BACKGROUND Gastric cancer(GC)is one of the most common malignancies and types of cancer worldwide.AIM To compare the differences in tumor markers of GC with GC dissection,we evaluated the efficacy of recent tumor remo...BACKGROUND Gastric cancer(GC)is one of the most common malignancies and types of cancer worldwide.AIM To compare the differences in tumor markers of GC with GC dissection,we evaluated the efficacy of recent tumor removal.METHODS A prospective cohort study was conducted to analyze the clinical data of patients with GC.Patients were divided into two groups based on the surgical approach:The membrane dissection(MD)group,which underwent membrane-guided laparoscopic radical gastrectomy with D2 lymph node dissection plus complete mesocolic excision,and the D2 group,which underwent traditional laparoscopic radical gastrectomy with D2 lymph node dissection.Abdominal lavage fluid was collected pre-and postoperatively from patients in both groups.The expression of carcinoembryonic antigen(CEA)and cytokeratin-19(CK-19)message RNAs in the abdominal lavage fluid was detected using reverse transcription polymerase chain reaction.The factors influencing the increase of the tumor markers were analyzed,and the short-term efficacy of the two surgery types was compared.RESULTS In total,135 eligible patients were included in this study,with 69 and 66 cases in the MD and D2 groups,respectively.Fourteen patients with benign gastric lesions were selected to detect tumor marker expression.After excluding patients positive for preoperative cancer leakage,we found that 9.52%and 26.67%of patients in the MD and D2 groups developed postoperative CEA positivity,respectively.Multivariate analysis revealed that the degree of differentiation and surgical approach were independent risk factors for postoperative CEA positivity.The surgical approach was an independent risk factor affecting postoperative CK-19 positivity and postoperative CEA and CK-19 positivity.Surgical time,intraoperative blood loss,number of lymph nodes dissected,time to first postoperative flatus,and time to first liquid intake were all significantly different between the two surgical approaches.There were no significant differences in the incision length,duration of postoperative hospital stays,or postoperative complications.CONCLUSION MD is a better radical surgical treatment than traditional D2 surgery and is worthy of further clinical promotion and application.展开更多
Objective:To find out whether warm bladder irrigation fluid can decrease the occurrence of perioperative hypothermia,blood loss and shiver in patients treated with benign prostatic hyperplasia(BPH).Method:A comprehens...Objective:To find out whether warm bladder irrigation fluid can decrease the occurrence of perioperative hypothermia,blood loss and shiver in patients treated with benign prostatic hyperplasia(BPH).Method:A comprehensive literature review and meta-analysis that included randomized controlled trials(RCTs)related to temperature of irrigation fluid in the perioperative treatment for BPH was taken by researchers.The relevant literature were searched in Chinese database,such as Retrieval Chinese Journal Full-text Database,VIP Journal Database,Wanfang database,as well as in English search engine and database,including Embase,Cochrane and Medline till January 2018.The study quality was assessed by recommended standards from Cochrane Handbook(version 5.1.0).Results:A total of 28 RCTs and 3858 patients were included.The results showed that the incidences of shiver(risk ratio[RR]Z 0.32,95%confidence interval[CI]:0.28e0.36,p<0.001,I^2 Z 0%)and hypothermia(RR Z 0.36,95%CI:0.21e0.59,p<0.001,I^2 Z 67%)in the group of warm irrigation fluid were lower than the group having room-temperature fluid.Room-temperature irrigation fluid group caused a greater drop in body temperature compared to warm irrigation fluid group(p<0.001,I^2 Z 96%).We performed a narrative descriptive statistics only because of substantial heterogeneity.Conclusions:Warm bladder irrigation fluid can decrease the drop of body temperature and the incidence of hypothermia and shiver during and after the operation for BPH.Warm irrigation fluid should be considered as a standard practice in BPH surgeries.展开更多
BACKGROUND Intraventricular hemorrhage is a neurosurgical emergency,and a dangerous condition associated with high morbidity and mortality.Previously,hematoma evacuation is generally executed by external intracranial ...BACKGROUND Intraventricular hemorrhage is a neurosurgical emergency,and a dangerous condition associated with high morbidity and mortality.Previously,hematoma evacuation is generally executed by external intracranial drainage(EVD)or surgical evacuation.Nowadays,endoscopic evacuation is emerging as a good alternative because it brings relatively less invasion and injury.However,successful endoscopic evacuation requires skilled manipulation of endoscopic devices and the evidence supporting its efficacy differs in different reports.AIM To improve the technique usage and provide more evidence of endoscopic evacuation efficacy,we summarize our surgical experience and compared the outcomes of the endoscopic evacuation with EVD using real-world data.METHODS We retrospectively studied 96 consecutive patients with intraventricular hemorrhage who underwent either endoscopic surgery(n=43)or non-endoscopic surgery(n=53)for hemorrhage evacuation between November 2013 and September 2019 in our center.Patients’conditions prior to and after the operation were evaluated and analyzed to assess the efficacy of the operation.The consciousness status improvement and perioperative in-hospital