Success Rate Of Surgery Research Articles

Cultivating "non-technical skills" in surgeons

Surgical operations are one of the high-risk activities in modern society, and surgeons in this high-pressure environment require not only excellent technical skills but also well-rounded non-technical skills. Non-technical skills encompass key abilities such as situational awareness, decision-making, communication and teamwork, leadership, and stress management, as well as the capacity for error correction feedback loops, emotional intelligence, and adaptability to complex environments. These "soft skills" help surgeons to more effectively handle emergencies during surgery, optimize team collaboration, ensure patient safety, and increase the success rate of operations. Western countries have systematized non-technical skills into physicians' training programs, while in China, further attention and promotion are still needed. By establishing comprehensive non-technical skill assessment standards and systematic training programs, the overall quality of surgeons can be enhanced, thereby ensuring patient safety, improving clinical outcomes, and fulfilling the professional mission of surgeons.

Comparing four-hook and double-hook localization needles in preoperative pulmonary nodule positioning: efficacy, safety, and patient perception

BackgroundPrecise preoperative localization is crucial for improving the success rate and reducing the duration of thoracoscopic surgeries. This study aimed to evaluate the efficacy, safety, and patient perception of the four-hook localization needle compared to the traditional double-hook localization needle in the localization of pulmonary nodules.MethodsWe conducted a retrospective analysis of 207 patients who underwent video-assisted thoracoscopic surgery (VATS). Seventy-six patients used a four-hook localization needle preoperatively, while 121 patients used the traditional double-hook needle. Propensity score matching was employed to balance the baseline characteristics of the two groups and minimize confounding bias. We compared the surgery success rate, surgical field success rate, complication rate, and post-localization respiratory pain score between the two groups.ResultsBoth localization methods achieved a 100% success rate. The four-hook needle had a statistically significant shorter localization time (20.00 min vs. 21.00 min, P = 0.046) and a lower preoperative displacement rate (5.81% vs. 17.36%, P = 0.014) compared to the double-hook needle. Both before and after propensity score matching, the postoperative respiratory pain score was significantly lower in the four-hook group compared to the double-hook group (P < 0.001). After balancing baseline characteristics, univariate (P = 0.036) and multivariate (P = 0.039) logistic regression analyses indicated that the four-hook group had a significantly lower risk of localization complications compared to the double-hook group.ConclusionsThe four-hook localization needle outperforms the traditional double-hook needle due to its shorter localization time, lower post-localization respiratory pain score, and reduced displacement rate, making it a simpler and safer option. Furthermore, the four-hook needle effectively reduces the risk of complications, presenting a promising method for preoperative localization of pulmonary nodules.

Impact of Intraoperative Nanocarbon Staining and parathyroid autotransplantation on parathyroid injury and recovery in adult thyroidectomy: a retrospective cohort study

BackgroundThyroid surgeries are intricate operations that carry the risk of damaging the parathyroid glands, which can result in hypocalcemia and potential long-term hypoparathyroidism. Innovative surgical techniques including Intraoperative Nanocarbon Staining (INS), aim to enhance the preservation of parathyroid glands. This study assesses the effectiveness of INS combined with parathyroid autotransplantation in reducing postoperative complications and preserving parathyroid function.MethodsThis retrospective cohort study assessed patients aged ≥ 18 who underwent thyroid surgery at a tertiary care hospital from January 2017 to December 2022. We compared the incidence of postoperative parathyroid injury, recovery rates of parathyroid function, and the incidence of permanent hypoparathyroidism between groups. Data on patient demographics, diagnosis, surgical details, parathyroid hormone levels, and calcium levels were collected and analyzed using chi-square tests, t-tests, and logistic regression.ResultsThe study included 198 patients, with 101 in the intervention group and 97 in the control group. Baseline characteristics such as sex ratio, age, BMI, and preoperative calcium levels showed no significant differences between groups. The intervention group demonstrated a significantly shorter duration of intravenous calcium supplementation (median 2 vs. 3 days, p < 0.001) and higher calcium nadir levels (median 8.36 vs. 7.85 mg/dL, p < 0.001) compared to controls. Furthermore, the incidence of postoperative parathyroid injury and permanent hypoparathyroidism was lower in the intervention group (15.84% vs. 20.62%, p = 0.045 and 4.95% vs. 15.46%, p = 0.003, respectively). Multivariate analysis revealed factors such as Blood iPTH monitoring level (OR 1.053, 95% CI 1.009–1.099, P = 0.018) and surgery type (Near Total Thyroidectomy) (OR 0.447, 95% CI 0.202–0.990, P = 0.047) were positively associated with surgical success. The intervention group also showed higher surgery success rates (OR 2.054, 95% CI 1.017–4.150, P = 0.045).ConclusionThe application of INS and parathyroid autotransplantation during thyroidectomy significantly improves postoperative parathyroid gland function, reducing the incidence of permanent hypoparathyroidism. These findings support the incorporation of these techniques into standard surgical practice for thyroidectomy.

