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- Cost-Effective Apporach of Video-Assisted Thoracic Surgery: 7 Years Experience
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- Video-Assisted Thoracoscopic Thymectomy for Myasthenia Gravis: Analysis of 20 Cases
- 影像胸腔鏡手術(VATS)
- 電視影像胸腔鏡手術
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題名 | Cost-Effective Apporach of Video-Assisted Thoracic Surgery: 7 Years Experience=具價值效益之影像輔助式胸腔鏡手術:7年經驗回顧 |
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作者 | 劉會平; 吳怡成; 劉永恆; 謝明儒; 鄭嘉遜; 朱肇基; 林萍章; Liu, Hui-ping; Wu, Yi-cheng; Liu, Yun-hen; Hsieh, Ming-ju; Cheng, Ka-shun; Chu, Jaw-ji; Lin, Pyng Jing; |
期刊 | 長庚醫學 |
出版日期 | 20000700 |
卷期 | 23:7 2000.07[民89.07] |
頁次 | 頁405-412 |
分類號 | 416.3 |
語文 | eng |
關鍵詞 | 價值效益; 影像胸腔鏡手術; Cost-effective; Video-assisted thoracic surgery; |
英文摘要 | Background. Cost containment is the driving force behind current health care reform. While video-assisted thoracic surgery (VATS) permits a less invasive approach to surgical diseases of the chest, cost is one aspect that is seldom discussed. In Asia, cost-effectiveness essential for the survival of this approach. We present our cost-effective experience with VATS in 2300 patients over a 7-year period. Method. Between 1992 and 1999, 2300 patients underwent video-assisted thoracic surgery at Chang Gung Memorial Hospital. The mean age was 53.2 years (range, 22 days to 102 years); 67% (1541 patients) were men. The VATS technique was mainly performed based on traditional surgical principles. Conventional instruments and the fundamental surgical techniques of dissection, suturing, hemostasis, and tissue approximation that are familiar in the open setting were modified and used to enhance cost savings during VATS. Results. Surgery was performed on 41 patients on an emergency basis (24 with impending cardiac tamponade and 17 with hemothorax). The mean hospital stay of the patients treated by VATS was 4.5 days. The majority of the patients were operated on successfully using conventional instruments under video vision. The overall operative cost was decreased as compared to common VATS techniques. No delayed morbidity was noted in our patients after a mean follow-up period of 39 months (range, 1 to 68 months). Conclusion. It is our experience that VATS procedures should be performed with the same expertise as open surgery. Conventional instruments similar to those used in open thoracotomy can be incorporated in VATS, and with a more natural hand manipulation. Only through stringent use of expensive endoscopic consumables and application of modified techniques based on traditional surgical principles can VATS be performed efficaciously and economically for a wide range of thoracic conditions. |
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