parameters in the two types of operation groups were assessed and compared.RESULTS Patients in the endoscopic and non-endoscopic groups presented with a similar state of consciousness,with a comparable Glasgow Coma Scale(GCS)index.The average operation time of the endoscopic group was longer than that of the nonendoscopic group(median 2.42 h vs 1.08 h,P<0.001).Although the endoscopic group was older and had a baseline Graeb score that indicated more severe hemorrhage than the non-endoscopic group(Graeb median:Endoscopic group=9 vs non-endoscopic group=8,P=0.023),the clearance rate of hematoma was as high as 60.5%.Both the endoscopic and non-endoscopic groups showed an improved GCS index after surgery.However,this improvement was more marked in patients in the endoscopic group(median improvement of GCS index:Endoscope group=4 vs non-endoscopic group=1,P<0.001).Additionally,the endoscopic group had a lower Graeb score than the non-endoscopic group after the operation.The intensive care unit stay of the endoscopic group was significantly shorter than that of the non-endoscopic group(median:endoscopic group=6 d vs non-endoscope group=7 d,P=0.017).CONCLUSION Endoscopic evacuation of intraventricular hemorrhage was generally an effective and efficient way for hemorrhage evacuation,and contributed remarkably to the improvement of consciousness in patients with intraventricular hemorrhage.展开更多
Background: With the advancement of technology, prostate resection can be performed nowadays using endoscopic techniques, which include monopolar and bipolar transurethral prostate resection. This study aimed to evalu...Background: With the advancement of technology, prostate resection can be performed nowadays using endoscopic techniques, which include monopolar and bipolar transurethral prostate resection. This study aimed to evaluate the results of bipolar transurethral prostate resection in a single urology center in Cameroon. Materials and Methods: This was a retrospective study carried out over two years (2015-2017) involving 112 patients with symptomatic prostate diseases who underwent transurethral prostate resection with the help of a bipolar Olympus generator. Results: The ages of the participants ranged from 44 years to 85 years, with a mean age of 64.41 ± 9.5 years. Fifty-six (50%) patients presented with only obstructive symptoms, five (4.46%) had only irritative symptoms, twenty (17.86%) presented with both obstructive and irritative symptoms, eight (7.14%) presented with macroscopic hematuria, seven (6.25%) with urinary tract infections, and sixteen (14.29%) with acute urinary retention. Digital rectal examination was unremarkable in 74 (66.07%) findings and was positive in 38 (33.93%) patients. The median prostate diameter was 70 [59 - 86.5] mm. The mean preoperative IPSS was 24.46 ± 5.68. The mean surgery duration was 77.61 ± 23.87 minutes. The mean volume of irrigation fluid used during surgery was 24.84 ± 6.40 ml. The differences between the preoperative and postoperative mean IPPS score, maximum urine flow rate, and quality of life were statistically significant (all P Conclusion: Bipolar transurethral prostate resection is a viable alternative to open surgery or laparoscopic surgery for large prostate glands. This technique is also associated with a reduction in prostate-related morbidity.展开更多
基金Supported by Putian Science and Technology Plan Project,No.2022SY003.
文摘BACKGROUND Gastric cancer(GC)is one of the most common malignancies and types of cancer worldwide.AIM To compare the differences in tumor markers of GC with GC dissection,we evaluated the efficacy of recent tumor removal.METHODS A prospective cohort study was conducted to analyze the clinical data of patients with GC.Patients were divided into two groups based on the surgical approach:The membrane dissection(MD)group,which underwent membrane-guided laparoscopic radical gastrectomy with D2 lymph node dissection plus complete mesocolic excision,and the D2 group,which underwent traditional laparoscopic radical gastrectomy with D2 lymph node dissection.Abdominal lavage fluid was collected pre-and postoperatively from patients in both groups.The expression of carcinoembryonic antigen(CEA)and cytokeratin-19(CK-19)message RNAs in the abdominal lavage fluid was detected using reverse transcription polymerase chain reaction.The factors influencing the increase of the tumor markers were analyzed,and the short-term efficacy of the two surgery types was compared.RESULTS In total,135 eligible patients were included in this study,with 69 and 66 cases in the MD and D2 groups,respectively.Fourteen patients with benign gastric lesions were selected to detect tumor marker expression.After excluding patients positive for preoperative cancer leakage,we found that 9.52%and 26.67%of patients in the MD and D2 groups developed postoperative CEA positivity,respectively.Multivariate analysis revealed that the degree of differentiation and surgical approach were independent risk factors for postoperative CEA positivity.The surgical approach was an independent risk factor affecting postoperative CK-19 positivity and postoperative CEA and CK-19 positivity.Surgical time,intraoperative blood loss,number of lymph nodes dissected,time to first postoperative flatus,and time to first liquid intake were all significantly different between the two surgical approaches.There were no significant differences in the incision length,duration of postoperative hospital stays,or postoperative complications.CONCLUSION MD is a better radical surgical treatment than traditional D2 surgery and is worthy of further clinical promotion and application.
