ObjectiveTo analyze the effect and incidence rate of major postoperative complications of pericardial devascularization in treatment of portal hypertension.
MethodsEnglish and Chinese literatures about pericardial deva-scularization in treatment of portal hypertension were searched through Medline, Elsevier, PubMed, CNKI, and WanFang database, and meta analysis was taken in the process by using R-2.15 software.
ResultsIn total of 671 literatures were searched and 23 were selected finally according to inclusion criteria and exclusion criteria.The results of meta analysis showed that, the effect of pericardial devascularization in treatment of portal hypertension were as follows:the incidence rate of rebleeding was 21%(95% CI: 0.18-0.24), the incidence rate of hepatic encephalopathy was 4%(95% CI: 0.02-0.06), the incidence rate of ascites was 29%(95% CI: 0.14-0.47), mortality of operation was 3%(95% CI: 0.02-0.04), mortality was 23%(95% CI: 0.15-0.33).
ConclusionsThere is a certain incidence rate of complications of pericardial devascularization, of which the most common complication is rebleeding.So, it is necessary to do further improvement and development of pericardial devascularization.
ObjectiveTo analyze the related risk factors of influencing on postoperative severe complications (PSC) in elderly patients with gastric cancer. MethodsAltogether 202 cases of elderly patients with gastric cancer who received surgical treatment between January 2003 and December 2008 in this hospital were analyzed. On the basis of the degree of complications, the patients were divided into the group with PSC and the group without PSC. The relevant clinical and laboratory data were evaluated, and compared with statistical analysis. ResultsClinically the preoperative comorbidity, total gastrectomy, more than 800 ml intraoperative blood loss, intraoperative transfusion, and combined organ resection were significantly correlated with PSC (Plt;0.05). In laboratory data, the lower preoperative serum albumin and the blood glucose level on the first day after operation were significantly correlated with PSC (Plt;0.05). ConclusionThe preoperative comorbidity, lower serum albumin, and extended radical resection are the danger factors leading to PSC.
Objective
To analyze the risk factors of no light perception (NLP) after vitreoretinal surgery for proliferative diabetic retinopathy (PDR).
Methods
Retrospectively analyzed the follow-up data of 882 patients (1000 eyes) with PDR who had undergone vitreoretinal surgery. The standard of NLP was: in a darkroom, one eye was covered, and the other one could not catch the candlelight 30 cm in front of the eye. The number of eyes with NLP was counted and the clinical data of the eyes with or without NLP were analyzed and compared. chi;2 test was used to analyze the risk factors of NLP.
Results
In these 1000 eyes with PDR,the postoperative visual acuity was NLP in 22 eyes (2.2%) and light perception in 978 eyes (97.8%). Comparing with the patients with light perception, the patients with NLP had severer disease condition, including ante-operative neovascular glaucoma (NVG)(36.4%), tension combined with retinal detachment 50%, and a need for lens excision during the surgery (45.5%) and for silicone oil filling at the end of the operation (63.6%). After the surgery, NVG was found in 14 eyes, un-reattached retina in 5 eyes (before the surgery was VI stage of PDR), and optic nerve atrophy and retinal vessel atresia in 3 eyes, which significantly differed from which in the patients with light perception (Plt;0.001，P=0.004, (Plt;0.001). The differences of sex, diabetes type and PDR stage between the NLP group and non-NLP group were not significant (P=0.136, P=0.681, P=0.955).
Conclusions
The incidence of NLP after vitreoretinal surgery for proliferative diabetic retinopathy is low. The direct causes were NVG, optic nerve atrophy, retinal vessel atresia and retinal redetachment, while the sex, type of diabetes mellitus and stage of PDR show no statistical relation to the occurrence of NLP after surgery.
(Chin J Ocul Fundus Dis,2007,23:244-247)
Complications of proliferative diabetic retinopathy have become the major indications of vitrectomy. The surgery, however, is not basically a causative therapy. The visual function after operation depends on the degree of retinal ischemia and damage induced. The surgery itself has a potential for severe complications. Therefore it is important to better understand the pathology and to master surgical strategy and techniques in order to improve surgical outcomes and reduce the surgical complications.
(Chin J Ocul Fundus Dis,2007,23:234-237)
Complications of proliferative diabetic retinopathy have become the major indications of vitrectomy. The surgery, however, is not basically a causative therapy. The visual function after operation depends on the degree of retinal ischemia and damage induced. The surgery itself has a potential for severe complications. Therefore it is important to better understand the pathology and to master surgical strategy and techniques in order to improve surgical outcomes and reduce the surgical complications.
(Chin J Ocul Fundus Dis,2007,231-233)
【Abstract】 Objective To multifactorially analyze the risk factors related to the post-pancreaticoduodenectomy (PD) complications and death. Methods Two hundred and thirty-three PD cases were analyzed, average age 56, of those cases, 210 malignant with 72 pancreatic head and 138 periampullary involvement, 23 benign. Fifty-nine cases suffered coexisting vital organ disorders. Results Sixty-three cases (27.0%) experienced postoperative complications, among those 58 cases (24.9%) early complications, 28(12.0%) infection, 15(6.4%) organ systemic disorder, 14(6.0%) bleeding, 12(5.2%) pancreatic fistula, 15(6.4%) reoperations, 16 postoperative death during hospitalization. The independent risk factors related to the postoperative complications included coexisting vital organ disorders, operation methods, main pancreatic duct (MPD) diameter and surgeon’s experiences, those related to the death during hospitalization included preoperative serum creatinine, coexisting vital organ disorders, surgeon’s experiences; those related to the reoperation included preoperative CA19-9, surgeon’s experiences, tumor diameters, lymph nodes metastasis; and those related to the pancreatic fistula included operation methods, MPD diameters and surgeon’s experiences. Conclusion Coexisting vital organ disorders and surgeon’s experiences are the independent risk factors related to postoperative complications and death during hospitalization, operation methods, MPD diameter and surgeon’s experiences are the independent risk factors related to the pancreatic fistula. Thus, it is very important to choose the appropriate PD candidates, select the right operation method and to familiarize the operation.
