首页 > 最新文献

Journal of Investigative Surgery最新文献

英文 中文
Relationship between Primary Tumor Resection for Metastatic Small Intestine Neuroendocrine Tumors and Survival: A Propensity Score-Matched Analysis. 转移性小肠神经内分泌肿瘤原发肿瘤切除与生存的关系:倾向评分匹配分析。
IF 1.9 4区 医学 Q2 SURGERY Pub Date : 2022-06-01 Epub Date: 2022-01-06 DOI: 10.1080/08941939.2021.2024306
Haihao Yan, Linlin Yin, Hao Han, Ye Jin, Zheng Liu

Background: At present, it has been controversial whether primary tumor resection (PTR) can bring survival advantage to patients with metastatic small intestine neuroendocrine tumors (SI-NETs). To answer this question, we conducted a retrospective cohort study to evaluate the effect of PTR on the survival of patients with metastatic SI-NETs.

Methods: Information on SI-NETs patients from 2004 to 2015 was extracted from Surveillance, Epidemiology, and End Results (SEER) databases. Demographics, tumor characteristics, treatment, and survival were compared. Propensity score-matched (PSM) was used 1:1 in the filtered queue. Cox proportional hazard regression model was used to evaluate the correlation between PTR and treatment results.

Results: Before PSM, survival analysis showed that PTR significantly prolonged the survival of metastatic SI-NETs patients. After PSM, there was no significant difference in overall survival (OS) and cancer-specific survival (CSS) between the PTR group and the non-PTR group. Multivariate analysis showed no significant difference in OS and CSS between the two groups (p > 0.05).

Conclusion: Our study shows that OS and CSS are comparable between the PTR group and the non-PTR group. Thus, we believe that PTR should not be actively performed on such patients. Meanwhile, it is undeniable that properly selected patients may also benefit from PTR. Therefore, prospective randomized controlled trials are still needed to verify the effect of PTR on patients in the future.

背景:目前,原发性肿瘤切除(PTR)是否能给转移性小肠神经内分泌肿瘤(SI-NETs)患者带来生存优势一直存在争议。为了回答这个问题,我们进行了一项回顾性队列研究,以评估PTR对转移性SI-NETs患者生存的影响。方法:从监测、流行病学和最终结果(SEER)数据库中提取2004年至2015年SI-NETs患者的信息。比较了人口统计学、肿瘤特征、治疗和生存率。在过滤后的队列中采用1:1的倾向得分匹配(PSM)。采用Cox比例风险回归模型评价PTR与治疗结果的相关性。结果:PSM前,生存分析显示PTR可显著延长转移性SI-NETs患者的生存期。PSM后,PTR组和非PTR组的总生存期(OS)和癌症特异性生存期(CSS)无显著差异。多因素分析显示,两组患者OS、CSS差异无统计学意义(p > 0.05)。结论:我们的研究表明,PTR组和非PTR组的OS和CSS具有可比性。因此,我们认为不应该对这类患者积极进行PTR。同时,不可否认的是,适当选择的患者也可以从PTR中获益。因此,未来仍需要前瞻性随机对照试验来验证PTR对患者的影响。
{"title":"Relationship between Primary Tumor Resection for Metastatic Small Intestine Neuroendocrine Tumors and Survival: A Propensity Score-Matched Analysis.","authors":"Haihao Yan,&nbsp;Linlin Yin,&nbsp;Hao Han,&nbsp;Ye Jin,&nbsp;Zheng Liu","doi":"10.1080/08941939.2021.2024306","DOIUrl":"https://doi.org/10.1080/08941939.2021.2024306","url":null,"abstract":"<p><strong>Background: </strong>At present, it has been controversial whether primary tumor resection (PTR) can bring survival advantage to patients with metastatic small intestine neuroendocrine tumors (SI-NETs). To answer this question, we conducted a retrospective cohort study to evaluate the effect of PTR on the survival of patients with metastatic SI-NETs.</p><p><strong>Methods: </strong>Information on SI-NETs patients from 2004 to 2015 was extracted from Surveillance, Epidemiology, and End Results (SEER) databases. Demographics, tumor characteristics, treatment, and survival were compared. Propensity score-matched (PSM) was used 1:1 in the filtered queue. Cox proportional hazard regression model was used to evaluate the correlation between PTR and treatment results.</p><p><strong>Results: </strong>Before PSM, survival analysis showed that PTR significantly prolonged the survival of metastatic SI-NETs patients. After PSM, there was no significant difference in overall survival (OS) and cancer-specific survival (CSS) between the PTR group and the non-PTR group. Multivariate analysis showed no significant difference in OS and CSS between the two groups (p > 0.05).</p><p><strong>Conclusion: </strong>Our study shows that OS and CSS are comparable between the PTR group and the non-PTR group. Thus, we believe that PTR should not be actively performed on such patients. Meanwhile, it is undeniable that properly selected patients may also benefit from PTR. Therefore, prospective randomized controlled trials are still needed to verify the effect of PTR on patients in the future.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"35 6","pages":"1239-1247"},"PeriodicalIF":1.9,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39790425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 4
RIP1 Regulates Mitochondrial Fission during Skeletal Muscle Ischemia Reperfusion Injury. RIP1调控骨骼肌缺血再灌注损伤过程中的线粒体分裂
IF 1.9 4区 医学 Q2 SURGERY Pub Date : 2022-06-01 Epub Date: 2022-03-06 DOI: 10.1080/08941939.2022.2036880
Yu Cao, Shunli Chen, Xiangqing Xiong, Lina Lin, Wantie Wang, Liangrong Wang

Background: Dynamin related protein-1 (Drp1)-mediated mitochondrial fission relates to ischemia reperfusion (IR) injury, and its association with necroptosis is implied. We hypothesized that receptor-interacting protein 1 (RIP1), a key kinase in necroptosis, acted as an upstream of Drp1-mediated mitochondrial fission during skeletal muscle IR.

Methods: Thirty rats were randomized into the SM, IR, NI, MI, and DI group (n = 6). The rats in the SM group were shamly operated, and those in the IR group were subjected to 4-hour ischemia of the right hindlimb that was followed by 4-hour reperfusion. Intraperitoneal administration of Nec-1 1 mg/kg, Mdivi-1 1.2 mg/kg and same volume of DMSO were given before ischemia in the NI, MI and DI groups, respectively. Upon reperfusion, the soleus muscles were harvested to determine morphological changes and the expression of RIP1, total Drp1 and p-Drp1 (Ser616). Moreover, the muscular oxidative stress indicators and plasma muscle damage biomarkers were detected.

Results: IR led to impaired histopathological structures and mitochondrial fragmentation in the soleus muscle tissue, accompanied with increased muscular oxidative stress and muscle injury biomarkers, which could be similarly alleviated by Mdivi-1 and Nec-1 (p < 0.05). RIP1 and p-Drp1 (Ser616) protein levels were significantly upregulated in the soleus muscle subjected to IR injury, this upregulation was attenuated in the NI group, and Mdivi-1 downregulated the protein expression of p-Drp1 (Ser616) but not of RIP1 (p < 0.05).