Study on the correlation between spontaneous cerebrospinal fluid rhinorrhea and increased intracranial pressure

Objective: To study the correlation between spontaneous cerebrospinal fluid rhinorrhea and increased intracranial pressure. Methods: Clinical data of patients with spontaneous cerebrospinal fluid rhinorrhea treated in the Department of Otorhinolaryngology of the Provincial Hospital of Shandong First Medical University from January 2019 to December 2023 and their epidemiology, clinical symptoms and signs, preoperative cerebrospinal fluid pressure, imaging data, leakage site, repair method and the presence or absebce of increased intracranial pressure were analysed. SPSS 23.0 software was used for statistical analysis. Results: Of the 57 patients with cerebrospinal fluid nasolacrimal leakage, 84.2%(48/57) were females and 15.8%(9/57) were males; 80.7%(46/57) were between 40 and 60 years old; and overweight and obese patients accounted for 75.4%(43/57). Of 57 patients, 35 patients received cranial MRI+magnetic resonance venography, and among them, 12(34.3%) patients were clinically with headache symptoms; the incidences of empty pterygoid and venous sinus stenosis were 40.0%(14/35) and 51.4%(18/35), respectively; and 33 patients underwent preoperative lumbar puncture examination, of whom 25(75.8%) patients had the increased cerebrospinal fluid pressure and 1 patient had idiopathic intracranial hypertension. All 57 patients underwent dural repair of the skull base, the postoperative follow-up period ranged from 3 to 60 months, and the success rate of surgery was 94.7%. The success rate was 100% in female patients and 33.3%(3/9) in male patients, including one with surgical failure receiving reoperation and two with postoperative recurrence in other areas of the skull base, with significant difference in the success rate of surgery between males and females (χ2=16.890, P<0.001). Conclusions: Most patients with spontaneous cerebrospinal fluid rhinorrhea have the increased cerebrospinal fluid pressures, but very few fulfil the diagnosis of idiopathic intracranial hypertension. The success rate of surgical repair alone is high, but some recurrences still exist, especially in male patients.

Inhibitory effect of RGD peptide hydrogel on inflammation and angiogenesis in vitro.

Inflammatory reaction and neovascularization are crucial physiological processes that occur during postoperative wound healing. However, excessive inflammatory response and uncontrolled angiogenesis lead to scar formation, which severely limits the success rate of glaucoma filtration surgery. Peptide hydrogels were well-established to possess good biocompatibility, inherent biodegradability, extracellular matrix analog property, and high drug loading efficiency. Herein, we examined the potential of Arg-Gly-Asp (RGD) peptide hydrogel to inhibit inflammation and angiogenesis in vitro experiments. RGD peptide hydrogel exhibited significant inhibitory effects on the inflammatory response by ELISA and western blot and considerable prohibitive effects on neovascularization via inhibiting the proliferation and migration of vascular endothelial cells. In this study, we found a novel biomaterial, RGD peptide hydrogel, which has a certain anti-cell proliferation and anti-scarring effect in vitro experiments.

