BACKGROUND Pancreatic neuroendocrine tumors(PNETs)are rare malignancies frequently associated with liver metastases(LM).The benefit of primary tumor resection(PTR)in patients with unresectable LM remains controversial...BACKGROUND Pancreatic neuroendocrine tumors(PNETs)are rare malignancies frequently associated with liver metastases(LM).The benefit of primary tumor resection(PTR)in patients with unresectable LM remains controversial.This study evaluates the impact of PTR on overall survival(OS)and tumor grading by integrating evidence from a systematic review,meta-analysis,and Surveillance,Epidemiology,and End Results(SEER)database analysis.AIM To evaluate the survival benefits of PTR in patients with PNETs and LM.METHODS This study was conducted in accordance with the PRISMA guidelines.A systematic literature search and meta-analysis were performed using five databases:PubMed,Web of Science,EMBASE,Cochrane Library,and CNKI,with records included up to February 2025.A total of 16 studies(n=8761;including 1 prospective and 15 retrospective studies)were included.A random-effects model was applied to pool hazard ratios for OS and odds ratios for tumor grading,with heterogeneity assessed by the I2 statistic.Risk of bias was evaluated using the ROBINS-I tool.In addition,an independent analysis based on the SEER database(n=791)was conducted using Kaplan-Meier survival curves and log-rank tests.RESULTS Meta-analysis results revealed that PTR significantly improved OS in patients showed that neither study design(prospective vs.retrospective)nor sample size(<400 vs≥400)significantly influenced the survival benefit.In terms of tumor grading,no statistically significant difference was observed between the surgical and non-surgical groups(odds ratio=1.60,95%confidence interval:0.70-3.63,P=0.26).Independent analysis of the SEER database(n=791)further confirmed the survival advantage of PTR across different tumor differentiation levels,with significant differences in OS between surgical and non-surgical groups(P<0.05).CONCLUSION PTR significantly improves OS in PNET patients with LM.However,its effect on tumor grading remains unclear,warranting further prospective studies to refine surgical strategies for this population.展开更多
Objective:To summarize the nursing experience of a patient with necrotizing fasciitis(NF)secondary to hypoproteinemia after spinal tumor resection.Methods:We analyzed the clinical data of a patient with hypoproteinemi...Objective:To summarize the nursing experience of a patient with necrotizing fasciitis(NF)secondary to hypoproteinemia after spinal tumor resection.Methods:We analyzed the clinical data of a patient with hypoproteinemia and described in detail his symptoms,examination results,and diagnosis.We explored the evaluation method of hypoproteinemia in orthopedic patients and its relationship with adverse postoperative outcomes,including the risk of reoperation and rehospitalization,the impact on postoperative wound healing,and the increased probability of wound infection.We also introduced the symptoms of NF and traditional Chinese medicine treatment methods,including debridement and drainage of NF and corresponding nursing measures.These measures involve wound management,antiinfection treatment,psychological nursing,pain management,complication monitoring and treatment,dietary guidance,etc.TCM nursing includes treatment methods such as hip bath and moxibustion.Results:After careful treatment and nursing,the patient was discharged 36 d after admission.Conclusions:The nursing experience from this case shows that early diagnosis and comprehensive treatment are essential for NF secondary to hypoproteinemia after resection of a spinal tumor.While evaluating and managing hypoproteinemia,it is essential that the postoperative condition of patients must be closely monitored,any occurrence of complications must be dealt with in time,and effective nursing measures,including TCM treatment methods,must be taken to promote the recovery and good prognosis of patients.展开更多
Surgical tumor resection is a common approach to cancer treatment.India Ink tattoos are widely used to aid tumor resection by localizing and mapping the tumor edge at the surface.However,India Ink tattoos are easily o...Surgical tumor resection is a common approach to cancer treatment.India Ink tattoos are widely used to aid tumor resection by localizing and mapping the tumor edge at the surface.However,India Ink tattoos are easily obscured during electrosurgical resection,and fade in intensity over time.In this work,a novel near-infrared(NIR)fluorescent marker is introduced as an alternative.The NIR marker was made by mixing indocyanine green(ICG),biocompatible cyanoacrylate,and acetone.The marking strategy was evaluated in a chronic ex vivo feasibility study using porcine tissues,followed by a chronic in vivo mouse study while compared with India Ink.In both studies,signal-to-noise(SNR)ratios and dimensions of the NIR markers and/or India Ink over the study period were calculated and reported.Electrocautery was performed on the last day of the mouse study after mice were euthanized,and SNR ratios and dimensions were quantified and compared.Biopsy was performed at all injection sites and slides were examined by a pathologist.The proposed NIR marker achieved(i)consistent visibility in the 26-day feasibility study and(ii)improved durability,visibility,and biocompatibility when compared to traditional India Ink over the six-week period in an in vivo mouse model.These effects persist after electrocautery whereas the India Ink markers were obscured.The use of a NIR fluorescent presurgical marking strategy has the potential for intraoperative tracking during long-term treatment protocols.展开更多
BACKGROUND Surgical resection is regarded as the only potentially curative treatment option for patients with metastatic colorectal cancer(CRC).The National Comprehensive Cancer Network clinical practice guidelines do...BACKGROUND Surgical resection is regarded as the only potentially curative treatment option for patients with metastatic colorectal cancer(CRC).The National Comprehensive Cancer Network clinical practice guidelines do not recommend palliative surgery unless there is a risk of severe symptoms.However,accumulating evidence has shown that palliative surgery is associated with more favorable outcomes for patients with metastatic CRC.AIM To investigate the separate role of palliative primary tumor resection for patients with stage IVA(M1a diseases)and stage IVB(M1b diseases)colorectal adenocarcinoma(CRA).METHODS CRA patients diagnosed from 2010 to 2015 with definite M1a and M1b categories according to the 8th edition of American Joint Committee on Cancer staging system were selected from the Surveillance Epidemiology and End Results(SEER)database.To minimize potential selection bias,the data were adjusted by propensity score matching(PSM).Baseline characteristics,including gender,year of diagnosis,age,marital status,primary site,surgical information,race,grade,chemotherapy,and radiotherapy,were recorded and analyzed.Univariate and multivariate analyses were performed to explore the separate role of palliative surgery for patients with M1a and M1b diseases.RESULTS A total of 19680 patients with metastatic CRA were collected from the SEER database,including 10399 cases of M1a diseases and 9281 cases of M1b diseases.Common independent prognostic factors for both M1a and M1b patients included year of diagnosis,age,race,marital status,primary site,grade,surgery,and chemotherapy.After PSM adjustment,3732 and 3568 matched patients in the M1a and M1b groups were included,respectively.Patients receiving palliative primary tumor resection had longer survival time than those without surgery(P<0.001).For patients with M1a diseases,palliative resection could increase the median survival time by 9 mo;for patients with M1b diseases,palliative resection could prolong the median survival time by 7 mo.For M1a diseases,patients with lung metastasis had more clinical benefit from palliative resection than those with liver metastasis(15 mo for lung metastasis vs 8 mo for liver metastasis,P<0.001).CONCLUSION CRA patients with M1a diseases gain more clinical benefits from palliative primary tumor resection than those with M1b diseases.Those patients with M1a(lung metastasis)have superior long-term outcomes after palliative primary tumor resection.展开更多
