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Romanian Surgery between Tradition and Innovation: The Priorities of the 2024-2028 Mandate at the Romanian Society of Surgery. 罗马尼亚外科介于传统与创新之间:罗马尼亚外科学会 2024-2028 年任期的优先事项。
IF 0.8 Q4 SURGERY Pub Date : 2024-08-01 DOI: 10.21614/chirurgia.3030
Viorel Scripcariu

img src="/images/viorel_scripcariu.jpg" alt="Viorel Scripcariu" style="float: right;max-width: 30%;"/ Assuming the leadership of the Romanian Society of Surgery for the next four years is for me a moment of deep significance and responsibility. With a tradition of almost 130 years, this organization is at the foundation of the Romanian surgeon community, and my role is to continue this legacy and open new paths for the future of Romanian surgery. I would like to share the priorities I have set for this mandate, given our shared commitment to promote excellence in surgical practice and to respond to contemporary challenges. An essential aspect of my mandate is to respect the rich tradition and history of Romanian surgery. The Romanian Society of Surgery was founded at the end of the 19th century in Bucharest, with the surgeon Constantin Severeanu at its head. At the meeting on January 27, 1899, the society constituted its first board, with Thoma Ionescu as president, together with other founding members such as Dr. Leonte, Dr. Racoviceanu-Pitesti, Dr. Duma and Dr. Staicovici. Over the years, numerous meetings were organized at the Institute of Topographic Anatomy in Bucharest, where clinical cases, new surgical methods and lectures by medical personalities from abroad were presented. Over the years, the society has continued to promote international collaboration, organizing congresses and inviting renowned surgeons from abroad to lecture and perform innovative surgery in Romania. This rich history and respect for traditional values are fundamental to preserving and enhancing the standards of excellence we have inherited. We will continue our efforts to honor our mentors and their achievements, ensuring that their legacy will continue to inspire and guide new generations of Romanian surgeons. [ a href="https://revistachirurgia.ro/pdfs/2024-4-357.pdf" read more /a ].

img src="/images/viorel_scripcariu.jpg" alt="Viorel Scripcariu" style="float: right;max-width: 30%;"/未来四年担任罗马尼亚外科学会的领导职务对我来说意义重大,责任重大。该组织拥有近 130 年的传统,是罗马尼亚外科医生团体的基础,而我的职责就是继承这一传统,为罗马尼亚外科的未来开辟新的道路。鉴于我们共同致力于促进卓越的外科实践和应对当代挑战,我想与大家分享我为这项任务设定的优先事项。我的任务的一个重要方面是尊重罗马尼亚外科丰富的传统和历史。罗马尼亚外科学会于 19 世纪末在布加勒斯特成立,由外科医生 Constantin Severeanu 领导。在 1899 年 1 月 27 日的会议上,学会成立了第一届理事会,由 Thoma Ionescu 担任主席,其他创始成员包括 Leonte 医生、Racoviceanu-Pitesti 医生、Duma 医生和 Staicovici 医生。多年来,该学会在布加勒斯特地形解剖研究所组织了多次会议,会上介绍了临床病例、新的手术方法以及国外医学人士的讲座。多年来,该学会不断促进国际合作,组织大会,邀请国外知名外科医生来罗马尼亚讲学和开展创新手术。这种丰富的历史和对传统价值观的尊重是我们保持和提高所继承的卓越标准的根本。我们将继续努力,向我们的导师及其成就致敬,确保他们的遗产将继续激励和指导新一代罗马尼亚外科医生。[ a href="https://revistachirurgia.ro/pdfs/2024-4-357.pdf" read more /a ].
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引用次数: 0
Case Report: An Unreported Presentation of Lemmel Syndrome Highlighting Diagnostic Challenges of Duodenal Masses. 病例报告:未报告的莱姆梅尔综合征病例,凸显十二指肠肿块的诊断难题。
IF 0.8 Q4 SURGERY Pub Date : 2024-08-01 DOI: 10.21614/chirurgia.119.eC.2998
Océane Wautelet, Nicolas Tinton, Emanuel Cambier, Francisco da Rocha

