Lower Postoperative Recurrence Rate Research Articles

Efficacy of combined tympanostomy tube insertion and adenoidectomy in the treatment of otitis media with effusion in children.

To assess the efficacy of combined tympanostomy tube insertion (TTI) and adenoidectomy (Ad) versus Ad alone in the treatment of otitis media with effusion (OME) in children. Clinical data of 145 children with OME who underwent surgical treatment in Jiaxing University Affiliated TCM Hospital from January 2022 to November 2023, were retrospectively analyzed. Patients were grouped based on whether or not Ad was performed with TTI: children who underwent Ad alone were grouped as Ad group (n=71), and children who underwent a combined TTI and Ad were grouped as TTI+Ad group (n=74). Clinical efficacy, clinical indicators (recovery of hearing, disappearance of tinnitus, eardrum healing, and disappearance time of middle ear effusion), serum levels of inflammatory factors, recurrence, and incidence of complications were compared between the two groups. Combined TTI+Ad resulted in a significantly better therapeutic effect three months after the surgery compared Ad alone (P<0.05). Combined treatment was associated with significantly shorter time needed for hearing recovery, disappearance of tinnitus, eardrum healing, and disappearance of middle ear effusion (P<0.05). Combined procedure significantly lowered levels of inflammatory factors (P<0.05), and was associated with lower postoperative recurrence rate (P<0.05) compared to Ad alone. There was no significant difference in the incidence of complications between the two methods of surgical OME treatment (P>0.05). Compared to Ad alone, combined TTI+Ad treatment is equally safe and more effective in the treatment of OME in children. This surgical approach is associated with reduced local inflammatory reactions and lower recurrence rate.

Evaluation and Analysis of the Clinical Effects of Laparoscopic Surgery for Pediatric Direct Inguinal Hernia.

Objective: To assess both the clinical effectiveness and practical experience of utilizing laparoscopic methods for addressing direct inguinal hernia in the pediatric population. Method: The study collected clinical data from 10 pediatric patients with direct inguinal hernia treated at the Children's Hospital of Anhui Province from July 2014 to July 2023. Among them, there were 8 males and 2 females, with an average age of 43.4 ± 22.0 months. All were initially diagnosed with indirect inguinal hernia before surgery. During the laparoscopic procedures, direct hernia was confirmed. Two cases had undergone open hernial sac high ligation surgery due to misdiagnosis as indirect hernia, resulting in recurrent groin bulges postoperatively. For these cases, laparoscopic direct hernia neck ligation with reinforcement and repair using the inner side of the umbilical ligament was performed. Results: All 10 cases of pediatric patients underwent surgeries smoothly without any need for open conversion. The average surgical duration was 29.8 ± 15.0 minutes, with minimal intraoperative bleeding. Patients were discharged on the first day postoperatively, and no significant surgery-related complications were observed. During the 12-month follow-up period, it was noted that the scar at the umbilical ring was superficial and inconspicuous. There were no occurrences of hernia recurrence, testicular retraction, or atrophy. Conclusion: Laparoscopic treatment for pediatric direct inguinal hernia has demonstrated favorable therapeutic outcomes, ensuring a safe surgical process, rapid recovery, and a low postoperative recurrence rate. The laparoscopic approach, specifically utilizing direct hernia neck ligation with reinforcement and repair using the inner side of the umbilical ligament, proves to be a secure and effective treatment for pediatric direct inguinal hernia. It can be considered as a conventional treatment method.

Retrospective Analysis of the Efficacy and Safety of Endoscopic Spinal Tuberculosis Focus Removal versus Posterior Pedicle Lesion Removal, Bone Grafting, and Internal Fixation Combined with Drug Chemotherapy for Thoracolumbar Tuberculosis.

