Objective:To analyze the impact of sentinel lymph node biopsy(SLNB)combined with breast-conserving surgery in the clinical treatment of early-stage breast cancer.Methods:80 patients with early-stage breast cancer admi...Objective:To analyze the impact of sentinel lymph node biopsy(SLNB)combined with breast-conserving surgery in the clinical treatment of early-stage breast cancer.Methods:80 patients with early-stage breast cancer admitted to the Second Department of Breast Surgery at Dezhou Second People’s Hospital from September 2020 to September 2022 were selected and randomly divided into a control group and an observation group using the random number table method,with 40 cases in each group.The control group underwent a modified radical mastectomy,while the observation group underwent SLNB combined with breast-conserving surgery.The surgical efficacy and prognosis between the two groups were compared.Results:The observation group exhibited shorter operation,hospitalization,and extubation times,as well as less intraoperative blood loss and drainage volume,all of which were significantly better than those in the control group(P<0.05).Additionally,the observation group demonstrated a higher rate of excellent breast cosmetology and quality of life,with lower complication incidence,significantly outperforming the control group(P<0.05).There was no statistical difference in the metastasis rate and recurrence rate between the two groups(P>0.05).Conclusion:The combination of SLNB and breast-conserving surgery proves highly effective for patients with early-stage breast cancer,presenting fewer complications and enhancing both breast cosmetic outcomes and quality of life.展开更多
Objective： To explore the therapeutic effect and associated techniques of breast-conserving therapy on patients with clinical stage Ⅰ and stage Ⅱ breast cancer. Methods： 216 female patients with breast cancer unde...Objective： To explore the therapeutic effect and associated techniques of breast-conserving therapy on patients with clinical stage Ⅰ and stage Ⅱ breast cancer. Methods： 216 female patients with breast cancer underwent breast-conserving therapy from December 1993 to October 2004. Their data were analyzed retrospectively. The breast-conserving therapy consisted of lumpectomy or quadrant removal of the breast, postoperative radiotherapy, chemotherapy and endocrine therapy. Of them, 209 patients underwent axillary lymph node dissection. Results： There were no operative complications. 216 patients were followed-up 3 to 147 months, the medial follow-up time was 78 months. The local recurrence rate was 1.85%. Two patients died and one of them was not related with breast cancer. Presence or absence of fibrosis, shape of breast, asymmetry, pigmentation and handle were taken into consideration for cosmetic evaluation by the patients and experienced breast surgeon. Breasts were scored cosmetically as excellent and good in 199 patients, the rate of satisfactory was 92.13%. Conclusion： Breast-conserving therapy for early breast cancer is e safe end effective therapy. It has less trauma end less complications and can also raise the quality of life in the patients. But we must obey the strict indications and reasonable techniques.展开更多
Objective To investigate the application of oncoplastic surgery in breast-conserving surgery.Methods We retrospectively analyzed the clinical data of 103 breast cancer patients who underwent breast-conserving surgery ...Objective To investigate the application of oncoplastic surgery in breast-conserving surgery.Methods We retrospectively analyzed the clinical data of 103 breast cancer patients who underwent breast-conserving surgery in the First Affiliated Hospital of Henan University.All the patients were female whose tumor volume-to-breast volume ratio was greater than 20%.Fifty-two patients were treated with oncoplastic breast-conversing surgery(observation group),and 51 patients were treated with traditional breast-conserving surgery(control group).The volume of resected tissue,subjective satisfaction with breast shape,objective score of breast shape,and follow-up were compared between the two groups.Results In the observation group,the weight of resected breast tissue was 64.2–172.1 g,with a median of 98.7 g.In the control group,the weight of resected breast tissue was 67.5–175.7 g,with a median of 102.3 g.After 12 months of follow-up,the subjective satisfaction rate and objective score of breast shape in the observation group were significantly better than those in the traditional breast-conserving surgery group(P<0.05).There was no recurrence,metastasis,or death in the two groups.There was no significant difference in postoperative complications between the two groups(P>0.05).Conclusion Oncoplastic breast-conserving surgery leads to better cosmetic results and a more satisfactory clinical results.展开更多
Objective To investigate the relationship between the expression of S100A7 protein and prediction of recurrence and prognosis of breast cancer in patients undergoing breast-conserving surgery combined with radiotherap...Objective To investigate the relationship between the expression of S100A7 protein and prediction of recurrence and prognosis of breast cancer in patients undergoing breast-conserving surgery combined with radiotherapy.Methods 349 samples of carcinoma tissue wax blocks were selected from January 2011 to January 2014 in Qingdao Central Hospital.All the patients had undergone breast-conserving surgery.We analyzed S100A7 expression in tumor tissue by immunohistochemical staining.Using univariate and multivariate analyses,we evaluated the relationship between S100A7 and clinical results,to explore independent risk factors for local regional recurrence(LRR).Results The positive expression of S100A7 in the recurrence group(66.7%)was significantly higher than in the non-recurrence group(38.4%),P=0.025.A log-rank test showed that high S100A7 expression was significantly correlated with 5-year regional recurrence free survival rate(RFS)(94.9%vs 89.5%,P=0.0408),distant metastasis free survival rate(DFS)(95.4%vs 83.5%,P<0.001),and overall survival rate(OS)(99.0%vs 92.5%,P=0.0011).Histological grade,vessel carcinoma embolus,lymph node metastasis,S100A7 expression,and tumor size were factors that influenced RFS.Multivariate analysis of the Cox proportional hazard model showed that high S100A7 expression was an independent risk factor that affected breast cancer RFS(HR=6.864,95%CI:1.575-29.915,P=0.01).Thus,we concluded that high S100A7 expression is associated with increased risk of LRR and distant metastasis of breast cancer after breast-conserving surgery and postoperative radiotherapy.S100A7 can be used as a molecular marker to screen for patients with high recurrence risk after breast-conserving surgery.展开更多