We present a case involving a 67-year-old patient with a medical history of gastric bypass who was recently diagnosed with a 6-centimeter duodenal mass causing biliary duct stenosis. Despite our best efforts, we were unable to access this tumor endoscopically, necessitating surgical intervention. During the surgical exploration, we discovered a duodenal diverticulum filled with stones, leading to the obstruction of the biliary ductâ?"a manifestation of Lemmel syndrome. This rare condition is characterized by obstructive jaundice in the absence of choledocholithiasis or tumors and is secondary to dilatation of peri-ampullary diverticula. While it is typically managed through endoscopy, our diagnostic and therapeutic approach was complicated by the patient's history of bariatric surgery (gastric bypass), making endoscopic access impossible despite our multiple attempts. This case report sheds light on the challenges posed by the concurrence of a rare pathology and surgically modified anatomy, which is increasingly encountered in daily surgical practice. In such situations, exploratory surgery continues to play a significant role.

我们介绍了一个病例,患者 67 岁,有胃旁路手术病史,最近被诊断出患有一个 6 厘米的十二指肠肿块,导致胆管狭窄。尽管我们尽了最大努力,但仍无法在内镜下探查到该肿瘤,因此必须进行手术治疗。在手术探查过程中,我们发现十二指肠憩室内充满结石,导致胆管阻塞,这是莱姆尔综合征的一种表现。这种罕见病症的特点是在没有胆总管结石或肿瘤的情况下出现梗阻性黄疸,继发于胰腺周围憩室的扩张。虽然这种疾病通常通过内镜检查进行治疗,但由于患者曾接受过减肥手术(胃旁路手术),尽管我们多次尝试,但内镜检查仍无法进入,这使得我们的诊断和治疗方法变得更加复杂。本病例报告揭示了罕见病理和手术改变解剖结构同时存在所带来的挑战,这种情况在日常手术实践中越来越多地遇到。在这种情况下,探查手术将继续发挥重要作用。
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引用次数: 0
Evaluating VATS versus Open Surgery for Non-Small Cell Lung Cancer: A 5-year Retrospective Study. 评估非小细胞肺癌 VATS 与开放手术:五年回顾性研究
IF 0.8 Q4 SURGERY Pub Date : 2024-08-01 DOI: 10.21614/chirurgia.2999
Alin Ionut Burlacu, Bogdan Cosmin Tanase, Iolanda Augustin, Gabriel Veniamin Cozma

Background and objectives: The efficacy and safety of video-assisted thoracoscopic surgery (VATS) versus open thoracotomy in the treatment of non-small cell lung cancer (NSCLC) were evaluated with a focus on mediastinal lymph node dissection, postoperative recovery, and longterm outcomes including survival rates and disease-free intervals. Materials and Methods: This retrospective study analyzed data from 228 NSCLC patients treated at the Institute of Oncology Bucharest from 2016 to 2022. Both VATS and open surgical approaches were compared, with variables including demographic data, comorbidities, surgical outcomes, and postoperative complications meticulously recorded. Statistical significance was assessed using chi-square and independent samples t-tests. Results: Among the findings, VATS demonstrated significantly better two-year progression-free survival rates for patients in early stages (Stages 1-3) of NSCLC compared to open surgery, with p-values 0.01 and 0.001, respectively. In contrast, no significant difference was observed in Stage 4. Furthermore, VATS resulted in shorter operative times (mean 299 vs. 347 minutes, p 0.001), less estimated blood loss (98.68 mL vs. 160.88 mL, p 0.001), reduced chest tube duration (5.78 days vs. 12.17 days, p 0.001), and decreased hospital stays (12.0 days vs. 27.7 days, p 0.001). Conclusions: VATS is associated with improved long-term disease-free survival for early-stage NSCLC and more favorable short-term surgical outcomes, highlighting its advantages over open thoracotomy. Despite its benefits, VATS did not significantly reduce postoperative complications compared to open surgery.

