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Cancellation Causes of Elective surgical procedures in a Major Pediatric Surgery Department

Open Journal of Pediatrics 2022年第1期12卷 131-136页

作者： Salsabil Mohamed Sabounji Mbaye Fall Cheikh Seye Mouhamadou Mansour Diene Gabriel Ngom Pediatric Surgery Department Albert Royer Children’s Hospital Dakar Senegal Pediatric Surgery Department Aristide Le Dantec Hospital Dakar Senegal Pediatric Surgery Department Heinrich Lubke Hospital Diourbel Senegal

Introduction: Cancellation of surgical operation is a surgical operation registered in the official schedule the day before or added to the list after and not carried out on the operating day. The purpose of this work was to determine the causes of cancellation of elective surgical operations in a major pediatric surgery department in Senegal. Patients and methods: It was a prospective and descriptive study of 278 patients scheduled during a period of 13 weeks. The study took place between April 3rd, 2017, and January 31st, 2018. Mean age was 2.9 years with extremes of 3 days and 15 years. The age group of 29 days to 30 months was the most represented (62.2%). Sex ratio was 1.41. Causes of cancellation were categorized into administrative and organizational causes, patient-related causes and staff-related causes. Results: Cancellation rate was 29.4%. Patient-related causes were most common (51.2%). Upper Respiratory tract infection (URTI) was commonest reason within this category (57.5%). Organizational causes (28.1%) came second and were mainly represented by the unavailability of the operating room (60.8%) related to breakdowns of anesthesia equipment. Finally, staff-related causes (20.7%) were due for most to the unavailability of the anesthesiologist (12 cases/17). Conclusion: Majority of causes that led to cancellation of elective surgical operations in our Pediatric surgery department are related to intercurrent illnesses affecting the patient, in particular URTI.

关键词： Cancellation Elective Surgery URTI Pediatric Surgery surgical procedures

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Primary adrenal diffuse large B-cell lymphoma with normal adrenal cortex function:A case report

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World Journal of Clinical Cases 2022年第2期10卷 709-716页

作者： Zhi-Nan Fan Hong-Jin Shi Bo-Bo Xiong Jin-Song Zhang Hai-Feng Wang Jian-Song Wang Department of Urology The Second Affiliated HospitalKunming Medical UniversityKunming 650000Yunnan ProvinceChina

BACKGROUND Diffuse large B-cell lymphoma,which accounts for about approximately 30%to 40%of non-Hodgkin's lymphomas,is the most common type and is a class of aggressive B-cell ***,diffuse large B-cell lymphomas primary to the adrenal gland are *** SUMMARY A 73-year-old man was admitted with abdominal pain and *** admission,enhanced adrenal computed tomography indicated irregular masses on both adrenal glands,with the larger one on the left side,approximately 8.0 cm×4.3 cm in *** boundary was irregular,and surrounding tissues were *** obvious enhancement was observed in the arterial *** of the left adrenal gland was *** diagnosis revealed diffuse large B-cell *** surgery,the patient received RCHOP *** the fourth immunochemotherapy,patient condition deteriorated,and he eventually died of respiratory *** R-CHOP is the conventional immunochemotherapy for primary adrenal diffuse large B-cell *** is mainly used to diagnose the ***,the ideal treatment plan remains to be confirmed.

关键词： Large B-cell lymphoma Adrenal glands Immunochemotherapy surgical procedures Case report

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Glissonian approach combined with major hepatic vein first for laparoscopic anatomic hepatectomy

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Hepatobiliary & Pancreatic Diseases International 2018年第4期17卷 316-322页

作者： De-Cai Yu Xing-Yu Wu Xi-Tai Sun Yi-Tao Ding Department of Hepatobiliary Surgery The Affiliated Drum Tower HospitalSchool of MedicineNanjing University

Background: Laparoscopic anatomic hepatectomy remains challenging because of the complex interior structures of the liver. Our novel strategy includes the Glissonian approach and the major hepatic vein first, which serves to define the external and internal landmarks for laparoscopic anatomic ***: Eleven cases underwent laparoscopic anatomic hepatectomy, including three right hepatectomies, three left hepatectomies, three right posterior hepatectomies, and two mesohepatectomies. The Glissonian approach was used to transect the hepatic pedicles as external demarcation. The major hepatic vein near the hepatic portal was exposed and served as the internal landmark for parenchymal transection. The liver parenchyma below and above the major hepatic vein was transected along the major hepatic vein. Fifty-nine subjects were used to compare the distance between the major hepatic vein and secondary Glisson pedicles among different liver ***: The average operative time was 327 min with an estimated blood loss of 554.55 m L. Only two patients received three units of packed red blood cells. The others recovered normally and were discharged on postoperative day 7. The distance between right posterior Glissonian pedicle and right hepatic vein was shorter in the patients with cirrhosis than that without cirrhosis, and this distance was even shorter in patients with hepatocellular ***: The Glissonian approach with the major hepatic vein first is easy and feasible for laparoscopic anatomic hepatectomy, especially in patients with hepatocellular carcinoma and cirrhosis.

