Dataset Information

No-waiting segmentectomy: an optimized approach for segmentectomy.

ABSTRACT:

Background

Currently, modified inflation-deflation is considered the easiest way to identify the intersegmental plane during pulmonary segmentectomy. However, this approach requires a wait of about 10-20 min during the operative procedure. Therefore, we optimized the procedure, which we call no-waiting segmentectomy. In this study, we compared no-waiting segmentectomy with the modified inflation-deflation method.

Methods

We studied 123 consecutive patients with pulmonary ground-glass nodules who underwent segmentectomy by uniportal video-assisted thoracoscopic surgery in a single medical group from January 2019 to April 2020. Forty-five patients underwent the modified inflation-deflation method and 78 patients underwent the no-waiting method. The no-waiting procedure involved severing of the target segmental pulmonary artery, inflating the lung with atmospheric air, dissecting the hilum, and dividing the target segmental bronchus. The entire procedure could be performed at a stretch and no pause was needed. We compared the two methods for surgery time, bleeding volume, drainage time, and postoperative hospital stay. Propensity-score matching was used to adjust the baseline characteristics.

Results

Thirty-three pairs of 123 patients were successfully matched. Before propensity-score matching, there was no difference between the two methods in terms of surgery time, bleeding volume, drainage time, and postoperative hospital stay. After propensity-score matching, the surgery time in the no-waiting group was significantly shorter than that in the modified inflation-deflation method group (80.12±35.53 vs. 102.97±48.07 min, P=0.03). There was no difference between the two methods in terms of bleeding volume, drainage time, and postoperative hospital stay.

Conclusions

No-waiting segmentectomy was associated with a reduced surgery time, compared to that associated with modified inflation-deflation segmentectomy. Furthermore, no-waiting segmentectomy did not increase bleeding volume, drainage time, and postoperative hospital stay. Thus, no-waiting segmentectomy is an optional optimized approach for segmentectomy.

SUBMITTER: Wang C

PROVIDER: S-EPMC7947514 | biostudies-literature | 2021 Feb

REPOSITORIES: biostudies-literature

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Publications

No-waiting segmentectomy: an optimized approach for segmentectomy.

Wang Changchun C Cai Lei L Chen Qian Q Xu Xiaofang X Liang Jinxiao J Mao Weimin W Chen Qixun Q

Journal of thoracic disease 20210201 2

<h4>Background</h4>Currently, modified inflation-deflation is considered the easiest way to identify the intersegmental plane during pulmonary segmentectomy. However, this approach requires a wait of about 10-20 min during the operative procedure. Therefore, we optimized the procedure, which we call no-waiting segmentectomy. In this study, we compared no-waiting segmentectomy with the modified inflation-deflation method.<h4>Methods</h4>We studied 123 consecutive patients with pulmonary ground-gl ...[more]

PMID: 33717551

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Project description:BackgroundGel-forming mucins (GFMs) play important roles in otitis media (OM) pathogenesis. Increased mucin expression is activated by pathogens and proinflammatory cytokines. Bacterial biofilms influence inflammation and resolution of OM and may contribute to prolonged mucin production. The influence of specific pathogens on mucin expression and development of chronic OM with effusion (OME) remains an area of significant knowledge deficit.ObjectivesTo assess the relationship between GFM expression, specific pathogens, middle ear mucosal (MEM) changes, biofilm formation, and antibiotic utilization.MethodsMixed gender chinchillas were inoculated with nontypeable Haemophilus influenzae (NTHi) strain 86028NP or Streptococcus pneumoniae (SP) strain TIGR4 via transbulla injection. Antibiotic was administered on day 3-5 post inoculation. GFM expression was measured by quantitative PCR. Biofilm formation was identified and middle ear histologic changes were measured.ResultsSP infection resulted in higher incidence of biofilm and ME effusion compared with NTHi infection. However, NTHi persisted in the ME longer than SP with no substantive bacterial clearance detected on day 10 compared with complete bacterial clearance on day 10 for 50-60% of the SP-infected chinchillas. Both infections increased MEM inflammatory cell infiltration and thickening. NTHi upregulated the Muc5AC, Muc5B and Muc19 expression on day 10 (p = 0.0004, 0.003, and 0.002 respectively). SP-induced GFM upregulations were trended toward significant. In both NTHi and SP infections, the degree of GFM upregulation had a direct relationship to increased MEM hypertrophy, inflammatory cell infiltration and biofilm formation. Antibiotic treatment reduced the incidence of ME effusion and biofilm, limited the MEM changes and reversed the GFM upregulation. In NTHi infection, the rate of returning to baseline level of GFMs in treated chinchillas was quicker than those without treatment.ConclusionsIn an animal model of OM, GFM genes are upregulated in conjunction with MEM hypertrophy and biofilm formation. This upregulation is less robust and more quickly ameliorated to a significant degree in the NTHi infection with appropriate antibiotic therapy. These findings contribute to the understanding of pathogen specific influences on mucin expression during OM pathogenesis and provide new data which may have implications in clinical approach for OM treatment.

Dataset Information

No-waiting segmentectomy: an optimized approach for segmentectomy.

Background

Methods

Results

Conclusions

Publications

No-waiting segmentectomy: an optimized approach for segmentectomy.

Similar Datasets

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