Objective:This single-center,prospective,observational study was designed to investigate the toxicities,patient-reported outcome(PRO),and dosimetric analysis of whole breast ultrafractionation radiotherapy(RT)after br...Objective:This single-center,prospective,observational study was designed to investigate the toxicities,patient-reported outcome(PRO),and dosimetric analysis of whole breast ultrafractionation radiotherapy(RT)after breast-conserving surgery(BCS)in early breast cancer(BC).Patients and methods:Patients diagnosed with BC stage I,II and treated with BCS were enrolled.A dose of 26 Gray(Gy)in five fractions was prescribed to the whole breast and tumor bed.Clinical endpoints included toxicities,PRO,and dosimetric analysis.PRO was measured by the European Organization for Research and Treatment of Cancer general quality of life questionnaire(EORTC QLQ-C30)and the BC-specific questionnaire(EORTC QLQ-BR23)questionnaires.Results:Between January 2022 and June 2023,62 female patients were enrolled.The median age was 45 years.Most patients(83.9%)were diagnosed with pathological stage I disease.The median planning target volume(PTV)was 456.4 mL.The minimum,maximum,and mean doses,and D95(dose of PTV irradiated volume more than 95%)to PTV were 20.2,28.8,27.2,and 26.3 Gy,respectively.The median mean lung dose and percentage lung volume receiving 8 Gy(V8)were 3.6 Gy and 13.4%,respectively.The median mean heart dose,V1.5(percentage of organ volume irradiated with 1.5 Gy or higher),and V7(percentage of organ volume irradiated with 7 Gy or higher)were 0.6 Gy,6.8%,and 0.4%,respectively.Cosmetic effects before RT showed no obvious differences compared to that post RT.No toxicities of grade 3 or higher occurred.Five patients had asymptomatic radiation pneumonia(grade 1),and 12 patients had radiation dermatitis(grade 1).No factor was significantly related to radiation dermatitis or radiation pneumonia.For the EORTC QLQ-C30 and QLQ-BR23 questionnaires,all function and symptom scores before RT had no significant differences compared with that after RT,1−2 months after RT,and 3−4 months after RT.Ultrafractionation RT did not worsen PRO.The 1-year crude local control was 100%.Conclusion:Whole breast ultrafractionation RT after BCS in early BC has no severe toxicities and does not affect PRO.These results need to be further validated with a longer follow-up and a larger sample size.展开更多
Background:Although breast-conserving surgery is one of the standard treatments for breast cancer,few studies have assessed its recent implementation in China.We aimed to clarify the current real-world status of breas...Background:Although breast-conserving surgery is one of the standard treatments for breast cancer,few studies have assessed its recent implementation in China.We aimed to clarify the current real-world status of breast-conserving surgery in China.Methods:This cross-sectional survey relied on data collected by the Chinese Society of Breast Surgery(CSBrS)to examine patients who underwent this surgery between January 2018 and December 2018.The survey was conducted using a uniform electronic questionnaire to collect information,including clinical and pathological data on these patients.Results:Overall,4459 breast-conserving surgeries were performed in 34 member units of CSBrS,accounting for 14.6%of all breast cancer surgeries performed in these units during the study period.In patients who underwent breast-conserving surgery with information on tumor size available,more than half(61.2%)of the tumors were smaller than 2 cm in diameter,and only 87(3.2%)tumors were larger than 4 cm in diameter.Among patients who underwent breast-conserving surgeries,457(10.2%)patients received neoadjuvant therapy before the surgery.Among patients with a reported margin width,34(2.0%)patients had a margin of≤2 mm,and 1530(88.2%)of them had a margin of>5 mm.Conclusions:This study demonstrated the rates of breast-conserving surgery in member units of the CSBrS,and introduced the characteristics and surgical margins of patients who underwent this surgery.This information helps describe the real-world status of breast-conserving surgery in China.展开更多
Background This multicenter prospective study aimed to assess the utility of dynamic enhanced magnetic resonance imaging （MRI） prior to breast-conserving surgery for breast cancer.Methods The research subjects were ...Background This multicenter prospective study aimed to assess the utility of dynamic enhanced magnetic resonance imaging （MRI） prior to breast-conserving surgery for breast cancer.Methods The research subjects were drawn from patients with primary early resectable breast cancer treated in the breast disease centers of six three-level hospitals in Beijing from 1 January 2010 to 31 December 2012.The participants were allocated to a breast-conserving surgery group （breast-conserving group） or a total mastectomy group （total mastectomy group）.Enhanced MRI was used to measure breast volume,longest diameter of tumor and tumor volume.The correlations between these measurements and those derived from histopathologic findings were assessed.The relationships between the success rate of breast-conserving surgery and MRI-and pathology-based measurement results were statistically analyzed in the breast-conserving group.Results The study included 461 cases in the total mastectomy group and 195 in the breast-conserving group.Allocation to these groups was based on clinical indications and patient preferences.The cut-off for concurrence between MRI-and pathology-based measurements of the longest diameter of tumor was set at 0.3 cm.In the total mastectomy group,the confidence interval for 95％ concurrence of these measurements was 35.41％-44.63％.Correlation coefficients for MRI and histopathology-based measurements of breast volume,tumor volume and tumor volume/breast volume ratio were r=0.861,0.569,and 0.600,respectively （all P ＜0.001）.In the breast-conserving group,with 0.30 cm taken as the cut-off for concurrence,the 95％ confidence interval for MRI and pathology-based measurements of the longest diameter of tumor was 29.98％-44.01％.The subjective and objective success rates for breast-conserving surgery were 100％ and 88.54％,respectively.Conclusions There were significant correlations between dynamic enhanced MRI-and histopathology-based measurements of the longest diameter of breast lesions,breast and tumor volumes,and breast volume/tumor volume ratios.Preoperative MRI examination improves the success rate of breast-conserving surgery.展开更多
Recent observational studies showed that breast-conserving surgery(BCS) resulted in superior survival compared to mastectomy in breast cancer patients. This study compared the clinical outcomes of BCS and mastectomy u...Recent observational studies showed that breast-conserving surgery(BCS) resulted in superior survival compared to mastectomy in breast cancer patients. This study compared the clinical outcomes of BCS and mastectomy using propensity score(PS)matching analysis, which had advantages over conventional methods in reducing bias. Nonmetastatic breast cancer patients who underwent BCS and mastectomy were matched 1:1 based on their PS. We used the Kaplan-Meier method and Cox-regression model to estimate the treatment effects. A total of 2,866 patients with a median follow-up time of 67 months were included in the original study population. Although the mastectomy cohort(N=1,219) had more advanced disease compared to the BCS cohort(N=1,647), LRFS was similar between the two groups(93.8% vs. 92.4%, P>0.05). BCS(vs. mastectomy) was associated with improved DFS(73.8% vs. 58.7%, P<0.01) and CSS(91% vs. 78.2%, P<0.01) in the original population. In the PS-matched population(N=1,668), clinicopathological features were equally distributed between the two cohorts. BCS(vs. mastectomy) was not associated with improved DFS(70.7% vs. 66.9%, P>0.05) or CSS(87.5% vs. 84.9%, P>0.05). We found that PS methods reduce bias when estimating treatment effects using observational data. BCS and mastectomy show equivalent outcomes in nonmetastatic breast cancer patients.展开更多