关键词： Hepatectomy Laparoscopy Liver diseases surgical procedures Major hepatic vein

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Comparative study of minimally invasive versus open esophagectomy for esophageal cancer in a single cancer center

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Chinese Medical Journal 2014年第4期127卷 747-752页

作者： Mu Juwei Yuan Zuyang Zhang Baihua Li Ning Lyu Fang Mao Yousheng Xue Qi Gao Shugeng Zhao Jun Wang Dali Li Zhishan Gao Yushun Zhang Liangze Huang Jinfeng Shao Kang Feng Feiyue Zhao Liang Li Jian Cheng Guiyu Sun Kelin He Jie Department of Thoracic surgical Oncology Cancer Institute &amp Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100021 China

Background In order to minimize the injury reaction during the surgery and reduce the morbidity rate,hence reducing the mortality rate of esophagectomy,minimally invasive esophagectomy （MIE） was *** aim of this study was to compare the postoperative outcomes in patients with esophageal squamous cell carcinoma undergoing minimally invasive or open esophagectomy （OE）.Methods The medical records of 176 consecutive patients,who underwent minimally invasive esophagectomy （MIE） between January 2009 and August 2013 in Cancer Institute ＆amp; Hospital,Chinese Academy of Medical Sciences,were retrospectively *** the same period,142 patients who underwent OE,either Ivor Lewis or McKeown approach,were selected randomly as *** clinical variables of paired groups were compared,including age,sex,Charlson score,tumor location,duration of surgery,number of harvested lymph nodes,morbidity rate,the rate of leak,pulmonary morbidity rate,mortality rate,and hospital length of stay （LOS）.Results The number of harvested lymph nodes was not significantly different between MIE group and OE group （median 20 vs.16,P=0.740）.However,patients who underwent MIE had longer operation time than the OE group （375 vs.300 minutes,P 〈0.001）.Overall morbidity,pulmonary morbidity,the rate of leak,in-hospital death,and hospital LOS were not significantly different between MIE and OE *** including anastomotic leak and pulmonary morbidity,inhospital death,hospital LOS,and hospital expenses were not significantly different between MIE and OE groups as *** MIE and OE appear equivalent with regard to early oncological *** is a trend that hospital LOS and hospital expenses are reduced in the MIE group than the OE group.

关键词： surgical procedures minimally invasive esophagectomy comparative study

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surgical treatment of brachiocephalic vessel involvement in Takayasu＇s arteritis

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Chinese Medical Journal 2010年第9期123卷 1122-1126页

作者： WU Xin DUAN Hong-yong GU Yong-quan LI Jian-xin CHEN Bing WANG Zhong-gao ZHANG Jian Department of Vascular Surgery Xuanwu HospitalCapital Medical UniversityBeijing 100053China

Background Takayasu＇s arteritis （TA） is a chronic idiopathic inflammatory disease that affects large and medium size arteries. The brachiocephalic trunk is the most frequently involved site in TA, and multi-vessel lesions are common. surgical treatment includes vessel reconstruction surgery and percutaneous transluminal angioplasty （PTA）. Herein, we report our preliminary experience with surgical treatment of cerebral ischemia caused by cervical arterial lesions due to *** From January 2000 to December 2007, 38 patients with cerebral ischemia caused by cervical arterial occlusive lesions due to TA were treated surgically. There were three males and 35 females, with an age range of 15-42 years （mean 26.5 years）. All patients had operative repairs undertaken. Twenty eight patients received bypass operation and 10 patients received percutaneous transluminal angioplasty. One case with coronary stenosis received coronary artery bypass simultaneously. Patients were followed up for 11 months to eight *** There were no peri-operative deaths in cerebrovascular reconstruction patients. Symptoms of cerebral ischemia were improved or cured in 25 of 38 patients. There was a low incidence of cerebral reperfusion syndrome. Two patients died at five and seven years after surgery due to heart failure. Another 8 patients （20%） required further surgery for stenosis （5 patients） or anastomotic aneurysms （3 patients）. Percutaneous transluminal angioplasty was performed successfully for treatment of aortic and renal lesions. Repeated angioplasty for revascularization was performed in six PTA cases with restenosis after 5-24 *** When cerebral perfusion has potential to be affected by TA, a definitive corrective procedure is advised when the patient is relatively stable. Although the recurrence rate is very high, percutaneous transluminal angioplasty is the first choice procedure. Bypass operation is optimal for brachiocephalic-vessel involvement in TA. Cere

关键词： Takayasu's arteritis brain ischemia brachiocephalic trunk surgical procedures operative reperfusion syndrome

