest wall stabilization.
The investigators design a new surgical method of video-assisted thoracoscopic surgery for rib fractures, evaluate the advantages and disadvantages of the new surgical techniques with a prospective study.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| video-assisted rib planting | Experimental |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| video-assisted rib planting | Procedure | Give the patient intercostal nerve block and laryngeal mask anesthesia, after that, put the patient in lateral position. Make a 4-6cm posterolateral incision along the lower edge of the scapula，sever latissimus dorsi and serratus anterior and reach the rib surface. Lift the scapula with the abdominal retractor (or xiphoid retractor), Free adhesion tissue inside the scapula and put in the thoracoscopic lens. Free the tissue of the upper and lower edges of the ribs carefully, reset ribs and insert rib plate, which is fixed by 90° electric drill and locking screw. |
| Measure | Description | Time Frame |
|---|---|---|
| The pain score after operation | The investigators evaluate and record the patients' pain score after operation by visual analog scale (VAS)，which is used to evaluate pain scores 6h,12h,and 24h after the operation. 0-10 is used to represent different degrees of pain, 0 is painless and 10 is severe pain. The grading criteria of pain were: 0: no pain; 1-3: mild pain; 4-6: moderate pain; 7-10: severe pain. | 6 hours after operation |
| The pain score after operation | The investigators evaluate and record the patients' pain score after operation by visual analog scale (VAS). 0-10 is used to represent different degrees of pain, 0 is painless and 10 is severe pain. The grading criteria of pain were: 0: no pain; 1-3: mild pain; 4-6: moderate pain; 7-10: severe pain. | 12 hours after operation |
| The pain score after operation | The investigators evaluate and record the patients' pain score after operation by visual analog scale (VAS). 0-10 is used to represent different degrees of pain, 0 is painless and 10 is severe pain. The grading criteria of pain were: 0: no pain; 1-3: mild pain; 4-6: moderate pain; 7-10: severe pain. | 24 hours after operation |
| Measure | Description | Time Frame |
|---|---|---|
| The postoperative drainage | The investigators record the postoperative drainage of patients.The drainage of chest catheter or negative pressure ball was recorded by the nurse every day after surgery. Less postoperative drainage means faster recovery and shorter discharge times. | 7 days at most |
| Measure | Description | Time Frame |
|---|---|---|
| The operation time | The investigators record patients' operation time duration. | During surgery |
| The length of incision | The investigators record the length of operative incision. |
Inclusion Criteria:
-≥3 unilateral rib displacement fractures
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Weigang Zhao | Shanghai Jiao Tong University Affiliated Sixth People's Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Shanghai Jiao Tong University Affiliated Sixth People's Hospital | Shanghai | China |
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| ID | Term |
|---|---|
| D012253 | Rib Fractures |
| ID | Term |
|---|---|
| D050723 | Fractures, Bone |
| D014947 | Wounds and Injuries |
| D013898 | Thoracic Injuries |
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| ID | Term |
|---|---|
| D020775 | Thoracic Surgery, Video-Assisted |
| ID | Term |
|---|---|
| D013906 | Thoracoscopy |
| D004724 | Endoscopy |
| D003949 | Diagnostic Techniques, Surgical |
| D019937 | Diagnostic Techniques and Procedures |
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| During surgery |
| The intraoperative bleeding | The investigators record the intraoperative bleeding of patients. | During surgery |
| The treatment costs | The investigators record the treatment costs and calculate per capita treatment costs of patients,which is recorded and counted at the time of discharge. Total treatment costs include hospitalization, treatment, surgery, medications, and other related expenses. | from the date of hospitalization to the date of leave hospital,assessed up to 100 months |
| Days of stay hospital | Days of stay hospital | from the date of hospitalization to the date of leave hospital,assessed up to 100 months |
| D003933 | Diagnosis |
| D020535 | Video-Assisted Surgery |
| D019060 | Minimally Invasive Surgical Procedures |
| D013514 | Surgical Procedures, Operative |
| D019616 | Thoracic Surgical Procedures |