Annali italiani di chirurgia最新文献

{"title":"Effects of Thoracoscopic Right Upper Lobe Apical Segmentectomy on Exercise Capacity and Quality of Life in Early-Stage NSCLC Patients.","authors":"Longshan Zhou, Yuchao Shen, Xiaoping Jin, Jianfeng Jing","doi":"10.62713/aic.3378","DOIUrl":"10.62713/aic.3378","url":null,"abstract":"<p><strong>Aim: </strong>Thoracoscopic lobectomy (TL) is an effective surgical approach for resecting tumor lesions in patients with early non-small cell lung cancer (NSCLC). However, TL may result in damage to normal lung tissue, potentially impacting prognosis. Thoracoscopic right upper lobe apical segmentectomy (TS) has been proposed as an alternative to improve surgical outcomes, but its impact on exercise capacity and quality of life remains unclear. This study aimed to investigate the effect of TS on exercise capacity and quality of life in patients with early-stage NSCLC.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on the clinical data of 120 patients with early-stage NSCLC who underwent surgical treatment in Shangyu People's Hospital of Shaoxing between August 2020 and August 2023. The patients were divided into two groups based on the surgical approach: the TL group (n = 66) and the TS group (n = 54). The primary objective was to compare surgery-related indicators and the overall incidence of complications between the TS group and the TL group. Additionally, changes in forced vital capacity (FVC), forced expiratory volume in one second (FEV1), maximum ventilatory volume (MVV), 6-minute walking distance (6MWD), and European Organization for Research and Treatment of Cancer quality of life (EORTC QLQ-C30) scores were evaluated before and after operation.</p><p><strong>Results: </strong>The TS group showed significantly reduced intraoperative blood loss, chest drainage, and hospital stay compared to the TL group (p < 0.05). However, there was no significant difference in the operation time and the number of lymph node dissections between the two groups after operation (p > 0.05). FVC, FEV1, MVV, and 6MWD values of the two groups were significantly lower than those before operation (p < 0.05). However, FVC, FEV1, MVV, and 6MWD in the TS group were significantly higher than those in the TL group (p < 0.05). The scores of roles, emotion, cognition, social function, and total health status in the two groups after operation were significantly higher than those before operation, and the scores of physical functions, shortness of breath, diarrhea, fatigue, pain, cough and insomnia were significantly lower than those before operation (p < 0.05). Compared to the TL group, the TS group showed higher scores of physical, social function dimensions, and total health status, as well as lower scores of fatigues, shortness of breath, insomnia, and pain (p < 0.05).</p><p><strong>Conclusions: </strong>TS treatment has less surgical trauma and a lower risk of complications for patients with early-stage NSCLC, which is beneficial for promoting postoperative recovery, reducing lung function damage and improving the quality of life of patients.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"95 4","pages":"715-723"},"PeriodicalIF":0.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142054800","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":"Exploring the ED50 and ED95 of Remimazolam for Laryngeal Mask Airway Insertion During General Anesthesia in Pediatric Strabismus Correction Surgery.","authors":"Qing Shen, Qun Liu, Bo Lu, Ruichun Wang, Wei Gan, Jinling Qin","doi":"10.62713/aic.3430","DOIUrl":"10.62713/aic.3430","url":null,"abstract":"<p><strong>Aim: </strong>Remimazolam, known for its rapid onset, quick metabolism, and short recovery time from sedation, offers significant advantages in clinical anesthesia. Previous studies have primarily investigated its application in adult surgical anesthesia, with less focus on its utilization in pediatric patients. Therefore, we aimed to explore the 50% effective dose (ED50) and 95% effective dose (ED95) of remimazolam for laryngeal mask airway (LMA) insertion during general anesthesia in pediatric strabismus correction surgery and investigate its dose-response relationship, thereby providing valuable reference data for safer and more rational clinical use of remimazolam.