This study aims to investigate the clinical efficacy of endoscopic spinal tuberculosis focus removal, posterior pedicle lesion removal, bone grafting, and internal fixation combined with drug chemotherapy in treating thoracolumbar tuberculosis. It also seeks to summarize strategies for preventing complications and provide a reference for clinical treatment. We retrospectively analyzed 105 patients with spinal tuberculosis treated in our hospital from January 2018 to December 2022. Patients were divided into two groups: Group A (n=38), who underwent endoscopic spinal tuberculosis focus removal, and Group B (n=67), who underwent posterior pedicle lesion removal, bone grafting, and internal fixation. All patients received preoperative quadruple anti-tuberculosis drug chemotherapy (Isoniazid, Rifampicin, Pyrazinamide, Ethambutol) for 2-4 weeks. We recorded and compared parameters such as operation time, intraoperative blood loss, postoperative drainage, recovery time, hospital stay, blood transfusion, and complications. We also compared pre- and postoperative lumbar VAS, ODI, erythrocyte sedimentation rate, C-reactive protein, Procalcitonin, D-Dimer, Neutrophil to Lymphocyte ratio, hemoglobin, total protein, and Cobb angle to evaluate kyphotic deformity and correction. Preoperative data including age, sex, body mass index, segment involvement, past medical history, smoking history, preoperative erythrocyte sedimentation rate, C-reactive protein, Procalcitonin, D-Dimer, Neutrophil to Lymphocyte ratio, hemoglobin, total protein, lumbar VAS score, lumbar ODI score, and spinal Cobb's angle showed no significant difference between the groups (P>0.05). Main postoperative indicators revealed that Group A had significantly lower lumbar VAS scores, higher hemoglobin and total protein levels, and a lower recurrence rate than Group B at the last follow-up (P<0.05). Secondary postoperative indicators showed that Group A required significantly less blood transfusion, had shorter operative time, less intraoperative blood loss, shorter postoperative hospitalization time, and lower Cobb Angle than Group B (P<0.05). Endoscopic spinal tuberculosis focus removal can achieve comparable safety to posterior pedicle lesion removal, bone grafting, and internal fixation, with shorter operation time, less intraoperative bleeding, lower postoperative recurrence rate, and less postoperative drainage. This method can effectively improve blood sedimentation, lumbar function, restore Cobb angle, and reduce pain, making it worthy of promotion and application.

Combined application of gluteus maximus muscle flaps and random pattern skin flaps in repairing sacrococcygeal sinus tracts: a prospective study and technical note.

Sacrococcygeal sinus ulcers are caused by pressure sores, trauma, or surgery. Several surgical techniques have been developed for its treatment; however, studies are ongoing to develop the ideal method. The present study aims to introduce an innovative application of gluteus maximus muscle flaps (GMMFs) packing combined with local random pattern skin flaps (RPSFs) in repairing sacrococcygeal sinus tracts (SSTs). This was a prospective analysis study conducted on the patients (n = 26) with SSTs underwent an innovative repairing surgery in Qilu Hospital of Shandong University, China between December 2015 and December 2020. The repairing surgery was GMMFs combined with RPSFs. The demographic information and the clinical parameters including operative time, postoperative healing time, and recurrence rate were used to evaluate the efficacy of the operation. Except one case of partial necrosis at the edge of the flap due to severe fibrosis, which was cured after dressing change, all the other cases showed effective healing after the operation. The combined application of GMMFs and RPSFs for the treatment of sacrococcygeal sinus tracts gains the advantages of short operative time, quick postoperative recovery, and low postoperative recurrence rate.

Outcomes of Arthroscopic Latarjet as a Revision Surgery After Failed Arthroscopic Bankart Repair

