Synergistic impact of resection margin and microscopic vascular invasion for patients with HBV-related intrahepatic cholangiocarcinoma.

OBJECTIVES: The resection margin (RM) status and microscopic vascular invasion (MVI) are known prognostic factors for intrahepatic cholangiocarcinoma (ICC). An enhanced understanding of their impact on long-term prognosis is required to improve oncological outcomes. METHODS: A total of 711 consecutive patients who underwent curative liver resection for hepatitis B virus-related ICC were retrospectively analyzed. The different impact of the RM status (narrow, <1 cm, or wide, ≥1 cm) and MVI (positive, +, or negative, -) on overall survival (OS) and recurrence-free survival (RFS) were analyzed. RESULTS: The 1-, 3-, and 5-year OS rates were 67.6%, 42.5%, and 33.2% in wide RM & MVI (-), 58.0%, 36.1%, and 26.5% in narrow RM & MVI (-), 51.0%, 27.0%, and 24.3% in wide RM & MVI (+), and 39.0%, 20.4% and 14.3% in narrow RM & MVI (+) (p < 0.001). Multivariate analysis showed that RM & MVI were independent risk factors for the OS and RFS. CONCLUSION: Combined analysis of RM and MVI can better stratify the risks of postoperative death and recurrence in patients with HBV-related ICC, which may help subsequent adjuvant therapy and closer follow-up.

[Clinical observation of combined surgery for cataract and glaucoma: phacoemulsification and viscocanalostomy].

OBJECTIVE: To evaluate the therapeutic effects and safety of phacoemulsification-intraocular lens (IOL) implantation combined with viscocanalostomy (V-P) and compared the outcomes of phacoemulsification-IOL implantation combined with trabeculectomy (T-P). METHODS: Combined phacoemulsification with corneal incision, foldable intraocular lens implantation and viscocanalostomy was performed in 30 eyes of 28 cataract patients with primary open-angle glaucoma. RESULTS: Follow-up was performed up to 6 months after surgery. The mean intraocular pressure (IOP) of V-P group was (14.65 +/- 2.70) mm Hg (1 mm Hg = 0.133 kPa) with a mean pressure reduction of 10.33 mm Hg compared with IOP before the operation (P = 0.000). There were no statistical differences of the IOP within two groups during postoperative 1 week, 1 and 6 month (P = 0.661, 0.381, 0.526). Postoperatively, the best corrected visual acuities of V-P group were > or = 0.5 in 18 eyes (follow-up 29 eyes, 62.1%), 20 eyes (28 eyes, 71.4%), 24 eyes (30 eyes, 80.0%) at 1 week, 1 month and 6 months, but no statistical difference with T-P group, (P = 0.621, 0.702, 0.893). Complications of V-P group included: Descemet's membrane puncture 2 eyes (6.7%), Schlemm's tube puncture 2 eyes (6.7%) and IOP spikes 4 eyes (13.3% at 24 hours postoperatively). The V-P group showed a significantly less inflammation, hyphema and choroidal detachment than that in the T-P group. CONCLUSIONS: Phacoemulsification-IOL implantation combined with viscocanalostomy is a safe and efficacious surgery with lower complications.