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

{"title":"[Clinical effect of laparoscopy for the treatment of biliary stricture after biliary dilatation operation].","authors":"R Y Cai,&nbsp;X Y He,&nbsp;S W Zhu,&nbsp;Y F Li,&nbsp;X M Yin","doi":"10.3760/cma.j.cn112139-20221230-00554","DOIUrl":"https://doi.org/10.3760/cma.j.cn112139-20221230-00554","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the safety and effect of laparoscopy for the treatment of biliary stricture after the biliary dilatation operation. <b>Methods:</b> The clinical data of 78 patients,including 27 males and 51 females aged (48.6±14.2)years(range:17 to 76 years),who presented biliary stricture after biliary dilatation operation from January 2017 to June 2021 in the Department of Minimally Invasive Hepatobiliary Surgery,Hunan Provincial People's Hospital,were retrospectively collected,with 38 cases in the laparoscopy group and 40 cases in the laparotomy group. Of the 78 patients,there were 67 cases of cholangiojejunostomy stricture and 11 cases of stricture of the high intrahepatic bile duct. Statistical methods such as <i>t</i>-test and <i>χ</i>² test were carried out to compare perioperative clinical data and follow-up information between the two groups. <b>Results:</b> Less intraoperative blood loss((102.6±76.4)ml <i>vs.</i> (162.5±105.9) ml, <i>t</i>=-2.874,<i>P</i>=0.005),shorter postoperative stay length of stay((10.5±3.7)days <i>vs.</i> (14.5±6.4)days, <i>t</i>=-3.379,<i>P</i>=0.001) and shorter waiting time for postoperative anal exhaust((2.0±0.6)days <i>vs.</i> (2.5±0.9)days, <i>t</i>=-2.827,<i>P</i>=0.006) were found in the laparoscopy group than that in the laparotomy group,with statistically significant differences. While there was no statistically difference in the operative time((252.8±54.7)minutes <i>vs.</i> (257.4±68.6)minutes,<i>t</i>=-0.331,<i>P</i>=0.742). Postoperative review and follow-up did not show statistically significant differences between the two groups in the residual stone rate(5.3%(2/38) <i>vs.</i> 5.0%(2/40)) and the incidence of recurrent biliary stricture(5.3%(2/38) <i>vs.</i> 7.5%(3/40))(both <i>P</i>>0.05). <b>Conclusion:</b> Laparoscopy may be safe and effective in the treatment of biliary stricture after the biliary dilatation operation,with less trauma,faster recovery compared to laparotomy.</p>","PeriodicalId":23966,"journal":{"name":"Zhonghua wai ke za zhi [Chinese journal of surgery]","volume":"61 5","pages":"375-380"},"PeriodicalIF":0.0,"publicationDate":"2023-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9200499","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 brief discussion on the inspiration and thinking of the Metaverse concept to promote the innovative development of intelligent medicine in China].","authors":"Q P Lu,&nbsp;H W Fu,&nbsp;X S Zhang","doi":"10.3760/cma.j.cn112139-20230118-00029","DOIUrl":"https://doi.org/10.3760/cma.j.cn112139-20230118-00029","url":null,"abstract":"<p><p>Created by digital technology,the Metaverse is a digital platform where the digital virtual world and the actual real world can coexist to some extent. Based on the integration of Metaverse and medical science,this article describes the great development of intelligent medicine in the fields of medical practice,medical education and medical research,especially in the field of surgery. First,the technical source of the Metaverse concept in the field of intelligent medicine can be traced back to technology to generate actual digital data sets from human anatomy. Second,the successful industrial practice of Metaverse in the field of intelligent medicine conforms to the authentic and credible fundamental purpose of \"taking people as the first priority and serving people\"， that is， \"virtual\" must be based on \"actual\" for \"actual\".