Surgical Practice最新文献_第4页

Surgery is safe and improves survival in extremely old aged patients with breast cancer: A retrospective study 对高龄乳腺癌患者来说，手术是安全的，而且能提高生存率：回顾性研究

IF 0.8 4区医学 Q4 SURGERY

Surgical Practice

Pub Date : 2024-02-29 DOI: 10.1111/1744-1633.12676

Alyson Cheung MBChB, Ka-wai Ray Hung MBChB, FRCS, Yee Kei Tsoi MBChB, FRCS, Sze Hong Law MBChB, FRCS, Wing Cheong Chan MBChB, FRCS

Introduction

In 2019, 11% of breast cancers are diagnosed at age 80 or above and this group of older patients constitutes 27% of breast cancer deaths. Previous clinical trials demonstrated comparable survival in older patients given hormonal therapy alone versus standard surgical treatment. However, newer studies showed that surgical treatment in older patients is associated with reduced all-cause and cancer-related mortality. Our study aims to compare the survival of older patients with breast cancer who received surgery versus hormonal therapy alone or expectant management, analyse the factors affecting survival and compare the local complication rates.

Methods

Patients treated under the New Territories East Cluster breast clinic with breast cancer diagnosed at age 80 or above were included in the study. Patients with metastatic disease were excluded. All medical records on the Hospital Authority Clinical Management System were retrospectively reviewed. Predictors including whether surgery was performed, human epidermal growth factor receptor 2 (HER2) status, oestrogen receptor (ER) status, T stage, N stage and activities of daily living status were assessed.

Results

Seventy-eight consecutive patients with breast cancer (median age 85, range 80-99) from 2004 to 2020 were included. Of these, 39 (50%) received surgery, whereas 39 (50%) did not. Patients who received surgery have a longer survival time (median 113 months vs 62 months; log-rank test P = .001). Univariate analysis and multivariate Cox regression model demonstrated that surgery and ER status affect survival. Patients who received surgery also have a lower incidence of local tumour progression and skin ulceration (χ²₁ = 6.3, P = .012).

Conclusion

In older patients with newly diagnosed breast cancer, surgical treatment is associated with a better survival and lower rates of local progression and complications. Surgery is advised even in older patients as long as they are fit for surgery.

2019 年，11% 的乳腺癌患者确诊年龄在 80 岁或以上，而这部分老年患者占乳腺癌死亡人数的 27%。以往的临床试验表明，老年患者单独接受激素治疗与标准手术治疗的生存率相当。然而，较新的研究表明，老年患者接受手术治疗可降低全因死亡率和癌症相关死亡率。我们的研究旨在比较接受手术治疗与单纯荷尔蒙治疗或预期治疗的老年乳癌患者的生存率，分析影响生存率的因素，并比较局部并发症的发生率。在新界東聯網乳房科診所接受治療的 80 歲或以上乳癌患者均被納入研究範圍，但不包括已轉移的患者。研究人员回顾了医院管理局临床管理系统的所有医疗记录。研究评估了包括是否进行手术、人类表皮生长因子受体2（HER2）状态、雌激素受体（ER）状态、T分期、N分期和日常生活活动状况在内的预测因素。其中，39 人（50%）接受了手术治疗，39 人（50%）未接受手术治疗。接受手术的患者生存时间更长（中位 113 个月对 62 个月；对数秩检验 P = .001）。单变量分析和多变量考克斯回归模型表明，手术和ER状态会影响生存期。接受手术治疗的患者局部肿瘤进展和皮肤溃疡的发生率也较低（χ21 = 6.3，P = .012）。即使是老年患者，只要他们适合手术，也建议进行手术治疗。

{"title":"Surgery is safe and improves survival in extremely old aged patients with breast cancer: A retrospective study","authors":"Alyson Cheung MBChB, Ka-wai Ray Hung MBChB, FRCS, Yee Kei Tsoi MBChB, FRCS, Sze Hong Law MBChB, FRCS, Wing Cheong Chan MBChB, FRCS","doi":"10.1111/1744-1633.12676","DOIUrl":"10.1111/1744-1633.12676","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>In 2019, 11% of breast cancers are diagnosed at age 80 or above and this group of older patients constitutes 27% of breast cancer deaths. Previous clinical trials demonstrated comparable survival in older patients given hormonal therapy alone versus standard surgical treatment. However, newer studies showed that surgical treatment in older patients is associated with reduced all-cause and cancer-related mortality. Our study aims to compare the survival of older patients with breast cancer who received surgery versus hormonal therapy alone or expectant management, analyse the factors affecting survival and compare the local complication rates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients treated under the New Territories East Cluster breast clinic with breast cancer diagnosed at age 80 or above were included in the study. Patients with metastatic disease were excluded. All medical records on the Hospital Authority Clinical Management System were retrospectively reviewed. Predictors including whether surgery was performed, human epidermal growth factor receptor 2 (HER2) status, oestrogen receptor (ER) status, T stage, N stage and activities of daily living status were assessed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seventy-eight consecutive patients with breast cancer (median age 85, range 80-99) from 2004 to 2020 were included. Of these, 39 (50%) received surgery, whereas 39 (50%) did not. Patients who received surgery have a longer survival time (median 113 months vs 62 months; log-rank test <i>P</i> = .001). Univariate analysis and multivariate Cox regression model demonstrated that surgery and ER status affect survival. Patients who received surgery also have a lower incidence of local tumour progression and skin ulceration (χ<sup>2</sup><sub>1</sub> = 6.3, <i>P</i> = .012).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In older patients with newly diagnosed breast cancer, surgical treatment is associated with a better survival and lower rates of local progression and complications. Surgery is advised even in older patients as long as they are fit for surgery.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"28 1","pages":"5-10"},"PeriodicalIF":0.8,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140410307","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

