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Patient-reported dissatisfaction following second side in staged bilateral total knee arthroplasty: A systematic review

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World Journal of Orthopedics 2022年第11期13卷 1029-1037页

作者： Eric Gruenberger Andrew S Bae Tyler Kelly Brent A Ponce James McGrory The Hughston Foundation ColumbusGA 31909United States Department of Orthopedic Surgery Jack Hughston Memorial HospitalPhenix CityAL 36867United States Department ofOrthopedic Surgery Hughston Foundation and Jack Hughston Memorial HospitalColumbusGA 31909United States

BACKGROUND Around one third of patients who undergo total knee arthroplasty(TKA)will eventually have the contralateral knee replaced.Overall patient satisfaction after staged bilateral total knee arthroplasty procedures performed on different days is reportedly similar to unilateral TKA.Nevertheless,in our anecdotal experience patients often report less satisfying outcomes following the second side.A cursory review of available literature tended to confirm that observation.We sought therefore to consolidate all of the available data on this issue to further investigate this phenomenon.AIM To consolidate available published data revealing satisfaction scores among patients following staged bilateral TKA,and to evaluate the phenomenon of less satisfying results following TKA2.METHODS A systematic review of available literature reporting on satisfaction with TKA1 and TKA2 after staged bilateral knee arthroplasty was undertaken using PubMed,Google Scholar,and Embase.From 427 records,five full-length articles met criteria for inclusion in the meta-analysis.The data were then extracted and assessed on the basis of the Reference Citation Analysis(https://***/).RESULTS A total of 1889 patients with an average age of 68(range:38–92)underwent staged bilateral TKA with outcomes reported at 1 year following each TKA with a mean 21.9 mo between surgeries(range:2 d to 14.5 years).Overall satisfaction with both knees was 83.70%(1581)and dissatisfaction with both knees was 2.75%(52).In the remaining 13.56%(256)who were dissatisfied with one side,61.0%were dissatisfied with TKA2,and 39.0%were dissatisfied with TKA1.Patient-reported outcome scores for TKA2 were frequently lower than TKA1 even in patients reporting overall satisfaction with both knees.CONCLUSION At 1-year follow-up,there was a 50%greater risk of dissatisfaction with TKA2 among the 13.56%of patients reporting dissatisfaction in one knee after staged bilateral TKA.Whether the interval between procedures or long-term follow-up changes these results requires further in

关键词： staged Staggered Sequential Bilateral arthroplasty Total knee arthroplasty Patient-reported outcomes

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Experimental study on NO_x emission correlation of fuel staged combustion in a LPP combustor at high pressure based on NO-chemiluminescence

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Chinese Journal of Aeronautics 2020年第2期33卷 550-560页

作者： Zhichao WANG Yuzhen LIN Jianchen WANG Chi ZHANG Zhijun PENG National Key Laboratory of Science and Technology on Aero-Engine Aero-thermodynamics Collaborative Innovation Center for Advanced Aero-EngineSchool of Energy and Power EngineeringBeihang UniversityBeijing 100083China Creative Arts Technologies and ScienceUniversity of BedfordshireLuton LU13JUUK

Experimental investigations on NOx emissions of a single-cup,Lean Premixed Prevaporized(LPP),module combustor were carried out at elevated inlet temperature and pressure up to810 K and 2.0 MPa,close to the real operating conditions of aero-engine combustors.This LPP combustor adopts centrally staged fuel injections which could produce separated stratified swirling spray flame.In the NOx emissions measurements,the ranges of dome equivalence ratio and fuel stage ratio were from 0.55 to 0.58 and 8%to 24%,respectively.The optical diagnosis on separated stratified swirling spray flame were carried out with fuel stage ratio changing from 15%to 30%.Therefore,NO*and OH*chemiluminescence images were obtained.The results show that NOx emissions increase with the increase of the fuel stage ratio.And from the chemiluminescence images,the main flame and pilot flame are found weakly coupled.The pilot flame plays a significant role in NOx emission production because of its higher adiabatic flame temperature.Based on the results of chemiluminescence optical tests,a new NOx emission prediction model is proposed based on the Lefebvre’s single flame model The estimate of local equivalence ratio of the pilot stage’s nonpremixed flame is modified considering the characteristics of spray combustion,and a"PLUS"emission prediction model suitable for separated stratified swirling spray flame is obtained.Compared to the experimental data,the"PLUS"model exhibits a good prediction in a range of±13%of deviation.