</p>","PeriodicalId":23966,"journal":{"name":"Zhonghua wai ke za zhi [Chinese journal of surgery]","volume":"61 5","pages":"353-356"},"PeriodicalIF":0.0,"publicationDate":"2023-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9200493","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":"[Analysis of surgical treatment of severe angular kyphosis with keeping the spinal cord length constant in osteotomy area].","authors":"W Li,&nbsp;G J Tong,&nbsp;G F Zhou,&nbsp;B B Cai,&nbsp;C F Wang,&nbsp;R F Quan","doi":"10.3760/cma.j.cn112139-20220706-00300","DOIUrl":"https://doi.org/10.3760/cma.j.cn112139-20220706-00300","url":null,"abstract":"<p><p><b>Objective:</b> To explore the surgical methods and clinical outcomes of severe angular kyphosis with the length of the spinal cord constant in the osteotomy area. <b>Methods:</b> Clinical data from 20 patients with severe angular kyphosis who underwent surgical treatment from January 2017 to December 2020 in the Department of Spinal Surgery,Hangzhou Xiaoshan District Hospital of Traditional Chinese Medicine were retrospectively analyzed. There were 11 males and 9 females, aged (28.5±8.9) years (range:17 to 46 years).There were 15 cases with congenital angular kyphosis,5 cases with tuberculous angular kyphosis.The angle of kyphosis was (107.1±12.9)° (range:93.2° to 131.4°).Frankel classification:2 cases with grade B,4 cases with grade C,3 cases with grade D.The kyphotic vertex is located at the T₉ to T₁₂ segments.Pedicle screws were placed in 3 or 4 adjacent segments at the proximal and distal kyphosis apex of the patients using a surgical navigation system.Piezosurgery combined with a grinding drill was used to complete the osteotomy in the apical vertebral region.Titanium mesh or artificial vertebral body was implanted,and the osteotomy surface was closed using this as the fulcrum to complete osteotomy.Spinal X-ray examination was performed before surgery,immediately after surgery and at the last follow-up,and sagittal and coronal Cobb angle,sagittal and coronary balance parameters,anterior vertebral height,posterior vertebral height,and spinal cord length were measured.Pulmonary function,visual analogue scale (VAS),and Oswestry's disability index (ODI) were collected and estimated before and after treatment.The analysis of variance of repeated measurement data was used for each evaluation index before and after treatment,and the <i>t</i> test was used for pairwise comparison. <b>Results:</b> All patients successfully completed surgery,with artificial vertebral body in 11 cases and double titanium mesh in 9 cases.The follow-up time was (28.2±2.3) months (range:26 to 31 months).Sagittal vertical axis improved from (46.9±13.7)mm(range:21.7 to 75.7 mm) before surgery to (10.7±5.5)mm (range:3.6 to 28.1 mm) after surgery,and (11.0±5.7)mm(range:3.6 to 29.3 mm) at the last follow-up,the differences were statistically significant compared to before surgery (all <i>P</i><0.01).The mean kyphotic Cobb angle was corrected from (107.1±12.9) ° (range:93.2 ° to 131.4°) before surgery to (30.6±8.5) ° (range:20.0 ° to 47.8 °) after surgery (all <i>P</i><0.01),and (32.1±8.7) ° (range:18.2 ° to 50.8°) at the last follow-up,the differences were statistically significant compared to before surgery(all <i>P</i><0.01).The anterior vertebral height improved from (14.2±2.9)mm(range:11.04 to 23.6 mm) before surgery to (45.3±7.5)mm(range:29.4 to 56.5 mm) after surgery,and (44.3±6.8)mm(range:29.6 to 56.0 mm) at the last follow-up,the differences were statistically significant compared to before surgery (all <i>P</i><0.01).The posterior verteb","PeriodicalId":23966,"journal":{"name":"Zhonghua wai ke za zhi [Chinese journal of surgery]","volume":"61 5","pages":"403-411"},"PeriodicalIF":0.0,"publicationDate":"2023-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9205112","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":"[Use of indocyanine green fluorescence navigation in laparoscopic anatomical hepatectomy].","authors":"Z Q Hou,&nbsp;Q Y Xie,&nbsp;M H Liao,&nbsp;C Liu,&nbsp;G T Qiu,&nbsp;Z X Jin,&nbsp;S Z Mi,&nbsp;J W