Background: The role of arthroscopic Latarjet as a revision surgery after failed arthroscopic Bankart repair has yet to be established. Purpose: To compare clinical outcomes, recurrences, and complication rates of arthroscopic Latarjet as a revision procedure after failed arthroscopic Bankart repair versus arthroscopic Latarjet as a primary procedure. Design: Cohort study; Level of evidence, 3. Methods: This is a retrospective study of prospectively collected data of patients who were diagnosed with anterior shoulder instability and underwent arthroscopic Latarjet stabilization between 2009 and 2018. Patients were separated into 2 groups depending on whether Latarjet was performed after a previous instability surgery (revision) or as a primary surgery (primary). Rowe score, Western Ontario Shoulder Instability Index (WOSI), Constant-Murley Shoulder Outcome (CMSO) score, and Single Assessment Numeric Evaluation (SANE) were assessed pre- and postoperatively with a minimum 24 months of follow-up. In addition, pre- and postoperative levels of sports activity, dislocations, subluxations, and complications were assessed. Results: A total of 97 patients (n = 62 revision; n = 35 primary), with a mean age of 31.0 ± 8.8 and 29.4 ± 7.6 years old in the revision and primary Latajet group, respectively, met the inclusion criteria. The mean follow-up in the revision group was 32 months (24-53) and 35.5 months (27.7-42.2) in the primary Latarjet group. No significant differences between groups were observed in Rowe score (revision = 91.4, primary = 94.1; P = .223), CMSO score (revision = 90.7, primary = 94; P = .105), and SANE (revision = 85.8, primary = 87.3; P = .683) postoperatively. However, the postoperative difference in the WOSI score between the revision and primary Latarjet groups was nearly significant (510 ± 334 vs 403 ± 343, respectively; P = .05). Four (6.4%) postoperative dislocations were reported in the revision and 1 (2.8%) in the primary Latarjet group (P = .14). Patients in the revision group had a lower return to the previous level of sports participation (P = .008) and decreased external rotation with the arm by the side compared with the primary Latarjet group (P = .000). Conclusion: Arthroscopic Latarjet as a revision surgery is a reasonable surgical option in failed Bankart repair cases. The decision to perform arthroscopic Latarjet stabilization as a revision surgery should not be influenced by the potential risk of future complications as it provides comparable clinical outcomes to the primary Latarjet procedure with a low postoperative recurrence rate. However, a decreased level of postoperative sports participation and external rotation with the arm by the side can be expected.

Laparoscopy and Laparotomy for Endometrioid Adenocarcinoma: Short‐ and Long‐Term Outcomes’ Comparison

Aims. To analyze the short‐term and long‐term outcomes of laparoscopy versus laparotomy in treatment of endometrioid adenocarcinoma and examine the benefits of laparoscopy. Methods. From January 2012 to July 2020, 693 endometrioid adenocarcinoma patients undergoing laparoscopy versus laparotomy were retrospectively identified and enrolled in this study. Basic information for the patients, their perioperative indexes, and recurrence rates were reviewed to assess the therapeutic effect of these two approaches for endometrioid adenocarcinoma. Results. A total of 365 endometrioid adenocarcinoma patients underwent laparoscopy, and 328 patients underwent laparotomy. When compared with the laparotomic group, the laparoscopic group had longer operative times, lower intraoperative bleeding volumes, and shorter postoperative hospital stays. The rate of less‐radical hysterectomy and radical hysterectomy performed in the laparoscopic group (59/365, 16.16%) was significantly lower than that in the laparotomic group (162/328, 49.39%). There was no statistically significant difference in the local recurrence rate between the two groups; however, the remote recurrence rate in the laparotomic group (15/308, 4.87%) was significantly higher than that in the laparoscopic group (3/351, 0.85%). A further subgroup analysis revealed a higher survival benefit both in I/II patients (314/314, 100%, vs. 7/242, 28.93%) and III/IV patients (35/37, 94.59%, vs. 51/66, 77.27%) in the laparoscopic group, when compared with the laparotomic group. Conclusion. Patients who received laparoscopic surgery had a faster surgical recovery and a lower postoperative recurrence rate in the short term than patients who received laparotomic surgery. Laparoscopic surgery is a safe and effective treatment for endometrioid adenocarcinoma.

Efficacy of various surgical approaches in treating hematospermia using transurethral seminal vesiculoscopy

PurposeTo explore the efficacy of different approaches of seminal vesiculoscopy surgery and the predictive factors of good treatment outcome.Materials and MethodsA retrospective analysis of 68 patients who underwent seminal vesiculoscopy for hematospermia in our hospital from January 2015 to January 2021. According to different surgical approaches, they were divided into three groups: natural ejaculatory ducts (method A, 45 cases), assisted transurethral resection/incision of ejaculatory ducts (method B, 14 cases), fenestration in prostatic utricle (method C, 9 cases). We analyzed the recurrence rate of the three surgical approaches and the predictive factors of treatment efficacy.ResultsThe total recurrence rate after the seminal vesiculoscopy for hematospermia in this group was 32.35%. The postoperative recurrence rates of the three methods were 24.44% for method A, 50.00% for method B and 44.44% for method C, and there was no significant difference among the three methods (P > 0.05). The data of five predictors of 45 cases in method A group were included in the Univariate Logistic analysis, the results suggest that whether complicated with seminal tract stones/cysts was an effective predictor (OR 0.250, P = 0.022), which was still an effective predictor in the Multivariate Logistic analysis model (OR 0.244, P = 0.010).ConclusionsThe Transurethral seminal vesiculoscopy technique demonstrates a low postoperative recurrence rate in treating hematospermia. Among the various approaches, the intraoperative use of natural orifices through the ejaculatory duct exhibits the lowest recurrence rate. Additionally, seminal tract stones/cysts effectively predict favorable postoperative outcomes.