Neonatal seizures revealing a ruptured congenital arterial aneurysm: A case report and review of the literature 新生儿惊厥显示先天性动脉瘤破裂：病例报告和文献综述

IF 0.3 4区医学 Q4 SURGERY

Surgical Practice

Pub Date : 2024-02-26 DOI: 10.1111/1744-1633.12674

F. Badr, M. Chemsi, A. Badre, M. Lehlimi, L. Derrak, K. Chbani, S. Salam, A. Habzi, K. Ibahioin, O. Benomar

Neonatal seizures are a frequently encountered neurological condition, with intracranial aneurysms being a rare but notable cause. Cerebellar imaging plays a pivotal role in their diagnosis. Treatment options are microsurgery or embolisation. In this report, we present the case of a 26-day-old neonate who experienced a neonatal seizure, revealing a ruptured aneurysm. The condition was successfully treated surgically, resulting in a favourable outcome.

新生儿癫痫发作是一种常见的神经系统疾病，颅内动脉瘤是一种罕见但值得注意的病因。小脑成像在诊断中起着关键作用。治疗方法有显微外科手术或栓塞术。在本报告中，我们介绍了一例 26 天大的新生儿病例，该患儿在新生儿期发作，显示动脉瘤破裂。该病例成功接受了手术治疗，结果良好。

引用次数: 0

What is Valentino's syndrome? 什么是瓦伦蒂诺综合症？

IF 0.8 4区医学 Q4 SURGERY

Surgical Practice

Pub Date : 2024-02-23 DOI: 10.1111/1744-1633.12673

Theodore N. Pappas MD

The eponym ‘Valentino's syndrome’ is used to describe patients with perforated peptic ulcer disease who present with right lower quadrant pain and suspected appendicitis. It is named for Rudolph Valentino, the film star who died on 23 August 1926 at the age of 31 from complications of perforated peptic ulcer disease. In the early 1920s, the Italian-born actor had a meteoric rise to fame in the burgeoning film industry. His first starring role in the 1921 silent film, The Four Horseman of the Apocalypse, was a sensation and was followed quickly by a string of commercially successful movies. He was in good health until he presented with an acute abdomen in early August of 1926. He underwent a laparotomy and was found to have a perforated peptic ulcer that was repaired with simple closure and an omental patch. He initially rallied after surgery but ultimately died on the eighth post-operative day from complications of sepsis. This manuscript will review Valentino's brief acting career, his medical history, and how the eponym which bears his name describes a disease presentation that is different from his actual clinical course.

瓦伦蒂诺综合征 "这一病名用于描述患有穿孔性消化性溃疡病并伴有右下腹疼痛和疑似阑尾炎的患者。鲁道夫-华伦天奴（Rudolph Valentino）是1926年8月23日死于消化性溃疡穿孔并发症的电影明星，年仅31岁。20 世纪 20 年代初，这位出生于意大利的演员在新兴的电影业一举成名。他在 1921 年的默片《启示录之四骑士》中首次担任主演，引起轰动，随后又迅速拍摄了一系列商业片。1926 年 8 月初，他突发急腹症，之后身体一直很健康。他接受了开腹手术，发现消化性溃疡穿孔，通过简单的缝合和网膜补片进行了修补。术后他起初恢复良好，但最终在术后第八天死于败血症并发症。本手稿将回顾华伦天奴短暂的演艺生涯、他的病史，以及以他的名字命名的外号是如何描述一种与他的实际临床过程不同的疾病表现的。

引用次数: 0

Application of glasses-free augmented reality localization in precision neurosurgery and literature review 裸眼增强现实定位技术在精准神经外科手术中的应用及文献综述

IF 0.3 4区医学 Q4 SURGERY

Surgical Practice

Pub Date : 2024-02-22 DOI: 10.1111/1744-1633.12675

Yahui Cui, Hui Hou, Yupeng Zhou, Haipeng Zhang, Liangyan Jin

To summarize the characteristics and therapeutic effects of glasses-free augmented reality (AR) in neurosurgery, a case series of seven patients undergoing resection of intracranial lesions at the Neurosurgery Department of Hangzhou Xixi Hospital from November 2019 to October 2021 was collected. During the surgeries, glasses-free AR was used for multi-angle and multi-modal image localization. The intraoperative positioning errors of all seven patients who underwent body surface localization with glasses-free AR, in addition to routine surgical procedures, were less than 10 mm. These findings suggest that glasses-free AR holds great promise for precision neurosurgery.

为总结裸眼增强现实技术（AR）在神经外科手术中的应用特点和治疗效果，收集了2019年11月至2021年10月在杭州市西溪医院神经外科接受颅内病变切除术的7例患者的系列病例。手术过程中，使用裸眼AR进行多角度、多模态图像定位。除常规手术外，使用裸眼AR进行体表定位的7名患者的术中定位误差均小于10毫米。这些研究结果表明，裸眼 AR 在精确神经外科手术中大有可为。

引用次数: 0

Day surgery in the treatment of benign prostatic obstruction with photoselective vaporisation of the prostate: A single-institution experience 前列腺光选择性汽化术治疗良性前列腺梗阻的日间手术：单一机构的经验

IF 0.8 4区医学 Q4 SURGERY

Surgical Practice

Pub Date : 2024-02-07 DOI: 10.1111/1744-1633.12672

Kin Chung Wong, Ting Kit Lo, Siu Kei Li, Ning Hong Chan, Cheuk Man Li, Ka Wing Wong

Aim

To assess the feasibility, efficacy and safety of performing photoselective vaporisation of the prostate (PVP) as a day-surgery procedure for patients with benign prostatic obstruction.