The impact of root end filling material type and the application of bone graft on healing of periapical tissues after endodontic microsurgery (a clinical randomized controlled trial)

To evaluate the effect of combining different bioactive root-end filling materials with composite bone graft (xenogeneic mixed with autogenous bone fragments) on the healing process of periapical tissues after endodontic micro-surgery procedure. In this triple-blinded clinical trial, 56 patients were divided into 2 main groups (28 each) according to the root-end filling material and 2 subgroups according to the presence or absence of the composite bone graft material. Group I: MTA root-end filling (n = 28) in which there are Sub-group A: without bone graft (n = 14) and Sub-group B: with composite bone graft (n = 14). Group II: TotalFill root-end filling (n = 28) in which there are Sub-group A: without bone graft (n = 14) and Sub-group B: with composite bone graft (n = 14). Healthy patients whose ages range from 20 to 50 years with small-to-medium size radiolucency in CBCT related to single-rooted maxillary teeth were included in this study. Patients were assigned a number starting from 1 to 56 and were randomly allocated to four test groups (2 main groups and 2 sub-groups) following simple randomization procedure guidelines described by IBM SPSS V23 (IBM USA) statistical analysis software. This trial was triple-blind where the patient, the outcome assessors, and the main operator were blinded to the applied intervention. Every patient was evaluated clinically and by CBCT at two main observation periods: presurgical and 12-month post-operative. They were also examined and evaluated clinically and radiographically through periapical x-rays after one week, three, and six months. Statistical analysis was performed with IBM SPSS Statistics for Windows Version 23.0. Armonk, NY: IBM Corp. Of the 56 patients enrolled in the study, 49 patients were available for the final analysis. All groups showed no statistically significant differences with regard to healing or success rates at the 12-month follow-up mark. No adverse effects were encountered. Results showed that high success rates were achieved using MTA and TotalFill in the healing of periapical lesions after endodontic surgery. The addition of bone graft in small-to-medium size lesions did not affect the success rate of endodontic surgeries.

A novel technique for snuffbox fistula creation.

In this pilot study, we describe a novel technique for creating a snuffbox fistula (SBF) and present the preliminary outcomes after 4-6 weeks of follow-up. The study included eight male patients with a mean age of 50 years (range 36-66 years). All patients received an SBF using the modified no-touch technique (MNTT) and piggyback straight-line on-lay technique (pSLOT). Immediate patency was obtained for all patients. In one case, a thrombosis developed at the juxta anastomosis. The remaining seven SBFs met the clinical arteriovenous fistula maturity criteria at the physical examination performed 4-6 weeks after surgery, showing an easily palpable vein, a straight superficial segment >10 cm in length and a sufficient diameter, and good palpable thrill. In addition, an ultrasound examination showed that the diameter of the drainage vein was 4-6 mm, and the brachial blood flow was ⩾500 mL/min. The combination of MNTT and pSLOT was used to successfully establish SBFs, and the success rate of surgery and access maturity were high.

Endoscopic Cartilage Slice Reinforcement Technique for Anterior Perforation Repair with Anterior Canal Wall Protrusion.

Objective: To evaluate the outcomes and complications of the endoscopic cartilage slice reinforcement technique used on anterior margins for anterior perforation repair with anterior canal wall protrusion. Material and Methods: We conducted a prospective study on 38 cases of anterior perforation with anterior canal wall protrusion, treated using the endoscopic cartilage slice reinforcement technique from February 1, 2017 to August 29, 2023. The follow-up period was 6 months. Results: Of the 38 patients, medium perforations were present in 28.9%, large in 65.8%, and subtotal in 5.3%. The cause was mucosal chronic otitis media in 92.1%, traumatic perforation in 5.3%, and ventilation tube removal in 2.6%. The average operation time was 27.2 ± 4.6 minutes. The graft success rate was 94.7% (36/38) at 6 months postoperative. The average preoperative air-bone gap (ABG) was 19.8 ± 4.2 dB, and postoperative ABG was 8.6 ± 2.9 dB; this improvement was statistically significant (P < .001; paired-sample t-test). The ABG gain was 11.8 ± 5.1 dB, and the rate of successful surgery (postoperative ABG ≤ 20 dB) was 97.4% (37/38). No complications such as altered taste, vertigo, or tinnitus were reported, and no cases involved graft lateralization, significant blunting, graft atelectasis, graft adhesions, or effusion. However, myringitis was observed in 4 (10.5%) patients. Conclusion: The endoscopic cartilage slice reinforcement technique for anterior margins is a simple and effective method for repairing anterior perforations with anterior canal wall protrusion, achieving a high graft success rate, improved hearing, and minimal complications.

