Curative Effect Of Surgical Treatment Research Articles

Axial Convex-Shaped Hematoma was Associated with Poor Curative Effect of Surgical Treatment for Traumatic Posterior Fossa Epidural Hematoma in Children.

Posterior fossa epidural hematoma (PFEDH) is rare which accounts for just 4-12.9% of all EDH cases. Since its frequently subtle and nonspecific clinical presentation, CT scan has great importance for early diagnosis and treatment of PFEDH. However, indications for surgery depending on the findings of CT image are still controversial. We retrospectively analyzed 40 pediatric cases of PFEDH. Their baseline characteristic, clinical presentation, imaging findings and outcomes were collected and analyzed. The ellipsoid volume equation X × Y × Z/2 was used to measure the hematoma volume. The Glasgow Outcome Scale (GOS) was used to assess the neurologic functional outcome. A total of 40 pediatric PFEH patients were included with 8 patients having poor outcome and 32 patients having a relatively good prognosis. GCS score showed a significant difference between good and poor outcome groups (p < 0.001). Y value on CT image was significantly bigger in poor outcome group than good outcome group (p < 0.01). Similar results were got in X/Z value (p < 0.05) and Y/Z value (p < 0.01) which reflected the shape of hematoma. A predictive model with Y + X/Z showed the largest area under the ROC curve with a sensitivity of 75.0% and specificity of 93.7%. GCS score at admission was closely related to the prognosis of the pediatric patients with PFEDH. The morphometry of PFEDH has a crucial role in judging the prognosis. Axial convex-shaped hematoma was associated with poor curative effect of surgical treatment.

Short-term efficacy of cholecystectomy plus bile duct T-tube drainage or choledochojejunostomy in the treatment of gallbladder cancer and its effects on median survival time and postoperative complications.

To explore the short-term efficacy of cholecystectomy plus bile duct T-tube drainage or choledochojejunostomy (CJ) in the treatment of gallbladder cancer (GC) and its effects on the median survival time and postoperative complications. The clinical data of 121 patients who underwent laparoscopic cholecystectomy (LC) in department of hepatobiliary surgery of the hospital from January 2018 to December 2018 were retrospectively analyzed. According to the adjuvant treatment methods, the patients were divided into 2 groups: the control group (n = 61, LC + bile duct T-tube drainage) and experimental group (n = 60, LC + CJ). The perioperative indicators, short-term efficacy, median survival time, postoperative complications and immune stress response were compared between the 2 groups of patients before and after propensity score matching. The surgical time, postoperative anal first exhaust time, and intraoperative blood loss in the experimental group were no different from those in the control group (P > .05), but the hospital stay was shorter than that in the control group (P < .05). There was no difference in the effective rate of treatment and median survival time between the 2 groups (P > .05). The total incidence rate of complications in the experimental group at 14 days after surgery was lower than that in the control group (P < .05). Day 3 after surgery, the levels of immunoglobulin M (IgM) and immunoglobulin G (IgG) of the experimental group were higher than those of the control group (P < .05), while the level of C-reactive protein (CRP) was lower than that of the control group (P < .05). Compared with bile duct T-tube drainage, LC + CJ in the treatment of GC can better shorten the postoperative hospital stay and reduce the postoperative complications and immune stress response, but and the median survival time of the 2 is similar, which can be promoted in clinical practice.

Efficacy of Anterior Cervical Discectomy and Fusion for Female Patients with Hirayama Disease

To compare the preoperative and postoperative hand function and radiographic parameters in female patients with HD. Consecutive female patients with HD undergoing anterior cervical discectomy and fusion were followed-up. The postoperative hand functional data were obtained from the last follow-up, while the postoperative radiographic data were obtained from the examinations in 3- or 6-month follow-up after surgical treatments. The preoperative and postoperative data of hand functional and radiographic assessments were collected and compared between them. Logistic regression analysis was used to clear potential risk factors for surgical treatment. In all, 15 female patients with HD were included in the follow-up study over 9 years. Significant differences were found in total scores (P<0.001) and all five dimensions, including function (P=0.003), activities of daily life (P=0.002), work (P=0.003), satisfaction (P=0.002), appearance (P=0.005), and HD-specific hand symptoms (P=0.001) in hand functional assessment. The comparison of C2-7 Cobb angle was statistically different (P=0.042) in radiographic assessments. The course of illness was of marginal significance (P=0.065) with curative effect of surgical treatment in logistic regression analysis. Anterior cervical discectomy and fusion was an effective way to treat female patients with HD, and the course of illness may be correlated with the efficacy of surgery. For some female patients with HD with a clear diagnosis, early surgical treatment is worthy of clinical consideration.