Background:Several reconstructive techniques have been used to reconstruct scalp defects.Numerous researchers have studied the utilization of bipedicled scalp advancement flaps for scalp defect coverage.In this study,...Background:Several reconstructive techniques have been used to reconstruct scalp defects.Numerous researchers have studied the utilization of bipedicled scalp advancement flaps for scalp defect coverage.In this study,we will assess the adaptability of a bipedicled scalp advancement flap for coverage of huge scalp defects after tumor resection.Methods:This study was performed at the Plastic Surgery Department,Fayoum University Hospital,on 20 patients with huge scalp tumors treated by adequate excision and reconstructed using a bipedicled scalp advancement flap from December 2021 to July 2023.Results:The study was conducted on 20 patients:16(80%)were men and 4(20%)were women presenting with large scalp tumors.The mean age was 57.4 years(33-68 years).The sites of the tumors were 10(50%)occipital,6(30%)parietal,and 4(20%)parieto-occipital.No major complications occurred postoperatively,and the bipedicled flaps survived well in all cases,with no necrosis.Conclusion:Huge scalp defects after tumor resection can be safely reconstructed with a large versatile bipedicled advancement scalp flap,either transversely or longitudinally oriented,with favorable functional results and accepted aesthetic results,apart from the alopecic area over the grafted donor site,which can be treated by tissue expansion if desired later.展开更多
Objective: to analyze the effect of fast recovery surgery (FTS) concept in perioperative nursing intervention and patient satisfaction in laparoscopic adrenal tumor resection. Methods: according to the touch-ball meth...Objective: to analyze the effect of fast recovery surgery (FTS) concept in perioperative nursing intervention and patient satisfaction in laparoscopic adrenal tumor resection. Methods: according to the touch-ball method, 120 patients who underwent laparoscopic adrenal tumor resection in our hospital from April 2018 to June 2021 were divided into an observation group and a control group, with 60 cases in each group. The control group was given routine nursing intervention, while the observation group was combined with the FTS concept on the basis of routine nursing intervention. The clinical indicators, visual analogue scale (VAS) score, psychological state score, complication rate and nursing satisfaction were compared between the two groups. Results: the clinical indicators in the observation group were shorter than those in the control group (P<0.05);the VAS score in the observation group after nursing was lower than that in the control group (P<0.05);the psychological state score in the observation group after nursing was higher than that in the control group (P < 0.05);the incidence of complications in the observation group was lower than that in the control group (P < 0.05);the nursing satisfaction score in the observation group was higher than that in the control group (P < 0.05). Conclusion: the application of FTS concept in the perioperative period for patients undergoing laparoscopic adrenal tumor resection can speed up the patients recovery process, relieve the patients pain, reduce their psychological pressure, and at the same time reduce the risk of postoperative complications, and the patients nursing satisfaction is relatively high. It is recommended for clinical application.展开更多
Objective:To explore the impact of a continuity of care model on negative emotions and self-efficacy in patients undergoing digestive endoscopic tumor resection.Methods:A retrospective analysis was conducted on 80 pat...Objective:To explore the impact of a continuity of care model on negative emotions and self-efficacy in patients undergoing digestive endoscopic tumor resection.Methods:A retrospective analysis was conducted on 80 patients who underwent digestive endoscopic tumor resection in the Gastroenterology Department of Baoying County People’s Hospital between October 2022 and October 2024.Patients were randomly divided into a control group(n=40)and an observation group(n=40)using a random number table.The control group received routine nursing care,while the observation group was additionally provided with continuity of care interventions.After two months of intervention,the negative emotions and self-efficacy of the two groups were compared and statistically analyzed.Results:There was no statistically significant difference in baseline data between the two groups(P>0.05).After two months of intervention,the observation group demonstrated significantly lower HAMD and HAMA scores compared to the control group(both P=0.000),and significantly higher GSES scores(P=0.000).Conclusion:Applying a continuity of care model to patients undergoing digestive endoscopic tumor resection can alleviate negative emotions,enhance self-efficacy,and improve self-care abilities.展开更多
Objective: to explore the effect of operating room nursing on postoperative rehabilitation of patients undergoing laparoscopic colorectal tumor resection. Methods: the study was conducted from January 2019 to December...Objective: to explore the effect of operating room nursing on postoperative rehabilitation of patients undergoing laparoscopic colorectal tumor resection. Methods: the study was conducted from January 2019 to December 2020. The subjects were patients who underwent laparoscopic colorectal tumor resection (n = 80). According to different treatment models, the patients were divided into the control group (n = 40) and the observation group (n = 40) for treatment in the operating room. The incidence of postoperative complications in the two groups was compared. Results: the incidence of postoperative complications was 10.00% in the observation group and 27.50% in the control group, the former was significantly lower than the latter. Conclusion: operating room nursing for patients undergoing laparoscopic colorectal tumor resection can produce better results, reduce the possibility of postoperative complications, and accelerate postoperative rehabilitation of patients. It is worthy of application.展开更多
Objective To observe the supplementary analgesic effect of electroacupuncture and its influence on the maintenance of anesthesia and the speed of recovery of patients undergoing craniotomy. Methods Eighty cases of sup...Objective To observe the supplementary analgesic effect of electroacupuncture and its influence on the maintenance of anesthesia and the speed of recovery of patients undergoing craniotomy. Methods Eighty cases of supratentorial tumor resection were randomly divided into a group A and a group S, 40 cases in each group. All the patients were anesthetized with 2% Sevoflurane. The patients in group A received eleetroacupuneture at Hegu （合谷 LI 4） and Waiguan （外关 TE 5）, Jinmen （金门 BL 63） and Taichong （太冲 LR 3）, Zusanli （足三里 ST 36） and Qiuxtu（丘墟 GB 40） from anesthesia beginning to the end of operation, and in group S without electroacupuncture. tidal Sevoflurane concentration, minimum alveolar concentration （MAC）, bispectral index （BIS） and the information during anesthesia recovery stage were recorded, respectively. Results The end-tidal concentration and MAC of Sevoflurane in group A at all times were significant lower than those in group S （P〈0.05, P〈0.01） with a Sevoflurane saving of 9.62% on average. The BIS in group A during a few phases were higher than that in group S （all P〈0.05）. During anesthesia recovery stage, the time of each phase in group A was significantly shorter than that in group S （all P〈0.01）. No dysphoria and one case with nausea and vomiting were shown in group A, but in group S, 2 patients had dysphoria and 3 patients had nausea and vomiting. Conclusion Electroacupuncture combined with Sevoflurane anesthesia can decrease the dosage of Sevoflurane, shorten the recovery time of anesthesia and improve the quality of anesthesia recovery of the patients undergoing resection of supratentorial tumor.展开更多
