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@#Objective To compare the differences of clinical effects between the bilateral endoscopic breast reconstruction and the open breast reconstruction. Methods The clinical data of 28 female patients who underwent bilateral breast graft reconstruction in the Department of Breast Surgery of West China Hospital from January 2017 to January 2021 were analyzed retrospectively. The patients were divided into two groups: an endoscopic group (n=12, aged 41.3±8.9 years) and an open group (n=16, aged 41.6±8.8 years). The clinical data of the two groups of patients were compared. Results There was no significant difference in demographic and oncological data between the two groups (P>0.05). There was a significant difference in the implants between the two groups (P=0.008). The operation time (298.2±108.6 min vs. 326.5±95.8 min, P=0.480) and anesthesia time (373.4±91.2 min vs. 400.3±97.1 min, P=0.463) were not significantly different. The total complications (P=0.035) and major complications (P=0.024) in the open group were more than those in the endoscopic group. For the comparison of breast satisfaction, psychosocial well-being and sexual well-being, the scores at six months and one year after surgery were higher in the endoscopic group than those in the open group (P<0.05). Conclusion The endoscopic reconstruction is safe and effective, with high satisfaction rates regarding breast reconstruction and quality of life, and is superior to conventional open surgery.
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@#The conventional total arch replacement (cTAR) with frozen elephant trunk implantation is commonly regarded as the gold standard for aortic pathologies involving ascending aorta and proximal aortic arch. By combining open supra-aortic vessels debranching and emerging endovascular technologies, hybrid arch repair (HAR) has been increasingly performed as a promising alternative in risky patients with comorbidities and frailties. Nevertheless, the advantages or disadvantages of hybrid arch procedures and cTAR in terms of survival and related outcomes remain controversial. This study is aimed to briefly review the role and results of HAR in the management of aortic arch pathology in comparison of contemporary cTAR.
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@#Objective To compare and analyze the treatment effect of thoracoscopic surgery and traditional open surgery on infants with congenital diaphragmatic eventration, and summarize the experience of thoracoscopic surgery in infants with congenital diaphragmatic eventration. Methods We retrospectively analyzed the clinical data of 105 children with congenital diaphragmatic eventration who received operation in the Department of Cardiothoracic Surgery of Children’s Hospital of Chongqing Medical University from January 2010 to January 2019. The patients were divided into an open group and a thoracoscopic group according to the operation methods. There were 41 patients in the thoracoscopic group, including 30 males and 11 females, with an average of 13.42±11.08 months (range: 1 d to 3 years). There were 64 patients in the open group, including 44 males and 20 females, with an average age of 8.21±9.33 months (range: 15.0 d to 1.6 years). The operation time, intraoperative bleeding volume, postoperative mechanical ventilation time, hospital stay and other operation indexes as well as the mortality, recurrence rate and complication rate of the two groups were observed. Results The operation indexes such as operation time, intraoperative bleeding volume, postoperative mechanical ventilation time, thoracic drainage time, CCU stay and hospital stay of the thoracoscopic group were better than those in the open group (P<0.05). There was no statistical difference between two groups in postoperative diaphgram muscles descent, postoperative feeding time or patients needing thoracic drainage (P>0.05). The incidence of postoperative complications in the thoracoscopic group (19.51%) was lower than that in the open group (23.44%, P>0.05), and the difference in mortality and recurrence rate between the two groups was not statistically significant (P>0.05). Conclusion Both thoracoscopic diaphragmatic plication and traditional open surgery can effectively treat congenital diaphragmatic eventration, but compared with traditional open surgery, thoracoscopic diaphragmatic plication has the advantages of shorter operation time, less trauma, more rapid recovery and fewer complications, so it should be the first choice for children with congenital diaphragmatic eventration.
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Objective To compare the effect between Mammotome minimally invasive surgery and traditional surgery in resection of youth giant breast fibroadenoma (YGBF).Methods We randomly selected 73 patients who had YGBF and already accepted surgical treatment in our hospital from Jul.2009 to Jan.2016.The 75 patients recruited from screening programmes were alloted to either treatment according to their choice (37 cases in MS and 38 cases in traditional surgery).The median follow-up was 18 months (from 6 to 36 months).Comparative analysis was done between the two groups in operation time,incision healing time,incision length,intraoperative bleeding,wound infection,subcutaneous hematoma,residual tumor,breast deformation,scar size,and patient satisfaction degree.Results There was no statisticaly significant difference betwen these two groups in operation time,intraoperative blood loss,incision infection,subcutaneous hematoma,or residual tumor (P＞0.05),however,MS group was superior to traditional surgery group in the incision healing time,incision length,breast deformation,scar size and postoperative satisfaction degree,and the difference was statistically significant(P＜ 0.05).Conclusion The advantage of Mammotome minimally invasive operation auxiliary for YGBF is obvious,such as fast wound healing,small incision,infection rate,small breast without deformation and scar etc.,also higher satisfaction degree to the treatment,which is regarded as the preferred surgical treatment for YGBF patients.