Surgical treatment ofpatients with severe non-flail chest rib fractures.

BACKGROUNDMany patients have inadequate long-term analgesia, respiratory distress, and hypoxemia due to a long-standing substantial smoking history or the presence of primary pulmonary diseases; analgesic treatment is not valid in these patients. Even if the imaging findings of rib fractures are relatively mild, rib fractures may cause severe position limitation, respiratory distress, and hypoxemia.AIMTo investigate the curative effect of surgical treatment for patients with severe non-flail chest rib fractures.METHODSA total of 78 patients from our hospital with severe noncontinuous thoracic rib fractures from September 2016 to September 2018 were enrolled in our study. Thirty-nine patients underwent surgical treatment, and 39 underwent conservative treatment. The surgical treatment group received surgery performed with titanium plates, and the screws were inserted with open reduction and internal fixation. The conservative treatment group received analgesia and symptomatic treatment. The pain scores at 72 h, 1 wk, 2 wk, 4 wk, 6 wk, 3 mo, and 6 mo were compared, and the SF-36 quality of life scores were compared atthe 3rd and 6th months.RESULTSPain relief in the surgical group was significantly better than that in the conservative group at each time point (72 h, 1 wk, 2 wk, 4 wk, 6 wk, 3 mo, and 6 mo after surgery, P < 0.001). ( The SF-36 scores were significantly higher in the surgical group than in the conservative group at 1 mo and 6 mo (P < 0.05).CONCLUSIONPatients with severe non-flail chest rib fractures have a better quality of life following surgical treatment than following conservative treatment, and surgical treatment is also useful for relieving pain. We should pay more attention to the physiological functions and clinical manifestations of patients with severe rib fractures. In patients with non-flail chest rib fractures, surgical treatment is feasible and effective.

Imaging characteristics and surgical treatment of invasive meningioma.

In order to provide an effective way to prevent or substantially delay the recurrence of invasive meningioma, and improve the curative effect of surgical treatment, we collected and analyzed the clinical manifestations, pathological features, preoperative imaging characteristics as well the data obtained during the surgical treatment of invasive meningioma. From February 2014 to February 2016, 59 patients with invasive meningioma were enrolled in this study. Invasive meningioma was confirmed in all patients by operation. Information about clinical manifestations, pathological features, preoperative imaging and surgical treatment were collected and analyzed. After surgery, pathological specimens were collected, and cases were confirmed as invasive meningioma by pathological examination. The course of disease ranged from 15 days to 7 years (average, 13.2 months). We used World Health Organization (WHO) criteria for classification of meningioma in the nervous system tumors as our reference. Symptoms were as follows: Intracranial hypertension (29 cases), cranial nerve dysfunction (10 cases), epilepsy (11 cases) and other symptoms (9 cases). We had 56 cases of WHO grade I; 6 cases of WHO grade II and 7 cases of WHO grade III. Surgical removal was: Simpson grade I (56 cases), Simpson grade II (2 cases), Simpson grade III and above (56 cases). We used before surgery imaging data to formulate our surgical plan. In general, during surgeries we did not proceed to complete resection, because in the majority of cases, some key structures were invaded and meningioma was very deep and any attempt for total resection could easily lead to significant damage to these structures.