Background The impact of the preoperative carbohydrate antigen 125(CA125)level on the survival of metastatic colorectal cancer(CRC)patients undergoing primary tumor resection(PTR)remains uncertain.The aim of this stud...Background The impact of the preoperative carbohydrate antigen 125(CA125)level on the survival of metastatic colorectal cancer(CRC)patients undergoing primary tumor resection(PTR)remains uncertain.The aim of this study was to assess the prognostic value in overall survival(OS)and cancer-specific survival(CSS)between patients with and without an elevated preoperative CA125 level.Methods All metastatic CRC patients receiving PTR between 2007 and 2017 at the Sixth Affiliated Hospital of Sun Yat-sen University(Guangzhou,China)were retrospectively included.OS and CSS rates were compared between patients with and without elevated preoperative CA125 levels.Results Among 326 patients examined,46(14.1%)exhibited elevated preoperative CA125 levels and the remaining 280(85.9%)had normal preoperative CA125 levels.Patients with elevated preoperative CA125 levels had lower body mass index,lower preoperative albumin level,lower proportion of preoperative chemotherapy,higher carcinoembryonic antigen and carbohydrate antigen 19–9(CA19–9)levels,poorer differentiation,and more malignant histopathological type than patients with normal preoperative CA125 levels.In addition,patients with elevated preoperative CA125 levels exhibited more advanced pathological T and N stages,more peritoneal metastasis,and more vessel invasion than patients with normal preoperative CA125 levels.Moreover,the primary tumor was more likely to be located at the colon rather than at the rectum in patients with elevated CA125 levels.Both OS and CSS rates in patients with elevated preoperative CA125 levels were significantly lower than those in patients with normal preoperative CA125 levels.Multivariate Cox regression analysis revealed that an elevated preoperative CA125 level was significantly associated with poor prognosis in metastatic CRC patients undergoing PTR.The hazard ratio(HR)in OS was 2.36(95%confidence interval[CI],1.67–3.33,P<0.001)and the HR in CSS was 2.50(95%CI,1.77–3.55,P<0.001).The survival analysis stratified by peritoneal metastasis also demonstrated that patients with elevated preoperative CA125 levels had lower OS and CSS rates regardless of peritoneal metastasis.Conclusion Based on an analysis of metastatic CRC patients undergoing PTR,an elevated preoperative CA125 level was associated with poor prognosis,which should be taken into consideration in clinical practice.展开更多
Many scientific efforts have been made to penetrate the blood-brain barrier and target glioblastoma cells,but the outcomes have been limited.More attention should be given to local inhibition of recurrence after gliob...Many scientific efforts have been made to penetrate the blood-brain barrier and target glioblastoma cells,but the outcomes have been limited.More attention should be given to local inhibition of recurrence after glioblastoma resection to meet real medical needs.A biodegradable wafer containing the chemotherapeutics carmustine(1,3-bis(2-chloroethyl)-1-nitrosourea,BCNU)was the only local drug delivery system approved for clinical glioblastoma treatment,but with a prolonged survival time of only two months and frequent side effects.In this study,to improve the sustained release and prolonged therapeutic effect of drugs for inhibiting tumor recurrence after tumor resection,both free BCNU and BCNU-poly(lactic-co-glycolic acid)(the ratio of lactic acid groups to glycolic acid groups is 75/25)nanoparticles were simultaneously loaded into natural extracellular matrix hydrogel from pigskin to prepare BCNU gels.The hydrogel was injected into the resection cavity of a glioblastoma tumor immediately after tumor removal in a fully characterized resection rat model.Free drugs were released instantly to kill the residual tumor cells,while drugs in nanoparticles were continuously released to achieve a continuous and effective inhibition of the residual tumor cells for 30 days.These combined actions effectively restricted tumor growth in rats.Thus,this strategy of local drug implantation and delivery may provide a reliable method to inhibit the recurrence of glioblastoma after tumor resection in vivo.展开更多
BACKGROUND Patients with right sided colorectal cancer are known to have a poorer prognosis than patients with left sided colorectal cancer, whatever the cancer stage. To this day, primary tumor resection(PTR) is stil...BACKGROUND Patients with right sided colorectal cancer are known to have a poorer prognosis than patients with left sided colorectal cancer, whatever the cancer stage. To this day, primary tumor resection(PTR) is still controversial in a metastatic, non resectable setting.AIM To explore the survival impact of PTR in patients with metastatic colorectal cancer(mCRC) depending on PTL.METHODS We retrospectively collected data from all consecutive patients treated for mCRC at the Centre Georges Francois Leclerc Hospital. Univariate and multivariate Cox proportional hazard regression models were used to assess the influence of PTR on survival. We then evaluated the association between PTL and overall survival among patients who previously underwent or did not undergo PTR. A propensity score was performed to match cohorts.RESULTS Four hundred and sixty-six patients were included. A total of 153(32.8%) patients had unresected synchronous mCRC and 313(67.2%) patients had resected synchronous mCRC. The number of patients with right colic cancer, left colic cancer and rectal cancer was respectively 174(37.3%), 203(43.6%) and 89(19.1%). In the multivariate analysis only PTL, PTR, resection of hepatic and or pulmonary metastases and the use of oxaliplatin, EGFR inhibitors or bevacizumab throughout treatment were associated to higher overall survival rates. Survival evaluation depending on PTR and PTL found that PTR improved the prognosis of both left and right sided mCRC. Results were confirmed by using a weighted propensity score.CONCLUSION In mCRC, PTR seems to confer a higher survival rate to patients whatever the PTL.展开更多
Background:In stage Ⅳ breast cancer,surgical resection of the primary tumor was traditionally performed solely to palliate symptoms such as bleeding,infection,or pain.The ongoing discussion has shown that there are m...Background:In stage Ⅳ breast cancer,surgical resection of the primary tumor was traditionally performed solely to palliate symptoms such as bleeding,infection,or pain.The ongoing discussion has shown that there are many research gaps in the current literature and differences in clinical practice.Thus,this systematic review and meta-analysis was designed to evaluate how primary tumor resection(PTR)affects the overall survival(OS)of patients with stage Ⅳ breast cancer.Method:A thorough literature search was completed using different databases(PubMed,Google Scholar,Scopus,ScienceDirect,and Cochrane Library)to find papers contrasting PTR with no PTR.The quality of research articles was evaluated using the Cochrane Risk of Bias 2.0 Tool and the Newcastle-Ottawa Scale(NOS).Review Manager 5.4 was used to determine how much demographic and clinical factors contribute to heterogeneity through subgroup and meta-regression analysis.Results:Data derived from 44 observational studies(OS)and four randomized controlled trials(RCTs)including 227,889 patients were analyzed.Of all cases,150,239 patients were included in the non-PTR group,and 70,795 patients in the PTR group(37 observational studies and 4 randomized control trials).The pooled outcomes of four RCT studies(Hazard Ratio(HR)=1.03,95%CI:0.67-1.58;I2=88%;P<0.0001;chi-square 24.57)favor non-PTR.While pooled outcomes of 43 observational studies showed PTR significantly improved OS(HR=0.66,95%CI:0.61-0.71;I2=87%;P<0.00001;chi-square 359.12).Additionally,subgroup analysis that compared PTR with non-PTR in patients with stage IV breast cancer for progression free-survival(HR=0.89,95%CI:0.62-1.28;P=0.03;I2=71%)and locoregional progression-free survival(LPFS)(HR=0.33,95%CI:0.14-0.74;P=0.0004;I^(2)=87%)was found to be significant favoring the PTR group.Distant progression-free survival(DPFS)had a non-significant relationship(HR=0.42,95%CI:0.29-0.60;P=0.12;I^(2)=53%),while overall,there was a significant relationship(HR=0.49,95%CI:0.32-0.75;P<0.00001;I2=90%).Subgroup analysis revealed that PTR is beneficial in patients with bone metastasis(HR=0.83,95%CI:0.68-1.01;P=0.01;I^(2)=56%),with one metastatic site(HR=0.75,95%CI:0.63-0.59;P=0.006;I2=62%),but not in patients with positive margins(HR=0.84,95%CI:0.67-1.06;P=0.07;I^(2)=61%),negative margins(HR=0.61,95%CI:0.59-0.63,P=1.00;I^(2)=0%).Most of the patients in PTR and non-PTR groups belonged to white compared to other ethnic groups.Overall,observational studies were of high quality,while RCTs were of low quality.Conclusion:The current research suggests that PTR may be discussed as a possible option.展开更多
