Objective:To analyze the therapeutic effect of laparoscopy combined with choledochoscopy in the treatment of difficult cholelithiasis.Methods:A total of 60 patients with difficult cholelithiasis admitted for treatment...Objective:To analyze the therapeutic effect of laparoscopy combined with choledochoscopy in the treatment of difficult cholelithiasis.Methods:A total of 60 patients with difficult cholelithiasis admitted for treatment from January 2022 to December 2024 were selected and evenly divided into two groups using a random number table.The combined group received laparoscopy combined with choledochoscopy treatment,while the single group received laparoscopy treatment alone.The total treatment efficacy,perioperative indicators,angiotensin(Ang)levels,quality of life scores,and complication rates were compared between the two groups.Results:The total treatment efficacy in the combined group was higher than that in the single group;except for operative time,the perioperative indicators in the combined group were superior to those in the single group;the Ang levels after treatment in the combined group were lower than those in the single group,and the quality of life scores were higher(P<0.05).The complication rate in the combined group was lower than that in the single group(P<0.05).Conclusion:Laparoscopy combined with choedochoscopy can enhance the treatment effectiveness for patients with difficult cholelithiasis,improve perioperative indicators,regulate their Ang levels,elevate quality of life,and demonstrate high surgical safety.展开更多
Liver transplantation is a life-saving procedure for patients with end-stage liver diseases and acute liver failure.With advances in surgical techniques and immunosuppressive regimens,patient survival rates have signi...Liver transplantation is a life-saving procedure for patients with end-stage liver diseases and acute liver failure.With advances in surgical techniques and immunosuppressive regimens,patient survival rates have significantly improved.While the systemic complications of post-transplantation are well recognized,ophthalmic manifestations remain underreported.Ophthalmic complications can significantly impair visual function and increase morbidity in these patients.Prolonged immunosuppression makes the patients susceptible to the opportunistic pathogens such as Cytomegalovirus,Candida,Aspergillus,etc.Other common findings include dry eye disease,cataracts and retinal vascular complications which further contribute to the long-term morbidity in these patients.Early ophthalmic evaluation and prompt management are essential to prevent irreversible vision loss and improve post-transplant outcomes.High index of suspicion and multidisciplinary approach is essential to facilitate early diagnosis and treatment.This review highlights the range of ophthalmic complications observed in liver transplant recipients and underscores the need for future research focused on understanding the underlying pathophysiological mechanisms and refining the prophylactic protocols to improve outcomes in this unique patient population.展开更多
Objective:To explore the clinical effect of personalized nutritional support in elderly women with gestational diabetes(GDM),and explore its impact on the incidence of maternal complications and pregnancy outcomes.Met...Objective:To explore the clinical effect of personalized nutritional support in elderly women with gestational diabetes(GDM),and explore its impact on the incidence of maternal complications and pregnancy outcomes.Methods:A total of 90 elderly pregnant women with gestational diabetes who were delivered in our hospital from January 2023 to January 2024 were selected as the research objects.They were randomly divided into an observation group and a control group,with 45 cases in each group.The control group only received routine pregnancy care and basic nutrition guidance,while the observation group received personalized nutrition support on this basis.Compare the blood glucose control,incidence of pregnancy complications,pregnancy outcomes,and neonatal outcomes between two groups of parturient.Result:After intervention,the fasting blood glucose(FPG),2-hour postprandial blood glucose(2hPG),and glycated hemoglobin(HbA1c)of the observation group were significantly lower than those of the control group,and the differences were statistically significant(p<0.05);The incidence of complications such as gestational hypertension syndrome,polyhydramnios,premature rupture of membranes,and postpartum hemorrhage in the observation group was significantly lower than that in the control group,and the difference was statistically significant(p<0.05);The cesarean section rate in the observation group was significantly lower than that in the control group,and the incidence of adverse neonatal outcomes such as fetal distress,macrosomia,neonatal asphyxia,and neonatal hypoglycemia in the observation group was significantly lower than that in the control group,with statistical significance(p<0.05).Conclusion:Individualized nutritional support for elderly women with gestational diabetes can effectively improve the level of maternal blood sugar control,reduce the incidence of complications during pregnancy,and improve the outcome of pregnancy and neonatal outcomes,which is of high clinical value.展开更多
BACKGROUND Elderly patients with colorectal cancer(CRC)can judge the risk of postoperative complications and oncological outcomes due to visceral obesity,which can provide data reference for the early prediction of pr...BACKGROUND Elderly patients with colorectal cancer(CRC)can judge the risk of postoperative complications and oncological outcomes due to visceral obesity,which can provide data reference for the early prediction of prognosis.AIM To explore the effect of visceral obesity on postoperative complications and oncological outcomes in elderly patients with CRC.METHODS A total of 150 elderly patients who underwent radical surgery for CRC at Inner Mongolia Medical University and Inner Mongolia Autonomous Region People’s Hospital from January 2021 to June 2024 were retrospectively analyzed.Patients were divided into the abdominal[visceral fat area(VFA)≥100.00 cm^(2),n=80]and non-abdominal(VFA<100.00 cm^(2),n=70)obesity groups according to the VFA measured by preoperative computed tomography.The two groups showed no significant differences in age,sex,tumor location,tumor-node-metastasis stage,and underlying disease(P>0.05).All patients underwent standardized laparoscopic assisted surgery and received unified perioperative management.Complications,nutritional status,changes in biochemical indicators,and tumor recurrence and metastasis were evaluated postoperatively.RESULTS The overall incidence of postoperative complications was significantly higher in the abdominal obesity group than in the non-abdominal obesity group(P<0.05).The pulmonary infection on postoperative day(POD)3(P=0.038),anastomotic leakage on POD 7(P=0.042),and moderate-to-severe complications(Clavien-Dindo class III,P=0.03)were significantly different.With respect to biochemical indicators,the white blood cell count,neutrophil percentage,and C-reactive protein level in the abdominal obesity group continuously increased after surgery(P<0.05);the albumin level on POD 1 was even lower(P=0.024).Regarding tumor markers,carcinoembryonic antigen(P=0.039)and carbohydrate antigen 19-9(P=0.048)levels were significantly higher in the abdominal obesity group at 3 months after surgery,and local recurrence rates were higher than those in the non-abdominal obesity group at 30 days and 3 months after surgery(P<0.05).Abdominal obesity was an independent risk factor for postoperative complications(odds ratio:3.843,P=0.001),overall survival[hazard ratio(HR):1.937,P=0.011],and disease-free survival(HR:1.769,P=0.018).CONCLUSION Visceral obesity significantly increases the risk of postoperative complications in elderly patients with CRC and may adversely affect short-term tumor prognosis.Preoperative risk identification and interventions for abdominal obesity should be strengthened to improve perioperative safety and postoperative rehabilitation quality.展开更多