</p><p><strong>Methods: </strong>This study included 32 patients aged 3-12 years undergoing strabismus correction surgery at Ningbo Aier Guangming Eye Hospital in 2024. The dosage of remimazolam was determined according to the Dixon 'up-and-down' sequential method: the starting induction dose was 0.2 mg/kg, with a step dose of 0.05 mg/kg. In cases of positive anesthetic effect, the subsequent patient received a reduced step dose, while in cases of negative anesthetic effect, the next subject received an increased step dose. The trial was terminated upon observing seven \"positive-negative\" crossover points. Furthermore, the ED50 and ED95, along with their 95% confidence intervals (95% CI) were calculated using the Probit regression analysis. Additionally, vital signs of the patients, such as peripheral oxygen (SpO2), heart rate, and blood pressure, along with the incidence of adverse events, were monitored.</p><p><strong>Results: </strong>The ED50 of remimazolam for LMA insertion in pediatric strabismus correction surgery was 0.300 mg/kg (95% CI 0.276-0.323 mg/kg), and the ED95 was 0.369 mg/kg (95% CI 0.324-0.414 mg/kg). Throughout the surgery, SpO2, heart rate, and blood pressure remained stable without any significant fluctuations.</p><p><strong>Conclusions: </strong>The ED50 and ED95 of remimazolam for LMA insertion in pediatric strabismus correction surgery are 0.300 mg/kg and 0.369 mg/kg, respectively. This study demonstrates that remimazolam is both safe and effective for LMA insertion during general anesthesia in pediatric strabismus correction surgery.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"95 4","pages":"690-698"},"PeriodicalIF":0.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142054804","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":"With 144 Retained Stones alongside Ureteropelvic Junction Obstruction: Is Stone-Free Status Possible? A Case Presentation.","authors":"Tugay Aksakalli, Ahmet Emre Cinislioglu, Adem Utlu, Feyzullah Celik, Ibrahim Karabulut","doi":"10.62713/aic.3289","DOIUrl":"https://doi.org/10.62713/aic.3289","url":null,"abstract":"<p><p>Ureteropelvic junction (UPJ) obstruction, in addition to causing progressive renal function loss, can lead to the formation of retained stones. Management planning for concomitant stones and UPJ obstruction is a topic of debate in the literature. We performed laparoscopic pyeloplasty and extracted all 144 stones from the renal pelvis and calyces of a 37-year-old male with UPJ stricture, using wireless flexible cystoscopic guidance. No complications occurred during the perioperative and postoperative periods. In challenging cases of UPJ obstruction with stones in multiple calyceal locations, simultaneous flexible cystoscopy offers clinicians a significant advantage.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"95 5","pages":"778-782"},"PeriodicalIF":0.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142520779","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":"Efficacy and Safety of Single Clip Traction Assisted Endoscopic Submucosal Dissection for Colonic Neoplasms: A Propensity Score Matching Analysis.","authors":"Xiaotan Dou, Danndan Zhu, Chunrong Wang, Min Chen, Xiaoqi Zhang, Lei Wang, Chenggong Yu","doi":"10.62713/aic.3441","DOIUrl":"https://doi.org/10.62713/aic.3441","url":null,"abstract":"<p><strong>Aim: </strong>Endoscopic submucosal dissection (ESD) for colonic neoplasms is a technically intricate procedure. Internal traction using a single clip has emerged as a promising supportive technique for colonic ESD. Therefore, this study aimed to comprehensively evaluate and compare the efficacy and safety of ESD with and without the aid of single-clip traction.</p><p><strong>Methods: </strong>This retrospective study encompassed 36 patients who underwent single clip traction-assisted colonic ESD and 66 who underwent the traditional method of colonic ESD at Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University. We employed the propensity score-matching method to mitigate disparities in resected specimen size and tumor location. Post-matching, we comprehensively assessed treatment outcomes and incidence of adverse events between the two treatment groups (single clip traction-assisted ESD (scESD) and conventional ESD (cESD)).