scholarly journals Comparative analysis of safety and effect of minimally invasive esophageal cancer radical resection and conventional thoracotomy for esophageal cancer

2018 ◽  
Vol 2 (6) ◽  
Author(s):  
Ke Du ◽  
Zhenxing Wang
Keyword(s):  
Esophageal Cancer ◽  
Blood Loss ◽  
Minimally Invasive ◽  
Lymph Nodes ◽  
Radical Surgery ◽  
Radical Resection ◽  
Control Group ◽  
Clinical Effects ◽  
Intraoperative Blood Loss ◽  
Experimental Group

【Abstract】Objective: To compare the clinical effects of minimally invasive esophageal cancer radical resection and traditional esophageal cancer radical resection.Methods: 200 cases of esophageal cancer radical resection were performed from July 2014 to July 2017 in our hospital.The cases were divided into experimental group and control group, 82 cases in the experimental group and 118 cases in the control group.The experimental group was treated with minimally invasive esophageal cancer radical surgery, and the control group was treated with conventional thoracotomy.Record the comparison between the two groups (1) surgical conditions, including the time of surgery, intraoperative blood loss, hospitalization time; (2) the number of lymph nodes cleaned; (3) the postoperative control group used conventional thoracotomy, including lung lesions, anastomotic fistula / narrow.RESULTS: The parameters of operation time, intraoperative blood loss, hospitalization time, and number of lymph nodes cleaned in the experimental group were lower than those in the control group, and the difference was statistically significant (p<0.05). In addition to pulmonary infection (p<0.05), There was no significant difference in the incidence of other complications between the experimental group and the control group (p>0.05).Conclusion: Minimally invasive esophageal cancer radical resection and conventional thoracotomy have good clinical effects in the treatment of esophageal cancer. Minimally invasive esophageal cancer radical surgery can effectively reduce intraoperative trauma and postoperative reaction, which is worthy of popularization and application.

scholarly journals Study on the Effect of Removing the Slide Wire Screw on Locking Plate by Nail Groove Reconstruction Method

2021 ◽  
Author(s):  
Guanglei Zheng ◽  
Yingjie Qi
Keyword(s):  
Blood Loss ◽  
Locking Plate ◽  
Operation Time ◽  
Healing Time ◽  
Control Group ◽  
Reconstruction Method ◽  
Intraoperative Blood Loss ◽  
Limb Function ◽  
Experimental Group ◽  
Tungsten Steel

Abstract Background: This paper is to describe and evaluate the nail groove reconstruction method in removing slide wire screw on locking plate. Then compare the method with tungsten steel drilling nail method, to explore a new method of removing slide wire screw on locking plate.Method: A total of 1254 patients with removal fracture internal fixation devices were collected from the Affiliated Hospital of Hangzhou Normal University from July 2015 to September 2021, of which 62 cases met the inclusion and exclusion criteria. All patients were randomly divided into the experimental group and the control group. 31 people per group. There were 19 males and 12 females in the experimental group, the age of patients was 35.68±11.70years; while 18 males and 13 females in the control group, the age of patients was 36.27±10.37years. Nail groove reconstruction method was used in the experimental group, and the tungsten steel drilling nail method was used in the control group. Collect and count surgical-related indicators, the data of two groups were compared and analyzed from four aspects: intraoperative blood loss, operation time, incision healing time and limb function recovery time.Result: All slide wire screws were removed successfully, and all patients had no serious postoperative complications such as internal fixation retention and neurovascular injury. The experimental group was better than the control group in the following three aspects: the amount of intraoperative blood loss, the operative time, the recovery time of limb function, and the differences were statistically significant(p < 0.05). There was no significant difference in incision healing time between the two groups.Conclusion: The nail groove reconstruction method has less damage to the bone and soft tissue, less intraoperative blood loss, shorter operation time, and faster postoperative recovery of limb function. The nail groove reconstruction method is a simple and effective method, it has obvious advantages compared with the traditional method.

scholarly journals A non-bioartificial liver support system combined with transplantation in HBV-related acute-on-chronic liver failure

