Xinxin Zhang, Qian Wang, Min Zhang, Liguang Chen, Danhong Peng
Background: Sex, in the sense of gender, is a major social demographic characteristic that has been shown to affect health care outcomes. The concept of enhanced recovery after surgery (ERAS) is an effective perioperative management measure that can reduce the perioperative stress response in patients. However, there are few studies on the differences between male and female patients under this type of care. We aimed to analyze sex differences in clinical characteristics among patients undergoing hepatobiliary and pancreatic surgery with accelerated rehabilitation. Methods: We enrolled patients who underwent liver, biliary tract, and gallbladder operations in the Department of Hepatobiliary and Pancreatic Surgery of Taizhou Hospital, Zhejiang Province, China, from April 2021 to July 2021. Key measures were collected for patients undergoing perioperative accelerated rehabilitation (i.e., the case group). The study group was assembled by performing 1:1 matching for age, sex, chronic disease, and type of surgery. Postoperative risk assessment, postoperative recovery indicators, and postoperative length of hospital stay (days) were compared between male and female patients. Results: A total of 226 surgical patients were enrolled, including 109 male (48.23%) and 117 female patients (51.77%). The outcomes, presented as the median (min, max), were as follows: pulmonary rehabilitation risk assessment in females (1(0,3)) and males (0(0,2)), postoperative nausea and vomiting in females (2(1,3)) and males (1(0,2)), and time to first defecation in females (31(4,61)) and males (36(10,78)). Significant differences were indicated by p values < 0.05. Conclusion: We identified sex differences in the clinical prognosis and performance of perioperative patients undergoing hepatobiliary and pancreatic surgery with accelerated rehabilitation. The perioperative pulmonary rehabilitation risk of male patients was higher than that of female patients, and the time to first defecation was longer in male than in female patients. The incidence of nausea and vomiting in women was higher than in men.
{"title":"Sex Differences in Outcomes of Hepatobiliary and Pancreatic Surgery with Accelerated Rehabilitation","authors":"Xinxin Zhang, Qian Wang, Min Zhang, Liguang Chen, Danhong Peng","doi":"10.62713/aic.3169","DOIUrl":"https://doi.org/10.62713/aic.3169","url":null,"abstract":"Background: Sex, in the sense of gender, is a major social demographic characteristic that has been shown to affect health care outcomes. The concept of enhanced recovery after surgery (ERAS) is an effective perioperative management measure that can reduce the perioperative stress response in patients. However, there are few studies on the differences between male and female patients under this type of care. We aimed to analyze sex differences in clinical characteristics among patients undergoing hepatobiliary and pancreatic surgery with accelerated rehabilitation. \u0000Methods: We enrolled patients who underwent liver, biliary tract, and gallbladder operations in the Department of Hepatobiliary and Pancreatic Surgery of Taizhou Hospital, Zhejiang Province, China, from April 2021 to July 2021. Key measures were collected for patients undergoing perioperative accelerated rehabilitation (i.e., the case group). The study group was assembled by performing 1:1 matching for age, sex, chronic disease, and type of surgery. Postoperative risk assessment, postoperative recovery indicators, and postoperative length of hospital stay (days) were compared between male and female patients. \u0000Results: A total of 226 surgical patients were enrolled, including 109 male (48.23%) and 117 female patients (51.77%). The outcomes, presented as the median (min, max), were as follows: pulmonary rehabilitation risk assessment in females (1(0,3)) and males (0(0,2)), postoperative nausea and vomiting in females (2(1,3)) and males (1(0,2)), and time to first defecation in females (31(4,61)) and males (36(10,78)). Significant differences were indicated by p values < 0.05. \u0000Conclusion: We identified sex differences in the clinical prognosis and performance of perioperative patients undergoing hepatobiliary and pancreatic surgery with accelerated rehabilitation. The perioperative pulmonary rehabilitation risk of male patients was higher than that of female patients, and the time to first defecation was longer in male than in female patients. The incidence of nausea and vomiting in women was higher than in men.","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140680999","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}
Mehmet Aziret, Feyza Aşıkuzunoğlu, Fatih Altıntoprak, M. Tozlu, Ayşe Demirci, Metin Ercan, Doğukan Saydan, Ali İmran Küçük
