ABSTRACT
Objective:To investigate the application value of right minimal invasive three-port technique of laparoscopic sleeve gastrectomy (RMIT-LSG) for the treatment of obesity.Methods:The retrospective and descriptive study was conducted. The clinical data of 66 obesity patients who underwent RMIT-LSG in the Sir Run Run Shaw Hospital of Zhejiang University School of Medicine from January to October 2021 were collected. There were 15 males and 51 females, aged 28.5(range, 16.0?54.0)years. The body mass index (BMI) of the 66 patients was (36.9±4.3)kg/m 2. There were 20 of the 66 patients combined with type 2 diabetes. Observation indicators: (1) surgical situations; (2) postoperative situations; (3) follow-up. Follow-up was conducted using outpatient examination or the WeChat to detect postoperative recovery of patients including body mass changing, BMI and complications 6 months after operation. The follow-up was up to December 2021. Measurement data with normal distribution were represented as Mean± SD. Measurement data with skewed distribution were represented as M(range). Count data were described as absolute numbers. Results:(1) Surgical situations. All the 66 patients underwent RMIT-LSG successfully, without conversion to laparotomy or changing surgical method. The operation time and the volume of intraoperative blood loss of the 66 patients were (132±22)minutes and (14±8)mL, respectively. (2) Postoperative situations. The time to postoperative initial out-of-bed activities, time to postoperative first flatus, time to postoperative initial water intake, time to postoperative initial liquid food intake and duration of postoperative hospital stay of the 66 patients were (15±6)hours, (1.80±0.60)days, (1.00±0.20)days, (2.00±0.20)days and (3.40±0.60)days, respectively. Of the 66 patients, one case underwent post-operative abdominal hemorrhage at postoperative day 1 and received a second surgery for hemostasis. The patient with postoperative abdominal hemorrhage and other 65 patients recovered well without gastroparesis, gastric fistula, abdominal infection and other complication. (3) Follow-up. All the 66 patients were followed up for 6(range, 1?11)months. All the 66 patients completed the postoperative scar photography at postoperative 1 month, and results of scar photography showed concealed scar with good cosmetic effects. Twenty-seven of the 66 patients were followed up for 6 months after operation, with the weight loss, percentage of weight loss and decrease of BMI were (42±7)kg, 34.8%±2.9%, (14.2±1.9)kg/m 2, respectively. None of the 66 patient had innutrition during the follow-up. Conclusion:The RMIT-LSG is safe and feasible for the treatment of obesity, with a good cosmetic effect of the wound.
ABSTRACT
Objective: To investigate the clinical characteristics, diagnosis, treatment, and prognostic factors of pancreatic neuroendocrine neoplasms (PNENs). Methods: From August 2004 to August 2016, the clinical data of 63 patients with PNENs in the Sir Run Run Shaw Hospital, an affiliate of the Zhejiang University School of Medicine, were retrospectively analyzed. The data included age, gender, function, tumor location, tumor size, pathological characteristics, lymph nodes, metastasis, and treatment. Association of these factors with PNEN prognosis was proven by univariate analysis and multivariate analysis. Results: In our study, the patients' overall survival time was between 5 and 127 months; the median time was about 46.6 months. Moreover, the survival rates in three years and five years are 88.8％ and 84.1％ respectively. Univariate analysis showed that factors such as lymph node metastasis, liver metastasis, vascular invasion, TNM staging and pathological grading, and radical operation were associated with prognosis (P<0.05). We did not prove any of the factors to be an independent factor associated with poor short-term outcome by multivariate analysis. Conclusion: PNENs are rare low-grade malignant tumors with heterogeneity, which is why they can be erroneously diagnosed. AJCC TNM staging in 2017 and the WHO pathological classification in 2010 can actively guide the prognosis evaluation. The lymph node metastasis, liver metastasis,and vascular invasion affected the prognosis of PNENs. Patients with radical operation had improved prognosis.