Zhonghua wai ke za zhi [Chinese journal of surgery]最新文献

{"title":"[Core techniques and values of full-endoscopic spine surgery via transforaminal approach].","authors":"Z Z Li,&nbsp;S X Hou","doi":"10.3760/cma.j.cn112139-20230321-00118","DOIUrl":"10.3760/cma.j.cn112139-20230321-00118","url":null,"abstract":"<p><p>Full-endoscopic spinal surgery via transforaminal approach (TF-FESS) originated from the minimally invasive techniques of percutaneous interventional treatment of intervertebral disc diseases through posterolateral approach.Thanks to the continuous development and improvement of full-endoscopic equipment alongside surgical instruments and techniques, a developed technical system has been established in discectomy, spinal canal decompression, interbody fusion, etc. The combination of these basic techniques can treat relatively complex degenerative spinal diseases. The core techniques of TF-FESS include percutaneous puncture, foraminoplasty, spinal canal decompression, discectomy, annulus fibrosus suture, interbody fusion. This paper elaborates on the key points of the core techniques, indications, advantages, disadvantages, and prospects of the TF-FESS.</p>","PeriodicalId":23966,"journal":{"name":"Zhonghua wai ke za zhi [Chinese journal of surgery]","volume":"61 8","pages":"650-655"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10106105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Chinese Protocol of Diagnosis and Treatment of Colorectal Cancer (2023 edition)].","authors":"","doi":"10.3760/cma.j.cn112139-20230603-00222","DOIUrl":"10.3760/cma.j.cn112139-20230603-00222","url":null,"abstract":"<p><p>Colorectal cancer is one of the most common malignant tumors in China. In recent years, the incidence and mortality of colorectal cancer in China has been on the rise. According to the China Cancer Statistics Report in 2020, the incidence and mortality of colorectal cancer in China ranked second and fifth among all malignant tumors, with 555, 000 new cases and 286, 000 deaths. China has become the country with the highest number of new cases and deaths of colorectal cancer every year in the world, which seriously threatens the health of Chinese residents. In 2010, the National Ministry of Health organized the colorectal cancer expertise of the Chinese Medical Association to write the Chinese Protocol of Diagnosis and Treatment of Colorectal Cancer (2010 edition) and publish it publicly. Since 2010, the National Health and Family Planning Commission has organized experts to revise the protocol in 2015 and 2017, while the National Health Commission revised it in 2020 and 2023. The revised part of the Chinese Protocol of Diagnosis and Treatment of Colorectal Cancer (2023 edition) involves new progress in the field of imaging examination, pathological evaluation, surgery, chemotherapy and radiotherapy. The 2023 edition of the protocol not only referred to the contents of the international guidelines, but also combined with specific national conditions and clinical practice in China, and also included many evidence-based clinical data recently in China. The 2023 edition of the protocol would further promote the standardization of the diagnosis and treatment of colorectal cancer in China, improve the survival and prognosis of patients, and benefit millions of patients with colorectal cancer and their families.</p>","PeriodicalId":23966,"journal":{"name":"Zhonghua wai ke za zhi [Chinese journal of surgery]","volume":"61 8","pages":"617-644"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10106109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Proximal tibial aspect ratio and matching of tibial component in total knee arthroplasty: a narrative review].","authors":"D D Cao,&nbsp;A F Liu,&nbsp;Umiti Tashi,&nbsp;N N Ji,&nbsp;P Wang,&nbsp;Y Zhang","doi":"10.3760/cma.j.cn112139-20230201-00046","DOIUrl":"10.3760/cma.j.cn112139-20230201-00046","url":null,"abstract":"<p><p>Proximal tibial aspect ratio (PTAR) is closely related to age, disease status and cutting parameters with considerable inter-individual variation independent of gender and race, nevertheless the aspect ratio of tibial components from different manufacturers remains relatively constant from smallest to largest size. As a result, component mismatching is an unavoidable dilemma during tibia preparation in total knee arthroplasty (TKA). Various prosthesis systems all can achieve more than 80% coverage on proximal tibia, whereas their optimal fit rates are generally not more than 50%. It is