Patients and Methods

A prospective single-arm observational study was performed involving patients with benign prostatic obstruction (BPO) who received PVP between 2017 and 2021. Data were collected on demographics, prostate volume by transrectal ultrasonography, mean peak flow rate (Q_max), post-void residual urine volume, International Prostate Symptom Score (IPSS) with quality-of-life (QoL) index, length of stay, success in weaning off catheter on the day of operation and complications.

Results

PVP was performed successfully in all 37 men between 2017 and 2021. Their mean age was 67 years. The mean prostate volume was 54 mL. The mean duration of operation was 80 min. The mean peak urinary flow rate improved from 9.14 to 16.8, 17.3 and 15.4 mL/s at post-operative 1, 3 and 12 months, respectively (P = .001). The mean IPSS score improved from 19.5 to 8.94, 6.40 and 5.63 at post-operative 1, 3 and 12 months, respectively (P < .001). The mean QoL index improved from 4.07 to 2.43, 2.25 and 1.81 at post-operative 1, 3 and 12 months, respectively (P = .001). The mean duration of catheterisation after PVP was 5.81 h. Thirty-three (89.2%) patients were discharged on the same day. Overall, the 30-day complication rate was 27%. The most common complication was haematuria (6 patients, 16.2%). Five patients (13.5%) required readmission and inpatient care. There was one Clavien–Dindo grade III and IV complication (2.6%), respectively.

Conclusion

This study demonstrated the feasibility of performing PVP as a day-surgery procedure with good short- and medium-term functional outcomes and safety profiles.

目的：评估对良性前列腺梗阻患者实施光选择性前列腺汽化术（PVP）作为日间手术的可行性、有效性和安全性。研究人员开展了一项前瞻性单臂观察研究，涉及2017年至2021年期间接受光选择性前列腺汽化术的良性前列腺梗阻（BPO）患者。研究收集了有关人口统计学、经直肠超声检查前列腺体积、平均峰值流速（Qmax）、排尿后残余尿量、国际前列腺症状评分（IPSS）和生活质量（QoL）指数、住院时间、手术当天成功断开导尿管以及并发症等方面的数据。2017年至2021年间，37名男性患者均成功实施了PVP手术。他们的平均年龄为 67 岁。他们的平均年龄为 67 岁，平均前列腺体积为 54 毫升。平均手术时间为 80 分钟。术后1个月、3个月和12个月时，平均尿流峰值分别从9.14 mL/s提高到16.8 mL/s、17.3 mL/s和15.4 mL/s（P = .001）。术后 1 个月、3 个月和 12 个月时，IPSS 平均得分分别从 19.5 分提高到 8.94 分、6.40 分和 5.63 分（P < .001）。术后 1、3 和 12 个月时，平均 QoL 指数分别从 4.07 降至 2.43、2.25 和 1.81（P = .001）。33 名患者（89.2%）当天就出院了。总体而言，30 天的并发症发生率为 27%。最常见的并发症是血尿（6 名患者，16.2%）。五名患者（13.5%）需要再次入院并接受住院治疗。这项研究表明，PVP 日间手术具有良好的中短期功能效果和安全性。

{"title":"Day surgery in the treatment of benign prostatic obstruction with photoselective vaporisation of the prostate: A single-institution experience","authors":"Kin Chung Wong, Ting Kit Lo, Siu Kei Li, Ning Hong Chan, Cheuk Man Li, Ka Wing Wong","doi":"10.1111/1744-1633.12672","DOIUrl":"10.1111/1744-1633.12672","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To assess the feasibility, efficacy and safety of performing photoselective vaporisation of the prostate (PVP) as a day-surgery procedure for patients with benign prostatic obstruction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>A prospective single-arm observational study was performed involving patients with benign prostatic obstruction (BPO) who received PVP between 2017 and 2021. Data were collected on demographics, prostate volume by transrectal ultrasonography, mean peak flow rate (Q<sub>max</sub>), post-void residual urine volume, International Prostate Symptom Score (IPSS) with quality-of-life (QoL) index, length of stay, success in weaning off catheter on the day of operation and complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>PVP was performed successfully in all 37 men between 2017 and 2021. Their mean age was 67 years. The mean prostate volume was 54 mL. The mean duration of operation was 80 min. The mean peak urinary flow rate improved from 9.14 to 16.8, 17.3 and 15.4 mL/s at post-operative 1, 3 and 12 months, respectively (<i>P</i> = .001). The mean IPSS score improved from 19.5 to 8.94, 6.40 and 5.63 at post-operative 1, 3 and 12 months, respectively (<i>P</i> < .001). The mean QoL index improved from 4.07 to 2.43, 2.25 and 1.81 at post-operative 1, 3 and 12 months, respectively (<i>P</i> = .001). The mean duration of catheterisation after PVP was 5.81 h. Thirty-three (89.2%) patients were discharged on the same day. Overall, the 30-day complication rate was 27%. The most common complication was haematuria (6 patients, 16.2%). Five patients (13.5%) required readmission and inpatient care. There was one Clavien–Dindo grade III and IV complication (2.6%), respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study demonstrated the feasibility of performing PVP as a day-surgery procedure with good short- and medium-term functional outcomes and safety profiles.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"28 1","pages":"11-15"},"PeriodicalIF":0.8,"publicationDate":"2024-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139857536","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 test for intermittent theta burst stimulation during motor rehabilitation in patients post-stroke in a tertiary centre in Hong Kong 香港三级医疗中心间歇性θ脉冲刺激对中风后患者运动康复的疗效测试

