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surgical approach affecting long-term urinary continence status after robot-assisted laparoscopic prostatectomy prospectively evaluated using self-reported functional status(Expanded Prostate Cancer Index Composite,EPIC-26)

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Current Urology 2024年第1期18卷 61-65页

作者： Mathias Reichert Ame Strauß Joost Wilhelm Voß Hans Christoph von Knobloch Hannah Maria Neuenhofer Annemarie Uhlig Lutz Trojan Mirjam Naomi Mohr Department of Urology University Medical CenterGoettingenGermany Department of Pediatrics University HospitalBonnGermany

Purpose:The aim of the study was to examine the influence of the surgical approach for robot-assisted laparoscopic prostatectomy(RALP)on long-term urinary continence status in the era of self-reported functional status measures using the Expanded Prostate Cancer Index Composite *** and methods:This is a prospective evaluation of 232 patients undergoing RALP between September,2019 and September,*** continence status and postoperative incontinence(pad usage)were evaluated 12 months after RALP using Expanded Prostate Cancer Index Composite 26 *** were categorized according to their surgical approach and outcome into the following groups:successful nerve sparing(NS),primarily without nerve sparing(***),and no nerve sparing by secondary resection(NNS by SR).The median levels of their questionnaire outcomes were evaluated and compared using the Wilcoxon rank sum test with continuity ***:Urinary continence status 12 months after RALP differed significantly between the NS and ***(p=0.0071)and the NS and NNS by SR(p=0.0076)*** was no significant difference between the *** and NNS by SR(p=0.53)*** usage 12 months after RALP had no significant difference with regard to SR of the neurovascular bundle(p=0.14).Conclusions:Patient-reported outcomes of long-term urinary continence status seem to show no difference in postoperative continence,regardless of whether a non-nerve-sparing result was planned or reached through ***,preservation of neurovascular bundle seems to lead to better long-term continence rates.

关键词： Prostate cancer Robot-assisted radical prostatectomy Expanded Prostate Cancer Index Composite 26 Urinary incontinence surgical approach Nerve sparing

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Proximal gastric cancer： lymph node metastatic patterns according to different T stages dictate surgical approach

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Chinese Medical Journal 2014年第23期127卷 4049-4054页

作者： Song Wu Liu Yuyi Ye Jinning Peng Jianjun He Weiling Chen Jianhui Chen Chuangqi He Yulong Department of Gastrointestinal Surgery First Affiliated Hospital Sun Yat-sen University Guangzhou Guangdong 510080 China

Background As a common form of gastric cancer migration,lymph node metastasis largely affects the surgical treatment and prognosis of gastric *** is the fundamental curative option for gastric cancer that varies depending on different *** study aimed to compare the clinicopathological characteristics and lymph node metastatic patterns in patients of proximal gastric cancer with different T stages and investigate a reasonable radical gastrectomy approach in terms of the range of lymphadenectomy for proximal gastric *** In our retrospective study,the data of 328 patients of proximal gastric cancer with different T stages were *** comparing the differences of lymph node metastatic rate and ratio,we investigated the clinicopathological characteristics and metastatic patterns of lymph ***,we were especially interested in the differences in survival rates between patients with and without No.5 and 6 group metastasis with the same TNM *** The overall lymph node metastatic rate and ratio of advanced proximal gastric cancer were 73.4％ and 23.3％,*** tumors of different T stages were statistically significant in size and differentiation degree （P ＜0.05）,multivariate analysis showed that the depth of tumor invasion was an independent risk factor for lymph node metastasis in proximal gastric cancer （RR,12.025; 95％ CI,2.326 to 62.157; P=0.003）.The overall survival rate of patients with No.5,6 group lymph node metastasis and those without was significantly different,but the differences in survival rates between patients with and without No.5 and 6 group metastasis with the same TNM stage were not statistically *** Different T stages in proximal gastric cancer showed different patterns and characteristics of lymph node metastasis.D2 lymphadenectomy in patients with early gastric cancer had little survival benefit because metastasis to level 2 nodes was *** the range of the lymph node d

关键词： proximal gastric cancer lymph node metastasis surgical approach

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Subclavian Artery Pseudoaneurysm following Stab Injury and Its surgical approach: A Case Report and Literature Review

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World Journal of Cardiovascular Surgery 2021年第7期11卷 61-67页