背景和目的:评估视频辅助胸腔镜手术(VATS)与开胸手术治疗非小细胞肺癌(NSCLC)的疗效和安全性,重点关注纵隔淋巴结清扫、术后恢复以及包括生存率和无病间隔期在内的长期疗效。材料和方法:这项回顾性研究分析了布加勒斯特肿瘤研究所从2016年至2022年治疗的228名NSCLC患者的数据。比较了 VATS 和开放手术两种方法,并详细记录了人口统计学数据、合并症、手术结果和术后并发症等变量。统计意义采用卡方检验和独立样本 t 检验进行评估。结果研究结果表明,与开放手术相比,VATS 手术对早期(1-3 期)NSCLC 患者的两年无进展生存率明显更高,P 值分别为 0.01 和 0.001。相比之下,第 4 期患者则无明显差异。此外,VATS 手术时间更短(平均 299 分钟对 347 分钟,P 0.001),估计失血量更少(98.68 毫升对 160.88 毫升,P 0.001),胸管插管时间更短(5.78 天对 12.17 天,P 0.001),住院时间更短(12.0 天对 27.7 天,P 0.001)。结论:与开胸手术相比,VATS 可提高早期 NSCLC 的长期无病生存率,并获得更有利的短期手术效果,这凸显了它的优势。与开胸手术相比,VATS 尽管有其优势,但并不能显著减少术后并发症。
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引用次数: 0
Splenic Hydatid Cysts Treated by Partial Splenectomy: Case Series and Literature Review. 通过部分脾切除术治疗脾水囊肿:病例系列和文献综述。
IF 0.8 Q4 SURGERY Pub Date : 2024-08-01 DOI: 10.21614/chirurgia.3010
Beatrice M Tivadar, Corina E Minciună, Cătălin Vasilescu

Purpose: Hydatic cysts (HC) rarely occur primarily in the spleen. Partial splenectomy (PS) is an established procedure for preserving spleen parenchyma, but rarely used in the treatment of HC. We aim to present our experience with PS for HC and to review the literature of splenic HC treated by PS. Material and Methods: The databases of PS performed between 2000 and 2023 in the Department of General Surgery of Fundeni Clinical Institute (Bucharest) for HC have been reviewed retrospectively. Searching the PubMed, Medline, and Google Scholar databases for keywords such as "partial splenectomy", "splenic hydatid cyst" etc, we retrieved publications from 2000 to December 2023 in English for a literature review. We excluded studies which were not published in English and studies which did not provide accurate or specific data regarding the treatment of splenic HC by PS. Results: There were 10 PS for HC. Six females and 4 males, ages between 16 and 41 (31Ã+-8.43), 9 with HC in the upper splenic pole (UP) treated by PS with lower pole (LP) preservation and one inferior pole HC treated by LP PS. There were 4 open, 2 laparoscopic and 4 robotic PS. There were no complications or recurrences at follow up (2 years). The literature review consists of 14 full-text articles, presenting 42 PS for HC.

Conclusion: PS for HC is feasible, achieves complete removal of the cyst, while preserving splenic function. The procedure can be performed laparoscopically or robotically with the advantages of minimally invasive surgery.

