Videosurgery and Other Miniinvasive Techniques最新文献

{"title":"Clinical efficacy of various resuscitation fluids in the management of sepsis in postoperative surgical and trauma patients: a systematic review and meta--analysis.","authors":"Yongjie Wang, Kewu Chen, Xiaolu Li, Jianing Guan","doi":"10.20452/wiitm.2024.17900","DOIUrl":"10.20452/wiitm.2024.17900","url":null,"abstract":"<p><strong>Introduction: </strong>Fluid resuscitation is the primary sepsis management strategy aimed at reducing mortality and achieving better treatment outcomes in critically hypotensive patients. Still, there are significant ambiguities regarding the most suitable fluid type that would ensure optimization of patient outcomes.</p><p><strong>Aim: </strong>The aim of this systematic review and meta-analysis was to assess the clinical effectiveness of different resuscitation fluids for sepsis management in critically hypotensive patients.</p><p><strong>Materials and methods: </strong>A systematic search of 4 electronic databases (PubMed, EMBASE, Scopus, and Cochrane Library) was conducted to identify relevant papers published in peer-reviewed journals since database inception until June 30, 2024. Odds ratios (ORs) with 95% CIs were calculated to evaluate the impact of individual resuscitation fluids on improvements in hemodynamic parameters and all-cause mortality. Heterogeneity was assessed using the Cochran Q, I² statistic, and the appropriate <i>P</i> value.</p><p><strong>Results: </strong>Our meta-analysis included 18 randomized controlled trials comparing the efficacy of different resuscitation fluids for sepsis management in 14 469 critically hypotensive patients. We found that Ringer's lactate solution was more effective than saline in reducing mortality (OR, 0.53; 95% CI, 0.41-0.7; χ²= 3.47; degree of freedom [df] = 6; Z = 4.6; I² = 0%; <i>P</i> <⁠0.001) and improving hemodynamic parameters (OR, 2.64; 95% CI, 2.45-2.86; χ² = 48.36; df = 6; Z = 24.84; I² = 18%; <i>P</i> <⁠0.001). However, saline was superior to albumin and hydroxyethyl starch in reaching these end points.</p><p><strong>Conclusion: </strong>We showed that in critically hypotensive septic patients, Ringer's lactate solution reduces all-cause mortality and improves hemodynamic parameters more effectively than saline, hydroxyethyl starch, and albumin solutions.</p>","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"19 3","pages":"275-288"},"PeriodicalIF":1.6,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867275/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of dexmedetomidine combined with intravenous general anesthesia on hemodynamics and inflammatory factors in patients undergoing laparoscopic colorectal cancer surgery.","authors":"Chunling Liu, Yong Gui, Min Zeng, Zhidong Zhou","doi":"10.20452/wiitm.2024.17891","DOIUrl":"10.20452/wiitm.2024.17891","url":null,"abstract":"<p><strong>Introduction: </strong>Surgery is the principal treatment option for early colorectal cancer (CRC). Anesthesia plays a crucial role in any surgery as it allows for a painless procedure. Dexmedetomidine is a local anesthetic that reduces pain and discomfort during surgery.</p><p><strong>Aim: </strong>The aim of this study was to investigate the efficacy of application of dexmedetomidine combined with total intravenous anesthesia in laparoscopic CRC surgery, with particular focus on its effects on patient hemodynamics and inflammatory factors.</p><p><strong>Materials and methods: </strong>For the purposes of this study, 80 patients undergoing elective laparoscopic rectal cancer surgery were selected and subsequently divided into 2 groups: the experimental group (0.5 µg/kg dexmedetomidine infused at a constant speed for 20 minutes, followed by 0.4 µg/kg/h dexmedetomidine) and the control group (0.5 µg/kg sufentanil infused at a constant speed for 20 minutes, followed by 0.4 µg/kg/h sufentanil). Each group comprised 40 patients. Hemodynamic parameters were recorded 1 minute before pumping dexmedetomidine or sufentanil (S0), 1 minute after pneumoperitoneum position (S1), 1 hour after pneumoperitoneum (S2), and 1 minute after elimination of air from the patient's peritoneal cavity and position change (S3).</p><p><strong>Result: </strong>Systolic blood pressure (SBP) and diastolic blood pressure (DBP) at S1 and S2 in the experimental group were lower than in the control group (P <0.05). Heart rate (HR) and mean arterial pressure (MAP) at S1, S2, and S3 in the experimental group were lower, as compared with the control group (P <0.05). The levels of serum inflammatory factors (tumor necrosis factor α [TNF‑α], interleukin [IL]‑8, and IL‑6) and stress response indicators (plasma epinephrine, norepinephrine, and plasma cortisol) at S1, S2, and S3 in the experimental group were lower than in the control group (P <0.05). The expressions of TNF‑α, IL‑8, and IL‑6 in the experimental group negatively correlated with SBP and DBP (P <0.05), and with MAP and HR (P <0.001).