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Peng Li ◽  
Xi Liang ◽  
Shan Xu ◽  
Ye Xiong ◽  
Jianrong Huang
Keyword(s):  
Survival Rate ◽  
Blood Loss ◽  
Liver Failure ◽  
Control Group ◽  
Observation Group ◽  
Intraoperative Blood Loss ◽  
Chronic Liver Failure ◽  
Short Term ◽  
Liver Support ◽  
Liver Support System

AbstractWe aim to determine the impact of an artificial liver support system (ALSS) treatment before liver transplantation (LT), and identify the prognostic factors and evaluate the predictive values of the current commonly used ACLF prognostic models for short-term prognosis after LT. Data from 166 patients who underwent LT with acute-on-chronic liver failure (ACLF) were retrospectively collected from January 2011 to December 2018 from the First Affiliated Hospital of Zhejiang University School of Medicine. Patients were divided into two groups depending on whether they received ALSS treatment pre-LT. In the observation group, liver function tests and prognostic scores were significantly lower after ALSS treatment, and the waiting time for a donor liver was significantly longer than that of the control group. Both intraoperative blood loss and period of postoperative ICU care were significantly lower; however, there were no significant differences between groups in terms of total postoperative hospital stays. Postoperative 4-week and 12-week survival rates in the observation group were significantly higher than those of the control group. Similar trends were also observed at 48 and 96 weeks, however, without significant difference. Multivariate Cox regression analysis of the risk factors related to prognosis showed that preoperative ALSS treatment, neutrophil–lymphocyte ratio, and intraoperative blood loss were independent predicting factors for 4-week survival rate after transplantation. ALSS treatment combined with LT in patients with HBV-related ACLF improved short-term survival. ALSS treatment pre-LT is an independent protective factor affecting the 4-week survival rate after LT.

scholarly journals Placenta previa with posterior extrauterine adhesion: clinical features and management practice

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yoshikazu Nagase ◽  
Shinya Matsuzaki ◽  
Masayuki Endo ◽  
Takeya Hara ◽  
Aiko Okada ◽  
...  
Keyword(s):  
Propensity Score ◽  
Blood Loss ◽  
Cesarean Delivery ◽  
Clinical Features ◽  
Surgical Outcomes ◽  
Multivariate Regression ◽  
Placenta Previa ◽  
Control Group ◽  
Intraoperative Blood Loss ◽  
Intraoperative Bleeding

Abstract Background A diagnostic sign on magnetic resonance imaging, suggestive of posterior extrauterine adhesion (PEUA), was identified in patients with placenta previa. However, the clinical features or surgical outcomes of patients with placenta previa and PEUA are unclear. Our study aimed to investigate the clinical characteristics of placenta previa with PEUA and determine whether an altered management strategy improved surgical outcomes. Methods This single institution retrospective study examined patients with placenta previa who underwent cesarean delivery between 2014 and 2019. In June 2017, we recognized that PEUA was associated with increased intraoperative bleeding; thus, we altered the management of patients with placenta previa and PEUA. To assess the relationship between changes in practice and surgical outcomes, a quasi-experimental method was used to examine the difference-in-difference before (pre group) and after (post group) the changes. Surgical management was modified as follows: (i) minimization of uterine exteriorization and adhesion detachment during cesarean delivery and (ii) use of Nelaton catheters for guiding cervical passage during Bakri balloon insertion. To account for patient characteristics, propensity score matching and multivariate regression analyses were performed. Results The study cohort (n = 141) comprised of 24 patients with placenta previa and PEUA (PEUA group) and 117 non-PEUA patients (control group). The PEUA patients were further categorized into the pre (n = 12) and post groups (n = 12) based on the changes in surgical management. Total placenta previa and posterior placentas were more likely in the PEUA group than in the control group (66.7% versus 42.7% [P = 0.04] and 95.8% versus 63.2% [P < 0.01], respectively). After propensity score matching (n = 72), intraoperative blood loss was significantly higher in the PEUA group (n = 24) than in the control group (n = 48) (1515 mL versus 870 mL, P < 0.01). Multivariate regression analysis revealed that PEUA was a significant risk factor for intraoperative bleeding before changes were implemented in practice (t = 2.46, P = 0.02). Intraoperative blood loss in the post group was successfully reduced, as opposed to in the pre group (1180 mL versus 1827 mL, P = 0.04). Conclusions PEUA was associated with total placenta previa, posterior placenta, and increased intraoperative bleeding in patients with placenta previa. Our altered management could reduce the intraoperative blood loss.