IF 0.3 4区医学 Q4 SURGERY

Surgical Practice

Pub Date : 2023-12-30 DOI: 10.1111/1744-1633.12671

Hiu Ming Leung, Ming Him Yuen, Calvin Hoi Kwan Mak, Tak Lap Poon, Fung Ching Cheung, Helen Ka Yan Luk, Bryan Swee Haw Chee

Aim

Stroke represents a significant cause of long-term disability in adults. Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive brain stimulation method known for its potential to enhance motor recovery. Intermittent theta burst stimulation (iTBS), a standardised rTMS protocol initially utilised in patients with depression, has garnered attention in the realm of stroke rehabilitation. This study seeks to establish the efficacy profile of iTBS in motor rehabilitation for patients with subacute or chronic stroke.

Patients and methods

This study is a prospective cohort trial in which eligible patients with stroke were recruited into the iTBS group. Ten sessions of iTBS were conducted, followed by physiotherapy. An equal number of matched controls were recruited into the conventional physiotherapy group. The differences in various scoring systems related to motor performance at 6 months were analysed using independent two-sample t test.

Results

Forty patients were enrolled in the study. At 6 months, iTBS demonstrated a statistically significant improvement compared with conventional physiotherapy across various scoring systems, including motor power grading (47.4% vs 0%, P < .0001), Upper Extremity Fugl–Meyer Assessment (19.8% vs 0.7%, P < .0001), Box and Block Test (25.6% vs 1.7%, P = .007) and Barthel Index (17.8% vs 0.1%, P = .0002). No major adverse events were reported in the iTBS group at 6 months.

Conclusion

iTBS resulted in significant improvement in motor performance across various domains at 6 months compared with conventional physiotherapy alone. This method proves to be a safe approach for motor rehabilitation.

中风是导致成年人长期残疾的主要原因。重复经颅磁刺激（rTMS）是一种非侵入性的脑刺激方法，可促进运动康复。间歇θ脉冲刺激（iTBS）是一种标准模式的经颅磁刺激方案，最初用于抑郁症患者，在脑卒中康复中越来越受欢迎。本研究旨在确定 iTBS 对亚急性或慢性中风患者运动康复的疗效。符合条件的中风患者被纳入 iTBS 组。进行 10 次 iTBS 训练，然后进行物理治疗。常规物理治疗组招募相同数量的匹配对照组。通过独立双样本 t 检验分析 6 个月时与运动表现相关的各种评分系统的差异。与传统物理疗法相比，iTBS 在 6 个月时，在包括运动能力分级在内的各种评分系统方面均有显著改善（47.4% vs 0%，P<0.05）。4% vs 0%，p<0.0001）、上肢--Fugl-Meyer评估（UE-FMA）（19.8% vs 0.7%，p<0.0001）、方框和块测试（BBT）（25.6% vs 1.7%，p=0.007）、巴特尔指数（BI）（17.8% vs 0.1%，p=0.0002）。与传统物理治疗相比，iTBS治疗组在6个月后各领域的运动表现均有显著改善。这是一种安全的运动康复方法。本文受版权保护。

{"title":"Efficacy test for intermittent theta burst stimulation during motor rehabilitation in patients post-stroke in a tertiary centre in Hong Kong","authors":"Hiu Ming Leung, Ming Him Yuen, Calvin Hoi Kwan Mak, Tak Lap Poon, Fung Ching Cheung, Helen Ka Yan Luk, Bryan Swee Haw Chee","doi":"10.1111/1744-1633.12671","DOIUrl":"10.1111/1744-1633.12671","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Stroke represents a significant cause of long-term disability in adults. Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive brain stimulation method known for its potential to enhance motor recovery. Intermittent theta burst stimulation (iTBS), a standardised rTMS protocol initially utilised in patients with depression, has garnered attention in the realm of stroke rehabilitation. This study seeks to establish the efficacy profile of iTBS in motor rehabilitation for patients with subacute or chronic stroke.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and methods</h3>\u0000 \u0000 <p>This study is a prospective cohort trial in which eligible patients with stroke were recruited into the iTBS group. Ten sessions of iTBS were conducted, followed by physiotherapy. An equal number of matched controls were recruited into the conventional physiotherapy group. The differences in various scoring systems related to motor performance at 6 months were analysed using independent two-sample <i>t</i> test.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Forty patients were enrolled in the study. At 6 months, iTBS demonstrated a statistically significant improvement compared with conventional physiotherapy across various scoring systems, including motor power grading (47.4% vs 0%, <i>P</i> < .0001), Upper Extremity Fugl–Meyer Assessment (19.8% vs 0.7%, <i>P</i> < .0001), Box and Block Test (25.6% vs 1.7%, <i>P</i> = .007) and Barthel Index (17.8% vs 0.1%, <i>P</i> = .0002). No major adverse events were reported in the iTBS group at 6 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>iTBS resulted in significant improvement in motor performance across various domains at 6 months compared with conventional physiotherapy alone. This method proves to be a safe approach for motor rehabilitation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"28 2","pages":"82-86"},"PeriodicalIF":0.3,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139139172","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