Aim: The growing elderly population is facing an increasing risk of cancers, consequently raising the pancreatic cancer surgery rate. This study aimed to determine whether advanced age is a risk factor for morbidity and mortality following pancreaticoduodenectomy (PD) for periampullary tumors. Materials and Methods: The present study included 90 patients who underwent PD for periampullary tumors. Patients were divided into two age-related groups, including those aged 60–74 years (n = 60) (Group 1) and those aged ≥75 years (n = 30) (Group 2). Each patient's characteristics, perioperative features, morbidity, and long-term results were evaluated retrospectively. Results: In both univariate and multivariate logistic regression analyses, old age (≥75 years) was not a risk factor for morbidity and hospital mortality. The multivariate analysis demonstrated that male gender (p = 0.008), pancreatic duct diameter (<3 mm) (p < 0.001), and length of hospital stay (p = 0.005) were independent risk factors for pancreatic fistula post-operation and reoperation. Additionally, hospital mortality was significantly associated with reoperation (p = 0.011). The overall median survival was 27 ± 4.1 (18.8–35.1) months. Lymph node positivity (p < 0.001), neural tumor invasion (p = 0.026), and age ≥75 years (p = 0.045) were risk factors affecting the overall survival rate. Moreover, there was no statistically significant difference in terms of PD rates during the Coronavirus disease-19 (COVID-19) period among groups, and PD during this period was not related to the occurrence of pancreatic fistula. Conclusion: PD can be performed effectively in selected elderly patients with tolerable morbidity and mortality rates.
{"title":"Early and Long-Term Morbidity and Mortality Following Pancreaticoduodenectomy for Periampullary Tumors in Elderly Patients","authors":"Mehmet Aziret, Feyza Aşıkuzunoğlu, Fatih Altıntoprak, M. Tozlu, Ayşe Demirci, Metin Ercan, Doğukan Saydan, Ali İmran Küçük","doi":"10.62713/aic.3380","DOIUrl":"https://doi.org/10.62713/aic.3380","url":null,"abstract":"Aim: The growing elderly population is facing an increasing risk of cancers, consequently raising the pancreatic cancer surgery rate. This study aimed to determine whether advanced age is a risk factor for morbidity and mortality following pancreaticoduodenectomy (PD) for periampullary tumors. \u0000Materials and Methods: The present study included 90 patients who underwent PD for periampullary tumors. Patients were divided into two age-related groups, including those aged 60–74 years (n = 60) (Group 1) and those aged ≥75 years (n = 30) (Group 2). Each patient's characteristics, perioperative features, morbidity, and long-term results were evaluated retrospectively. \u0000Results: In both univariate and multivariate logistic regression analyses, old age (≥75 years) was not a risk factor for morbidity and hospital mortality. The multivariate analysis demonstrated that male gender (p = 0.008), pancreatic duct diameter (<3 mm) (p < 0.001), and length of hospital stay (p = 0.005) were independent risk factors for pancreatic fistula post-operation and reoperation. Additionally, hospital mortality was significantly associated with reoperation (p = 0.011). The overall median survival was 27 ± 4.1 (18.8–35.1) months. Lymph node positivity (p < 0.001), neural tumor invasion (p = 0.026), and age ≥75 years (p = 0.045) were risk factors affecting the overall survival rate. Moreover, there was no statistically significant difference in terms of PD rates during the Coronavirus disease-19 (COVID-19) period among groups, and PD during this period was not related to the occurrence of pancreatic fistula. \u0000Conclusion: PD can be performed effectively in selected elderly patients with tolerable morbidity and mortality rates.","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140681799","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}
I. Perysinakis, Evangelia E. Vassalou, Georgios Saridakis, Matthaios Triantafyllou, Vasilis Christodoulou, Paraskevi Triantafylla, Eufrosini Papadaki, Eelco de Bree
Although routine intra-abdominal drain insertion following surgery represents a common practice worldwide, its utility has been questioned during the last decades. Several comparative studies have failed to document significant benefits from routine draining, and drain insertion has been correlated with various complications as well. Drain-related complications include, but are not limited, to infection, bleeding, and tissue erosion. Herein, we present the case of a 32-year-old patient with perforated peptic ulcer and purulent peritonitis, whose postoperative course was complicated by early mechanical bowel obstruction due to an abdominal drain. A high level of clinical suspicion, along with accurate imaging diagnosis, dictated prompt removal of the drain, which resulted in immediate resolution of the patient's symptoms. We aim to increase the clinical awareness of this rare complication related to intra-abdominal drain utilization with this report.
