Impact of previous upper/lower abdominal surgery on pancreatic surgical outcomes and complications: a propensity score matching study.

PURPOSE: Pancreatic surgery is a complex operation that has been associated with severe intraoperative and postoperative complications, especially in patients with previous abdominal surgery (PAS). Our study aimed to assess the impact of PAS on pancreatic surgery. METHODS: A total of 1430 patients who underwent pancreatic surgery were included in this retrospective study and classified into the following 3 groups: previous upper abdominal surgery (PUAS) (n = 135); previous lower abdominal surgery (PLAS) (n = 161), and no history of abdominal surgery (non-PAS) (n = 1134). Using propensity score matching (PSM), patients were matched to one another at a 1:1:1 ratio with balanced baseline characteristics. Intraoperative factors, surgical complications, hospital costs, and postoperative hospitalization were collected and compared. RESULTS: A longer operative duration was observed in the PUAS group compared to the non-PAS group (187.54 vs. 150.50 min, p = 0.016). The intraoperative blood loss in the PUAS group was significantly higher (193.68 vs. 150.51 and 156.81 mL, p < 0.05), while the intraoperative plasma transfusion volume was higher in PLAS patients than in non-PAS patients (183.8 vs. 102.7 mL, p = 0.008). Intra-abdominal adhesions in PUAS patients were most severe, and non-PAS patients exhibited significantly lower intra-abdominal adhesion grading (p < 0.001). No significant differences were observed in postoperative complications, postoperative histopathology, postoperative hospitalization, or hospital cost. CONCLUSION: PAS has no significant influences on surgical outcomes, and pancreatic surgery is relatively safe in this patient population. A patient history of PAS may prolong operation duration and increase intraoperative blood loss but has no impact on postoperative complications and does not increase the economic burden.

[The rules of acupoint selection of acupuncture for dry eye].

The rules of acupoint selection of acupuncture for dry eye in recent 10 years were summarized to provide reference for clinical treatment. The clinical researches regarding acupuncture for dry eye published from May 5, 2007 to December 1, 2017 were searched in CNKI, WANFANG and VIP database. The acupoint and meridian used and application frequency were analyzed to summarize the rules of acupoint selection. Totally, 52 related clinical papers were collected, involving 60 acupoints, 14 meridians and 5 extra point. The total frequency of acupoints was 541, which were mainly related with the bladder meridian, stomach meridian and gallbladder meridian. In conclusion, the rules of acupoint selection of acupuncture for dry eye highlighted meridians circulation, acupoint combination, and syndrome differentiation.