</p><p><strong>Results: </strong>After propensity score matching, we observed 34 matched pairs. There were no significant differences between the two treatment groups regarding the en bloc resection rate, complete resection rate, and curative rate. However, the procedure duration was significantly shorter in the single clip traction-assisted ESD group compared to the conventional ESD group (20.00 [Interquatile Range (IQR)] (16.00-32.50) minutes vs 31.50 [IQR] (17.00-54.00) minutes, p = 0.0474). Furthermore, there was a significant increase in dissection speed in the single clip traction-assisted ESD group compared to the conventional ESD group (0.29 [IQR] (0.20-0.45) mm2/min vs 0.19 [IQR] (0.11-0.35) mm2/min, p = 0.0015). All lesions were resected in a single piece. Among the propensity-score-matched patients, only those treated with single clip traction-assisted ESD exhibited faster dissection speeds (p = 0.015). Furthermore, there were no substantial differences in adverse events such as intraoperative perforation, delayed perforation, or delayed bleeding.</p><p><strong>Conclusions: </strong>Our findings suggest that single clip traction-assisted colonic ESD is preferable to traditional colonic ESD, owing to its shorter procedure duration and faster dissection speed.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"95 5","pages":"956-962"},"PeriodicalIF":0.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142520847","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":"Head and Neck Myopericytoma (MPC): A Case Report of Double Synchronous Sinonasal MPC.","authors":"Francesco Bandi, Francesco Chu, Luigi Marco Stringa, Rita De Berardinis, Marta Tagliabue, Giacomo Pietrobon, Fausto Maffini, Paolo Castelnuovo, Mohssen Ansarin","doi":"10.62713/aic.3484","DOIUrl":"10.62713/aic.3484","url":null,"abstract":"<p><strong>Aim: </strong>Myopericytoma (MPC) is a rare tumour characterized by a perivascular proliferation of pericytic cells with myoid differentiation and a typical spindle shape. Except for the rare malignant cases, MPC mostly shows a benign course. Symptoms are often non-specific, and the diagnosis could be accidental. Simple biopsies are often non-diagnostic and do not provide any information about the benign or malignant course of the disease. General agreement for its management is lacking.</p><p><strong>Case presentation: </strong>An old patient was referred to our tertiary cancer centre for left nasal obstruction for the previous three months. No worker risk factors were reported. The nasal endoscopy with enhanced endoscopic systems equipped with digital post-processing image enhancement technology (I-SCAN) and Narrow Band Imaging (NBI) revealed a non-bleeding reddish mass located at the anterior third of the left nasal fossa floor, about 1 cm in size and posteriorly a second more minor similar lesion at the level of the nasal septum. The patient underwent a radical endoscopic excision with diagnostic and curative intent.</p><p><strong>Results: </strong>No significant intra-peri- and postoperative complications were recorded. The final histopathological exam revealed a double synchronous sinonasal myopericitoma removed with safe margins. The patient is still alive with no evidence of disease after three years from surgery.</p><p><strong>Conclusions: </strong>MPC is a challenging disease that must be considered in the differential diagnosis of all the vascular lesions of the head and neck region. Surgery should be performed with radical margins to provide a definitive cure. The endoscopic approach may allow a radical removal with a low risk of surgical complications, allowing the possibility of removing representative material for an accurate histopathological diagnosis.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"95 5","pages":"760-766"},"PeriodicalIF":0.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142520850","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":"A Meta-analysis of the Efficacy of Different Surgical Methods in the Treatment of Uterine Prolapse.","authors":"Hongxiang Chen, Xiumei Wei, Nuerbiya Kurexi, Shuang Yang","doi":"10.62713/aic.3385","DOIUrl":"10.62713/aic.3385","url":null,"abstract":"<p><strong>Aim: </strong>The management of uterine prolapse poses a significant clinical challenge, with surgical intervention often necessary for symptom relief and restoration of pelvic floor function. However, the optimal surgical approach for uterine prolapse remains uncertain, prompting a comprehensive meta-analysis to compare the efficacy of various surgical methods. This study aims to assess the effectiveness of different surgical methods for treating uterine prolapse.