{"title":"Postoperative Bowel Obstruction as a Rare Complication of an Abdominal Drain","authors":"I. Perysinakis, Evangelia E. Vassalou, Georgios Saridakis, Matthaios Triantafyllou, Vasilis Christodoulou, Paraskevi Triantafylla, Eufrosini Papadaki, Eelco de Bree","doi":"10.62713/aic.3294","DOIUrl":"https://doi.org/10.62713/aic.3294","url":null,"abstract":"Although routine intra-abdominal drain insertion following surgery represents a common practice worldwide, its utility has been questioned during the last decades. Several comparative studies have failed to document significant benefits from routine draining, and drain insertion has been correlated with various complications as well. Drain-related complications include, but are not limited, to infection, bleeding, and tissue erosion. Herein, we present the case of a 32-year-old patient with perforated peptic ulcer and purulent peritonitis, whose postoperative course was complicated by early mechanical bowel obstruction due to an abdominal drain. A high level of clinical suspicion, along with accurate imaging diagnosis, dictated prompt removal of the drain, which resulted in immediate resolution of the patient's symptoms. We aim to increase the clinical awareness of this rare complication related to intra-abdominal drain utilization with this report.","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140682028","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}
Background: Scientific nursing is of great significance for improving negative emotions, self-management ability and quality of life of patients after cancer surgery. The Omaha system has been widely used in the field of care in many countries and regions, and although it helps to improve the quality of life of cancer patients after surgery, there are still large differences between different patients. This study examines factors affecting postoperative quality of life in renal cancer patients under the continuous care Omaha system, aiming to refine nursing plans. Methods: We retrospectively analyzed clinical data from 108 renal cancer patients undergoing radical treatment, all of whom received care via the Omaha system. The score for quality of life and the scores for Strategies Used by People to Promote Health (SUPPH), Social Support Rate Scale (SSRS), and Medical Coping Modes Questionnaire (MCMQ) of patients with different baseline data were compared. Results: Patients with spouses as primary caregivers scored higher across psychological, physical, physiological, and societal dimensions of quality of life than those with children or others as caregivers (p < 0.001). Patients without underlying diseases have higher physiological, societal dimensions, overall satisfaction total score for quality of life (compared to those with underlying diseases, p < 0.001), patients with clinical stage III have lower physiological, societal dimensions, overall satisfaction, and total score for quality of life (compared to stage I/II, p < 0.001). The physiological, societal dimensions, overall satisfaction, and total quality of life score for patients with medical or commercial insurance as the settlement method for medical expenses are higher (compared to self-funded, p < 0.001). In the SUPPH scale, the positive attitude score, stress reduction score, making decisions score, and total score were positively correlated with the total score for quality of life (p < 0.001, p < 0.001, p = 0.008, p < 0.001, respectively). In the SSRS scale, the objective support score, subjective support score, useless support score, and total score were positively correlated with the total score for quality of life (all p < 0.001). In the MCMQ scale, the confrontation score was positively correlated with the total score for quality of life (p < 0.001). The acceptance-resignation and avoidance scores were negatively correlated with the total score for quality of life (p < 0.001). Conclusion: The quality of life of patients is not only affected by primary caregivers, underlying diseases, clinical staging, and medical expense settlement methods, but also positively correlated with self-efficacy and social support, and negatively correlated with coping styles.