Laparoscopic single anastomosis sleeve ileal bypass in the surgical management of morbid obesity: A single-centre experience 腹腔镜单吻合袖式回肠（SASI）旁路术在肥胖症外科治疗中的应用--单中心经验

IF 0.3 4区医学 Q4 SURGERY

Surgical Practice

Pub Date : 2023-12-06 DOI: 10.1111/1744-1633.12670

Hosam Barakat, Alhassan Hassan, Mohamed Elsheikh, Amir Abdelhamid

Background

Single anastomosis sleeve ileal (SASI) bypass is a recently developed two-step bariatric operation that involves a sleeve gastrectomy followed by a side-to-side sleeve-ileal anastomosis. While the primary outcomes are promising, more evidence is required before SASI can be considered a standard bariatric procedure.

Objective

This study aims to evaluate short-term outcomes of SASI bypass regarding safety, efficacy and complications.

Methods

This retrospective study involved the analysis of 75 patients who underwent SASI between January 2019 and January 2022. The study examined patients’ characteristics, comorbidities, surgical technique, operative details, post-operative weight loss and complications.

Results

Of the 88 patients who underwent SASI, 13 were excluded, leaving 75 participants for analysis. The mean age was 36.9 ± 8.3 years, and the mean body mass index was 49.23 ± 5.5 kg/m². Among the participants, 19 patients (25.3%) had diabetes and 8 patients (10.6%) had hypertension. The mean operative time was 78.42 ± 13.18 min. The mean excess weight loss percentage was 25.53 ± 3.63, 43.33 ± 8.78, 63.51 ± 10.85, 82.11 ± 11.42 and 88.95 ± 8.69 at 1, 3, 6, 12 and 24 months, respectively. The diabetic remission rate was 100%, and the hypertension remission rate was 75%. Post-operative complications were observed in 12 patients (16%), with most being minor. Notably, two patients underwent SASI reversal to sleeve gastrectomy due to excessive weight loss, and one patient experienced weight regain in the second post-operative year.

Conclusion

SASI bypass emerges as a straightforward and highly effective bariatric procedure, with an acceptable complication rate. It is easy to perform and revise, offering not only excellent and sustained weight loss outcomes during short-term follow-up but also the resolution or improvement of obesity-associated comorbidities.

单吻合术套筒回肠旁路(SASI)是一种最近发展起来的两步减肥手术，包括套筒胃切除术(SG)，然后进行侧对侧套筒回肠吻合。虽然，初步结果是有希望的，但在SASI考虑成为标准的减肥程序之前，还需要更多的证据。评估SASI旁路术的安全性、有效性和并发症的短期预后。这项回顾性研究包括2019年1月至2022年1月期间接受SASI的75例患者。分析患者的特点、合并症、手术技术、手术细节、术后体重减轻情况及并发症。88例SASI患者中，13例被排除，75例被纳入(平均年龄36.9±8.3岁，平均体重指数(BMI) 49.23±5.5 kg/m2)。糖尿病19例(25.3%)，高血压8例(10.6%)。平均手术时间78.42±13.18分钟。1、3、6、12、24个月的平均EWL%分别为25.53±3.63、43.33±8.78、63.51±10.85、82.11±11.42、88.95±8.69。糖尿病缓解率100%，高血压缓解率75%。术后总并发症12例(16%)。大多数并发症是轻微的，然而，2例患者由于体重减轻过多而将SASI逆转为SG。一名患者在术后第二年出现体重反弹。SASI旁路是一种简单、高效的减肥手术，并发症发生率可接受，操作简单，易于修改。它不仅在短期随访中提供了良好和持续的减肥结果，而且还解决或改善了肥胖相关的合并症。这篇文章受版权保护。版权所有。

{"title":"Laparoscopic single anastomosis sleeve ileal bypass in the surgical management of morbid obesity: A single-centre experience","authors":"Hosam Barakat, Alhassan Hassan, Mohamed Elsheikh, Amir Abdelhamid","doi":"10.1111/1744-1633.12670","DOIUrl":"10.1111/1744-1633.12670","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Single anastomosis sleeve ileal (SASI) bypass is a recently developed two-step bariatric operation that involves a sleeve gastrectomy followed by a side-to-side sleeve-ileal anastomosis. While the primary outcomes are promising, more evidence is required before SASI can be considered a standard bariatric procedure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aims to evaluate short-term outcomes of SASI bypass regarding safety, efficacy and complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study involved the analysis of 75 patients who underwent SASI between January 2019 and January 2022. The study examined patients’ characteristics, comorbidities, surgical technique, operative details, post-operative weight loss and complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 88 patients who underwent SASI, 13 were excluded, leaving 75 participants for analysis. The mean age was 36.9 ± 8.3 years, and the mean body mass index was 49.23 ± 5.5 kg/m<sup>2</sup>. Among the participants, 19 patients (25.3%) had diabetes and 8 patients (10.6%) had hypertension. The mean operative time was 78.42 ± 13.18 min. The mean excess weight loss percentage was 25.53 ± 3.63, 43.33 ± 8.78, 63.51 ± 10.85, 82.11 ± 11.42 and 88.95 ± 8.69 at 1, 3, 6, 12 and 24 months, respectively. The diabetic remission rate was 100%, and the hypertension remission rate was 75%. Post-operative complications were observed in 12 patients (16%), with most being minor. Notably, two patients underwent SASI reversal to sleeve gastrectomy due to excessive weight loss, and one patient experienced weight regain in the second post-operative year.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>SASI bypass emerges as a straightforward and highly effective bariatric procedure, with an acceptable complication rate. It is easy to perform and revise, offering not only excellent and sustained weight loss outcomes during short-term follow-up but also the resolution or improvement of obesity-associated comorbidities.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"28 2","pages":"68-75"},"PeriodicalIF":0.3,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138596088","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