The top goal of modern medicine is treating disease without destroying organ structures and making patients as healthy as they were before their sickness.Minimally invasive surgery(MIS)has dominated the surgical realm...The top goal of modern medicine is treating disease without destroying organ structures and making patients as healthy as they were before their sickness.Minimally invasive surgery(MIS)has dominated the surgical realm because of its lesser invasiveness.However,changes in anatomical structures of the body and reconstruction of internal organs or different organs are common after traditional surgery or MIS,decreasing the quality of life of patients post-operation.Thus,I propose a new treatment mode,super MIS(SMIS),which is defined as“curing a disease or lesion which used to be treated by MIS while preserving the integrity of the organs”.In this study,I describe the origin,definition,operative channels,advantages,and future perspectives of SMIS.展开更多
Diabetes mellitus(DM)and obesity have become public issues of global concern.Bariatric surgery for the treatment of obesity combined with type 2 DM has been shown to be a safe and effective approach;however,there are ...Diabetes mellitus(DM)and obesity have become public issues of global concern.Bariatric surgery for the treatment of obesity combined with type 2 DM has been shown to be a safe and effective approach;however,there are limited studies that have systematically addressed the challenges of surgical treatment of obesity combined with DM.In this review,we summarize and answer the most pressing questions in the field of surgical treatment of obesity-associated DM.I believe that our insights will be of great help to clinicians in their daily practice.展开更多
Introduction: Ultrafast latest developments in artificial intelligence (ΑΙ) have recently multiplied concerns regarding the future of robotic autonomy in surgery. However, the literature on the topic is still scarce...Introduction: Ultrafast latest developments in artificial intelligence (ΑΙ) have recently multiplied concerns regarding the future of robotic autonomy in surgery. However, the literature on the topic is still scarce. Aim: To test a novel AI commercially available tool for image analysis on a series of laparoscopic scenes. Methods: The research tools included OPENAI CHATGPT 4.0 with its corresponding image recognition plugin which was fed with a list of 100 laparoscopic selected snapshots from common surgical procedures. In order to score reliability of received responses from image-recognition bot, two corresponding scales were developed ranging from 0 - 5. The set of images was divided into two groups: unlabeled (Group A) and labeled (Group B), and according to the type of surgical procedure or image resolution. Results: AI was able to recognize correctly the context of surgical-related images in 97% of its reports. For the labeled surgical pictures, the image-processing bot scored 3.95/5 (79%), whilst for the unlabeled, it scored 2.905/5 (58.1%). Phases of the procedure were commented in detail, after all successful interpretations. With rates 4 - 5/5, the chatbot was able to talk in detail about the indications, contraindications, stages, instrumentation, complications and outcome rates of the operation discussed. Conclusion: Interaction between surgeon and chatbot appears to be an interesting frontend for further research by clinicians in parallel with evolution of its complex underlying infrastructure. In this early phase of using artificial intelligence for image recognition in surgery, no safe conclusions can be drawn by small cohorts with commercially available software. Further development of medically-oriented AI software and clinical world awareness are expected to bring fruitful information on the topic in the years to come.展开更多
Accurate segmentation of oral surgery-related tissues from cone beam computed tomography(CBCT)images can significantly accelerate treatment planning and improve surgical accuracy.In this paper,we propose a fully autom...Accurate segmentation of oral surgery-related tissues from cone beam computed tomography(CBCT)images can significantly accelerate treatment planning and improve surgical accuracy.In this paper,we propose a fully automated tissue segmentation system for dental implant surgery.Specifically,we propose an image preprocessing method based on data distribution histograms,which can adaptively process CBCT images with different parameters.Based on this,we use the bone segmentation network to obtain the segmentation results of alveolar bone,teeth,and maxillary sinus.We use the tooth and mandibular regions as the ROI regions of tooth segmentation and mandibular nerve tube segmentation to achieve the corresponding tasks.The tooth segmentation results can obtain the order information of the dentition.The corresponding experimental results show that our method can achieve higher segmentation accuracy and efficiency compared to existing methods.Its average Dice scores on the tooth,alveolar bone,maxillary sinus,and mandibular canal segmentation tasks were 96.5%,95.4%,93.6%,and 94.8%,respectively.These results demonstrate that it can accelerate the development of digital dentistry.展开更多
BACKGROUND This study aimed to evaluate the safety of enhanced recovery after surgery(ERAS)in elderly patients with gastric cancer(GC).AIM To evaluate the safety of ERAS in elderly patients with GC.METHODS The PubMed,...BACKGROUND This study aimed to evaluate the safety of enhanced recovery after surgery(ERAS)in elderly patients with gastric cancer(GC).AIM To evaluate the safety of ERAS in elderly patients with GC.METHODS The PubMed,EMBASE,and Cochrane Library databases were used to search for eligible studies from inception to April 1,2023.The mean difference(MD),odds ratio(OR)and 95%confidence interval(95%CI)were pooled for analysis.The quality of the included studies was evaluated using the Newcastle-Ottawa Scale scores.We used Stata(V.16.0)software for data analysis.RESULTS This study consists of six studies involving 878 elderly patients.By analyzing the clinical outcomes,we found that the ERAS group had shorter postoperative hospital stays(MD=-0.51,I2=0.00%,95%CI=-0.72 to-0.30,P=0.00);earlier times to first flatus(defecation;MD=-0.30,I²=0.00%,95%CI=-0.55 to-0.06,P=0.02);less intestinal obstruction(OR=3.24,I2=0.00%,95%CI=1.07 to 9.78,P=0.04);less nausea and vomiting(OR=4.07,I2=0.00%,95%CI=1.29 to 12.84,P=0.02);and less gastric retention(OR=5.69,I2=2.46%,95%CI=2.00 to 16.20,P=0.00).Our results showed that the conventional group had a greater mortality rate than the ERAS group(OR=0.24,I2=0.00%,95%CI=0.07 to 0.84,P=0.03).However,there was no statistically significant difference in major complications between the ERAS group and the conventional group(OR=0.67,I2=0.00%,95%CI=0.38 to 1.18,P=0.16).CONCLUSION Compared to those with conventional recovery,elderly GC patients who received the ERAS protocol after surgery had a lower risk of mortality.展开更多
Breast-conserving surgery(BCS)with radiotherapy is the primarily agreed surgical choice for eligible patients with an early diagnosis of breast cancer.In 2019,the panel of Chinese experts assembled by the Chinese Soci...Breast-conserving surgery(BCS)with radiotherapy is the primarily agreed surgical choice for eligible patients with an early diagnosis of breast cancer.In 2019,the panel of Chinese experts assembled by the Chinese Society for Breast Surgery(CSBrS)developed a Chinese experts’consensus on BCS for early-stage breast cancer(Version 2019)with the aim of standardizing BCS in China.Subsequently,the CSBrS conducted a review of published reports and discussions between experts to determine the key clinical questions for the Clinical Practice Guideline for BCS in Patients with Early-Stage Breast Cancer.The group evaluated the relevant evidence using the grading of recommendations assessment,development,and evaluation system,and developed a Clinical Practice Guideline for BCS in Patients with Early-Stage Breast Cancer(Version 2021),with the aim of providing guidance on clinical practice to breast surgeons in China.展开更多
