Comparison of prolonged postoperative ileus between laparoscopic right and left colectomy under enhanced recovery after surgery: a propensity score matching analysis.

BACKGROUND: There were differences in the recovery of bowel function and prolonged postoperative ileus (PPOI) between laparoscopic right colectomy (RC) and left colectomy (LC) under the guidance of enhanced recovery after surgery. METHODS: We selected 870 patients who underwent elective laparoscopic colectomy from June 2016 to December 2021, including 272 patients who had RC and 598 who had LC. According to 1:1 proportion for propensity score matching and correlation analysis, 247 patients who had RC and 247 who had LC were finally enrolled. RESULTS: The incidence of PPOI in all patients was 13.1%. Age, sex, smoking habit, preoperative serum albumin level, operation type, and operation time were the important independent risk factors based on multivariate logistic regression and correlation analysis for PPOI (p<0.05). Age, sex, body mass index, preoperative serum albumin level, operation time, and degree of differentiation between the two groups were significantly different before case matching (p<0.05). There were no statistically significant differences in baseline characteristics and preoperative biochemical parameters between the two groups after case matching (p>0.05). The incidence of PPOI in patients who had RC was 21.9%, while that in patients who had LC was 13.0%. The first flatus, first semi-liquid, and length of stay in LC patients were lower than those in RC patients (p<0.05). CONCLUSION: The return of bowel function in LC was faster than that in RC, and the incidence of PPOI was relatively lower. Therefore, caution should be taken during the early feeding of patients who had laparoscopic RC.

Development of an individualized model for predicting postoperative delirium in elderly patients with hepatocellular carcinoma.

Postoperative delirium (POD) is a common complication in older patients with hepatocellular carcinoma (HCC) that adversely impacts clinical outcomes. We aimed to evaluate the risk factors for POD and to construct a predictive nomogram. Data for a total of 1481 older patients (training set: n=1109; validation set: n=372) who received liver resection for HCC were retrospectively retrieved from two prospective databases. The receiver operating characteristic (ROC) curve, calibration plot, and decision curve analysis (DCA) were used to evaluate the performance. The rate of POD was 13.3% (148/1109) in the training set and 16.4% (61/372) in the validation set. Multivariate analysis of the training set revealed that factors including age, history of cerebrovascular disease, American Society of Anesthesiologists (ASA) classification, albumin level, and surgical approach had significant effects on POD. The area under the ROC curves (AUC) for the nomogram, incorporating the aforementioned predictors, was 0.798 (95% CI 0.752-0.843) and 0.808 (95% CI 0.754-0.861) for the training and validation sets, respectively. The calibration curves of both sets showed a degree of agreement between the nomogram and the actual probability. DCA demonstrated that the newly established nomogram was highly effective for clinical decision-making. We developed and validated a nomogram with high sensitivity to assist clinicians in estimating the individual risk of POD in older patients with HCC.

A predictive nomogram model for low anterior resection syndrome after rectal cancer resection.

BACKGROUND: The aim of this study was to identify risk factors associated with the low anterior resection syndrome (LARS) and to construct a nomogram capable of predicting the risk of LARS in patients who undergo rectal cancer resection. METHODS: About 538 patients who had undergone anterior resection were recruited as a development set. In addition, 114 patients with rectal cancer were analysed as a validation set to test the new nomogram. Patients in the development set were grouped into two separate cohorts: those with major LARS and those with minor or no LARS. Multiple logistic regression was conducted to detect risk factors for major LARS. RESULTS: The prevalence of major LARS was 40.7%, of minor LARS was 28.6% and the proportion with no LARS was 30.7% in the development set. In multivariate analysis, female gender, preoperative chemoradiation, low tumour height, diverting ileostomy, postoperative anastomotic leakage were shown to be independently associated with major LARS occurring in patients after rectal cancer resection. The area under the curve (AUC) values of the nomogram were 0.726 (95% CI: 0.682-0.769) and 0.750 (95% CI: 0.655-0.845) in the development and validation sets, respectively. The calibration curves and Hosmer-Lemeshow goodness of fit tests showed that the model was acceptably accurate. CONCLUSION: A nomogram model based on risk factors could be valuable as a predictor of the probability of major LARS after rectal cancer surgery, and provides a guide that clinical staff can use to take preventive measures for high-risk patients.

Chitosan cross-linked graphene oxide/lignosulfonate composite aerogel for enhanced adsorption of methylene blue in water.

Graphene oxide (GO)/polymer composites have received wide interests in adsorption of pollutants in water. However, the use of synthetic polymers and toxic cross-linking agents impacts the environment. Herein, a new GO/lignosulfonate aerogel (GLCA) cross-linked by chitosan was prepared without using any toxic chemicals. Characterizations by scanning electron microscopy, Fourier transform infrared spectroscopy, X-ray photoelectron spectroscopy, Raman spectroscopy, and X-ray diffraction confirmed the three-dimensional porous structure and diverse functionalities of GLCA. The adsorption performance of GLCA to methylene blue (MB) was investigated by varying pH, dosage, contacting time, temperature and initial concentration. The obtained GLCA could capture MB molecules efficiently and over 99% MB could be removed from a MB solution (100 mg/L). The maximum adsorption capacity of MB onto GLCA was 1023.9 mg/g, higher than other reported GO/polymer composites and activated carbon. Adsorption thermodynamic analysis revealed the adsorption of MB on GLCA was spontaneous and endothermic. The interaction mechanisms involved electrostatic attraction, π-π interaction and hydrogen bond between GLCA and MB. Moreover, GLCA could be regenerated by washing with HCl solution and ethanol for multiple usage. Overall, this study indicated the GLCA could be an eco-friendly, cost-effective and recyclable adsorbent for the removal of dyes from water.

Effect of straight-chain alcohols on the physicochemical properties of calcium lignosulfonate.

Lignosulfonate is an anionic surfactant from pulp processing industries. Alcohols are often used as cosurfactants in the application of surfactant. The improvement of straight-chain alcohols with different alkyl chain lengths as cosurfactant on the physicochemical properties of calcium lignosulfonate (CL) aqueous solution has been investigated. The results indicate that small amounts of straight-chain alcohols with longer alkyl chains are helpful in improving the surface activity of CL, especially when the number of carbon atoms in alcohols is 10 or larger. The adsorption amount of CL solutions with additives of longer chain alcohols on TiO(2) particles increases greatly, and the zeta potential of TiO(2) particles adsorbing CL rises significantly. It can be concluded that there is a cooperative effect of the longer chain alcohols on lignosulfonate to form a tighter adsorption layer at the interface. The steric hindrance increases with the increasing amount of adsorption, and the static repulsive force increases with the increasing zeta potential. Therefore, the effect of CL on the stability of the TiO(2) suspension is enhanced dramatically by addition of longer chain alcohols. This understanding can lead to further development in expanding the functionalities of the lignosulfonate through manipulation of the adsorption capacity of CL on solid particles and enhance the dispersive ability of CL on solid suspensions by adding longer straight-chain alcohols.