Analysis of risk factors associated with distant metastasis detected at laparotomy in patients with radiologically resectable pancreatic ductal adenocarcinoma 放射学可切除胰腺导管腺癌患者开腹手术发现远处转移的相关风险因素分析

IF 0.3 4区医学 Q4 SURGERY

Surgical Practice

Pub Date : 2023-11-28 DOI: 10.1111/1744-1633.12669

Pipit Burasakarn MD, PhD, Kwanchanok Yochum MD, Sermsak Hongjinda MD, Anuparp Thienhiran MD, Pusit Fuengfoo MD

Purpose

This study aimed to evaluate the preoperative risk factors in patients with radiologically resectable pancreatic ductal adenocarcinomas (PDACs), deemed to be unresectable intraoperatively.

Methods

Data on patients radiologically diagnosed with resectable PDACs and subsequently underwent pancreatectomy between January 2020 and December 2021 were retrospectively collected. Preoperative risk factors were also analysed.

Results

Fifty-three patients with resectable PDAC who underwent laparotomy for curative intent were divided into the no-metastases (n = 32) and distant metastases (n = 21) groups. Univariate analysis identified factors associated with distant metastases found intraoperatively, such as significant weight loss (odds ratio [OR] 5.29, P = .02), tumour size >35 mm (OR 4.15, P = .017), tumours located at the body and tail of the pancreas (OR 6, P = .041), superior mesenteric vein (SMV) abutment from the tumour (OR 7.5, P = .02), serum carbohydrate antigen 19-9 > 385 IU/mL (OR 3.58, P = .031) and serum carcinoembryonic antigen (CEA) levels >9 IU/mL. However, multivariate analysis showed that only significant weight loss (adjusted OR 27.19, P = .011), SMV abutment from the tumour (adjusted OR 52.64, P = .01) and serum CEA levels >9 IU/mL were associated with distant metastases found intraoperatively.

Conclusion

Significant weight loss, SMV abutment and serum CEA levels of >9 IU/mL were intraoperatively associated with distant metastases. Staging laparoscopy and positron emission tomography–computed tomography may reduce unnecessary laparotomies and change clinical management in these patients.

这项研究旨在评估术中被认为无法切除的放射学可切除胰腺导管腺癌患者的术前风险因素。研究人员回顾性收集了2020年1月至2021年12月期间经放射学确诊为可切除胰腺导管腺癌（PDAC）并随后接受胰腺切除术的患者数据。53名可切除的PDAC患者因治愈目的接受了开腹手术，被分为无转移组（32人）和远处转移组（21人）。单变量分析确定了与术中发现的远处转移相关的因素，如体重明显减轻（比值比 [OR]：5.29，P = 0.02）、肿瘤大小 >35 mm（OR：4.15，P = 0.017）、肿瘤位于胰体和胰尾（OR：6，P = 0.041）、肠系膜上静脉（SMV）与肿瘤相连（OR：7.5，P = 0.02）、血清碳水化合物抗原 19-9 > 385 IU/mL（OR：3.58，P = 0.031）和血清癌胚抗原（CEA）水平 > 9 IU/mL。然而，多变量分析表明，只有体重明显减轻（调整后 OR：27.19，p = 0.011）、SMV 与肿瘤相连（调整后 OR：52.64，p = 0.01）和血清 CEA 水平大于 9 IU/mL 与术中发现的远处转移相关。分期腹腔镜检查和正电子发射计算机断层扫描（PET-CT）可减少不必要的开腹手术，并改变这些患者的临床治疗。本文受版权保护。

{"title":"Analysis of risk factors associated with distant metastasis detected at laparotomy in patients with radiologically resectable pancreatic ductal adenocarcinoma","authors":"Pipit Burasakarn MD, PhD, Kwanchanok Yochum MD, Sermsak Hongjinda MD, Anuparp Thienhiran MD, Pusit Fuengfoo MD","doi":"10.1111/1744-1633.12669","DOIUrl":"10.1111/1744-1633.12669","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This study aimed to evaluate the preoperative risk factors in patients with radiologically resectable pancreatic ductal adenocarcinomas (PDACs), deemed to be unresectable intraoperatively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data on patients radiologically diagnosed with resectable PDACs and subsequently underwent pancreatectomy between January 2020 and December 2021 were retrospectively collected. Preoperative risk factors were also analysed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fifty-three patients with resectable PDAC who underwent laparotomy for curative intent were divided into the no-metastases (n = 32) and distant metastases (n = 21) groups. Univariate analysis identified factors associated with distant metastases found intraoperatively, such as significant weight loss (odds ratio [OR] 5.29, <i>P</i> = .02), tumour size >35 mm (OR 4.15, <i>P</i> = .017), tumours located at the body and tail of the pancreas (OR 6, <i>P</i> = .041), superior mesenteric vein (SMV) abutment from the tumour (OR 7.5, <i>P</i> = .02), serum carbohydrate antigen 19-9 > 385 IU/mL (OR 3.58, <i>P</i> = .031) and serum carcinoembryonic antigen (CEA) levels >9 IU/mL. However, multivariate analysis showed that only significant weight loss (adjusted OR 27.19, <i>P</i> = .011), SMV abutment from the tumour (adjusted OR 52.64, <i>P</i> = .01) and serum CEA levels >9 IU/mL were associated with distant metastases found intraoperatively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Significant weight loss, SMV abutment and serum CEA levels of >9 IU/mL were intraoperatively associated with distant metastases. Staging laparoscopy and positron emission tomography–computed tomography may reduce unnecessary laparotomies and change clinical management in these patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"28 2","pages":"76-81"},"PeriodicalIF":0.3,"publicationDate":"2023-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139221430","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

