scholarly journals Comparison of Left Lower Entrance and Traditional Laparoscopic Greater Omentum Resection for Stage I Ovarian Cancer

Author(s):  
Aiwen Le ◽  
Fan Yang ◽  
Kai Kang ◽  
Guna He

Abstract Objective : To describe the surgical method, safety and convenience of " lower left entrance laparoscopic greater omentum resection" and evaluate its clinical application value for stage I ovarian cancer. Methods: 31 patients with early stage I ovarian cancer underwent with laparoscopic staging surgery adopted " lower left entrance laparoscopic omentum resection " as the observation group, and 29 cases underwent by conventional laparoscopy as control group. The intraoperative and postoperative indexes were compared. Results: During the greater omentum resection, there was no significant difference between two groups in the blood loss, but the operation time in observation group was significantly shorter than the control group. There was no difference in postoperative hospital stay、gastrointestinal exhaust time and postoperative severe complications.Conclusion: " lower left entrance laparoscopic greater omentum resection " may be a safe and effective technique in stage I ovarian cancer.

2019 ◽  
Vol 3 (1) ◽  
Author(s):  
Jun Wang ◽  
Xian Zhang

【Abstract】Objective: To investigate the clinical efficacy of carboprost tromethamine combined with mifepristone in the treatment of uterine fibroids. METHODS: A total of 66 patients with uterine fibroids admitted to our hospital between April 2018 and January 2019 were selected as subjects. According to the two different treatment methods, patients were divided equally. The observation group and the control group, each group of 33 people. The oxytocin drug treatment was medicated to the control group, and the prostaglandin tromethamine combined with mifepristone was medicated to the observation group. The treatment effect, adverse reaction, operation, and uterine muscle before and after surgery were observed in these two groups. Tumor tissue progesterone receptor and estrogen receptor levels. Results: The clinical treatment effect of the observation group was 93.94%, and the clinical treatment effect of the control group was 60.61%. The clinical treatment effect of the observation group was significantly higher than that of the control group; also the incidence of adverse reactions in the observation group in terms of rash, fatigue, nausea and vomiting was much lower than the control group, and could observe a significant difference. Finally in observation group, the amount of intraoperative blood loss, operation time and hospitalization time were better than those of the control group. The progesterone receptor and estrogen receptor levels in the uterine fibroid tissue after surgery should also be better than the control group, it is worth to make further comparison. Conclusion: Carprostol tromethamine combined with mifepristone is effective in the treatment of uterine fibroids and can be further developed.


Author(s):  
Hua HUANG ◽  
Yunfei GU ◽  
Lijiang JI ◽  
Youran LI ◽  
Shanshan XU ◽  
...  

ABSTRACT Background: Varicose veins appear above and below the dentate line in mixed hemorrhoids, which seriously affects anal function and quality of life. Aim: To propose an improvement in tissue-selecting therapy repair of anal pad combined with complete anal canal epithelial retention comparing with Milligan-Morgan surgery. Methods: A prospective randomized controlled study was designed enrolling 200 patients with grade III and IV hemorrhoids. They were divided into control and observation groups. The control received Milligan-Morgan surgery, and the observation the modified tissue-selecting therapy stapler combined with complete anal canal preservation surgery. All patients were followed for six months to evaluate the treatment differences. Results: In final, control group included 82 and observation 87. The average operation time of the control group was significantly lower than that of the observation, while the bleeding volume was significantly lower in control group. The control group VAS score was 3 (1, 4), and observation 4 (2, 5). There was no significant difference in the incidence of urinary retention, bleeding and wound margin edema after surgery at one month postoperatively. Digital incidence of anal stenosis in the observation group was significantly lower than in control; the same occurred with residual anal margins. The postoperative anal canal diameter was significantly larger than the control group. Wexner anal incontinence score showed that no anal incontinence occurred in both groups, and the control group scored was significantly higher than observation. In final six months follow-up, the observation group did not experience any relapse and four cases were found among controls. The treatment satisfaction of the observation group was better. Conclusions: In grades III and IV hemorrhoids, modified tissue-selecting therapy combined with complete anal canal preservation had better prognosis and treatment satisfaction than Milligan-Morgan procedure, and it is a new surgical method for patients with advanced mixed hemorrhoids.