Curative effect of surgical treatment on thoracolumbar burst fracture complicated with incomplete spinal cord injury

Objective To investigate the timing and methods in surgical treatment of thoracolumbar burst fracture complicated with incomplete spinal cord injury. Methods A retrospective analysis was conducted on 52 patients who had surgical treatment for thoracolumbar burst fracture complicated with incomplete spinal cord injury from February 2011 to March 2014. The patients comprised 45 males and 7 females, at mean 41.8 years of age (range, 19-67 years). Multiple trauma was noted in 29 patients. Mean injury severity score (ISS) was 23 points (range, 16-50 points). There were altogether 61 fractured segments including 2 T11, 10 T12, 29 L1 and 20 L2. Ten patients suffered from bi-segmental lesions and 2 tri-segmental lesions. American Spinal Injury Association (ASIA) scale was B in 16 patients, C in 15 and D in 21. Two patients underwent anterior spinal decompression and fusion, and the remaining patients were treated by posterior reduction, decompression, interbody fusion and pedicle screw fixation. ASIA scale, sense or motion score, spinal stenosis and Cobb angle were recorded and their correlation with different operation time was evaluated. Results All patients were followed up for 13-50 months[(32.8±10.4) months]. ASIA scale (3 grade B, 14 grade C, 16 grade D and 19 grade E) and sense or motion score presented some improvements after operation, with the results much better in patients operated within 1-3 d after injury than those operated 4-7 d and 9-22 d after injury (P<0.05 or 0.01). Operation within 4-7 d postinjury exhibited no apparent improvements in spinal stenosis and Cobb angle, but the result was still better than that when operation was done 9-22 days postinjury (P<0.05). Conclusions Thoracolumbar burst fracture complicated with incomplete spinal cord injury should adopt active operation treatment within 3 days postinjury as soon as possible. The time of decompression and deformity correction should not be over 1 week postinjury. Early operation of posterior spinal decompression and fusion appears to have good effects. Key words: Spinal fractures; Thoracic vertebra; Lumbar vertebra; Spinal cord injuries; Decompression

Curative effect of surgical treatment for severe hypertensive intracerebral hemorrhages in basal ganglia and broken into ventricles

Objective To investigate the clinical treatment of severe hypertensive intracerebral hemorrhage in basal ganglia and broken into ventricles. Methods 16 patients with severe hypertensive intracerebral hemorrhage in basal ganglia and broken into ventricles received microsurgical treatment using posterior central gyrus posterior-lateral fissure upper approach.The hematoma cavity and ventricle were opened,and brain surgical department drainage was placed in the hematoma cavity in the operation.The curative effect was analyzed retrospectively 6 months after operation. Results According to Glasgow Outcome Scale(GOS):6 cases had good recovery;4 cases had moderate disability;2 cases had severe disability;1 case was in persistent vegetative state and 3 cases were dead. Conclusion Craniotomy microsurgical operation using posterior central gyrus posterior-lateral fissure upper approach is an effective treatment of severe hypertensive intracerebral hemorrhage in basal ganglia and broken into ventricles.The fatality rate was reduced. Key words: Neurosurgical procedures; Cerebral hemorrhage

Curative effect of surgical treatment of hilar cholangiocarcinoma: Analysis of 41 cases

Curative effect of surgical treatment of hilar cholangiocarcinoma: Analysis of 41 cases

Curative effect and costs of surgical and gamma knife treatments on intractable epilepsy caused by temporal-hippocampal sclerosis.

This study aimed to investigate the curative effect and costs of surgical and gamma knife treatments on intractable epilepsy caused by temporal-hippocampal sclerosis. The subjects comprised patients who suffered from intractable epilepsy caused by temporal-hippocampal sclerosis and received treatment in the Department of Neurosurgery of our hospital between 2010 and 2011. After obtaining their consent, patients were evaluated and selected to receive surgical or gamma knife treatments. In the surgical group, the short-term curative rate was 92.60% and the average cost was US$ 1311.50 while in the gamma knife group, the short-term curative rate was 53.79%, and the average cost was US$ 2786.90. Both surgical and gamma knife treatments of intractable epilepsy caused by temporal-hippocampal sclerosis are safe and effective, but the short-term curative effect of surgical treatment is better than that of gamma knife, and its cost is lower.