Objective： To observe the advantage of total intravenous anesthesia for transurethral resection of bladder tumor （TURBT）. Methods.. Sixty ASA Ⅰ-Ⅱ patients undergoing TURBT were randomly assigned to 2 groups. Spin...Objective： To observe the advantage of total intravenous anesthesia for transurethral resection of bladder tumor （TURBT）. Methods.. Sixty ASA Ⅰ-Ⅱ patients undergoing TURBT were randomly assigned to 2 groups. Spinal anesthesia with 0. 75% pure bupivacaine （8-12 rag） was applied to patients in Group Ⅰ （n= 30）. Patients in Group Ⅱ （n=30） received total intravenous anesthesia with continuous infusion of Propofol and Remifentanil ; and a laryngeal mask was used to ensure the airway and ventilation. BP, HR, SPO2 and pertinent side effects were monitored and recorded. Results ： The patients in group Ⅱ experienced more stable hemodynamics than those in group Ⅰ . Obturator nerve reflex was observed in 15 （50. 0%） patients in Group Ⅰ , but none （0%） in Group Ⅱ （P〈0. 01）. Conclusion.. Total intravenous anesthesia with laryngeal mask is a safe, reliable, controllable and simple manual for patient undergoing TURBT.展开更多
BACKGROUND Breast cancer is one of the most common malignant tumors in women worldwide and poses a severe threat to their health.Therefore,this study examined patients who underwent breast cancer surgery,analyzed hosp...BACKGROUND Breast cancer is one of the most common malignant tumors in women worldwide and poses a severe threat to their health.Therefore,this study examined patients who underwent breast cancer surgery,analyzed hospitalization costs and structure,and explored the impact of China Healthcare Security Diagnosis Related Groups(CHS-DRG)management on patient costs.It aimed to provide medical institutions with ways to reduce costs,optimize cost structures,reduce patient burden,and improve service efficiency.AIM To study the CHS-DRG payment system’s impact on breast cancer surgery costs.METHODS Using the CHS-DRG(version 1.1)grouping criteria,4073 patients,who underwent the radical resection of breast malignant tumors from January to December 2023,were included in the JA29 group;1028 patients were part of the CHS-DRG payment system,unlike the rest.Through an independent sample t-test,the length of hospital stay as well as total hospitalization,medicine and consumables,medical,nursing,medical technology,and management expenses were compared.Pearson’s correlation coefficient was used to test the cost correlation.RESULTS In terms of hospitalization expenses,patients in the CHS-DRG payment group had lower medical,nursing,and management expenses than those in the diagnosis-related group(DRG)non-payment group.For patients in the DRG payment group,the factors affecting the total hospitalization cost,in descending order of relevance,were medicine and consumable costs,consumable costs,medicine costs,medical costs,medical technology costs,management costs,nursing costs,and length of hospital stay.For patients in the DRG nonpayment group,the factors affecting the total hospitalization expenses in descending order of relevance were medicines and consumable expenses,consumable expenses,medical technology expenses,the cost of medicines,medical expenses,nursing expenses,length of hospital stay,and management expenses.CONCLUSION The CHS-DRG system can help control and reduce unnecessary medical expenses by controlling medicine costs,medical consumable costs,and the length of hospital stay while ensuring medical safety.展开更多
BACKGROUND Intravesical explosion during transurethral resection of bladder tumor(TUR-BT)is a very rare complication,and it may result in rupture of the bladder,which usually requires surgical correction and causes a ...BACKGROUND Intravesical explosion during transurethral resection of bladder tumor(TUR-BT)is a very rare complication,and it may result in rupture of the bladder,which usually requires surgical correction and causes a potential threat to the patient’s life.CASE SUMMARY This paper reports a case of intravesical explosion during TUR-BT.Combined with the literature review,the risk factors are analyzed and measures of prevention and treatment are discussed.CONCLUSION Although rare,intravesical explosions can cause serious consequences,and the loud explosion can also lead to a profound psychological shadow on the patient.Urologists must be aware of this potential complication.Careful operative techniques and special precautions can reduce the risk of this complication.展开更多
Objective To report evaluat of division region of abdominal wall large defect after tumors resection and repair methods by tissue flaps with pedicle. Methods Form October 1992 to September 2001, 8 cases large abdomina...Objective To report evaluat of division region of abdominal wall large defect after tumors resection and repair methods by tissue flaps with pedicle. Methods Form October 1992 to September 2001, 8 cases large abdominal wall defect after malignant tumors resection(10 × 10 cm-32 cm×32 cm) were reviewed. The defectcontributed:Ⅰ region, 2 cases; twin-Ⅱ region, 2; Ⅲ region, 2; Ⅰ and Ⅱ region of one side, 1 and total abdominal wall,one case, The tissue flaps of transposition included: gracilis myocutaneous flaps, 4; retus abdominal myocutaneous flaps, 2; external abdominal obligue musculo-fascia flaps, 2; latissimus dorsi muscle, tensor fasciae latae muscle and retus femoris muscle flaps each, 1. One patient used MycroMesh also. Results In the course of peroperation, the incisions of 8 cases healed in first time; total tissue flaps survived and all pateints started exercise left the bed in 3 weeks. All 8 patients were followed up average of 2 years and 5 months: the success rate of reconstruction展开更多
Objective To observe the effects on functional gastrointestinal motility disorder of postoperation of gastrointestinal tumor treated with electroacupuncture. Methods Twenty-nine cases of functional gastrointestinal mo...Objective To observe the effects on functional gastrointestinal motility disorder of postoperation of gastrointestinal tumor treated with electroacupuncture. Methods Twenty-nine cases of functional gastrointestinal motility disorder of postoperation of gastrointestinal tumor were randomized into electroacupuncture group （19 cases） and control group （10 cases）. In electroacupuncture group, routine treatment after gastrointestinal operation and electroacupucture treatment were applied, Zusanli （足三里 ST 36）, Shangjuxu （上巨虚 ST 37）, Xiajuxu （下巨虚 ST 39） and Hegu （合谷 LI 4） were applied with electroacupuncture; in control group, the routine treatment after gastrointestinal operation was only applied. Anus exhaust, defecation, abdominal distension, stomachache, amount of gastrointestinal decompression drainage and changes of borborygmus were observed in two groups. Results Anus exhaust, defecation, abdominal distension, stomachache, amount of gastrointestinal decompression drainage and changes of borborygmus were relieved in two groups; and the effects of abdominal distension, anus exhaust, defecation, amount of gastrointestinal decompression drainage and borborygmus in electroacupuncture group were superior to those in control group （all P〈0.05）. Conclusion For the functional gastrointestinal motility disorder of postoperation of gastrointestinal tumor, the theraputic effect of electroacupuncture combined with routine treatment after operation is better than the routine treatment after operation.展开更多
Objective To review the methods of the stability reconstruction after resections of primary malignant spinal tumors.Methods From January 1999 to January 2009,38 cases of primary malignant spinal turmors underwenttumor
As a result of the complex anatomy in upper cervical spine, the operative treatment of axis neoplasms is always complicated. Although the procedure for the second cervical vertebra （C2） surgery had been described pr...As a result of the complex anatomy in upper cervical spine, the operative treatment of axis neoplasms is always complicated. Although the procedure for the second cervical vertebra （C2） surgery had been described previously in diverse approaches and reconstruction forms, each has its own limita- tions and restrictions that usually result in less satisfactory conclusions. The purpose of this study was to evaluate the operation efficacy for axis tumors by using a combined anterior （retropharyngeal） cervical and posterior approach in achieving total resection of C2 and circumferential reconstruction. Eight con- secutive C2 tumor patients with mean age of 47.6 years in our institute sequentially underwent vertebra resection and fixation through aforementioned approach from Jan. 2006 to Dec. 2010. No surgical mor- tality or severe morbidity occurred in our group. In terms of complications, 2 cases developed transient difficulty in swallowing liquids （one of them experienced dysphonia） and 1 developed cerebrospinal fluid leakage （CSFL） that was resolved later. During a mean follow-up period of 31.9 months, the visual analogue scale （VAS） and Japanese orthopedic association （JOA） score revealed that the pain level and neurological function in all patients were improved postoperatively, and there was no evidence of fixa- tion failure and local recurrence. It is concluded that the anterior cervical retropharyngeal approach permits a visible exposure to facilitate the C2 vertebra resection and perform an effective anterior re- construction at the same time. The custom-made mesh cage applied in our cases can be acted as a firm and convenient implant in circumferential fixation.展开更多