difficult for symmetrical components to avoid anteroposterior mismatch, internal malrotation tends to occur when maximum coverage is pursued on the resected surface with a medial dominant plateau or lower PTAR. Although it is easier to achieve a balance of rotation and coverage with anatomical components, significant anteromedial overhang tends to appear on the resected surface with a symmetrical or lateral dominant plateau. Further researches should focus on the law of inter-individual variability of proximal tibial morphology, the quantitative definition of \"ideal matching\" safety zone of key morphological parameters on different areas of proximal tibia and the methodology of realizing\"ideal matching\"in the majority patients with the least amount of component sizes. In addition, with the rapid development of additive manufacturing and digital orthopedic technology, individual customized implant is expected to become a breakthrough point in the field of TKA component fitting.</p>","PeriodicalId":23966,"journal":{"name":"Zhonghua wai ke za zhi [Chinese journal of surgery]","volume":"61 8","pages":"727-732"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9748032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Role of blood markers in predicting the failure of prosthesis removal and antibiotic-loaded bone cement spacer implantation for treatment of periprosthetic joint infection].","authors":"J C Huang,&nbsp;Q K Wang,&nbsp;Z Y Song,&nbsp;Z Y Gao,&nbsp;X Chen,&nbsp;Z P Dai,&nbsp;J Zheng,&nbsp;Y Jin","doi":"10.3760/cma.j.cn112139-20221226-00545","DOIUrl":"10.3760/cma.j.cn112139-20221226-00545","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the value of inflammation,coagulation and nutrition markers in predicting the failure of prosthesis removal and antibiotic-loaded bone cement spacer implantation for treatment of periprosthetic joint infection(PJI). <b>Methods:</b> A retrospective study was conducted on 70 patients who undertook prosthesis removal and antibiotic-loaded bone cement spacer implantation due to PJI from June 2016 to October 2020 in the Department of Orthopedics,Henan Provincial People's Hospital. There were 28 males and 42 females,aged (65.5±11.9) years (range: 37 to 88 years). Patients were divided into two groups as the successful group and the failed group depended on whether reinfection occurred after prosthesis removal and antibiotic-loaded bone cement spacer implantation at the last follow up. Patient demographics,laboratory values (C-reactive protein (CRP),erythrocyte sedimentation rate (ESR),ESR and CRP ratio (ESR/CRP),white blood cell count(WBC),platelet count(PLT),hemoglobin(HB),total lymphocyte count(TLC),albumin、fibrinogen(FIB),CRP and albumin ratio (CAR),prognostic nutritional index(PNI)),and reinfection rates were assessed. Comparison between groups was conducted by the independent sample <i>t</i> test or <i>χ</i>²test. Receiver operating characteristic (ROC) curve was plotted,and the area under the curve (AUC),optimal diagnostic threshold,sensitivity,and specificity were analyzed to predict the failure of prosthesis removal and antibiotic-loaded bone cement spacer implantation. <b>Results:</b> All patients were followed up for at least two years,and the follow-up time was (38.4±15.2) months (range: 24 to 66 months). Fifteen patients suffered failure after prosthesis removal and antibiotic-loaded bone cement spacer implantation,while the other 55 patients succeeded. The overall failure rate of prosthesis removal and antibiotic-loaded bone cement spacer implantation in PJI treatment was 21.4%. Level of preoperative CRP ((35.9±16.2)mg/L),PLT ((280.0±104.0)×10⁹/L) and CAR (1.3±0.8) in successful group were lower than CRP ((71.7±47.3)mg/L),PLT ((364.7±119.3)×10⁹/L) and CAR (2.5±2.0) in failed group (all <i>P</i><0.05).Whereas,level of preoperative ESR/CRP (3.3±3.1), Albumin ((35.3±5.2)g/L) and PNI (43.6±6.2) in successful group were higher than ESR/CRP (1.6±1.4),Albumin ((31.3±4.8)g/L) and PNI (39.2±15.1) in failed group (all <i>P</i><0.05). AUC of ROC curve,optimal threshold value,sensitivity and specificity of CRP,ESR/CRP, PLT, Albumin,CAR and PNI for the predicting failure of prosthesis removal and antibiotic-loaded bone cement spacer implantation were 0.776(95%<i>CI</i>:0.660 to 0.867),35.4 mg/L,86.7%,67.3%;0.725(95%<i>CI</i>:0.605 to 0.825),1.0,60.0%,78.2%;0.713(95%<i>CI</i>:0.593 to 0.815),253,93.3%,47.3%;0.721(95%<i>CI</i>:0.601 to 0.822),35.7,93.3%,49.1%;0.772(95%<i>CI</i>:0.656 to 0.863),1.1,86.7%,67.3%;0.706(95%<i>CI</i>:0.585 