目的:水肿性囊肿(HC)很少主要发生在脾脏。脾脏部分切除术(PS)是一种保留脾脏实质的成熟手术,但很少用于治疗水样囊肿。我们旨在介绍 PS 治疗 HC 的经验,并回顾 PS 治疗脾脏 HC 的文献。材料和方法:我们回顾性地查阅了 2000 年至 2023 年间布加勒斯特 Fundeni 临床研究所普外科对 HC 进行 PS 治疗的数据库。我们在 PubMed、Medline 和 Google Scholar 数据库中搜索了 "脾部分切除术"、"脾包虫囊肿 "等关键词,检索了 2000 年至 2023 年 12 月期间发表的英文文献,并进行了文献综述。我们剔除了非英文发表的研究,以及未提供有关 PS 治疗脾水样囊肿的准确或具体数据的研究。结果:共有 10 篇 PS 治疗脾脏积液的文献。6名女性和4名男性,年龄在16-41岁(31+-8.43)之间,9名脾上极(UP)HC患者接受了保留脾下极(LP)的PS治疗,1名脾下极(LP)HC患者接受了LP PS治疗。其中4例采用开腹PS,2例采用腹腔镜PS,4例采用机器人PS。随访(2 年)期间无并发症或复发。文献综述包括14篇全文文章,介绍了42例PS治疗HC的情况:结论:HC PS 手术是可行的,可以完全切除囊肿,同时保留脾脏功能。该手术可通过腹腔镜或机器人进行,具有微创手术的优势。
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引用次数: 0
The Banaras Convention: A Safe and Reliable Technique for Axillary Dissection by Lateral exposure of Latissimus Dorsi Pedicle. 巴纳拉斯公约:一种安全可靠的腋窝解剖技术,通过外侧暴露背阔肌蒂。
IF 0.8 Q4 SURGERY Pub Date : 2024-08-01 DOI: 10.21614/chirurgia.3021
Mayank Tripathi, Kumar Vineet, Piyush K Shukla, Ravinder Kumar, Nitesh Joshi, Neha Mishra

Breast cancer is rising among women in India. Most of the cases are presented at the locally advanced stage where axillary dissection is needed. In this article, we have described our approach of axillary dissection in the technically challenging high nodal burden axillas.

印度妇女患乳腺癌的人数不断上升。大多数病例都处于局部晚期,需要进行腋窝清扫术。在本文中,我们介绍了在高结节负荷腋窝中进行腋窝解剖的技术难度。
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引用次数: 0
Ovarian Carcinoma: A Single-Centre Eight-Year Case-Series Study with Survival Analysis. 卵巢癌:一项为期八年的单中心病例系列研究及生存分析。
IF 0.8 Q4 SURGERY Pub Date : 2024-08-01 DOI: 10.21614/chirurgia.3025
George Daniel Subtirelu, Andreea Steriu, Eugen Bratucu

Introduction: This research describes an eight-year case-series of ovarian carcinoma by surgical (pTNM) staging and surgical procedure, explores the characteristics of ovarian surface epithelial cell (OSEC) tumours by histopathological type in a single centre of reference. Material and Methods: survival analysis with overall survivor probabilities for n=263 patients for 12 months and 60-month tumour free survival status (TFS). Results by staging (pTNM stage classification), histotype and for poor surgical candidate (PSC) status are shown. Histotype high grade serous carcinoma (HGSC) was the most frequently diagnosed type (63%). Results: 12-month survivor probabilities according to histotype, rank as follows: clear cell carcinoma (CCC) - 14%; rare carcinoma (RC) - 15%; carcinosarcoma (CS) - 29%; HGSC - 46%; low grade serous carcinoma (LGSC) - 74%; endometrioid carcinoma (EC) - 79%; mucinous carcinoma (MC) - 80% and borderline tumours (BLT) - 94%. At 60 months results are: RC and MC - 0%; CCC - 14%; HGSC - 16%; CS - 29%; LGSC - 62%; EC - 66%; and BLT - 94%. Overall median survival time is 26 months (CI95% 15 to 37); and 20 months when BLT excluded (CI95% CI 15 to 25). Conclusions: These results may guide further research for the OSEC pathology and its histotypes.