Huang","doi":"10.3760/cma.j.cn112139-20230113-00021","DOIUrl":"https://doi.org/10.3760/cma.j.cn112139-20230113-00021","url":null,"abstract":"<p><p><b>Objective:</b> To examine the clinical value of fluorescence-guided indocyanine green (ICG) laparoscopic anatomical hepatectomy in the treatment of primary hepatocellular carcinoma. <b>Methods:</b> Data from patients diagnosed with hepatocellular carcinoma and who underwent laparoscopic hepatectomy with ICG fluorescence navigation in the Department of Liver Surgery and Liver Transplantation Center of West China Hospital between September 2020 and May 2022 were retrospectively collected. There were 53 males and 19 females, with an age of (55.5±12.9)years(range:42.6 to 68.4 years). Among them, 13 of the cases underwent laparoscopic anatomical liver resection(LALR) guided by tans-arterial ICG,43 of the cases received LAIR guided by portal vein negative ICG, and 16 of the cases received LALR positive by portal vein. Comparison among the three groups was performed by one-way ANOVA; and the rank sum test was used for comparison between groups. The counting data was expressed as percentage,and the <i>χ</i>² test or Fisher's exact probability method was used for comparison between groups. <b>Results:</b> (1) Postoperative pathology: Resection R0 was achieved in all operations. The maximum tumor diameter of the patients in the arterial staining group, the reverse staining group, and the positive staining group(<i>M</i> (IQR)) was 2.5 (2.4) cm, 3.0 (2.5) cm and 3.0(2.4) cm,respectively. There were no statistically significant differences in the maximum tumor diameter between the three groups (<i>P</i>=0.364). The minimum tumor margin was 1.1 (1.1) cm, 1.0 (1.0) cm, 1.1 (1.6) cm in the the arterial staining group, reverse staining group and the positive staining group, respectively. There was no significant difference in the margin among the three groups (<i>P</i>=0.878). (2) Operation conditions: the operation time of the arterial staining group, the negative staining group, and the positive portal staining group was (348±93)minutes,(277±112)minutes,and (295±116)minutes,respectively. There were no significant differences in operation time among the three groups (<i>P</i>=0.134). The intraoperative blood loss of the three groups was 80(150)ml,200(350)ml,and 100(150)ml,respectively. There was no statistically significant difference in intraoperative bleeding volume between the three groups(<i>P</i>=0.743). All cases were not transfused during the operation and were not converted to laparotomy. ALT in the arterial staining group was higher than in the negative staining group in the first two days after the operation ((559±398)IU/L307(257) IU/L, <i>q</i>=235.5,<i>P</i>=0.004;(611±389)IU/L(331±242) IU/L, <i>q</i>=265.2, <i>P</i>=0.002). There was only one case of a grade III complication (Clavien-Dindo grading system) postoperative complication in the negative and positive staining group of the portal vein, respectively. Tumor markers in all patients decreased to the normal range after 2 months of operation. <b>Conclusion:</b> Laparoscopic a","PeriodicalId":23966,"journal":{"name":"Zhonghua wai ke za zhi [Chinese journal of surgery]","volume":"61 5","pages":"368-374"},"PeriodicalIF":0.0,"publicationDate":"2023-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9200500","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":"[Current status and hotspot of minimally invasive surgery for pancreatic head carcinoma].","authors":"T P Zhang,&nbsp;Y Z Liu,&nbsp;Y P Zhao","doi":"10.3760/cma.j.cn112139-20221104-00473","DOIUrl":"https://doi.org/10.3760/cma.j.cn112139-20221104-00473","url":null,"abstract":"<p><p>With the improvement of laparoscopic equipment and surgical technology,pancreatic surgery has entered the \"minimally invasive era\".However,the use of minimally invasive pancreaticoduodenectomy in patients with pancreatic head cancer remains controversial.In recent years,China's pancreatic surgeons have been at the forefront of the world in terms of surgical technology,however,surgical philosophy, selection of indication,and perioperative management should be further stregthened. Additionally, the development of medical standards in various regions of China is seriously uneven,and minimally invasive pancreaticoduodenectomy still needs to be further standardized and popularized.Through this article,the author discusses the development status of minimally invasive surgery for pancreatic head cancer and related hot topics with fellow surgeons,in order to further improve the standard diagnosis and treatment of pancreatic cancer in China.