Surgical Treatments and Long-Term Outcomes for Pediatric Patients With Lumbar Spinal Tumors.

Retrospective case‒control study. This study aimed to report the effects of surgical intervention on spinal stability recovery and to assess the long-term outcomes of children and adolescents with lumbar tumors. From January 2016 to June 2021, 42 pediatric patients with lumbar tumors were selected and separated into different groups based on the surgical method used (total en bloc resection (TER) group, n = 21; piecemeal resection (PR) group, n = 21; titanium mesh (TM) group n = 23; artificial vertebrae (AV) group n = 19). The clinicopathological characteristics, treatments and related outcomes were described in detail and compared between groups, with P value ≤.05 indicating statistically significant differences. The average follow-up duration was 24.89 months, and the mean age was 14.89 ± 2.41years. There were no significant differences in the mean operation time, average blood loss, complication rate, or length of hospital stay between the groups. The ODI, VAS and JOA scores at the final follow-up (FF) were elevated after surgery in all groups. The FF local angular drift (LOD) and lumbar angular drift (LUD) were greater in the TM group than in the AV group (P = .03, P = .001). After surgery, pediatric patients with lumbar tumors can obtain satisfactory spinal stability, effective relief of pain symptoms and substantial improvements in neurological function. There was no significant difference in the invasiveness, safety or timeliness between the 2 surgical methods, so TER is recommended due to its low postoperative recurrence rate and good local control. Spinal fusion in the AV group resulted in better spinal stability.

Intra-articular soft arthroscopic Latarjet technique as a Bankart-plus procedure for type V superior labrum anterior-posterior lesion: lower rate of instability recurrence and better functional outcomes of a prospective cohort study.

Intra-articular soft arthroscopic Latarjet technique (in-SALT) involves augmentation of arthroscopic Bankart repair (ABR) with soft tissue tenodesis of long head of biceps to upper subscapularis. This study was conducted to investigate superiority of outcomes of in-SALT-augmented ABR over those of concurrent ABR and anterosuperior labral repair (ASL-R) in management of type V superior labrum anterior-posterior (SLAP) lesion. This prospective cohort study (conducted between January 2015 and January 2022) included 53 patients with arthroscopic diagnosis of type V SLAP lesion. Patients were allocated into 2 consecutive groups: group A of 19 patients managed with concurrent ABR/ASL-R and group B of 34 patients managed with in-SALT-augmented ABR. Outcome measurements included 2-year postoperative pain, range of motion, and American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES) and Rowe instability scores. Failure was defined as frank/subtle postoperative recurrence of glenohumeral instability or objective diagnosis of Popeye deformity. The statistically matched studied groups showed significant postoperative improvement in outcome measurements. However, group B demonstrated significantly better 3-month postoperative visual analog scale score (3.6 vs. 2.6, P=.006) and 24-month postoperative external rotation at 0° abduction (44° vs. 50°, P=.020) and ASES (84 vs. 92, P<.001) and Rowe (83 vs. 88, P=.032) scores. Rate of postoperative recurrence of glenohumeral instability was relatively lower in group B (10.5% vs. 2.9%, P=.290). No Popeye deformity was reported. For management of type V SLAP lesion, in-SALT-augmented ABR yielded a relatively lower rate of postoperative recurrence of glenohumeral instability and significantly better functional outcomes compared with concurrent ABR/ASL-R. However, currently reported favorable outcomes of in-SALT should be validated via further biomechanical and clinical studies.

Spindle Epithelial Tumor With Thymus-Like Differentiation of Thyroid (SETTLE): A Case Report and Literature Review.