BACKGROUND This study was designed to investigate the clinical outcomes of enhanced recovery after surgery(ERAS)in the perioperative period in elderly patients with nonsmall cell lung cancer(NSCLC).AIM To investigate ...BACKGROUND This study was designed to investigate the clinical outcomes of enhanced recovery after surgery(ERAS)in the perioperative period in elderly patients with nonsmall cell lung cancer(NSCLC).AIM To investigate the potential enhancement of video-assisted thoracic surgery(VATS)in postoperative recovery in elderly patients with NSCLC.METHODS We retrospectively analysed the clinical data of 85 elderly NSCLC patients who underwent ERAS(the ERAS group)and 327 elderly NSCLC patients who received routine care(the control group)after VATS at the Department of Thoracic Surgery of Peking University Shenzhen Hospital between May 2015 and April 2017.After propensity score matching of baseline data,we analysed the postoperative stay,total hospital expenses,postoperative 48-h pain score,and postoperative complication rate for the 2 groups of patients who underwent lobectomy or sublobar resection.RESULTS After propensity score matching,ERAS significantly reduced the postoperative hospital stay(6.96±4.16 vs 8.48±4.18 d,P=0.001)and total hospital expenses(48875.27±18437.5 vs 55497.64±21168.63 CNY,P=0.014)and improved the satisfaction score(79.8±7.55 vs 77.35±7.72,P=0.029)relative to those for routine care.No significant between-group difference was observed in postoperative 48-h pain score(4.68±1.69 vs 5.28±2.1,P=0.090)or postoperative complication rate(21.2%vs 27.1%,P=0.371).Subgroup analysis showed that ERAS significantly reduced the postoperative hospital stay and total hospital expenses and increased the satisfaction score of patients who underwent lobectomy but not of patients who underwent sublobar resection.CONCLUSION ERAS effectively reduced the postoperative hospital stay and total hospital expenses and improved the satisfaction score in the perioperative period for elderly NSCLC patients who underwent lobectomy but not for patients who underwent sublobar resection.展开更多
BACKGROUND We report a case of uterine artery pseudoaneurysm(UAP)occurrence during hysteroscopic endometrial polypectomy and its treatment via uterine artery embolization(UAE).CASE SUMMARY A 48-year-old primigravid,pr...BACKGROUND We report a case of uterine artery pseudoaneurysm(UAP)occurrence during hysteroscopic endometrial polypectomy and its treatment via uterine artery embolization(UAE).CASE SUMMARY A 48-year-old primigravid,primiparous patient was incidentally found to have an endometrial polyp during a health checkup,and underwent a hysteroscopic polypectomy at another hospital.Her cervix was dilated with a Laminken-R®device.After the Laminken-R®was withdrawn,a large amount of genital bleeding was observed.This bleeding persisted after the hysteroscopic polypectomy,and,as hemostasis became impossible,the patient was transferred to our hospital by ambulance.On arrival,transvaginal ultrasonography revealed a 3-cm hypoechoic mass with a swirling internal pulse on the right side of the uterus,and color Doppler ultrasonography showed feeder vessels penetrating the mass.Pelvic contrast-enhanced computed tomography(CT)confirmed the presence of a mass at this site,and vascular proliferation was observed within the uterine cavity.Consequently,UAP was diagnosed,and UAE was performed.The patient’s postoperative course was uneventful,and 6 mo post-UAE,no recurrence of blood flow to the UAP was observed.CONCLUSION When abnormal genital bleeding occurs during hysteroscopic surgery,ultrasonography and contrast-enhanced CT can assist in the detection of early UAPs.展开更多
Obesity is a prevalent cause of diabetes mellitus(DM)and is a serious danger to human health.Type 2 DM(T2DM)mostly occurs along with obesity.Foodborne obesity-induced DM is caused by an excessive long-term diet and su...Obesity is a prevalent cause of diabetes mellitus(DM)and is a serious danger to human health.Type 2 DM(T2DM)mostly occurs along with obesity.Foodborne obesity-induced DM is caused by an excessive long-term diet and surplus energy.Bariatric surgery can improve the symptoms of T2DM in some obese patients.But different types of bariatric surgery may have different effects.There are some models built by researchers to discuss the surgical procedures’effects on me-tabolism in diabetes animal models and diabetes patients.It is high time to conclude all this effects and recommend procedures that can better improve metabolism.展开更多
BACKGROUND Hemolymphangioma of the jejunum is rare and lacks clinical specificity,and can manifest as gastrointestinal bleeding,abdominal pain,and intestinal obstruction.Computed tomography,magnetic resonance imaging,...BACKGROUND Hemolymphangioma of the jejunum is rare and lacks clinical specificity,and can manifest as gastrointestinal bleeding,abdominal pain,and intestinal obstruction.Computed tomography,magnetic resonance imaging,and other examinations show certain characteristics of the disease,but lack accuracy.Although capsule endoscopy and enteroscopy make up for this deficiency,the diagnosis also still re-quires pathology.CASE SUMMARY A male patient was admitted to the hospital due to abdominal distension and abdominal pain,but a specific diagnosis by computed tomography examination was not obtained.Partial resection of the small intestine was performed by robotic surgery,and postoperative pathological biopsy confirmed the diagnosis of hemo-lymphangioma.No recurrence in the follow-up examination was observed.CONCLUSION Robotic surgery is an effective way to treat hemolymphangioma through minima-lly invasive techniques under the concept of rapid rehabilitation.展开更多
BACKGROUND Ovarian cancer is one of the most common malignant tumors in female reproductive system in the world,and the choice of its treatment is very important for the survival rate and prognosis of patients.Traditi...BACKGROUND Ovarian cancer is one of the most common malignant tumors in female reproductive system in the world,and the choice of its treatment is very important for the survival rate and prognosis of patients.Traditional open surgery is the main treatment for ovarian cancer,but it has the disadvantages of big trauma and slow recovery.With the continuous development of minimally invasive technology,minimally invasive laparoscopic surgery under general anesthesia has been gradually applied to the treatment of ovarian cancer because of its advantages of less trauma and quick recovery.However,the efficacy and safety of minimally invasive laparoscopic surgery under general anesthesia in the treatment of ovarian cancer are still controversial.AIM To explore the efficacy and safety of general anesthesia minimally invasive surgery in the treatment of ovarian cancer.METHODS The clinical data of 90 patients with early ovarian cancer in our hospital were analyzed retrospectively.According to the different surgical treatment methods,patients