</p>","PeriodicalId":23966,"journal":{"name":"Zhonghua wai ke za zhi [Chinese journal of surgery]","volume":"61 5","pages":"357-361"},"PeriodicalIF":0.0,"publicationDate":"2023-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9200495","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":"[Surgical treatment for perihilar cholangiocarcinoma:a single-center experience].","authors":"W Y Deng,&nbsp;X D Shi,&nbsp;Y F Ye,&nbsp;Q B Tang,&nbsp;H M Lin,&nbsp;X H Yu,&nbsp;C Liu","doi":"10.3760/cma.j.cn112139-20221229-00550","DOIUrl":"https://doi.org/10.3760/cma.j.cn112139-20221229-00550","url":null,"abstract":"<p><p><b>Objective:</b> To investigate surgical strategies and the corresponding benefits for patients with perihilar cholangiocarcinoma(pCCA). <b>Methods:</b> A total of 81 patients with pCCA who underwent radical excision in the Department of Biliary and Pancreatic Surgery of Sun Yat-Sen Memorial Hospital between January 2014 and December 2021 were retrospectively collected.The cohort consisted of 50 male and 31 female patients,with an age of (62.5±11.5)years(range:26 to 83 years).Seventy-five cases were diagnosed with jaundice,60 of whom received preoperative biliary drainage,while 20 patients received portal vein embolization.Their serum bilirubin level within one week before the operation(<i>M</i>(IQR)) was 44.3 (41.9) μmol/L(range:8.0 to 344.2 μmol/L).Preoperative imaging examinations were performed to evaluate the Bismuth-Corlette type of pCCA,showing 3,6,21,27,and 24 cases of Bismuth-Corlette type Ⅰ,Ⅱ,Ⅲa,Ⅲb,and Ⅳ,respectively.The primary outcome was overall survival (OS),and the secondary outcomes were relapse-free survival (RFS),90-day postoperative morbidity and 90-day postoperative mortality.OS and RFS were estimated using the Kaplan-Meier method and compared by the Log-rank test.Significant prognostic factors were determined using univariate and multivariable Cox proportional hazard regression analyses. <b>Results:</b> In the cohort of 81 pCCA patients,67 cases(82.7%) underwent major hepatectomy while 3 cases received major hepatectomy combined with pancreaticoduodenectomy.Thirty-four patients underwent hepatectomy combined with vascular resection and reconstruction(18 cases of portal vein resection and reconstruction alone;9 cases of hepatic artery resection and reconstruction alone;7 cases of combination of portal vein and hepatic artery resection and reconstruction).Margin negative(R0 excision) were achieved in 53.1%(43/81) of these patients.The operation duration was (627±136)minutes(range:565 to 940 minutes),and the intraoperative blood loss was 400(455)ml(range:200 to 2 800 ml).The 90-day postoperative mortality was 3.7%(3/81).Grade 3-4 postoperative morbidity was 23.4% (19/81) according to the Clavien-Dindo classification of surgical complications.Up to the last follow-up at September 2022,the follow-up time was 34.0(24.2)months (range:0.4 to 103.6 months).Three patients who died within 90 days after surgery were excluded from the survival analysis.The median OS was 36.10 months (95%<i>CI</i>:18.23 to 42.97 months) and the 1-,3-and 5-year OS rates were 85.3%,46.8% and 27.3%,respectively.The median OS of 41 patients with negative margins was 47.83 months(95%<i>CI</i>:36.90 to 58.80 months) and that of 37 patients with positive margins was 20.47 months(95%<i>CI</i>:10.52 to 30.58 months).The median RFS of 70 patients with R0 and R1 resection was 24.50 