Objective:To explore the therapeutic effect of double-puncture tympanic membrane puncture and tympanic cavity drug injection in patients with acute secretory otitis media.Methods:A total of 84 patients with acute secr...Objective:To explore the therapeutic effect of double-puncture tympanic membrane puncture and tympanic cavity drug injection in patients with acute secretory otitis media.Methods:A total of 84 patients with acute secretory otitis media admitted to our hospital from June 2024 to June 2025 were selected and randomly divided into two groups by drawing lots.The control group(42 cases)was treated with the traditional single-puncture tympanic membrane puncture and tympanic cavity drug injection method,while the observation group(42 cases)was treated with the double-puncture tympanic membrane puncture and tympanic cavity drug injection method.The therapeutic effects of the two groups were compared.Results:The overall treatment response rate,overall complication rate,time to symptom relief,and improvement in hearing threshold in the observation group were all superior to those in the control group,with statistically significant differences(P<0.05).Conclusion:For acute secretory otitis media,the treatment method of double-puncture tympanic membrane puncture and tympanic cavity drug injection demonstrates definite efficacy,significantly reducing the incidence of complications,accelerating symptom relief,and improving hearing function,making it worthy of promotion.展开更多
Biliary complications like cholelithiasis and choledocholithiasis are more common in bariatric surgery patients due to obesity and rapid weight loss.Patients with a body mass index>40 face an eightfold risk of deve...Biliary complications like cholelithiasis and choledocholithiasis are more common in bariatric surgery patients due to obesity and rapid weight loss.Patients with a body mass index>40 face an eightfold risk of developing cholelithiasis.Postbariatric surgery,especially after laparoscopic Roux-en-Y gastric bypass(LRYGB),30%of patients develop biliary disease due to rapid weight loss.The aim of this review is to analyze the main biliary complications that occur after bariatric surgery and its management.A review of the literature was conducted mainly from 2010 up to 2023 with regard to biliary complications associated with bariatric patients in SciELO,PubMed,and MEDLINE.Patients undergoing LRYGB have a higher incidence(14.5%)of symptomatic calculi post-surgery compared to those undergoing laparoscopic sleeve gastrectomy at 4.1%.Key biliary complications within 6 to 12 months post-surgery include:Cholelithiasis:36%;Biliary colic/dyskinesia:3.86%;Acute cholecystitis:0.98%-18.1%;Chronic cholecystitis:70.2%;Choledocholithiasis:0.2%-5.7%and Pancreatitis:0.46%-9.4%.Surgeons need to be aware of these complications and consider surgical treatments based on patient symptoms to enhance their quality of life.展开更多
BACKGROUND Acute ischemic stroke(AIS)is an abrupt blood flow cessation to a specific brain region within a vascular zone,causing a subsequent decline in neurological capabilities.Stent thrombectomy is a recently estab...BACKGROUND Acute ischemic stroke(AIS)is an abrupt blood flow cessation to a specific brain region within a vascular zone,causing a subsequent decline in neurological capabilities.Stent thrombectomy is a recently established technique for treating AIS.It provides the benefits of being a relatively simple and safe procedure,capable of partially enhancing a patient’s condition.However,some patients may experience endothelial damage and recurrent thrombosis,with clinical outcomes that are not always satisfactory.Hence,the efficacy of this method remains unclear.AIM To survey the association of stent thrombectomy vs standard treatment with neurological function protection,complications,and short-term prognosis in patients diagnosed with AIS.METHODS This study assigned 90 patients with AIS to the observation and control groups(n=45 patients)from December 2020 to December 2022.Stent thrombectomy was conducted in the observation group,whereas routine treatment was provided to the control group.The study assessed the therapeutic outcomes of two groups,including a comparison of their neurological function,living ability,anxiety and depression status,plaque area,serum inflammatory factors,serum Smur100βprotein,neuron-specific enolase(NSE),homocysteine(Hcy),and vascular endo-thelial function.Additionally,the incidence of complications was calculated and analyzed for each group.RESULTS The total effective rate of treatment was 77.78%and 95.56%in the control and observation groups,respectively.After 8 weeks of treatment,the scores on the National Institutes of Health Stroke Scale,Hamilton Anxiety Scale,and Hamilton Depression Scale decreased remarkably;the Barthel index increased remarkably,with better improvement effects of the scores in the observation group(P<0.05);total cholesterol,triglyceride,C-reactive protein,and plaque area lessened remarkably,with fewer patients in the observation group(P<0.05);S-100βprotein,NSE,and Hcy levels lessened remarkably,with fewer patients in the observation group(P<0.05);serum vascular endothelial growth factor and nitric oxide synthase levels increased remarkably,whereas the endothelin-1 level decreased,with better improvement effect in the observation group(P<0.05).Complications occurred in 8.88%of patients in the observation group compared with 33.33%in the control group.CONCLUSION Stent thrombectomy appeared to provide more remarkable neuroprotective effects in patients with AIS compared to the intravenous thrombolysis regimen.Additionally,it has effectively improved the neurological function,daily activities,and vascular endothelial function of patients,while reducing the incidence of complications and improving short-term prognosis.展开更多
BACKGROUND Gastric cancer is a malignancy with high morbidity and mortality rates.Surgical intervention,particularly gastrectomy,is essential for curative treatment but carries a substantial risk of complications.Iden...BACKGROUND Gastric cancer is a malignancy with high morbidity and mortality rates.Surgical intervention,particularly gastrectomy,is essential for curative treatment but carries a substantial risk of complications.Identifying key risk factors and understanding complication profiles are crucial for improving outcomes and guiding perioperative management.AIM To analyze the incidence of postoperative complications in patients with gastric cancer and identify potential risk factors.METHODS We conducted a retrospective analysis of 500 patients who underwent gastrectomy between January 2018 and December 2022.Postoperative complications were classified using the Clavien-Dindo system.RESULTS The overall complication rate was 28.4%(142/500),with 15.2%(76/500)experiencing major complications(Clavien-Dindo grade≥III).Pulmonary complications were the most frequent(10.8%),followed by surgical site infections(8.6%),and anastomotic leakage(4.2%).Age 70 years or more,body mass index of 25 kg/m²or more,advanced tumor stage,total gastrectomy,and operative time 240 min or more emerged as independent risk factors.CONCLUSION Focused preoperative risk assessment,targeted interventions,and reduced operative time for older or obese patients requiring total gastrectomy or presenting with advanced disease are important to improve surgical outcomes.展开更多
This article aims to deepen the understanding of the role of Helicobacter pylori(H.pylori)infection in the development of cholelithiasis,initiated by the article by Yao et al,who investigated the potential link betwee...This article aims to deepen the understanding of the role of Helicobacter pylori(H.pylori)infection in the development of cholelithiasis,initiated by the article by Yao et al,who investigated the potential link between H.pylori infection and the development of cholelithiasis through a multicenter retrospective study on an Asian population of over 70000 participants.They also performed a compre-hensive analysis of previously published studies on H.pylori and cholelithiasis,finding a positive association therein[odds ratio(OR)=1.103,P=0.049].Patients positive for H.pylori also had lower levels of total and direct bilirubin,but higher levels of total cholesterol and low-density lipoprotein cholesterol compared to uninfected patients(P<0.05).Cohort studies have confirmed that H.pylori is a risk factor for cholelithiasis(P<0.0001),and aggregate analyses of case-control and cross-sectional studies have shown a positive association between H.pylori and cholelithiasis in Asia(OR=1.599,P=0.034),but not in Europe(OR=1.277,P=0.246).Moreover,H.pylori appears to be related to a higher ratio of choledocho-lithiasis/cholecystolithiasis(OR=3.321,P=0.033).The authors conclude that H.pylori infection is positively correlated with cholelithiasis,particularly with the choledocholithiasis phenotype,especially in Asia,and it is potentially related to bilirubin and cholesterol metabolism.展开更多