Spindle epithelial tumor with thymus-like differentiation of thyroid (SETTLE) is very rare neoplasm with 2 cellular forms, epithelial cell and spindle cell, and most reported cases have been in young people. An 11-year-old boy presented with painless swelling of the right neck lasting for more than 2months. A tumor size measuring approximately 3 × 3cm was resected, and intraoperative frozen pathology suggested a spindle cell tumor, which was confirmed as SETTLE by immunohistochemical staining and external hospital consultation. The immunohistochemical staining profile of the resected tumor tissue was as follows: cytokeratin (CK) (+), smooth muscle actin (weak+), vimentin (+), CK7 (focal+), B-cell lymphoma 2 (partial+), CD99 (-), calcitonin (+), galectin-3 (+), CK19 (+), and Ki-67 (10%+). Ultrasound at 1-year postoperative follow-up revealed no local recurrence of the lesion or lymph node metastasis in the thyroid gland. We summarized the disease characteristics of SETTLE among 6 cases reported to date and found that SETTLE is associated with a good prognosis and low postoperative recurrence rate. Thus, for this type of malignant thyroid tumor, diagnosis depends mainly on postoperative pathology and immunohistochemical staining and simple surgical resection is recommended.

Safety and clinical efficacy of endoscopic procedures for the treatment of adjacent segmental disease after lumbar fusion: A systematic review and meta-analysis.

Adjacent segment disease (ASD) is a common complication after lumbar fusion and is still traditionally treated by open surgery. In recent years, with the development of minimally invasive techniques, percutaneous endoscopic surgery(PES) has been used for the treatment of ASD after lumbar fusion due to its unique benefits. Nevertheless, it remains unclear about its significant clinical efficacy and advantages over conventional open surgery. To evaluate the clinical efficacy and safety of PES in the treatment of ASD after lumbar fusion. A systematic review and meta-analysis studies about the role of PES in managing ASD after lumbar fusion. A systematic search review was conducted in PubMed, EMBASE, Cochrane Library, Web of Science, CNKI, VIP, WanFang, and SinoMed databases from the start of their construction to 15 November 2021. Eligible studies included references to clinical trials of PES for ASD after open lumbar fusion. Observations included pain relief, recovery of postoperative function, overall excellent rates, and indicators of the advantages of minimally invasive surgery compared to conventional surgery. Postoperative complications and recurrence rates were also recorded. A total of 24 studies, including 20 single-arm studies and 4 clinical control studies, all involving 928 patients were included. A total of 694 patients were included in the single-arm analysis. The results of the single-arm meta-analysis showed that PES could significantly reduce low back and leg pain and improve the functional status of the lumbar spine in patients with ASD after open lumbar fusion compared to preoperatively, and had good clinical efficacy after surgery. A total of 234 patients were included in the four clinically controlled studies, and the results of the meta-analysis showed that PES could clearly reduce pain and improve lumbar function, with no significant difference in efficacy between PES and open surgery. However, PES has a lower surgical incision, less intraoperative bleeding, and shorter operative time and length of hospital stay compared to open surgery. Moreover, it has a lower rate of postoperative recurrence as well as complications and a longer duration of efficacy. On the basis of the available clinical literature and the results of this study, PES could achieve satisfactory clinical effects in ASD treatment after lumbar fusion. Compared with conventional open surgery, PES can not only obtain similar clinical results, but also had the advantages of less trauma and faster recovery. Nevertheless, a randomized controlled study is still needed to validate the findings of this study. Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42022298387.

Effect of CO2 laser combined with low-temperature plasma radiofrequency ablation on the early glottic laryngeal carcinoma

ObjectiveTo explore the effect of CO2 laser combined with low-temperature plasma radiofrequency ablation on the early glottic laryngeal carcinoma. Methods70 patients with early glottic laryngeal carcinoma were enrolled in this retrospective study. The patients (40 cases) in the control group were treated by CO2 laser. The patients in the combination group (30 cases) were treated by CO2 laser combined with low-temperature plasma radiofrequency ablation. ResultsThe postoperative recurrence rate in the combination group was notably decreased than the control group (P < 0.05). There were 2 patients with postoperative bleeding, 3 with vocal cord adhesion, and one with dyspnea in the combination group. Similarly, there were 3 patients with postoperative bleeding, 5 with vocal cord adhesion, and 1 with dyspnea in the control group. ConclusionCO2 laser combined with low-temperature plasma radiofrequency ablation has a low postoperative recurrence rate in the treatment of the early glottic laryngeal carcinoma.