months(95%<i>CI</i>:12.15 to 31.85 months)and the 1-,3-and 5-year RFS rates were 65.2%,45.7% and 29.9%,respectively.The median RFS of 41 patients with R0 resection was 38.57 months(","PeriodicalId":23966,"journal":{"name":"Zhonghua wai ke za zhi [Chinese journal of surgery]","volume":"61 5","pages":"381-388"},"PeriodicalIF":0.0,"publicationDate":"2023-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9200498","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":"[Application of augmented reality navigation in laparoscopic and robot-assisted liver surgery].","authors":"H Zheng,&nbsp;J W Zhang,&nbsp;T Zhang,&nbsp;Y G Liu,&nbsp;S T Jiang,&nbsp;Y S Zhang,&nbsp;L Zhang,&nbsp;Y Y Xu,&nbsp;H T Zhao,&nbsp;X Lu,&nbsp;X T Sang","doi":"10.3760/cma.j.cn112139-20221012-00435","DOIUrl":"https://doi.org/10.3760/cma.j.cn112139-20221012-00435","url":null,"abstract":"<p><p>In recent years, laparoscopic surgery and robotic surgery have been widely used, and various intraoperative image navigation systems have also developed rapidly. However, the liver itself has a complex vessel and duct system, which increase the difficulty of liver surgery. The augmented reality image navigation system combines the three-dimensional reconstructed image of the liver with the real liver anatomy, which presents the specific relationship between the tumor location and the surrounding vessels for the surgeon. Compared with other intraoperative image navigation methods, augmented reality has its unique advantages. This paper provides an overview of current advances in registration technology in augmented reality image navigation system, and focuses on its applications in liver surgery, including laparoscopic surgery and robotic surgery. Finally, the technological problems and difficulties still faced at present are summarized, and future directions worth studying in this field are proposed.</p>","PeriodicalId":23966,"journal":{"name":"Zhonghua wai ke za zhi [Chinese journal of surgery]","volume":"61 5","pages":"431-436"},"PeriodicalIF":0.0,"publicationDate":"2023-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9205117","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":"[Analysis of the pathogenesis and risk factors of gallstone].","authors":"L G Gu,&nbsp;Y M Zheng,&nbsp;C Xu,&nbsp;X Gao,&nbsp;Z Zhou,&nbsp;Y Huang,&nbsp;X Chu,&nbsp;J Zhao,&nbsp;J Su,&nbsp;W N Song","doi":"10.3760/cma.j.cn112139-20220927-00410","DOIUrl":"https://doi.org/10.3760/cma.j.cn112139-20220927-00410","url":null,"abstract":"<p><p><b>Objective:</b> To explore the pathogenesis and risk factors of gallstone formation. <b>Methods:</b> The findings of hepatobiliary ultrasound and related data were collected from healthy subjects who underwent a physical examination at Xuanwu Hospital of Capital Medical University from January 2012 to December 2021. A total of 98 344 healthy subjects were included in the study,including 48 241 males and 50 103 females,with a ratio of 1∶1.03,aged (42.0±15.6)years(range:14 to 97 years). The gender,age,body mass index,waist circumference,systolic pressure,diastolic pressure,ALT,AST,total bilirubin,fasting blood glucose,triglyceride,total cholesterol,low-density lipoprotein,high-density lipoprotein were collected.Healthy subjects were required to sit for at least 10 minutes before blood pressure was measured.Rresults of fasting venous blood were collected after 8 to 12 hours on an empty stomach.According to the presence of gallstones by ultrasound results, healthy subjects were divided into study group and control group. Data were analyzed by rank-sum tests and <i>χ²</i> test, and risk factors for gallstone formation were explored by Logistic regression analysis. <b>Results:</b> The incidence of gallstones in this group was 5.42%(5 333/98 344). Among them,the incidence of gallstones in people aged 60 years and above was significantly higher than that in people under 60 years old(15.31%(2 348/15 334) <i>vs.