</p><p><strong>Methods: </strong>We used computer search to retrieve relevant literature to compare the therapeutic effects of different surgical methods for treating uterine prolapse. The search was conducted in the Web of Science and PubMed databases, and articles published until October 2023 were obtained. We employed random effects and fixed effects models and performed a meta-analysis using the R software.</p><p><strong>Results: </strong>This study included 40 standard papers covering 25,896 patients with uterine prolapse. We used random and fixed effects models to conduct a meta-analysis of hysterectomy and uterine fixation procedures. The findings indicated that different surgical approaches had no significant impact on surgical success rates (I2 = 69%, p < 0.01; risk ratio (RR) (95% confidence intervals (CI)): 1.00 [0.98; 1.03]) or postoperative adverse reactions (I2 = 54%, p < 0.01; RR (95% CI), 1.10 [0.83; 1.45]). However, the durations of the surgical procedure for hysterectomy (I2 = 91%, p < 0.01; standardized mean difference (SMD) (95% CI), 0.78 [0.49; 1.07]), surgical blood loss (I2 = 97%, p < 0.01, SMD (95% CI): 1.14 [0.21; 2.07]), and intraoperative adverse reactions (I2 = 0%, p = 0.61, RR (95% CI): 1.37 [1.10; 1.71]) were statistically significant between hysterectomy and uterine fixation procedures. Additionally, publication bias and sensitivity tests showed no publication bias in this meta-analysis and no literature causing significant sensitivity.</p><p><strong>Conclusions: </strong>In the treatment of uterine prolapse, both hysterectomy and uterine fixation are similar in terms of surgical success rates and postoperative adverse reactions. However, hysterectomy is associated with longer duration of the surgical procedure, increased blood loss and higher incidence of intraoperative adverse reactions compared to uterine fixation.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"95 3","pages":"257-274"},"PeriodicalIF":0.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141449465","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":"Assessing Surgical Benefits and Creating a Prognostic Model for Breast Cancer with Lung-only Metastasis: An Analysis of the National Cancer Database.","authors":"Wangyan Zhong, Guansheng Zhong, Wanlin Ye, Xueying Jin","doi":"10.62713/aic.3365","DOIUrl":"https://doi.org/10.62713/aic.3365","url":null,"abstract":"<p><strong>Aim: </strong>The decision to perform surgery on breast cancer patients with lung-only metastasis is a subject of ongoing debate. Our investigation seeks to assess the survival rates following surgical intervention among individuals diagnosed with breast cancer experiencing isolated metastasis to the lungs. Additionally, we endeavor to devise a predictive nomogram aimed at forecasting the long-term survival.</p><p><strong>Methods: </strong>We analyzed patients diagnosed with primary lung metastases from breast cancer between 2010 and 2015, utilizing datasets obtained from the National Cancer Database (NCDB). We employed the Cox proportional hazards regression model and the Kaplan-Meier method to analyze survival data. Additionally, we constructed nomograms to forecast survival outcomes.</p><p><strong>Results: </strong>The study comprised 2403 patients, with 1058 (44.0%) undergoing breast-specific surgery and 1345 (56.0%) not receiving surgical treatment. The group that underwent surgical procedures exhibited a significantly enhanced overall survival (OS) compared to the non-surgery group (multivariate analysis: hazard ratio [HR] = 0.64; 95% confidence interval [CI], 0.54-0.75; p < 0.001). Surgical intervention consistently improved survival across nearly all patient subgroups. The research successfully established a predictive nomogram designed to calculate the likelihood of long-term survival, attaining a concordance index (C-index) of approximately 0.7 in both validation and training cohorts. By integrating multiple clinicopathological variables, the nomogram efficiently classified patients into categories reflecting different survival forecasts.</p><p><strong>Conclusions: </strong>The findings of this investigation support the notion that surgical treatment can enhance the overall survival of patients with initial lung-only metastasis from breast cancer. The investigation further introduces a nomogram demonstrating reasonable accuracy in forecasting long-term survival of patients in this cohort.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"95 3","pages":"391-400"},"PeriodicalIF":0.