作者： Md. Abir Tazim Chowdhury Sohail Ahmed Md. Zulfiqur Haider S. M. A. Zulker Nine Md. Kamrul Hasan Mohammad Sanaul Hoque Sarker Department of Cardiothoracic and Vascular Surgery Evercare Hospital Dhaka Bangladesh

Penetrating injuries to the subclavian arteries as well as post traumatic pseudoaneurysm involving Subclavian artery (SCA) are very much uncommon. We present one case of a 21 year-old male sustained a physical assault with a post stab injury left subclavian artery pseudoaneurysm. He was referred to our facility, two days after sustaining a penetrating chest trauma over left infraclavicular area of the chest. The presentation, diagnostic procedures and surgical approach for management of this very rare injury are discussed.

关键词： Penetrating Chest Injury Subclavian Artery (SCA) Injury Pseudo Aneurysm of Subclavian Artery Diagnosis surgical approach

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Therapeutic interventional endoscopic ultrasound in pancreatobiliary disorders:Does it really replace the surgical/percutaneous approach?

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World Journal of Gastrointestinal Surgery 2021年第6期13卷 537-547页

作者： Cosmas Rinaldi Adithya Lesmana Maria Satya Paramitha Rino Alvani Gani Department of Internal Medicine Hepatobiliary DivisionDr.Cipto Mangunkusumo National General HospitalMedical Faculty Universitas IndonesiaJakarta 10430Indonesia Digestive Disease and GI Oncology Center Medistra HospitalJakarta 12950Indonesia

Pancreato-biliary disorders are still incredibly challenging in the field of gastroenterology,as they would sometimes require multi-approach interventional ***,therapeutic interventional endoscopic ultrasound(EUS)has emerged as a potential alternative to surgical or percutaneous ***,considering the high cost of EUS,lack of facility and expertise,most gastroenterologists still often refer cases to undergo surgical interventions without contemplating the possibility of utilizing EUS ***-guided biliary drainage has become one of the best choices for establishing access to biliary system,given the clear visualization of pancreas,gallbladder,and common bile *** there are still only a few studies which directly compare EUSguided and surgical approaches for biliary drainage,current evidence demonstrated the superiority of EUS-guided approach in terms of adverse events and reintervention rates,with similarly high technical and clinical success rates compared to percutaneous and surgical approaches,especially in patients with history of failed endoscopic retrograde cholangiopancreatography *** success rates with shorter length of hospital stay between endoscopic and surgical approaches have also been exhibited for pancreatic pseudocysts and walled-off *** findings about the progress of EUS approach in gastroenterostomy/jejunostomy also indicated a promising potential of EUS,as a less invasive approach,for managing gastric outlet obstruction.

关键词： Pancreato-biliary Endoscopic ultrasound Percutaneous approach surgical approach Biliary drainage Pancreatic fluid collection

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Comparison of surgical indications for hysterectomy by age and approach in 4653 Chinese women

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Frontiers of Medicine 2014年第4期8卷 464-470页

作者： Jingjing Jiang Ting Ding Aiyue Luo Yunping Lu Ding Ma Shixuan Wang Department of Obstetrics and Gynecology Tongji Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan 430030 China

Approximately one million hysterectomies are performed each year in China. However, national data regarding the indications and the surgical approaches for hysterectomy are lacking. The aim of this study was to examine the surgical indications for hysterectomy in different age groups and the relative merits of different surgical approaches for hysterectomy in Chinese women. Clinical data from 4653 cases of hysterectomy performed in Tongji Hospital from 2004 to 2009 were analysed. Hysterectomy was most commonly performed among women aged 40-49 years （2299; 49.4%）. Overall, colporrhagia and abdominal pain were the two most common indications for hysterectomy. The most common indications by age groups were as follows： malignant ovarian tumour, 〈 20 years; malignant uterine tumour, 20-29 and 30-39 years; uterine myoma, 40-49 and 50-59 years; and uterine prolapse, 60-69 and 〉 70 years. The proportion of malignant aetiology also varied by age, being the highest in women aged 〈 20 years （75.0%） and the lowest in those aged 40-49 years （19.9%）. Approximately 35% women who had hysterectomies also had concomitant bilateral oophorectomy. The lowest rate of oophorectomy occurred in women aged 30-39years （15.8%）, whereas the highest rate was in those aged 50-59years （75.9%）. The abdominal surgical approach was used in 84% of all hysterectomies. Surgeries using the vaginal approach required a significantly shorter operating time （118 min average） than all other approaches （P 〈 0.05）. Both the amount of bleeding and the blood transfusion volume required were smaller in vaginal approaches, with no significant differences between the others. The surgical approaches used were also related to the scope of surgery. Both the surgical indications and the rates of bilateral oophorectomy varied by age. In terms of both operating time and the amount of bleeding and blood transfusion volume required, the vaginal approach was superior to all other surgical approaches.