</i> 3.60%(2 985/83 010), <i>χ²</i>=3 473.46,<i>P</i><0.05).The healthy subjects were divided by age for every 10 years,and the results showed that the incidence of gallstones increased with age. The incidence of gallstones in females was 5.68%(2 844/50 103),greater than 5.16%(2 489/48 241) in males(<i>χ²</i>=11.81,<i>P</i><0.05). Among them,1 478 cases underwent gallbladder surgical resection due to gallstones,and the operation rate was 27.71%. The operation rate reached the peak between 60 and <70 years old,and decreased after 70 years old. The results of the multivariate analysis showed that,female(<i>OR</i>=1.38, <i>P</i><0.01),age(<i>OR</i>=1.58, <i>P</i><0.01),body mass index≥24 kg/m²(<i>OR</i>=1.31, <i>P</i><0.01),waist circumference≥85 cm(<i>OR</i>=1.24, <i>P</i><0.01),fasting blood glucose>6.1 mmol/L(<i>OR</i>=1.18,<i>P</i><0.01),total cholesterol≥5.18 mmol/L(<i>OR</i>=0.87, <i>P</i>=0.019),low-density lipoprotein≥3.37 mmol/L(<i>OR</i>=1.15,<i>P</i>=0.001) were the risk factors for gallstone formation;high-density lipoprotein≥1.55 mmol/L(<i>OR</i>=0.87, <i>P</i><0.01) was a protective factor for gallstone formation. <b>Conclusions:</b> The incidence of gallstones increases with age in male and female. Gender,age,body mass index,waist circumferenc,fasting blood glucose,total cholesterol,LDL,and HDL are related factors with gallstone formation.</p>","PeriodicalId":23966,"journal":{"name":"Zhonghua wai ke za zhi [Chinese journal of surgery]","volume":"61 5","pages":"389-394"},"PeriodicalIF":0.0,"publicationDate":"2023-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9200497","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":"[Efficacy of partial nephrectomy in patients with localized renal carcinoma: a 20-year experience of 2 046 patients in a single center].","authors":"X P Zou,&nbsp;K Ning,&nbsp;Z L Zhang,&nbsp;L B Xiong,&nbsp;Y L Peng,&nbsp;Z H Zhou,&nbsp;Y X Huang,&nbsp;X Luo,&nbsp;J B Li,&nbsp;P Dong,&nbsp;S J Guo,&nbsp;H Han,&nbsp;F J Zhou","doi":"10.3760/cma.j.cn112139-20221002-00416","DOIUrl":"https://doi.org/10.3760/cma.j.cn112139-20221002-00416","url":null,"abstract":"<p><p><b>Objectives:</b> To analyze the long-term survival of patients with localized renal cell carcinoma after partical nephrectomy. <b>Methods:</b> The clinicopathological records and survival follow-up data of 2 046 patients with localized renal cell carcinoma, who were treated with partial nephrectomy from August 2001 to February 2021 in the Department of Urology, Sun Yat-sen University Cancer Center, were retrospectively analyzed. There were 1 402 males and 644 females, aged (<i>M</i>(IQR)) 51 (19) years (range: 6 to 86 years). The primary end point of this study was cancer-specific survival. Survival curves were estimated using the Kaplan-Meier method, and the difference test was performed by Log-rank test. Univariate and multivariate Cox analysis were fitted to determine factors associated with cancer-specific survival. <b>Results:</b> The follow-up time was 49.2 (48.0) months (range: 1 to 229 months), with 1 974 patients surviving and 72 dying. The median cancer-specific survival time has not yet been reached. The 5- and 10-year cancer specific survival rates were 97.0% and 91.2%, respectively. The 10-year cancer-specific survival rates for stage pT1a (<i>n</i>=1 447), pT1b (<i>n</i>=523) and pT2 (<i>n</i>=58) were 95.3%, 81.8%, and 81.7%, respectively. The 10-year cancer-specific survival rates of patients with nuclear grade 1 (<i>n</i>=226), 2 (<i>n</i>=1 244) and 3 to 4 (<i>n</i>=278) were 96.6%, 89.4%, and 85.5%, respectively. There were no significant differences in 5-year cancer-specific survival rates among patients underwent open, laparoscopic, or robotic surgery (96.7% <i>vs.</i> 97.1% <i>vs.</i> 97.5%, <i>P</i>=0.600). Multivariate analysis showed that age≥50 years (<i>HR</i>=3.93, 95%<i>CI</i>: 1.82 to 8.47, <i>P</i><0.01), T stage (T1b <i>vs.</i> T1a: <i>HR</i>=3.31, 95%<i>CI</i>: 1.83 to 5.99, <i>P</i><0.01; T2+T3 <i>vs.</i> T1a: <i>HR</i>=2.88, 95%<i>CI</i>: 1.00 to 8.28, <i>P</i>=0.049) and nuclear grade (G3 to 4 <i>vs.