International journal of surgery
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Randomized Controlled Trial
Surfactant Protein-D: A sensitive predictor for efficiency of preoperative pulmonary rehabilitation.
Surfactant Protein D (SP-D) as a lung-derived biomarker for inflammatory lung disease is being studied in depth. Meanwhile, the Pre-operative Rehabilitation Program (PRP) has been proposed as an effective treatment to reduce the incidence of Post-operative Pulmonary Complications (PPCs) and further improve quality of life. However, the relationship between serum SP-D levels and PRP remains unclear. This study aimed to explore the correlation between these two phenomena and validate the feasibility of using preoperative serum SP-D levels to predict or assess the effectiveness of PRP. ⋯ The Preoperative Intensity Rehabilitation Program could positively decrease the serum SP-D levels in lung cancer patients with PPC risk factors, and higher preoperative serum SP-D levels may related to a higher incidence of PPCs. Serum SP-D may be a potential predictor for evaluating the efficiency of PRPs and the risk of PPC occurrence.
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Review
Update on the role of ultrasound guided radiofrequency ablation for thyroid nodule treatment.
Thyroid nodules can be frequently detected in general population, most of them are benign, however malignant cases are rising in the past decades. Ultrasound (US) is the most common imaging modality to assess thyroid nodular lesions, plan patient work-up and guide minimally invasive treatment. The present review paper has been researched to evaluate the current status of radiofrequency ablation (RFA) treatment in order to evaluate indications, techniques, complications, limitations and outcome assessment in benign solid, partially cystic nodules and recurrent malignant nodules. ⋯ US guided Radiofrequency ablation has been proved to be effective and safe in cases of benign thyroid nodules and a promising treatment method alternative to surgery for patients with recurrent papillary thyroid cancer. It's major role lies in significant reduction of thyroid nodule mean volume and improvement of the patient symptoms. However, future multicenter studies are warranted to better clarify the multi-parametric patient selection criteria and evaluate RFA technique efficacy, advantages and limitations in the variety of thyroid nodular disease.
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Papillary thyroid carcinoma (PTC) is the most common thyroid malignancy. Despite its extremely favorable prognosis, cervical lymph node metastases are a common feature of PTC and a known independent risk factor for local recurrence. However, the role of prophylactic central neck dissection (PCND) remains a matter of debate in patients with clinically node-negative (cN0) PTC. To better clarify the current role of PCND in the surgical treatment of PTC, evaluating advantages and disadvantages of PCND and outcome of cN0 PTC patients who have been treated with either total thyroidectomy alone or in combination with PCND. A review of recent literature data is performed. ⋯ The results of the present study do not support the routine use of PCND in the treatment of cN0 PTC patients.
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Medullary thyroid carcinoma is an aggressive tumor and presents with significant morbidity and mortality and a high rate of lymph node metastases. The combination of total thyroidectomy and cervical lymphadenectomy is the essential treatment for those patients presenting with cervical lymph node metastases. ⋯ Total thyroidectomy and cervical lymphadenectomy planned on the ultrasound preoperative study and on the calcitonin level represent the standard of treatment for medullary thyroid carcinoma.
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Review Meta Analysis Comparative Study
Decompression and coflex interlaminar stabilisation compared with conventional surgical procedures for lumbar spinal stenosis: A systematic review and meta-analysis.
Decompression plus spinal fusion is one of the most common surgeries for the treatment of degenerative spine disease in older adults. However, complications caused by fusion surgery have been reported in some studies. Recently published studies have reported that coflex is a safe and viable option in the selection of instrumentation for spinal stabilisation. Our meta-analysis was conducted to investigate whether decompression and coflex results in better performance for lumbar spinal stenosis (LSS) patients when compared with decompression and fusion surgery. ⋯ Compared with conventional decompression plus fusion surgery, coflex was not inferior in terms of functional clinical outcomes, including ODI and VAS pain score. Moreover, coflex showed less blood loss, shorter LOS and similar device-related complications compared to decompression plus fusion surgery. Therefore, the coflex interlaminar stabilisation device was found to be safe and effective compared to decompression plus fusion for the treatment of LSS.