BACKGROUND Single-balloon enteroscopy(SBE)is an established procedure for evaluating small bowel lesions.While its efficacy is well recognized,the incidence of major complications and their associated risk factors in ...BACKGROUND Single-balloon enteroscopy(SBE)is an established procedure for evaluating small bowel lesions.While its efficacy is well recognized,the incidence of major complications and their associated risk factors in a large population remain unclear.AIM To investigate the complications and risk factors associated with diagnostic SBE.METHODS This multicenter retrospective study included consecutive patients who underwent diagnostic SBE at three tertiary care hospitals between January 2016 and September 2024.Data on baseline characteristics,procedural parameters,indications,findings,and major complications were collected and analyzed.RESULTS A total of 2865 SBE procedures were performed in 1840 patients.The mean age was 51±18 years,and 64.5%were male.The most common indication was obscure gastrointestinal bleeding(57.1%),followed by abdominal pain(30.5%).The major complication rate was 0.4%(7/1840),all of which involved acute intestinal perforation identified during the procedure.Among the perforation cases,6 occurred in patients undergoing SBE for abdominal pain and 1 for obscure gastrointestinal bleeding.The perforation sites included the ileum(6/7)and duodenum(1/7).All cases were successfully managed surgically.Previous abdominal surgery and the use of abdominal compression were significantly associated with an increased risk of perforation(P value<0.001 for both).In subgroup analysis,perforation rates were 2.1%(6/288)in patients with prior abdominal surgery and 1.6%(7/428)with abdominal compression.CONCLUSION Acute intestinal perforation is a rare but serious complication.Prior abdominal surgery and abdominal compression are important risk factors,and careful patient selection is recommended to minimize complications.展开更多
AIM:To evaluate the visual outcomes of implantable collamer lenses(ICLs)and identify the possible risk factors for ICL axis misalignment,and consequently,repositioning,explanting,or exchanging at a specialized eye hos...AIM:To evaluate the visual outcomes of implantable collamer lenses(ICLs)and identify the possible risk factors for ICL axis misalignment,and consequently,repositioning,explanting,or exchanging at a specialized eye hospital in Saudi Arabia.METHODS:The medical records of 813 eyes with different refractive errors corrected with ICL implantation were identified and included in this single-arm retrospective cohort study.The following data were collected:demographic characteristics,primary diagnosis,preoperative refraction,anterior chamber depth(ACD),white-to-white(WTW)measurement,endothelial cell density(ECD),and axial length.Patients’satisfaction and complaints,and their postoperative refraction,vault depth,and axis alignment with the preoperative target,were reviewed during the postoperative period.Collectively,these data were correlated with symptomatic axis rotation and the need for repositioning,explantation,or exchange due to high or low ICL vaults.RESULTS:Of 813 eyes,27(3.32%),13(1.59%),and 11(1.35%)required ICL repositioning,ICL explantation only without exchange,and ICL explantation with the placement of a new ICL,respectively.The mean follow-up period was 37.5mo.The main cause of explanation or exchange was incorrect WTW measurement in seven(29.17%)eyes,followed by high vault in four(16.56%)eyes.ICL repositioning was required in 27(3.32%)eyes with considerable rotation.Only 2(0.24%)eyes developed cataracts that required ICL removal,and retinal complications were reported in 7(0.86%)eyes.Long-term glaucoma and corneal decompensation were not observed in this cohort.CONCLUSION:With a high safety profile and reversibility,ICL implantation is a good alternative to corneal-based refractive surgery in eyes unsuitable for laser vision correction.The rate of secondary procedures in our study was 6.26%.Old age is a risk factor for secondary surgical interventions in the repositioning group,whereas abnormal vault and toric ICL rotation in the explantation group necessitated subsequent surgical procedures.Overall,ICL implantation demonstrates a good efficacy index and safety profile in patients with diverse refractive errors.展开更多
BACKGROUND Laparoscopic surgery,with the advantage of less trauma,has been predominantly performed to treat pediatric inguinal hernia.However,the traditional three-port laparoscopic surgery remains extremely traumatic...BACKGROUND Laparoscopic surgery,with the advantage of less trauma,has been predominantly performed to treat pediatric inguinal hernia.However,the traditional three-port laparoscopic surgery remains extremely traumatic for children,whereas singleport laparoscopic surgery causes less damage to children than traditional laparoscopy.However,single-port laparoscopic surgery is more challenging;thus,studies on the effect of its application in pediatric inguinal hernia remain relatively limited.AIM To analyze the association of single-incision laparoscopic herniorrhaphy needle treatment with surgical outcomes,postoperative complications,and serum inflammation in pediatric inguinal hernia.METHODS This retrospective study included 113 pediatric patients with inguinal hernia who underwent surgery at the Children’s Hospital,Capital Institute of Pediatrics,from April 2022 to May 2023.Participants were categorized into the observation group(single-incision laparoscopic herniorrhaphy needle,n=60)and the control group(two-port laparoscopic surgery,n=53).Comparative analyses involved surgical duration,intraoperative blood loss,and length of hospital stay.C-reactive protein(CRP)and white blood cell count(WBC)levels were measured preoperatively and 24 hours postoperatively.Postoperative pain was evaluated with the face,legs,activity,cry,and Consolability scale.Further,the incidence of complications,recurrence,and reoperation rates was assessed.Logistic regression was employed to determine independent risk factors related to poor prognosis.RESULTS The observation group demonstrated significantly reduced intraoperative blood loss and shorter hospitalization compared to the control group(P<0.05).Both groups demonstrated increased CRP and WBC levels postoperatively,but the observation group exhibited significantly lower levels(P<0.05).Further,pain scores at 24 hours postoperatively were significantly lower in the observation group(P<0.05).Additionally,the observation group experienced fewer adverse events,recurrence rates,and reoperations compared to the control group(P<0.05).Logistic regression analysis determined increased postoperative stress markers and surgical technique as independent predictors of recurrence(P<0.05).CONCLUSION Single-incision laparoscopic herniorrhaphy needle treatment for pediatric inguinal hernia exhibits significant efficacy,effectively reduces postoperative complications,ensures a more concealed surgical incision,and promotes faster postoperative recovery than conventional two-port laparoscopy.This approach merits wider application.展开更多
Background: In children, acute bacterial rhinosinusitis (ABRS) is often complicated by ophthalmological and/or neurological involvement. These complications should be known and recognized, as they require urgent treat...Background: In children, acute bacterial rhinosinusitis (ABRS) is often complicated by ophthalmological and/or neurological involvement. These complications should be known and recognized, as they require urgent treatment with intravenous antibiotics and close in-hospital monitoring. In this study, we aimed to identify the main risk factors associated with the development of complications in children aged 2 - 17 years with ABRS. Methods: We conducted a retrospective cohort study of patients with ABRS complications in a primary hospital. Participants were divided into two groups: the control group comprising patients without complications (Group 1, n = 82) and the study group comprising patients with complications requiring hospitalization (Group 2, n = 41). We assessed the sociodemographic, clinical, and imaging data of both groups. Using multivariate logistic regression, we assessed risk factors of ABRS complications. Results: No socio-demographic characteristics were associated with ABRS complications (p ≥ 0.05). Factors associated with complications were delay in consultation (t = 5.282;p Conclusions: Intracranial and extracranial complications of ABRS in children have become rare in our setting. These complications can be serious and potentially fatal. Risk factors of these complications are delays in consultation, the presence of ophthalmological signs, and more than one affected sinus. Controlling modifiable factors would improve the treatment success of ABRS complications in children.展开更多