scholarly journals Safety and effectiveness evaluation of a two-handed technique combining harmonic scalpel and laparoscopic Peng’s multifunction operative dissector in laparoscopic hemihepatectomy

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Jingwei Cai ◽  
Guixing Jiang ◽  
Yuelong Liang ◽  
Yangyang Xie ◽  
Junhao Zheng ◽  
...  
Keyword(s):  
Blood Loss ◽  
Operative Time ◽  
Harmonic Scalpel ◽  
Peak Level ◽  
Bile Leakage ◽  
Liver Parenchyma ◽  
Control Group ◽  
Case Group ◽  
Intraoperative Blood Loss ◽  
And Control

Abstract Objectives This study was designed to evaluate the safety and effectiveness of a two-hand technique combining harmonic scalpel (HS) and laparoscopic Peng’s multifunction operative dissector (LPMOD) in patients who underwent laparoscopic hemihepatectomy (LHH). Methods We designed and conducted a case-control study nested in a prospectively collected laparoscopic liver surgery database. Patients who underwent LHH for liver parenchyma transection using HS + LPMOD were defined as cases (n = 98) and LPMOD only as controls (n = 47) from January 2016 to May 2018. Propensity score matching (1:1) between the case and control groups was used in the analyses. Results The case group had significantly less intraoperative blood loss in milliliters (169.4 ± 133.5 vs. 221.5 ± 176.3, P = 0.03) and shorter operative time in minutes (210.5 ± 56.1 vs. 265.7 ± 67.1, P = 0.02) comparing to the control group. The conversion to laparotomy, postoperative hospital stay, resection margin, the mean peak level of postoperative liver function parameters, bile leakage rate, and others were comparable between the two groups. There was no perioperative mortality. Conclusions We demonstrated that the two-handed technique combing HS and LPMOD in LHH is safe and effective which is associated with shorter operative time and less intraoperative blood loss compared with LPMOD alone. The technique facilitates laparoscopic liver resection and is recommended for use.

scholarly journals Treatment of thoracolumbar trauma by short-segment percutaneous transpedicular screw instrumentation: prospective comparative study with a minimum 2-year follow-up

2014 ◽  
Vol 20 (2) ◽  
pp. 150-156 ◽  
Author(s):  
Petr Vanek ◽  
Ondrej Bradac ◽  
Renata Konopkova ◽  
Patricia de Lacy ◽  
Jiri Lacman ◽  
...  
Keyword(s):  
Blood Loss ◽  
Minimally Invasive ◽  
Cobb Angle ◽  
Control Group ◽  
Working Ability ◽  
Short Segment ◽  
Transpedicular Screw ◽  
Significant Difference ◽  
Screw Group

Object The main aim of this study was to compare clinical and radiological outcomes after stabilization by a percutaneous transpedicular system and stabilization from the standard open approach for thoracolumbar spine injury. Methods Thirty-seven consecutive patients were enrolled in the study over a period of 16 months. Patients were included in the study if they experienced 1 thoracolumbar fracture (A3.1–A3.3, according to the AO/Magerl classification), had an absence of neurological deficits, had no other significant injuries, and were willing to participate. Eighteen patients were treated by short-segment, minimally invasive, percutaneous pedicle screw instrumentation. The control group was composed of 19 patients who were stabilized using a short-segment transpedicular construct, which was performed through a standard midline incision. The pain profile was assessed by a visual analog scale (VAS), and overall satisfaction by a simple 4-stage scale relating to performance of daily activities. Working ability and return to original occupation were also monitored. Radiographic follow-up was defined by the vertebral body index (VBI), vertebral body angle (VBA), and bisegmental Cobb angle. The accuracy of screw placement was examined using CT. Results The mean surgical duration in the percutaneous screw group was 53 ± 10 minutes, compared with 60 ± 9 minutes in the control group (p = 0.032). The percutaneous screw group had a significantly lower perioperative blood loss of 56 ± 17 ml, compared with 331 ± 149 ml in the control group (p < 0.001). Scores on the VAS in patients in the percutaneous screw group during the first 7 postoperative days were significantly lower than those in the control group (p < 0.001). There was no significant difference between groups in VBI, VBA, and Cobb angle values during follow-up. There was no significant difference in screw placement accuracy between the groups and no patients required surgical revision. There was no significant difference between groups in overall satisfaction at the 2-year follow-up (p = 0.402). Working ability was insignificantly better in the percutaneous screw group; previous working position was achieved in 17 patients in this group and in 12 cases in the control group (p = 0.088). Conclusions This study confirms that the percutaneous transpedicular screw technique represents a viable option in the treatment of preselected thoracolumbar fractures. A significant reduction in blood loss, postoperative pain, and surgical time were the main advantages associated with this minimally invasive technique. Clinical, functional, and radiological results were at least the same as those achieved using the open technique after a 2-year follow-up. The short-term benefits of the percutaneous transpedicular screw technique are apparent, and long-term results have to be studied in other well-designed studies evaluating the theoretical benefit of the percutaneous technique and assessing whether the results of the latter are as durable as the ones achieved by open surgery.