导言:本研究描述了一项为期八年的卵巢癌病例系列研究,通过手术(pTNM)分期和手术过程,探讨了单个参考中心卵巢表面上皮细胞(OSEC)肿瘤的组织病理学类型特征。材料与方法:对 263 名患者进行 12 个月和 60 个月无瘤生存状态(TFS)的总生存概率生存分析。结果按分期(pTNM 分期分类)、组织型和不良手术候选者(PSC)状态显示。组织型高级别浆液性癌(HGSC)是最常见的诊断类型(63%)。结果根据组织类型,12 个月的存活概率排名如下:透明细胞癌 (CCC) - 14%;罕见癌 (RC) - 15%;癌肉瘤 (CS) - 29%;高级别浆液性癌 (HGSC) - 46%;低级别浆液性癌 (LGSC) - 74%;子宫内膜样癌 (EC) - 79%;粘液腺癌 (MC) - 80%;边缘性肿瘤 (BLT) - 94%。60 个月的结果如下RC和MC--0%;CCC--14%;HGSC--16%;CS--29%;LGSC--62%;EC--66%;BLT--94%。总体中位生存时间为 26 个月(CI95% 15 至 37);如果不包括 BLT,则为 20 个月(CI95% CI 15 至 25)。结论:这些结果可指导对 OSEC 病理学及其组织型的进一步研究。
{"title":"Ovarian Carcinoma: A Single-Centre Eight-Year Case-Series Study with Survival Analysis.","authors":"George Daniel Subtirelu, Andreea Steriu, Eugen Bratucu","doi":"10.21614/chirurgia.3025","DOIUrl":"https://doi.org/10.21614/chirurgia.3025","url":null,"abstract":"<p><p><b>Introduction:</b> This research describes an eight-year case-series of ovarian carcinoma by surgical (pTNM) staging and surgical procedure, explores the characteristics of ovarian surface epithelial cell (OSEC) tumours by histopathological type in a single centre of reference. Material and <b>Methods:</b> survival analysis with overall survivor probabilities for n=263 patients for 12 months and 60-month tumour free survival status (TFS). Results by staging (pTNM stage classification), histotype and for poor surgical candidate (PSC) status are shown. Histotype high grade serous carcinoma (HGSC) was the most frequently diagnosed type (63%). <b>Results:</b> 12-month survivor probabilities according to histotype, rank as follows: clear cell carcinoma (CCC) - 14%; rare carcinoma (RC) - 15%; carcinosarcoma (CS) - 29%; HGSC - 46%; low grade serous carcinoma (LGSC) - 74%; endometrioid carcinoma (EC) - 79%; mucinous carcinoma (MC) - 80% and borderline tumours (BLT) - 94%. At 60 months results are: RC and MC - 0%; CCC - 14%; HGSC - 16%; CS - 29%; LGSC - 62%; EC - 66%; and BLT - 94%. Overall median survival time is 26 months (CI95% 15 to 37); and 20 months when BLT excluded (CI95% CI 15 to 25). <b>Conclusions:</b> These results may guide further research for the OSEC pathology and its histotypes.</p>","PeriodicalId":10171,"journal":{"name":"Chirurgia","volume":"119 4","pages":"373-384"},"PeriodicalIF":0.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142281166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Prognostic Factors in Intrahepatic Cholangiocarcinoma - A Systematic Review. 肝内胆管癌的预后因素 - 系统综述。
IF 0.8 Q4 SURGERY Pub Date : 2024-08-01 DOI: 10.21614/chirurgia.2945
Anca Zgura, Catalin Savin, Luiza Tirca, Irina Balescu, Mihai Eftimie, Sorin Petrea, Adrian Hasegan, Bogdan Gaspar, Gabriel Petre Gorecki, Cristina Martac, Marilena Stoian, Nicolae Bacalbasa

Introduction: intrahepatic cholangiocarcinoma (ICCA) are rare, aggressive cancers that develop in second order or smaller bile ducts. The aim of this review is to systematically review the most important prognostic factors affecting the long-term outcomes of these patients. Material and Methods: articles conducted on this issue, written in English, published between from January 2000 to December 2023 in Cochrane Library, PubMed, Embase, MedLine, Web of Science, Elsevier, Google Scholar were systematically researched and reviewed. Results: ICCA are usually late diagnosed cancers because of the asymptomatic character, and curative procedures are often not feasible, only 20 to 30% of patients being fit for surgery. With the prognostic of this aggressive malignancy being baleful, the most important risk factors but also prognosis factors seem to be represented by socioeconomic factors, morphological presentation, dimensions, number and extension of the tumor as well as resection margins. Conclusions: once these factors are widely recognized and identified in each case, the clinician will be able to find the best treatment for these patients in order to improve the long-term outcomes.