Comparative study of modified Koyanagi and staged Duckett for proximal hypospadias.

To compare and analyze the clinical efficacy of modified Koyanagi and staged Duckett for proximal hypospadias. The clinical and prognostic data of children were treated and underwent surgery (modified Koyanagi or stage Duckett) in the Department of Urology, Kunming Children's Hospital from January 2020 to January 2023 were retrospectively analyzed. According to different surgical methods, the subjects were divided into the modified Koyanagi group and the staged Duckett group. Patients in both groups were followed up for more than 6 months after surgery. The success rate and complications of postoperative surgery in both groups were analyzed. A total of 63 patients were included in this study, 34 in the modified Koyanagi group and 29 in the staged Duckett group. A total of 14 patients in the modified Koyanagi group experienced postoperative complications, the success rate of the surgery was 58.82%, and 5 among them experienced more than two kinds of complications. A total of 5 children in the staging Duckett group experienced postoperative complications, and the success rate of the operation was 82.75%. There were significant differences in the incidence of overall complications and fistula between the two surgical methods (P = 0.028). Compare with modified Koyanagi, staged Duckett can significantly reduce the incidence of overall complications and urethral fistula in patients, and have obvious advantages in the treatment of proximal hypospadias.

Visual Prognosis in Craniosynostosis Patients: A 20-year Retrospective Cohort Study at a Tertiary Referral Center in Thailand

Objective: This study aims to evaluate the visual prognosis in craniosynostosis patients in order to identify ophthalmologic manifestations in craniosynostosis patients and strabismus surgery outcomes in these patients. Materials and Methods: The medical record charts of craniosynostosis patients were reviewed retrospectively from January 2000 to June 2023. All the relevant patient data, such as age, sex, visual acuity, ophthalmologic examinations, and strabismus surgery outcomes were recorded. Results: In total, 123 patients were included in the study, among whom 65 (52.84%) were male. Overall, there were 70 cases (56.91%) of non-syndromic craniosynostosis, and 53 cases of syndromic craniosynostosis, comprising Crouzon syndrome (15 cases), Apert syndrome (8 cases), Pfeiffer syndrome (2 cases), and other syndromes (28 cases). The mean age at first examination was 3.11 years old. Out of 107 cases with visual impairment at the first visit, 92 (85.98%) showed no visual impairment at the last visit. Among the 87 patients with strabismus, 28 (32.18%) had strabismus at the primary position, with exotropia being the most common type (18 cases). Eight cases underwent strabismus surgery, and 4 cases achieved success (deviation &lt; 10 prism diopters). Other ophthalmologic manifestations were lagophthalmos, exposure keratopathy, ptosis, proptosis, and nasolacrimal duct obstruction. Conclusion: Among the craniosynostosis cases, 85.98% had no visual impairment, with the common ophthalmologic manifestations being refractive errors, strabismus, lagophthalmos, and exposure keratopathy. The syndromic craniosynostosis cases showed worse visual outcomes and a higher incidence of ocular diseases than non-syndromic cases. The success rate for strabismus surgery in craniosynostosis patients was 50%.

Optimizing Random Forest for Predicting Thoracic Surgery Success in Lung Cancer Using Recursive Feature Elimination and GridSearchCV