scholarly journals Nanoparticles can improve the positive rate of metastatic lymph node in thyroid cancer surgery

2020 ◽  
Author(s):  
Xindi Su ◽  
Fang Chai ◽  
Benrui Lin ◽  
Lu Qu ◽  
Keyi Liu ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Metastatic Lymph Node ◽  
Cancer Surgery ◽  
Control Group ◽  
Blood Calcium ◽  
Metastatic Lymph ◽  
Positive Rate ◽  
Experimental Group

Abstract Objective. To investigate the application of carbon nanoparticles in lymph node dissection and parathyroid gland protection during thyroid cancer surgery. Subjects and Methods. Retrospective analysis was performed on 282 cases of thyroid cancer surgery in our hospital from 2018 to 2019. All patients underwent total thyroidectomy and cervical central lymph node dissection. Nanocarbon was not used in the control group, but was used in the experimental group. The general situation of the patients, the number of postoperative lymph nodes and the number of metastasis were collected, and the differences between serum parathyroid hormone and blood calcium were compared before and on the 3rd and 30th day after surgery. Results. There was no difference in age, sex and TNM stage between the two groups (P > 0.05). The number of metastatic lymph nodes in the experimental group (9.80 ± 4.80) was different from that in the control group (6.95 ± 3.86) (P < 0.05), and the number of metastatic lymph nodes in the experimental group was different from that in the control group (χ2 = 14.968, P < 0.05). There was no difference in blood calcium and PTH between the two groups before and at 3 and 30 days after surgery (P > 0. 05). Conclusion. The application of carbon nanoparticles in thyroid cancer surgery can significantly increase the number of lymph nodes seized and the positive rate of metastatic lymph node removal, but the protection of parathyroid gland is not obvious.

scholarly journals Safety of laparoscopic pancreaticoduodenectomy in patients with liver cirrhosis using propensity score matching

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0246364
Author(s):  
Ke Cheng ◽  
Wei Liu ◽  
Jiaying You ◽  
Shashi Shah ◽  
Yunqiang Cai ◽  
...  
Keyword(s):  
Overall Survival ◽  
Liver Cirrhosis ◽  
Blood Loss ◽  
Postoperative Morbidity ◽  
Control Group ◽  
Complication Rates ◽  
Laparoscopic Pancreaticoduodenectomy ◽  
Intraoperative Blood Loss ◽  
Cirrhotic Patients