</p><p><strong>Conclusion: </strong>Dexmedetomidine can effectively maintain hemodynamic stability and inhibit inflammatory and stress responses in patients undergoing laparoscopic CRC surgery, with its effect being superior to those of sufentanil.</p>","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"19 3","pages":"391-398"},"PeriodicalIF":1.6,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Results of 1‑year follow‑up after umbilical hernia with rectus abdominis muscle diastasis repair using endoscopic subcutaneous onlay approach (SCOLA).","authors":"Mindaugas Kiudelis, Matas Pažusis, Linas Venclauskas, Eglė Kubiliūtė, Algirda Venclauskienė","doi":"10.20452/wiitm.2024.17889","DOIUrl":"10.20452/wiitm.2024.17889","url":null,"abstract":"<p><strong>Introduction: </strong>Endoscopic subcutaneous onlay approach (SCOLA) mesh repair in combination with anterior plication of diastasis has recently become a commonly performed procedure.</p><p><strong>Aim: </strong>The aim of this study was to analyze the results of 1‑year follow‑up in patients after umbilical hernia with rectal abdominal muscle diastasis repair using endoscopic SCOLA.</p><p><strong>Materials and methods: </strong>Our prospective cohort study included patients who underwent elective surgery for small‑ (<2 cm) and medium‑ (2-4 cm) size primary umbilical hernia with diastasis recti. The follow‑up period was 12 months. Hernia recurrence and postoperative seroma diagnosis were based on the patient's physical examination and ultrasound assessment. The Carolinas Comfort Scale questionnaire was used to evaluate the quality of life after the surgery.</p><p><strong>Result: </strong>One hundred patients underwent surgery for umbilical hernia with rectal abdominal muscle diastasis repair. Their mean (SD) age was 39.6 (11.8) years. Most of the patients (n = 77) were women. We found no hernia or diastasis recurrence during 1‑year follow‑up. Seroma was found in 15 patients during the first month of follow‑up. The rate of seroma was 11% after 3 months and 2% after 6 months of follow‑up. Almost all the patients reported mild or moderate symptoms during daily activities after the surgery.</p><p><strong>Conclusion: </strong>SCOLA is a safe and effective technique for patients with small umbilical hernia with diastasis. It provides an acceptable cosmetic result for carefully selected patients, low postoperative pain, and good quality of life.</p>","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"19 3","pages":"330-335"},"PeriodicalIF":1.6,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temporary uterine artery blocking and uterine artery embolization in treating cesarean scar pregnancy.","authors":"Kefei Zeng, Xianghua Lei, Tingting Xia","doi":"10.20452/wiitm.2024.17890","DOIUrl":"10.20452/wiitm.2024.17890","url":null,"abstract":"<p><strong>Introduction: </strong>Cesarean scar pregnancy (CSP) is a rare form of ectopic pregnancy. Lack of timely CSP treatment can lead to severe postpartum bleeding, affect fertility, and threaten patients' life and health.</p><p><strong>Aim: </strong>This work explored the use of laparoscopic temporary uterine artery blocking (TUAB) and uterine artery embolization (UAE) in treating CSP.</p><p><strong>Materials and methods: </strong>For the purpose of the study, 60 patients with CSP were selected and equally divided into the UAE group and the TUAB group. Both groups underwent cesarean scar lesion repair (CSLR) after the procedure. The differences in surgical outcomes, β‑human chorionic gonadotropin (β‑HCG) levels, ovarian reserve, endocrine function indicators, as well as the incidence of complications were compared between the groups.</p><p><strong>Result: </strong>The TUAB group presented a shorter length of hospital stay, shorter vaginal bleeding time, shorter menstrual recovery time, and shorter mass disappearance time than the UAE group (all P <0.05). The patients in the TUAB group had lower β‑HCG, estradiol, and progesterone levels, and higher levels of luteinizing hormone and follicle‑stimulating hormone (all P <0.05). Furthermore, the TUAB patients had a larger mean ovary diameter, an increased antral follicle count, and an elevated level of anti‑Müllerian hormone, as compared with the individuals treated with UAE (all P <0.05). The total incidence of complications in the UAE and TUAB groups was 23.33% (7/30) and 6.67% (2/30), respectively (P <0.05).</p><p><strong>Conclusions: </strong>Laparoscopic TUAB for CSLR proved to be a more effective and safer CSP treatment method than UAE.