Abstract. Lung cancer is one of the deadliest forms of cancer, claiming numerous lives annually. Thoracic surgery is a strategy to manage lung cancer patients; however, it poses high risks, including potential nerve damage and fatal complications leading to mortality. Predicting the success rate of thoracic surgery for lung cancer patients can be accomplished using data mining techniques based on classification principles. Medical data mining involves employing mathematical, statistical, and computational methods. In this study, the prediction of thoracic surgery success employs the random forest algorithm with recursive feature elimination for feature selection. The feature selection process yields the top 8 features. The 8 best features include 'DGN', 'PRE4', 'PRE5', 'PRE6', 'PRE10', 'PRE14', 'PRE30', and 'AGE'. Hyperparameter using GridSearchCV is then applied to enhance classification accuracy. The results of this method implementation demonstrate a predictive accuracy of 91.41%. Purpose: The study aims to develop and evaluate a Random Forest model with a Recursive Feature Elimination feature selection and applies hyperparameter GridSearchCV for predicting thoracic surgery success rate. Methods: This study uses the thoracic surgery dataset and applies various data preprocessing techniques. The dataset is then used for classification using the Random Forest algorithm and applies the Recursive Feature Elimination feature selection to obtain the best features. GridSearchCV is used in this study for hyperparameter. Result: The accuracy using the Random Forest algorithm and Recursive Feature Elimination feature selection with hyperparameters tuning GridSearchCV resulted in an accuracy of 91,41%. The accuracy was obtained from the following parameters values: bootstrap set to false, criterion set to gini, n_estimator equal to 100, max_depth set to none, min_samples_split equal to 4, min_samples_leaf equal to 1, max_features set to auto, n_jobs set to -1, and verbose set to 2 with 10-fold cross validation. Novelty: This study comparison and analysis of various dataset preprocessing methods and different model configurations are conducted to find the best model for predicting the success rate of thoracic surgery. The study also employs feature selection to choose the best feature to be used in classification process, as well as hyperparameter tuning to achieve optimal accuracy and discover the optimal values for these hyperparameters.

Review of methods for detecting electrode-tissue contact status during atrial fibrillation ablation

Atrial fibrillation is a common cardiac arrhythmia with an annually increasing global prevalence. Ablation of atrial fibrillation is a minimally invasive procedure that treats atrial fibrillation by using a catheter to deliver radiofrequency energy to heart tissues generating abnormal electrical potentials. The success of this procedure relies significantly on the adhesion between the catheter and the heart tissue, presenting a challenge in accurately assessing the contact force (CF) during surgery. To improve the safety and success rate of surgery, researchers are committed to developing various methods to evaluate or detect catheter-tissue CF. Among these, some studies integrated optical fibers or magnetic elements into the catheter tip to create CF sensing catheters that monitor CF in real time; other studies used impedance measurement, electrical coupling index, local impedance and other methods to evaluate the CF between the catheter and the tissue by measuring changes in electrical signals. These methods have achieved certain success in clinical practice, offering new ways to improve the effectiveness and safety of cardiac radiofrequency ablation surgery.

Postoperative Changes of Fusional Vergence in Children Intermittent Exotropia

: This study aimed to evaluate changes in fusional vergence after strabismus surgery and to explore predictive parameters and the impact of fusional vergence on surgical outcomes. All patients diagnosed with intermittent exotropia (IXT) between March 2015 and October 2017 were included. Orthoptic assessments, including visual acuity, cover test, and mean fusional vergence (breakage/recovery, both negative and positive), were measured using a synoptophore. Subjects with symptomatic exotropia who underwent strabismus surgery were included. The primary outcome measure was the surgical success (SS) rate at a 6-month follow-up, with adverse effects such as over-correction and under-correction also evaluated. Data were analyzed using SPSS version 20.0. Surgical success was achieved in 62 patients (75.61%) at the 6-month follow-up. The postoperative fusional divergence breakpoints for the SS group and the surgical failure (SF) group were -7.52 ± 4.14 degrees and -10.00 ± 5.96 degrees (P = 0.040), respectively. The postoperative fusional convergence breakpoints for the SS group and the SF group were 10.03 ± 4.36 degrees and 4.65 ± 7.27 degrees (P &lt; 0.001), respectively. The postoperative amplitude of fusional divergence was higher in the SS group compared to the SF group (P = 0.008). There was a significant difference in the duration of deviation (2.08 ± 0.84 vs. 4.23 ± 1.36, P &lt; 0.001) between the groups, suggesting that the success rate of surgery is affected by the cumulative disease duration. Subjective deviation (-8.00 vs. -11.00, P = 0.049) and the amplitude of fusional divergence (6.52 ± 4.10 vs. 4.80 ± 2.59, P = 0.032) were also significantly different between the SS and SF groups. Postoperative breakpoints of fusional divergence and convergence, as well as the amplitude, were distinct between the SS and SF groups. Duration of deviation, angle of deviation, and subjective deviation were independent factors for (SS). Subjective deviation exhibited a predictive index for (SS) and may also reflect the severity of strabismus.