ObjectiveTo evaluate the effects of multi-disciplinary diagnosis and treatment model based on doctor-patient shared decision making on treatment outcomes, quality of life and postoperative complications of breast cancer patients. MethodsA total of 100 breast cancer patients were included in this study through a prospective randomized controlled design, and were randomly divided into control group and intervention group, with 50 patients in each group. The control group received traditional treatment mode, while the intervention group implemented a multidisciplinary treatment mode based on doctor-patient sharing decision making. The results of treatment, quality of life and postoperative complication rate were compared between the two groups. ResultsThe completion rate of adjuvant radiotherapy and chemotherapy in the intervention group was 94.0%, which was higher than that in the control group (80.0%), and the difference was statistically significant (P=0.037). The satisfaction rate of postoperative breast appearance in the intervention group was 90.0%, which was higher than that in the control group (60.0%), with statistical significance (P<0.001). There was no significant difference in grade Ⅲ/Ⅳ toxicity between the two groups (P>0.05). After treatment, the scores of patients’ quality of life in the intervention group were higher than those in the control group, and the difference was statistically significant (P<0.05). The incidence of postoperative complications in the intervention group was 6.0%, which was lower than that in the control group (22.0%), and the difference was statistically (P=0.021). ConclusionsThe application of multidisciplinary diagnosis and treatment model based on doctor-patient sharing decision-making in the treatment of breast cancer patients has significantly improved the treatment effect and quality of life, and effectively reduced the rate of postoperative complications. This model provides a new approach to the treatment of breast cancer that is more personalized, comprehensive and efficient.
Objective
To investigate the characteristics and risk factors of optic nerve atrophy in eyes with complicated retinal detachment after silicone oil tamponade during the procedure of vitreoretinal operation.
Methods
The clinical data of 97 patients with complicated retinal detachment who had optic nerve atrophy after silicone oil tamponade during the procedure of vitreoretinal operation were an alyzed retrospectively. Logistic regression analysis by SPSS statistical software was used to analyze the factors like age, disease history, primary diseases, preoperative ocular condition, complications in and after the operation, the time taking out the silicone oil, and emulsification of the silicone oil, and Ple;0.05 was considered to be the symbol of significant difference.
Results
All of the affected eyes had optic discs with clear border, including paler optic disc in 65 eyes, pale one in 21 eyes, and paler optic disc with enlargement of the cup/disc (ge; 0.6) in 11 eyes. The result of logistic regression analysis showed that the intraocular pressure (P=0.022) and the visual acuity (P=0.001) during the silicone oil removal were in the equation.
Conclusion
The risk factor of optic nerve atrophy is the chronic increase of intraocular pressure after silicone oil tamponade.
(Chin J Ocul Fundus Dis, 2006, 22: 305-307)
Objective To investigate the application of transverse fascia in inguinal hernia repair. Methods In this study, 617 patients underwent inguinal hernia repair between January 1990 and December 2005 in our hospital were included, which were divided into two groups according to different operative ways: transverse fascia method group (n=337) and Bassini method group (n=280). Then intraoperative results, postoperative complications, and rehabilitated results of patients in two groups were compared. Results Compared with Bassini method group, the patients in transverse fascia method group did not show significant difference in operative time and blood loss during operation (Pgt;0.05). The differences of severe postoperative pain, testicular swelling, the time of the body’s restore for normal activities, and recurrence rate of patients between two groups were significant (Plt;0.05), while the difference of hematoma of scrotum and infection of incisional wound (Pgt;0.05). Conclusion The strengthening of posterior wall by transverse fascia and reconstruction of inner ring is a simple and effective method for inguinal hernia repair.
ObjectiveTo analyze risk factors of postoperative complications associated with reversal of defunctioning ileostomy in patients with rectal cancer undergoing sphincter preservation surgery.
MethodData were collected retrospectively for consecutive patients undergoing defunctioning ileostomy following sphincter preservation surgery for rectal cancer, from January 2014 to December 2014.
ResultsOne hundred and thirty patients were included (median time to reversal 132 d, range 39-692 d), of whom 35 patients (26.92%) had postoperative complications after stoma reversal. The main complications included 23 cases of diarrhea, 6 cases of bowel obstruction, 9 cases of incision infection, and 4 cases of perianal eczema. The results of univariate analysis showed that the distant of tumor from anal verge <5 cm (P=0.010), postoperative adjuvant chemotherapy (P=0.002), and time to reversal (P=0.025) were related to the postoperative complications associated with reversal of defunctioning ileostomy in patients with rectal cancer undergoing sphincter preservation surgery. The result of multivariate analysis by using a logistic regression model showed that the time to reversal (OR=1.006, P=0.021) was a significant independent risk factor for it.
ConclusionDelay reversal of defunctiong ileostomy might increase risk of postoperative complications associated with reversal of defunctioning ileostomy in patients with rectal cancer undergoing sphincter preservation surgery.