Conclusion: RIP1 functions as an upstream of Drp1-mediated mitochondrial fission in the execution of necroptosis during skeletal muscle IR.

动力蛋白相关蛋白-1 (Drp1)介导的线粒体分裂与缺血再灌注(IR)损伤有关,并与坏死下垂有关。我们假设受体相互作用蛋白1 (RIP1)是骨骼肌IR中drp1介导的线粒体裂变的上游,RIP1是坏死性凋亡的关键激酶。方法30只大鼠随机分为SM、IR、NI、MI、DI组(n = 6)。SM组采用假手术治疗,IR组右后肢缺血4小时,再灌注4小时。NI组、MI组、DI组缺血前分别腹腔注射Nec-1 1 mg/kg、Mdivi-1 1.2 mg/kg及等量DMSO。再灌注时,取比目鱼肌,测定形态学变化及RIP1、总Drp1和p-Drp1 (Ser616)的表达。此外,检测肌肉氧化应激指标和血浆肌肉损伤生物标志物。结果IR导致比目鱼肌组织病理结构受损,线粒体断裂,肌肉氧化应激和肌肉损伤生物标志物增加,Mdivi-1和Nec-1可类似地减轻肌肉损伤(p < 0.05)。IR损伤后比目鱼肌中RIP1和p- drp1 (Ser616)蛋白水平显著上调,NI组上调幅度减弱,Mdivi-1下调p- drp1 (Ser616)蛋白表达,但不下调RIP1蛋白表达(p < 0.05)。结论RIP1作为drp1介导的线粒体分裂的上游参与骨骼肌IR中坏死下垂的发生。
{"title":"RIP1 Regulates Mitochondrial Fission during Skeletal Muscle Ischemia Reperfusion Injury.","authors":"Yu Cao,&nbsp;Shunli Chen,&nbsp;Xiangqing Xiong,&nbsp;Lina Lin,&nbsp;Wantie Wang,&nbsp;Liangrong Wang","doi":"10.1080/08941939.2022.2036880","DOIUrl":"10.1080/08941939.2022.2036880","url":null,"abstract":"<p><strong>Background: </strong>Dynamin related protein-1 (Drp1)-mediated mitochondrial fission relates to ischemia reperfusion (IR) injury, and its association with necroptosis is implied. We hypothesized that receptor-interacting protein 1 (RIP1), a key kinase in necroptosis, acted as an upstream of Drp1-mediated mitochondrial fission during skeletal muscle IR.</p><p><strong>Methods: </strong>Thirty rats were randomized into the SM, IR, NI, MI, and DI group (<i>n</i> = 6). The rats in the SM group were shamly operated, and those in the IR group were subjected to 4-hour ischemia of the right hindlimb that was followed by 4-hour reperfusion. Intraperitoneal administration of Nec-1 1 mg/kg, Mdivi-1 1.2 mg/kg and same volume of DMSO were given before ischemia in the NI, MI and DI groups, respectively. Upon reperfusion, the soleus muscles were harvested to determine morphological changes and the expression of RIP1, total Drp1 and p-Drp1 (Ser616). Moreover, the muscular oxidative stress indicators and plasma muscle damage biomarkers were detected.</p><p><strong>Results: </strong>IR led to impaired histopathological structures and mitochondrial fragmentation in the soleus muscle tissue, accompanied with increased muscular oxidative stress and muscle injury biomarkers, which could be similarly alleviated by Mdivi-1 and Nec-1 (<i>p</i> < 0.05). RIP1 and p-Drp1 (Ser616) protein levels were significantly upregulated in the soleus muscle subjected to IR injury, this upregulation was attenuated in the NI group, and Mdivi-1 downregulated the protein expression of p-Drp1 (Ser616) but not of RIP1 (<i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>RIP1 functions as an upstream of Drp1-mediated mitochondrial fission in the execution of necroptosis during skeletal muscle IR.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"35 1","pages":"1269-1274"},"PeriodicalIF":1.9,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46386104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clinical, Histological, and Profibrotic Extracellular Matrix Protein Changes in a Model of Tracheal Stenosis Induced by Cervical Tracheal Autotransplantation 气管自体移植所致气管狭窄模型的临床、组织学和纤维化细胞外基质蛋白变化
IF 1.9 4区 医学 Q2 SURGERY Pub Date : 2022-06-01 DOI: 10.1080/08941939.2022.2081388
M. Silva-Martínez, J. R. Olmos-Zúñiga, J. Calyeca, M. Baltazares-Lipp, M. Gaxiola-Gaxiola, Andrea Nachón-Acosta, L. E. Pensado-Piedra, F. Juárez-Hernández, R. Sotelo-Robledo, R. Jasso-Victoria, Antonia Luna-Flores, J. C. Vázquez-Minero
Abstract Background Tracheal stenosis (TS) is a complication of prolonged intubation, tracheotomy, and tracheal surgery that compromises the vascular supply. Animal models are essential for studying its pathophysiology and the effect of interventions. Objective To establish a TS model in rats secondary to tracheal autotransplantation with a graft submerged in bleomycin (Atx-Bleo). Additionally, to evaluate the clinical and histological changes, as well as the expression of newly formed collagen (NFC), isoforms of transforming growth factor beta (TGFβ), fibronectin (FN), elastin (ELN), integrin β1 (ITGβ1), and matrix metalloproteinase 1 (MMP1) in TS. Methods Twenty Wistar rats were divided into three groups: group I (n = 20) control; group II (n = 10) end-to-end anastomosis of the trachea (tracheoplasty); and group III (n = 10) Atx-Bleo. The animals were evaluated clinically, tomographically, macroscopically, morphometrically, and microscopically. NFC deposition, and the expression of profibrotic and antifibrotic proteins were evaluated in tracheal scars. Results All animals survived the surgical procedure and the study period. Compared with the other study groups, the Atx-Bleo group developed TS and fibrosis, exhibited higher expression of NFC, TGFβ1, TGFβ2, FN, ELN, and ITGβ1, and mild expression of TGFβ3 and MMP1 (p < 0.005; analysis of variance, Dunnett and Tukey tests). Conclusion Atx-Bleo in TS model rats produces tomographic and histological changes, and induces the upregulation of profibrotic proteins (TGFβ1, TGFβ2, collagen, FN, ELN, ITGβ1) and downregulation of antifibrotic proteins (TGFβ3, MMP1). Therefore, this model may be used to test new pharmacological treatments for reversing or preventing TS, and conduct basic studies regarding its pathophysiology.
摘要背景气管狭窄(TS)是长时间插管、气管切开和气管手术的并发症,会损害血管供应。动物模型对于研究其病理生理学和干预措施的效果至关重要。目的建立博莱霉素(Atx Bleo)浸泡自体气管移植大鼠TS模型。方法Wistar大鼠20只,随机分为三组:Ⅰ组(P<0.01),Ⅱ组(P>0.05),Ⅰ组(p<0.01) = 20) 控制;第II组(n = 10) 气管端对端吻合(气管成形术);和III组(n = 10) Atx Bleo。对动物进行了临床、断层、宏观、形态和显微镜评估。在气管瘢痕中评估NFC沉积以及促纤维化和抗纤维化蛋白的表达。结果所有动物均在手术和研究期内存活。与其他研究组相比,Atx-Bleo组出现TS和纤维化,NFC、TGFβ1、TGFα2、FN、ELN和ITGβ1表达增加,TGFβ3和MMP1轻度表达(p < 0.005;方差分析、Dunnett和Tukey检验)。结论Atx-Bleo在TS模型大鼠中产生断层和组织学变化,并诱导促纤维化蛋白(TGFβ1、TGFβ2、胶原、FN、ELN、ITGβ1)的上调和抗纤维化蛋白(TGFβ3、MMP1)的下调。因此,该模型可用于测试逆转或预防TS的新药物治疗方法,并对其病理生理学进行基础研究。
{"title":"Clinical, Histological, and Profibrotic Extracellular Matrix Protein Changes in a Model of Tracheal Stenosis Induced by Cervical Tracheal Autotransplantation","authors":"M. Silva-Martínez, J. R. Olmos-Zúñiga, J. Calyeca, M. Baltazares-Lipp, M. Gaxiola-Gaxiola, Andrea Nachón-Acosta, L. E. Pensado-Piedra, F. Juárez-Hernández, R. Sotelo-Robledo, R. Jasso-Victoria, Antonia Luna-Flores, J. C. Vázquez-Minero","doi":"10.1080/08941939.2022.2081388","DOIUrl":"https://doi.org/10.1080/08941939.2022.2081388","url":null,"abstract":"Abstract Background Tracheal stenosis (TS) is a complication of prolonged intubation, tracheotomy, and tracheal surgery that compromises the vascular supply. Animal models are essential for studying its pathophysiology and the effect of interventions. Objective To establish a TS model in rats secondary to tracheal autotransplantation with a graft submerged in bleomycin (Atx-Bleo). Additionally, to evaluate the clinical and histological changes, as well as the expression of newly formed collagen (NFC), isoforms of transforming growth factor beta (TGFβ), fibronectin (FN), elastin (ELN), integrin β1 (ITGβ1), and matrix metalloproteinase 1 (MMP1) in TS. Methods Twenty Wistar rats were divided into three groups: group I (n = 20) control; group II (n = 10) end-to-end anastomosis of the trachea (tracheoplasty); and group III (n = 10) Atx-Bleo. The animals were evaluated clinically, tomographically, macroscopically, morphometrically, and microscopically. NFC deposition, and the expression of profibrotic and antifibrotic proteins were evaluated in tracheal scars. Results All animals survived the surgical procedure and the study period. Compared with the other study groups, the Atx-Bleo group developed TS and fibrosis, exhibited higher expression of NFC, TGFβ1, TGFβ2, FN, ELN, and ITGβ1, and mild expression of TGFβ3 and MMP1 (p < 0.005; analysis of variance, Dunnett and Tukey tests). Conclusion Atx-Bleo in TS model rats produces tomographic and histological changes, and induces the upregulation of profibrotic proteins (TGFβ1, TGFβ2, collagen, FN, ELN, ITGβ1) and downregulation of antifibrotic proteins (TGFβ3, MMP1). Therefore, this model may be used to test new pharmacological treatments for reversing or preventing TS, and conduct basic studies regarding its pathophysiology.","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"35 1","pages":"1551 - 1561"},"PeriodicalIF":1.9,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41368627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Feasibility of Magnetic Technique for Axillary Staging after Neoadjuvant Therapy in Breast Cancer Patients. 磁共振技术在乳腺癌患者新辅助治疗后腋窝分期中的可行性。
IF 1.9 4区 医学 Q2 SURGERY Pub Date : 2022-06-01 Epub Date: 2022-02-17 DOI: 10.1080/08941939.2022.2038737
Osman Cem Yılmaz, Veli Vural

