Operations in the pleural cavity are connected with circulatory changes in pulmonary circulation and general changes of hemodynamics. These changes are influenced by the position of patient's body on the operation table and by the introduction of artificial pneumothorax. Thoracoscopy is an advanced surgical approach in thoracic surgery, but its hemodynamic effect is still not known. The aim of the present study was to compare the hemodynamic response to surgeries carried out by open (thoracotomy – TT) and closed (thoracoscopy – TS) surgical approach. Thirty-eight patients have been monitored throughout the operation – from the introduction of anesthesia to completing the surgery. Monitored parameters were systolic blood pressure (BPs), diastolic blood pressure (BPd), O2 saturation (SaO2), systolic blood pressure in pulmonary artery (BPPAs), diastolic blood pressure in pulmonary artery (BPPAd), wedge pressure (PW), central venous pressure in right atrium (CVP), cardiac output (CO) and total peripheral resistance (TPR). No significant difference has been found in hemodynamic response between TT and TS groups. Significant changes of hemodynamic parameters occurring during the whole surgical procedure were detected in both technical approaches. The most prominent changes were found after the position of patients was changed to the hip position (significantly decreased BPs, BPd, MAP, SaO2 and BPPAs) and 5 min after the pneumothorax was established (restoration of the cardiac output to the initial value and significant decrease of the TPR). It can be concluded that the thoracoscopy causes almost identical hemodynamic changes like the thoracotomy.
- MeSH
- Time Factors MeSH
- Central Venous Pressure MeSH
- Vascular Resistance MeSH
- Adult MeSH
- Financing, Organized MeSH
- Hemodynamics MeSH
- Pneumothorax, Artificial MeSH
- Middle Aged MeSH
- Humans MeSH
- Cardiac Output MeSH
- Young Adult MeSH
- Monitoring, Intraoperative MeSH
- Pulmonary Circulation MeSH
- Pulmonary Wedge Pressure MeSH
- Patient Positioning MeSH
- Prospective Studies MeSH
- Aged MeSH
- Thoracoscopy MeSH
- Thoracotomy MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Young Adult MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Comparative Study MeSH
1st ed. VIII, 111 s. : fot., bar. fot., obr., rejstř., přeruš. lit. ; 28 cm
XXIII, 959 s. : bar.fot., obr. ; 30 cm
- MeSH
- Humans MeSH
- Pneumothorax therapy MeSH
- Thoracoscopy diagnostic use methods therapeutic use MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
Autoři se zabývají možnostmi a přínosem minimálně invazivní techniky v diagnostice a léčbě hrudního empyemu. V sedmiletém období prospektivně hodnotili soubor 157 nemocných. Sledovali použité metody diagnostiky a léčby, délku hospitalizace po chirurgické intervenci, její úspěšnost. Jednotlivé parametry statisticky hodnotili. Z výsledků plyne, že časná torakoskopická intervence zásadně přispívá ke zkrácení hospitalizace a úspěšnému vyhojení stavu.
Authors deal with possibilities and contribution of minimally invasive technique to diagnostics and treatment of thoracic empyema. In seven years period they prospectively evaluated the group of 157 patients. They followed applied methods of diagnostics, and treatment, the lengths of hospital stay after surgical intervention, and its success. They statistically evaluated mentioned parameters. Results of this survey show that early thoracoscopic intervention substantially contributes to shortening of hospital stay and successful healing of the condition.
[1st ed.] XIII, 289 s. : obr., tab., přeruš. lit., rejstř. ; 26 cm
- Conspectus
- Lékařské vědy. Lékařství
- NML Fields
- chirurgie
- pediatrie
- radiologie, nukleární medicína a zobrazovací metody