Use of a lockable pigtail catheter (Cook Dawson-Mueller Multipurpose Drainage Catheter) for nephrostomy reduces the risk of slippage of the catheter 使用可锁定的尾纤导管（Cook® Dawson-Mueller 多用途引流导管）进行肾造瘘术可降低导管滑脱的风险

IF 0.8 4区医学 Q4 SURGERY

Surgical Practice

Pub Date : 2023-11-28 DOI: 10.1111/1744-1633.12668

Shugo Yajima MD, Yasukazu Nakanishi MD, PhD, Kohei Hirose MD, Madoka Kataoka MD, Hitoshi Masuda MD, PhD

Objective

This study compared the outcomes of using Mac-Loc catheters and non–Mac-Loc catheters for percutaneous nephrostomy (PCN). Mac-Loc catheters have a locking mechanism that forms a curl at the tip by pulling a suture and securing it in place.

Methodology

This retrospective study compared the outcomes of consecutive patients who received PCN with catheters equipped with Mac-Loc versus those with catheters without Mac-Loc. Catheter failure was the primary endpoint of the study and was defined as all cases of catheter malfunction after PCN. A propensity score was calculated from covariates based on clinical variables, and patients in each group were matched 1:1 based on the propensity score.

Results

During the follow-up period, a total of 289 cases underwent PCN, 72 with catheters equipped with Mac-Loc and 217 without Mac-Loc. Failure of the catheter occurred in 63 cases (22%). There were 44 cases (70%) of slippage, 18 cases (29%) of obstruction, and 1 case (2%) of catheter rupture. After propensity score matching, catheter failure–free survival was significantly higher in the group with catheters equipped with Mac-Loc than in the group without Mac-Loc (P = .003).

Conclusions

The use of catheters equipped with Mac-Loc for PCN reduces the risk of unintentional catheter slippage.

这项研究比较了使用 Mac-Loc® 导管和非 Mac-Loc® 导管进行经皮肾造瘘术 (PCN) 的疗效。这项回顾性研究比较了使用装有 Mac-Loc® 导管和未装 Mac-Loc® 导管的 PCN 连续患者的治疗效果。导管故障是研究的主要终点，定义为 PCN 后导管发生故障的所有病例。根据临床变量的协变量计算出倾向得分，并根据倾向得分对每组受试者进行1:1配对。在随访期间，共有289例接受了PCN手术，其中72例导管配备了Mac-Loc®，217例导管未配备Mac-Loc®。导管发生故障的有 63 例（22%）；其中 44 例（70%）导管滑脱，18 例（29%）导管阻塞，1 例（2%）导管破裂。经过倾向评分匹配后，配备 Mac-Loc® 的导管组的导管无故障存活率明显高于未配备 Mac-Loc® 的导管组（p = 0.003）。本文受版权保护。

{"title":"Use of a lockable pigtail catheter (Cook Dawson-Mueller Multipurpose Drainage Catheter) for nephrostomy reduces the risk of slippage of the catheter","authors":"Shugo Yajima MD, Yasukazu Nakanishi MD, PhD, Kohei Hirose MD, Madoka Kataoka MD, Hitoshi Masuda MD, PhD","doi":"10.1111/1744-1633.12668","DOIUrl":"10.1111/1744-1633.12668","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study compared the outcomes of using Mac-Loc catheters and non–Mac-Loc catheters for percutaneous nephrostomy (PCN). Mac-Loc catheters have a locking mechanism that forms a curl at the tip by pulling a suture and securing it in place.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methodology</h3>\u0000 \u0000 <p>This retrospective study compared the outcomes of consecutive patients who received PCN with catheters equipped with Mac-Loc versus those with catheters without Mac-Loc. Catheter failure was the primary endpoint of the study and was defined as all cases of catheter malfunction after PCN. A propensity score was calculated from covariates based on clinical variables, and patients in each group were matched 1:1 based on the propensity score.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>During the follow-up period, a total of 289 cases underwent PCN, 72 with catheters equipped with Mac-Loc and 217 without Mac-Loc. Failure of the catheter occurred in 63 cases (22%). There were 44 cases (70%) of slippage, 18 cases (29%) of obstruction, and 1 case (2%) of catheter rupture. After propensity score matching, catheter failure–free survival was significantly higher in the group with catheters equipped with Mac-Loc than in the group without Mac-Loc (<i>P</i> = .003).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The use of catheters equipped with Mac-Loc for PCN reduces the risk of unintentional catheter slippage.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"28 1","pages":"27-31"},"PeriodicalIF":0.8,"publicationDate":"2023-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139219733","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

Comparison of nephrostomy and double-J stent in the management of percutaneous nephrolithotomy–induced renal pelvis trauma: A prospective randomized controlled trial 比较肾造瘘术和双j支架治疗经皮肾镜碎石术引起的肾盂创伤：前瞻性随机对照试验研究

IF 0.3 4区医学 Q4 SURGERY

Surgical Practice

Pub Date : 2023-11-27 DOI: 10.1111/1744-1633.12667

Kaveh Mehravaran MD, Mohammad Kolbadinezhad MD, Robab Maghsoudi MD, Amir Hossein Kashi MD, Saeed Reza Ghanbarizadeh MD, Behzad Narouie MD, Hamidreza Rouientan MD

Objective

This study aimed to compare the efficacy of nephrostomy versus double-J (DJ) ureteral stent in managing kidney pelvis trauma during percutaneous nephrolithotomy (PCNL) procedures.