were divided into study group and control group(45 cases in each group).The study group received minimally invasive laparoscopic surgery under general anesthesia for ovarian cancer,while the control group received traditional open surgery for ovarian cancer.The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire(EORTC QLQ-C30),clinical efficacy and safety of the two groups were compared.RESULTS The intraoperative blood loss,length of hospital stay,postoperative gas evacuation time,and postoperative EORTC QLQ-C30 score of the study group were significantly better than those of the control group(P<0.05).The incidence of postoperative complications in the study group was significantly lower than in the control group(P<0.05).The two groups had no significant differences in the preoperative adrenocorticotropic hormone(ACTH),androstenedione(AD),cortisol(Cor),cluster of differentiation 3 positive(CD3+),and cluster of differentiation 4 positive(CD4+)indexes(P>0.05).In contrast,postoperatively,the study group's ACTH,AD,and Cor indexes were lower,and the CD3+and CD4+indexes were higher than those in the control group(P<0.05).CONCLUSION Minimally invasive laparoscopic surgery under general anesthesia in patients with early ovarian cancer can significantly improve the efficacy and safety,improve the short-term prognosis and quality of life of patients,and is worth popularizing.展开更多
文摘Objective:To analyze the impact of sentinel lymph node biopsy(SLNB)combined with breast-conserving surgery in the clinical treatment of early-stage breast cancer.Methods:80 patients with early-stage breast cancer admitted to the Second Department of Breast Surgery at Dezhou Second People’s Hospital from September 2020 to September 2022 were selected and randomly divided into a control group and an observation group using the random number table method,with 40 cases in each group.The control group underwent a modified radical mastectomy,while the observation group underwent SLNB combined with breast-conserving surgery.The surgical efficacy and prognosis between the two groups were compared.Results:The observation group exhibited shorter operation,hospitalization,and extubation times,as well as less intraoperative blood loss and drainage volume,all of which were significantly better than those in the control group(P<0.05).Additionally,the observation group demonstrated a higher rate of excellent breast cosmetology and quality of life,with lower complication incidence,significantly outperforming the control group(P<0.05).There was no statistical difference in the metastasis rate and recurrence rate between the two groups(P>0.05).Conclusion:The combination of SLNB and breast-conserving surgery proves highly effective for patients with early-stage breast cancer,presenting fewer complications and enhancing both breast cosmetic outcomes and quality of life.
文摘Objective： To explore the therapeutic effect and associated techniques of breast-conserving therapy on patients with clinical stage Ⅰ and stage Ⅱ breast cancer. Methods： 216 female patients with breast cancer underwent breast-conserving therapy from December 1993 to October 2004. Their data were analyzed retrospectively. The breast-conserving therapy consisted of lumpectomy or quadrant removal of the breast, postoperative radiotherapy, chemotherapy and endocrine therapy. Of them, 209 patients underwent axillary lymph node dissection. Results： There were no operative complications. 216 patients were followed-up 3 to 147 months, the medial follow-up time was 78 months. The local recurrence rate was 1.85%. Two patients died and one of them was not related with breast cancer. Presence or absence of fibrosis, shape of breast, asymmetry, pigmentation and handle were taken into consideration for cosmetic evaluation by the patients and experienced breast surgeon. Breasts were scored cosmetically as excellent and good in 199 patients, the rate of satisfactory was 92.13%. Conclusion： Breast-conserving therapy for early breast cancer is e safe end effective therapy. It has less trauma end less complications and can also raise the quality of life in the patients. But we must obey the strict indications and reasonable techniques.
基金the Key Research and Development Promotion Projects in Henan Province(grant no.:202102310423)。
文摘Objective To investigate the application of oncoplastic surgery in breast-conserving surgery.Methods We retrospectively analyzed the clinical data of 103 breast cancer patients who underwent breast-conserving surgery in the First Affiliated Hospital of Henan University.All the patients were female whose tumor volume-to-breast volume ratio was greater than 20%.Fifty-two patients were treated with oncoplastic breast-conversing surgery(observation group),and 51 patients were treated with traditional breast-conserving surgery(control group).The volume of resected tissue,subjective satisfaction with breast shape,objective score of breast shape,and follow-up were compared between the two groups.Results In the observation group,the weight of resected breast tissue was 64.2–172.1 g,with a median of 98.7 g.In the control group,the weight of resected breast tissue was 67.5–175.7 g,with a median of 102.3 g.After 12 months of follow-up,the subjective satisfaction rate and objective score of breast shape in the observation group were significantly better than those in the traditional breast-conserving surgery group(P<0.05).There was no recurrence,metastasis,or death in the two groups.There was no significant difference in postoperative complications between the two groups(P>0.05).Conclusion Oncoplastic breast-conserving surgery leads to better cosmetic results and a more satisfactory clinical results.
基金Supported by a grant from The Medical Foundation of Wu Jieping(No.320.6750.16229)
文摘Objective To investigate the relationship between the expression of S100A7 protein and prediction of recurrence and prognosis of breast cancer in patients undergoing breast-conserving surgery combined with radiotherapy.Methods 349 samples of carcinoma tissue wax blocks were selected from January 2011 to January 2014 in Qingdao Central Hospital.All the patients had undergone breast-conserving surgery.We analyzed S100A7 expression in tumor tissue by immunohistochemical staining.Using univariate and multivariate analyses,we evaluated the relationship between S100A7 and clinical results,to explore independent risk factors for local regional recurrence(LRR).Results The positive expression of S100A7 in the recurrence group(66.7%)was significantly higher than in the non-recurrence group(38.4%),P=0.025.A log-rank test showed that high S100A7 expression was significantly correlated with 5-year regional recurrence free survival rate(RFS)(94.9%vs 89.5%,P=0.0408),distant metastasis free survival rate(DFS)(95.4%vs 83.5%,P<0.001),and overall survival rate(OS)(99.0%vs 92.5%,P=0.0011).Histological grade,vessel carcinoma embolus,lymph node metastasis,S100A7 expression,and tumor size were factors that influenced RFS.Multivariate analysis of the Cox proportional hazard model showed that high S100A7 expression was an independent risk factor that affected breast cancer RFS(HR=6.864,95%CI:1.575-29.915,P=0.01).Thus,we concluded that high S100A7 expression is associated with increased risk of LRR and distant metastasis of breast cancer after breast-conserving surgery and postoperative radiotherapy.S100A7 can be used as a molecular marker to screen for patients with high recurrence risk after breast-conserving surgery.
