BACKGROUND Supracondylar humerus fractures account for more than 60%of all elbow fractures and about 1/5 of all pediatric fractures.Unfortunately,these fractures can be associated with risk of complications including ...BACKGROUND Supracondylar humerus fractures account for more than 60%of all elbow fractures and about 1/5 of all pediatric fractures.Unfortunately,these fractures can be associated with risk of complications including neurovascular injuries,malunions and limb deformities.Controversy exists regarding the effect of time of surgical intervention and/or level of surgeon performing the surgery on outcome of these fractures.AIM To determine whether time of surgical intervention and/or surgeon level influence the outcomes of surgically managed pediatric supracondylar humerus fractures.METHODS We retrospectively studied 155 pediatric patients presenting with a supracondylar humerus fracture in a level 1 trauma center from January 2006 to December 2019.The data extracted included demographic data,fracture characteristics,surgical data,and follow-up outcomes.The collected data was analyzed and P values of<0.05 were considered statistically significant.RESULTS Of the cohort,11%of patients had documented post-operative complications,of which the majority occurred in surgeries performed after day time working hours and in fractures requiring open reduction.While the lowest complication rate was found in surgeries performed by pediatric orthopaedic surgeons,this did not reach statistical significance.CONCLUSION In pediatric patients undergoing surgery for supracondylar fractures,we found a higher complication rate when surgeries were not performed during working hours.Surgeon level and training had no significant effect on the risk of post-operative complications.展开更多
Crohn’s disease(CD)is a chronic inflammatory disorder of the gastrointestinal tract with an increasing incidence worldwide.Comprehensive therapy for CD focuses on symptom control and healing the intestinal mucosa to ...Crohn’s disease(CD)is a chronic inflammatory disorder of the gastrointestinal tract with an increasing incidence worldwide.Comprehensive therapy for CD focuses on symptom control and healing the intestinal mucosa to improve the quality of life and prevent complications.Surgical intervention plays a vital role in comprehensive therapy.However,deciding the optimal timing for surgical intervention has long been a focus of controversy.This review provides insights into the timing of surgery for CD and guides clinicians in daily treatment.展开更多
As an indispensable part of congenital cataract surgery,intraocular lens(IOL)implantation in infantile patients has long-term positive impacts on visual rehabilitation,as well as postoperative complications inevitably...As an indispensable part of congenital cataract surgery,intraocular lens(IOL)implantation in infantile patients has long-term positive impacts on visual rehabilitation,as well as postoperative complications inevitably.Timing of IOL implantation in infantile congenital cataract patients is not simply a point-in-time but a personalized decision that comprehensively takes age at surgery,risks of postoperative complications,and economic condition of family in consideration,and combines with choosing suitable IOL type and power.For infants with well-developed eyeballs and good systemic conditions,IOL implantation at six months of age or older is safe and effective.Otherwise,secondary IOL implantation may be a safer choice.展开更多
The aim of this study was to explore the optimal timing of holmium laser enucleation of the prostate(HoLEP)in patients presenting benign prostatic hyperplasia(BPH)with lower urinary tract symptoms(LUTS).A retrospectiv...The aim of this study was to explore the optimal timing of holmium laser enucleation of the prostate(HoLEP)in patients presenting benign prostatic hyperplasia(BPH)with lower urinary tract symptoms(LUTS).A retrospective analysis was conducted based on the perioperative and postoperative outcome data of 1212 patients who underwent HoLEP in Shanghai Ninth People’s Hospital(Shanghai,China)between January 2009 and December 2018.According to the preoperative International Prostate Symptom Score(IPSS),all patients whom we analyzed were divided into Group A(IPSS of 8–18)and Group B(IPSS of 19–35).Peri-and postoperative outcome data were obtained during the 1-year follow-up.IPSS changes were the main postoperative outcomes.The postoperative IPSS,quality of life,peak urinary flow rate,postvoid residual,and overactive bladder symptom score(OABSS)improved significantly.The IPSS improved further in the group with severe LUTS symptoms,but the postoperative IPSS was still higher than that in the moderate LUTS group.OABSSs showing moderate and severe cases after follow-up were more frequent in Group B(9.1%)than in Group A(5.2%)(P<0.05).There were no significant intergroup differences in the intraoperative American Society of Anesthesiologists or hospitalization expense scores,and the medication costs,as well as the total costs,were significantly higher in Group B.In this retrospective study,HoLEP was an effective treatment for symptomatic BPH.For patients with LUTS,earlier surgery in patients with moderate severity may result in a marginally better 12-month IPSS than that in men with severe symptoms.展开更多