Purpose: Optimal axillary staging after neoadjuvant chemotherapy (NAC) in node-negative breast cancer is an area of controversy. Sentinel node biopsy with Technetium-sulphur colloid (99m Tc) alone or with blue dye is the recommended technique for evaluating axilla in these patients. However, this technique has drawbacks such as limited access to nuclear departments and timing limitations related to Tc injection exposing patients to unnecessary radiation. Superparamagnetic iron oxide nanoparticles (SPIO) may represent a valid option for SLN biopsy. In this study, we assessed the feasibility of the magnetic technique (Sentimag) with combination of isosulfan blue dye in breast cancer patients who received NAC.

Methods: The study sample consisted of 54 female breast cancer patients who received NAC. Sentinel node localization was performed using magnetic technique and blue dye. Sentinel node identification rate (IFR) of magnetic technique was calculated and postoperative complications were assessed.

Results: Sentinel lymph node was detected in 52 patients with Sentimag method (identification rate = 96.3%, 95% CI: 87.4-98.9%). Blue dye was successful to find SLN in 38 patients (identification rate = 70%). The most common histologic type was invasive ductal (n = 51; 94.4%). Mean tumor size was 2.1 cm after NAC. Most of patients had T2 (n = 30; 55.5%) and HER2 + positive (n = 49; 90.7%) cancer.

Conclusion: Sentimag which is a magnetic technique appears to be safe, easy to perform with minimal adverse effects, may be an alternative and accurate technique in patients with NAC, especially in breast units where nuclear medicine unit is not available.

Supplemental data for this article is available online at https://doi.org/10.1080/08941939.2022.2038737 .