2021 ◽  
Author(s):  
Panpan Zhang ◽  
Dan Liu ◽  
Dong Luo ◽  
Fuli Pang

Abstract Background To investigate the effects of modified subxiphoid thoracoscopic surgery and traditional surgery on pain mediators and pain stress levels in patients with anterior mediastinal teratoma. Method Eighty patients with anterior mediastinal teratoma who underwent surgery in our hospital from May 2019 to May 2021 were selected as the subjects of this prospective study. According to the random residue grouping method, they were divided into a control group and observation group with 40 cases each. Among them, the control group underwent traditional surgery, and the observation group underwent modified subxiphoid thoracoscopic surgery. Observe and compare the surgical indicators, pain-causing mediators, and pain stress levels of the two groups of patients. Result The intraoperative blood loss, postoperative extubation time, and total drainage volume of the observation group were significantly lower than those of the control group, while the operation time was significantly higher than that of the control group, which was statistically significant (P < 0.05). There was no statistically significant difference in the pain-causing mediators of the two groups before surgery (P > 0.05), while the NPY, PGE2 and 5-HT at 1 day after surgery were significantly different, and the observation group was better than the control group. The comparison was statistically significant. Significance (P < 0.05). There was no statistically significant difference in pain stress levels between the two groups before surgery (P > 0.05), while NO, IL-6, and IL-β 1 day after surgery were significantly different, and the observation group was better than the control group. Statistically significant (P < 0.05). Conclusion The modified subxiphoid thoracoscopic surgery has a significant effect, reduces the level of peripheral blood pain-causing factors, relieves the pain of the patient, and promotes the recovery of the patient. It provides a certain reference for the mediastinal teratoma before the clinical operation.


BMC Cancer ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Hiroaki Kajiyama ◽  
Shiro Suzuki ◽  
Nobuhisa Yoshikawa ◽  
Michiyasu Kawai ◽  
Kimio Mizuno ◽  
...  

Abstract Background The aim of this study was to investigate how much the risks of recurrence and death are increased as a consequence of selecting fertility-sparing surgery (FSS) in young women with epithelial ovarian cancer (EOC). Methods After a central pathological review and search of the medical records from 14 collaborating hospitals, a non-randomized, observational cohort study was conducted between 1987 and 2015, including 1183 women with stage I EOC. Finally, a total of 285 patients with stage I EOC at reproductive age were recruited. Oncologic outcomes were compared between the FSS (N = 101) and radical surgery (RS) group (N = 184) using a propensity score (PS)-matching technique to adjust for relevant risk factors: the age, substage, histological type, grade, CA125 values, ascites cytology, ascites volume, and chemotherapy. Results During 66.0 months (median) of follow-up, 42 patients (14.7%) developed recurrence, and 31 patients (10.9%) died. In the original cohort, there was no significant difference in overall survival (OS) or recurrence-free survival (RFS) between the FSS and RS groups {Log-rank: OS (P = 0.838), RFS (P = 0.377)}. In the PS-matched cohort after adjustment for multiple clinicopathologic factors, there was no significant difference in RFS or OS between the FSS and RS groups {RFS (FSS vs. RS), HR: 1.262 (95% CI: 0.559–2.852), P = 0. 575; OS (FSS vs. RS), HR: 1.206 (95% CI: 0.460–3.163), P = 0.704}. Conclusions After adjustment for clinicopathologic factors, FSS in itself may not worsen the oncologic outcome in young women with early-stage EOC. A large-scale clinical study is necessary to validate the findings.


2021 ◽  
Vol 5 (3) ◽  
Author(s):  
Zhonglong Zheng ◽  
Tao Li ◽  
Yang Chen ◽  
Yang Zhang ◽  
Pan Zhang

Objective: To analyze the feasibility of simultaneous bilateral thoracoscopic lung resection in the treatment of multiple primary lung cancers in the early stage. Methods: The study time range is between March 2019 and March 2021. A sample of 30 patients with early multiple primary lung cancer admitted to this hospital were included, and they were divided into a study group, a control group, and samples within the group using a random number table scheme n=15, patients in the control group underwent staged bilateral thoracoscopic pneumonectomy, and patients in the study group underwent bilateral thoracoscopic pneumonectomy at the same time. The indicators of the two groups were compared and analyzed. Results: There was no significant difference in the operation time and intraoperative blood loss between the two groups (P>0.05). There were significant differences in the VAS score, total length of hospital stay, and total surgical costs on the first day after surgery (P<0.05); there was no significant difference in the two groups' postoperative recovery indicators and the incidence of complications (P>0.05). Conclusion: It is safe and feasible to treat patients with multiple primary lung cancer in both lungs at the same time with simultaneous bilateral thoracoscopic surgery, and is suitable for promotion.