导言:肝内胆管癌(ICCA)是一种罕见的侵袭性癌症,发生在二阶或更小的胆管中。本综述旨在系统回顾影响这些患者长期预后的最重要预后因素。材料与方法:对2000年1月至2023年12月期间在Cochrane图书馆、PubMed、Embase、MedLine、Web of Science、Elsevier、Google Scholar上发表的有关这一问题的英文文章进行了系统研究和综述。研究结果由于无症状的特点,ICCA 通常是晚期诊断的癌症,通常无法进行根治性手术,只有 20% 至 30% 的患者适合手术。这种侵袭性恶性肿瘤的预后很差,最重要的危险因素和预后因素似乎是社会经济因素、形态表现、肿瘤的大小、数目和扩展以及切除边缘。结论:一旦这些因素在每个病例中被广泛认识和识别,临床医生就能为这些患者找到最佳治疗方法,从而改善长期预后。
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引用次数: 0
Experimenting with Pig-based Skin Model for Burns. Testing of Mean Literature Findings. 以猪为基础的烧伤皮肤模型试验。测试平均文献结论。
IF 0.8 Q4 SURGERY Pub Date : 2024-08-01 DOI: 10.21614/chirurgia.3008
Bogdan Ciornei, Adrian Vaduva, Ioan Hutu, Bianca Cornelia Lungu, Daniel George Bratu, Diana Popescu, Vlad-Laurentiu David, Florin-George Horhat, Eugen Sorin Boia

Introduction: Animal models that closely mimic human burn wound healing processes are essential for developing effective burn wound treatments. Pigs are useful animal models for studying burn wound healing. From their extensive literature review, Andrews and Cuttle (2017) reported mean temperature and exposure time values. This study was done to provide initial burn depth for another experiment comparing two burn wound treatments. The secondary goal was to validate a systematic review on porcine burn model standardization. Material and Methods: Six four-week-old Large White x Landrace gilts were housed in a closed structure for 10 days to acclimatize. The procedures were performed under general anesthesia. A round 2.5 cm copper plate welded to an aluminum rod with a wooden handle caused the injuries. The burning device was used to reach a contact temperature of 110 C on the pig's skin. The objective was to create a superficial partial thickness (SPT) burn for 10 seconds (Group 10s) and a deep partial thickness (DPT) burn for 20 seconds (Group 20s) using a plate heated at 110ºC. No stabilizer or pressure controller was used. Wounds were conclusively dressed and harvested 24 hours later. The usual hematoxylin-eosin protocol was used to cut and stain 4-micron sections. Results: A significant difference (p 0.01) was observed in dermis involvement, with a mean of 85.61 % (95% CI= 80.62 to 90.61) for group 10s and 123.71% (95% CI= 114.91 to 132.50) for group 20s. An exposure time of 20 seconds increased dermis depth-related total collagen denaturation by almost 50% compared to 10 seconds. Conclusions: In conclusion, our experiment produced DPT burns in 10 seconds and FT burns in 20 seconds without a pressure application device.

