Objective To evaluate the clinical effects of harmonic scalpel application in thoracoscopic surgery for lung cancer, which may guide its reasonable application. Methods We retrospectively analyzed the clinical data of 145 lung cancer patients receiving thoracoscopic surgery from January to March 2017 in our hospital. There were 57 patients with thoracoscopic pulmonary wedge resection, and harmonic scalpel was used in 34 patients (8 males, 26 females at age of 59.68±10.91 years), and was not used in 23 patients (13 males and 10 females at age of 59.13±11.21 years). There were 88 patients receiving thoracoscopic pulmonary lobectomy, among whom harmonic scalpel was used in 80 patients (36 males and 44 females at age of 59.68±10.91 years), and was not used in 8 patients (5 males, 3 females at age of 61.63±5.60 years). We recorded the perioperative outcomes of all patients. Results In the 34 patients undergoing thoracoscopic pulmonary wedge resection by harmonic scalpe, the operation time was 90.09±43.52 min, the blood loss was 21.32±12.75 ml, the number of lymph nodes resected was 5.12±4.26, duration of drainage was 3.15±1.16 d, volume of drainage was 535.00±291.69 ml, the length of postoperative hospital stay was 4.56±1.40 d, and no postoperative complication was observed. In the 80 patients receiving thoracoscopic pulmonary lobectomy by harmonic scalpel, operation time was 131.88±41.82 min, blood loss was 42.79±31.62 ml, the number of lymph nodes resected was 13.54±8.75, duration of thoracic drainage was 4.47±2.30 d, drainage volume was 872.09±585.24 ml, the length of postoperative hospital stay was 5.81±2.26 d, and 20 patients had postoperative complications. No complication occurred in the 8 patients without harmonic scalpel. Conclusion Harmonic scalpel showed satisfactory effectiveness and safety in lung cancer thoracoscopic surgery.
The application of robots in thoracic surgery is mainly based on the da Vinci general surgery robot. With the popularization of artificial intelligence (AI) application scenarios, the combination of AI and robots is more closely, and there is a strong clinical demand and huge application space for the development of specialized disease-specific robotic systems for thoracic surgery. This article aims to systematically describe the history of the rise of specialized surgical robots and the status of the localization of surgical robots in China, propose the concept of applying AI to the research and development of integrated specialized disease-specific robots in thoracic surgery, and clarify the ethics and prospects that intelligent specialized disease-specific surgical robots will face.
ObjectiveTo investigate whether treatment of rivaroxaban, an approved oral direct coagulation factor Xa inhibitor, attenuates functional changes in LPS -induced acute lung injury (ALI) mouse.MethodsC57BL/6 mice were randomly divided into PBS group, N-LPS group, L-LPS group, and H-LPS group. In the C57BL/6 mice being fed chow containing 0.2 mg/g or 0.4 mg/g rivaroxaban for 10 days (L-LPS group and H-LPS group), plasma concentration and coagulation indices were measured. Next, the role of rivaroxaban in ALI by using mice fed by rivaroxaban was studied in a murine ALI model induced by direct intratracheal injection lipopolysaccharides (LPS). Lung injury by histopathological scoring, micro computed tomography, pulmonary edema, inflammatory cell recruitment and activity of inflammatory cytokines in lung tissue or bronchoalveolar lavage fluid (BALF) were assessed. Western blot and immunohistochemistry were performed to examine expression of multiple proteins, including myeloperoxidase, protease-activatedreceptor 2 (PAR-2) and nuclear factor kappa B (NF-κB).ResultsThe increased plasma concentration of rivaroxaban and the prolonged prothrombin time were displayed in the mice with rivaroxaban treatment. Rivaroxaban treatment groups showed significant reductions in neutrophil sequestration and preservation of the lung tissue architecture compared to the LPS positive control (P<0.05). Tumor necrosis factor-alpha (TNF-α), interleukin-1 beta (IL-1β) and interleukin-6 (IL-6) levels, in addition to total protein and Evans blue concentration were all significantly reduced in BALF from the mice treated with the chow containing rivaroxaban. Administration of rivaroxaban ameliorated ALI with concomitant reductions in the expression of PAR-2 and proinflammatory cytokines. LPS-induced PAR-2 increase and NF-κB activation were also suppressed by rivaroxaban in lung tissues. Furthermore, rivaroxaban inhibited the phosphorylation levels of P65 in ALI.ConclusionsThe results demonstrate that rivaroxaban effectively attenuates LPS-induced inflammatory responses by noncoagulative pathway in ALI. The beneficial effects are associated with the decreased phosphorylation of NF-κB pathways and the reduced expression of PAR-2.