BACKGROUND Red blood cell distribution width(RDW)is associated with the development and progression of various diseases.AIM To explore the association between pretreatment RDW and short-term outcomes after laparoscopi...BACKGROUND Red blood cell distribution width(RDW)is associated with the development and progression of various diseases.AIM To explore the association between pretreatment RDW and short-term outcomes after laparoscopic pancreatoduodenectomy(LPD).METHODS A total of 804 consecutive patients who underwent LPD at our hospital between March 2017 and November 2021 were retrospectively analyzed.Correlations between pretreatment RDW and clinicopathological characteristics and short-term outcomes were investigated.RESULTS Patients with higher pretreatment RDW were older,had higher Eastern Cooperative Oncology Group scores and were associated with poorer short-term outcomes than those with normal RDW.High pretreatment RDW was an independent risk factor for postoperative complications(POCs)(hazard ratio=2.973,95%confidence interval:2.032-4.350,P<0.001)and severe POCs of grade IIIa or higher(hazard ratio=3.138,95%confidence interval:2.042-4.824,P<0.001)based on the Clavien-Dino classification system.Subgroup analysis showed that high pretreatment RDW was an independent risk factor for Clavien-Dino classi-fication grade IIIb or higher POCs,a comprehensive complication index score≥26.2,severe postoperative pancreatic fistula,severe bile leakage and severe hemorrhage.High pretreatment RDW was positively associated with the neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio and was negatively associated with albumin and the prognostic nutritional index.CONCLUSION Pretreatment RDW was a special parameter for patients who underwent LPD.It was associated with malnutrition,severe inflammatory status and poorer short-term outcomes.RDW could be a surrogate marker for nutritional and inflammatory status in identifying patients who were at high risk of developing POCs after LPD.展开更多
BACKGROUND Cauda equina syndrome(CES)is characterized by a group of symptoms that may be caused by inflammation,spinal cord compression,venous congestion,or ischemia.This syndrome is commonly an indication for surgica...BACKGROUND Cauda equina syndrome(CES)is characterized by a group of symptoms that may be caused by inflammation,spinal cord compression,venous congestion,or ischemia.This syndrome is commonly an indication for surgical intervention but has not been determined as a postoperative complication following surgery for lumbar spine disease.CASE SUMMARY To report the case of a 54-year-old male patient who had CES following spinal surgery,with no obvious compression lesions found during re-exploration,suggesting that vascular insufficiency may have contributed to the condition.Furthermore,a series of urodynamic studies on bladder recovery patterns in such complications have also been investigated.CONCLUSION Postoperative CES requires urgent imaging and exploration to rule out compression;noncompressive cases,including vascular insufficiency may performed conservative management.展开更多
Background: In developing countries, charity cleft surgical mission is always operated by sporadic surgical teams without systematic follow up and quality assurance. In the past few decades, many mission projects have...Background: In developing countries, charity cleft surgical mission is always operated by sporadic surgical teams without systematic follow up and quality assurance. In the past few decades, many mission projects have been held regularly in China. The purpose of this audit was a retrospective analysis of a 9-year cleft lip and palate charity project operated in a tertiary hospital in China Shenzhen Area to evaluate perioperative and postoperative complications. Nevertheless, understanding the risk profile is essential for establishing a sustainable in-house cleft service in Shenzhen. Methods: A detailed analysis of hospital centralized record in the The University of Hong Kong-Shenzhen Hospital (HKUSZH) was reviewed since the first charity project held in 2015. The parameters of this audit were focused on perioperative complications including anesthesia related problems, early postoperative complications in patients who underwent primary or secondary cleft surgeries. A total of 430 consecutive admitted cases of 311 non-syndromic cleft lip & palate patients were enrolled into the charity project from June 2015 to July 2024. The main anesthesia related complications that occurred during general anesthesia were respiratory tract problems, while intraoperative complication was excessive bleeding, so as wound local infection and reaction were the main early postoperative complications. Results: In our 9-year clinical audit of 430 cleft lip and palate charity surgeries in Shenzhen, we observed no mortalities and a anesthesia-related complication rate of 1.16%. Specific intraoperative complications included excessive bleeding, while early postoperative issues were dominated by wound infections. The fistula rate of 18.7% post palate repair and the average hospital stay of 3.71 days complete the profile of our surgical outcomes. These data underscore the project’s efficacy and offer a reference for international cleft missions aiming for safe and efficient surgical care. Conclusions: This study provides a thorough data review of the complications in the past 9 years charity missions for cleft lip and palate surgery in a well-structured hospital infrastructure and logistic support by local surgical team. There were no perioperative or postoperative death during the study period and the overall short-term complication rate was low. Therefore, it could be a reference model for other international cleft mission in developing country for a safe and efficient service in future.展开更多
Background and Objectives: Post-operative complications (POC) are new pathological phenomena occurring in the post-operative period and worsening the previous situation through their morbidity and mortality. Our aim w...Background and Objectives: Post-operative complications (POC) are new pathological phenomena occurring in the post-operative period and worsening the previous situation through their morbidity and mortality. Our aim was to determine the prevalence and preoperative factors associated with early POC at University Clinics of Kisangani (CUKIS). Methods: This was a cross-sectional study conducted in the CUKIS, Department of Surgery from 1 January 2014 to 31 December 2023. The target population consisted of all patients who had undergone full post-operative follow-up. A logistic regression model using RStudio version 4.4.0 software was used to determine the factors predicting early postoperative complications. Results: The prevalence of early POC was estimated at 35%, with surgical site infection the most frequent POC at 45.3%. After multivariate analysis using logistic regression, the social category of widow(er)s, transfer, previous laparotomy, acute generalised peritonitis, preoperative length of stay of more than 10 days and ASA score 2 and 5 were significant risk factors associated with the occurrence of POC in the preoperative period. Conclusion: Certain factors can predict the occurrence of POC. Knowledge of these factors can help practitioners to take useful measures before each surgical operation on a patient with these factors, with a view to preventing or managing POC.展开更多
Background: Diabetes Mellitus (DM) is a growing health issue in Bangladesh, with significant complications affecting the quality of life (QoL). This study aims to assess long-term complications, treatment patterns, an...Background: Diabetes Mellitus (DM) is a growing health issue in Bangladesh, with significant complications affecting the quality of life (QoL). This study aims to assess long-term complications, treatment patterns, and QoL of diabetic patients during COVID-19. Methods: A cross-sectional study was conducted on 385 diabetic patients (aged 18-80) from tertiary hospitals in Dhaka and Mymensingh between May and October 2022. Data were collected via a semi-structured questionnaire on sociodemographics, complications, treatment patterns, and QoL (SF-12 scale). Chi-square tests, ANOVA, and linear regression were used for inferential analysis. Results: The sample predominantly included middle-aged males (41 - 55 years) with type 2 diabetes. Diabetic retinopathy (34.5%), polyneuropathy (32.2%), and hypertension (52.3%) were the most common complications. Oral medications were used by 59.7% of patients, with 29.1% on insulin. Chi-square analysis showed a significant association between treatment adherence and complications (p β = 0.45, p Conclusion: Complications in diabetic patients significantly affect QoL in Bangladesh. Treatment adherence, especially with oral medications, positively impacts QoL. There is a need for improved access to diabetes care to manage complications and enhance the overall well-being of diabetic patients.展开更多
