Zhonghua wai ke za zhi [Chinese journal of surgery]
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Zhonghua Wai Ke Za Zhi · Oct 2019
[Reduction of the atlantoaxial dislocation associated with basilar invagination through single-stage posterior approach: using Xuanwu occipital-cervical reduction surgical suite].
Objective: To examine the effect of posterior reduction in atlantoaxial dislocation (AAD) associated with basilar invagination(BI) using Xuanwu occipital-cervical fusion system in single stage. Methods: Thirty-seven AAD accompanied with BI cases treated at Department of Neurosurgery, Xuanwu Hospital, Capital Medical Universiy and the Second Hospital of Hebei Medical University were retrospective analyzed. There were 15 males and 22 females with age of (42.3±12.3)years (range: 18-69 yars). ⋯ No implant failure, spacer subsidence or infection was observed. Conclusions: The treatment of AAD associated with BI using Xuanwu occipital-cervical fusion system from posterior approach in single stage is effective and safe. Cage implantation intraarticularly and fixation with cantilever technique achieve complete reduction in most cases.
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Objective: To summarize the experience of treatment for blunt pancreatic trauma. Methods: The clinical data of 52 patients with blunt pancreatic trauma admitted to the Department of Pancreatic and Biliary Surgery of the First Affiliated Hospital of Harbin Medical University from January 2013 to June 2018 were analyzed retrospectively. There were 40 male and 12 female patients, aging from 12 to 112 years with a median age of 35.5 years. ⋯ For the 5 cases of grade Ⅳ,2 patients underwent jejunostomy and abdominal cavity drainage, 1 patient had a pancreaticoduodenectomy with drainage,1 patient received suture repair of the pancreas and pancreaticojejunostomy, and 1 patient was managed with suture repair of the head of pancreas and external drainage. For the 2 patients of grade Ⅴ,1 patient received exploratory laparotomy and gauze compression packing hemostasis, and the other patient underwent pancreaticoduodenal repair, gastrointestinal anastomosis, duodenal exclusion surgery and external drainage. Conclusion: According to the AAST classifications, associated injuries, physiological status and intraoperative situation, it could be better to make a comprehensive judgment, achieve early diagnosis and take appropriate individualized treatment strategy, and to improve the overall therapeutic effect for blunt pancreatic trauma.
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Zhonghua Wai Ke Za Zhi · Aug 2019
[Current practice of implant-based breast reconstruction: results from China national practice questionnaire survey].
Objective: To explore the current clinical practice of implant-based breast reconstruction (IBBR) in China. Methods: The current survey was sponsored by Chinese Anti-Cancer Association, Committee of Breast Cancer Society and Chinese Society of Breast Surgeons. A survey was mailed to 110 hospitals in China, which have more than 200 breast cancer operations performed in 2017. ⋯ Conclusions: IBBR was the most common used surgery in breast reconstruction after mastectomy. However, the proportion of IBBR in patients after mastectomy was still low. Reginal economy, surgery volume of hospitals, lack of specialty training program and the concern about complications and patient's satisfaction were the factors affecting the development of IBBR.
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Zhonghua Wai Ke Za Zhi · Jun 2019
[The effect of perioperative fluid therapy on early postoperative pulmonary complications after orthotopic liver transplantation].
Objective: To investigate the effect of perioperative fluid therapy on early postoperative pulmonary complication (PPC) after orthotopic liver transplantation (OLT). Methods: The clinical data of 132 patients who underwent OLT in the First Affiliated Hospital of Xi'an Jiaotong University from April 2016 to December 2017 were analyzed retrospectively. These patients included 96 males and 36 females, aged (47.3±9.6) years (range: 24-69 years). ⋯ Using multivariate analysis by Logistic regression, only the red blood units >10 U (OR=3.55, 95% CI: 1.35-9.26, P=0.010) and the cumulative fluid intake >12 L (OR=2.98, 95% CI: 1.14-7.80, P=0.026) within the first 72 h after operation were independent prognosis factors of PPC after OLT. Kaplan-Meier analysis showed that the cumulative survival rate was lower in PPC group than that in non-PPC group (χ(2)=6.590, P=0.01). Conclusion: Massive red blood cell transfusion and the cumulative fluid volume >12 L during perioperative 72 hours are independent prognosis factors of PPC after OLT.
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Zhonghua Wai Ke Za Zhi · Jun 2019
Comparative Study[Comparative study of clinical outcomes of robot versus laparoscopic radical surgery for rectal cancer based on propensity score matching].
Objective: To compare the short-term and long-term outcomes of robotic rectectomy and laparoscopic rectectomy for rectal cancer based on propensity score matching. Methods: The clinical data of 106 patients who underwent robotic or laparoscopic radical resection of rectal cancer at Department of General Surgery, the First Affiliated Hospital of Nanchang University from January 2015 to December 2015 were retrospectively collected. Propensity score matching method was used to perform 1∶1 matching between robot and laparoscopic rectal cancer radical surgery. ⋯ There were no statistical differences in separation time, numbers of retrieved lymph nodes, time to first flatus, postoperative hospital stay, postoperative complication and Clavien-Dindo classification of postoperative complications (t=0.336, t=0.714, t=-0.568, Z=-1.766, Fisher Z=-0.586, respectively, all P>0.05). Conclusions: Robotic surgery not only has similar safety and feasibility but also has advantages of short-term outcomes compared with laparoscopic rectectomy for rectal cancer. The long-term outcomes were similar between two groups.