文摘BACKGROUND Pancreatic neuroendocrine tumors(PNETs)are rare malignancies frequently associated with liver metastases(LM).The benefit of primary tumor resection(PTR)in patients with unresectable LM remains controversial.This study evaluates the impact of PTR on overall survival(OS)and tumor grading by integrating evidence from a systematic review,meta-analysis,and Surveillance,Epidemiology,and End Results(SEER)database analysis.AIM To evaluate the survival benefits of PTR in patients with PNETs and LM.METHODS This study was conducted in accordance with the PRISMA guidelines.A systematic literature search and meta-analysis were performed using five databases:PubMed,Web of Science,EMBASE,Cochrane Library,and CNKI,with records included up to February 2025.A total of 16 studies(n=8761;including 1 prospective and 15 retrospective studies)were included.A random-effects model was applied to pool hazard ratios for OS and odds ratios for tumor grading,with heterogeneity assessed by the I2 statistic.Risk of bias was evaluated using the ROBINS-I tool.In addition,an independent analysis based on the SEER database(n=791)was conducted using Kaplan-Meier survival curves and log-rank tests.RESULTS Meta-analysis results revealed that PTR significantly improved OS in patients showed that neither study design(prospective vs.retrospective)nor sample size(<400 vs≥400)significantly influenced the survival benefit.In terms of tumor grading,no statistically significant difference was observed between the surgical and non-surgical groups(odds ratio=1.60,95%confidence interval:0.70-3.63,P=0.26).Independent analysis of the SEER database(n=791)further confirmed the survival advantage of PTR across different tumor differentiation levels,with significant differences in OS between surgical and non-surgical groups(P<0.05).CONCLUSION PTR significantly improves OS in PNET patients with LM.However,its effect on tumor grading remains unclear,warranting further prospective studies to refine surgical strategies for this population.
文摘Objective:To summarize the nursing experience of a patient with necrotizing fasciitis(NF)secondary to hypoproteinemia after spinal tumor resection.Methods:We analyzed the clinical data of a patient with hypoproteinemia and described in detail his symptoms,examination results,and diagnosis.We explored the evaluation method of hypoproteinemia in orthopedic patients and its relationship with adverse postoperative outcomes,including the risk of reoperation and rehospitalization,the impact on postoperative wound healing,and the increased probability of wound infection.We also introduced the symptoms of NF and traditional Chinese medicine treatment methods,including debridement and drainage of NF and corresponding nursing measures.These measures involve wound management,antiinfection treatment,psychological nursing,pain management,complication monitoring and treatment,dietary guidance,etc.TCM nursing includes treatment methods such as hip bath and moxibustion.Results:After careful treatment and nursing,the patient was discharged 36 d after admission.Conclusions:The nursing experience from this case shows that early diagnosis and comprehensive treatment are essential for NF secondary to hypoproteinemia after resection of a spinal tumor.While evaluating and managing hypoproteinemia,it is essential that the postoperative condition of patients must be closely monitored,any occurrence of complications must be dealt with in time,and effective nursing measures,including TCM treatment methods,must be taken to promote the recovery and good prognosis of patients.
基金This work is spported by the National Istitutes of Health under award rumbers 1RO1BB020610 and R21EB024707spprted by the Intramua Research Progam of the National Insites of Health,Natioial Cancer Istitutet Center for Cancer Reearch.
文摘Surgical tumor resection is a common approach to cancer treatment.India Ink tattoos are widely used to aid tumor resection by localizing and mapping the tumor edge at the surface.However,India Ink tattoos are easily obscured during electrosurgical resection,and fade in intensity over time.In this work,a novel near-infrared(NIR)fluorescent marker is introduced as an alternative.The NIR marker was made by mixing indocyanine green(ICG),biocompatible cyanoacrylate,and acetone.The marking strategy was evaluated in a chronic ex vivo feasibility study using porcine tissues,followed by a chronic in vivo mouse study while compared with India Ink.In both studies,signal-to-noise(SNR)ratios and dimensions of the NIR markers and/or India Ink over the study period were calculated and reported.Electrocautery was performed on the last day of the mouse study after mice were euthanized,and SNR ratios and dimensions were quantified and compared.Biopsy was performed at all injection sites and slides were examined by a pathologist.The proposed NIR marker achieved(i)consistent visibility in the 26-day feasibility study and(ii)improved durability,visibility,and biocompatibility when compared to traditional India Ink over the six-week period in an in vivo mouse model.These effects persist after electrocautery whereas the India Ink markers were obscured.The use of a NIR fluorescent presurgical marking strategy has the potential for intraoperative tracking during long-term treatment protocols.
文摘BACKGROUND Surgical resection is regarded as the only potentially curative treatment option for patients with metastatic colorectal cancer(CRC).The National Comprehensive Cancer Network clinical practice guidelines do not recommend palliative surgery unless there is a risk of severe symptoms.However,accumulating evidence has shown that palliative surgery is associated with more favorable outcomes for patients with metastatic CRC.AIM To investigate the separate role of palliative primary tumor resection for patients with stage IVA(M1a diseases)and stage IVB(M1b diseases)colorectal adenocarcinoma(CRA).METHODS CRA patients diagnosed from 2010 to 2015 with definite M1a and M1b categories according to the 8th edition of American Joint Committee on Cancer staging system were selected from the Surveillance Epidemiology and End Results(SEER)database.To minimize potential selection bias,the data were adjusted by propensity score matching(PSM).Baseline characteristics,including gender,year of diagnosis,age,marital status,primary site,surgical information,race,grade,chemotherapy,and radiotherapy,were recorded and analyzed.Univariate and multivariate analyses were performed to explore the separate role of palliative surgery for patients with M1a and M1b diseases.RESULTS A total of 19680 patients with metastatic CRA were collected from the SEER database,including 10399 cases of M1a diseases and 9281 cases of M1b diseases.Common independent prognostic factors for both M1a and M1b patients included year of diagnosis,age,race,marital status,primary site,grade,surgery,and chemotherapy.After PSM adjustment,3732 and 3568 matched patients in the M1a and M1b groups were included,respectively.Patients receiving palliative primary tumor resection had longer survival time than those without surgery(P<0.001).For patients with M1a diseases,palliative resection could increase the median survival time by 9 mo;for patients with M1b diseases,palliative resection could prolong the median survival time by 7 mo.For M1a diseases,patients with lung metastasis had more clinical benefit from palliative resection than those with liver metastasis(15 mo for lung metastasis vs 8 mo for liver metastasis,P<0.001).CONCLUSION CRA patients with M1a diseases gain more clinical benefits from palliative primary tumor resection than those with M1b diseases.Those patients with M1a(lung metastasis)have superior long-term outcomes after palliative primary tumor resection.