Diabetes is a major public health concern worldwide. Low and middle-income countries are the most affected. Diabetes self-management can significantly reduce the burden of diabetes complications and mortality. This cr...Diabetes is a major public health concern worldwide. Low and middle-income countries are the most affected. Diabetes self-management can significantly reduce the burden of diabetes complications and mortality. This cross-sectional study was conducted at the outpatient department of a county referral hospital in Kenya, from 1st August 2022 to 30th October 2022. Patients with known type II diabetes of age ≥ 20 years visiting the hospital for routine follow-up visits were included. A 7-tem Summary of Diabetes Self-care Activities (SDSAC) Questionnaire was used to assess Diabetes self-care activities. For data entry and statistical analysis, SPSS for Windows version 27.0 was used. There were 96 (39.2%) males and 149 (60.8%) females. Most of the participants were more than 61 years, 148 (60.4%). Significant association was found between the sum scale scores of dietary activities, blood glucose testing, physical activity, foot care, and neuropathy at 95% CI and (p Conclusions: Diabetes self-management activities have an impact on microvascular complications in patients with diabetes.展开更多
Dear Editor,Observational studies in epidemiology have identified a correlation between hypothyroidism and cholelithiasis[1–2].However,the causal relationship between the two diseases remains unclear.To investigate t...Dear Editor,Observational studies in epidemiology have identified a correlation between hypothyroidism and cholelithiasis[1–2].However,the causal relationship between the two diseases remains unclear.To investigate the potential causal relationship,we employed a two-sample bidirectional Mendelian randomization(MR)analysis.展开更多
文摘Objective:To analyze the therapeutic effect of laparoscopy combined with choledochoscopy in the treatment of difficult cholelithiasis.Methods:A total of 60 patients with difficult cholelithiasis admitted for treatment from January 2022 to December 2024 were selected and evenly divided into two groups using a random number table.The combined group received laparoscopy combined with choledochoscopy treatment,while the single group received laparoscopy treatment alone.The total treatment efficacy,perioperative indicators,angiotensin(Ang)levels,quality of life scores,and complication rates were compared between the two groups.Results:The total treatment efficacy in the combined group was higher than that in the single group;except for operative time,the perioperative indicators in the combined group were superior to those in the single group;the Ang levels after treatment in the combined group were lower than those in the single group,and the quality of life scores were higher(P<0.05).The complication rate in the combined group was lower than that in the single group(P<0.05).Conclusion:Laparoscopy combined with choedochoscopy can enhance the treatment effectiveness for patients with difficult cholelithiasis,improve perioperative indicators,regulate their Ang levels,elevate quality of life,and demonstrate high surgical safety.
文摘Liver transplantation is a life-saving procedure for patients with end-stage liver diseases and acute liver failure.With advances in surgical techniques and immunosuppressive regimens,patient survival rates have significantly improved.While the systemic complications of post-transplantation are well recognized,ophthalmic manifestations remain underreported.Ophthalmic complications can significantly impair visual function and increase morbidity in these patients.Prolonged immunosuppression makes the patients susceptible to the opportunistic pathogens such as Cytomegalovirus,Candida,Aspergillus,etc.Other common findings include dry eye disease,cataracts and retinal vascular complications which further contribute to the long-term morbidity in these patients.Early ophthalmic evaluation and prompt management are essential to prevent irreversible vision loss and improve post-transplant outcomes.High index of suspicion and multidisciplinary approach is essential to facilitate early diagnosis and treatment.This review highlights the range of ophthalmic complications observed in liver transplant recipients and underscores the need for future research focused on understanding the underlying pathophysiological mechanisms and refining the prophylactic protocols to improve outcomes in this unique patient population.
文摘Objective:To explore the clinical effect of personalized nutritional support in elderly women with gestational diabetes(GDM),and explore its impact on the incidence of maternal complications and pregnancy outcomes.Methods:A total of 90 elderly pregnant women with gestational diabetes who were delivered in our hospital from January 2023 to January 2024 were selected as the research objects.They were randomly divided into an observation group and a control group,with 45 cases in each group.The control group only received routine pregnancy care and basic nutrition guidance,while the observation group received personalized nutrition support on this basis.Compare the blood glucose control,incidence of pregnancy complications,pregnancy outcomes,and neonatal outcomes between two groups of parturient.Result:After intervention,the fasting blood glucose(FPG),2-hour postprandial blood glucose(2hPG),and glycated hemoglobin(HbA1c)of the observation group were significantly lower than those of the control group,and the differences were statistically significant(p<0.05);The incidence of complications such as gestational hypertension syndrome,polyhydramnios,premature rupture of membranes,and postpartum hemorrhage in the observation group was significantly lower than that in the control group,and the difference was statistically significant(p<0.05);The cesarean section rate in the observation group was significantly lower than that in the control group,and the incidence of adverse neonatal outcomes such as fetal distress,macrosomia,neonatal asphyxia,and neonatal hypoglycemia in the observation group was significantly lower than that in the control group,with statistical significance(p<0.05).Conclusion:Individualized nutritional support for elderly women with gestational diabetes can effectively improve the level of maternal blood sugar control,reduce the incidence of complications during pregnancy,and improve the outcome of pregnancy and neonatal outcomes,which is of high clinical value.
文摘BACKGROUND Elderly patients with colorectal cancer(CRC)can judge the risk of postoperative complications and oncological outcomes due to visceral obesity,which can provide data reference for the early prediction of prognosis.AIM To explore the effect of visceral obesity on postoperative complications and oncological outcomes in elderly patients with CRC.METHODS A total of 150 elderly patients who underwent radical surgery for CRC at Inner Mongolia Medical University and Inner Mongolia Autonomous Region People’s Hospital from January 2021 to June 2024 were retrospectively analyzed.Patients were divided into the abdominal[visceral fat area(VFA)≥100.00 cm^(2),n=80]and non-abdominal(VFA<100.00 cm^(2),n=70)obesity groups according to the VFA measured by preoperative computed tomography.The two groups showed no significant differences in age,sex,tumor location,tumor-node-metastasis stage,and underlying disease(P>0.05).All patients underwent standardized laparoscopic assisted surgery and received unified perioperative management.Complications,nutritional status,changes in biochemical indicators,and tumor recurrence and metastasis were evaluated postoperatively.RESULTS The overall incidence of postoperative complications was significantly higher in the abdominal obesity group than in the non-abdominal obesity group(P<0.05).The pulmonary infection on postoperative day(POD)3(P=0.038),anastomotic leakage on POD 7(P=0.042),and moderate-to-severe complications(Clavien-Dindo class III,P=0.03)were significantly different.With respect to biochemical indicators,the white blood cell count,neutrophil percentage,and C-reactive protein level in the abdominal obesity group continuously increased after surgery(P<0.05);the albumin level on POD 1 was even lower(P=0.024).Regarding tumor markers,carcinoembryonic antigen(P=0.039)and carbohydrate antigen 19-9(P=0.048)levels were significantly higher in the abdominal obesity group at 3 months after surgery,and local recurrence rates were higher than those in the non-abdominal obesity group at 30 days and 3 months after surgery(P<0.05).Abdominal obesity was an independent risk factor for postoperative complications(odds ratio:3.843,P=0.001),overall survival[hazard ratio(HR):1.937,P=0.011],and disease-free survival(HR:1.769,P=0.018).CONCLUSION Visceral obesity significantly increases the risk of postoperative complications in elderly patients with CRC and may adversely affect short-term tumor prognosis.Preoperative risk identification and interventions for abdominal obesity should be strengthened to improve perioperative safety and postoperative rehabilitation quality.