目的:淋巴结阴性乳腺癌新辅助化疗(NAC)后最佳腋窝分期是一个有争议的领域。前哨淋巴结活检单独使用锝硫胶体(99m Tc)或蓝色染料是评估这些患者腋窝的推荐技术。然而,这种技术有一些缺点,比如进入核科的机会有限,以及注射Tc使患者暴露在不必要的辐射下的时间限制。超顺磁性氧化铁纳米颗粒(SPIO)可能是SLN活检的有效选择。在这项研究中,我们评估了磁性技术(Sentimag)联合异硫丹蓝染料在接受NAC的乳腺癌患者中的可行性。方法:研究对象为54例接受NAC治疗的女性乳腺癌患者。前哨淋巴结定位采用磁性技术和蓝色染料。计算磁导术前哨淋巴结识别率(IFR),并评估术后并发症。结果:52例患者采用Sentimag方法检出前哨淋巴结,检出率为96.3%,95% CI: 87.4 ~ 98.9%。蓝色染色成功发现SLN 38例(检出率70%)。最常见的组织学类型为浸润性导管性(n = 51;94.4%)。NAC术后平均肿瘤大小为2.1 cm。大多数患者有T2 (n = 30;55.5%)和HER2 +阳性(n = 49;90.7%)癌症。结论:Sentimag是一种安全、操作简单、不良反应小的磁性技术,可作为NAC患者的替代技术,特别是在没有核医学单元的乳腺科室。本文的补充数据可在https://doi.org/10.1080/08941939.2022.2038737上在线获得。
{"title":"Feasibility of Magnetic Technique for Axillary Staging after Neoadjuvant Therapy in Breast Cancer Patients.","authors":"Osman Cem Yılmaz,&nbsp;Veli Vural","doi":"10.1080/08941939.2022.2038737","DOIUrl":"https://doi.org/10.1080/08941939.2022.2038737","url":null,"abstract":"<p><strong>Purpose: </strong>Optimal axillary staging after neoadjuvant chemotherapy (NAC) in node-negative breast cancer is an area of controversy. Sentinel node biopsy with Technetium-sulphur colloid (99m Tc) alone or with blue dye is the recommended technique for evaluating axilla in these patients. However, this technique has drawbacks such as limited access to nuclear departments and timing limitations related to Tc injection exposing patients to unnecessary radiation. Superparamagnetic iron oxide nanoparticles (SPIO) may represent a valid option for SLN biopsy. In this study, we assessed the feasibility of the magnetic technique (Sentimag) with combination of isosulfan blue dye in breast cancer patients who received NAC.</p><p><strong>Methods: </strong>The study sample consisted of 54 female breast cancer patients who received NAC. Sentinel node localization was performed using magnetic technique and blue dye. Sentinel node identification rate (IFR) of magnetic technique was calculated and postoperative complications were assessed.</p><p><strong>Results: </strong>Sentinel lymph node was detected in 52 patients with Sentimag method (identification rate = 96.3%, 95% CI: 87.4-98.9%). Blue dye was successful to find SLN in 38 patients (identification rate = 70%). The most common histologic type was invasive ductal (<i>n</i> = 51; 94.4%). Mean tumor size was 2.1 cm after NAC. Most of patients had T2 (<i>n</i> = 30; 55.5%) and HER2 + positive (<i>n</i> = 49; 90.7%) cancer.</p><p><strong>Conclusion: </strong>Sentimag which is a magnetic technique appears to be safe, easy to perform with minimal adverse effects, may be an alternative and accurate technique in patients with NAC, especially in breast units where nuclear medicine unit is not available.</p><p><p>Supplemental data for this article is available online at https://doi.org/10.1080/08941939.2022.2038737 .</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"35 6","pages":"1275-1278"},"PeriodicalIF":1.9,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39808908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
S2-Alar-Iliac Screw Fixation versus Iliac Screw Fixation in the Treatment of Sacral Fractures. 骶髂椎弓根螺钉内固定与髂椎弓根螺钉内固定治疗骶骨骨折的比较。
IF 1.9 4区 医学 Q2 SURGERY Pub Date : 2022-06-01 Epub Date: 2022-01-02 DOI: 10.1080/08941939.2021.2022253
Yangxing Luo, Yue Li, Li He, Chengla Yi

Purpose: To compare the short-term therapeutic effects of S2-alar-iliac (S2AI) screw fixation and iliac screw fixation techniques in managing sacral fractures.

Methods: From September 2015 to May 2020, 42 patients with sacral fractures who underwent lumbopelvic fixation by a single surgeon were analyzed. The patients were divided into the S2AI screw group (19 patients) and the iliac screw group (23 patients). Operative data, reduction quality, postoperative complications, and functional outcomes were evaluated.

Results: The incidence of unplanned reoperation was significantly different between patients treated with S2AI screws than in those treated with iliac screws (0 versus 6, p = 0.02). The mean intraoperative estimated blood loss was 405.26 ± 229.67 mL in the S2AI screw group and 539.13 ± 246.32 mL in the iliac screw group (P = 0.08). No significant difference was observed in either group regarding the quality of reduction, functional outcome, or low back pain. The reduction quality based on the Matta criteria and excellent/good outcomes were 21/2 in the iliac screw group and 17/2 in the S2AI screw group. The functional outcomes based on the Majeed score and excellent/good/fair outcomes were 17/3/3 in the iliac screw group and 17/1/1 in the S2AI screw group. No complications, including implant breakage, loosening of the implant, or loss of reduction were found in either group during follow-up.

Conclusion: Both S2AI screws and iliac screws were effective in the treatment of sacral fractures. The use of S2AI screws, however, was independently associated with fewer unplanned reoperations for surgical site infection, wound dehiscence, and symptoms of screw protrusion than the use of iliac screws.

目的:比较骶髂侧(S2AI)螺钉内固定与髂螺钉内固定技术治疗骶骨骨折的近期疗效。方法:对2015年9月至2020年5月由同一外科医生行腰骨盆固定的42例骶骨骨折患者进行分析。患者分为S2AI螺钉组(19例)和髂螺钉组(23例)。评估手术资料、复位质量、术后并发症和功能结果。结果:与髂螺钉组相比,S2AI螺钉组的意外再手术发生率有显著性差异(0比6,p = 0.02)。S2AI螺钉组术中平均预估出血量为405.26±229.67 mL,髂螺钉组539.13±246.32 mL (P = 0.08)。两组在复位质量、功能结局或腰痛方面均无显著差异。基于Matta标准的复位质量和优/良结果,髂螺钉组为2.1 /2,S2AI螺钉组为17/2。基于Majeed评分和优/良/一般评分的功能评分,髂螺钉组为17/3/3,S2AI螺钉组为17/1/1。随访期间,两组均未发现假体断裂、假体松动或复位丢失等并发症。结论:S2AI螺钉与髂螺钉均可有效治疗骶骨骨折。然而,与髂螺钉相比,S2AI螺钉的使用与手术部位感染、伤口裂开和螺钉突出症状的意外再手术较少独立相关。
{"title":"S2-Alar-Iliac Screw Fixation versus Iliac Screw Fixation in the Treatment of Sacral Fractures.","authors":"Yangxing Luo,&nbsp;Yue Li,&nbsp;Li He,&nbsp;Chengla Yi","doi":"10.1080/08941939.2021.2022253","DOIUrl":"https://doi.org/10.1080/08941939.2021.2022253","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the short-term therapeutic effects of S2-alar-iliac (S2AI) screw fixation and iliac screw fixation techniques in managing sacral fractures.</p><p><strong>Methods: </strong>From September 2015 to May 2020, 42 patients with sacral fractures who underwent lumbopelvic fixation by a single surgeon were analyzed. The patients were divided into the S2AI screw group (19 patients) and the iliac screw group (23 patients). Operative data, reduction quality, postoperative complications, and functional outcomes were evaluated.</p><p><strong>Results: </strong>The incidence of unplanned reoperation was significantly different between patients treated with S2AI screws than in those treated with iliac screws (0 versus 6, p = 0.02). The mean intraoperative estimated blood loss was 405.26 ± 229.67 mL in the S2AI screw group and 539.13 ± 246.32 mL in the iliac screw group (P = 0.08). No significant difference was observed in either group regarding the quality of reduction, functional outcome, or low back pain. The reduction quality based on the Matta criteria and excellent/good outcomes were 21/2 in the iliac screw group and 17/2 in the S2AI screw group. The functional outcomes based on the Majeed score and excellent/good/fair outcomes were 17/3/3 in the iliac screw group and 17/1/1 in the S2AI screw group. No complications, including implant breakage, loosening of the implant, or loss of reduction were found in either group during follow-up.</p><p><strong>Conclusion: </strong>Both S2AI screws and iliac screws were effective in the treatment of sacral fractures. The use of S2AI screws, however, was independently associated with fewer unplanned reoperations for surgical site infection, wound dehiscence, and symptoms of screw protrusion than the use of iliac screws.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"35 6","pages":"1224-1230"},"PeriodicalIF":1.9,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39777687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Preoperative Anti-TNF Therapy is Associated with a Shorter Length of Resected Bowel in Patients Undergoing Ileocolic Resection for Crohn's Disease. 术前抗肿瘤坏死因子治疗与克罗恩病回结肠切除术患者切除肠长度缩短相关
IF 1.9 4区 医学 Q2 SURGERY Pub Date : 2022-06-01 Epub Date: 2022-01-04 DOI: 10.1080/08941939.2021.2023713
Yuhua Huang, Danhua Yao, Feilong Guo, Zhiyuan Zhou, Yousheng Li

