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简介：Objective:Theobjectiveofthecurrentstudywastoevaluatethefeasibilityandsafetyofnonintubateduniportalvideo-assistedthoracoscopicsurgery（VATS）forthemanagementofprimaryspontaneouspneumothorax（PSP）.Methods:FromNovember2011toJune2013,32consecutivepatientswithPSPweretreatedbynonintubateduniportalthoracoscopicbullectomyusingepiduralanaesthesiaandsedationwithoutendotrachealintubation.Anincision2cminlengthwasmadeatthe6thintercostalspaceinthemedianaxillaryline.Thepleuralspacewasenteredbybluntdissectionforplacementofasoftincisionprotector.Instrumentsweretheninsertedthroughtheincisionprotectortoperformthoracoscopicbullectomy.Datawerecollectedwithinaminimumfollow-upperiodof10months.Results:Theaveragetimeofsurgerywas49.0min（range,33-65min）.Nocomplicationswererecorded.Thepostoperativefeedingtimewas6h.Themeanpostoperativechesttubedrainageandhospitalstaywere19.3hand41.6h,respectively.Thepostoperativepainwasmildfor30patients（93.75%）andmoderatefortwopatients（6.25%）.Norecurrencesofpneumothoraxwereobservedatfollow-up.Conclusions:Theinitialresultsindicatedthatnonintubateduniportalvideo-assistedthoracoscopicoperationsarenotonlytechnicallyfeasible,butmayalsobeasafeandlessinvasivealternativeforselectpatientsinthemanagementofPSP.ThisisthefirstreporttoincludetheuseofanonintubateduniportaltechniqueinVATSforsuchalargenumberofPSPcases.Furtherworkanddevelopmentofinstrumentsareneededtodefinetheapplicationsandadvantagesofthistechnique.

简介：BackgroundThevideo-assistedthoracoscopicsurgicaltechniquesarewidelyusedinthetreatmentofpatientswithcongenitalheartdiseaseswithgoodoutcomes.However,thefeasibilityandsignificanceofnursebasedearlycardiacrehabilitationincardiacintensivecareunit(ICU)forpatientswithtotallythoracoscopiccardiacoperationhasbeenseldomstudied.MethodsThirty-sixpatientswithtotallythoracoscopiccardiacoperationundertheconditionofthecardiacICUinGuangdongGeneralHospitalwererandomallocatedtotheinterventiongroupandthecontrolgroupbetweenJanuary2012toDecember2014.Thecontrolgroupreceivedstandardnursingcare,andtheinterventiongroupreceivedearlycardiacrehabilitationnursingcareinadditiontostandardcare.Theoutcomemeasuresincludedtheoxygensaturation(SpO2%),vitalcapacity,forcedexpiratoryvolumein1second(FEV1),andpaininthethoracicwound(visualanaloguescale,VAS),whichweremeasuredatthebaselineandwithin2-dayafter4-weeknursingcare.Forsafetyreason,wealsomonitoredtherateofperceivedexertion(RPE),heartrate,systemicbloodpressure.ResultsTherewerenon-significantdifferencesbetweenthegroupsinage,sex,totalnumberofcomorbidconditions,totalnumberofmedications,surgicaltime,andanesthetictime(P>0.05).Following4weekstreatment,thecardiopulmonaryfunctionsandVASscorewereimproved(P<0.05)inallgroups.Inaddition,theimprovementsweremoreintheearlycardiacrehabilitationnursecaregroupthaninthecontrolgroup(P<0.05).ConclusionTheearlycardiacrehabilitationnursingcareincardiacICUissafe,feasibleandbeneficialforpatientswithtotallythoracoscopiccardiacoperation.