文摘Objective:To explore the therapeutic effect of double-puncture tympanic membrane puncture and tympanic cavity drug injection in patients with acute secretory otitis media.Methods:A total of 84 patients with acute secretory otitis media admitted to our hospital from June 2024 to June 2025 were selected and randomly divided into two groups by drawing lots.The control group(42 cases)was treated with the traditional single-puncture tympanic membrane puncture and tympanic cavity drug injection method,while the observation group(42 cases)was treated with the double-puncture tympanic membrane puncture and tympanic cavity drug injection method.The therapeutic effects of the two groups were compared.Results:The overall treatment response rate,overall complication rate,time to symptom relief,and improvement in hearing threshold in the observation group were all superior to those in the control group,with statistically significant differences(P<0.05).Conclusion:For acute secretory otitis media,the treatment method of double-puncture tympanic membrane puncture and tympanic cavity drug injection demonstrates definite efficacy,significantly reducing the incidence of complications,accelerating symptom relief,and improving hearing function,making it worthy of promotion.
基金The authors have read the PRISMA 2009 Checklist,and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
文摘Biliary complications like cholelithiasis and choledocholithiasis are more common in bariatric surgery patients due to obesity and rapid weight loss.Patients with a body mass index>40 face an eightfold risk of developing cholelithiasis.Postbariatric surgery,especially after laparoscopic Roux-en-Y gastric bypass(LRYGB),30%of patients develop biliary disease due to rapid weight loss.The aim of this review is to analyze the main biliary complications that occur after bariatric surgery and its management.A review of the literature was conducted mainly from 2010 up to 2023 with regard to biliary complications associated with bariatric patients in SciELO,PubMed,and MEDLINE.Patients undergoing LRYGB have a higher incidence(14.5%)of symptomatic calculi post-surgery compared to those undergoing laparoscopic sleeve gastrectomy at 4.1%.Key biliary complications within 6 to 12 months post-surgery include:Cholelithiasis:36%;Biliary colic/dyskinesia:3.86%;Acute cholecystitis:0.98%-18.1%;Chronic cholecystitis:70.2%;Choledocholithiasis:0.2%-5.7%and Pancreatitis:0.46%-9.4%.Surgeons need to be aware of these complications and consider surgical treatments based on patient symptoms to enhance their quality of life.
文摘BACKGROUND Acute ischemic stroke(AIS)is an abrupt blood flow cessation to a specific brain region within a vascular zone,causing a subsequent decline in neurological capabilities.Stent thrombectomy is a recently established technique for treating AIS.It provides the benefits of being a relatively simple and safe procedure,capable of partially enhancing a patient’s condition.However,some patients may experience endothelial damage and recurrent thrombosis,with clinical outcomes that are not always satisfactory.Hence,the efficacy of this method remains unclear.AIM To survey the association of stent thrombectomy vs standard treatment with neurological function protection,complications,and short-term prognosis in patients diagnosed with AIS.METHODS This study assigned 90 patients with AIS to the observation and control groups(n=45 patients)from December 2020 to December 2022.Stent thrombectomy was conducted in the observation group,whereas routine treatment was provided to the control group.The study assessed the therapeutic outcomes of two groups,including a comparison of their neurological function,living ability,anxiety and depression status,plaque area,serum inflammatory factors,serum Smur100βprotein,neuron-specific enolase(NSE),homocysteine(Hcy),and vascular endo-thelial function.Additionally,the incidence of complications was calculated and analyzed for each group.RESULTS The total effective rate of treatment was 77.78%and 95.56%in the control and observation groups,respectively.After 8 weeks of treatment,the scores on the National Institutes of Health Stroke Scale,Hamilton Anxiety Scale,and Hamilton Depression Scale decreased remarkably;the Barthel index increased remarkably,with better improvement effects of the scores in the observation group(P<0.05);total cholesterol,triglyceride,C-reactive protein,and plaque area lessened remarkably,with fewer patients in the observation group(P<0.05);S-100βprotein,NSE,and Hcy levels lessened remarkably,with fewer patients in the observation group(P<0.05);serum vascular endothelial growth factor and nitric oxide synthase levels increased remarkably,whereas the endothelin-1 level decreased,with better improvement effect in the observation group(P<0.05).Complications occurred in 8.88%of patients in the observation group compared with 33.33%in the control group.CONCLUSION Stent thrombectomy appeared to provide more remarkable neuroprotective effects in patients with AIS compared to the intravenous thrombolysis regimen.Additionally,it has effectively improved the neurological function,daily activities,and vascular endothelial function of patients,while reducing the incidence of complications and improving short-term prognosis.
基金Supported by the Chongqing Natural Science Foundation,No.cstc2020jcyj-msxmX0288the Chongqing Medical University Program for Youth Innovation in Future Medicine,No.W0190.
文摘BACKGROUND Gastric cancer is a malignancy with high morbidity and mortality rates.Surgical intervention,particularly gastrectomy,is essential for curative treatment but carries a substantial risk of complications.Identifying key risk factors and understanding complication profiles are crucial for improving outcomes and guiding perioperative management.AIM To analyze the incidence of postoperative complications in patients with gastric cancer and identify potential risk factors.METHODS We conducted a retrospective analysis of 500 patients who underwent gastrectomy between January 2018 and December 2022.Postoperative complications were classified using the Clavien-Dindo system.RESULTS The overall complication rate was 28.4%(142/500),with 15.2%(76/500)experiencing major complications(Clavien-Dindo grade≥III).Pulmonary complications were the most frequent(10.8%),followed by surgical site infections(8.6%),and anastomotic leakage(4.2%).Age 70 years or more,body mass index of 25 kg/m²or more,advanced tumor stage,total gastrectomy,and operative time 240 min or more emerged as independent risk factors.CONCLUSION Focused preoperative risk assessment,targeted interventions,and reduced operative time for older or obese patients requiring total gastrectomy or presenting with advanced disease are important to improve surgical outcomes.
文摘This article aims to deepen the understanding of the role of Helicobacter pylori(H.pylori)infection in the development of cholelithiasis,initiated by the article by Yao et al,who investigated the potential link between H.pylori infection and the development of cholelithiasis through a multicenter retrospective study on an Asian population of over 70000 participants.They also performed a compre-hensive analysis of previously published studies on H.pylori and cholelithiasis,finding a positive association therein[odds ratio(OR)=1.103,P=0.049].Patients positive for H.pylori also had lower levels of total and direct bilirubin,but higher levels of total cholesterol and low-density lipoprotein cholesterol compared to uninfected patients(P<0.05).Cohort studies have confirmed that H.pylori is a risk factor for cholelithiasis(P<0.0001),and aggregate analyses of case-control and cross-sectional studies have shown a positive association between H.pylori and cholelithiasis in Asia(OR=1.599,P=0.034),but not in Europe(OR=1.277,P=0.246).Moreover,H.pylori appears to be related to a higher ratio of choledocho-lithiasis/cholecystolithiasis(OR=3.321,P=0.033).The authors conclude that H.pylori infection is positively correlated with cholelithiasis,particularly with the choledocholithiasis phenotype,especially in Asia,and it is potentially related to bilirubin and cholesterol metabolism.