Background: Massive or repeated intestinal resections for Crohn's disease (CD) could lead to disabling consequences. The present study aimed to assess the effect of preoperative anti-TNF therapy on the length of resected bowel and identify risk factors for postoperative morbidity following ileocolic resection for CD.

Methods: Patients undergoing elective ileocolic resection for CD were included prospectively. Medical variables including demographics, Montréal classification, preoperative treatment, surgical details and 30-day postoperative morbidity were collected. Potential impact of preoperative anti-TNF treatment on length of ileocolic specimen and risk factors for postoperative morbidity were investigated.

Results: One hundred and eight-four patients were included in this study, and 66 (35.9%) of them received anti-TNF agents within 8 weeks prior to surgery. Primary anastomosis was performed in 145 patients (78.8%). The mean length of resected intestine was 10 cm shorter in subjects receiving preoperative anti-TNF treatment than those without preoperative anti-TNF therapy (P < 0.001). The rates of postoperative overall, infectious and intra-abdominal septic morbidity were 29.9%, 19.0% and 7.6%, respectively. In multivariate analysis, anti-TNF therapy < 8 weeks before surgery was independently associated with a shorter length of resected bowel but didn't increase overall and septic complications, while systemic steroids use within 8 weeks prior to surgery independently increased overall complications and intra-abdominal sepsis.

Conclusions: Preoperative anti-TNF therapy was associated with a shorter length of resected bowel but not the overall and septic postoperative complications in ileocolic resection for CD. Weaning off systemic steroids before surgery may improve postoperative outcomes in patients with CD.

背景:克罗恩病(CD)的大面积或反复的肠道切除可能导致致残的后果。本研究旨在评估术前抗肿瘤坏死因子治疗对切除肠长度的影响,并确定CD回结肠切除术后并发症的危险因素。方法:前瞻性纳入选择性回结肠切除术治疗CD的患者。医学变量包括人口统计学、montracimal分类、术前治疗、手术细节和术后30天发病率。探讨术前抗肿瘤坏死因子治疗对回肠结肠标本长度和术后发病率危险因素的潜在影响。结果:本研究纳入184例患者,其中66例(35.9%)患者在手术前8周内接受了抗tnf药物治疗。一期吻合145例(78.8%)。术前接受抗肿瘤坏死因子治疗的患者切除的平均肠长度比术前未接受抗肿瘤坏死因子治疗的患者短10厘米(P结论:术前抗肿瘤坏死因子治疗与切除的肠长度较短有关,但与CD回结肠切除术的总体并发症和脓毒性术后并发症无关。术前停用全身性类固醇可能改善CD患者的术后预后。
{"title":"Preoperative Anti-TNF Therapy is Associated with a Shorter Length of Resected Bowel in Patients Undergoing Ileocolic Resection for Crohn's Disease.","authors":"Yuhua Huang,&nbsp;Danhua Yao,&nbsp;Feilong Guo,&nbsp;Zhiyuan Zhou,&nbsp;Yousheng Li","doi":"10.1080/08941939.2021.2023713","DOIUrl":"https://doi.org/10.1080/08941939.2021.2023713","url":null,"abstract":"<p><strong>Background: </strong>Massive or repeated intestinal resections for Crohn's disease (CD) could lead to disabling consequences. The present study aimed to assess the effect of preoperative anti-TNF therapy on the length of resected bowel and identify risk factors for postoperative morbidity following ileocolic resection for CD.</p><p><strong>Methods: </strong>Patients undergoing elective ileocolic resection for CD were included prospectively. Medical variables including demographics, Montréal classification, preoperative treatment, surgical details and 30-day postoperative morbidity were collected. Potential impact of preoperative anti-TNF treatment on length of ileocolic specimen and risk factors for postoperative morbidity were investigated.</p><p><strong>Results: </strong>One hundred and eight-four patients were included in this study, and 66 (35.9%) of them received anti-TNF agents within 8 weeks prior to surgery. Primary anastomosis was performed in 145 patients (78.8%). The mean length of resected intestine was 10 cm shorter in subjects receiving preoperative anti-TNF treatment than those without preoperative anti-TNF therapy (<i>P</i> < 0.001). The rates of postoperative overall, infectious and intra-abdominal septic morbidity were 29.9%, 19.0% and 7.6%, respectively. In multivariate analysis, anti-TNF therapy < 8 weeks before surgery was independently associated with a shorter length of resected bowel but didn't increase overall and septic complications, while systemic steroids use within 8 weeks prior to surgery independently increased overall complications and intra-abdominal sepsis.</p><p><strong>Conclusions: </strong>Preoperative anti-TNF therapy was associated with a shorter length of resected bowel but not the overall and septic postoperative complications in ileocolic resection for CD. Weaning off systemic steroids before surgery may improve postoperative outcomes in patients with CD.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"35 6","pages":"1357-1365"},"PeriodicalIF":1.9,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39873964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
The Use of Social Media to Deliver Surgical Education in Response to the COVID-19 Pandemic. 利用社交媒体开展外科教育以应对COVID-19大流行
IF 1.9 4区 医学 Q2 SURGERY Pub Date : 2022-06-01 Epub Date: 2022-02-07 DOI: 10.1080/08941939.2022.2035859
Shijie Yang, Chao Jin, Jinhui Wang, Xiequn Xu

Background: As clinical rotations were disrupted by the COVID-19 pandemic, with surgical specialty being the one most severely affected among all disciplines, social media had become increasingly used for surgical education. We aimed to identify and present the application of social media as an essential tool for surgical education during the COVID-19 pandemic.

Materials and methods: A literature review was conducted using PubMed/MEDLINE and EMBASE databases for potentially eligible articles published until April 2021. The review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

Results: A total of 23 articles were identified and systematically reviewed that related to the application of social media use in surgical education during the COVID-19 pandemic. These may be grouped into 3 discrete categories (online learning, scientific research, networking) and 14 topics (online resources, virtual conferencing, preparing for exams, etc.).