Comparison of the prognostic factors of total en bloc spondylectomy and total piecemeal spondylectomy in patients with Enneking stage III giant cell tumor in the thoracic and lumbar spine

PurposeTo compare total en bloc spondylectomy with marginal margins against piecemeal spondylectomy with intralesional margins in the surgical treatment of Enneking stage III spinal giant cell tumor (GCT) in terms of local recurrence.MethodsA retrospective survival analysis of patients with Enneking stage III GCT who underwent TES with marginal margins or total piecemeal spondylectomy with intralesional margins was performed between January 2006 and April 2020. Local recurrence-free survival (LRFS) was the time between the date of surgery and recurrence. Factors with p-values < 0.05 in the univariate analysis were included in the multivariate analysis using proportional hazard analysis.ResultsSixty patients (25 men and 35 women) with a mean age of 35.6 (range 11–71) years were included. The mean follow-up duration was 93 (range 24–198) months. Two patients were lost to follow-up 6 and 14 years after the procedure. Over a 10-year period, the recurrence rate was 13.3%. The 2-, 5-, and 10-year LRFS rates were 95%, 88%, and 78%, respectively. Univariate analysis identified total piecemeal spondylectomy and no adjuvant radiotherapy as prognostic factors for LRFS. Multivariate Cox‐regression models showed a significant association between local recurrence and total piecemeal spondylectomy and no adjuvant radiotherapy.ConclusionTES with marginal margins is better than total piecemeal spondylectomy with intralesional margins owing to its lower postoperative recurrence rate. Adjuvant radiotherapy should be administered to reduce postoperative recurrence rates.

Application of liquid biopsy in early screening and recurrence prediction of hepatocellular carcinoma

The incidence and mortality of HCC in China account for approximately 50% of all cases worldwide. Low early diagnosis rate and high postoperative recurrence rate are two major causes for poor 5-year survival rate of HCC patients in China. At present, multiple problems such as low performance and compliance of screening technology and lack of effective markers for predicting postoperative recurrence, remain to be resolved. Due to the simplicity and accuracy, new molecular markers, such as liquid biopsy, are expected to serve as supplementary tools to traditional screening and early warning approaches, thereby realizing early detection and accurate treatment of HCC. In this article, research progress upon the clinical application of liquid biopsy in early screening and prediction of postoperative recurrence of HCC was reviewed, and prospects the future research.

Clinical characteristics and literature review of 12 cases of granulosa cell tumor of head and neck

Objective:To investigate the clinical and pathological features, treatment, prognostic and its influence factors of granulosa cell tumor of head and neck. Methods:The clinical medical records of 12 patients with head and neck granulosa cell tumor confirmed by pathology for diagnosis and treatment in Beijing Tongren Hospital affiliated to Capital Medical University were reviewed and collected. Results:The follow-up durations were 4-57 months, with a median of 23 months. The origination of twelve cases were reviewed: 3 cases of the vocal cords, 2 cases of the retroannular region, 1 cases of the ventricular bands, 1 cases of the interarytenoid region, 1 cases of the paraglottic space, 1 cases of the epiglottis, 1 cases of the soft palate, 1 cases of the ventricle of larynx, 1 cases of the trapezius muscle. All 12 patients were undergoing surgical treatment in our hospital, including one who had postoperative adjuvant radiotherapy after second operation. Conclusion:Granulosa cell tumor occurs in the head and neck, usually a benign tumor with diverse morphology, and its diagnosis is mainly based on tumor histopathological examination. Surgical local excision is used in most cases, especially minimally invasive surgery is recommended, with lower postoperative recurrence rate and better prognosis.

The external oblique muscle flap technique for the reconstruction of abdominal wall defects