关键词： Combustors Lean staged combustion Low emissions NOx correlation Optical diagnosis

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maturity of associating liver partition and portal vein ligation for staged hepatectomy-derived liver regeneration in a rat model

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World Journal of Gastroenterology 2018年第10期24卷 1107-1119页

作者： Yi-fan Tong Ning Meng Miao-qin Chen Han-ning Ying Ming Xu Billy Lu Jun-Jie Hong Yi-fan Wang Xiujun Cai Department of General Surgery Sir Run Run Shaw HospitalSchool of MedicineZhejiang UniversityHangzhou 310000Zhejiang ProvinceChina Department of General Surgery Second HospitalSchool of MedicineHangzhou Normal UniversityHangzhou 310000Zhejiang ProvinceChina Department of Biological Treatment Research Center Sir Run Run Shaw HospitalSchool of MedicineZhejiang UniversityHangzhou 310000Zhejiang ProvinceChina National Center for Advancing Translational Science/National Institutes of Health(NIH) Rickville 20850American Samoa

AIM To establish a rat model for evaluating the maturity of liver regeneration derived from associating liver partition and portal vein ligation for staged hepatectomy(ALPPS).METHODS In the present study, ALPPS, partial hepatecotmy(PHx), and sham rat models were established initially, which were validated by significant increase of proliferative markers including Ki-67, proliferating cell nuclear antigen, and cyclin D1. In the setting of accelerated proliferation in volume at the second and fifth day after ALPPS, the characteristics of newborn hepatocytes, as well as specific markers of progenitor hepatic cell, were identified. Afterwards, the detection of liver function followed by cluster analysis of functional gene expression were performed to evaluate the maturity.RESULTS Compared with PHx and sham groups, the proliferation of f LR was significantly higher in ALPPS group(P = 0.023 and 0.001 at second day, P = 0.034 and P < 0.001 at fifth day after stage I). Meanwhile, the increased expression of proliferative markers including Ki-67, proliferating cell nuclear antigen, and cyclin D1 verified the accelerated liver regeneration derived from ALPPS procedure. However, ALPPS-induced Sox9 positive hepatocytes significantly increased beyond the portal triad, which indicated the progenitor hepatic cell was potentially involved. And the characteristics of ALPPSinduced hepatocytes indicated the lower expression of hepatocyte nuclear factor 4 and anti-tryptase in early proliferative stage. Both suggested the immaturity of ALPPS-derived liver regeneration. Additionally, the detection of liver function and functional genes expression confirmed the immaturity of renascent hepatocytes derived in early stage of ALPPS-derived liver regeneration.CONCLUSION Our study revealed the immaturity of ALPPS-derived proliferation in early regenerative response, which indicated that the volumetric assessment overestimated the functional proliferation. This could be convincing evidence that the stage Ⅱ of ALPPS should be performed prudent

关键词： associating liver partition and portal vein ligation for staged hepatectomy Liver regeneration Hepatic progenitor cell Function Immature

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Numerical Simulation and Optimization of staged Combustion and NO_x Release Characteristics in Precalciner

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Journal of Thermal Science 2019年第5期28卷 1024-1034页

作者： WANG Weishu LIAO Yihan LIU Jun HUANG Zhihao TIAN Miao Thermal Engineering Research Centre North China University of Water Resources and Electric Power

In order to study the combustion characteristics in a precalciner, the temperature and composition field in a typical Trinal-sprayed calciner were numerically analysed. The results obtained by simulation were compared to actual measurements and the simulated results were in good agreement with the measured ones. The results indicated that the aerodynamic flow field in the precalciner is satisfactory, and a symmetrical reflux occurs in the shrinkage zone of the precalciner because of air staging, which can increase the residence time of the solid particles. The temperature distribution in the furnace is uniform, and the average temperature is greater than 1200 K, which can satisfy the conditions for the pulverised coal combustion and raw material decomposition. The mass fraction distribution of oxygen, carbon monoxide, and carbon dioxide in the precalciner is closely related to the temperature distribution. The concentration of nitrogen oxides(NO_x) exhibits a trend of increasing, decreasing and then increasing, and finally tending to a stable level. Within a certain velocity range, the average temperature in the precalciner and the decomposition efficiency of the raw material increase as the flue gas velocity increases. When the flue gas velocity is 24 m/s, the overall performance of the precalciner is optimal.