文摘Objective:To find out whether warm bladder irrigation fluid can decrease the occurrence of perioperative hypothermia,blood loss and shiver in patients treated with benign prostatic hyperplasia(BPH).Method:A comprehensive literature review and meta-analysis that included randomized controlled trials(RCTs)related to temperature of irrigation fluid in the perioperative treatment for BPH was taken by researchers.The relevant literature were searched in Chinese database,such as Retrieval Chinese Journal Full-text Database,VIP Journal Database,Wanfang database,as well as in English search engine and database,including Embase,Cochrane and Medline till January 2018.The study quality was assessed by recommended standards from Cochrane Handbook(version 5.1.0).Results:A total of 28 RCTs and 3858 patients were included.The results showed that the incidences of shiver(risk ratio[RR]Z 0.32,95%confidence interval[CI]:0.28e0.36,p<0.001,I^2 Z 0%)and hypothermia(RR Z 0.36,95%CI:0.21e0.59,p<0.001,I^2 Z 67%)in the group of warm irrigation fluid were lower than the group having room-temperature fluid.Room-temperature irrigation fluid group caused a greater drop in body temperature compared to warm irrigation fluid group(p<0.001,I^2 Z 96%).We performed a narrative descriptive statistics only because of substantial heterogeneity.Conclusions:Warm bladder irrigation fluid can decrease the drop of body temperature and the incidence of hypothermia and shiver during and after the operation for BPH.Warm irrigation fluid should be considered as a standard practice in BPH surgeries.
文摘BACKGROUND Intraventricular hemorrhage is a neurosurgical emergency,and a dangerous condition associated with high morbidity and mortality.Previously,hematoma evacuation is generally executed by external intracranial drainage(EVD)or surgical evacuation.Nowadays,endoscopic evacuation is emerging as a good alternative because it brings relatively less invasion and injury.However,successful endoscopic evacuation requires skilled manipulation of endoscopic devices and the evidence supporting its efficacy differs in different reports.AIM To improve the technique usage and provide more evidence of endoscopic evacuation efficacy,we summarize our surgical experience and compared the outcomes of the endoscopic evacuation with EVD using real-world data.METHODS We retrospectively studied 96 consecutive patients with intraventricular hemorrhage who underwent either endoscopic surgery(n=43)or non-endoscopic surgery(n=53)for hemorrhage evacuation between November 2013 and September 2019 in our center.Patients’conditions prior to and after the operation were evaluated and analyzed to assess the efficacy of the operation.The consciousness status improvement and perioperative in-hospital parameters in the two types of operation groups were assessed and compared.RESULTS Patients in the endoscopic and non-endoscopic groups presented with a similar state of consciousness,with a comparable Glasgow Coma Scale(GCS)index.The average operation time of the endoscopic group was longer than that of the nonendoscopic group(median 2.42 h vs 1.08 h,P<0.001).Although the endoscopic group was older and had a baseline Graeb score that indicated more severe hemorrhage than the non-endoscopic group(Graeb median:Endoscopic group=9 vs non-endoscopic group=8,P=0.023),the clearance rate of hematoma was as high as 60.5%.Both the endoscopic and non-endoscopic groups showed an improved GCS index after surgery.However,this improvement was more marked in patients in the endoscopic group(median improvement of GCS index:Endoscope group=4 vs non-endoscopic group=1,P<0.001).Additionally,the endoscopic group had a lower Graeb score than the non-endoscopic group after the operation.The intensive care unit stay of the endoscopic group was significantly shorter than that of the non-endoscopic group(median:endoscopic group=6 d vs non-endoscope group=7 d,P=0.017).CONCLUSION Endoscopic evacuation of intraventricular hemorrhage was generally an effective and efficient way for hemorrhage evacuation,and contributed remarkably to the improvement of consciousness in patients with intraventricular hemorrhage.
文摘Background: With the advancement of technology, prostate resection can be performed nowadays using endoscopic techniques, which include monopolar and bipolar transurethral prostate resection. This study aimed to evaluate the results of bipolar transurethral prostate resection in a single urology center in Cameroon. Materials and Methods: This was a retrospective study carried out over two years (2015-2017) involving 112 patients with symptomatic prostate diseases who underwent transurethral prostate resection with the help of a bipolar Olympus generator. Results: The ages of the participants ranged from 44 years to 85 years, with a mean age of 64.41 ± 9.5 years. Fifty-six (50%) patients presented with only obstructive symptoms, five (4.46%) had only irritative symptoms, twenty (17.86%) presented with both obstructive and irritative symptoms, eight (7.14%) presented with macroscopic hematuria, seven (6.25%) with urinary tract infections, and sixteen (14.29%) with acute urinary retention. Digital rectal examination was unremarkable in 74 (66.07%) findings and was positive in 38 (33.93%) patients. The median prostate diameter was 70 [59 - 86.5] mm. The mean preoperative IPSS was 24.46 ± 5.68. The mean surgery duration was 77.61 ± 23.87 minutes. The mean volume of irrigation fluid used during surgery was 24.84 ± 6.40 ml. The differences between the preoperative and postoperative mean IPPS score, maximum urine flow rate, and quality of life were statistically significant (all P Conclusion: Bipolar transurethral prostate resection is a viable alternative to open surgery or laparoscopic surgery for large prostate glands. This technique is also associated with a reduction in prostate-related morbidity.