Currently, safety of laparoscopic pancreaticoduodenectomy (LPD) in patients with liver cirrhosis is unknown. The aim of this study was to explore postoperative morbidity and mortality and long-term outcomes of cirrhotic patients after LPD. The study was a one-center retrospective study comprising 353 patients who underwent LPD between October 2010 and December 2019. A total of 28 patients had liver cirrhosis and were paired with 56 non-cirrhotic counterparts through propensity score matching (PSM). Baseline data, intra-operative data, postoperative data, and survival data were collected. Postoperative morbidity was considered as primary outcome whereas postoperative mortality, surgical parameters (operative durations, intraoperative blood loss), and long-term overall survival were secondary outcomes. Cirrhotic patients showed postoperative complication rates of 82% compared with rates of patients in the control group (48%) (P = 0.003). Further, Clavien-Dindo ≥III complication rates of 14% and 11% (P = 0.634), Clavien-Dindo I-II complication rates of 68% and 38% (P = 0.009), hospital mortality of 4% and 2% (P = 0.613) were observed for cirrhotic patients and non-cirrhotic patients, respectively. In addition, an overall survival rate of 32 months and 34.5 months (P = 0.991), intraoperative blood loss of 300 (200–400) ml and 150 (100–250) ml (P<0.0001), drain amount of 2572.5 (1023.8–5275) ml and 1617.5 (907.5–2700) ml (P = 0.048) were observed in the cirrhotic group and control group, respectively. In conclusion, LPD is associated with increased risk of postoperative morbidity in patients with liver cirrhosis. However, the incidence of Clavien-Dindo ≥III complications and post-operative mortality showed no significant increase. In addition, liver cirrhosis showed no correlation with poor overall survival in patients who underwent LPD. These findings imply that liver cirrhosis patients can routinely be considered for LPD at high volume centers with rigorous selection and management.

scholarly journals Immediate results of spleen-preserving distal subtotal pancreatic resection

2021 ◽  
Vol 26 (1) ◽  
pp. 100-106
Author(s):  
T. S. Mirzaev ◽  
D. V. Podluzhny ◽  
R. E. Izrailov ◽  
Yu. I. Patyutko ◽  
E. V. Glukhov ◽  
...  
Keyword(s):  
Blood Loss ◽  
Pancreatic Resection ◽  
The Body ◽  
Pancreatic Tumors ◽  
Benign Tumors ◽  
Control Group ◽  
Intraoperative Blood Loss ◽  
Spleen Preserving ◽  
Subtotal Pancreatectomy ◽  
Malignancy Potential

Aim. To assess the possibility of open spleen-preserving distal subtotal pancreatic resection for tumors of the body and tail of the pancreas.Material and methods. A retrospective comparative analysis of the immediate results of the spleen-preserving interventions in 41 patients was carried out. Mainly benign tumors or tumors with a low malignancy potential of the corpus and (or) the tail of the pancreas were detected. Distal subtotal pancreatectomy with splenectomy was performed in 53 patients with pancreatic tumors of different histogenesis with low malignancy potential (control group).Results. The duration of spleen-preserving distal subtotal pancreatectomy was 12 minutes shorter, compared with the distal subtotal pancreatectomy with splenectomy group (p = 0.180). Significantly lower volume of intraoperative blood loss during spleen-preserving procedure was noted – by 460 ml (p = 0.0001). The level of postoperative complications in the spleen-preserving pancreatectomy group was 15 (37%), while in the group of distal subtotal pancreatectomy with splenectomy was 26 (49%) (p = 0.227), respectively. External pancreatic fistula after spleenpreserving pancreatectomy was noted in 13 (32%) patients, in the other group in 21 (40%; p = 0.429). The duration of hospital stay did not statistically significantly differ in the compared groups and amounted to: 18.6 ± 6.9 and 20.3 ± 5.4 days (p = 0.123), respectively.Conclusion. Open spleen-preserving pancreatectomy is a relatively safe type of surgical treatment for patients with benign tumors and tumors with a low potential for malignancy of the body and/or tail of the pancreas. The surgery is shorter in time, accompanied by a lower level of complications, significantly less intraoperative blood loss, compared with a similar procedure involving splenectomy.

scholarly journals Study on clinical effects of pedicle screw combined with immobilized implantation bone by wirerope and hallow compression screw immobilization in treating spondylolysis of lumbar vertebra of multiple segments of adults

2020 ◽  
Vol 6 (3) ◽  
pp. 19
Author(s):  
Dongdong Zhao ◽  
Feng Li ◽  
Yao Wu ◽  
Xiaoyan Zhang
Keyword(s):  
Pedicle Screw ◽  
Screw Fixation ◽  
Pedicle Screw Fixation ◽  
Control Group ◽  
Clinical Effects ◽  
Observation Group ◽  
Intraoperative Blood Loss ◽  
Compression Screw ◽  
Lumbar Spondylolysis ◽  
Duration Of Surgery