关键词： TTF precalciner staged combustion NOx emission characteristics optimization

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Current status of associating liver partition with portal vein ligation for staged hepatectomy: Comparison with two-stage hepatectomy and strategies for better outcomes

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World Journal of Gastroenterology 2019年第43期25卷 6373-6385页

作者： Kin Pan Au Albert Chi Yan Chan Department of Surgery Queen Mary HospitalHong KongChina Department of Surgery and State Key Laboratory for Liver Research The University of Hong KongHong KongChina

Since its introduction in 2012,associating liver partition with portal vein ligation for staged hepatectomy(ALPPS)has significantly expanded the pool of candidates for liver resection.It offers patients with insufficient liver function a chance of a cure.ALPPS is most controversial when its high morbidity and mortality is concerned.Operative mortality is usually a result of posthepatectomy liver failure and can be minimized with careful patient selection.Elderly patients have limited reserve for tolerating the demanding operation.Patients with colorectal liver metastasis have normal liver and are ideal candidates.ALPPS for cholangiocarcinoma is technically challenging and associated with fair outcomes.Patients with hepatocellular carcinoma have chronic liver disease and limited parenchymal hypertrophy.However,in selected patients with limited hepatic fibrosis satisfactory outcomes have been produced.During the inter-stage period,serum bilirubin and creatinine level and presence of surgical complication predict mortality after stage II.Kinetic growth rate and hepatobiliary scintigraphy also guide the decision whether to postpone or omit stage II surgery.The outcomes of ALPPS have been improved by a combination of technical modifications.In patients with challenging anatomy,partial ALPPS potentially reduces morbidity,but remnant hypertrophy may compare unfavorably to a complete split.When compared to conventional two-stage hepatectomy with portal vein embolization or portal vein ligation,ALPPS offers a higher resection rate for colorectal liver metastasis without increased morbidity or mortality.While ALPPS has obvious theoretical oncological advantages over two-stage hepatectomy,the long-term outcomes are yet to be determined.

关键词： Associating liver partition with portal vein ligation for staged hepatectomy Two-stage hepatectomy Patient selection Surgical outcomes

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Complete or partial split in associating liver partition and portal vein ligation for staged hepatectomy: A systematic review and meta-analysis

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World Journal of Gastroenterology 2019年第39期25卷 6016-6024页

作者： Han-Chun Huang Jin Bian Yi Bai Xin Lu Yi-Yao Xu Xin-Ting Sang Hai-Tao Zhao Department of Liver Surgery Peking Union Medical College Hospital Chinese Academy of Medical Sciences and Peking Union Medical College

BACKGROUND Associating liver partition and portal vein ligation for staged hepatectomy(ALPPS)has been adopted by liver surgeons in recent years.However,high morbidity and mortality rates have limited the promotion of this technique.Some recent studies have suggested that ALPPS with a partial split can effectively induce the growth of future liver remnant(FLR)similar to a complete split with better postoperative safety profiles.However,some others have suggested that ALPPS can induce more rapid and adequate FLR growth,but with the same postoperative morbidity and mortality rates as in partial split of the liver parenchyma in ALPPS(p-ALPPS).AIM To perform a systematic review and meta-analysis on ALPPS and p-ALPPS.METHODS A systematic literature search of PubMed,Embase,the Cochrane Library,and ClinicalTrials.gov was performed for articles published until June 2019.Studies comparing the outcomes of p-ALPPS and ALPPS for a small FLR in consecutive patients were included.Our main endpoints were the morbidity,mortality,and FLR hypertrophy rates.We performed a subgroup analysis to evaluate patients with and without liver cirrhosis.We assessed pooled data using a random-effects model.RESULTS Four studies met the inclusion criteria.Four studies reported data on morbidity and mortality,and two studies reported the FLR hypertrophy rate and one study involved patients with cirrhosis.In the non-cirrhotic group,p-ALPPS-treated patients had significantly lower morbidity and mortality rates than ALPPStreated patients[odds ratio(OR)=0.2;95%confidence interval(CI):0.07–0.57;P=0.003 and OR=0.16;95%CI:0.03-0.9;P=0.04].No significant difference in the FLR hypertrophy rate was observed between the two groups(P>0.05).The total effects indicated no difference in the FLR hypertrophy rate or perioperative morbidity and mortality rates between the ALPPS and p-ALPPS groups.In contrast,ALPPS seemed to have a better outcome in the cirrhotic group.CONCLUSION The findings of our study suggest that p-ALPPS is safer than ALPPS in patients without