2020 ◽  
Vol 3 (1) ◽  
pp. 22
Author(s):  
Haibin Wang

Objective: To explore and discuss the clinical therapeutic effects of the application of cross-injury vertebral fixation and via-injury vertebrae fixation in the treatment of bone tumor with thoracolumbar spine fracture. Methods: A total of 58 patients with bone tumors and thoracolumbar spine fractures admitted to our hospital from February to February 2019 were selected as the study subjects. They were randomly divided into control group and observation group, with 29 cases in each group. The patients in the control group received cross-injury vertebral fixation treatment, while the patients in the observation group were treated with via-injury vertebral fixation. The therapeutic effects of the two groups were compared. Results: The operation time and hospitalization time of the observation group were significantly shorter than those of the control group (P<0.05), and the postoperative drainage volume of the intraoperative blood loss was significantly less than that of the control group (P<0.05). There was no significant difference in postoperative pain and spinal JOA scores between the two groups (P>0.05); there was no significant difference in the compression ratio of the injured vertebrae and the kyphosis Cobb angle between the two groups (P>0.05), after the operation, the two groups of patients were significantly reduced, and the compression ratio of the injured vertebrae and kyphosis Cobb angle of the observation group were more obvious (P<0.05); the vertebral height loss and Cobb angle loss in the observation group were significantly lower than those in the control group (P<0.05). Conclusion: In the treatment of bone tumor with thoracolumbar spine fracture, compared with cross-injury vertebral fixation, via-injury vertebral fixation has a more significant clinical effect and is more suitable for clinical application and promotion.


2019 ◽  
Vol 17 ◽  
pp. 205873921983704
Author(s):  
Wentao Wang ◽  
Dequan Zhong ◽  
Hua Cheng ◽  
Chengfu Ji ◽  
Zhouming Shen ◽  
...  

The aim of this study is to investigate the efficacy of expanded endonasal approaches (EEAs) in the treatment of pituitary adenoma, and the effects of serum levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and interleukin-12 (IL-12) in patients were further analyzed. A total of 80 cases of patients with pituitary adenoma admitted to our hospital from January 2013 to May 2015 were randomly divided into the observation group and control group, with 40 cases in each group. The observation group was treated with EEA technique, while the control group was treated with transcranial microsurgery. The prolactin (PRL), growth hormone (GH) and other endocrine hormone indexes, as well as inflammatory factors such as TNF-α, IL-6, and IL-12 were compared before and 1 week after the operation between the two groups. Moreover, the scores of Karnofsky performance status (KPS) and Mini-Mental State Examination (MMSE) at preoperative and postoperative 1 week were also compared between the two groups. The operation time, hospitalization time, and postoperative complications were compared between the two groups. And the patients were followed up for 2 years to observe the recurrence rate. The operation time and hospital stay in the observation group were 62.8 ± 9.3 min and 12.5 ± 2.1 days, respectively, while the operation time and length of stay in the control group were 105.6 ± 15.7 min and 18.2 ± 3.4 days, respectively. The operation time and hospitalization time were shorter than those in the control group, and the differences were statistically significant ( P < 0.05). Before surgery, there was no significant difference in serum levels of PRL and GH between the two groups ( P > 0.05). At 1 week after surgery, the levels of PRL and GH in the two groups were significantly lower than those before surgery ( P < 0.05). And the serum levels of PRL and GH in the observation group were significantly lower than those in the observation group at 1 week after the operation ( P < 0.05). Before operation, there was no significant difference between the two groups of KPS and MMSE scores ( P > 0.05). At 1 week after operation, the scores of KPS and MMSE in both groups were significantly higher than those before the operation ( P < 0.05), and the scores of KPS and MMSE in the observation group were significantly higher than those in the control group ( P < 0.05). Furthermore, there was no significant difference in the serum levels of IL-6, IL-12, and TNF-α between the two groups before operation ( P > 0.05). At 1 week after surgery, the serum levels of IL-6, IL-12, and TNF-α in the two groups were significantly lower than those before surgery ( P < 0.05), while the serum levels of IL-6, IL-12, and TNF-α in the observation group were evidently lower than those in the control group at 1 week after the operation. Besides, the incidence of postoperative complications in the observation group was 7.5%, which was significantly lower than that in the control group (17.5%) ( P < 0.05). All the patients in the two groups were followed up for 2 years. And there was no recurrence in the observation group and one case in the control group. The therapeutic effect of EEAs on pituitary adenoma is better. It can improve the level of high endocrine hormone in patients with pituitary adenoma, improve the functional status of the patients, reduce the serum level of inflammatory factors, and shorten the hospital stay. Meanwhile, it also has the characteristics of fewer complications and low recurrence rate, so it can be popularized in clinical practice.


