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Objectives The research aimed to determine the effects of different surgical procedures on postsurgical pain and early prognosis. We reviewed the perioperative data of patients who underwent single/two-port television-assisted thoracoscopic pulmonary nodule surgery in the day surgery ward of Nanjing Drum Tower Hospital. Methods The clinical and follow-up data of 693 patients undergoing thoracoscopic for pulmonary nodules in the day surgery ward under the centralized management model of our hospital were retrospectively analyzed during the period of January 2021 to December 2022. The patients were divided into a single-port and a two-port thoracoscopy group. The propensity-matching was used to balance the baseline data and analyze the differences in postoperative pain and prognosis of the patientsin the two groups. Results After propensity score matching, the single-port group had lower intraoperative fentanyl consumption [0.5 (0.35, 0.50) mg vs. 0.5 (0.40, 0.50) mg, P = 0.034], remifentanil consumption [0.48 (0.33, 0.63) mg vs. 0.53 (0.35, 0.73) mg, P = 0.031], intraoperative hemorrhage [20 (10, 50) mL vs. 50 (20, 50) mL, P = 0.001], and Visual Analogue Scale on postoperative third day [2 (2, 4) point vs. 3 (2, 4) point, P = 0.007], which were statistically different. There were no statistically significant differences between the two groups in terms of postoperative rescue analgesia, chest drainage volume, length of hospitalization, pain on postoperative 1st, 5th, 9th, and 30th days, postoperative cough, pulmonary complications within 30 days after surgery, and unplanned hospital visits. Conclusion Compared with two-port thoracoscopy, single-port thoracoscopic day surgery for pulmonary nodules is a safe and feasible procedure that can significantly reduce the use of intraoperative opioid analgesics and the pain level of patients on postoperative 3rd day. [ABSTRACT FROM AUTHOR]

Objective To explore the effect of protective ventilation strategies based on individualized positive end expiratory pressure (PEEP) regulated by driving pressure (Pd) in infants under OLV. Methods Sixty infants undergoing elective thoracoscopic surgery were randomly divided into the control group and driving pressure group, with 30 cases in each group. The two groups were compared in terms of MAP, HR, tidal volume (Vt), PEEP, Pd, airway peak pressure (Pk), and static lung compliance (Cs), and arterial blood gas during OLV before the artificial pneumothorax (T0), 10 min (T,), 30 min (T2), and 60 min (T3) after the artificial pneumothorax, and right at the end of the artificial pneumothorax (T4). Results There were no significant differences in MAP, HR, and Vt between the two groups at all the time points (P > 0.05). Both groups showed the increase in Pd and Pk and decresase in Cs at T,, T2, and T3 (all P < 0.05). PaO2 and OI in both group were decreased and PaCO2 was increased at T2 (all P < 0.05). Compared with the control group, the driving pressure group presented lower Pd and Pk, higher PEEP and Cs at T,, T2, and T3 (P < 0.05), and higher PaO2 and OI (P < 0.05) and no significant differences in PaCO2 and FiO2 at T2 (P < 0.05). The rate of rescue ventilation during OLV was lower in the driving pressure group (2 cases) than in the control group (9 cases) (6.9% versus 32.4%, P < 0.05). There was no significant difference in the incidence of postoperative complications between the two groups (P < 0.05). Conclusion The individualized positive end expiratory pressure (PEEP) regulated by Pd can optimize the PEEP settings upon infant individuals under OLV and improve the compliance and oxygenation of ventilated lung. [ABSTRACT FROM AUTHOR]

Objective To explore the clinical efficacy of preoperative precise rehabilitation on endoscopic spinal decompression （Endo-LOVE） for lumbar spinal stenosis （LSS）. Methods A retrospective study was con⁃ ducted among 52 patients with Endo-LOVE from January 2020 to April 2022. The patients were equally divided into observation group and control group, treated with precision rehabilitation and traditional rehabilitation accord⁃ ing to the different rehabilitation patterns, respectively. The two groups were compared in terms of the score by Visual Analogue Scale （VAS）, Oswestry Disability Index （ODI） and JOA scores as well as the ratio of left and right supporting phases in gait parameters before the operation, 7 days and 3 months after the operation. Results There were no serious surgical complications in all patients. The VAS and ODI scores 7 days and 3 months after the operation were significantly lower （P < 0.05） and the JOA score and the ratio of left and right supporting phases were significantly higher than before the operation（P < 0.05）. The indexes of the observation group were statisti⁃ cally significantly different with those of the control group 7 days and 3 months after the operation （P < 0.05）. Conclusion Preoperative precise rehabilitation in Endo-LOVE for LSS can relieve postoperative residual pain, improve walking function, reduce the degree of lumbar dysfunction, improve the ability of daily living, and shorten the rehabilitation period. It is of value for clinical application. [ABSTRACT FROM AUTHOR]