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Use of mid-vastus approach in less invasive primary total knee arthroplasty

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Chinese Medical Journal 2008年第9期121卷 787-790页

作者： DAI Xue-song YU Xue-zhong WU Li-dong HE Rong-xin WANG Xiang-hua YAN Shi-gui Department of Orthopedics Second Affiliated Hospital School of Medicine Zhejiang University Hangzhou Zhejiang 310009 China

Background Total knee arthroplasties （TKR） combined with the concept of reduced trauma to tissue has been performed by many doctors. The aim of this study was to retrospectively assess the early results of a group of TKR with a mid-vastus approach, which was characterized as no patellar eversion, no disruption of suprapatellar pouch and extensor mechanism, and to compare the outcome with conventional operative techniques. Methods A total of 59 patients （67 knees） were followed. All patients received the same prosthesis of Genesis II posterior-stabilized total knees. Of them, 29 consecutive patients （34 knees） had a mid-vastus approach and were operated on with less invasive instruments and techniques. The mean follow-up duration was 11.6 months. Clinical evaluations were performed according to the Hospital for Special Surgery scores; radiographic assessment followed the guidelines of the Knee Society. Postoperative recovery of quadriceps strength and the extensor mechanism was also evaluated. Results No prosthetic loosening or anterior knee pain was found at the latest follow-up; 1 patient had a superficial infection and postoperative stiffness of the knee who undertook a debridement and manipulation several months later. The angulations of tibial osteotomy were within normal range. The average preoperative and postoperative Hospital for Special Surgery scores were 57.9 points and 86.1 points respectively. The mean postoperative range of motion was 113.5^-. Most patients regained their quadriceps strength at the third or fourth month postoperatively. Conclusions The overall early results from using the mid-vastus approach were comparable with that of using a standard approach, and the exposure did not affect the accuracy of the tibial cut. The muscle maximal contraction strenath recovered araduallv after oDeration. The aDDroach was safe and Datients of this aroup obtained satisfactorv outcomes.

关键词： arthroplasty knee prosthesis minimally invasive surgical procedures outcome

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Factors associated with post-pancreaticoduodenectomy hemorrhage： 303 consecutive cases analysis

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Chinese Medical Journal 2012年第9期125卷 1571-1575页

作者： GAO Qing-xiang LEE Hua-yu WU Wen-han GAO Song YANG Yin-mo MA Irene Teting CAI Meng-shan Department of Surgery Peking University First HospitalBeijing 100034China University of New Mexico AlbuquerqueNMUSA

Background Because of the complexity and severity of the surgery and its associated complications, pancreaticoduodenectomy （PD） is associated with significant morbidity and mortality, especially the hemorrhage post-PD. Exploring the factors associated with post-PD hemorrhage is very important for the patients’ safety.Methods Clinical data from 303 cases of PD between January 1998 and December 2008 were analyzed retrospectively.Results The overall mortality rate was 4.95% （15/303）. However, post-operative bleeding occurred in 25 patients （8.25%） with nine episodes resulting in death （36.00%）. Univariate analysis was performed and identified tumor size, Child’s classification, total pancreatic uncinatic process resection, and pancreatic leakage as significant risk factors for post-PD hemorrhage. In the severe hemorrhage group, incomplete resection of uncinate process of pancreas and pancreatic leakage were the main causes. The multivariate Logistic regression analysis revealed that each of these variables is an independent risk factor.Conclusions Primary prevention of bleeding complications depends on total pancreatic uncinatic process resection and meticulous hemostatic techniques during surgery. In addition, several peri-operative factors were found to contribute to post-PD bleeding.

关键词： pancreaticoduodenectomy post-operative bleeding surgical procedures

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Original article——surgical treatment of IIIb-T4 lung cancer invading left atrium and great vessels

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Chinese Medical Journal 2010年第3期123卷 265-268页

作者： WANG Xiao-xin LIU Tong-lin YIN Xing-ru Department of Thoracic Surgery Peking University First Hospital Beijing 100034 China Department of Thoracic Surgery Fifth People's Hospital of Dalian Dalian Liaoning 116021 China