Clinical effect of XEN gel stent implantation or combined with phacoemusification and intraocular lens implantation on glaucoma

Objective: To evaluate the efficacy and safety of internal XEN gel stent implantation or combined with phacoemusification and intraocular lens (IOL) implantation in the treatment of glaucoma. Methods: It was a retrospective case series study. Forty-five patients (28 males and 17 females; 52 eyes) who had different types of glaucoma treated at the Shenzhen Eye Hospital from December 2021 to June 2023 were included. XEN gel stent implantation (the XEN group) or XEN implantation combined with phacoemusification and IOL implantation (the combined group) were performed in these patients. The postoperative follow-up was 18 months. The observational indexes included the best corrected visual acuity (recorded as the logarithm of the minimum angle of resolution), intraocular pressure (IOP), XEN implantation quadrant, number of IOP-lowering medications, corneal endothelial cell count, operation success rate and surgical complications. The one-way repeated measures of variance, LSD-t test, and rank sum test were used for statistical analysis. Results: There were 28 patients (33 eyes) in the XEN group and 17 patients (19 eyes) in the combined group. The postoperative best corrected visual acuity had no significant change in the XEN group, but improved significantly (0.21±0.30 at 6 months; P<0.05) in the combined group, compared with the preoperative value. The IOP of the two groups at 18 months after surgery [(12.2±3.1) and (11.9±3.9) mmHg (1 mmHg=0.133 kPa)] was significantly lower than that before surgery [(22.1±8.5) and (19.4±10.2) mmHg; P<0.05]. The average number of IOP-lowering medications in all patients was 3 (2, 3) before surgery and 0 (0, 0) at 18 months after surgery. The difference was statistically significant (P<0.05). In the XEN group, the corneal endothelial cell count was (2 387.37±478.22) cells/mm² preoperatively and (2 193.89±311.96) cells/mm² at 12 months. The decrease showed no statistical significance. The XEN gel stent was implanted in the supranasal quadrant in 8 eyes (15.4%), in the inferonasal quadrant in 36 eyes (69.2%), and in the infratemporal quadrant in 8 eyes (15.4%). The operation success rate [complete success rate, 86.5% (45/52); conditional success rate, 9.6% (5/52)] was 96.2% (50/52). The filtering bleb scarring occurred in 9.6% (5/52) of eyes. A small amount of hyphema, postoperative shallow anterior chamber, transient hypertension, and intraoperative drain breakage were found in 7.7% (4/52) of eyes, respectively. A small amount of subconjunctival bleeding was observed in 5.8%(3/52) of eyes. Re-implantation of an XEN gel stent was performed in 5.8% (3/52) of eyes. The intraoperative conjunctival tissue rupture, hypotony macular edema, and drain exposure were observed in 1.9% (1/52) of eyes, respectively. Conclusion: The XEN gel stent implantation or combined with phacoemusification and IOL implantation was effective and safe in treating different types of glaucoma, but its long-term clinical efficacy needs further follow-up observations in multi-center, larger-scale research.

Evaluation of Children with Aortic Coarctation: A Single-Center Experience.