{"title":"Analysis of Influencing Factors of Postoperative Quality of Life in Patients with Renal Cancer under the Continuing Care Model Based on the Omaha System","authors":"Xiaowei Wang, Lingna Hua, Xiaosi Hong, Xiaoqun Xu, Chunxia Huang","doi":"10.62713/aic.3135","DOIUrl":"https://doi.org/10.62713/aic.3135","url":null,"abstract":"Background: Scientific nursing is of great significance for improving negative emotions, self-management ability and quality of life of patients after cancer surgery. The Omaha system has been widely used in the field of care in many countries and regions, and although it helps to improve the quality of life of cancer patients after surgery, there are still large differences between different patients. This study examines factors affecting postoperative quality of life in renal cancer patients under the continuous care Omaha system, aiming to refine nursing plans. \u0000Methods: We retrospectively analyzed clinical data from 108 renal cancer patients undergoing radical treatment, all of whom received care via the Omaha system. The score for quality of life and the scores for Strategies Used by People to Promote Health (SUPPH), Social Support Rate Scale (SSRS), and Medical Coping Modes Questionnaire (MCMQ) of patients with different baseline data were compared. \u0000Results: Patients with spouses as primary caregivers scored higher across psychological, physical, physiological, and societal dimensions of quality of life than those with children or others as caregivers (p < 0.001). Patients without underlying diseases have higher physiological, societal dimensions, overall satisfaction total score for quality of life (compared to those with underlying diseases, p < 0.001), patients with clinical stage III have lower physiological, societal dimensions, overall satisfaction, and total score for quality of life (compared to stage I/II, p < 0.001). The physiological, societal dimensions, overall satisfaction, and total quality of life score for patients with medical or commercial insurance as the settlement method for medical expenses are higher (compared to self-funded, p < 0.001). In the SUPPH scale, the positive attitude score, stress reduction score, making decisions score, and total score were positively correlated with the total score for quality of life (p < 0.001, p < 0.001, p = 0.008, p < 0.001, respectively). In the SSRS scale, the objective support score, subjective support score, useless support score, and total score were positively correlated with the total score for quality of life (all p < 0.001). In the MCMQ scale, the confrontation score was positively correlated with the total score for quality of life (p < 0.001). The acceptance-resignation and avoidance scores were negatively correlated with the total score for quality of life (p < 0.001). \u0000Conclusion: The quality of life of patients is not only affected by primary caregivers, underlying diseases, clinical staging, and medical expense settlement methods, but also positively correlated with self-efficacy and social support, and negatively correlated with coping styles.","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140679591","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}
Özgecan Gündoğar, S. Bektaş, Emine Yıldırım, Doğan Gönüllü
Aim: This study aims to elucidate the associations between microsatellite instability (MSI) status, BRAF mutation, and p53 reactions with pathological parameters and survival outcomes in colorectal carcinoma. Material and Method: MutL homologous 1 (MLH1), Postmeiotic segregation increased 2 (PMS2), MutS homologous 2 (MSH2), MutS homologous 6 (MSH6), BRAF, and p53 antibodies were performed on 130 adenocarcinoma samples, including 65 from the right colon and 65 from the left colon. The relationships of MSI status with BRAF mutation, p53 reaction, clinical and pathological parameters, and survival times were statistically analyzed. Results: A statistically significant relationship was found between MSI and right colon localization, tumor size, histological grade, intraepithelial tumor-infiltrating lymphocytes, Crohn-like lymphocytic reaction, expansive growth pattern, and BRAF mutation (p < 0.05). No significant correlation was found between MSI status and the disease-free or overall survival times (p > 0.05). Conclusion: In colorectal adenocarcinoma, MSI and BRAF mutation are associated with parameters, indicating the host immune response and prognostic histopathological parameters, including tumor size and histological grade. The evaluation of MSI status and BRAF mutation can be particularly informative for predicting the prognosis and guiding the treatment management in poorly differentiated colorectal adenocarcinoma. Understanding the mechanisms of molecular carcinogenesis in colorectal carcinoma and organizing treatment algorithms based on molecular foundations will increase the success of the treatment.
{"title":"The Relationship of Microsatellite Instability with BRAF and p53 Mutations and Histopathological Parameters in Colorectal Adenocarcinoma","authors":"Özgecan Gündoğar, S. Bektaş, Emine Yıldırım, Doğan Gönüllü","doi":"10.62713/aic.3377","DOIUrl":"https://doi.org/10.62713/aic.3377","url":null,"abstract":"Aim: This study aims to elucidate the associations between microsatellite instability (MSI) status, BRAF mutation, and p53 reactions with pathological parameters and survival outcomes in colorectal carcinoma. \u0000Material and Method: MutL homologous 1 (MLH1), Postmeiotic segregation increased 2 (PMS2), MutS homologous 2 (MSH2), MutS homologous 6 (MSH6), BRAF, and p53 antibodies were performed on 130 adenocarcinoma samples, including 65 from the right colon and 65 from the left colon. The relationships of MSI status with BRAF mutation, p53 reaction, clinical