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141449469","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":"Observation on the Effect of Rapid Rehabilitation Nursing with Integrated Medical Care in Perioperative Period of Laparoscopic Appendicitis in Children.","authors":"Huibo Hong, Kongjia Qian, Yan Ying, Hongzhen Xu","doi":"10.62713/aic.3137","DOIUrl":"https://doi.org/10.62713/aic.3137","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;Acute appendicitis is one of the most common causes of acute abdomen in pediatric surgery. The purpose of this study was to observe the effects of integrated rapid rehabilitation nursing in children with laparoscopic appendectomy (LA) during the perioperative period.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A total of 200 children with appendicitis who underwent LA in our hospital from January 2022 to January 2023 were retrospectively selected as the study subjects. According to the nursing mode, they were divided into a control group (n = 100) and an observation group (n = 100). The control group was treated with routine nursing intervention, and the observation group was treated with an integrated rapid rehabilitation nursing intervention. Perioperative indices (operation time, first postoperative exhaust time, length of hospital stay) were recorded and compared between the two groups. The visual analog scale (VAS) was used to score the two groups at 6 h, 12 h, 24 h, and 48 h after surgery, and the pain degree of the children was quantitatively evaluated. The levels of serum stress response indices (cortisol (Cor), norepinephrine (NE), and adrenocorticotropic hormone (ACTH)) in the two groups were measured. The incidence of postoperative complications, improvement of postoperative quality of life, and nursing satisfaction were compared between the two groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The operation time, first postoperative exhaust time, and hospitalization time in the observation group were significantly shorter than those in the control group (p &lt; 0.05), and the VAS scores of the patients in the observation group were lower than those in the control group at each time point of 6 h, 12 h, 24 h, and 48 h after surgery (p &lt; 0.05). One hour after surgery, the serum Cor, NE, and ACTH levels of the two groups of patients were significantly higher than those before surgery, and the levels for the observation group were significantly lower than those of the control group (p &lt; 0.05). After treatment, the quality of life scores of patients in both groups was significantly higher than before treatment, and the quality of life scores of patients in the observation group was significantly higher than that of the control group (p &lt; 0.05). The postoperative complication rate of the observation group was 3.00% (3/100), which was significantly lower than that of the control group (13.00% (13/100)) (χ2 = 6.793, p = 0.009). The nursing satisfaction of the observation group was 95.00% (95/100), which was significantly higher than that of the control group (79.00% (79/100)) (χ2 = 11.317, p = 0.001).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The integrated rapid rehabilitation nursing management mode is an intervention that can effectively alleviate the effects of LA on stress reactions and pain in children with appendicitis. It can effectively reduce the incidence of postoperative complications and improve the patient's nursing satisfaction, allow","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"95 3","pages":"401-410"},"PeriodicalIF":0.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141449488","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":"Transurethral Cylindrical Water Sac Prostate Enlargement Surgery for the Treatment of Small-Volume Benign Prostatic Hyperplasia: A Retrospective Analysis.","authors":"Tingbo Fu, Xinjie Jiang, Guojun Li, Lizhuan Liu, Youjiao Chen, Junfeng Mo","doi":"10.62713/aic.3574","DOIUrl":"https://doi.org/10.62713/aic.3574","url":null,"abstract":"<p><strong>Aim: </strong>To investigate the clinical efficacy of transurethral columnar balloon dilation of prostate (TUCBDP) in the treatment of small-volume benign prostatic hyperplasia (BPH) and provide the optimal treatment for the surgical treatment of small volume benign prostatic hyperplasia.