Coarctation of the aorta (CoA) accounts for 3.5% of all congenital heart diseases in children. The clinical manifestations range from heart failure to asymptomatic hypertension. Treatment options include surgical repair, balloon angioplasty, and stenting. We aimed to investigate the long-term results of surgery and balloon angioplasty to identify the possible risk factors for recoarctation and predictors associated with early success in treatment modalities. The data of 138 children who underwent examinations at a tertiary center between 2015 and 2020 with the diagnosis of CoA were evaluated. The basic demographic characteristics, clinical and echocardiographic findings, results, and treatment methods of the patients were evaluated retrospectively. The mean follow-up period was 75.1 months (range of 1-223). As initial treatment, 75 patients (60.5%) underwent balloon angioplasty, 44 (35.5%) underwent surgery, and 5 (4%) underwent stenting. The early success rate of balloon angioplasty and surgery was 72.5% and 79.5%, respectively. Recoarctation occurred in 47.6% of patients following the first therapy. The median reintervention-free survival time was 138 months for all patients and was significantly higher in the surgery group (P = .025). The recoarctation rate was slightly lower in the surgery group than in those who underwent balloon angioplasty, but it was not statistically significant. None of the clinical and echocardiographic findings were found to be associated with recoarctation or early success. The rate of recoarctation is still high in long-term follow-up after aortic coarctation treatment, and clinical and echocardiographic findings are insufficient to predict the chance of early success and the risk of recoarctation.

Application of ultrasound in the diagnosis, evaluation, and interventional therapy monitoring of patent foramen ovale

Abstract To explore the impact of pre-intervention ultrasound diagnosis results of PFO and evaluation criteria on the success rate of surgery, intraoperative ultrasound monitoring methods, and postoperative ultrasound follow-up results, and to analyse the results of ultrasound-related examinations and the evaluation value of the success rate of surgery and interventional efficacy. A total of 1617 patients with related symptoms who were diagnosed and treated in our hospital from January 2022 to March 2023 were selected for screening, and transthoracic echocardiography (TTE), contrast transthoracic echocardiography (cTTE), and contrast-enhanced Transcranial Doppler (cTCD) were performed. Positive patients were selected for transesophageal Echocardiography (TEE). And interventional surgery for patent foramen ovale in 70 of these patients. cTTE was performed 3 months and 6 months respectively after surgery to evaluate the therapeutic efficacy. Among the 1617 cases of cTTE, 938 cases were positive, including 538 cases of grade 1, 198 cases of grade 2, and 202 cases of grade 3. TEE was performed in 317 patients with positive cTTE, and 228 patients were diagnosed as PFO with definite shunt. Then selected 76 patients of grade 2-3 in cTTE with positive TEE to perform the closure surgery of the PFO, and 70 cases were successfully operated, with a success rate of 92.11%. cTTE、cTCD and TEE results are correlated with the success rate of interventional surgery. Evaluation using multiple ultrasound techniques can provide guidance for rational selection of treatment in clinical application.

Analysis of postoperative complications of orbital fracture.

To analyze the types and causes of complications following orbital fracture reconstruction and enhance clinicians' capacity to manage or prevent such complications. We conducted a retrospective case series analysis, retrospectively collecting and analyzing clinical data of patients with orbital fractures who received surgical treatment at the Affiliated Eye Hospital of Nanchang University from May 2012 to May 2022. Descriptive statistics were employed to document common postoperative complications, and we recorded complications persisting after a minimum 6-month follow-up period. Among the 227 patients who underwent orbital fracture surgery, they were followed up for 6 to 36 months, and complications occurred in 15 cases, resulting in an incidence rate of 6.61%. These complications included implant material infections and rejections (4 cases), persistent diplopia (3 cases), intraorbital hematomas (2 cases), epiphora (2 cases), lower eyelid eversion or retraction (2 cases), and skin scars (2 cases). The primary cause of postoperative infection was chronic inflammation in the paranasal sinuses or closed cavities within the fracture area. Postoperative complications in orbital fractures were associated with various factors, including the timing of surgery, surgical approach, repair materials, surgical skills, and auxiliary techniques. Standardizing surgical techniques and implementing precise auxiliary technologies may reduce the incidence of complications and enhance the operation's success rate.