and pathological parameters, and survival times were statistically analyzed. \u0000Results: A statistically significant relationship was found between MSI and right colon localization, tumor size, histological grade, intraepithelial tumor-infiltrating lymphocytes, Crohn-like lymphocytic reaction, expansive growth pattern, and BRAF mutation (p < 0.05). No significant correlation was found between MSI status and the disease-free or overall survival times (p > 0.05). \u0000Conclusion: In colorectal adenocarcinoma, MSI and BRAF mutation are associated with parameters, indicating the host immune response and prognostic histopathological parameters, including tumor size and histological grade. The evaluation of MSI status and BRAF mutation can be particularly informative for predicting the prognosis and guiding the treatment management in poorly differentiated colorectal adenocarcinoma. Understanding the mechanisms of molecular carcinogenesis in colorectal carcinoma and organizing treatment algorithms based on molecular foundations will increase the success of the treatment.","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140681778","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}
Background: Surgical resection is the most effective method for craniopharyngioma, with complex operations and a high incidence of complications, especially for complex craniopharyngioma. The study focuses on selecting a proper surgical method to treat complex craniopharyngioma. A clinical study was conducted in this direction to explore the efficacy of expanded endoscopic endonasal transsphenoidal approach (EETS) and transcranial approach (TCA) in the treatment of complex craniopharyngioma and their effects on pituitary function and complications of patients. Methods: The clinical data of 73 patients with complex craniopharyngioma in Baoding No.2 Central Hospital from December 2017 to December 2022 were retrospectively analyzed. 13 patients who did not meet the admission criteria were excluded, and 60 patients were finally included. The included patients were divided into the TCA and EETS groups according to the treatment method. The surgical conditions, total tumor resection rate, clinical remission rate, and complications of patients in two groups were compared. The pituitary function of all patients, including thyroid stimulating hormone (TSH), adrenocorticotropic hormone (ACTH), and human growth hormone (hGH), was compared. Results: A total of 60 patients were finally included in the study, including 30 cases in the EETS group and 30 cases in the TCA group. The two groups had no statistical difference in baseline demographic characteristics and pathological types (p > 0.05). Compared with the TCA group, the EETS group had less intraoperative blood loss, operation time, tumor resection time, and hospitalization time (p < 0.001) and had a significantly higher total tumor resection rate and clinical remission rate (p < 0.05). The EETS group had higher ACTH and hGH levels than the TCA group (p < 0.05). There was no statistical difference between the two groups incidence of complications and disease recurrence rate (p > 0.05). Conclusion: The craniopharyngioma resection via EETS has a significant therapeutic effect in complex craniopharyngioma with a high total tumor resection rate and clinical remission rate, which can protect the pituitary function of patients and provide more benefits for patients.
{"title":"Efficacy of the Craniopharyngioma Resection via Expanded Endoscopic Endonasal Transsphenoidal Approach in the Treatment of Complex Craniopharyngioma and Its Effect on Pituitary Function and Complications of Patients","authors":"Xiongjian Bu","doi":"10.62713/aic.3145","DOIUrl":"https://doi.org/10.62713/aic.3145","url":null,"abstract":"Background: Surgical resection is the most effective method for craniopharyngioma, with complex operations and a high incidence of complications, especially for complex craniopharyngioma. The study focuses on selecting a proper surgical method to treat complex craniopharyngioma. A clinical study was conducted in this direction to explore the efficacy of expanded endoscopic endonasal transsphenoidal approach (EETS) and transcranial approach (TCA) in the treatment of complex craniopharyngioma and their effects on pituitary function and complications of patients. \u0000Methods: The clinical data of 73 patients with complex craniopharyngioma in Baoding No.2 Central Hospital from December 2017 to December 2022 were retrospectively analyzed. 13 patients who did not meet the admission criteria were excluded, and 60 patients were finally included. The included patients were divided into the TCA and EETS groups according to the treatment method. The surgical conditions, total tumor resection rate, clinical remission rate, and complications of patients in two groups were compared. The pituitary function of all patients, including thyroid stimulating hormone (TSH), adrenocorticotropic hormone (ACTH), and human growth hormone (hGH), was compared. \u0000Results: A total of 60 patients were finally included in the study, including 30 cases in the EETS group and 30 cases in the TCA group. The two groups had no statistical difference in baseline demographic characteristics and pathological types (p > 0.05). Compared with the TCA group, the EETS group had less intraoperative blood loss, operation time, tumor resection time, and hospitalization time (p < 0.001) and had a significantly higher total tumor resection rate and clinical remission rate (p < 0.05). The EETS group had higher ACTH and hGH levels than the TCA group (p < 0.05). There was no statistical difference between the two groups incidence of complications and disease recurrence rate (p > 0.05). \u0000Conclusion: The craniopharyngioma resection via EETS has a significant therapeutic effect in complex craniopharyngioma with a high total tumor resection rate and clinical remission rate, which can protect the pituitary function of patients and provide more benefits for patients.","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140681437","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}