</p><p><strong>Methods: </strong>This retrospective study analyzed 106 patients with small-volume BPH who underwent surgical treatment at the Department of Urology, Xiangya Changde Hospital from December 2023 to January 2024. The patients were divided into two groups based on the type of surgery received: TUCBDP group (n = 53) and transurethral resection of prostate (TURP) group (n = 53), which serves as the control group. We observed and measured the primary outcome indexes of the two groups, including international prostate symptom score (IPSS), maximum urinary flow rate (Qmax), postvoid residual (PVR), and quality of life (QoL) score, as well as the secondary outcome indicators, such as operation time, hospital stay, indwelling catheter time, the frequency of night urination and daytime urination, and the total incidence of long-term and short-term complications.</p><p><strong>Results: </strong>Preoperative IPSS, Qmax, PVR, and QoL scores showed no significant differences between the TUCBDP and TURP groups (p > 0.05). Postoperatively, the TUCBDP group showed superior results in terms of shortened operation time (-15.96 minutes, 95% confidence interval (CI) [-20.06, -11.86], p < 0.001), hospitalization time (-1.73 days, 95% confidence interval (CI) [-2.26, -1.20], p < 0.001), and indwelling catheter time (-1.17 days, 95% CI [-1.55, -0.79], p < 0.001), reduced night urination frequency (-0.71 times, 95% CI [-0.89, -0.53], p < 0.001) and daytime urination frequency (-1.80 times, 95% CI [-2.25, -1.35], p < 0.001). For patients receiving TUCBDP, improvements were also noted in IPSS (-2.27, 95% CI [-3.58, -0.96], p < 0.001), Qmax (4.50 mL/s, 95% CI [3.30, 5.70], p < 0.001), PVR (-6.89 mL, 95% CI [-9.48, -4.30], p < 0.001), and QoL (-0.87, 95% CI [-1.57, -0.17], p = 0.026). The TUCBDP group also had lower rates of near-term (15.09% vs. 35.85%, χ2 = 6.013, p = 0.014) and long-term complications (11.32% vs. 37.74%, χ2 = 9.988, p = 0.002).</p><p><strong>Conclusions: </strong>TUCBDP demonstrates significant clinical efficacy in the treatment of small-volume BPH, causing a low incidence of postoperative complications.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"95 6","pages":"1155-1162"},"PeriodicalIF":0.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891682","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":"Enhancing Post-Surgical Wound Care in Anorectal Diseases: A Comparative Study of Advanced Convolutional Neural Network (CNN) Architectures for Image Classification and Analysis.","authors":"Qiaolan Zhang, Zhaobo Chen, Shunfang Hu, Xinkun Bao","doi":"10.62713/aic.3700","DOIUrl":"https://doi.org/10.62713/aic.3700","url":null,"abstract":"<p><strong>Aim: </strong>Anorectal diseases, often requiring surgical intervention and careful post-operative wound management, pose substantial challenges in healthcare. This study presents a novel application of artificial intelligence, specifically machine learning, aimed at improving the classification and analysis of post-surgical wound images. By doing so, it seeks to enhance patient outcomes through personalized and optimized wound care strategies.</p><p><strong>Methods: </strong>This research utilizes convolutional neural networks (CNNs) and employs three advanced architectures-MobileNet, ResNet50, and Inception-v4-to detect and classify key characteristics of post-surgical wounds, including size, location, severity, and tissue type involved. Additionally, the study integrates Gradient-weighted Class Activation Mapping (Grad-CAM) technology to provide interpretative insights into the decision-making processes of these algorithms, offering a deeper understanding of model predictions.</p><p><strong>Results: </strong>The effectiveness of the employed CNN architectures was assessed based on accuracy, precision, and recall metrics. The findings demonstrate that Inception-v4, in particular, exhibits superior performance across all evaluated metrics, underscoring its potential in clinical applications. Grad-CAM visualizations further clarified the rationale behind the model's decisions, enhancing the interpretability of the results.</p><p><strong>Conclusions: </strong>The integration of machine learning technologies in the classification and analysis of wound images represents a significant advancement in medical image analysis and AI-driven healthcare solutions. This research not only enhances the technical capabilities of AI applications in healthcare but also improves the precision of post-operative care in anorectal surgery, ultimately contributing to better treatment outcomes.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"95 6","pages":"1186-1195"},"PeriodicalIF":0.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891495","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}