基金Ethical approval was obtained from the Imam Abdulrahman Bin Faisal University review board(IRB-UGS-2019-01-333)。
文摘BACKGROUND Supracondylar humerus fractures account for more than 60%of all elbow fractures and about 1/5 of all pediatric fractures.Unfortunately,these fractures can be associated with risk of complications including neurovascular injuries,malunions and limb deformities.Controversy exists regarding the effect of time of surgical intervention and/or level of surgeon performing the surgery on outcome of these fractures.AIM To determine whether time of surgical intervention and/or surgeon level influence the outcomes of surgically managed pediatric supracondylar humerus fractures.METHODS We retrospectively studied 155 pediatric patients presenting with a supracondylar humerus fracture in a level 1 trauma center from January 2006 to December 2019.The data extracted included demographic data,fracture characteristics,surgical data,and follow-up outcomes.The collected data was analyzed and P values of<0.05 were considered statistically significant.RESULTS Of the cohort,11%of patients had documented post-operative complications,of which the majority occurred in surgeries performed after day time working hours and in fractures requiring open reduction.While the lowest complication rate was found in surgeries performed by pediatric orthopaedic surgeons,this did not reach statistical significance.CONCLUSION In pediatric patients undergoing surgery for supracondylar fractures,we found a higher complication rate when surgeries were not performed during working hours.Surgeon level and training had no significant effect on the risk of post-operative complications.
文摘Crohn’s disease(CD)is a chronic inflammatory disorder of the gastrointestinal tract with an increasing incidence worldwide.Comprehensive therapy for CD focuses on symptom control and healing the intestinal mucosa to improve the quality of life and prevent complications.Surgical intervention plays a vital role in comprehensive therapy.However,deciding the optimal timing for surgical intervention has long been a focus of controversy.This review provides insights into the timing of surgery for CD and guides clinicians in daily treatment.
基金the National Natural Science Foundation of China(No.81870680)the Innovation Discipline of Zhejiang Province(lens disease in children)(No.2016cxxk1)。
文摘As an indispensable part of congenital cataract surgery,intraocular lens(IOL)implantation in infantile patients has long-term positive impacts on visual rehabilitation,as well as postoperative complications inevitably.Timing of IOL implantation in infantile congenital cataract patients is not simply a point-in-time but a personalized decision that comprehensively takes age at surgery,risks of postoperative complications,and economic condition of family in consideration,and combines with choosing suitable IOL type and power.For infants with well-developed eyeballs and good systemic conditions,IOL implantation at six months of age or older is safe and effective.Otherwise,secondary IOL implantation may be a safer choice.
基金This research was supported by grant from the multi-center clinical research project of Shanghai Jiao Tong University School of Medicine(grant No.DLY201809)grant from the 2021 Shanghai Science and Technology Innovation Cooperation Program of Science and Technology Commission of Shanghai Municipality(grant No.21015801700)。
文摘The aim of this study was to explore the optimal timing of holmium laser enucleation of the prostate(HoLEP)in patients presenting benign prostatic hyperplasia(BPH)with lower urinary tract symptoms(LUTS).A retrospective analysis was conducted based on the perioperative and postoperative outcome data of 1212 patients who underwent HoLEP in Shanghai Ninth People’s Hospital(Shanghai,China)between January 2009 and December 2018.According to the preoperative International Prostate Symptom Score(IPSS),all patients whom we analyzed were divided into Group A(IPSS of 8–18)and Group B(IPSS of 19–35).Peri-and postoperative outcome data were obtained during the 1-year follow-up.IPSS changes were the main postoperative outcomes.The postoperative IPSS,quality of life,peak urinary flow rate,postvoid residual,and overactive bladder symptom score(OABSS)improved significantly.The IPSS improved further in the group with severe LUTS symptoms,but the postoperative IPSS was still higher than that in the moderate LUTS group.OABSSs showing moderate and severe cases after follow-up were more frequent in Group B(9.1%)than in Group A(5.2%)(P<0.05).There were no significant intergroup differences in the intraoperative American Society of Anesthesiologists or hospitalization expense scores,and the medication costs,as well as the total costs,were significantly higher in Group B.In this retrospective study,HoLEP was an effective treatment for symptomatic BPH.For patients with LUTS,earlier surgery in patients with moderate severity may result in a marginally better 12-month IPSS than that in men with severe symptoms.