文摘BACKGROUND Single-balloon enteroscopy(SBE)is an established procedure for evaluating small bowel lesions.While its efficacy is well recognized,the incidence of major complications and their associated risk factors in a large population remain unclear.AIM To investigate the complications and risk factors associated with diagnostic SBE.METHODS This multicenter retrospective study included consecutive patients who underwent diagnostic SBE at three tertiary care hospitals between January 2016 and September 2024.Data on baseline characteristics,procedural parameters,indications,findings,and major complications were collected and analyzed.RESULTS A total of 2865 SBE procedures were performed in 1840 patients.The mean age was 51±18 years,and 64.5%were male.The most common indication was obscure gastrointestinal bleeding(57.1%),followed by abdominal pain(30.5%).The major complication rate was 0.4%(7/1840),all of which involved acute intestinal perforation identified during the procedure.Among the perforation cases,6 occurred in patients undergoing SBE for abdominal pain and 1 for obscure gastrointestinal bleeding.The perforation sites included the ileum(6/7)and duodenum(1/7).All cases were successfully managed surgically.Previous abdominal surgery and the use of abdominal compression were significantly associated with an increased risk of perforation(P value<0.001 for both).In subgroup analysis,perforation rates were 2.1%(6/288)in patients with prior abdominal surgery and 1.6%(7/428)with abdominal compression.CONCLUSION Acute intestinal perforation is a rare but serious complication.Prior abdominal surgery and abdominal compression are important risk factors,and careful patient selection is recommended to minimize complications.
文摘AIM:To evaluate the visual outcomes of implantable collamer lenses(ICLs)and identify the possible risk factors for ICL axis misalignment,and consequently,repositioning,explanting,or exchanging at a specialized eye hospital in Saudi Arabia.METHODS:The medical records of 813 eyes with different refractive errors corrected with ICL implantation were identified and included in this single-arm retrospective cohort study.The following data were collected:demographic characteristics,primary diagnosis,preoperative refraction,anterior chamber depth(ACD),white-to-white(WTW)measurement,endothelial cell density(ECD),and axial length.Patients’satisfaction and complaints,and their postoperative refraction,vault depth,and axis alignment with the preoperative target,were reviewed during the postoperative period.Collectively,these data were correlated with symptomatic axis rotation and the need for repositioning,explantation,or exchange due to high or low ICL vaults.RESULTS:Of 813 eyes,27(3.32%),13(1.59%),and 11(1.35%)required ICL repositioning,ICL explantation only without exchange,and ICL explantation with the placement of a new ICL,respectively.The mean follow-up period was 37.5mo.The main cause of explanation or exchange was incorrect WTW measurement in seven(29.17%)eyes,followed by high vault in four(16.56%)eyes.ICL repositioning was required in 27(3.32%)eyes with considerable rotation.Only 2(0.24%)eyes developed cataracts that required ICL removal,and retinal complications were reported in 7(0.86%)eyes.Long-term glaucoma and corneal decompensation were not observed in this cohort.CONCLUSION:With a high safety profile and reversibility,ICL implantation is a good alternative to corneal-based refractive surgery in eyes unsuitable for laser vision correction.The rate of secondary procedures in our study was 6.26%.Old age is a risk factor for secondary surgical interventions in the repositioning group,whereas abnormal vault and toric ICL rotation in the explantation group necessitated subsequent surgical procedures.Overall,ICL implantation demonstrates a good efficacy index and safety profile in patients with diverse refractive errors.
基金Supported by Research Unit of Minimally Invasive Pediatric Surgery on Diagnosis and Treatment,Chinese Academy of Medical Sciences,No.2021RU016.
文摘BACKGROUND Laparoscopic surgery,with the advantage of less trauma,has been predominantly performed to treat pediatric inguinal hernia.However,the traditional three-port laparoscopic surgery remains extremely traumatic for children,whereas singleport laparoscopic surgery causes less damage to children than traditional laparoscopy.However,single-port laparoscopic surgery is more challenging;thus,studies on the effect of its application in pediatric inguinal hernia remain relatively limited.AIM To analyze the association of single-incision laparoscopic herniorrhaphy needle treatment with surgical outcomes,postoperative complications,and serum inflammation in pediatric inguinal hernia.METHODS This retrospective study included 113 pediatric patients with inguinal hernia who underwent surgery at the Children’s Hospital,Capital Institute of Pediatrics,from April 2022 to May 2023.Participants were categorized into the observation group(single-incision laparoscopic herniorrhaphy needle,n=60)and the control group(two-port laparoscopic surgery,n=53).Comparative analyses involved surgical duration,intraoperative blood loss,and length of hospital stay.C-reactive protein(CRP)and white blood cell count(WBC)levels were measured preoperatively and 24 hours postoperatively.Postoperative pain was evaluated with the face,legs,activity,cry,and Consolability scale.Further,the incidence of complications,recurrence,and reoperation rates was assessed.Logistic regression was employed to determine independent risk factors related to poor prognosis.RESULTS The observation group demonstrated significantly reduced intraoperative blood loss and shorter hospitalization compared to the control group(P<0.05).Both groups demonstrated increased CRP and WBC levels postoperatively,but the observation group exhibited significantly lower levels(P<0.05).Further,pain scores at 24 hours postoperatively were significantly lower in the observation group(P<0.05).Additionally,the observation group experienced fewer adverse events,recurrence rates,and reoperations compared to the control group(P<0.05).Logistic regression analysis determined increased postoperative stress markers and surgical technique as independent predictors of recurrence(P<0.05).CONCLUSION Single-incision laparoscopic herniorrhaphy needle treatment for pediatric inguinal hernia exhibits significant efficacy,effectively reduces postoperative complications,ensures a more concealed surgical incision,and promotes faster postoperative recovery than conventional two-port laparoscopy.This approach merits wider application.
文摘Background: In children, acute bacterial rhinosinusitis (ABRS) is often complicated by ophthalmological and/or neurological involvement. These complications should be known and recognized, as they require urgent treatment with intravenous antibiotics and close in-hospital monitoring. In this study, we aimed to identify the main risk factors associated with the development of complications in children aged 2 - 17 years with ABRS. Methods: We conducted a retrospective cohort study of patients with ABRS complications in a primary hospital. Participants were divided into two groups: the control group comprising patients without complications (Group 1, n = 82) and the study group comprising patients with complications requiring hospitalization (Group 2, n = 41). We assessed the sociodemographic, clinical, and imaging data of both groups. Using multivariate logistic regression, we assessed risk factors of ABRS complications. Results: No socio-demographic characteristics were associated with ABRS complications (p ≥ 0.05). Factors associated with complications were delay in consultation (t = 5.282;p Conclusions: Intracranial and extracranial complications of ABRS in children have become rare in our setting. These complications can be serious and potentially fatal. Risk factors of these complications are delays in consultation, the presence of ophthalmological signs, and more than one affected sinus. Controlling modifiable factors would improve the treatment success of ABRS complications in children.
基金Supported by the National Natural Science Foundation of China,No.81302124.