Background IIIb-T4 non-small cell lung cancer （NSCLC） is commonly considered a contraindication to surgery, although chemo-radiotherapy also achieves a poor survival rate. We reviewed our experience with T4 NSCLC patients who underwent surgery to explore the indications and prognostic factors of surgical treatment of lung cancer invading the left atrium and great vessels. Methods We investigated a cohort of 105 patients, 79 men and 26 women, who underwent surgery from May 1996 to July 2008. Their pathological staging was T4No-2M0. The median age was 59 years, ranging from 36 to 75 years. Patients were grouped based on invading sites： tumors invading the left atrium （LA group）, tumors invading the superior vena cava （SVC group）, and tumors invading the intrapericardial pulmonary artery （PA group）. Patients were further characterized based upon the type of operation, complete resection and incomplete resection groups, and on the lymph node pathological status, No, N1 and N2 groups. We calculated the overall five-year survival rate. Results All patients received resection of primary lesions, with partial resection of the left atrium in the LA group （n=-25）, angioplasty of superior vena cava in the SVC group （n=-23） and intrapericardial ligation of the pulmonary artery in the PA group （n=57）. Complete resection was possible in 77 patients （73.3%）. The overall survival rate of the 105 patients was 41.0% at 5 years; 36.0% for the LA group, 34.8% for the SVC group and 45.6% for the PA group. Pathological N status significantly influenced the overall 5-year survival rate; 61.5% for No, 51.1% for the N1 and 11.8% for the N2 groups （N2 group versus No group, P 〈0.0001, N2 versus N1 group, P〈0.0001）. surgical resection also influenced survival; 49.4% for the complete resection group and 17.9% for the incomplete resection group （P 〈0.0001）. Cox regression analysis demonstrated that pathological N status was a significant independent predictor of prognosis. Conclusions Pathologi

关键词： lung neoplasms surgical procedures vena cava superior pulmonary artery neoplasm invasiveness

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Clinical Experience with the Fifth-Generation of a Breast Implant with a Smooth, Fine Surface from a Korean Manufacturer in Asian Women

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Journal of Biosciences and Medicines 2022年第6期10卷 132-144页

作者： Dong Yeon Hwang Sang Wha Kim Joon Yong Jung Robert Kim NANA Plastic Surgery Seoul Korea Department of Plastic and Reconstructive Surgery Seoul National University Hospital College of Medicine Seoul National University Seoul Korea Department of Radiology Seoul St. Mary’s Hospital College of Medicine The Catholic University of Korea Seoul Korea Department of Medical and Pharmaceutical Affairs Doctor CONSULT Seoul Korea

Background: In this study, we describe our clinical experience with the fifth-generation of a breast implant with a smooth, fine surface from a Korean manufacturer (BellaGel® SmoothFine;HansBiomed Co. Ltd., Seoul, Korea) in Asian women. Methods: We analyzed 223 women (mean age = 35.28 ± 9.45 years and mean follow-up period = 12.03 ± 2.48 months), comprising 118 bilateral cases and 109 unilateral ones, who received breast augmentation using the BellaGel® SmoothFine at our hospital between June 4, 2018 and February 28, 2019. For safety assessment, we analyzed frequencies of postoperative complications and overall survival of the BellaGel® SmoothFine. Results: Postoperatively, complications (12 cases, 5.38%) include asymmetry (3 cases, 1.35%), hematoma (2 cases, 0.90%), hypertrophic scars (2 cases, 0.90%), wound disruption (2 cases, 0.90%), rippling (1 case, 0.45%), capsular contracture (1 case, 0.45%), stretch deformities with skin excess (1 case, 0.45%). In addition, time-to-events were calculated as 10.94 ± 0.64 months (95% CI 9.69 - 12.19) and the survival rate reached 0.290 ± 0.168 (95% CI 0.094 - 0.901) at 12 months postoperatively. Conclusions: Here, we describe our clinical experience with the BellaGel® SmoothFine. Our results are of significance in that this is the first report about the fifth-generation of a breast implant with a smooth, fine surface from a Korean manufacturer for Asian women.

关键词： Clinical Study Retrospective Studies surgical procedures Operative Postoperative Period Follow-Up Studies

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What is the best surgical procedure of transverse colon cancer?An evidence map and minireview

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World Journal of Gastrointestinal Oncology 2021年第5期13卷 391-399页

作者： Chen Li Quan Wang Ke-Wei Jiang Department of Gastrointestinal Surgery Peking University People's HospitalBeijing 100044China

Colorectal cancers comprise a large percentage of tumors worldwide,and transverse colon cancer(TCC)is defined as tumors located between hepatic and splenic *** to the anatomy and embryology complexity,and lack of large randomized controlled trials,it is a challenge to standardize TCC *** this study,the current situation of transverse/extended colectomy,robotic/laparoscopic/open surgery and complete mesocolic excision(CME)concept in TCC operations is discussed and a heatmap is conducted to show the evidence level and *** summary,transverse colectomy challenges the dogma of traditional extended colectomy,with similar oncological and prognostic *** with conventional open resection,laparoscopic and robotic surgery plays a more important role in both transverse colectomy and extended *** CME concept may contribute to the radical resection of TCC and adequate harvested lymph *** to published studies,laparoscopic or robotic transverse colectomy based on the CME concept was the appropriate surgical procedure for TCC patients.

关键词： Evidence map Extended colectomy Review surgical procedures Transverse colectomy Transverse colon cancer

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