to 0.809),45.7,100%,41.8% respectively. <b>Conclus","PeriodicalId":23966,"journal":{"name":"Zhonghua wai ke za zhi [Chinese journal of surgery]","volume":"61 8","pages":"681-687"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10106107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Progress in minimally invasive surgery for adjacent segment disease after lumbar fusion].","authors":"D S Liu,&nbsp;Y X Wang,&nbsp;Paerhati Rexiti","doi":"10.3760/cma.j.cn112139-20230220-00074","DOIUrl":"10.3760/cma.j.cn112139-20230220-00074","url":null,"abstract":"<p><p>Adjacent segment disease (ASDis) is a common complication of posterior lumbar spine fusion and often requires surgical treatment. In the treatment of ASDis, percutaneous spinal endoscopy can be used for simple decompression without removal of the original internal fixation, or for posterior fixation and fusion under the scope or in combination with other access fixation and fusion techniques, with the advantages of less surgical trauma, less bleeding, and faster postoperative recovery. Traditional trajectory screw technique is one of the risk factors for adjacent segment degeneration because of its tendency to cause damage to the adjacent synovial joint during surgery. In contrast, the cortical tone trajectory (CBT) screw placement technique not only reduces the damage to the articular joint during the screw placement process, but also preserves the original internal fixation in the treatment of ASDis, which significantly reduces the surgical trauma. Secondly, the implantation of CBT screws with the aid of digital technologies such as three-dimentinal printed guides, CT navigation, and robotics allows for more precise \"double nailing\" of ASDis patients to complete the fusion of adjacent segments, and is a minimally invasive procedure to be considered for patients who meet the clinical indications for fusion. This article reviews the literature on the use of percutaneous spinal endoscopy and CBT in the surgical management of ASDis.</p>","PeriodicalId":23966,"journal":{"name":"Zhonghua wai ke za zhi [Chinese journal of surgery]","volume":"61 8","pages":"722-727"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10106110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Uniportal thoracoscopic thorough debridement for tubercular empyema with abscess of the chest wall].","authors":"H M Cai,&nbsp;R Mao,&nbsp;Y Deng,&nbsp;Y M Zhou","doi":"10.3760/cma.j.cn112139-20221002-00417","DOIUrl":"10.3760/cma.j.cn112139-20221002-00417","url":null,"abstract":"<p><p><b>Objective:</b> To examine the feasibility and technical considerations of thorough debridement using uniportal thoracoscopic surgery for tuberculous empyema complicated by chest wall tuberculosis. <b>Methods:</b> A retrospective analysis was conducted on 38 patients who underwent comprehensive uniportal thoracoscopy debridement for empyema complicated by chest wall tuberculosis in the Department of Thoracic Surgery, Shanghai Pulmonary Hospital, from March 2019 to August 2021. There were 23 males and 15 females, aged (<i>M</i>(IQR)) 30 (25) years (range: 18 to 78 years). The patients were cleared of chest wall tuberculosis under general anesthesia and underwent an incision through the intercostal sinus, followed by the whole fiberboard decortication method. Chest tube drainage was used for pleural cavity disease and negative pressure drainage for chest wall tuberculosis with SB tube, and without muscle flap filling and pressure bandaging. If there was no air leakage, the chest tube was removed first, followed by the removal of the SB tube after 2 to 7 days if there was no obvious residual cavity on the CT scan. The patients were followed up in outpatient clinics and by telephone until October 2022. <b>Results:</b> The operation time was 2.0 (1.5) h (range: 1 to 5 h), and blood loss during the operation was 100 (175) ml (range: 100 to 1 200 ml). The most common postoperative complication was prolonged air leak, with an incidence rate of 81.6% (31/38). The postoperative drainage time of the chest tube was 14 (12) days (range: 2 to 31 days) and the postoperative drainage time of the SB tube was 21 (14) days (range: 4 to 40 days). The follow-up time was 25 (11) months (range: 13 to 42 months). All patients had primary healing of their incisions and there was no tuberculosis recurrence during the follow-up period. <b>Conclusion:</b> Uniportal thoracoscopic thorough debridement combined with postoperative standardized antituberculosis treatment is safe and feasible for the treatment of tuberculous empyema with chest wall tuberculosis, which could achieve a good long-term recovery effect.