BACKGROUND Although substantial evidence supports the advantages of cold snare polypectomy(CSP)in terms of polypectomy efficacy and reduced postoperative adverse events,few studies have examined the cost differences b...BACKGROUND Although substantial evidence supports the advantages of cold snare polypectomy(CSP)in terms of polypectomy efficacy and reduced postoperative adverse events,few studies have examined the cost differences between CSP and traditional endoscopic mucosal resection(EMR)for the treatment of intestinal polyps.AIM To compare the efficacy-cost of EMR and CSP in the treatment of intestinal polyps.METHODS A total of 100 patients with intestinal polyps were included in the retrospective data of our hospital from April 2022 to May 2023.According to the treatment methods,they were divided into EMR(n=46)group and CSP(n=54)group.The baseline data of the two groups were balanced by 1:1 propensity score matching(PSM),and the cost-effectiveness analysis was performed on the two groups after matching.The recurrence rate of the two groups of patients was followed up for 1 year,and they were divided into recurrence group and non-recurrence group according to whether they recurred.Multivariate logistic regression analysis was used to screen out the influencing factors affecting the recurrence of intestinal polyps after endoscopic resection.RESULTS Significant disparities were observed in the number of polyps and smoking background between the two groups before PSM(P<0.05).Following PSM,the number of polyps and smoking history were well balanced between the EMR and CSP groups.The direct cost incurred by the CSP group was markedly higher than that incurred by the EMR group.Concurrently,the cost-effectiveness ratio in the CSP group was substantially reduced when juxtaposed with that in the EMR group(P<0.05).Upon completion of the 1-year follow-up,the rate of recurrence after endoscopic intestinal polypectomy was 38.00%.Multivariate methods revealed that age≥60 years,male sex,number of polyps≥3,and pathological type of adenoma were risk factors for recurrence after endoscopic intestinal polypectomy(all P<0.05).CONCLUSION CSP was more cost-effective for the treatment of intestinal polyps.An age≥60 years,male sex,having a number of polyps≥3,and pathological type of adenoma are independent influencing factors for recurrence.展开更多
AIM:To investigate the outcomes of pancreas-sparing duodenectomy(PSD)with regional lymph node dissection vs pancreaticoduodenectomy(PD).METHODS:Between August 2001 and June 2014,228 patients with early-stage ampullary...AIM:To investigate the outcomes of pancreas-sparing duodenectomy(PSD)with regional lymph node dissection vs pancreaticoduodenectomy(PD).METHODS:Between August 2001 and June 2014,228 patients with early-stage ampullary carcinoma(Amp Ca)underwent surgical treatment(PD,n=159;PSD with regional lymph node dissection,n=69).The patients were divided into two groups:the PD group and the PSD group.Propensity scoring methods were used to select patients with similar disease statuses.A total of 138 matched cases,with 69 patients in each group,were included in the final analysis.RESULTS:The median operative time was shorter among the patients in the PSD group(435 min)compared with those in the PD group(481 min,P=0.048).The median blood loss in the PSD group was significantly less than that in the PD group.The median length of hospital stay was shorter for patients in the PSD group vs the PD group.The incidence of pancreatic fistula was higher among patients in the PD group vs the PSD group.The 1-,3-,and 5-year overall survival and disease-free survival rates for patients in the PSD group were 83%,70%,44%and 73%,61%,39%,respectively,and these values were not different than compared with those in the PD group(P=0.625).CONCLUSION:PSD with regional lymph node dissection presents an acceptable morbidity in addition to its advantages over PD.PSD may be a safe and feasible alternative to PD in the treatment of earlystage Amp Ca.展开更多
目的利用倾向性评分匹配法(PSM)分析新生儿病理性黄疸(PJON)病情转归不良的影响因素。方法回顾性分析医院收治的670例PJON患儿的临床资料,根据PJON病情转归情况分为不良组(n=54)、良好组(n=616)。比较匹配前不良组、良好组一般资料;基于...目的利用倾向性评分匹配法(PSM)分析新生儿病理性黄疸(PJON)病情转归不良的影响因素。方法回顾性分析医院收治的670例PJON患儿的临床资料,根据PJON病情转归情况分为不良组(n=54)、良好组(n=616)。比较匹配前不良组、良好组一般资料;基于PSM匹配两组资料,比较匹配后不良组(n=52)、匹配后良好组(n=52)一般资料;基于匹配后数据采用Logistic回归模型分析PJON病情转归不良的影响因素。结果PJON转归不良率为8.06%;匹配前,与良好组比较,不良组新生儿的宫内窘迫、产道感染、双胎或多胎占比升高(P<0.05),母婴ABO溶血、蓝光照射占比降低(P<0.05);匹配前、后,与良好组比较,不良组的宫内感染、胎膜早破、新生儿产时窒息、重度PJON的占比升高(P<0.05),母婴ABO溶血构成比降低(P<0.05),出生胎龄、出生体重减小(P<0.05),出生后5 min Apgar评分升高(P<0.05);Logistic回归模型分析显示,胎膜早破(OR=3.029,95%CI:1.320~6.955)、出生胎龄(OR=0.579,95%CI:0.386~0.867)、出生后5 min Apgar评分(OR=0.538,95%CI:0.374~0.775)、母婴ABO溶血(OR=2.958,95%CI:1.287~6.798)、重度PJON(OR=3.180,95%CI:1.402~7.216)是PJON病情转归不良的影响因素(P<0.05)。结论利用PSM法分析发现,胎膜早破、出生胎龄、出生后5 min Apgar评分、母婴ABO溶血、重度PJON是PJON病情转归不良的影响因素。展开更多