Objective: To observe clinical effects of pedicle screw fixation combined with cable wires and bone graft and cannulated compression screws on adult multi-segment lumbar spondylolysis.Methods: 70 cases of patients with multi-segment lumbar spondylolysis were selected in our hospital. According to different surgical schemes, these patients were divided into the observation group (35 cases) and the control group (35 cases). The observation group received pedicle screw fixation combined with cable wires and bone graft and the control group received cannulated compression screw fixation. Macnab criteria were adopted to implement a therapeutic evaluation of two groups of patients to make an observation and comparison of the excellent and good rate of surgery and a series of indicators including perioperative clinical effects, intraoperative blood loss, duration of surgery, hospital length of stay (HLOS), visual analogue scale (VAS), Oswestry disability index and Japanese Orthopaedic Association (JOA) score.Results: The excellent and good rate of the observation group was 97.14%, and that of the control group was 82.86%, the difference between two groups was statistically significant (χ2 = 6.248, p = .012). The differences in intraoperative blood loss, duration of surgery and HLOS between two groups were statistically significant (t = -4.55, t = -4.55, t = -4.55; p < .05). Oswestry index, VAS score and JOA score of the observation group were (2.4 ± 0.9), (28.5 ± 6.4) and (27.1 ± 3.1) respectively, and these of the control group were (3.5 ± 1.2), (37.1 ± 7.8) and (21.3 ± 2.7) respectively, the differences between two groups were statistically significant (t = 4.338, t = 5.043, t = 8.347, p < .05).Conclusions: Pedicle screw combined with immobilized implantation bone by wirerope has an excellent clinical effect on the treatment of adult multi-segment lumbar spondylolysis, and it has a series of advantages such as fast postoperative recovery, small surgical trauma and so on. In addition, this technique can also restore the stability of spinal segments and relieve pains to a greater degree.

scholarly journals Clinical Application of a Neurosurgical Robot in Intracranial Ommaya Reservoir Implantation

2021 ◽  
Vol 15 ◽  
Author(s):  
Huan-Guang Liu ◽  
De-Feng Liu ◽  
Kai Zhang ◽  
Fan-Gang Meng ◽  
An-Chao Yang ◽  
...  
Keyword(s):  
Blood Loss ◽  
Minimally Invasive ◽  
Operation Time ◽  
Hole Diameter ◽  
Drainage Tube ◽  
Ommaya Reservoir ◽  
Implantation Technique ◽  
Intraoperative Blood Loss ◽  
Robot Assisted ◽  
Robot Assisted Surgery

Background: The Ommaya reservoir implantation technique allows for bypass of the blood-brain barrier. It can be continuously administered locally and be used to repeatedly flush the intracranial cavity to achieve the purpose of treatment. Accurate, fast, and minimally invasive placement of the drainage tube is essential during the Ommaya reservoir implantation technique, which can be achieved with the assistance of robots.Methods: We retrospectively analyzed a total of 100 patients undergoing Ommaya reservoir implantation, of which 50 were implanted using a robot, and the remaining 50 were implanted using conventional surgical methods. We then compared the data related to surgery between the two groups and calculated the accuracy of the drainage tube of the robot-assisted group.Results: The average operation time of robot-assisted surgery groups was 41.17 ± 11.09 min, the bone hole diameter was 4.1 ± 0.5 mm, the intraoperative blood loss was 11.1 ± 3.08 ml, and the average hospitalization time was 3.9 ± 1.2 days. All of the Ommaya reservoirs were successful in one pass, and there were no complications such as infection or incorrect placement of the tube. In the conventional Ommaya reservoir implantation group, the average operation time was 65 ± 14.32 min, the bone hole diameter was 11.3 ± 0.3 mm, the intraoperative blood loss was 19.9 ± 3.98 ml, and the average hospitalization time was 4.1 ± 0.5 days. In the robot-assisted surgery group, the radial error was 2.14 ± 0.99 mm and the axial error was 1.69 ± 1.24 mm.Conclusions: Robot-assisted stereotactic Ommaya reservoir implantation is quick, effective, and minimally invasive. The technique effectively negates the inefficiencies of craniotomy and provides a novel treatment for intracranial lesions.

Sign in / Sign up

Export Citation Format

Share Document