关键词： hysterectomy surgical indications surgical approach bilateral oophorectomy

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Standardized surgical approaches to ear surgery in rats

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Journal of Otology 2015年第2期10卷 72-77页

作者： Peng Li Dalian Ding Kelei Gao Richard Salvi Department of Otolaryngology Head and Neck Surgery The Third Affiliated Hospital of Sun Yat-Sen University Center for Hearing and Deafness University of New York at Buffalo Department of Otolaryngology Head and Neck Surgery Xiangya Hospital Central South University

Objective： To describe several approaches of ear surgeries for experimental studies in rats. Methods： Anesthetized rats were prepared for demonstration of various ear surgery approaches designed to optimize experimental outcomes in studies with specific goals and exposure requirements. The surgical approaches included the posterior tympanum, superior tympanum, inferior tympanum and occipital approaches. Results： The middle ear cavity and inner ear were successfully exposed from different angles via the mentioned surgical approaches. For example, electrode placement for recording of cochlear bioelectric responses was easily achieved through the posterior tympanum or inferior tympanum approach. Alternatively, drug delivery or gene transfection via round window membrane was most easily accomplished using the posterior tympanum approach. Cochlear perfusion of protective or ototoxic drugs was best performed using the inferior tympanum approach. Ossicular chain interruption to induce a prolonged conductive hearing loss was readily achieved using a superior tympanum approach. Lastly, surgical destruction of the endolymphatic sac to induce experimental endolymphatic hydrops was readily performed via an occipital surgical ***： These standardized surgical approaches can be applied in scientific studies of the ear with different purposes covering electro- physiology, conductive hearing loss, intra-cochlear drug perfusion and experimental studies relevant to Meniere＇s disease.

关键词： Rat Middle ear Inner ear surgical approach

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The impact of round window vs cochleostomy surgical approaches on interscalar excursions in the cochlea:Preliminary results from a flat-panel computed tomography study

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2016年第3期2卷 -页

作者： Nicole T. Jiam Charles J. Limb Department of 0tolaryngology e Head and Neck Surgery University of California San Francisco School of Medicine USA

Objective:To evaluate incidence of interscalar excursions between round window (RW) and cochleostomy approaches for cochlear implant (CI) insertion. Methods:This was a retrospective case-comparison. Flat-panel CT (FPCT) scans for 8 CI users with Med-El standard length electrode arrays were collected. surgical technique was identified by a combination of operative notes and FPCT imaging. Four cochleae underwent round win-dow insertion and 4 cochleae underwent cochleostomy approaches anterior and inferior to the round window. Results:In our pilot study, cochleostomy approaches were associated with a higher likeli-hood of interscalar excursion. Within the cochleostomy group, we found 29% of electrode contacts (14 of 48 electrodes) to be outside the scala tympani. On the other hand, 8.5%of the electrode contacts (4 of 47 electrodes) in the round window insertion group were extra-scalar to the scala tympani. These displacements occurred at a mean angle of occur-rence of 364? ? 133?, near the apex of the cochlea. Round window electrode displacements tend to localize at angle of occurrences of 400? or greater. Cochleostomy electrodes occurred at an angle of occurrence of 19?e490?.

关键词： Cochlear implantation Round window insertion Cochleostomy Interscalar excursion Electrode position Flat-panel computed tomography surgical approach

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Esophagogastric junction gastrointestinal stromal tumor:Resection vs enucleation

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World Journal of Gastroenterology 2010年第35期16卷 4374-4376页

作者： Federico Coccolini Fausto Catena Luca Ansaloni Daniel Lazzareschi Antonio Daniele Pinna Unit of General Emergency and Transplant SurgerySt.Orsola-Malpighi University Hospital Department of Integrative Biology University of CaliforniaBerkeley

Esophageal gastrointestinal stromal tumors(GISTs) are extremely uncommon,representing approximately 5% of GISTs with the majority of esophageal GISTs occurring at the esophagogastric junction(EGJ).The treatment options available for these GISTs are fairly *** different options are nowadays at our *** surgery to the target therapies we have the possibility to treat the majority of GISTs,including those which are defined as *** EGJ GISTs represent a stimulating challenge for the *** anatomical location increases the possibility of postoperative *** the role of negative margins in GIST surgery is still controversial and the eff icacy of target therapy has been demonstrated,why not treat EGJ GISTs with enucleation and,where indicated,adjuvant target therapy?