关键词： Liver,Cancer Partial split staged hepatectomy Systematic review Metaanalysis

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Rescue associating liver partition and portal vein ligation for staged hepatectomy after portal embolization: Our experience and literature review

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World Journal of Clinical Oncology 2017年第4期8卷 351-359页

作者： Charlotte Maulat Antoine Philis Bérénice Charriere Fatima-Zohra Mokrane Rosine Guimbaud Philippe Otal Bertrand Suc Fabrice Muscari Department of Visceral Surgery Toulouse-Rangueil University Hospital Department of Radiology Toulouse-Rangueil University Hospital Department of Digestive Oncology Toulouse-Rangueil University Hospital

AIM To report a single-center experience in rescue associating liver partition and portal vein ligation for staged hepatectomy(ALPPS), after failure of previous portal embolization. We also performed a literature review.METHODS Between January 2014 and December 2015, every patient who underwent a rescue ALPPS procedure in Toulouse Rangueil University Hospital, France, was included. Every patient included had a project of major hepatectomy and a previous portal vein embolization(PVE) with insufficient future liver remnant to body weight ratio after the procedure. The ALPPS procedure was performed in two steps(ALPPS-1 and ALPPS-2), separated by an interval phase. ALPPS-2 was done within 7 to 9 d after ALPPS-1. To estimate the FLR, a computed tomography scan examination was performed 3 to 6 wk after the PVE procedure and 6 to 8 d after ALPPS-1. A transcystic stent was placed during ALPPS-1 and remained opened duringthe interval phase, in order to avoid biliary complications. Postoperative liver failure was defined using the 50-50 criteria. Postoperative complications were assessed according to the Dindo-Clavien Classification.RESULTS From January 2014 to December 2015, 7 patients underwent a rescue ALPPS procedure. Median FLR before PVE, ALPPS-1 and ALPPS-2 were respectively 263 cc(221-380), 450 cc(372-506), and 660 cc(575-776). Median FLR/BWR before PVE, ALPPS-1 and ALPPS-2 were respectively 0.4%(0.3-0.5), 0.6%(0.5-0.8), and 1%(0.8-1.2). Median volume growth of FLR was 69%(18-92) after PVE, and 45%(36-82) after ALPPS-1. The combination of PVE and ALPPS induced a growth of median initial FLR of +408 cc(254-513), leading to an increase of +149%(68-199). After ALPPS-2, 4 patients had stage Ⅰ-Ⅱ complications. Three patients had more severe complications(one stage Ⅲ, one stage Ⅳ and one death due to bowel perforation). Two patients suffered from postoperative liver failure according to the 50/50 criteria. None of our patients developed any biliary complication during the ALPPS procedure.CONCLUSION Rescue ALPPS may be an

关键词： Rescue associating liver partition and portal vein ligation for staged hepatectomy Associating liver partition and portal vein ligation for staged hepatectomy Portal vein embolization Liver resection Future liver remnant

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Outcomes of staged hepatectomies for liver malignancy

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World Journal of Hepatology 2019年第6期11卷 513-521页

作者： Naif A Albati Ali A Korairi Ibrahim Al Hasan Helayel K Almodhaiberi Abdullah A Algarni Hepatobiliary and Liver Transplant Unit Department of General Surgery Prince Sultan Military Medical City

Liver malignancies are the fifth most common cause of death worldwide.Surgical intervention with curative intent is the treatment of choice for liver tumors as it provides long-term survival.However,only 20%of patients with metastatic liver lesions can be managed by curative liver resection.In most of the cases,hepatectomy is not feasible because of insufficient future liver remnant(FLR).Two-stage hepatectomy is advocated to achieve liver resection in a patient who is considered to not be a candidate for resection.Procedures of staged hepatectomy include conventional two-stage hepatectomy,portal vein embolization,and associating liver partition and portal vein ligation for a staged hepatectomy.Technical success is high for each of these procedures but variable between them.All the procedures have been reported as being effective in achieving a satisfactory FLR and completing the second-stage resection.Moreover,the overall survival and disease-free survival rates have improved significantly for patients who were otherwise considered nonresectable;yet,an increase in the morbidity and mortality rates has been observed.We suggest that this type of procedure should be carried out in high-flow centers and through a multidisciplinary approach.An experienced surgeon is key to the success of those interventions.