Conclusions: Social media has played a multidimensional critical role in training surgical students and residents in the COVID-19 era, with special superiority that cannot be substituted by other online tools.

背景:由于新冠肺炎大流行打乱了临床轮转,外科专业是所有学科中受影响最严重的,社交媒体越来越多地用于外科教育。我们的目的是确定并展示社交媒体作为COVID-19大流行期间外科教育的重要工具的应用。材料和方法:使用PubMed/MEDLINE和EMBASE数据库对2021年4月前发表的潜在符合条件的文章进行文献综述。根据系统评价和荟萃分析的首选报告项目(PRISMA)指南进行评价。结果:共识别并系统回顾了与COVID-19大流行期间社交媒体在外科教育中的应用相关的23篇文章。这些可以分为3个独立的类别(在线学习、科学研究、网络)和14个主题(在线资源、虚拟会议、备考等)。结论:社交媒体在新冠肺炎时代外科学生和住院医师培训中发挥了多维度的关键作用,具有其他在线工具无法替代的特殊优势。
{"title":"The Use of Social Media to Deliver Surgical Education in Response to the COVID-19 Pandemic.","authors":"Shijie Yang,&nbsp;Chao Jin,&nbsp;Jinhui Wang,&nbsp;Xiequn Xu","doi":"10.1080/08941939.2022.2035859","DOIUrl":"https://doi.org/10.1080/08941939.2022.2035859","url":null,"abstract":"<p><strong>Background: </strong>As clinical rotations were disrupted by the COVID-19 pandemic, with surgical specialty being the one most severely affected among all disciplines, social media had become increasingly used for surgical education. We aimed to identify and present the application of social media as an essential tool for surgical education during the COVID-19 pandemic.</p><p><strong>Materials and methods: </strong>A literature review was conducted using PubMed/MEDLINE and EMBASE databases for potentially eligible articles published until April 2021. The review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.</p><p><strong>Results: </strong>A total of 23 articles were identified and systematically reviewed that related to the application of social media use in surgical education during the COVID-19 pandemic. These may be grouped into 3 discrete categories (online learning, scientific research, networking) and 14 topics (online resources, virtual conferencing, preparing for exams, etc.).</p><p><strong>Conclusions: </strong>Social media has played a multidimensional critical role in training surgical students and residents in the COVID-19 era, with special superiority that cannot be substituted by other online tools.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"35 6","pages":"1350-1356"},"PeriodicalIF":1.9,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39897122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Efficacy of Adjuvant Transarterial Chemoembolization after Radical Hepatectomy in Solitary Hepatocellular Carcinoma Patients: A Retrospective Study. 单纯性肝癌根治术后经动脉化疗栓塞的疗效:回顾性研究。
IF 1.9 4区 医学 Q2 SURGERY Pub Date : 2022-06-01 Epub Date: 2022-01-25 DOI: 10.1080/08941939.2021.2021334
Guifang Zeng, Baojia Zou, Yongliang Li, En Lin, Xialei Liu, Peiping Li, Jiafan Chen, Baimeng Zhang, Yingbin Jia, Chaonong Cai, Jian Li

Background: More and more studies have suggested that hepatocellular carcinoma (HCC) patients with high-risk recurrence factors can benefit the most from postoperative adjuvant transarterial chemoembolization (PA-TACE) for its potential effect in delaying cancer recurrence. However, it remains unclear if solitary HCC (SHCC) patients particularly those without high-risk recurrence factors should also receive PA-TACE. This study aimed to analyze the efficacy of PA-TACE in them. Methods: Retrospectively, we enrolled 123 SHCC patients who either received radical hepatectomy alone (No TACE group, n = 39) or followed by PA-TACE (PA-TACE group, n = 84) in our institution. Prognostic risk factors, disease-free survival (DFS), and overall survival (OS) were analyzed using the Cox proportional hazard regression model, the Kaplan-Meier method, and the log-rank test. Results: Liver cirrhosis was the only independent risk factor for SHCC patients. Overall, the PA-TACE group had no improved OS (P = 0.977) but worse DFS compared with the No TACE group (P = 0.045). Consistently, in subgroup analysis, SHCC patients with negative microvascular invasion (MVI), tumor size ≤ 5 cm and preoperative alpha-fetoprotein (AFP) < 400 ng/ml had similar OS (P = 0.466, P = 0.864, P = 0.488, respectively) but even worse DFS (P = 0.035, P = 0.040, P = 0.019, respectively) than those in the No TACE group. Besides, there was no significant difference in DFS and OS between the two groups of SHCC patients with liver cirrhosis (P = 0.342, P = 0.941, respectively). Conclusions: PA-TACE may not improve the long-term survival of SHCC patients, but may even potentially promote their postoperative tumor recurrence, especially for those with MVI-negative, tumor size ≤ 5 cm, and preoperative AFP < 400 ng/ml.