导言:接近人类烧伤伤口愈合过程的动物模型对于开发有效的烧伤伤口治疗方法至关重要。猪是研究烧伤伤口愈合的有用动物模型。安德鲁斯和卡特尔(2017 年)在其广泛的文献综述中报告了平均温度和暴露时间值。这项研究的目的是为另一项比较两种烧伤创面治疗方法的实验提供初始烧伤深度。次要目标是验证猪烧伤模型标准化的系统综述。材料和方法:将六头四周龄的大白×兰德良种后备母猪饲养在一个封闭的结构中 10 天以适应环境。手术在全身麻醉下进行。一个 2.5 厘米的圆形铜板焊接在一根带木柄的铝棒上,造成伤害。灼烧装置在猪皮肤上的接触温度为 110 摄氏度。目的是利用加热到 110ºC 的铜板,在 10 秒钟内造成表层部分厚度 (SPT) 烧伤(10 秒组),在 20 秒钟内造成深层部分厚度 (DPT) 烧伤(20 秒组)。没有使用稳定器或压力控制器。24 小时后对伤口进行包扎和采血。采用常规苏木精-伊红方案切割 4 微米切片并染色。结果:在真皮受累方面观察到明显差异(P 0.01),10 秒组的平均受累率为 85.61%(95% CI= 80.62 至 90.61),20 秒组为 123.71%(95% CI= 114.91 至 132.50)。与 10 秒钟相比,20 秒钟的曝光时间可使真皮深度相关的胶原总变性增加近 50%。结论总之,我们的实验在不使用加压装置的情况下,在 10 秒钟内产生了 DPT 烧伤,在 20 秒钟内产生了 FT 烧伤。
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引用次数: 0
Evaluating VATS versus Open Surgery for Non-Small Cell Lung Cancer: A 5-year Retrospective Study. 评估非小细胞肺癌 VATS 与开放手术:五年回顾性研究
IF 0.8 Q4 SURGERY Pub Date : 2024-08-01 DOI: 10.21614/chirurgia.2999
Alin Ionut Burlacu, Bogdan Cosmin Tanase, Iolanda Augustin, Gabriel Veniamin Cozma

Background and objectives: The efficacy and safety of video-assisted thoracoscopic surgery (VATS) versus open thoracotomy in the treatment of non-small cell lung cancer (NSCLC) were evaluated with a focus on mediastinal lymph node dissection, postoperative recovery, and longterm outcomes including survival rates and disease-free intervals. Materials and Methods: This retrospective study analyzed data from 228 NSCLC patients treated at the Institute of Oncology Bucharest from 2016 to 2022. Both VATS and open surgical approaches were compared, with variables including demographic data, comorbidities, surgical outcomes, and postoperative complications meticulously recorded. Statistical significance was assessed using chi-square and independent samples t-tests. Results: Among the findings, VATS demonstrated significantly better two-year progression-free survival rates for patients in early stages (Stages 1-3) of NSCLC compared to open surgery, with p-values 0.01 and 0.001, respectively. In contrast, no significant difference was observed in Stage 4. Furthermore, VATS resulted in shorter operative times (mean 299 vs. 347 minutes, p 0.001), less estimated blood loss (98.68 mL vs. 160.88 mL, p 0.001), reduced chest tube duration (5.78 days vs. 12.17 days, p 0.001), and decreased hospital stays (12.0 days vs. 27.7 days, p 0.001). Conclusions: VATS is associated with improved long-term disease-free survival for early-stage NSCLC and more favorable short-term surgical outcomes, highlighting its advantages over open thoracotomy. Despite its benefits, VATS did not significantly reduce postoperative complications compared to open surgery.

背景和目的:评估视频辅助胸腔镜手术(VATS)与开胸手术治疗非小细胞肺癌(NSCLC)的疗效和安全性,重点关注纵隔淋巴结清扫、术后恢复以及包括生存率和无病间隔期在内的长期疗效。材料和方法:这项回顾性研究分析了布加勒斯特肿瘤研究所从2016年至2022年治疗的228名NSCLC患者的数据。比较了 VATS 和开放手术两种方法,并详细记录了人口统计学数据、合并症、手术结果和术后并发症等变量。统计意义采用卡方检验和独立样本 t 检验进行评估。结果研究结果表明,与开放手术相比,VATS 手术对早期(1-3 期)NSCLC 患者的两年无进展生存率明显更高,P 值分别为 0.01 和 0.001。相比之下,第 4 期患者则无明显差异。此外,VATS 手术时间更短(平均 299 分钟对 347 分钟,P 0.001),估计失血量更少(98.68 毫升对 160.88 毫升,P 0.001),胸管插管时间更短(5.78 天对 12.17 天,P 0.001),住院时间更短(12.0 天对 27.7 天,P 0.001)。结论:与开胸手术相比,VATS 可提高早期 NSCLC 的长期无病生存率,并获得更有利的短期手术效果,这凸显了它的优势。与开胸手术相比,VATS 尽管有其优势,但并不能显著减少术后并发症。
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引用次数: 0
Experimenting with Pig-based Skin Model for Burns. Testing of Mean Literature Findings. 以猪为基础的烧伤皮肤模型试验。测试平均文献结论。
IF 0.8 Q4 SURGERY Pub Date : 2024-08-01 DOI: 10.21614/chirurgia.3008
Bogdan Ciornei, Adrian Vaduva, Ioan Hutu, Bianca Cornelia Lungu, Daniel George Bratu, Diana Popescu, Vlad-Laurentiu David, Florin-George Horhat, Eugen Sorin Boia

