ABSTRACT
To examine the effect of VAE and open surgery on the postoperativelocal recurrence of benign phyllodes tumors of breast and to investigate the clinical efficacy of VAE in the treatment of benign phyllodes tumors. The clinical data of 128 patients with benign phyllodes tumors of breast admitted to the Guangdong Women and Children Hospital from January 2013 to January 2018 were retrospectively analyzed. All patients were female, aged (37.7±9.1) years (range: 16 to 56 years). Eighty patients underwent ultrasound-guided VAE (minimally invasive group) and 48 patients underwent open surgery (open group). The -test, χ(2) test or Fisher exact probability method were used to compare the clinical characteristics of the two groups of patients. Logistic regression was used to analyze the prognostic factors of postoperative local recurrence. The maximum diameter of tumor in the minimally invasive group was smaller than that in the open group ((20.6±7.4) mm . (42.0±2.0) mm, -7.173, 0.000). The follow-up time was (36.4±1.8) months (range: 12 to 71 months). There were 7 cases of local recurrences during the follow-up period. The local recurrence rates in the minimally invasive and open groups were 5.0% (4/80) and 6.3% (3/48). The results of multivariate analysis showed that the maximum tumor diameter of 25 mm was an independent prognosis factor for postoperativelocal recurrence (0.122, 95: 0.016 to 0.901, 0.039). While surgical procedure, age, menopausal status and history of fibroadenomas in the ipsilateral breast is not an independent prognostic factor for postoperative local recurrence. In the minimally invasive surgery group, the local recurrence rates were 2.9% (2/69) and 2/11 in patients with tumor maximum diameters<25 mm and ≥25 mm, respectively. Local recurrence of breast benign phyllodes tumors is closely related to the tumor size. For patients with tumor diameter25 mm, the postoperative local recurrence rate of VAE is low, which can be used in clinical practice. Intraoperative complete resection to achieve a negative surgical margin should be guaranteed to avoid local recurrence.
ABSTRACT
<p><b>OBJECTIVE</b>To compare activation and concentration of insulin, and blood glucose control in patients between insulin added into "all in one" bags and syringes at parenteral nutrition (PN).</p><p><b>METHODS</b>From April 2006 to August 2006, 20 consecutive patients after gastrointestinal operations were recruited and randomized to instillation group and pump group. In instillation group, the insulin was directly added into PN and transfused. In pump group, the insulin was added into syringes and transfused by infusion pump. Activation and concentration of insulin, and blood glucose in patients were measured at beginning infusion, infused 1000 ml, infused 2000 ml, and remained 100 ml daily for the first 3 days after operation.</p><p><b>RESULTS</b>There was a tendency of decrease for the activation and concentration of insulin in both groups with the time. There was no significant difference of activation of insulin between the two groups (P = 0.347). There were no significant differences of blood glucoses between the two groups, and between the four time points in each groups (P > 0.05). There were no complications association with blood glucoses in the two groups.</p><p><b>CONCLUSIONS</b>Both of activation and concentration of insulin at PN decreased gradually and slightly with the time no matter the ways of insulin infusion. Activation of insulin and blood glucoses in patients are no significant differences between the two groups. Insulin can be safely added into "all in one" bags at PN.</p>