文摘Objective:This single-center,prospective,observational study was designed to investigate the toxicities,patient-reported outcome(PRO),and dosimetric analysis of whole breast ultrafractionation radiotherapy(RT)after breast-conserving surgery(BCS)in early breast cancer(BC).Patients and methods:Patients diagnosed with BC stage I,II and treated with BCS were enrolled.A dose of 26 Gray(Gy)in five fractions was prescribed to the whole breast and tumor bed.Clinical endpoints included toxicities,PRO,and dosimetric analysis.PRO was measured by the European Organization for Research and Treatment of Cancer general quality of life questionnaire(EORTC QLQ-C30)and the BC-specific questionnaire(EORTC QLQ-BR23)questionnaires.Results:Between January 2022 and June 2023,62 female patients were enrolled.The median age was 45 years.Most patients(83.9%)were diagnosed with pathological stage I disease.The median planning target volume(PTV)was 456.4 mL.The minimum,maximum,and mean doses,and D95(dose of PTV irradiated volume more than 95%)to PTV were 20.2,28.8,27.2,and 26.3 Gy,respectively.The median mean lung dose and percentage lung volume receiving 8 Gy(V8)were 3.6 Gy and 13.4%,respectively.The median mean heart dose,V1.5(percentage of organ volume irradiated with 1.5 Gy or higher),and V7(percentage of organ volume irradiated with 7 Gy or higher)were 0.6 Gy,6.8%,and 0.4%,respectively.Cosmetic effects before RT showed no obvious differences compared to that post RT.No toxicities of grade 3 or higher occurred.Five patients had asymptomatic radiation pneumonia(grade 1),and 12 patients had radiation dermatitis(grade 1).No factor was significantly related to radiation dermatitis or radiation pneumonia.For the EORTC QLQ-C30 and QLQ-BR23 questionnaires,all function and symptom scores before RT had no significant differences compared with that after RT,1−2 months after RT,and 3−4 months after RT.Ultrafractionation RT did not worsen PRO.The 1-year crude local control was 100%.Conclusion:Whole breast ultrafractionation RT after BCS in early BC has no severe toxicities and does not affect PRO.These results need to be further validated with a longer follow-up and a larger sample size.
基金This work was supported by grants from the National Key Research and Development Program of China(Nos.2016YFC0901300 and 2016YFC0901302)。
文摘Background:Although breast-conserving surgery is one of the standard treatments for breast cancer,few studies have assessed its recent implementation in China.We aimed to clarify the current real-world status of breast-conserving surgery in China.Methods:This cross-sectional survey relied on data collected by the Chinese Society of Breast Surgery(CSBrS)to examine patients who underwent this surgery between January 2018 and December 2018.The survey was conducted using a uniform electronic questionnaire to collect information,including clinical and pathological data on these patients.Results:Overall,4459 breast-conserving surgeries were performed in 34 member units of CSBrS,accounting for 14.6%of all breast cancer surgeries performed in these units during the study period.In patients who underwent breast-conserving surgery with information on tumor size available,more than half(61.2%)of the tumors were smaller than 2 cm in diameter,and only 87(3.2%)tumors were larger than 4 cm in diameter.Among patients who underwent breast-conserving surgeries,457(10.2%)patients received neoadjuvant therapy before the surgery.Among patients with a reported margin width,34(2.0%)patients had a margin of≤2 mm,and 1530(88.2%)of them had a margin of>5 mm.Conclusions:This study demonstrated the rates of breast-conserving surgery in member units of the CSBrS,and introduced the characteristics and surgical margins of patients who underwent this surgery.This information helps describe the real-world status of breast-conserving surgery in China.
文摘Background This multicenter prospective study aimed to assess the utility of dynamic enhanced magnetic resonance imaging （MRI） prior to breast-conserving surgery for breast cancer.Methods The research subjects were drawn from patients with primary early resectable breast cancer treated in the breast disease centers of six three-level hospitals in Beijing from 1 January 2010 to 31 December 2012.The participants were allocated to a breast-conserving surgery group （breast-conserving group） or a total mastectomy group （total mastectomy group）.Enhanced MRI was used to measure breast volume,longest diameter of tumor and tumor volume.The correlations between these measurements and those derived from histopathologic findings were assessed.The relationships between the success rate of breast-conserving surgery and MRI-and pathology-based measurement results were statistically analyzed in the breast-conserving group.Results The study included 461 cases in the total mastectomy group and 195 in the breast-conserving group.Allocation to these groups was based on clinical indications and patient preferences.The cut-off for concurrence between MRI-and pathology-based measurements of the longest diameter of tumor was set at 0.3 cm.In the total mastectomy group,the confidence interval for 95％ concurrence of these measurements was 35.41％-44.63％.Correlation coefficients for MRI and histopathology-based measurements of breast volume,tumor volume and tumor volume/breast volume ratio were r=0.861,0.569,and 0.600,respectively （all P ＜0.001）.In the breast-conserving group,with 0.30 cm taken as the cut-off for concurrence,the 95％ confidence interval for MRI and pathology-based measurements of the longest diameter of tumor was 29.98％-44.01％.The subjective and objective success rates for breast-conserving surgery were 100％ and 88.54％,respectively.Conclusions There were significant correlations between dynamic enhanced MRI-and histopathology-based measurements of the longest diameter of breast lesions,breast and tumor volumes,and breast volume/tumor volume ratios.Preoperative MRI examination improves the success rate of breast-conserving surgery.
基金supported by grants from the National Key Research and Development Program of China (2016YFC1302300)the National Natural Science Foundation of China (81720108029, 81621004, 81490750)+2 种基金Guangdong Science and Technology Department (2016B030229004)Guangzhou Science Technology and Innovation Commission (201803040015)supported by FountainValley Life Sciences Fund of University of Chinese Academy of Sciences Education Foundation
文摘Recent observational studies showed that breast-conserving surgery(BCS) resulted in superior survival compared to mastectomy in breast cancer patients. This study compared the clinical outcomes of BCS and mastectomy using propensity score(PS)matching analysis, which had advantages over conventional methods in reducing bias. Nonmetastatic breast cancer patients who underwent BCS and mastectomy were matched 1:1 based on their PS. We used the Kaplan-Meier method and Cox-regression model to estimate the treatment effects. A total of 2,866 patients with a median follow-up time of 67 months were included in the original study population. Although the mastectomy cohort(N=1,219) had more advanced disease compared to the BCS cohort(N=1,647), LRFS was similar between the two groups(93.8% vs. 92.4%, P>0.05). BCS(vs. mastectomy) was associated with improved DFS(73.8% vs. 58.7%, P<0.01) and CSS(91% vs. 78.2%, P<0.01) in the original population. In the PS-matched population(N=1,668), clinicopathological features were equally distributed between the two cohorts. BCS(vs. mastectomy) was not associated with improved DFS(70.7% vs. 66.9%, P>0.05) or CSS(87.5% vs. 84.9%, P>0.05). We found that PS methods reduce bias when estimating treatment effects using observational data. BCS and mastectomy show equivalent outcomes in nonmetastatic breast cancer patients.