</p>","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"19 3","pages":"377-383"},"PeriodicalIF":1.6,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopy-assisted anterior cervical discectomy and fusion with internal fixation vs conventional surgery in the treatment of cervical disc herniation.","authors":"Haicun Zhang, Yanbo Lin, Canglu Wu, Fangling Cheng, Danqing Bao, Yuyan Chen","doi":"10.20452/wiitm.2024.17888","DOIUrl":"10.20452/wiitm.2024.17888","url":null,"abstract":"<p><strong>Introduction: </strong>Cervical disc herniation (CDH) is a common condition, usually caused by excessive strain or trauma to the spine. Initially, it is treated conservatively; however, complex and resistant cases may require a surgical intervention.</p><p><strong>Aim: </strong>We aimed to compare the clinical effect of endoscopy-assisted anterior cervical discectomy and fusion (ACDF) with internal fixation and conventional surgery in the treatment of CDH.</p><p><strong>Materials and methods: </strong>Patients with CDH who underwent ACDF with fixation at the Zhoushan Dinghai Guanghua Hospital were enrolled. Of them, 10 individuals were treated with conventional ACDF (conventional surgery group), and the other 10 with endoscopy-assisted ACDF (endoscopy-assisted surgery group). The general characteristics, postoperative Japanese Orthopedic Association (JOA), visual analogue scale (VAS), 12-Item Short Form Survey Physical Component Summary (SF-12 PCS), and SF-12 Mental Component Summary (SF-12 MCS) scores, physiological stress response, rate of the improved JOA score (RIS), hemoglobin level, and bone graft fusion were compared between the groups.</p><p><strong>Result: </strong>Outcomes of the patients treated with endoscopy-assisted surgery were clearly superior to those observed in the conventional surgery group. The postoperative JOA, VAS, SF-12 PCS, and SF-12 MCS scores and RIS in the endoscopy-assisted surgery group were higher than in the conventional surgery group (<i>P </i><⁠0.05). Following operation, there were significant differences between the 2 groups with respect to RIS at 1 week and 6 months postsurgery and hemoglobin levels on postoperative day 2. Changes in heart rate and diastolic blood pressure in the endoscopy-assisted surgery group were less pronounced than in the conventional surgery group (<i>P </i><⁠0.05), and the fusion rate was significantly higher in the former group (90% vs 80%, respectively).</p><p><strong>Conclusion: </strong>Endoscopy-assisted ACDF with internal fixation has a greater clinical therapeutic effect than the conventional approach in the treatment of CDH. It is associated with a higher bone graft fusion rate and reduced intraoperative blood loss.</p>","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"19 3","pages":"399-406"},"PeriodicalIF":1.6,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic review and meta‑analysis of factors predicting postoperative lung function after lung cancer resection.","authors":"Hongling Wang, Lihong He, Xiaoyun Hu, Gongxue Xian","doi":"10.20452/wiitm.2024.17892","DOIUrl":"10.20452/wiitm.2024.17892","url":null,"abstract":"<p><strong>Introduction: </strong>Lung resection continues to be the most effective treatment for early‑stage lung cancer. Prediction of postoperative lung function is particularly important when evaluating patient eligibility for surgery, as it helps assess the likelihood of experiencing difficulty breathing after the operation.</p><p><strong>Aim: </strong>We aimed to identify the most common methods used to predict postoperative lung function in clinical practice and to compare their accuracy.</p><p><strong>Materials and methods: </strong>A systematic review and meta‑analysis were performed to synthesize research focused on the prediction of postoperative lung function. A total of 10 studies were included in the analysis. The Cochrane risk of bias tool was utilized to evaluate the risk of bias in the studies. Additionally, a meta‑analysis of the mean difference between the predicted and measured values of forced expiratory volume in 1 second (FEV₁) was conducted. The I² value was computed as a metric of coherence among studies, while funnel plots and the Begg test were used to evaluate the likelihood of publication bias.</p><p><strong>Results: </strong>The analyzed studies had a low risk of bias. The meta‑analysis showed that computed tomography (CT) volume and density measurement had the highest level of accuracy for predicting postoperative FEV₁ , with a mean difference between the predicted and actual value of 83 ml (95% CI, 41-116).