2020 ◽  
Author(s):  
Xiuyu Du ◽  
Xiaodong Zhai ◽  
Zhi Liu ◽  
Jinliang Teng ◽  
Chunyan Liu

Abstract Objectives: This study describes an intradermal injection technique for reducing bleeding during a percutaneous dilatation tracheotomy (PDT).Methods: Fifty-two consecutively recruited patients who underwent PDTs were analysed in a prospective study that was conducted between May 2019 and January 2020. This is a prospective study and fifty-two patients who underwent PDT were recruited from May 2019 to January 2020. They were randomly divided into an observation group and a control group. The patients in the observation group accepted the execution of the intradermal injection technique during their local anaesthesia. A comparison was made between the two groups’ intraoperative bleeding, postoperative bleeding, operation time and length of incision.Results: A total of 52 patients were enrolled in this study, 33 males (63.5%) and 19 females. The mean age was 63.0±9.9 years, with the patients’ age ranging from 45 to 80 years. The mean BMI was 29.2±5.1 kg/m2. There was no significant difference in gender, age, BMI index and whether they had an endotracheal tube between the two groups (P > 0.05). The observation group’s intraoperative bleeding was less than that of control group (χ2 = 8.308, P = 0.009). There was no significant difference in operation time between the two groups (t = -0.904, P = 0.372). There was no PDT-related death.Conclusion: The intradermal injection technique can be used to effectively and safely reduce bleeding during PDTs. This technique provides a lower intraoperative bleeding grade without increased the procedure’s duration.


2019 ◽  
Vol 3 (4) ◽  
Author(s):  
Hao Zhang

Objective: To analyze the efficacy of laparoscopic resection of anterior rectal cancer in treating rectal cancer. Methods: Fifty patients with rectal cancer who were treated in Gucheng County Hospital of Hebei Province from September 2017 to September 2019 were selected and recruited in the present study. These patients were divided into two groups, namely the control group and observation groups, by random number table method. Each group consisted of 25 patients. The control group underwent laparoscopic assisted transanorectal mesorectal excision, whereas the observation group underwent laparoscopic resection of anterior rectal cancer. The two groups were compared for related indicators, indicators pertaining to postoperative recovery, and complications. Results: There was no significant difference in the number of lymph node dissections between the two groups (P>0.05). The amount of intraoperative blood loss, surgical operation time, and incision length in the observation group were lower than those in the control group, and the differences were statistically significant (P<0.05). The time of getting out of bed, anal exhaust, and duration of hospital stay were shorter in the observation group than those of the control group, and the differences were statistically significant (P<0.05). In addition, the incidence of postoperative complications in the observation group was lower than that in the control group, and the differences were statistically significant (P<0.05). Conclusions: Laparoscopic resection of anterior rectal cancer is effective for rectal cancer patients. This treatment method can effectively reduce the amount of intraoperative bleeding, shorten the operation time, the time of anal exhaust, get out of bed, and the length of hospital stay, as well as improve condition of the patients.


2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Axiang He ◽  
Yanjie Mao ◽  
Ying Zhou ◽  
Qin Kong ◽  
Hui zhang ◽  
...  

Abstract Background The accuracy of targeted lower limb alignment correction following HTO is closely related to patients’ pain relief and knee joint survival time. How to accurately perform osteotomy and how to obtain the ideal target limb alignment to maximize the curative effect are the difficulty in HTO practice. The purpose of this study is to evaluate the predictive and application value of osteotomy master software (OsteoMaster) in coronal plane preoperative planning of high tibial osteotomy. Method Sixty-seven patients with medial compartment osteoarthritis and varus deformity treated by medial open-weight high tibial osteotomy were enrolled and divided into observation group (31 cases) and control group (36 cases). The observation group was planned by OsteoMaster, while the control group was planned by Miniaci. The preoperative predicted values of osteotomy depth, open height, correction angle, WBL ratio, and FTA of the observation group were compared with the actual intraoperative values to study their accuracy. The operative time, blood loss, number of fluoroscopy, and WBL ratio were compared between the observation group and the control group to study its application value. Result There was no significant difference between two groups in preoperative prediction and intraoperative reality of osteotomy depth, open height, correction angle, FTA, and WBL ratio (P > 0.05). The operation time and number of fluoroscopy in the observation group were significantly less than those in the control group (P < 0.05), while the difference in blood loss was not statistically significant (P > 0.05). The good rate of WBL ratio was 87.1% in the observation group and 75% in the control group. Conclusion OsteoMaster has predictive value in osteotomy depth, open height, correction angle, FTA, and WBL ratio of HTO, which is also helpful to reduce the number of fluoroscopy, shorten the operation time, and improve the accuracy of target limb alignment. The drawback of this approach is 2-dimensional approach in contrast to 3-dimensional preoperative planning that is including the more real study.


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