ABSTRACT
Objective:To compare the clinical outcomes of the Laennec’s approach versus the two-step separation stylized approach in laparoscopic left lateral sectionectomy (LLLS).Methods:A total of 60 patients who underwent LLLS at the Department of Hepatobiliary and Pancreatic Surgery, the Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University from March 2019 to April 2022 were prospectively entered into this study. There were 40 males and 20 females, aged (49.1±9.3) years, with 31 patients suffering from liver cancer, 14 patients hepatic hemangioma and 15 patients hepatolithiasis. A randomized number table was used to assign the patients into two groups: the Laennec’s approach group ( n=30) and the two-step separation stylized approach group ( n=30). The age, gender, liver function, operation time, intraoperative blood loss, abdominal drainage amount, drainage tube retention time, postoperative hospital stay, total hospital costs and postoperative complications were compared between the two groups. Results:There were no significant differences between the two groups in gender, age and Child-Pugh grading of liver function (all P>0.05). Comparison of intraoperative bleeding, postoperative hospital stay, postoperative complications, postoperative recurrence between the two groups showed there were no significant differences between the two groups (all P>0.05). The operative time [(85.6±24.5) min vs (99.1±30.7) min, P<0.05] was significantly less in the stylized group than the Laennec’s group, while the Laennec’s group were superior to the stylized group in the amount of draining [(144.1±38.3) ml vs (290.9±59.5) ml], drainage tube retention time [(2.7±1.5) d vs (4.3±1.9) d] and total hospital costs [(35 100.7±13 200.6) yuan vs (44 700.1±11 800.8) yuan](all P<0.05). Conclusions:Both the Laennec’s and stylized approaches for LLLS were safe and feasible. The stylized approach for LLLS could be performed more quickly, while the Laennec’s approach could more accurately dissect and handle intrahepatic and extrahepatic ducts, thus resulting in decreased postoperative exudation and treatment costs.
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Objective To analyse the survival time and related factors of patients with brain stem glioma who received 3DCRT.Methods Thirty-six patients with brain stem tumor were admitted from October 2004 to December 2008 and all received 3D-CRT with the dosage (50-54 Gy,25-30 f,5-6 weeks).During treatment,the patients’ outcomes were analyzed by observing the changes of symptoms,signs and adverse radiotherapy reaction and all of them were followed-up in the next 3 years.The survival data were analyzed by Kaplan-Meire method.Results The median survival time was 9 months in the 23 pediatric patients and 15 months in 13 adult patients.One-,two-and three-year survival rates between pediatric group and the adult group were 43.5 ％ (10/13) vs 76.9 ％ (10/13),26.1％ (6/23) vs 46.2 ％ (6/13),8.7 ％ (2/23) vs 38.5 ％ (5/13).Karnofsky performance scale score at admission (x2 =20.059,P =0.000),tumor site (x2 =17.585,P =0.000),growth pattern (x2 =21.247,P =0.000) were associate with survival time.Conclusion 3DCRT is an effective therapy to brain stem glioma,childhood onset,pontine glioma,diffusion style and Karnofsky performance scale less than 80 are risk factors of poor prognosis.
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Objective To probe an accurate,rapid and effective method for the calculation and measurement of output dose of the accelerator with IAEA regulation.Methods The parameter value of measurement was determined according to IAEA regulations,and absorbed dose calculation forma was briefed to the form that the reading of instrument multiplies cumulative correction factor.The output dose was measured in water phantom on sandard condition,and then regrafted into plexiglass phantom,which made the measurement more convenience.Results Staistics of measurement had been done to PRIMUS accelerator in 66 weeks output dose.Over 85% of the measurement had the error less then 1%,and others were less then 2%.Conclusion This measurement can be used for the measuremen of output dose in precise radiotherapy of linear accelerator.