文摘BACKGROUND Red blood cell distribution width(RDW)is associated with the development and progression of various diseases.AIM To explore the association between pretreatment RDW and short-term outcomes after laparoscopic pancreatoduodenectomy(LPD).METHODS A total of 804 consecutive patients who underwent LPD at our hospital between March 2017 and November 2021 were retrospectively analyzed.Correlations between pretreatment RDW and clinicopathological characteristics and short-term outcomes were investigated.RESULTS Patients with higher pretreatment RDW were older,had higher Eastern Cooperative Oncology Group scores and were associated with poorer short-term outcomes than those with normal RDW.High pretreatment RDW was an independent risk factor for postoperative complications(POCs)(hazard ratio=2.973,95%confidence interval:2.032-4.350,P<0.001)and severe POCs of grade IIIa or higher(hazard ratio=3.138,95%confidence interval:2.042-4.824,P<0.001)based on the Clavien-Dino classification system.Subgroup analysis showed that high pretreatment RDW was an independent risk factor for Clavien-Dino classi-fication grade IIIb or higher POCs,a comprehensive complication index score≥26.2,severe postoperative pancreatic fistula,severe bile leakage and severe hemorrhage.High pretreatment RDW was positively associated with the neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio and was negatively associated with albumin and the prognostic nutritional index.CONCLUSION Pretreatment RDW was a special parameter for patients who underwent LPD.It was associated with malnutrition,severe inflammatory status and poorer short-term outcomes.RDW could be a surrogate marker for nutritional and inflammatory status in identifying patients who were at high risk of developing POCs after LPD.
文摘BACKGROUND Cauda equina syndrome(CES)is characterized by a group of symptoms that may be caused by inflammation,spinal cord compression,venous congestion,or ischemia.This syndrome is commonly an indication for surgical intervention but has not been determined as a postoperative complication following surgery for lumbar spine disease.CASE SUMMARY To report the case of a 54-year-old male patient who had CES following spinal surgery,with no obvious compression lesions found during re-exploration,suggesting that vascular insufficiency may have contributed to the condition.Furthermore,a series of urodynamic studies on bladder recovery patterns in such complications have also been investigated.CONCLUSION Postoperative CES requires urgent imaging and exploration to rule out compression;noncompressive cases,including vascular insufficiency may performed conservative management.
文摘Background: In developing countries, charity cleft surgical mission is always operated by sporadic surgical teams without systematic follow up and quality assurance. In the past few decades, many mission projects have been held regularly in China. The purpose of this audit was a retrospective analysis of a 9-year cleft lip and palate charity project operated in a tertiary hospital in China Shenzhen Area to evaluate perioperative and postoperative complications. Nevertheless, understanding the risk profile is essential for establishing a sustainable in-house cleft service in Shenzhen. Methods: A detailed analysis of hospital centralized record in the The University of Hong Kong-Shenzhen Hospital (HKUSZH) was reviewed since the first charity project held in 2015. The parameters of this audit were focused on perioperative complications including anesthesia related problems, early postoperative complications in patients who underwent primary or secondary cleft surgeries. A total of 430 consecutive admitted cases of 311 non-syndromic cleft lip & palate patients were enrolled into the charity project from June 2015 to July 2024. The main anesthesia related complications that occurred during general anesthesia were respiratory tract problems, while intraoperative complication was excessive bleeding, so as wound local infection and reaction were the main early postoperative complications. Results: In our 9-year clinical audit of 430 cleft lip and palate charity surgeries in Shenzhen, we observed no mortalities and a anesthesia-related complication rate of 1.16%. Specific intraoperative complications included excessive bleeding, while early postoperative issues were dominated by wound infections. The fistula rate of 18.7% post palate repair and the average hospital stay of 3.71 days complete the profile of our surgical outcomes. These data underscore the project’s efficacy and offer a reference for international cleft missions aiming for safe and efficient surgical care. Conclusions: This study provides a thorough data review of the complications in the past 9 years charity missions for cleft lip and palate surgery in a well-structured hospital infrastructure and logistic support by local surgical team. There were no perioperative or postoperative death during the study period and the overall short-term complication rate was low. Therefore, it could be a reference model for other international cleft mission in developing country for a safe and efficient service in future.
文摘Background and Objectives: Post-operative complications (POC) are new pathological phenomena occurring in the post-operative period and worsening the previous situation through their morbidity and mortality. Our aim was to determine the prevalence and preoperative factors associated with early POC at University Clinics of Kisangani (CUKIS). Methods: This was a cross-sectional study conducted in the CUKIS, Department of Surgery from 1 January 2014 to 31 December 2023. The target population consisted of all patients who had undergone full post-operative follow-up. A logistic regression model using RStudio version 4.4.0 software was used to determine the factors predicting early postoperative complications. Results: The prevalence of early POC was estimated at 35%, with surgical site infection the most frequent POC at 45.3%. After multivariate analysis using logistic regression, the social category of widow(er)s, transfer, previous laparotomy, acute generalised peritonitis, preoperative length of stay of more than 10 days and ASA score 2 and 5 were significant risk factors associated with the occurrence of POC in the preoperative period. Conclusion: Certain factors can predict the occurrence of POC. Knowledge of these factors can help practitioners to take useful measures before each surgical operation on a patient with these factors, with a view to preventing or managing POC.
文摘Background: Diabetes Mellitus (DM) is a growing health issue in Bangladesh, with significant complications affecting the quality of life (QoL). This study aims to assess long-term complications, treatment patterns, and QoL of diabetic patients during COVID-19. Methods: A cross-sectional study was conducted on 385 diabetic patients (aged 18-80) from tertiary hospitals in Dhaka and Mymensingh between May and October 2022. Data were collected via a semi-structured questionnaire on sociodemographics, complications, treatment patterns, and QoL (SF-12 scale). Chi-square tests, ANOVA, and linear regression were used for inferential analysis. Results: The sample predominantly included middle-aged males (41 - 55 years) with type 2 diabetes. Diabetic retinopathy (34.5%), polyneuropathy (32.2%), and hypertension (52.3%) were the most common complications. Oral medications were used by 59.7% of patients, with 29.1% on insulin. Chi-square analysis showed a significant association between treatment adherence and complications (p β = 0.45, p Conclusion: Complications in diabetic patients significantly affect QoL in Bangladesh. Treatment adherence, especially with oral medications, positively impacts QoL. There is a need for improved access to diabetes care to manage complications and enhance the overall well-being of diabetic patients.
文摘Diabetes is a major public health concern worldwide. Low and middle-income countries are the most affected. Diabetes self-management can significantly reduce the burden of diabetes complications and mortality. This cross-sectional study was conducted at the outpatient department of a county referral hospital in Kenya, from 1st August 2022 to 30th October 2022. Patients with known type II diabetes of age ≥ 20 years visiting the hospital for routine follow-up visits were included. A 7-tem Summary of Diabetes Self-care Activities (SDSAC) Questionnaire was used to assess Diabetes self-care activities. For data entry and statistical analysis, SPSS for Windows version 27.0 was used. There were 96 (39.2%) males and 149 (60.8%) females. Most of the participants were more than 61 years, 148 (60.4%). Significant association was found between the sum scale scores of dietary activities, blood glucose testing, physical activity, foot care, and neuropathy at 95% CI and (p Conclusions: Diabetes self-management activities have an impact on microvascular complications in patients with diabetes.
基金by grants from the Jiangsu Province 333 High-level Talent Training Project(Grant No.LGY2016010)the Nanjing Science and Technology Development Plan(Grant No.201715003)the Jiangsu Province Six Talent Peaks(Grant No.WSN-030).
文摘Dear Editor,Observational studies in epidemiology have identified a correlation between hypothyroidism and cholelithiasis[1–2].However,the causal relationship between the two diseases remains unclear.To investigate the potential causal relationship,we employed a two-sample bidirectional Mendelian randomization(MR)analysis.