背景:越来越多的研究表明,具有高危复发因素的肝细胞癌(HCC)患者术后辅助经动脉化疗栓塞(PA-TACE)具有延缓癌症复发的潜在作用,获益最大。然而,目前尚不清楚是否孤立性HCC (SHCC)患者,特别是那些没有高风险复发因素的患者也应该接受PA-TACE治疗。本研究旨在分析PA-TACE对其治疗效果。方法:回顾性纳入我院123例单行根治性肝切除术(未行肝移植组,n = 39)或随后行PA-TACE (PA-TACE组,n = 84)的SHCC患者。采用Cox比例风险回归模型、Kaplan-Meier法和log-rank检验分析预后危险因素、无病生存期(DFS)和总生存期(OS)。结果:肝硬化是SHCC患者唯一的独立危险因素。总体而言,PA-TACE组OS无改善(P = 0.977), DFS较no -TACE组差(P = 0.045)。与此一致,在亚组分析中,微血管侵袭(MVI)阴性、肿瘤大小≤5 cm、术前甲胎蛋白(AFP) < 400 ng/ml的SHCC患者的OS (P = 0.466、P = 0.864、P = 0.488)与No TACE组相似,但DFS更差(P = 0.035、P = 0.040、P = 0.019)。此外,两组SHCC合并肝硬化患者的DFS和OS差异无统计学意义(P = 0.342, P = 0.941)。结论:PA-TACE不能改善SHCC患者的长期生存,甚至可能促进其术后肿瘤复发,特别是对于mvi阴性、肿瘤大小≤5 cm、术前AFP < 400 ng/ml的患者。
{"title":"Efficacy of Adjuvant Transarterial Chemoembolization after Radical Hepatectomy in Solitary Hepatocellular Carcinoma Patients: A Retrospective Study.","authors":"Guifang Zeng,&nbsp;Baojia Zou,&nbsp;Yongliang Li,&nbsp;En Lin,&nbsp;Xialei Liu,&nbsp;Peiping Li,&nbsp;Jiafan Chen,&nbsp;Baimeng Zhang,&nbsp;Yingbin Jia,&nbsp;Chaonong Cai,&nbsp;Jian Li","doi":"10.1080/08941939.2021.2021334","DOIUrl":"https://doi.org/10.1080/08941939.2021.2021334","url":null,"abstract":"<p><p><b>Background:</b> More and more studies have suggested that hepatocellular carcinoma (HCC) patients with high-risk recurrence factors can benefit the most from postoperative adjuvant transarterial chemoembolization (PA-TACE) for its potential effect in delaying cancer recurrence. However, it remains unclear if solitary HCC (SHCC) patients particularly those without high-risk recurrence factors should also receive PA-TACE. This study aimed to analyze the efficacy of PA-TACE in them. <b>Methods:</b> Retrospectively, we enrolled 123 SHCC patients who either received radical hepatectomy alone (No TACE group, n = 39) or followed by PA-TACE (PA-TACE group, n = 84) in our institution. Prognostic risk factors, disease-free survival (DFS), and overall survival (OS) were analyzed using the Cox proportional hazard regression model, the Kaplan-Meier method, and the log-rank test. <b>Results:</b> Liver cirrhosis was the only independent risk factor for SHCC patients. Overall, the PA-TACE group had no improved OS (<i>P</i> = 0.977) but worse DFS compared with the No TACE group (<i>P</i> = 0.045). Consistently, in subgroup analysis, SHCC patients with negative microvascular invasion (MVI), tumor size ≤ 5 cm and preoperative alpha-fetoprotein (AFP) < 400 ng/ml had similar OS (<i>P</i> = 0.466, <i>P</i> = 0.864, <i>P</i> = 0.488, respectively) but even worse DFS (<i>P</i> = 0.035, <i>P</i> = 0.040, <i>P</i> = 0.019, respectively) than those in the No TACE group. Besides, there was no significant difference in DFS and OS between the two groups of SHCC patients with liver cirrhosis (<i>P</i> = 0.342, <i>P</i> = 0.941, respectively). <b>Conclusions:</b> PA-TACE may not improve the long-term survival of SHCC patients, but may even potentially promote their postoperative tumor recurrence, especially for those with MVI-negative, tumor size ≤ 5 cm, and preoperative AFP < 400 ng/ml.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"35 6","pages":"1208-1216"},"PeriodicalIF":1.9,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39963519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Preoperative Simulation and Three-Dimensional Model for the Operative Treatment of Forearm Double Fracture: A Randomized Controlled Clinical Trial. 前臂双侧骨折手术治疗的术前模拟及三维模型:一项随机对照临床试验。
IF 1.9 4区 医学 Q2 SURGERY Pub Date : 2022-06-01 Epub Date: 2022-01-04 DOI: 10.1080/08941939.2021.2024305
Yin Zhang, Junchao Luo, Li Cao, Shuijun Zhang, Yu Tong, Qing Bi, Qiong Zhang

Background: To assess the safety and efficacy of preoperative simulation and three-dimensional (3D) models in the treatment of ulnoradial diaphyses fracture. It was hypothesized that preoperative simulation and 3D printing might significantly shorten the mean operative time, intraoperative bleeding, and intraoperative fluoroscopy.

Material and methods: Forty patients with forearm double fracture were divided into 3D printing group and conventional surgery group. Preoperative simulation and 3D printing were performed on patients in the 3D printing group to examine implant reduction and placement as well as preoperative plate/screw size. The operation time, intraoperative bleeding, and frequency of fluoroscopies were recorded.

Results: In the conventional surgery group, the operative time, intraoperative bleeding, and the frequency of fluoroscopy were 106.2 ± 15.92 min, 61.45 ± 11.33 ml and 5.65 ± 1.23 times, whereas in the 3D printing group, values of all the three parameters were better than those of the conventional surgery group (91.3 ± 14.85 min, 48.6 ± 10.39 ml and 3.85 ± 1.04 times, respectively). The forearm pronation and supination of the 3D printing group improved to 79.55 ± 5.12° and 76.80 ± 3.96°, respectively. In the conventional surgery group, patients also had significant improvement in these indicators, which improved to 78.60 ± 5.18° and 75.4 ± 5.30°.

Conclusions: The results showed that preoperative simulation and 3D printing can enhance the safety as well as personalization of the surgical process during the treatment of forearm double fracture and therefore holds potential for future application in clinical practice.

Trial registry: Name of the registry: This study was registered in the Chinese Clinical Trial Registry; Trial registration number: ChiCTR2100045790.

背景:评价术前模拟和三维模型治疗尺桡骨骨干骨折的安全性和有效性。假设术前模拟和3D打印可以显著缩短平均手术时间、术中出血和术中透视时间。材料与方法:40例前臂双侧骨折患者分为3D打印组和常规手术组。3D打印组患者进行术前模拟和3D打印,检查种植体复位和放置以及术前钢板/螺钉大小。记录手术时间、术中出血情况及透视次数。结果:常规手术组手术时间、术中出血、透视次数分别为106.2±15.92 min、61.45±11.33 ml、5.65±1.23次,而3D打印组3项指标均优于常规手术组(分别为91.3±14.85 min、48.6±10.39 ml、3.85±1.04次)。3D打印组前臂旋前、旋后分别提高到79.55±5.12°和76.80±3.96°。常规手术组患者上述指标均有明显改善,分别为78.60±5.18°和75.4±5.30°。结论:在前臂双侧骨折治疗过程中,术前模拟和3D打印技术可以提高手术过程的安全性和个性化,具有未来临床应用的潜力。注册中心名称:本研究已在中国临床试验注册中心注册;试验注册号:ChiCTR2100045790。
{"title":"Preoperative Simulation and Three-Dimensional Model for the Operative Treatment of Forearm Double Fracture: A Randomized Controlled Clinical Trial.","authors":"Yin Zhang,&nbsp;Junchao Luo,&nbsp;Li Cao,&nbsp;Shuijun Zhang,&nbsp;Yu Tong,&nbsp;Qing Bi,&nbsp;Qiong Zhang","doi":"10.1080/08941939.2021.2024305","DOIUrl":"https://doi.org/10.1080/08941939.2021.2024305","url":null,"abstract":"<p><strong>Background: </strong>To assess the safety and efficacy of preoperative simulation and three-dimensional (3D) models in the treatment of ulnoradial diaphyses fracture. It was hypothesized that preoperative simulation and 3D printing might significantly shorten the mean operative time, intraoperative bleeding, and intraoperative fluoroscopy.</p><p><strong>Material and methods: </strong>Forty patients with forearm double fracture were divided into 3D printing group and conventional surgery group. Preoperative simulation and 3D printing were performed on patients in the 3D printing group to examine implant reduction and placement as well as preoperative plate/screw size. The operation time, intraoperative bleeding, and frequency of fluoroscopies were recorded.</p><p><strong>Results: </strong>In the conventional surgery group, the operative time, intraoperative bleeding, and the frequency of fluoroscopy were 106.2 ± 15.92 min, 61.45 ± 11.33 ml and 5.65 ± 1.23 times, whereas in the 3D printing group, values of all the three parameters were better than those of the conventional surgery group (91.3 ± 14.85 min, 48.6 ± 10.39 ml and 3.85 ± 1.04 times, respectively). The forearm pronation and supination of the 3D printing group improved to 79.55 ± 5.12° and 76.80 ± 3.96°, respectively. In the conventional surgery group, patients also had significant improvement in these indicators, which improved to 78.60 ± 5.18° and 75.4 ± 5.30°.</p><p><strong>Conclusions: </strong>The results showed that preoperative simulation and 3D printing can enhance the safety as well as personalization of the surgical process during the treatment of forearm double fracture and therefore holds potential for future application in clinical practice.</p><p><strong>Trial registry: </strong>Name of the registry: This study was registered in the Chinese Clinical Trial Registry; Trial registration number: ChiCTR2100045790.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"35 6","pages":"1231-1238"},"PeriodicalIF":1.9,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39873966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Jump Technique versus Seton Method for Anal Fistula Repair: A Randomized Controlled Trial. 跳跃技术与Seton法修复肛瘘:一项随机对照试验。
IF 1.9 4区 医学 Q2 SURGERY Pub Date : 2022-06-01 Epub Date: 2022-01-06 DOI: 10.1080/08941939.2021.2022252
Jalaluddin Khoshnevis, Roberto Cuomo, Farzaneh Karami, Terifeh Dashti, Alireza Kalantar Motamedi, Mohammadreza Kalantar Motamedi, Eznollah Azargashb, Negaar Aryan, Payam Sadeghi