基金Supported by National Key R&D Programs of China,No.2022YFC2503600.
文摘The top goal of modern medicine is treating disease without destroying organ structures and making patients as healthy as they were before their sickness.Minimally invasive surgery(MIS)has dominated the surgical realm because of its lesser invasiveness.However,changes in anatomical structures of the body and reconstruction of internal organs or different organs are common after traditional surgery or MIS,decreasing the quality of life of patients post-operation.Thus,I propose a new treatment mode,super MIS(SMIS),which is defined as“curing a disease or lesion which used to be treated by MIS while preserving the integrity of the organs”.In this study,I describe the origin,definition,operative channels,advantages,and future perspectives of SMIS.
文摘Diabetes mellitus(DM)and obesity have become public issues of global concern.Bariatric surgery for the treatment of obesity combined with type 2 DM has been shown to be a safe and effective approach;however,there are limited studies that have systematically addressed the challenges of surgical treatment of obesity combined with DM.In this review,we summarize and answer the most pressing questions in the field of surgical treatment of obesity-associated DM.I believe that our insights will be of great help to clinicians in their daily practice.
文摘Introduction: Ultrafast latest developments in artificial intelligence (ΑΙ) have recently multiplied concerns regarding the future of robotic autonomy in surgery. However, the literature on the topic is still scarce. Aim: To test a novel AI commercially available tool for image analysis on a series of laparoscopic scenes. Methods: The research tools included OPENAI CHATGPT 4.0 with its corresponding image recognition plugin which was fed with a list of 100 laparoscopic selected snapshots from common surgical procedures. In order to score reliability of received responses from image-recognition bot, two corresponding scales were developed ranging from 0 - 5. The set of images was divided into two groups: unlabeled (Group A) and labeled (Group B), and according to the type of surgical procedure or image resolution. Results: AI was able to recognize correctly the context of surgical-related images in 97% of its reports. For the labeled surgical pictures, the image-processing bot scored 3.95/5 (79%), whilst for the unlabeled, it scored 2.905/5 (58.1%). Phases of the procedure were commented in detail, after all successful interpretations. With rates 4 - 5/5, the chatbot was able to talk in detail about the indications, contraindications, stages, instrumentation, complications and outcome rates of the operation discussed. Conclusion: Interaction between surgeon and chatbot appears to be an interesting frontend for further research by clinicians in parallel with evolution of its complex underlying infrastructure. In this early phase of using artificial intelligence for image recognition in surgery, no safe conclusions can be drawn by small cohorts with commercially available software. Further development of medically-oriented AI software and clinical world awareness are expected to bring fruitful information on the topic in the years to come.
基金supported by National Natural Science Foundation of China(No.81970987).
文摘Accurate segmentation of oral surgery-related tissues from cone beam computed tomography(CBCT)images can significantly accelerate treatment planning and improve surgical accuracy.In this paper,we propose a fully automated tissue segmentation system for dental implant surgery.Specifically,we propose an image preprocessing method based on data distribution histograms,which can adaptively process CBCT images with different parameters.Based on this,we use the bone segmentation network to obtain the segmentation results of alveolar bone,teeth,and maxillary sinus.We use the tooth and mandibular regions as the ROI regions of tooth segmentation and mandibular nerve tube segmentation to achieve the corresponding tasks.The tooth segmentation results can obtain the order information of the dentition.The corresponding experimental results show that our method can achieve higher segmentation accuracy and efficiency compared to existing methods.Its average Dice scores on the tooth,alveolar bone,maxillary sinus,and mandibular canal segmentation tasks were 96.5%,95.4%,93.6%,and 94.8%,respectively.These results demonstrate that it can accelerate the development of digital dentistry.
基金Supported by Chongqing Medical University Program for Youth Innovation in Future Medicine,No.W0190.
文摘BACKGROUND This study aimed to evaluate the safety of enhanced recovery after surgery(ERAS)in elderly patients with gastric cancer(GC).AIM To evaluate the safety of ERAS in elderly patients with GC.METHODS The PubMed,EMBASE,and Cochrane Library databases were used to search for eligible studies from inception to April 1,2023.The mean difference(MD),odds ratio(OR)and 95%confidence interval(95%CI)were pooled for analysis.The quality of the included studies was evaluated using the Newcastle-Ottawa Scale scores.We used Stata(V.16.0)software for data analysis.RESULTS This study consists of six studies involving 878 elderly patients.By analyzing the clinical outcomes,we found that the ERAS group had shorter postoperative hospital stays(MD=-0.51,I2=0.00%,95%CI=-0.72 to-0.30,P=0.00);earlier times to first flatus(defecation;MD=-0.30,I²=0.00%,95%CI=-0.55 to-0.06,P=0.02);less intestinal obstruction(OR=3.24,I2=0.00%,95%CI=1.07 to 9.78,P=0.04);less nausea and vomiting(OR=4.07,I2=0.00%,95%CI=1.29 to 12.84,P=0.02);and less gastric retention(OR=5.69,I2=2.46%,95%CI=2.00 to 16.20,P=0.00).Our results showed that the conventional group had a greater mortality rate than the ERAS group(OR=0.24,I2=0.00%,95%CI=0.07 to 0.84,P=0.03).However,there was no statistically significant difference in major complications between the ERAS group and the conventional group(OR=0.67,I2=0.00%,95%CI=0.38 to 1.18,P=0.16).CONCLUSION Compared to those with conventional recovery,elderly GC patients who received the ERAS protocol after surgery had a lower risk of mortality.
文摘Breast-conserving surgery(BCS)with radiotherapy is the primarily agreed surgical choice for eligible patients with an early diagnosis of breast cancer.In 2019,the panel of Chinese experts assembled by the Chinese Society for Breast Surgery(CSBrS)developed a Chinese experts’consensus on BCS for early-stage breast cancer(Version 2019)with the aim of standardizing BCS in China.Subsequently,the CSBrS conducted a review of published reports and discussions between experts to determine the key clinical questions for the Clinical Practice Guideline for BCS in Patients with Early-Stage Breast Cancer.The group evaluated the relevant evidence using the grading of recommendations assessment,development,and evaluation system,and developed a Clinical Practice Guideline for BCS in Patients with Early-Stage Breast Cancer(Version 2021),with the aim of providing guidance on clinical practice to breast surgeons in China.
基金Supported by the Scientific Research Foundation of Peking University Shenzhen Hospital,No.KYQD2021096the National Natural Science Foundation of China,No.81972829Precision Medicine Research Program of Tsinghua University,No.2022ZLA006.