文摘Background:Several reconstructive techniques have been used to reconstruct scalp defects.Numerous researchers have studied the utilization of bipedicled scalp advancement flaps for scalp defect coverage.In this study,we will assess the adaptability of a bipedicled scalp advancement flap for coverage of huge scalp defects after tumor resection.Methods:This study was performed at the Plastic Surgery Department,Fayoum University Hospital,on 20 patients with huge scalp tumors treated by adequate excision and reconstructed using a bipedicled scalp advancement flap from December 2021 to July 2023.Results:The study was conducted on 20 patients:16(80%)were men and 4(20%)were women presenting with large scalp tumors.The mean age was 57.4 years(33-68 years).The sites of the tumors were 10(50%)occipital,6(30%)parietal,and 4(20%)parieto-occipital.No major complications occurred postoperatively,and the bipedicled flaps survived well in all cases,with no necrosis.Conclusion:Huge scalp defects after tumor resection can be safely reconstructed with a large versatile bipedicled advancement scalp flap,either transversely or longitudinally oriented,with favorable functional results and accepted aesthetic results,apart from the alopecic area over the grafted donor site,which can be treated by tissue expansion if desired later.
文摘Objective: to analyze the effect of fast recovery surgery (FTS) concept in perioperative nursing intervention and patient satisfaction in laparoscopic adrenal tumor resection. Methods: according to the touch-ball method, 120 patients who underwent laparoscopic adrenal tumor resection in our hospital from April 2018 to June 2021 were divided into an observation group and a control group, with 60 cases in each group. The control group was given routine nursing intervention, while the observation group was combined with the FTS concept on the basis of routine nursing intervention. The clinical indicators, visual analogue scale (VAS) score, psychological state score, complication rate and nursing satisfaction were compared between the two groups. Results: the clinical indicators in the observation group were shorter than those in the control group (P<0.05);the VAS score in the observation group after nursing was lower than that in the control group (P<0.05);the psychological state score in the observation group after nursing was higher than that in the control group (P < 0.05);the incidence of complications in the observation group was lower than that in the control group (P < 0.05);the nursing satisfaction score in the observation group was higher than that in the control group (P < 0.05). Conclusion: the application of FTS concept in the perioperative period for patients undergoing laparoscopic adrenal tumor resection can speed up the patients recovery process, relieve the patients pain, reduce their psychological pressure, and at the same time reduce the risk of postoperative complications, and the patients nursing satisfaction is relatively high. It is recommended for clinical application.
文摘Objective:To explore the impact of a continuity of care model on negative emotions and self-efficacy in patients undergoing digestive endoscopic tumor resection.Methods:A retrospective analysis was conducted on 80 patients who underwent digestive endoscopic tumor resection in the Gastroenterology Department of Baoying County People’s Hospital between October 2022 and October 2024.Patients were randomly divided into a control group(n=40)and an observation group(n=40)using a random number table.The control group received routine nursing care,while the observation group was additionally provided with continuity of care interventions.After two months of intervention,the negative emotions and self-efficacy of the two groups were compared and statistically analyzed.Results:There was no statistically significant difference in baseline data between the two groups(P>0.05).After two months of intervention,the observation group demonstrated significantly lower HAMD and HAMA scores compared to the control group(both P=0.000),and significantly higher GSES scores(P=0.000).Conclusion:Applying a continuity of care model to patients undergoing digestive endoscopic tumor resection can alleviate negative emotions,enhance self-efficacy,and improve self-care abilities.
文摘Objective: to explore the effect of operating room nursing on postoperative rehabilitation of patients undergoing laparoscopic colorectal tumor resection. Methods: the study was conducted from January 2019 to December 2020. The subjects were patients who underwent laparoscopic colorectal tumor resection (n = 80). According to different treatment models, the patients were divided into the control group (n = 40) and the observation group (n = 40) for treatment in the operating room. The incidence of postoperative complications in the two groups was compared. Results: the incidence of postoperative complications was 10.00% in the observation group and 27.50% in the control group, the former was significantly lower than the latter. Conclusion: operating room nursing for patients undergoing laparoscopic colorectal tumor resection can produce better results, reduce the possibility of postoperative complications, and accelerate postoperative rehabilitation of patients. It is worthy of application.
基金Supported by the National Key Basic Research Program (973 Program): 2007 CB 512503
文摘Objective To observe the supplementary analgesic effect of electroacupuncture and its influence on the maintenance of anesthesia and the speed of recovery of patients undergoing craniotomy. Methods Eighty cases of supratentorial tumor resection were randomly divided into a group A and a group S, 40 cases in each group. All the patients were anesthetized with 2% Sevoflurane. The patients in group A received eleetroacupuneture at Hegu （合谷 LI 4） and Waiguan （外关 TE 5）, Jinmen （金门 BL 63） and Taichong （太冲 LR 3）, Zusanli （足三里 ST 36） and Qiuxtu（丘墟 GB 40） from anesthesia beginning to the end of operation, and in group S without electroacupuncture. tidal Sevoflurane concentration, minimum alveolar concentration （MAC）, bispectral index （BIS） and the information during anesthesia recovery stage were recorded, respectively. Results The end-tidal concentration and MAC of Sevoflurane in group A at all times were significant lower than those in group S （P〈0.05, P〈0.01） with a Sevoflurane saving of 9.62% on average. The BIS in group A during a few phases were higher than that in group S （all P〈0.05）. During anesthesia recovery stage, the time of each phase in group A was significantly shorter than that in group S （all P〈0.01）. No dysphoria and one case with nausea and vomiting were shown in group A, but in group S, 2 patients had dysphoria and 3 patients had nausea and vomiting. Conclusion Electroacupuncture combined with Sevoflurane anesthesia can decrease the dosage of Sevoflurane, shorten the recovery time of anesthesia and improve the quality of anesthesia recovery of the patients undergoing resection of supratentorial tumor.
基金supported by the National Key R&D Program of China[no.2017YFC1308800]the National Natural Science Foundation of China[no.81870383]+1 种基金the Clinical Innovation Research Program of Bioland Laboratory(Guangzhou Regenerative Medicine and Health Guangdong Laboratory)[no.2018GZR0201005]the Science and Technology Planning Project of Guangzhou City[no.201804010014].