Objective: To investigate the effect of percutaneous balloon compression combined with carbamazepine on patients with Trigeminal Neuralgia (TN). Methods: The clinical data of 126 patients with TN admitted to our hospital from January, 2021 to January, 2022 were retrospectively analyzed. All patients underwent percutaneous balloon compression in our hospital. The patients were divided into a control group and an observation group, according to whether they continued to take carbamazepine after surgery. The general demographic data of patients, such as gender, age, family income, education level, pain site, diseased nerve, course of disease, and duration of pain were collected. Propensity score matching was used to balance the baseline data of the two groups, and the quality of life, treatment effect, and complications of the two groups were compared after matching. Results: After treatment, the total effective rate of the observation group (95.00%) was higher than that of the control group (70.00%) (p < 0.05). Before treatment, there were no significant differences in the scores for quality of life dimensions between the two groups (p > 0.05). After treatment, the scores for each quality of life dimension in the observation group were higher than those in the control group. After treatment, the incidence of complications in the observation group (7.50%) was lower than that in the control group (30.00%) (p < 0.05). Conclusions: Percutaneous balloon compression combined with carbamazepine can effectively enhance the treatment of patients by improving their quality of life and reducing the occurrence of complications. These results can improve the clinical management of TN.
{"title":"Clinical Efficacy of Percutaneous Balloon Compression Combined with Carbamazepine in the Treatment of Trigeminal Neuralgia: A Retrospective Study","authors":"Xing Yu, Yuan Liang","doi":"10.62713/aic.3209","DOIUrl":"https://doi.org/10.62713/aic.3209","url":null,"abstract":"Objective: To investigate the effect of percutaneous balloon compression combined with carbamazepine on patients with Trigeminal Neuralgia (TN). \u0000Methods: The clinical data of 126 patients with TN admitted to our hospital from January, 2021 to January, 2022 were retrospectively analyzed. All patients underwent percutaneous balloon compression in our hospital. The patients were divided into a control group and an observation group, according to whether they continued to take carbamazepine after surgery. The general demographic data of patients, such as gender, age, family income, education level, pain site, diseased nerve, course of disease, and duration of pain were collected. Propensity score matching was used to balance the baseline data of the two groups, and the quality of life, treatment effect, and complications of the two groups were compared after matching. \u0000Results: After treatment, the total effective rate of the observation group (95.00%) was higher than that of the control group (70.00%) (p < 0.05). Before treatment, there were no significant differences in the scores for quality of life dimensions between the two groups (p > 0.05). After treatment, the scores for each quality of life dimension in the observation group were higher than those in the control group. After treatment, the incidence of complications in the observation group (7.50%) was lower than that in the control group (30.00%) (p < 0.05). \u0000Conclusions: Percutaneous balloon compression combined with carbamazepine can effectively enhance the treatment of patients by improving their quality of life and reducing the occurrence of complications. These results can improve the clinical management of TN.","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140679843","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}
Alessia Kersik, Greta Bracchetti, A. Bonomi, Giorgio Bovo, Maria Serena Cuttin, A. Germini, E. Gjoni, S. Granieri, C. Cotsoglou
Introduction: Undifferentiated embryonal sarcoma of the liver (UESL) is a rare and aggressive malignant tumor, with nonspecific clinical symptoms and radiological features. Less than 150 cases have been reported in adults across the world. Presentation of Case: We report a case of an extremely rare subtype of UESL with epithelioid features in a 29-year-old woman, presenting as a cystic lesion of 27 × 17 cm, completely subverting the right hepatic lobe. She underwent a right hepatectomy with anterior approach, complete hilum lymphadenectomy and partial diaphragmatic resection for local infiltration, followed by systemic chemotherapy. She remains with no evidence of disease and liver mass has been restored after 6 months. Discussion: The present case report represents the second case of UESL with epithelioid features described across the world. The immunohistochemical expression pattern, cytokeratin (CK)19 + and CK7 –, strongly suggests an origin of this epithelioid component from native biliary cells and not from a reshaped ductal plate. Due to the rarity of this form, to date it is impossible to define the prognostic impact of this subtype of UESL, and treatment remains challenging. Conclusion: UESL is associated with a poor prognosis, especially in adults, but a comprehensive and multidisciplinary treatment based on radical resection and adjuvant therapy may provide a survival benefit. Surgical excision with negative margins remains mandatory to diagnose and treat UESL.