Background: The treatment of anal fistula has been a conundrum for surgeons over the years. Various methods such as fistulotomy, fistulectomy, seton, ligation of the intersphincteric fistula tract (LIFT), advancement flaps, fibrin glue, and plugs are well-known techniques. Yet, they may be followed by several considerable complications, including incontinency and recurrence.

Methods: In this study, the outcomes of the "Jump" and "Seton" techniques are compared. A randomized controlled trial consisting of 130 cases with cryptoglandular anal fistula randomly sorted into two groups was conducted. Group A underwent the "Jump technique" while group B underwent the "Seton technique." Outcomes, incontinency and recurrences in particular, were evaluated after a year of treatment. Data were analyzed by Fisher Exact, Chi-Square and Mann Whitney Tests.

Results: Group A with 65 cases underwent the "Jump technique" while group B with 65 cases underwent the "Seton Method." Recurrence was reported in 12 (20%) cases in group A and 10 (15.6%) cases in group B (p=0.687). Overall incontinence was reported in 3 (4.6%) cases in group A and 18 (27.7%) cases in group B (P=0.001). The total St. Mark's scores for incontinency of group A (0.092±0.52) and group B (1.8±02.47) significantly differed (p<0.001).

Conclusions: The "Jump technique", named after a runner who jumped over hurdles, has obviated these complications. The "Jump technique" had satisfactory results and can be utilized as a first-line approach for all types of fistulas. Moreover, it can be redone for cases with recurrences without affecting the continence, paving the way to change the technique during operations.

背景:肛瘘的治疗多年来一直是困扰外科医生的难题。各种方法,如瘘管切开术、瘘管切除术、塞顿、括约肌间瘘管束结扎(LIFT)、推进皮瓣、纤维蛋白胶和塞是众所周知的技术。然而,他们可能会出现一些相当大的并发症,包括尿失禁和复发。方法:在本研究中,比较“跳跃”技术和“西顿”技术的效果。将130例隐腺肛瘘患者随机分为两组,进行随机对照试验。A组采用“Jump技术”,B组采用“Seton技术”。结果,特别是尿失禁和复发,在治疗一年后进行评估。采用Fisher Exact、卡方检验和Mann Whitney检验对数据进行分析。结果:A组65例采用“跳跃法”,B组65例采用“Seton法”。A组复发12例(20%),B组复发10例(15.6%)(p=0.687)。A组有3例(4.6%)尿失禁,B组有18例(27.7%)尿失禁(P=0.001)。A组尿失禁St. Mark’s总分为0.092±0.52分,B组为1.8±02.47分,差异有统计学意义(p0.001)。结论:以一位跨栏运动员的名字命名的“跳跃技术”消除了这些并发症。“跳跃技术”有令人满意的结果,可以作为一线入路用于所有类型的瘘。此外,对于复发的病例,可以在不影响尿失禁的情况下重新进行,为手术中改变技术铺平了道路。
{"title":"Jump Technique versus Seton Method for Anal Fistula Repair: A Randomized Controlled Trial.","authors":"Jalaluddin Khoshnevis,&nbsp;Roberto Cuomo,&nbsp;Farzaneh Karami,&nbsp;Terifeh Dashti,&nbsp;Alireza Kalantar Motamedi,&nbsp;Mohammadreza Kalantar Motamedi,&nbsp;Eznollah Azargashb,&nbsp;Negaar Aryan,&nbsp;Payam Sadeghi","doi":"10.1080/08941939.2021.2022252","DOIUrl":"https://doi.org/10.1080/08941939.2021.2022252","url":null,"abstract":"<p><strong>Background: </strong>The treatment of anal fistula has been a conundrum for surgeons over the years. Various methods such as fistulotomy, fistulectomy, seton, ligation of the intersphincteric fistula tract (LIFT), advancement flaps, fibrin glue, and plugs are well-known techniques. Yet, they may be followed by several considerable complications, including incontinency and recurrence.</p><p><strong>Methods: </strong>In this study, the outcomes of the \"Jump\" and \"Seton\" techniques are compared. A randomized controlled trial consisting of 130 cases with cryptoglandular anal fistula randomly sorted into two groups was conducted. Group A underwent the \"Jump technique\" while group B underwent the \"Seton technique.\" Outcomes, incontinency and recurrences in particular, were evaluated after a year of treatment. Data were analyzed by Fisher Exact, Chi-Square and Mann Whitney Tests.</p><p><strong>Results: </strong>Group A with 65 cases underwent the \"Jump technique\" while group B with 65 cases underwent the \"Seton Method.\" Recurrence was reported in 12 (20%) cases in group A and 10 (15.6%) cases in group B (<math><mi>p</mi><mo>=</mo><mn>0.687</mn></math>). Overall incontinence was reported in 3 (4.6%) cases in group A and 18 (27.7%) cases in group B (<math><mi>P</mi><mo>=</mo><mn>0.001</mn></math>). The total St. Mark's scores for incontinency of group A (<math><mn>0.092</mn><mo>±</mo><mn>0.52</mn></math>) and group B (<math><mn>1.8</mn><mo>±</mo><mn>02.47</mn></math>) significantly differed (<math><mi>p</mi><mo><</mo><mn>0.001</mn></math>).</p><p><strong>Conclusions: </strong>The \"Jump technique\", named after a runner who jumped over hurdles, has obviated these complications. The \"Jump technique\" had satisfactory results and can be utilized as a first-line approach for all types of fistulas. Moreover, it can be redone for cases with recurrences without affecting the continence, paving the way to change the technique during operations.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"35 6","pages":"1217-1223"},"PeriodicalIF":1.9,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39879977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
期刊
Journal of Investigative Surgery
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1