</p>","PeriodicalId":23966,"journal":{"name":"Zhonghua wai ke za zhi [Chinese journal of surgery]","volume":"61 8","pages":"688-692"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9748030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Long term follow-up evaluation of combined surgery for congenital tibial pseudarthrosis in children].","authors":"Y X Liu,&nbsp;G Yang,&nbsp;X K Hu,&nbsp;Q Tan,&nbsp;H Pan,&nbsp;K Liu,&nbsp;Y Y Huang,&nbsp;A Yan,&nbsp;G H Zhu,&nbsp;H B Mei","doi":"10.3760/cma.j.cn112139-20230205-00051","DOIUrl":"10.3760/cma.j.cn112139-20230205-00051","url":null,"abstract":"<p><p><b>Objective:</b> To explore the long-term effect of combined surgery for the treatment of congenital tibial pseudarthrosis in children. <b>Methods:</b> The clinical data of 44 children with congenital tibial pseudarthrosis who underwent combined surgery (tibial pseudarthrosis tissue resection, intramedullary rod fixation, Ilizarov external fixator fixation, wrapped autologous iliac bone graft) from August 2007 to October 2011 at the Department of Pediatric Orthopedics, Hunan Children's Hospital were collected retrospectively. There were 33 males and 11 females. The age at the time of surgery was (3.7±2.2)years (range:0.6 to 12.4 years), including 25 cases under 3 years old and 19 cases above 3 years old.Among them, 37 cases were complicated with neurofibromatosis type 1.The operation status, postoperative complications and follow-up results were recorded. <b>Results:</b> The follow-up time after surgery was (10.9±0.7)years (range:10 to 11 years).Thirty-nine out of 44 patients (88.6%) achieved initial healing of tibial pseudarthrosis, with an average healing time of (4.3±1.1)months (range:3 to 10months).In the last follow-up, 36 cases (81.8%) had unequal tibial length, 20 cases (45.4%) had refractures, 18 cases (40.9%) had ankle valgus, 9 cases (20.4%) had proximal tibial valgus, and 11 cases (25.0%) had high arched feet.Nine cases (20.4%) developed distal tibial epiphyseal plate bridging.17 cases (38.6%) had abnormal tibial mechanical axis.Seven cases (15.9%) developed needle infection, and one case (2.3%) developed tibial osteomyelitis. 21 patients (47.7%) had excessive growth of the affected femur.Five patients (11.3%) had ankle stiffness, and 34 patients (77.2%) had intramedullary rod displacement that was not in the center of the tibial medullary cavity.Among them, 8 cases (18.1%) protruded the tibial bone cortex and underwent intramedullary rod removal.18 children have reached skeletal maturity, while 26 children have not been followed up until skeletal maturity. <b>Conclusion:</b> Combined surgery for the treatment of congenital pseudarthrosis of the tibia in children has a high initial healing rate, but complications such as unequal tibia length, refracture, and ankle valgus occur during long-term follow-up, requiring multiple surgical treatments.</p>","PeriodicalId":23966,"journal":{"name":"Zhonghua wai ke za zhi [Chinese journal of surgery]","volume":"61 8","pages":"675-680"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9802630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[C₂ pedicle screw insertion assisted by mobilization of the vertebral artery in cases with high-riding vertebral artery].","authors":"J Liu,&nbsp;M H Zeng,&nbsp;L Jia,&nbsp;S Y Ling,&nbsp;Y Ji,&nbsp;X P Wei,&nbsp;C Y Xia,&nbsp;C S Niu","doi":"10.3760/cma.j.cn112139-20221021-00452","DOIUrl":"10.3760/cma.j.cn112139-20221021-00452","url":null,"abstract":"<p><p><b>Objective:</b> To examine the feasibility, safety, and efficacy of mobilization of the vertebral artery for C₂ pedicle screws in cases with high-riding vertebral artery (HRVA). <b>Methods:</b> The clinical data of 12 patients with basilar invagination and atlantoaxial dislocation underwent atlantoaxial reduction and fixation in the Department of Neurosurgery, the First Affiliated Hospital of University of Science and Technology of China between January 2020 and November 2021 were retrospectively analyzed. All patients had high-riding vertebral artery on at least one side that prohibited the insertion of C₂ pedicle screws. There were 2 males and 10 females aged (48.0±12.8) years (range: 17 to 67 years). After correction of vertical dislocation during the operation, the C₂ pedicle screw insertion and occipitocervical fixation and fusion were performed using the vertebral artery mobilization