{"title":"Undifferentiated Embryonal Sarcoma of the Liver with Epithelioid Features: A Case Report of an Exceptional Histological Heterogeneity among Rare Diseases","authors":"Alessia Kersik, Greta Bracchetti, A. Bonomi, Giorgio Bovo, Maria Serena Cuttin, A. Germini, E. Gjoni, S. Granieri, C. Cotsoglou","doi":"10.62713/aic.3374","DOIUrl":"https://doi.org/10.62713/aic.3374","url":null,"abstract":"Introduction: Undifferentiated embryonal sarcoma of the liver (UESL) is a rare and aggressive malignant tumor, with nonspecific clinical symptoms and radiological features. Less than 150 cases have been reported in adults across the world. \u0000Presentation of Case: We report a case of an extremely rare subtype of UESL with epithelioid features in a 29-year-old woman, presenting as a cystic lesion of 27 × 17 cm, completely subverting the right hepatic lobe. She underwent a right hepatectomy with anterior approach, complete hilum lymphadenectomy and partial diaphragmatic resection for local infiltration, followed by systemic chemotherapy. She remains with no evidence of disease and liver mass has been restored after 6 months. \u0000Discussion: The present case report represents the second case of UESL with epithelioid features described across the world. The immunohistochemical expression pattern, cytokeratin (CK)19 + and CK7 –, strongly suggests an origin of this epithelioid component from native biliary cells and not from a reshaped ductal plate. Due to the rarity of this form, to date it is impossible to define the prognostic impact of this subtype of UESL, and treatment remains challenging. \u0000Conclusion: UESL is associated with a poor prognosis, especially in adults, but a comprehensive and multidisciplinary treatment based on radical resection and adjuvant therapy may provide a survival benefit. Surgical excision with negative margins remains mandatory to diagnose and treat UESL.","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140682302","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}
Background: The incidence of obesity is increasing globally, with approximately 1 in 3 adults either overweight or obese. Surgery provides the most effective treatment for advanced obesity; however, endoscopic treatment, including intragastric balloon therapy, is commonly used in patients who do not meet the indications for surgery. Our study aimed to evaluate short- and mid-term weight changes of patients who had intragastric balloon therapy. Material and Methods: In this single-center retrospective study, we enrolled 320 patients with body mass index (BMI) values between 30 and 40 kg/m2 and without comorbidities, who underwent intragastric balloon treatment. 284 patients successfully underwent the operation. All patients were followed-up at 6 months after treatment, balloons were removed, and BMIs were recorded. Further follow-up was performed 6 months after balloon removal, and patients' BMI and demographic data were recorded again. Results: Overall, 320 patients were enrolled in this study. In this cohort, 82 returned to their preprocedural weight at 1 year postprocedure, whereas 260 had BMI lower than the preprocedural values, but higher than the values at 6 months postprocedure. None of the patients had lower BMI compared to their 6-month postprocedural values. Conclusions: Balloon therapy typically helps patients lose 10% of body weight. Intragastric balloons are effective when used as weight loss tools, but are ineffective at maintaining weight loss. An intragastric device placed for 6 months may also be expected to help the patients develop better eating habits; however, we did not encounter this lifestyle change in our series.