Methodology

This prospective parallel-group clinical trial involved 60 PCNL patients diagnosed with kidney pelvis perforation during PCNL through nephroscopy (inclusion criteria). Exclusion criteria comprised a history of previous renal surgery or prior PCNL. Eligible patients were alternately assigned to either the insertion of a nephrostomy or a ureteral DJ stent.

Results

A total of 31 patients were included in the nephrostomy group, and 29 were in the DJ group. The mean ± SD of operation duration in nephrostomy and DJ groups were 50.8 ± 23.7 and 45.7 ± 19.3 min, respectively (P = .17). Two-access PCNLs were performed in 13% and 18% of PCNL operations in the nephrostomy and DJ groups, respectively (P = .72). In the nephrostomy group, 5 patients (17%) had urinoma collection around the kidney, compared with 11 (39%) in the DJ group, showing a statistically significant difference between the two groups (P = .036). Post-operative fever and urinary leakage were observed in 48% and 32% of patients in nephrostomy group versus 44% and 22% of patients in group DJ (P = .76 and P = .39).

Conclusion

The findings of this study indicate a higher percentage of urinoma detected one week after the insertion of a ureteral DJ compared with nephrostomy in PCNL patients who experienced renal pelvis injury during the operation.

本研究旨在比较肾造瘘术与双J（Dj）输尿管支架在经皮肾镜碎石术（PCNL）肾盂创伤治疗中的疗效。这项前瞻性平行分组临床试验的对象是60例PCNL患者，这些患者在PCNL过程中经肾镜诊断为肾盂穿孔（纳入标准），排除标准为既往接受过肾脏手术和既往接受过PCNL。符合条件的患者被分为插入肾造口术和插入输尿管Dj支架两组。N组和Dj组手术时间的平均值（±SD）分别为50.8±23.7和45.7±19.3（P=0.17）。在 N 组和 Dj 组的 PCNL 手术中，分别有 13% 和 18% 进行了两次入路 PCNL（P = 0.72）。N 组有 5 名患者（17%）在肾脏周围出现尿瘤聚集，而 Dj 组有 11 名患者（39%）。N组分别有48%和32%的患者出现术后发热和漏尿，而Dj组分别有44%和22%的患者出现术后发热和漏尿，两组差异有统计学意义（P = 0.036）。本研究结果显示，与肾造瘘术相比，PCNL 患者在插入输尿管 Dj 一周后发现尿瘤的比例更高，因为这些患者在手术过程中肾盂受伤。"本研究已在伊朗临床试验登记处登记，代码为 IRCT20191230045956N1。"

{"title":"Comparison of nephrostomy and double-J stent in the management of percutaneous nephrolithotomy–induced renal pelvis trauma: A prospective randomized controlled trial","authors":"Kaveh Mehravaran MD, Mohammad Kolbadinezhad MD, Robab Maghsoudi MD, Amir Hossein Kashi MD, Saeed Reza Ghanbarizadeh MD, Behzad Narouie MD, Hamidreza Rouientan MD","doi":"10.1111/1744-1633.12667","DOIUrl":"10.1111/1744-1633.12667","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to compare the efficacy of nephrostomy versus double-J (DJ) ureteral stent in managing kidney pelvis trauma during percutaneous nephrolithotomy (PCNL) procedures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methodology</h3>\u0000 \u0000 <p>This prospective parallel-group clinical trial involved 60 PCNL patients diagnosed with kidney pelvis perforation during PCNL through nephroscopy (inclusion criteria). Exclusion criteria comprised a history of previous renal surgery or prior PCNL. Eligible patients were alternately assigned to either the insertion of a nephrostomy or a ureteral DJ stent.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 31 patients were included in the nephrostomy group, and 29 were in the DJ group. The mean ± SD of operation duration in nephrostomy and DJ groups were 50.8 ± 23.7 and 45.7 ± 19.3 min, respectively (<i>P</i> = .17). Two-access PCNLs were performed in 13% and 18% of PCNL operations in the nephrostomy and DJ groups, respectively (<i>P</i> = .72). In the nephrostomy group, 5 patients (17%) had urinoma collection around the kidney, compared with 11 (39%) in the DJ group, showing a statistically significant difference between the two groups (<i>P</i> = .036). Post-operative fever and urinary leakage were observed in 48% and 32% of patients in nephrostomy group versus 44% and 22% of patients in group DJ (<i>P</i> = .76 and <i>P</i> = .39).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The findings of this study indicate a higher percentage of urinoma detected one week after the insertion of a ureteral DJ compared with nephrostomy in PCNL patients who experienced renal pelvis injury during the operation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"28 2","pages":"63-67"},"PeriodicalIF":0.3,"publicationDate":"2023-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139230822","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