Application of preoperative assessment of record sheet in neurosurgical procedures

Objective To study the application of preoperative assessment of record sheet on surgical patients in neurosurgery department .Methods Totals of 80 surgical patients were randomly divided into observation group and control group .Patients in observation group were given preoperative assessment record sheet, and patients in control group were given routine preoperative visit .The curative effect and postoperative nursing effects were compared .Results The intraoperative blood loss , operative time , length of hospital stay and patients increasing blood pressure in observation group were （268.88 ±38.38） ml, （142.1 ±10.10） min, （12.88 ±0.56） days,2, respectively, which were significantly lower than （407.50 ±54.05）ml, （178.40 ± 11.83）min, （25.63 ±1.02） days, 8 in control group.The differences were statistically significant （t=2.176, 2.288,10.960, respectively; χ2 =4.114;P 〈0.05）.HAMA and HAMD scores of patients in observation group after operation were （10.42 ±2.64）,（9.44 ±2.65）,respectively, which were lower than （13.53 ±4.63）, （12.32 ±2.44） before operation, and lower than （13.12 ±3.34）,（11.82 ±2.54） in control group after operation too, the differences were statistically significant （t=3.043,3.856,3.544,2.643, respectively;P〈0.05）.Patient satisfaction scores was （7.64 ±1.65） and the number of satisfied patients was 23 in observation group, which were significantly higher than （6.55 ±1.63） and 14 in the control group.The differences were statistically significant difference （t=3.643,Z=4.073;P〈0.05）.Conclusions Neurosurgery patients with preoperative assessment can better improve the patient ’ s emotional impact , the curative effect of surgical treatment and reduce the risk of intraoperative complications . Key words: Neurosurgical procedures; Preoperative assessment record sheet; Postoperative nursing

Curative effect of surgical treatment in complicated hepatolithiasis

Curative effect of surgical treatment in complicated hepatolithiasis

Standardization and promotion of surgical treatment for obesity and type 2 diabetes mellitus

The curative effect of surgical treatment for obesity and type 2 diabetes mellitus has been internationally recognized.In mainland China,the number of the minimally invasive gastric volume reduction surgery has been increased from 110 cases in 2008 to 2000 cases in 2012.While some of the patients suffered from poor curative effects or severe postoperative complications due to lack of unified standard treatment guidelines.Authoritative statistical agencies and the Chinese clinical database has not been formed till now,therefore the specification and promotion of Chinese surgical treatment standards for obesity and type 2 diabetes mellitus is imperative. Key words: Obesity; Diabetes mellitus, type 2; Surgical procedures, operative ; Standards

Surgical treatment of renal stenosis: a report of 80 cases

To evaluate the curative effect of surgical treatment for renal stenosis. Eighty cases from November 1997 to August 2008 were reviewed, including 53 males and 27 females, aged from 9 to 80 years old. There are 42 atherosclerosis, 23 Takayasu arteritis and 11 fibrodysplasia patients. Surgical procedures included aorto-renal bypass for 13 cases, autogenous renal transplantation for 5 cases, nephrectomy for 1 case, renal endarterectomy for 1 case, lesion resection and reconstruction for 1 case, balloon angioplasty for 14 cases, and stent implantation 48 cases. There were 1 mortality peri-operation. During follow-up (1 to 129 months), 2 among 63 patients died. Significant decline of blood pressure [(135.7 +/- 15.8)/(80.1 +/- 8.5) mm Hg (1 mm Hg = 0.133 kPa) vs. (149.8 +/- 18.3)/(88 +/- 13.6) mm Hg, P < 0.01] and totally 65.6% effective rate were observed. Atherosclerosis, Takayasu arteritis and fibrodysplasia group all presented positive anti-hypertension results with 50%, 73.3% and 100% effective rate respectively (P < 0.05). The creatine level also underwent significant decrease [(112.7 +/- 53.6) micromol/L vs. (131.7 +/- 91.7) micromol/L, P < 0.05], mainly in atherosclerosis group [(127.2 +/- 56.6) micromol/L vs. (138.0 +/- 87.0) micromol/L, P < 0.05]. Surgical treatment of renal stenosis can achieve improvement in hypertension and renal function. Endovascular stent and angioplasty are the first choices for atherosclerotic and fibrodysplasia patients respectively, while open surgery is better for Takayasu arteritis ones.