{"title":"Intragastric Balloon as a Noninvasive Method for Obesity Treatment: A Single-Center Retrospective Study","authors":"Levent Eminoğlu","doi":"10.62713/aic.3376","DOIUrl":"https://doi.org/10.62713/aic.3376","url":null,"abstract":"Background: The incidence of obesity is increasing globally, with approximately 1 in 3 adults either overweight or obese. Surgery provides the most effective treatment for advanced obesity; however, endoscopic treatment, including intragastric balloon therapy, is commonly used in patients who do not meet the indications for surgery. Our study aimed to evaluate short- and mid-term weight changes of patients who had intragastric balloon therapy. \u0000Material and Methods: In this single-center retrospective study, we enrolled 320 patients with body mass index (BMI) values between 30 and 40 kg/m2 and without comorbidities, who underwent intragastric balloon treatment. 284 patients successfully underwent the operation. All patients were followed-up at 6 months after treatment, balloons were removed, and BMIs were recorded. Further follow-up was performed 6 months after balloon removal, and patients' BMI and demographic data were recorded again. \u0000Results: Overall, 320 patients were enrolled in this study. In this cohort, 82 returned to their preprocedural weight at 1 year postprocedure, whereas 260 had BMI lower than the preprocedural values, but higher than the values at 6 months postprocedure. None of the patients had lower BMI compared to their 6-month postprocedural values. \u0000Conclusions: Balloon therapy typically helps patients lose 10% of body weight. Intragastric balloons are effective when used as weight loss tools, but are ineffective at maintaining weight loss. An intragastric device placed for 6 months may also be expected to help the patients develop better eating habits; however, we did not encounter this lifestyle change in our series.","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140680153","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}
Simone Frediani, Ivan Pietro Aloi, Andrzej Krzysztofiak, Tommaso D’Angelo, A. Bertocchini, S. Madafferi, A. Accinni, V. Pardi, Alessandro Inserra
Background: Laparoscopic appendectomy followed by postoperative intravenous (IV) antibiotics is the standard of care for acute appendicitis and postoperative prevention of intra-abdominal abscesses. The aim of or study was to determine if intraperitoneal irrigation with antibiotics could help prevent intra-abdominal abscess formation after laparoscopic appendectomy for complicated appendicitis in pediatric patients. Methods: A retrospective study was conducted on consecutive pediatric patients with acute appendicitis who had appendectomy in our Pediatric Surgery Department between August 2020 and February 2022. We compared two groups with similar age and symptoms. The first group (A) was treated with the normal standard of care, i.e., laparoscopic appendectomy and postoperative IV antibiotic therapy. For the second group (B) intraperitoneal cefazoline irrigation was added at the end of the laparoscopic procedure. Postoperative intra-abdominal abscess was diagnosed with ultrasound examination, performed after clinical suspicion/abnormal blood test results. Results: One hundred sixty patients (males:females 109:51; median age 10.5 years [range 3–17 years]) who had laparosopic appendectomy for complicated appendicitis were included, 82 in group A and 78 in group B. In the first 7 days after surgery, 18 patients in group and 5 in group B developed an intra-abdominal abscess (p < 0.005). Drains were positioned in 38 patients in group A vs. 9 in group B. One patient in group A had a different complication which was infection of the surgical incision. Conclusions: Intraperitoneal cefazoline irrigation at the end of the laparoscopic appendectomy in pediatric patients significantly reduces the formation of intra-abdominal abscesses
{"title":"The Intraperitoneal Use of Cephazolin: A Novelty in the Prevention of Intra-abdominal Abscess after Laparoscopic Appendectomy in Children","authors":"Simone Frediani, Ivan Pietro Aloi, Andrzej Krzysztofiak, Tommaso D’Angelo, A. Bertocchini, S. Madafferi, A. Accinni, V. Pardi, Alessandro Inserra","doi":"10.62713/aic.3381","DOIUrl":"https://doi.org/10.62713/aic.3381","url":null,"abstract":"Background: Laparoscopic appendectomy followed by postoperative intravenous (IV) antibiotics is the standard of care for acute appendicitis and postoperative prevention of intra-abdominal abscesses. The aim of or study was to determine if intraperitoneal irrigation with antibiotics could help prevent intra-abdominal abscess formation after laparoscopic appendectomy for complicated appendicitis in pediatric patients. \u0000Methods: A retrospective study was conducted on consecutive pediatric patients with acute appendicitis who had appendectomy in our Pediatric Surgery Department between August 2020 and February 2022. We compared two groups with similar age and symptoms. The first group (A) was treated with the normal standard of care, i.e., laparoscopic appendectomy and postoperative IV antibiotic therapy. For the second group (B) intraperitoneal cefazoline irrigation was added at the end of the laparoscopic procedure. Postoperative intra-abdominal abscess was diagnosed with ultrasound examination, performed after clinical suspicion/abnormal blood test results. \u0000Results: One hundred sixty patients (males:females 109:51; median age 10.5 years [range 3–17 years]) who had laparosopic appendectomy for complicated appendicitis were included, 82 in group A and 78 in group B. In the first 7 days after surgery, 18 patients in group and 5 in group B developed an intra-abdominal abscess (p < 0.005). Drains were positioned in 38 patients in group A vs. 9 in group B. One patient in group A had a different complication which was infection of the surgical incision. \u0000Conclusions: Intraperitoneal cefazoline irrigation at the end of the laparoscopic appendectomy in pediatric patients significantly reduces the formation of intra-abdominal abscesses","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140681314","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：