</p><p><strong>Conclusions: </strong>The results indicate that using CT volume and density is the optimal method for predicting postoperative FEV₁ . Additional research is necessary to establish the connection between the type of surgical procedure, adopted thresholds, and outcomes reported by patients.</p>","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"19 3","pages":"289-298"},"PeriodicalIF":1.6,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early-stage voiding function following uni- versus bilateral inferior vesical vessel resection during therapeutic lateral lymph node dissection with autonomic nerve sparing for advanced low rectal cancer (with video)","authors":"Hongjie Yang, Peishi Jiang, Zhichun Zhang, Jiafei Liu, Yuanda Zhou, Peng Li, Qingsheng Zeng, Yu Long, Xipeng Zhang, Yi Sun","doi":"10.5114/wiitm.2024.140318","DOIUrl":"https://doi.org/10.5114/wiitm.2024.140318","url":null,"abstract":"<b>Introduction</b><br/>Lateral lymph node dissection (LLND) has now been widely accepted as the optimal procedure to minimize lateral local recurrence (LLR) for selected cases with advanced lower rectal cancer in Asian countries. However, there is still controversy over the preservation or resection of the inferior vesical vessels (IVVs) during LLND due to concerns of impaired post-operative urinary function. Moreover, the standardized procedure for autonomic nerve preservation has not yet been established.<br/><br/><b>Aim</b><br/>To evaluate the early-stage postoperative voiding function in patients who underwent LLND with uni- versus bilateral resection of the IVVs and to introduce an autonomic nerve sparing technique with a fascial space priority approach (FSPA).<br/><br/><b>Material and methods</b><br/>LLND was performed in 106 consecutive patients with advanced low rectal cancer at Tianjin Union Medical Center from May 2017 to October 2022. Prospectively collected clinical data were retrospectively compared between patients who received uni-lateral and bilateral LLND. A video with narration was provided to introduce the stepwise procedure of autonomic nerve preservation during IVV resection.<br/><br/><b>Results</b><br/>The unilateral lymph node dissection (LND) group and the bilateral LND group included 75 and 31 cases, respectively. All LLNDs were performed with FSPA with IVV resection as a standard procedure. No significant differences were observed in overall catheterization days (p = 0.336) and re-catheterization rate (p = 0.575) between groups. No patients in either group suffered from long-term (≥ 30 days) voiding dysfunction.<br/><br/><b>Conclusions</b><br/>Autonomic nerve sparing is achievable with resection of IVVs during LLND. Satisfactory early-stage voiding function could be obtained with IVV resection on both sides.<br/><br/>","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"47 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141508871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect and prognosis of endoscopic intracranial hematoma removal and hematoma puncture and drainage in patients with hypertensive intracerebral hemorrhage","authors":"Yi Xiao, Renping Wang","doi":"10.5114/wiitm.2024.140613","DOIUrl":"https://doi.org/10.5114/wiitm.2024.140613","url":null,"abstract":"<b>Introduction</b><br/>Hypertensive intracerebral hemorrhage is one of the most serious complications of hypertension. The treatment focuses on reducing bleeding damage and promoting functional recovery.<br/><br/><b>Aim</b><br/>This study investigated the efficacy and prognosis of endoscopic intracranial hematoma removal (EIHR) and hematoma puncture and drainage (HPD) in treating hypertensive intracerebral hemorrhage (HICH).<br/><br/><b>Material and methods</b><br/>Ninety-two patients admitted to our hospital for EIHR and HPD between September 30, 2021 and September 30, 2022 were enrolled, including 14 cases of EIHR (endoscopy group) and 78 cases of HPD (puncture group). The efficacy of the two surgery modes in treating HICH patients was compared. Univariate logistic regression (ULR) and multivariate logistic regression (MLR) were employed to analyze the influences of different treatment methods on the prognosis of patients with HICH.<br/><br/><b>Results</b><br/>The average hematoma clearance rate (HCR) of all patients was 80.52%, and the patients in the endoscopy group had a higher HCR than those in the puncture group (73.00% vs. 86.00%) (p &lt; 0.001). The good prognosis rate (GPR) shown by the Glasgow Outcome Scale (GOS) score in the endoscopy group was 69.23%, and that in the puncture group was 40.38%, a large but statistically non-significant difference (p &gt; 0.05).<br/><br/><b>Conclusions</b><br/>The HCR of EIHR was greatly higher based on that of HPD, but showed no great difference in prognostic effect. The higher the GCS score on admission, the lower the likelihood of poor prognosis.