</i> G1: <i>HR</i>=2.81, 95%<i>CI</i>: 1.01 to 7.82, <i>P</i>=0.048) were independent prognostic factors of localized renal cell carcinoma after partial nephrectomy. <b>Conclusions:</b> The long-term cancer-specific survival rates of patients with localized renal cancer after partial nephrectomy are satisfactory. The type of operation (open, laparoscopic, or robotic) has no significant effect on survival. However, patients with older age, higher nuclear grade, and higher T stage have a lower cancer-specific survival rate. Grasping surgical indications, attaching importance to preoperative evaluation, perioperative management, and postoperative follow-up, could benefit achieving satisfactory long-term survival.</p>","PeriodicalId":23966,"journal":{"name":"Zhonghua wai ke za zhi [Chinese journal of surgery]","volume":"61 5","pages":"395-402"},"PeriodicalIF":0.0,"publicationDate":"2023-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9200494","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":"[Clinical application of a quantitative method of atlantoaxial reduction angle in basilar invagination].","authors":"F Cao,&nbsp;X J Hu,&nbsp;R F Kang,&nbsp;T Y Chen,&nbsp;H Deng,&nbsp;Y Z Xia,&nbsp;Y Yan","doi":"10.3760/cma.j.cn112139-20221202-00511","DOIUrl":"https://doi.org/10.3760/cma.j.cn112139-20221202-00511","url":null,"abstract":"<p><p><b>Objectives:</b> To investigate the clinical application effect of a quantitative method of atlantoaxial reduction angle in basilar invagination. <b>Methods:</b> A retrospective analysis of clinical and radiographic data was conducted of 38 patients with complicated atlantoaxial dislocation and basilar invagination admitted to the Department of Neurosurgery, First Affiliated Hospital of Chongqing Medical University from May 2020 to May 2022. There were 5 males and 33 females, aged (53.5±9.9) years (range: 38 to 80 years). All patients underwent C_1-2 interarticular fusion cage implantation+occipital-cervical fixation by pressing rob with the cantilever technique. The atlantoaxial reduction model of previous studies by our team was used to calculate the reduction angles before surgery. Then titanium rods of prebending angle were prepared according to the calculation before the operation. After that quantitative reduction of angle was performed during the operation. The paired <i>t</i>-test was used to compare the difference between the theoretical and actual reset value. <b>Results:</b> The theoretical reduction angle of all patients was (10.62±1.78)° (range: 6.40° to 13.20°), the actual reduction angle was (10.53±1.63)° (range: 6.70° to 13.30°) and there was no statistical difference between them (<i>t</i>=1.688, <i>P</i>=0.100). The theoretical posterior occipitocervical angle after the operation of all patients was (117.37±5.88)° (range: 107.00° to 133.00°), the actual posterior occipitocervical angle after the operation was (118.25±6.77)° (range: 105.40° to 135.80°) and there was no statistical difference between them (<i>t</i>=-0.737, <i>P</i>=0.466). The postoperative follow-up time of the patients was more than 6 months and the symptoms of all patients were relieved. All patients had satisfactory fusion between small joints without incision infection, internal fixation fracture, displacement, atlantoaxial redislocation, and other long-term complications. <b>Conclusion:</b> The quantitative method of atlantoaxial reduction angle in basilar invagination can calculate the theoretical reduction angle of the clivus axis angle and guide the preparation of the pre-bending titanium rod before surgery, so as to realize the quantification of the atlantoaxial reduction angle.</p>","PeriodicalId":23966,"journal":{"name":"Zhonghua wai ke za zhi [Chinese journal of surgery]","volume":"61 5","pages":"412-417"},"PeriodicalIF":0.0,"publicationDate":"2023-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9205110","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}