Introduction: Animal models that closely mimic human burn wound healing processes are essential for developing effective burn wound treatments. Pigs are useful animal models for studying burn wound healing. From their extensive literature review, Andrews and Cuttle (2017) reported mean temperature and exposure time values. This study was done to provide initial burn depth for another experiment comparing two burn wound treatments. The secondary goal was to validate a systematic review on porcine burn model standardization. Materials and Methods: Six four-week-old Large White x Landrace gilts were housed in a closed structure for 10 days to acclimatize. The procedures were performed under general anesthesia. A round 2.5 cm copper plate welded to an aluminum rod with a wooden handle caused the injuries. The burning device was used to reach a contact temperature of 110ºC on the pig's skin. The objective was to create a superficial partial thickness (SPT) burn for 10 seconds (Group 10s) and a deep partial thickness (DPT) burn for 20 seconds (Group 20s) using a plate heated at 110ºC. No stabilizer or pressure controller was used. Wounds were conclusively dressed and harvested 24 hours later. The usual hematoxylin-eosin protocol was used to cut and stain 4-micron sections. Results: A significant difference (p 0.01) was observed in dermis involvement, with a mean of 85.61 % (95% CI= 80.62 to 90.61) for group 10s and 123.71% (95% CI= 114.91 to 132.50) for group 20s. An exposure time of 20 seconds increased dermis depth-related total collagen denaturation by almost 50% compared to 10 seconds. Conclusions: In conclusion, our experiment produced DPT burns in 10 seconds and FT burns in 20 seconds without a pressure application device.

导言:接近人类烧伤伤口愈合过程的动物模型对于开发有效的烧伤伤口治疗方法至关重要。猪是研究烧伤伤口愈合的有用动物模型。安德鲁斯和卡特尔(2017 年)在其广泛的文献综述中报告了平均温度和暴露时间值。这项研究的目的是为另一项比较两种烧伤创面治疗方法的实验提供初始烧伤深度。次要目标是验证猪烧伤模型标准化的系统综述。材料和方法:将六头四周龄的大白×兰德良种后备母猪饲养在一个封闭的结构中,进行为期 10 天的适应性训练。手术在全身麻醉下进行。一个 2.5 厘米的圆形铜板焊接在一根带木柄的铝棒上,造成伤害。灼烧装置在猪皮肤上的接触温度为 110ºC。目的是用加热到 110ºC 的铜板造成浅层部分厚度 (SPT) 烧伤 10 秒(10 秒组)和深层部分厚度 (DPT) 烧伤 20 秒(20 秒组)。没有使用稳定器或压力控制器。24 小时后对伤口进行包扎和采血。采用常规苏木精-伊红方案切割 4 微米切片并染色。结果:在真皮受累方面观察到明显差异(P 0.01),10 秒组的平均受累率为 85.61%(95% CI= 80.62 至 90.61),20 秒组为 123.71%(95% CI= 114.91 至 132.50)。与 10 秒钟相比,20 秒钟的曝光时间可使真皮深度相关的胶原总变性增加近 50%。结论总之,我们的实验在不使用加压装置的情况下,在 10 秒钟内产生了 DPT 烧伤,在 20 秒钟内产生了 FT 烧伤。
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Chirurgia
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