<br/><br/>","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"31 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141529786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of minimally invasive surgery for pulmonary metastasis: who benefits the most?","authors":"Burcu Kılıç, Ömer Faruk Sağlam, Levani Chikvaidzade, Ezel Erşen, Hasan Kara, Akif Turna, Kamil Kaynak, Ahmet Demirkaya","doi":"10.5114/wiitm.2024.140300","DOIUrl":"https://doi.org/10.5114/wiitm.2024.140300","url":null,"abstract":"<b>Introduction</b><br/>Metastatic disease is one of the main causes of death and factors affecting overall survival. It is known that selected patients with pulmonary oligometastases whose primary tumor is under control and who have adequate respiratory capacity may benefit from metastasectomy by resecting all detected lesions.<br/><br/><b>Aim</b><br/>To report our findings on the use of video-assisted thoracoscopic surgery (VATS) for pulmonary metastasectomy, with a focus on identifying suitable candidates.<br/><br/><b>Material and methods</b><br/>Between August 2010 and 2023 a total of 532 pulmonary metastasectomy procedures were performed in our institution. Metastasectomy was performed with VATS for 281 of those patients.<br/><br/><b>Results</b><br/>VATS metastasectomy was performed in 131 patients with a single lesion on preoperative imaging, while 110 patients underwent metastasectomy for multiple lesions. The rate was significantly (p &lt; 0.05) lower in the group with multiple lesions removed during surgery (38 months) than in the group with only one lesion removed during surgery (60 months). The predicted survival time in the group with other tumor histology (79 months) was significantly (p &lt; 0.05) higher than in the groups with tumor histology carcinoma (41.4 months) and sarcoma (55.5 months).<br/><br/><b>Conclusions</b><br/>The best prognosis after metastasectomy is provided in cases with a single nodule. Grade is also an important prognostic factor affecting survival, particularly for grade 1 tumor. The histopathological type of the primary tumor is also a significant prognostic factor affecting survival after pulmonary metastasectomy in secondary pulmonary neoplasms, particularly for sarcoma and carcinoma.<br/><br/>","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"19 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141529924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meta-analysis of clinical efficacy and safety of transanal endoscopic microsurgery and endoscopic submucosal dissection in the treatment of rectal tumors","authors":"Jin Yao, Yongshen Fan","doi":"10.5114/wiitm.2024.139984","DOIUrl":"https://doi.org/10.5114/wiitm.2024.139984","url":null,"abstract":"<b>Aim</b><br/>The aim of the article was to systematically evaluate the clinical efficacy and safety of transanal endoscopic microsurgery (TEM) and endoscopic submucosal dissection (ESD) in the treatment of rectal tumors.<br/><br/><b>Material and methods</b><br/>Control studies were conducted on cases included in the electronic databases Medline, Embase, Cochrane Library, and CNKI. Patients with colorectal tumors were included in the TEM and ESD groups for treatment, with the main indicators being R0 resection rate, postoperative perforation and bleeding incidence, and tumor recurrence rate. The meta-analysis was carried out using RevMan 5.3 software.<br/><br/><b>Results</b><br/>A total of 10 studies were included, with 736 patients. The analysis showed that for the recurrence rate in the TEM group compared to ESD, OR = 1.23, 95% CI = 0.56–2.72, p = 0.60; for the R0 resection rate between the TEM group and ESD group, OR = 1.35, 95% CI = 0.82–2.22, p = 0.24; for the incidence of perforation in the TEM and ESD groups, OR = 0.59, 95% CI = 0.25–1.40, p = 0.23. The inter-group comparison of these three items was statistically significant. Compared with the ESD group, the hospitalization time and the incidence of bleeding of the TEM group were both lower, with SD = 0.48, 95% CI = 0.26–0.69, p &lt; 0.001 and OR = 0.35, 95% CI = 0.13–0.92, p = 0.03. The differences were statistically significant.<br/><br/><b>Conclusions</b><br/>Both TEM and ESD endoscopic treatment techniques can achieve a higher R0 resection rate and lower risk of tumor recurrence in the treatment of colorectal tumors. However, TEM may have higher surgical safety than ESD technology, and can shorten postoperative hospitalization time and lower postoperative bleeding rate.<br/><br/>","PeriodicalId":49361,"journal":{"name":"Videosurgery and Other Miniinvasive Techniques","volume":"20 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141508872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}