文摘Background The impact of the preoperative carbohydrate antigen 125(CA125)level on the survival of metastatic colorectal cancer(CRC)patients undergoing primary tumor resection(PTR)remains uncertain.The aim of this study was to assess the prognostic value in overall survival(OS)and cancer-specific survival(CSS)between patients with and without an elevated preoperative CA125 level.Methods All metastatic CRC patients receiving PTR between 2007 and 2017 at the Sixth Affiliated Hospital of Sun Yat-sen University(Guangzhou,China)were retrospectively included.OS and CSS rates were compared between patients with and without elevated preoperative CA125 levels.Results Among 326 patients examined,46(14.1%)exhibited elevated preoperative CA125 levels and the remaining 280(85.9%)had normal preoperative CA125 levels.Patients with elevated preoperative CA125 levels had lower body mass index,lower preoperative albumin level,lower proportion of preoperative chemotherapy,higher carcinoembryonic antigen and carbohydrate antigen 19–9(CA19–9)levels,poorer differentiation,and more malignant histopathological type than patients with normal preoperative CA125 levels.In addition,patients with elevated preoperative CA125 levels exhibited more advanced pathological T and N stages,more peritoneal metastasis,and more vessel invasion than patients with normal preoperative CA125 levels.Moreover,the primary tumor was more likely to be located at the colon rather than at the rectum in patients with elevated CA125 levels.Both OS and CSS rates in patients with elevated preoperative CA125 levels were significantly lower than those in patients with normal preoperative CA125 levels.Multivariate Cox regression analysis revealed that an elevated preoperative CA125 level was significantly associated with poor prognosis in metastatic CRC patients undergoing PTR.The hazard ratio(HR)in OS was 2.36(95%confidence interval[CI],1.67–3.33,P<0.001)and the HR in CSS was 2.50(95%CI,1.77–3.55,P<0.001).The survival analysis stratified by peritoneal metastasis also demonstrated that patients with elevated preoperative CA125 levels had lower OS and CSS rates regardless of peritoneal metastasis.Conclusion Based on an analysis of metastatic CRC patients undergoing PTR,an elevated preoperative CA125 level was associated with poor prognosis,which should be taken into consideration in clinical practice.
基金supported by the National Natural Science Foundation of China(Grant Nos.82074277,8177391)the Basic Research Cooperation Project of Beijing,Tianjin,Hebei from the Natural Science Foundation of Tianjin(Grant Nos.20JCZXJC00070 and J200018)the Young Elite Scientists Sponsorship Program of Tianjin(Grant No.TJSQNTJ-2017-14).
文摘Many scientific efforts have been made to penetrate the blood-brain barrier and target glioblastoma cells,but the outcomes have been limited.More attention should be given to local inhibition of recurrence after glioblastoma resection to meet real medical needs.A biodegradable wafer containing the chemotherapeutics carmustine(1,3-bis(2-chloroethyl)-1-nitrosourea,BCNU)was the only local drug delivery system approved for clinical glioblastoma treatment,but with a prolonged survival time of only two months and frequent side effects.In this study,to improve the sustained release and prolonged therapeutic effect of drugs for inhibiting tumor recurrence after tumor resection,both free BCNU and BCNU-poly(lactic-co-glycolic acid)(the ratio of lactic acid groups to glycolic acid groups is 75/25)nanoparticles were simultaneously loaded into natural extracellular matrix hydrogel from pigskin to prepare BCNU gels.The hydrogel was injected into the resection cavity of a glioblastoma tumor immediately after tumor removal in a fully characterized resection rat model.Free drugs were released instantly to kill the residual tumor cells,while drugs in nanoparticles were continuously released to achieve a continuous and effective inhibition of the residual tumor cells for 30 days.These combined actions effectively restricted tumor growth in rats.Thus,this strategy of local drug implantation and delivery may provide a reliable method to inhibit the recurrence of glioblastoma after tumor resection in vivo.
文摘BACKGROUND Patients with right sided colorectal cancer are known to have a poorer prognosis than patients with left sided colorectal cancer, whatever the cancer stage. To this day, primary tumor resection(PTR) is still controversial in a metastatic, non resectable setting.AIM To explore the survival impact of PTR in patients with metastatic colorectal cancer(mCRC) depending on PTL.METHODS We retrospectively collected data from all consecutive patients treated for mCRC at the Centre Georges Francois Leclerc Hospital. Univariate and multivariate Cox proportional hazard regression models were used to assess the influence of PTR on survival. We then evaluated the association between PTL and overall survival among patients who previously underwent or did not undergo PTR. A propensity score was performed to match cohorts.RESULTS Four hundred and sixty-six patients were included. A total of 153(32.8%) patients had unresected synchronous mCRC and 313(67.2%) patients had resected synchronous mCRC. The number of patients with right colic cancer, left colic cancer and rectal cancer was respectively 174(37.3%), 203(43.6%) and 89(19.1%). In the multivariate analysis only PTL, PTR, resection of hepatic and or pulmonary metastases and the use of oxaliplatin, EGFR inhibitors or bevacizumab throughout treatment were associated to higher overall survival rates. Survival evaluation depending on PTR and PTL found that PTR improved the prognosis of both left and right sided mCRC. Results were confirmed by using a weighted propensity score.CONCLUSION In mCRC, PTR seems to confer a higher survival rate to patients whatever the PTL.
文摘Background:In stage Ⅳ breast cancer,surgical resection of the primary tumor was traditionally performed solely to palliate symptoms such as bleeding,infection,or pain.The ongoing discussion has shown that there are many research gaps in the current literature and differences in clinical practice.Thus,this systematic review and meta-analysis was designed to evaluate how primary tumor resection(PTR)affects the overall survival(OS)of patients with stage Ⅳ breast cancer.Method:A thorough literature search was completed using different databases(PubMed,Google Scholar,Scopus,ScienceDirect,and Cochrane Library)to find papers contrasting PTR with no PTR.The quality of research articles was evaluated using the Cochrane Risk of Bias 2.0 Tool and the Newcastle-Ottawa Scale(NOS).Review Manager 5.4 was used to determine how much demographic and clinical factors contribute to heterogeneity through subgroup and meta-regression analysis.Results:Data derived from 44 observational studies(OS)and four randomized controlled trials(RCTs)including 227,889 patients were analyzed.Of all cases,150,239 patients were included in the non-PTR group,and 70,795 patients in the PTR group(37 observational studies and 4 randomized control trials).The pooled outcomes of four RCT studies(Hazard Ratio(HR)=1.03,95%CI:0.67-1.58;I2=88%;P<0.0001;chi-square 24.57)favor non-PTR.While pooled outcomes of 43 observational studies showed PTR significantly improved OS(HR=0.66,95%CI:0.61-0.71;I2=87%;P<0.00001;chi-square 359.12).Additionally,subgroup analysis that compared PTR with non-PTR in patients with stage IV breast cancer for progression free-survival(HR=0.89,95%CI:0.62-1.28;P=0.03;I2=71%)and locoregional progression-free survival(LPFS)(HR=0.33,95%CI:0.14-0.74;P=0.0004;I^(2)=87%)was found to be significant favoring the PTR group.Distant progression-free survival(DPFS)had a non-significant relationship(HR=0.42,95%CI:0.29-0.60;P=0.12;I^(2)=53%),while overall,there was a significant relationship(HR=0.49,95%CI:0.32-0.75;P<0.00001;I2=90%).Subgroup analysis revealed that PTR is beneficial in patients with bone metastasis(HR=0.83,95%CI:0.68-1.01;P=0.01;I^(2)=56%),with one metastatic site(HR=0.75,95%CI:0.63-0.59;P=0.006;I2=62%),but not in patients with positive margins(HR=0.84,95%CI:0.67-1.06;P=0.07;I^(2)=61%),negative margins(HR=0.61,95%CI:0.59-0.63,P=1.00;I^(2)=0%).Most of the patients in PTR and non-PTR groups belonged to white compared to other ethnic groups.Overall,observational studies were of high quality,while RCTs were of low quality.Conclusion:The current research suggests that PTR may be discussed as a possible option.