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Objective To investigate and compare the clinical efficacy and safety of laparoscopic and traditional open surgery in the rectal cancer surgery.Methods From March 2007 to February 2013,86 patients with radical resection of rectal carcinoma in General Surgery Department of Pinggu District Hospital of Beijing were selected as research objects,according to random number table method,they were divided into laparoscopic group(n=43) and laparotomy group(n=43).The laparoscopic group was given laparoscopic radical resection of rectal cancer,the laparotomy group was given traditional open surgery.The baseline data,operative incision length,intraoperative blood loss,operative time,postoperative hospital stay,total number of lymph nodes cleaning,exhaust time,time to get out of bed,hospitalization expenses,VAS score and postoperative complications between the two groups were observed and compared.And the survival rates of the two groups were compared.Results.The operative incision length of laparoscopic group was shorter than laparotomy group((4.20±1.15) cm vs.(16.53±4.62) cm),the intraoperative blood loss was less than laparotomy group((167.43±16.24) ml vs.(220.74±22.53) ml),postoperative hospital stay,exhaust time,time to get out of bed were shorter than laparotomy group((8.26±2.09) d vs.(13.52±2.97) d,(3.24±1.42) d vs.(4.23±1.60) d,(3.07±0.84) d vs.(4.23±1.29) d),the hospitalization expenses was higher than laparotomy group(all P0.05).The 5 year overall survival rate of laparoscopic group was 52.6%,the laparotomy group was 47.4%,there was no significant difference between the two groups(χ2=0.465,P>0.05).Conclusion The clinical efficacy of laparoscopic and traditional open surgery in the rectal cancer surgery are the same,and laparoscopic radical surgery is safe and effective,it has the advantages of less trauma,less complications and quick recovery,is worth popularizing.
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Objective To investigate curative effect of traditional open surgery and laparoscopic surgery on pediatric patients with cryptorchidism.Methods Sixty cases with cryptorchidism were randomly divided into two groups.Thirty cases in the control group were with open surgery,and 30 cases were given laparoscopic surgery and served as laparoscopic group.Operation time,blood loss,bed time,postoperative hospital stay,evaluating curative effect and complications were recorded.Results Twenty-three cases were unilateral cryptorchidism and 7 cases were bilateral cryptorchidism in laparoscopic group.The blood loss and operating time of patients with unilateral and bilateral cryptorchidism in laparoscopic group were (3.2± 0.5),(5.1 ± 1.4) ml,and (41.1 ± 6.3),(67.3 ± 5.6) min.In the control group,24 cases were with unilateral cryptorchidism,6 patients with bilateral cryptorchidism.The blood loss and operating time of patients with unilateral and bilateral cryptorchidism in control group were (13.4± 1.8) and (17.7 ± 2.1) ml,(56.1 ± 5.7) and (81.2 ± 8.9) min.The differences between groups were statistically significant (t =29.91,27.34,9.67,7.24;P＜ 0.05).The stay bed time and postoperative hospital time in observation group were (2.7±0.6),(4.3±0.9)d,significantly lower than those of the control group ((5.8 ± 0.7),(8.1 ± 0.5) d),and the differences were statistically significant(t =18.42,20.22;P＜0.05).Wound healing in two groups were better during follow-up periods,after operation,B ultrasound showed that 4 cases of poor blood supply,and located in the scrotum testis above middle,inelasti in control group,while there were without abnormal in observation grtoup with scrotal testis at bottom and elastic.The curative effect of observation group was better than that of control group (x2 =2.41,P＜0.05).Three cases of observation group occurred surgical infection.One case was scrotal testes retraction and 2 cases with atrophy,which needed a second operation.The complications occurred number of observation group was significant different from that in control groups(P＜0.05).Conclusion The laparoscopic is with small incision,good curative effect,quick recovery and less complications,and children with less pain,shorter hospitalization time,low cost than traditional open surgery treatment of children with cryptorchidism,which is worth popularizing widely used.
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Objective To compare the traumatic indicators of complete video-assisted thoracoscopic surgery (c-VATS) with traditional open surgery (TOS) for lung cancer patients, and further explore the minimal invasiveness of c-VATS. Methods From January 2010 to February 2013, 45 cases with complete video-assisted thoracoscopic surgery (c-VATS gurop) and 42 cases with traditional open surgery (TOS group) were compared in operation time, intraoperative blood loss, duration of chest drainage, the perioperative cytokine and immune cells (CRP,WBC,N,L),pain score and shoulder function score. Results There was no significant difference between groups in sex, age, pathological type, stage,operating time and the perioperative cytokine and immune cells (CRP, WBC, N, L) ( >0.05);Compared with TOS group, c-VATS group intraoperative blood loss was significantly reduced [(167.4±68.5) mL vs (288.6±84.0) mL, =0.000];Drainage time of TOS group was significantly longer than that of c-VATS group [(4.64±2.10) days vs (3.20±1.20) days, =0.000];The postoperative pain measurements in c-VATS group were less than that in TOS group, but the difference between groups was not significant on postoperative 1 day ( =0.542) and significant on postoperative 3 day,7 day,30 day ( = 0.034, 0.000, 0.000) . Patients activities of daily living scores at postoperative 7 day and 30 day in c-VATS group were significantly better than those in TOS group, with statistically significant differences ( =0.000,0.000) . Conclusion Whether the short-term effect or the long-term results,the VATS lung resection is better than the traditional open surgery. c-VATS resection of lung cancer is more invasive.