文摘BACKGROUND This study was designed to investigate the clinical outcomes of enhanced recovery after surgery(ERAS)in the perioperative period in elderly patients with nonsmall cell lung cancer(NSCLC).AIM To investigate the potential enhancement of video-assisted thoracic surgery(VATS)in postoperative recovery in elderly patients with NSCLC.METHODS We retrospectively analysed the clinical data of 85 elderly NSCLC patients who underwent ERAS(the ERAS group)and 327 elderly NSCLC patients who received routine care(the control group)after VATS at the Department of Thoracic Surgery of Peking University Shenzhen Hospital between May 2015 and April 2017.After propensity score matching of baseline data,we analysed the postoperative stay,total hospital expenses,postoperative 48-h pain score,and postoperative complication rate for the 2 groups of patients who underwent lobectomy or sublobar resection.RESULTS After propensity score matching,ERAS significantly reduced the postoperative hospital stay(6.96±4.16 vs 8.48±4.18 d,P=0.001)and total hospital expenses(48875.27±18437.5 vs 55497.64±21168.63 CNY,P=0.014)and improved the satisfaction score(79.8±7.55 vs 77.35±7.72,P=0.029)relative to those for routine care.No significant between-group difference was observed in postoperative 48-h pain score(4.68±1.69 vs 5.28±2.1,P=0.090)or postoperative complication rate(21.2%vs 27.1%,P=0.371).Subgroup analysis showed that ERAS significantly reduced the postoperative hospital stay and total hospital expenses and increased the satisfaction score of patients who underwent lobectomy but not of patients who underwent sublobar resection.CONCLUSION ERAS effectively reduced the postoperative hospital stay and total hospital expenses and improved the satisfaction score in the perioperative period for elderly NSCLC patients who underwent lobectomy but not for patients who underwent sublobar resection.
文摘BACKGROUND We report a case of uterine artery pseudoaneurysm(UAP)occurrence during hysteroscopic endometrial polypectomy and its treatment via uterine artery embolization(UAE).CASE SUMMARY A 48-year-old primigravid,primiparous patient was incidentally found to have an endometrial polyp during a health checkup,and underwent a hysteroscopic polypectomy at another hospital.Her cervix was dilated with a Laminken-R®device.After the Laminken-R®was withdrawn,a large amount of genital bleeding was observed.This bleeding persisted after the hysteroscopic polypectomy,and,as hemostasis became impossible,the patient was transferred to our hospital by ambulance.On arrival,transvaginal ultrasonography revealed a 3-cm hypoechoic mass with a swirling internal pulse on the right side of the uterus,and color Doppler ultrasonography showed feeder vessels penetrating the mass.Pelvic contrast-enhanced computed tomography(CT)confirmed the presence of a mass at this site,and vascular proliferation was observed within the uterine cavity.Consequently,UAP was diagnosed,and UAE was performed.The patient’s postoperative course was uneventful,and 6 mo post-UAE,no recurrence of blood flow to the UAP was observed.CONCLUSION When abnormal genital bleeding occurs during hysteroscopic surgery,ultrasonography and contrast-enhanced CT can assist in the detection of early UAPs.
文摘Obesity is a prevalent cause of diabetes mellitus(DM)and is a serious danger to human health.Type 2 DM(T2DM)mostly occurs along with obesity.Foodborne obesity-induced DM is caused by an excessive long-term diet and surplus energy.Bariatric surgery can improve the symptoms of T2DM in some obese patients.But different types of bariatric surgery may have different effects.There are some models built by researchers to discuss the surgical procedures’effects on me-tabolism in diabetes animal models and diabetes patients.It is high time to conclude all this effects and recommend procedures that can better improve metabolism.
基金Supported by Tianjin Key Medical Discipline(Specialty)Construction Project,No.TJYXZDXK-015A and No.TJYXZDXK-058B.
文摘BACKGROUND Hemolymphangioma of the jejunum is rare and lacks clinical specificity,and can manifest as gastrointestinal bleeding,abdominal pain,and intestinal obstruction.Computed tomography,magnetic resonance imaging,and other examinations show certain characteristics of the disease,but lack accuracy.Although capsule endoscopy and enteroscopy make up for this deficiency,the diagnosis also still re-quires pathology.CASE SUMMARY A male patient was admitted to the hospital due to abdominal distension and abdominal pain,but a specific diagnosis by computed tomography examination was not obtained.Partial resection of the small intestine was performed by robotic surgery,and postoperative pathological biopsy confirmed the diagnosis of hemo-lymphangioma.No recurrence in the follow-up examination was observed.CONCLUSION Robotic surgery is an effective way to treat hemolymphangioma through minima-lly invasive techniques under the concept of rapid rehabilitation.
文摘BACKGROUND Ovarian cancer is one of the most common malignant tumors in female reproductive system in the world,and the choice of its treatment is very important for the survival rate and prognosis of patients.Traditional open surgery is the main treatment for ovarian cancer,but it has the disadvantages of big trauma and slow recovery.With the continuous development of minimally invasive technology,minimally invasive laparoscopic surgery under general anesthesia has been gradually applied to the treatment of ovarian cancer because of its advantages of less trauma and quick recovery.However,the efficacy and safety of minimally invasive laparoscopic surgery under general anesthesia in the treatment of ovarian cancer are still controversial.AIM To explore the efficacy and safety of general anesthesia minimally invasive surgery in the treatment of ovarian cancer.METHODS The clinical data of 90 patients with early ovarian cancer in our hospital were analyzed retrospectively.According to the different surgical treatment methods,patients were divided into study group and control group(45 cases in each group).The study group received minimally invasive laparoscopic surgery under general anesthesia for ovarian cancer,while the control group received traditional open surgery for ovarian cancer.The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire(EORTC QLQ-C30),clinical efficacy and safety of the two groups were compared.RESULTS The intraoperative blood loss,length of hospital stay,postoperative gas evacuation time,and postoperative EORTC QLQ-C30 score of the study group were significantly better than those of the control group(P<0.05).The incidence of postoperative complications in the study group was significantly lower than in the control group(P<0.05).The two groups had no significant differences in the preoperative adrenocorticotropic hormone(ACTH),androstenedione(AD),cortisol(Cor),cluster of differentiation 3 positive(CD3+),and cluster of differentiation 4 positive(CD4+)indexes(P>0.05).In contrast,postoperatively,the study group's ACTH,AD,and Cor indexes were lower,and the CD3+and CD4+indexes were higher than those in the control group(P<0.05).CONCLUSION Minimally invasive laparoscopic surgery under general anesthesia in patients with early ovarian cancer can significantly improve the efficacy and safety,improve the short-term prognosis and quality of life of patients,and is worth popularizing.