关键词： Esophagogastric junction Gastrointestinal stromal tumor surgical approach Resection Enucleation

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surgical Correction of Coronary Artery Ectasia Combining Congenital Coronary Artery Fistula

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Congenital Heart Disease 2021年第1期16卷 95-106页

作者： Yulin Wang Ye Yang Limin Xia Wenjun Ding Qiang Ji Chunsheng Wang Department of Cardiovascular Surgery of Zhongshan Hospital Fudan University ShanghaiChina Shanghai Municipal Institute for Cardiovascular Diseases ShanghaiChina Department of Cardiovascular Surgery of Xiamen Branch of Zhongshan Hospital Fudan University XiamenChina

Background:Coronary artery ectasia(CAE)complicated with concomitant congenital coronary artery fistula(CCAF)is *** study characterizes the clinical characteristics of CAE combining CCAF,and reports a single-institution experience with surgical correction of CAE combining ***:A total of 24 symptomatic patients(8 males,median 52.5 years old)who underwent surgical correction of CAE combining CCAF in this center were *** on the size of ectatic segment,the CAE were classified as a giant CAE(>20 mm,n=14)and a non-giant CAE(≤20 mm,n=10).Individualized surgical approaches were *** patients were followed up for a median of 3.8 ***:The overwhelming majority of CAEs were solitary,and only 4.2%of CAEs were associated with multiple *** were predominantly located in the right coronary artery with predilection to women more than to men(2:1).95.8%of patients with the CCAF had single fistula *** right atrium was the most frequent drainage site(33.3%)followed by the left ventricle(25.0%).surgical mortality was 4.2%.All 22 follow-up patients survived with recovery from symptoms and New York Heart Association(NYHA)functional class *** 10 patients with non-giant CAEs undergoing closure of fistula alone,favorable in-hospital outcomes were recorded,but residual fistula(one patient)and acute inferior wall myocardial infarction related to intracoronary thrombosis(one patient)were observed at *** 11 patients with giant CAEs undergoing aneurysm resection plus distal bypass grafting at the time of closure of fistula,favorable in-hospital outcomes and encouraging midterm results were ***,in 3 patients with giant CAEs undergoing closure of fistula plus aneurysmal plication,adverse events occurred,including surgical death related to rupture of the ectatic segment(one patient),perioperative myocardial infarction caused by acute thromboembolism(one patient),nonfatal inferior wall myocardial infarction related

关键词： Coronary artery ectasia congenital coronary artery fistula surgical approach giant coronary artery ectasia

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Lateral epicondyle osteotomy approach for coronal shear fractures of the distal humerus:Report of three cases and review of the literature

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World Journal of Clinical Cases 2021年第17期9卷 4318-4326页

作者： Jie Li Vidmi Taolam Martin Zhi-Wen Su Dong-Tai Li Qi-Yi Zhai Bo Yu Department of Orthopedics Zhujiang Hospital of Southern Medical UniversityGuangzhou 510282Guangdong ProvinceChina

BACKGROUND Coronal shear fractures of the distal humerus are rare injuries and are technically challenging to *** reduction and internal fixation(ORIF)has become the preferred treatment because it provides anatomical reduction,stable internal fixation,and early motion,but the optimal surgical approach remains *** SUMMARY We report three cases of coronal shear fractures of the distal humerus treated successfully by ORIF via a novel surgical approach,in which lateral epicondyle osteotomy was performed based on the extended lateral *** named the novel surgical approach the lateral epicondyle osteotomy *** patients underwent surgical treatment and were discharged *** patients had excellent functional results according to the Mayo elbow performance *** average range of motion was 118°in flexion/extension and 172°in pronation/*** case 2 had a complication,which was implant *** We demonstrated that the lateral epicondyle osteotomy approach in ORIF is effective and safe for coronal shear fractures of the distal humerus.

关键词： Distal humerus fracture Coronal shear fracture Lateral epicondyle surgical approach Osteotomy Case report

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