文摘Objective： To observe the advantage of total intravenous anesthesia for transurethral resection of bladder tumor （TURBT）. Methods.. Sixty ASA Ⅰ-Ⅱ patients undergoing TURBT were randomly assigned to 2 groups. Spinal anesthesia with 0. 75% pure bupivacaine （8-12 rag） was applied to patients in Group Ⅰ （n= 30）. Patients in Group Ⅱ （n=30） received total intravenous anesthesia with continuous infusion of Propofol and Remifentanil ; and a laryngeal mask was used to ensure the airway and ventilation. BP, HR, SPO2 and pertinent side effects were monitored and recorded. Results ： The patients in group Ⅱ experienced more stable hemodynamics than those in group Ⅰ . Obturator nerve reflex was observed in 15 （50. 0%） patients in Group Ⅰ , but none （0%） in Group Ⅱ （P〈0. 01）. Conclusion.. Total intravenous anesthesia with laryngeal mask is a safe, reliable, controllable and simple manual for patient undergoing TURBT.
基金Research Center for Capital Health Management and Policy,No.2024JD09.
文摘BACKGROUND Breast cancer is one of the most common malignant tumors in women worldwide and poses a severe threat to their health.Therefore,this study examined patients who underwent breast cancer surgery,analyzed hospitalization costs and structure,and explored the impact of China Healthcare Security Diagnosis Related Groups(CHS-DRG)management on patient costs.It aimed to provide medical institutions with ways to reduce costs,optimize cost structures,reduce patient burden,and improve service efficiency.AIM To study the CHS-DRG payment system’s impact on breast cancer surgery costs.METHODS Using the CHS-DRG(version 1.1)grouping criteria,4073 patients,who underwent the radical resection of breast malignant tumors from January to December 2023,were included in the JA29 group;1028 patients were part of the CHS-DRG payment system,unlike the rest.Through an independent sample t-test,the length of hospital stay as well as total hospitalization,medicine and consumables,medical,nursing,medical technology,and management expenses were compared.Pearson’s correlation coefficient was used to test the cost correlation.RESULTS In terms of hospitalization expenses,patients in the CHS-DRG payment group had lower medical,nursing,and management expenses than those in the diagnosis-related group(DRG)non-payment group.For patients in the DRG payment group,the factors affecting the total hospitalization cost,in descending order of relevance,were medicine and consumable costs,consumable costs,medicine costs,medical costs,medical technology costs,management costs,nursing costs,and length of hospital stay.For patients in the DRG nonpayment group,the factors affecting the total hospitalization expenses in descending order of relevance were medicines and consumable expenses,consumable expenses,medical technology expenses,the cost of medicines,medical expenses,nursing expenses,length of hospital stay,and management expenses.CONCLUSION The CHS-DRG system can help control and reduce unnecessary medical expenses by controlling medicine costs,medical consumable costs,and the length of hospital stay while ensuring medical safety.
文摘BACKGROUND Intravesical explosion during transurethral resection of bladder tumor(TUR-BT)is a very rare complication,and it may result in rupture of the bladder,which usually requires surgical correction and causes a potential threat to the patient’s life.CASE SUMMARY This paper reports a case of intravesical explosion during TUR-BT.Combined with the literature review,the risk factors are analyzed and measures of prevention and treatment are discussed.CONCLUSION Although rare,intravesical explosions can cause serious consequences,and the loud explosion can also lead to a profound psychological shadow on the patient.Urologists must be aware of this potential complication.Careful operative techniques and special precautions can reduce the risk of this complication.
文摘Objective To report evaluat of division region of abdominal wall large defect after tumors resection and repair methods by tissue flaps with pedicle. Methods Form October 1992 to September 2001, 8 cases large abdominal wall defect after malignant tumors resection(10 × 10 cm-32 cm×32 cm) were reviewed. The defectcontributed:Ⅰ region, 2 cases; twin-Ⅱ region, 2; Ⅲ region, 2; Ⅰ and Ⅱ region of one side, 1 and total abdominal wall,one case, The tissue flaps of transposition included: gracilis myocutaneous flaps, 4; retus abdominal myocutaneous flaps, 2; external abdominal obligue musculo-fascia flaps, 2; latissimus dorsi muscle, tensor fasciae latae muscle and retus femoris muscle flaps each, 1. One patient used MycroMesh also. Results In the course of peroperation, the incisions of 8 cases healed in first time; total tissue flaps survived and all pateints started exercise left the bed in 3 weeks. All 8 patients were followed up average of 2 years and 5 months: the success rate of reconstruction
文摘Objective To observe the effects on functional gastrointestinal motility disorder of postoperation of gastrointestinal tumor treated with electroacupuncture. Methods Twenty-nine cases of functional gastrointestinal motility disorder of postoperation of gastrointestinal tumor were randomized into electroacupuncture group （19 cases） and control group （10 cases）. In electroacupuncture group, routine treatment after gastrointestinal operation and electroacupucture treatment were applied, Zusanli （足三里 ST 36）, Shangjuxu （上巨虚 ST 37）, Xiajuxu （下巨虚 ST 39） and Hegu （合谷 LI 4） were applied with electroacupuncture; in control group, the routine treatment after gastrointestinal operation was only applied. Anus exhaust, defecation, abdominal distension, stomachache, amount of gastrointestinal decompression drainage and changes of borborygmus were observed in two groups. Results Anus exhaust, defecation, abdominal distension, stomachache, amount of gastrointestinal decompression drainage and changes of borborygmus were relieved in two groups; and the effects of abdominal distension, anus exhaust, defecation, amount of gastrointestinal decompression drainage and borborygmus in electroacupuncture group were superior to those in control group （all P〈0.05）. Conclusion For the functional gastrointestinal motility disorder of postoperation of gastrointestinal tumor, the theraputic effect of electroacupuncture combined with routine treatment after operation is better than the routine treatment after operation.
文摘Objective To review the methods of the stability reconstruction after resections of primary malignant spinal tumors.Methods From January 1999 to January 2009,38 cases of primary malignant spinal turmors underwenttumor
文摘As a result of the complex anatomy in upper cervical spine, the operative treatment of axis neoplasms is always complicated. Although the procedure for the second cervical vertebra （C2） surgery had been described previously in diverse approaches and reconstruction forms, each has its own limita- tions and restrictions that usually result in less satisfactory conclusions. The purpose of this study was to evaluate the operation efficacy for axis tumors by using a combined anterior （retropharyngeal） cervical and posterior approach in achieving total resection of C2 and circumferential reconstruction. Eight con- secutive C2 tumor patients with mean age of 47.6 years in our institute sequentially underwent vertebra resection and fixation through aforementioned approach from Jan. 2006 to Dec. 2010. No surgical mor- tality or severe morbidity occurred in our group. In terms of complications, 2 cases developed transient difficulty in swallowing liquids （one of them experienced dysphonia） and 1 developed cerebrospinal fluid leakage （CSFL） that was resolved later. During a mean follow-up period of 31.9 months, the visual analogue scale （VAS） and Japanese orthopedic association （JOA） score revealed that the pain level and neurological function in all patients were improved postoperatively, and there was no evidence of fixa- tion failure and local recurrence. It is concluded that the anterior cervical retropharyngeal approach permits a visible exposure to facilitate the C2 vertebra resection and perform an effective anterior re- construction at the same time. The custom-made mesh cage applied in our cases can be acted as a firm and convenient implant in circumferential fixation.