Toward precision and efficiency: a bibliometric study on robotic-assisted unicompartmental knee arthroplasty research and development

Aim: With the increasing prevalence of knee diseases affecting human health and quality of life, it is essential to explore more advanced surgical assistive technologies to improve the precision, safety, and success rate of unilateral knee replacement surgery. This study aims to conduct a comprehensive bibliometric analysis of robotic-assisted unicompartmental knee arthroplasty (r-UKA) to understand its current status, trends, and future directions. Methods: Retrieve articles about r-UKA in the Web of Science Core Collection (WOSCC) database. Data from 128 selected articles, including author information, publication details, citations, and evidence level, were analyzed. Statistical analyses and data visualizations explored publication and citation trends, research interests, core author groups, and cooperative networks. Results: Interest in r-UKA research has grown, particularly after 2013, which is evident from increased publications and citations. The United States is the largest contributor, followed by the United Kingdom, both of which have prominent medical research institutions and universities actively involved in r-UKA research. Frequent keywords such as “alignment”, “accuracy”, “revision”, and “survivorship” highlight the focus on surgical precision, implant longevity, and patient outcomes. Conclusion: Robotic-assisted unicompartmental knee arthroplasty has gained significant attention, promising improved surgical precision and patient outcomes. Collaboration between researchers and medical institutions globally has driven progress in this field. However, long-term outcomes and clinical efficacy compared to traditional techniques require further investigation. As robotic technology evolves, its application in knee replacement surgery holds potential for better therapeutic effects and advancements toward more accurate, safe, and efficient procedures, benefiting patients and advancing unicompartmental knee arthroplasty (UKA).

Study on the influence of cortical bone heterogeneity on the spatio-temporal distribution of drilling temperature

The degree of thermal damage during cortical bone drilling is an important factor in determining the success rate of surgery and postoperative recovery time. In this study, high and low feed rate drilling experiments are carried out on bovine femoral cortical bone by chisel edge thinning drill. Combined with the characterization of cortical bone tissue structure and the measurement results of important thermal property parameters, the potential impact mechanisms of cortical bone heterogeneity on the spatio-temporal distribution of drilling temperature and thermal damage are analyzed. The temperature rise rate and overheating duration at different distances from the hole wall in cortical bone drilling under different feed rates are also compared. The experimental results show that the specific heat gradually increases and the thermal conductivity gradually decreases from the periosteum to the endosteum. The hole wall temperature and thermal diffusion of cortical bone with different tissue structures are different under high and low feed rates. The closer to the cortical bone endosteum, the lower the drilling temperature, thermal diffusion and thermal damage area. This is not only related to the contact time between the drill bit and the hole wall of cortical bone with different tissue structures, but also closely related to the heterogeneous structure of cortical bone. In addition, it is found that in high feed rate cortical bone drilling, the temperature rise rate at different positions from the hole wall is higher and the overheating duration is shorter.

Effect of Lacrimal Endoscopy on Operation Time in Silicone Tube Intubation for Nasolacrimal Duct Obstruction

Purpose: To evaluate the effect of lacrimal endoscopy on operation time in silicone tube intubation for patients with nasolacrimal duct obstruction.Methods: We conducted retrograde chart review of 168 eyes of 107 patients who were diagnosed with acquired nasolacrimal duct obstruction and underwent silicone tube intubation from January 2019 to February 2023. We analyzed relationship between use of lacrimal endoscopy and operation time, and effect of operation time on success rate of surgery according to use of lacrimal endoscopy.Results: Of 168 eyes, 58 eyes underwent silicone tube intubation with lacrimal endoscopy, and 110 eyes underwent silicone tube intubation without lacrimal endoscopy. Average operation time was 10.98 ± 2.24 minutes in the group with lacrimal endoscopy, and 12.44 ± 4.08 minutes in the group without lacrimal endoscopy. Operation time in the group with lacrimal endoscopy was relatively shorter and statistically significant (&lt;i&gt;p&lt;/i&gt; = 0.003). When analyzing correlation between operation time and success rate, success rate decreased by 0.877 times when operation time increased by 1 minute in the entire group, and there was statistical significance (&lt;i&gt;p&lt;/i&gt; = 0.022). There was no statistical significance in the correlation between operation time and success rate in the group with lacrimal endoscopy. And in the group without lacrimal endoscopy, success rate decreased by 0.865 times when operation time increased by 1 minute, and there was statistical significance (&lt;i&gt;p&lt;/i&gt; = 0.019).Conclusions: In silicone tube intubation for nasolacrimal duct obstruction, Lacrimal endoscopy is considered an effective treatment that can shorten operation time and prevent complications while accurately diagnosing cause and extent of obstruction by investigating the inside of the nasolacrimal duct.