Objective To explore the safety and feasibility of ultra-fast-track anesthesia (UFTA) in transcatheter aortic valve replacement (TAVR) under the concept of enhanced recovery after surgery (ERAS). Methods A retrospective analysis was conducted on the clinical data of patients who underwent TAVR at the First Hospital of Lanzhou University between January 2022 and June 2024. Based on the anesthesia technique, patients were categorized into an ultra-fast-track anesthesia group (group U) and a conventional general anesthesia group (group C). The general patient characteristics, operative duration, length of hospital stay, hospitalization costs, and complications were compared between the two groups. Results A total of 101 patients were ultimately included in the study, comprising 60 males and 41 females, with a mean age of (67.85±7.73) years. Among them, 57 patients were assigned to the group U and 44 to group C. Compared with the group C, the group U showed significantly shorter postoperative extubation time (0.18 h vs. 4.88 h), CCU stay (22 h vs. 37 h), hospital stay (8 d vs.13 d), and lower hospitalization costs (234 300 yuan vs. 251 100 yuan) (P<0.05). In addition, the incidences of pulmonary infection (3.5% vs. 15.9%) and atelectasis (3.5% vs. 15.9%) within 30 days after surgery in the group U were significantly reduced (P<0.05).There was no statistically significant difference in the intraoperative mean arterial pressure, heart rate, or other complications such as postoperative arrhythmia, pervalvular leakage, and cerebral infarction between the two groups (P>0.05). Conclusion UFTA not only ensures the safety of TAVR patients, but also significantly enhances postoperative recovery, shortens recovery time, and optimizes medical resource utilization,.
Objective To discuss the safety, feasibility and advantages of tubeless trans-subxiphoid thoracoscopic surgery in anterior mediastinal tumor resection. Methods A total of 32 patients suffering anterior mediastinal tumor were enrolled, including 17 patients (8 males and 9 females) with average age of 31.8±8.4 years who had been performed tubeless trans-subxipohoid tharcoscopic surgery and 15 patients (8 males and 7 females) with average age of 31.1±9.2 years who had been performed traditional trans-subxipohoid tharcoscopic surgery. The differences of surgical duration, the lowest intraoperative arterial oxygen saturation (SaO2), postoperative awaking time, postoperative pain visual analogue score (VAS), postoperative pulmonary recruitment time, duration of postoperative hospital stay and hospitalization cost were analyzed. Results Postoperative awaking time (18.5±1.8 min vs. 28.9±4.2 min, P=0.000), postoperative VAS (1.6±0.6 vs. 3.5±7.4, P=0.000), duration of postoperative hospital stay (2.5±7.2 d vs. 4.3±1.1 d, P=0.000) and hospitalization cost (3.2±1.1 ten thousand RMB vs. 4.9±1.1 10 ten thousand RMB, P=0.000) in the tubeless group were better than those in the control group. There was no significant difference in surgical duration (51.7±6.5 min vs. 55.1±8.5 min), the lowest intraoperative SaO2 (98.5%±0.9% vs. 98.1%±0.8%), postoperative pulmonary recruitment time (33.9±12.2 d vs. 38.4±15.2 d, P>0.05) between the two groups.Conclusion Tubeless trans-subxiphoid thoracoscopic surgery is safe, feasible and advanced in anterior mediastinal tumor resection.
