ABSTRACT
BACKGROUND: Hepatocellular carcinoma (HCC) is a commonly-seen cancer in the clinical setting. Laparoscopic hepatectomy (LH) and radiofrequency ablation (RFA) are used for the treatment of HCC, yet the effects and safety difference of LH and RFA for HCC treatment need further investigation. METHODS: This study was a retrospective study design. HCC patients treated with LH or RFA in our hospital were identified. All the patients underwent 2-year long follow-up. The characteristics and details of LH and RFA groups during hospitalization were collected and compared. The Kaplan-Meier method was used to calculate the cumulative survival, and the survival curve was drawn and compared. RESULTS: A total of 94 HCC patients were included. The duration of surgery, estimated intraoperative blood loss, pain score on the first day after surgery, time to get out of bed after operation, time to oral eating, aspartate transaminase (AST) on the second day after surgery, C-reactive protein (CRP) on the second day after surgery, total medical cost in RFA group were significantly less than that of LH group (all P<0.05). The incidence of abdominal infection and biliary fistula in RFA group were significantly less than that of LH group (all P<0.05), and there was no significant difference in the incidence of bleeding and pleural effusion between two groups (all P>0.05). The 2-year overall survival and recurrence-free survival of the two groups had no significant statistical difference (all P>0.05). CONCLUSIONS: RFA and LH have similar effects in the treatment of small HCC. And RFA has the advantages of less trauma, shorter operation duration, and quick postoperative recovery.
ABSTRACT
INTRODUCTION: Sepsis commonly results in acute kidney injury (AKI), whereas about 50% of AKI cases are due to sepsis. Sepsis-associated acute kidney injury (SA-AKI) increases morbidity and mortality especially among critically ill patients. This study aims to monitor renal microcirculation perfusion during sepsis using contrast-enhanced ultrasonography (CEUS), and to explore whether CEUS is useful for predicting the development of SA-AKI. METHODS AND ANALYSIS: This prospective observational study will enrol patients who were diagnosed with sepsis-3 definition. The total of septic or septic shock patients were stratified into AKI (including stages 1, 2 and 3) and non-AKI groups according to Kidney Disease Improving Global Outcomes criteria on days 0, 1, 2 and 7 after admission to the emergency intensive care unit, meanwhile, the CEUS technique will be performed to monitor renal microcirculation perfusion. A multivariable model including all CEUS variables were expected to create for predicting the development of AKI during sepsis. Ultrasonography results, demographic information, therapeutic interventions, survival outcomes, laboratory and other clinical datas will also be collected for further analysis. ETHICS AND DISSEMINATION: The study protocol was approved on 2 August 2017 by the Ethics Committee of Sir Run Run Shaw Hospital (Zhejiang University Medical College) (approval number: 2016C91401). The results will be published in a peer-reviewed journal and shared with the worldwide medical community within 2 years after the start of the recruitment. TRIAL REGISTRATION NUMBER: ISRCTN14728986.