PurposeSeveral modifications to the anterior component separation technique (ACST) have been reported to facilitate the closure of abdominal wall defects. In this study, the external oblique (EO) muscle flap for modified ACST during major abdominal wall defect reconstructions has been described. MethodsA retrospective review of consecutive patients undergoing modified ACST was conducted. The clinical data were collected and retrospectively analyzed. ResultsAmong the 36 patients admitted to our hospital from December 2014 to December 2020, 9 cases had rectus abdominis tumors, 1 case had rectus abdominis trauma, and 26 cases had incisional hernias. The average age was 61.17 ± 13.76 years, and the mean BMI was 24.25 ± 3.18 kg/m2. The average width of the defect was 14.33 ± 2.90 cm. Unilateral EO muscle flap technique was used to reconstruct the abdominal wall. 3 cases of surgical site infection (8.3%), 4 cases of grade III or IV seroma (11.1%) and 2 cases of intestinal obstruction (5.5%)were reported postoperatively. Ischemic necrosis of the abdominal EO muscle flap, incision dehiscence, intestinal fistula, or other complications were not observed. 1 case of incisional hernia recurrence (2.8%) was reported. Recurrence of tumors or abdominal wall bulging were not noted during the follow-up period of 32.53 ± 14.21 months. ConclutionsThe EO muscle flap technique is associated with low postoperative morbidity and recurrence rate, which approves it a reliable technique for selected groups of patients. Further research are needed to confirm the effectiveness of this technique.

Surgical Efficacy and Prognosis of 54 Cases of Spinal Metastases from Breast Cancer

To analyze the efficacy and complications of spinal metastasis surgery for breast cancer; to understand the survival and the influencing factors; and to verify the predictive ability of the currently used spinal metastasis cancer survival prediction scoring system on 1 year postoperative survival. A retrospective study was conducted of 54 patients with spinal metastases from breast cancer who underwent open surgery after multidisciplinary consultation in our hospital from January 2017 to October 2020. Patient demographic-related variables, breast cancer-related variables, spinal disorder-related variables, and treatment-related variables were collected. Survival curves were plotted using the Kaplan-Meier method, 1-way tests were performed using the log-rank method for factors that might affect prognosis, and candidate variables were included in the Cox model for multifactor analysis. The Tomita score, modified Tokuhashi score, modified Bauer score, and modified Katagiri score were examined by plotting the subject operating characteristic curve and calculating the area under the curve. The area under the curve was used to test the predictive ability of the SORG (Skeletal Oncology Research Group) original version, SORG line graph version, and SORG Web version for 1-year postoperative survival in patients with spinal metastases from breast cancer. The average age was 51.3 ± 8.6 years in 54 patients. Twenty-one patients underwent vertebral body debulking surgery, 32 patients underwent palliative canal decompression, and 1 patient underwent vertebral en bloc resection, with an operative time of 229.3 ± 87.6 minutes and intraoperative bleeding of 1018.1 ± 931.1 mL. Postoperatively, the patient experienced significant pain relief and gradual recovery from nerve injury. Major surgical complications included cerebrospinal fluid leakage, secondary spinal cord injury, spinal tumor progression, and broken fixation. The mean survival was 32.2 months, including a 6-month survival of 90.7%, a 1-year survival of 77.8%, and a 2-year survival of 60.3%. Univariate analysis showed that preoperation with neurologic deficits, hormone-insensitive type, with brain metastases were potential risk factors for poor prognosis. Multifactorial analysis showed that hormone-insensitive type and concomitant brain metastasis were independent risk factors associated with poor prognosis. The SORG Web version had good ability to predict 1-year postoperative survival in patients with spinal metastases from breast cancer. Spinal metastasis from breast cancer has good surgical efficacy, low postoperative recurrence rate, and relatively long survival after surgery. Patients with hormone-insensitive type, with brain metastasis, have a poor prognosis, and SORG Web version can predict patients' 1-year survival more accurately.

Does a gender have something to do with clinical pictures of primary spontaneous pneumothorax?

Primary spontaneous pneumothorax is relatively rarer in women than in men. In addition, women develop secondary spontaneous pneumothorax, such as lymphangioleiomyomatosis, which is rare and difficult to diagnose. Therefore, the clinical characteristics of primary spontaneous pneumothorax in women remain unknown presently. We compared the clinical characteristics of primary spontaneous pneumothorax between the two sexes at two pneumothorax centers. Between January 2015 and July 2019, we retrospectively evaluated 627 cases (106 women and 521 men) who underwent first video-assisted thoracoscopic surgery for primary spontaneous pneumothorax and extracted the medical backgrounds and postoperative recurrence between the sexes. Univariate and multivariate analysis was used to examine the effect of sexual specificity on postoperative recurrence. Among women and men with PSP, the mean ages were 27.8 ± 10.7 and 24.3 ± 10.0years, respectively; their mean heights were 162.0 ± 5.9 and 173.3 ± 6.1cm, respectively. These differences were statistically significant. Three women (2.8%) and 54 men (10.4%) developed postoperative recurrence, which showed significant difference on Kaplan-Meier analysis (p = 0.027). Univariate and multivariate analysis showed the factors; women (p = 0.045, hazard ratio: 0.289 [95% confidence interval 0.086-0.973]) and smoker (p = 0.035, hazard ratio: 0.269 [95% confidence interval 0.079-0.909]) had the preventing factor for postoperative recurrence, respectively. Women with PSP had lower postoperative recurrence rate than men. Although we could not reveal why women had lower postoperative recurrence rates than men in this study, the sexual difference such as hormonal cycle, development of body structure possibly affects the clinical characteristics of women with primary spontaneous pneumothorax.

