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Development and validation of a machine learning-based early prediction model for massive intraoperative bleeding in patients with primary hepatic malignancies

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World Journal of Gastrointestinal Oncology 2024年第1期16卷 90-101页

作者： Jin Li Yu-Ming Jia Zhi-Lei Zhang Cheng-Yu Liu Zhan-Wu Jiang Zhi-Wei Hao Li Peng Department of Hepatological Surgery The Fourth Hospital of Hebei Medical UniversityShijiazhuang 050011Hebei ProvinceChina Department of General Surgery II Baoding First Central HospitalBaoding 071000Hebei ProvinceChina

BACKGROUND Surgical resection remains the primary treatment for hepatic malignancies,and intraoperative bleeding is associated with a significantly increased risk of ***,accurate prediction of intraoperative bleeding risk in patients with hepatic malignancies is essential to preventing bleeding in advance and providing safer and more effective *** To develop a predictive model for intraoperative bleeding in primary hepatic malignancy patients for improving surgical planning and *** The retrospective analysis enrolled patients diagnosed with primary hepatic malignancies who underwent surgery at the Hepatobiliary Surgery Department of the Fourth Hospital of Hebei Medical University between 2010 and *** regression analysis was performed to identify potential risk factors for intraoperative bleeding.A prediction model was developed using Python programming language,and its accuracy was evaluated using receiver operating characteristic(ROC)curve *** Among 406 primary liver cancer patients,16.0%(65/406)suffered massive intraoperative *** regression analysis identified four variables as associated with intraoperative bleeding in these patients:ascites[odds ratio(OR):22.839;Pintraoperative bleeding were 0.844 in the training set and 0.80 in the prediction *** The developed and validated model predicts significant intraoperative blood loss in primary hepatic malignancies using four preoperative clinical factors by considering four preoperative clinical factors:ascites,history of alcohol consumption,TNM staging,and albumin-bilirubin ***

关键词： Primary liver cancer intraoperative bleeding Machine learning Model

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Will partial splenic embolization followed by splenectomy increase intraoperative bleeding?

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World Journal of Gastrointestinal Surgery 2024年第2期16卷 318-330页

作者： Long Huang Qing-Lin Li Qing-Sheng Yu Hui Peng Zhou Zhen Yi Shen Qi Zhang Department of No.1 Surgery The First Hospital Affiliated to Anhui University of Traditional Chinese MedicineHefei 230031Anhui ProvinceChina Anhui University of Traditional Chinese Medicine Anhui University of Traditional Chinese MedicineHefei 230038Anhui ProvinceChina Department of Surgery The Second Hospital Affiliated to Anhui University of Traditional Chinese MedicineHefei 230061Anhui ProvinceChina

BACKGROUND Partial splenic embolization(PSE)has been suggested as an alternative to splenectomy in the treatment of ***,some patients may experience recurrence of hypersplenism after PSE and require ***,there is a lack of evidence-based medical support regarding whether preoperative PSE followed by splenectomy can reduce the incidence of *** To investigate the safety and therapeutic efficacy of preoperative PSE followed by splenectomy in patients with cirrhosis and *** Between January 2010 and December 2021,321 consecutive patients with cirrhosis and hypersplenism underwent splenectomy at our *** on whether PSE was performed prior to splenectomy,the patients were divided into two groups:PSE group(n=40)and non-PSE group(n=281).Patient characteristics,postoperative complications,and follow-up data were compared between *** score matching(PSM)was conducted,and univariable and multivariable analyses were used to establish a nomogram predictive model for intraoperative bleeding(IB).The receiver operating characteristic curve,Hosmer-Lemeshow goodness-of-fit test,and decision curve analysis(DCA)were employed to evaluate the differentiation,calibration,and clinical performance of the *** After PSM,the non-PSE group showed significant reductions in hospital stay,intraoperative blood loss,and operation time(all P=0.00).Multivariate analysis revealed that spleen length,portal vein diameter,splenic vein diameter,and history of PSE were independent predictive factors for IB.A nomogram predictive model of IB was constructed,and DCA demonstrated the clinical utility of this *** groups exhibited similar results in terms of overall survival during the follow-up *** Preoperative PSE followed by splenectomy may increase the incidence of IB and a nomogram-based prediction model can predict the occurrence of IB.

关键词： Partial splenic embolization Splenectomy Hypertension,Portal Liver Cirrhosis intraoperative bleeding

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Laparoscopic vs open surgery for gastric cancer: Assessing time, recovery, complications, and markers

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World Journal of Gastrointestinal Surgery 2024年第1期16卷 40-48页

作者： Yun-Yao Lu Yun-Xiao Li Meng He Ya-Li Wang Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment Chongqing University Cancer HospitalChongqing 400030China

BACKGROUND Gastric cancer(GC)is one of the most common cancers *** and mortality have increased in recent years,making it an urgent issue to ***-paroscopic radical surgery(LRS)is a crucial method for treating patients with GC;However,its influence on tumor markers is still under *** data of 194 patients treated at Chongqing University Cancer Hospital bet-ween January 2018 and January 2019 were retrospectively *** who underwent traditional open surgery and LRS were assigned to the control(n=90)and observation groups(n=104),*** sample t-tests andχ2 tests were used to compare the two groups based on clinical efficacy,changes in tumor marker levels after treatment,clinical data,and the incidence of posto-perative *** investigate the association between tumor marker levels and clinical efficacy in patients with GC,three-year recurrence rates in the two groups were *** Patients in the observation group had a shorter duration of operation,less in-traoperative blood loss,an earlier postoperative eating time,and a shorter hospital stay than those in the control group(P0.05).After treatment,the overall response rate in the control group was significantly lower than that in the observation group(P=0.001).Furthermore,after treatment,the levels of carbohydrate antigen 19-9,cancer antigen 72-4,carcinoembryonic antigen,and cancer antigen 125 decreased *** observation group also exhibited a significantly lower incidence rate of postoperative complications compared to the control group(P0.05).CONCLUSION LRS effectively treats early gastric cancer by reducing intraoperative bleeding,length of hospital stays,and postoperative complications.I

关键词： Laparoscopic radical surgery Gastric cancer Serum tumor markers Prognosis Recurrence intraoperative bleeding

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Analysis of the Effects of Local Injection of Epinephrine and Lidocaine on Postoperative Pain and bleeding in Children Undergoing Tonsillectomy

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Journal of Clinical and Nursing Research 2024年第3期8卷 50-54页

作者： Ruijue Li Zhengzhou University Zhengzhou 450001Henan ProvinceChina

Objective:To explore the effects of local injection of epinephrine and lidocaine on postoperative pain and bleeding in children undergoing ***:Sixty-eight children who underwent a tonsillectomy in our hospital from March 2019 to October 2020 were *** children were randomly divided into two groups of 34 cases *** observation group received local anesthetic injections of lidocaine and the control group received local anesthetic injections of *** postoperative pain,operation time,blood pressure changes,and intraoperative blood loss of the two groups of children were observed and ***:The postoperative pain,operation time,and intraoperative blood loss scores of the children in the observation group were 4.36±0.69,0.36±0.09,and 39.36±1.78 respectively,which were significantly better than those of the children in the control group(P0.05).Conclusion:Local injection of epinephrine and lidocaine effectively relieved postoperative pain and reduced bleeding in children undergoing tonsillectomy as compared to epinephrine alone.

关键词： Epinephrine Lidocaine Tonsillectomy Postoperative pain intraoperative bleeding

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