关键词： staged hepatectomy Portal vein embolization Portal vein ligation Colorectal liver metastasis Hepatocellular carcinoma Associated liver partition and portal vein ligation for staged hepatectomy

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Alternative technique to save ischemic bowel segment in management of neonatal short bowel syndrome: A case report

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World Journal of Clinical Cases 2019年第20期7卷 3353-3357页

作者： Lei Geng Lei Zhou Guo-Jian Ding Xiao-Liang Xu Yu-Mei Wu Ji-Jun Liu Ting-Liang Fu Department of Pediatric Surgery Binzhou Medical University HospitalBinzhou 256603Shandong ProvinceChina Department of Hepatobiliary Surgery Binzhou Medical University HospitalBinzhou 256603Shandong ProvinceChina Department of Neonatology Binzhou Medical University HospitalBinzhou 256603Shandong ProvinceChina Department of Anorectal Surgery Binzhou Medical University HospitalBinzhou 256603Shandong ProvinceChina

BACKGROUND Congenital short bowel syndrome(SBS)associated with malrotation,gut volvulus and jejuno-ileal atresia is a very rare condition.It is a severe challenge for surgeons to preserve residual ischemic bowel segment in the management of short bowel syndrome,especially in neonates.CASE SUMMARY We report a newborn baby with gut malrotation associated with jejuno-ileal atresia,congenital SBS and jejunal volvulus.Hematemesis and abdominal distention were noted.At laparotomy,malrotation associated with jejuno-ileal atresia,congenital SBS and jenunal volvulus was confirmed.The total length of the small bowel was 63 cm with proximal jejunal bowel segment measuring 38 cm,including 18 cm necrotic segment below the Treitz’s ligament and 20 cm severe ischemic segment.The distal part of the small bowel was 25 cm in length and only about 0.8 cm in diameter.Ladd’s procedure,necrotic segment resection and end-to-back duodeno-ileal anastomosis were performed.The residual severe ischemic jejunum was preserved with single proximal stoma and distal end closure.Three months later,to restore the continuity of the isolated gut segment,end-to-end duodeno-jejunal and jejuno-ileal anastomosis was performed.The entire functional small bowel length increased to 80 cm.Intravenous fluid therapy and parenteral nutrition were discontinued on the 10th day postoperatively.Twelve months later,her body weight was 9.5 kg.CONCLUSION Isolation of severe ischemic bowel segment and staged anastomosis to restore the gut continuity for infants with SBS are safe and feasible.

关键词： Ischemic bowel segment Short bowel syndrome Bowel isolation technique staged salvaging procedure Case report

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Hepatocellular carcinoma successfully treated with ALPPS and apatinib: A case report

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World Journal of Clinical Cases 2019年第16期7卷 2384-2392页

作者： Ling Liu Nian-Feng Li Qi Zhang Ling Lin Department of Hepatobiliary and Pancreatic Surgery Xiangya Hospital Central South University

BACKGROUND Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) has becoming ever more recognized in the treatment of hepatocellular carcinoma (HCC).Nevertheless,long-term survival rate and postoperative complications are far from ideal,mainly since the majority of patients treated with ALPPS surgery have large or multiple lesions and microvascular tumor thrombus.CASE SUMMARY We present the case of a 47-year-old male patient with a huge right hepatic mass and an estimated insufficient residual liver,who was successfully treated with ALPPS surgery and apatinib.Postoperative pathology revealed HCC with several significant microvascular embolisms.Twenty months after operation,no tumor reoccurrence was observed.CONCLUSION Our case indicated that combined targeted drug therapy with ALPPS can lead to long-term survival for patients with large HCC.

关键词： Hepatocellular carcinoma Associating liver partition and portal vein ligation for staged hepatectomy Apatinib Case report

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