文摘BACKGROUND Although substantial evidence supports the advantages of cold snare polypectomy(CSP)in terms of polypectomy efficacy and reduced postoperative adverse events,few studies have examined the cost differences between CSP and traditional endoscopic mucosal resection(EMR)for the treatment of intestinal polyps.AIM To compare the efficacy-cost of EMR and CSP in the treatment of intestinal polyps.METHODS A total of 100 patients with intestinal polyps were included in the retrospective data of our hospital from April 2022 to May 2023.According to the treatment methods,they were divided into EMR(n=46)group and CSP(n=54)group.The baseline data of the two groups were balanced by 1:1 propensity score matching(PSM),and the cost-effectiveness analysis was performed on the two groups after matching.The recurrence rate of the two groups of patients was followed up for 1 year,and they were divided into recurrence group and non-recurrence group according to whether they recurred.Multivariate logistic regression analysis was used to screen out the influencing factors affecting the recurrence of intestinal polyps after endoscopic resection.RESULTS Significant disparities were observed in the number of polyps and smoking background between the two groups before PSM(P<0.05).Following PSM,the number of polyps and smoking history were well balanced between the EMR and CSP groups.The direct cost incurred by the CSP group was markedly higher than that incurred by the EMR group.Concurrently,the cost-effectiveness ratio in the CSP group was substantially reduced when juxtaposed with that in the EMR group(P<0.05).Upon completion of the 1-year follow-up,the rate of recurrence after endoscopic intestinal polypectomy was 38.00%.Multivariate methods revealed that age≥60 years,male sex,number of polyps≥3,and pathological type of adenoma were risk factors for recurrence after endoscopic intestinal polypectomy(all P<0.05).CONCLUSION CSP was more cost-effective for the treatment of intestinal polyps.An age≥60 years,male sex,having a number of polyps≥3,and pathological type of adenoma are independent influencing factors for recurrence.
基金Supported by National Natural Science Foundation of China,No.81170453 and No.81301025Tianjin City High School Science and Technology Fund Planning Project,No.20120118
文摘AIM:To investigate the outcomes of pancreas-sparing duodenectomy(PSD)with regional lymph node dissection vs pancreaticoduodenectomy(PD).METHODS:Between August 2001 and June 2014,228 patients with early-stage ampullary carcinoma(Amp Ca)underwent surgical treatment(PD,n=159;PSD with regional lymph node dissection,n=69).The patients were divided into two groups:the PD group and the PSD group.Propensity scoring methods were used to select patients with similar disease statuses.A total of 138 matched cases,with 69 patients in each group,were included in the final analysis.RESULTS:The median operative time was shorter among the patients in the PSD group(435 min)compared with those in the PD group(481 min,P=0.048).The median blood loss in the PSD group was significantly less than that in the PD group.The median length of hospital stay was shorter for patients in the PSD group vs the PD group.The incidence of pancreatic fistula was higher among patients in the PD group vs the PSD group.The 1-,3-,and 5-year overall survival and disease-free survival rates for patients in the PSD group were 83%,70%,44%and 73%,61%,39%,respectively,and these values were not different than compared with those in the PD group(P=0.625).CONCLUSION:PSD with regional lymph node dissection presents an acceptable morbidity in addition to its advantages over PD.PSD may be a safe and feasible alternative to PD in the treatment of earlystage Amp Ca.
文摘目的利用倾向性评分匹配法(PSM)分析新生儿病理性黄疸(PJON)病情转归不良的影响因素。方法回顾性分析医院收治的670例PJON患儿的临床资料,根据PJON病情转归情况分为不良组(n=54)、良好组(n=616)。比较匹配前不良组、良好组一般资料;基于PSM匹配两组资料,比较匹配后不良组(n=52)、匹配后良好组(n=52)一般资料;基于匹配后数据采用Logistic回归模型分析PJON病情转归不良的影响因素。结果PJON转归不良率为8.06%;匹配前,与良好组比较,不良组新生儿的宫内窘迫、产道感染、双胎或多胎占比升高(P<0.05),母婴ABO溶血、蓝光照射占比降低(P<0.05);匹配前、后,与良好组比较,不良组的宫内感染、胎膜早破、新生儿产时窒息、重度PJON的占比升高(P<0.05),母婴ABO溶血构成比降低(P<0.05),出生胎龄、出生体重减小(P<0.05),出生后5 min Apgar评分升高(P<0.05);Logistic回归模型分析显示,胎膜早破(OR=3.029,95%CI:1.320~6.955)、出生胎龄(OR=0.579,95%CI:0.386~0.867)、出生后5 min Apgar评分(OR=0.538,95%CI:0.374~0.775)、母婴ABO溶血(OR=2.958,95%CI:1.287~6.798)、重度PJON(OR=3.180,95%CI:1.402~7.216)是PJON病情转归不良的影响因素(P<0.05)。结论利用PSM法分析发现,胎膜早破、出生胎龄、出生后5 min Apgar评分、母婴ABO溶血、重度PJON是PJON病情转归不良的影响因素。
