ObjectiveTo compare the postoperative enhanced recovery outcomes of lobectomy performed under non-intubated video-assisted thoracic surgery (NIVATS) versus intubated video-assisted thoracic surgery (IVATS). Methods Computerized searches were performed in the following databases: China National Knowledge Infrastructure (CNKI), Wanfang Data, VIP Information, China Biomedical Literature Database (CBMdisc), Web of Science, Clinicaltrials.gov, The Cochrane Library, EMbase, and PubMed. We collected randomized controlled trials (RCTs) and observational studies comparing NIVATS and IVATS. The search period extended from the inception of each database to April 1, 2023. Two independent researchers screened the literature and assessed study quality. ResultsA total of 14 studies were included, comprising 4 RCTs, 7 retrospective cohort studies, and 3 propensity score matching studies, involving 1 840 patients. Meta-analysis results indicated that, compared to IVATS, NIVATS was associated with significantly shorter operative time [MD=–13.39, 95%CI (–20.16, –6.62), P<0.001], shorter length of hospital stay [MD=–0.81, 95%CI (–1.39, –0.22), P=0.005], shorter chest tube duration [MD=–0.73, 95%CI (–1.36, –0.10), P=0.02], shorter postoperative anesthesia recovery time [MD=–20.34, 95%CI (–26.83, –13.84), P<0.001], and shorter time to oral intake after surgery [MD=–5.68, 95%CI (–7.63, –3.73), P<0.001]. Furthermore, NIVATS showed a lower incidence of postoperative airway complications [OR=0.49, 95%CI (0.34, 0.71), P<0.001] and less total chest tube drainage volume [MD=–251.11, 95%CI (–398.25, –103.98), P<0.001], all contributing to significantly accelerated postoperative enhanced recovery for patients. Conclusion NIVATS is a safe and technically feasible anesthesia method in thoracoscopic lobectomy, which can to some extent replace IVATS.
Objective To address the lack of unified group standards, inconsistent rehabilitation service processes, and waste of rehabilitation resources in the field of traumatic spinal cord injury (TSCI) rehabilitation in China, a standardized rehabilitation specifications for TSCI was established based on the 2017 expert consensus, the latest evidence-based medical evidence, and the International Classification of Functioning, Disability and Health (ICF) framework. MethodsLed by the China Rehabilitation Research Center and funded by the National Key Research and Development Program of China and the Capital Health Research and Development of Special Funds, this guideline was developed by experts from multiple renowned domestic institutions, drawing on international experience and combining it with clinical practice in China. ResultsRehabilitation Guidelines and Specifications for Traumatic Spinal Cord Injury (2025 Edition) clarifies the terminology and definitions of TSCI and specifies standards for the entire process, including pre-hospital first aid, emergency management, clinical diagnosis, acute phase clinical treatment, rehabilitation assessment, and rehabilitation therapy. It details rehabilitation protocols such as physical therapy (motor therapy), occupational therapy, vocational rehabilitation, social rehabilitation, and psychological rehabilitation. Furthermore, it provides specific rehabilitation management strategies for common complications involving the respiratory system, bowel, bladder, cardiovascular system, as well as pain, spasticity, and pressure injuries. ConclusionThis guideline is applicable to medical and health institutions at all levels involved in the diagnosis and treatment of TSCI. Early, accurate, and standardized rehabilitation treatment can effectively reduce disability rates, restore limb function, and improve patients’ quality of life. The formulation of this guideline provides a significant basis for the standardized treatment and rehabilitation of TSCI patients in China.