technique. Neurological function was assessed using the Japanese Orthopedic Association (JOA) scale. The preoperative and postoperative JOA score and the main radiological measurements, including the anterior atlantodental interval (ADI), the distance of the odontoid tip above the Chamberlain line, the clivus-canal angle, were collected and compared by paired <i>t</i>-test. <b>Results:</b> Mobilization of the high-riding vertebral artery was successfully completed, and C₂ pedicle screws were then fulfilled after the vertebral artery was protected. There was no injury to the vertebral artery during the operation. Meanwhile, no severe surgical complications such as cerebral infarction or aggravated neurological dysfunction occurred during the perioperative period. Satisfactory C₂ pedicle screw placement and reduction were achieved in all 12 patients. All patients achieved bone fusion 6 months after surgery. No looseness and shift in internal fixation or reduction loss was observed during the follow-up period. Compared to the preoperative, the postoperative ADI decreased from (6.1±1.9) mm to (2.0±1.2) mm (<i>t</i>=6.73, <i>P</i><0.01), the distance of the odontoid tip above the Chamberlain line decreased from (10.4±2.5) mm to (5.5±2.3) mm (<i>t</i>=7.12, <i>P</i><0.01), the clivus-canal angle increased from (123.4±11.1) ° to (134.7±9.6) ° (<i>t</i>=2.50, <i>P</i>=0.032), the JOA score increased from 13.3±2.1 to 15.6±1.2 (<i>t</i>=6.99, <i>P</i><0.01). <b>Conclusion:</b> The C₂ pedicle screw insertion assisted by mobilization of the vertebral artery is safe and considerably effective, providing a choice for internal fixation in cases with high-riding vertebral arteries.</p>","PeriodicalId":23966,"journal":{"name":"Zhonghua wai ke za zhi [Chinese journal of surgery]","volume":"61 8","pages":"693-699"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9802628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[A medium- and long-term comparative observation on volumetric changes of cervical disc herniation after symmetrically or asymmetrically decompression and conservative treatment for cervical spondylotic myelopathy].","authors":"A D Zhu,&nbsp;C L Zhang,&nbsp;X Yan,&nbsp;S Fu,&nbsp;D Z Li,&nbsp;C Dong,&nbsp;Y K Wang","doi":"10.3760/cma.j.cn112139-20221008-00423","DOIUrl":"10.3760/cma.j.cn112139-20221008-00423","url":null,"abstract":"<p><p><b>Objective:</b> To compare the volumetric changes of cervical disc herniation (CDH) after cervical microendoscopic laminoplasty(CMEL),expansive open-door laminoplasty (EOLP) and conservative treatment. <b>Methods:</b> A retrospective study was conducted involving 101 patients with cervical spondylotic myelopathy(CSM),at the Department of Orthopaedic Surgery,the First Affiliated Hospital of Zhengzhou University from April 2012 to April 2021. The patients included 52 males and 49 females with an age of (54.7±11.8) years(range:25 to 86 years). Among them, 35 patients accepted CMEL treatment,33 patients accepted EOLP treatment,while 33 patients accepted conservative treatment. Volume data of CDH were measured by three-dimensional analysis of the initial and follow-up MRI images. The absorption rate and reprotrusion rate of CDH were calculated. The happening of resorption or reprotrusion was defined when the ratio was greater than 5%. The clinical outcomes and quality of life were evaluated by the Japanese Orthopaedic Association (JOA) score and the neck disability index (NDI).Quantitative data was analyzed by one-way ANOVA with post LSD-<i>t</i> test (multiple comparison) or Kruskal-Wallis test. Categorical data was analyzed by <i>χ</i>² test. <b>Results:</b> The follow-up time of the CMEL group,EOLP group and the conservative treatment group were (27.6±18.8)months,(21.6±6.9)months and(24.9±16.3)months respectively with no significant difference(<i>P</i>>0.05). Changes of CDH volume in patients:(1) There were 96 CDH of 35 patients in the CMEL group,among which 78 showed absorption. The absorption frequency was 81.3%(78/96) and the absorption rate was ranged 5.9% to 90.9%;9 CDH showed reprotrusion,the reprotrusion frequency was 9.4% (9/96) and the reprotrusion rate was 5.9% to 13.3%;(2) There were 94 CDH of 33 patients in the EOLP group,of which 45 showed absorption. The absorption prevalence was 47.9% (45/94) and the absorption rate was 5.0% to 26.7%;20 CDH showed reprotruded,with the reprotrusion frequency of 21.3% (20/94) and the reprotrusion rate was 5.8% to 28.3%;(3) There were 102 CDH in 33 patients of the conservative group. Among them, 