The clinical characteristics and surgical results of smoking-related young pneumothorax.

Primary spontaneous pneumothorax is a common disease that develops in relatively young healthy patients. Although smoking is generally believed to have a negative effect on the lungs, some authors reported that smokers with primary spontaneous pneumothorax had significantly lower postoperative recurrence rates than nonsmokers. This unexpected result suggests that primary spontaneous pneumothorax is classified into two categories: smoking-related young pneumothorax and residual primary spontaneous pneumothorax. We compared these two categories to determine their characteristics and corresponding surgical results. Between January 2009 and December 2018, we enrolled 267 consecutive cases that underwent first surgery for primary spontaneous pneumothorax in our hospital. A total of 252 eligible cases (211 residual primary spontaneous pneumothorax and 41 smoking-related young pneumothorax) underwent evaluation. Smoking-related young pneumothorax cases were defined as cases with characteristic HRCT findings and smoking habit. The mean ages for the residual primary spontaneous pneumothorax and smoking-related young pneumothorax groups were 25.9 ± 13.1 and 30.5 ± 6.9years, respectively. The groups included 186 (88.2%) and 41 (100.0%) men, and the mean body mass indices were 19.1 ± 2.2 and 20.0 ± 1.9, respectively. Fifty-nine (28.0%) and 41 (100.0%) subjects were smokers, and there were 43 (20.4%) and 1 (2.4%) cases of postoperative recurrence, respectively. These results were significantly different between the two groups. Individuals with smoking-related young pneumothorax were older, predominantly men, and had higher body mass index and significantly lower postoperative recurrence rates than those with residual primary spontaneous pneumothorax.

AB095. Transurethral holmium laser bladder tumor submucosal dissection (HoL-BTSD) for non-muscle invasive bladder cancer

BackgroundTo compare the clinical efficacy of transurethral holmium laser bladder tumor submucosal dissection (HoL-BTSD) and transurethral bipolar plasma dissection of bladder tumor (TURBT) in the treatment of non-muscle invasive bladder cancer (NMIBC).MethodsFrom September 2012 to April 2016, 105 patients diagnosed with NMIBC were randomly divided into HoL-BTSD and TURBT group. A total 53 cases in HoL-BTSD and 52 cases in TURBT according to the operation method. The operation time, intraoperative bleeding, postoperative urinary catheter indwelling time, hospitalization time, main complication rate and 1 and 2 years recurrence rate were compared between two groups.ResultsBetween HoL-BTSD group and TURBT group, the mean operation time was 27.46±9.45 vs. 24.43±8.51 min (P>0.05). The mean intraoperative blood loss was 12.07±6.14 vs. 20.62±8.20 mL (P<0.05). The incidence of obturator reflex was 0% vs. 33.9% (P<0.05). The incidence of bladder perforation is 1.92% vs. 15.1% (P<0.05). The mean postoperative hospital stay was 6.10±1.62 vs. 7.66±1.79 days (P<0.05). The catheter retention time was 5.12 ±1.69 vs. 6.70±1.67 days (P<0.05). The incidence of postoperative bleeding was 0% vs. 11.3% (P<0.05). The incidence of urethral stricture was 3.85% vs. 7.55% (P>0.05). The rate of 1-year tumor recurrence was 5.8% vs. 18.9%. The rate of 2 years tumor recurrence was 13.5% vs. 35.8%.ConclusionsTransurethral holmium laser dissection of bladder tumor in the treatment of non-muscular infiltration of bladder cancer is effective with less complications, rapid recovery, early discharge, and low postoperative recurrence rate.