5 showed absorption. The absorption frequency was 4.9% (5/102),and the absorption rate was 7.2% to 14.3%;58 CDH showed reprotruded with the re-protrusion ratio of 56.9% (58/102) and the re-protrusion rate was 5.4% to 174.1%. The absorption ratio and reprotrusion ratio of the CMEL group were statistically different from EOLP group or the conservative group (<i>P</i><0.01).The absorption ratio and reprotrusion ratio of the EOLP group was different from conservative group (all <i>P</i><0.01). In terms of clinical outcomes, the excellent/good rate of the JOA score and NDI scores in the CMEL group were different from that of conservative group (all <i>P</i><0.01) but not from that of the EOLP group(<i>P</i>>0.05). <b>Conclusions:</b> CMEL is an effective method for the treatment of CSM,making CDH e","PeriodicalId":23966,"journal":{"name":"Zhonghua wai ke za zhi [Chinese journal of surgery]","volume":"61 8","pages":"666-674"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10106108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Effect of sugammadex on postoperative nausea and vomiting after surgery for intracranial aneurysm].","authors":"J Cui,&nbsp;L Yao,&nbsp;J L Wu,&nbsp;C Y Lu,&nbsp;Y Zhao,&nbsp;Y L Zhao","doi":"10.3760/cma.j.cn112139-20230111-00016","DOIUrl":"10.3760/cma.j.cn112139-20230111-00016","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the effect of sugammadex on postoperative nausea and vomiting(PONV) after intracranial aneurysm surgery. <b>Methods:</b> Data from intracranial aneurysms patients who met the inclusion and exclusion criteria and underwent interventional surgery in the Department of Neurosurgery, Peking University International Hospital from January 2020 to March 2021 were prospectively included. According to the random number table method, the patients were divided by 1∶1 into the neostigmine+atropine group (group N) and the sugammadex group (group S). Use an acceleration muscle relaxation monitor for muscle relaxation monitoring, and administer neostigmine+atropine and sugammadex to block residual muscle relaxation drugs after surgery. The incidence rates of PONV and severity, the appearance of anesthesia, and the correlation between PONV and postoperative complications were recorded in both groups during five periods after surgery: 0-0.5 hours (T1),>0.5-2.0 hours(T2),>2.0-6.0 hours (T3),>6.0-12.0 hours (T4) and >12.0-24.0 hours (T5). Group comparisons of quantitative data were performed by the independent sample <i>t</i>-test, and categorical data was performed by the <i>χ</i>² or rank sum test. <b>Results:</b> A total of 66 patients were included in the study, including 37 males and 29 female, aged (59.3±15.4) years (range: 18 to 77 years). The incidence rates of PONV of 33 patients in group S at different time periods of T1, T2, T3, T4, and T5 after surgery were respectively 27.3%(9/33),30.3%(10/33),12.1%(4/33),3.0%(1/33),0(0/33),and the incidence rates of PONV of 33 patients in the group N at different time periods of T1, T2, T3, T4 and T5 after surgery were respectively 36.4%(12/33),36.4%(12/33),33.3%(11/33),6.1%(2/33) and 0(0/33).The incidence of PONV was lower in the group S only in the T3 period after reversal than in the group N (<i>χ</i>²=4.227, <i>P</i>=0.040).However, there was no statistically significant difference in the incidence of PONV between the two groups of patients in other periods (all <i>P</i>>0.05). The recovery time for spontaneous breathing in patients in group S was (7.7±1.4) minutes, the extubation time was (12.4±5.3) minutes, and the safe exit time for anesthesia recovery was (12.3±3.4) minutes; the N groups were (13.9±2.0) minutes, (18.2±6.0) minutes, and (18.6±5.2) minutes, respectively; three time periods in group S were shorter than those in group N, and the differences were statistically significant (all <i>P</i><0.05). The results regarding the occurrence of complications in patients with different levels of PONV at different time intervals after surgery in the two groups were as follows: in the T3 time period of group N, a significant difference was observed only in the occurrence of postoperative complications among patients with different levels of PONV (<i>χ</i>²=24.786, <i>P</i><0.01). However, in the T4 time period, significant differences were foun","PeriodicalId":23966,"journal":{"name":"Zhonghua wai ke za zhi [Chinese journal of surgery]","volume":"61 8","pages":"700-706"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9748034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}