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Objective To discuss the clinical characteristics for central compartment lymph node metastasis in stage cNO papillary thyroid microcarcinoma and significance and feasibility of preventive dissection,aimed to provide reference for clinical treatment.Methods Reviewed the clinical data of 277 patients with stage cNO papillary thyroid microcarcinoma from Jul.2011 to Dec.2015 underwent surgery in the Department of General Surgery of Lianyungang East Hospital.Evaluated the necessity of prophylactic central lymph node dissection.Adopted chi square test and Logistic regression to analyze its relationship with patients' gender,age,tumor number,tumor size,enveloped infiltration,single and bilateral tumor.All 277 patients underwent primary radical resection with ipsilateral central lymph node dissection.The specimen of resection was analyzed by routine pathology.Results The positive rate of thyroid papillary microcarcinoma lymph node metastasis was 36.8 ％ (102/277).The elements of male patients (P =0.023),age ＜ 45 years (P ＜ 0.001) and tumor diameter ＞ 0.5 cm (P =0.019)had high positive rate.The multivariable analysis showed that male patients (OR =2.63,P ＜ 0.001),age ＜ 45 years (OR =2.25,P =0.016),tumor diameter ＞ 0.5 c m (OR =2.13,P =O.009) were independent risk factors for CLN metastasis.Forty-three (15.5％) cases had transient parathyroid function.No Permanent recurrent nerve paralysis and hyperparathyroidism occurred in this group.Conclusions Prophylactic central lymph node dissection is helpful for accurate staging of tumor classification and risk assessment,has important significance,on the follow-up of patients after treatment of choice.For male patients,age ＜ 45,tumor diameter ＞ 0.5 cm,enveloped infiltration,the central compartment lymph node dissection may be necessary.
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Objective To evaluate reformative encircling constriction combined with the retrograde venograms in operation for treating primary deep venous insufficiency. Methods The clinical data of 25 cases (29lower extremities) undergoing primary deep venous insufficiency from March 1998 to December 2006 were analyzed retrospectively. 25 eases(29 lower extremities) were treated with reformative encircling constriction combined with the retrograde venograms in operations. Results 25 eases were treated with reformative encircling constriction combined with the retrograde venograms in operations,the leg swelling improved and no deep vein thrombus occurred; all the varicose veins are welt controlled. Conclusion Reformative encircling constriction operations are eutherapeutic for severe femoral venous valve dysfunction, when combined with the retrograde venogram, it can be a guidance in encircling constriction of superficial femoral vein and number of femoral venous valves.
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Objective To evaluate the effect of procaine on prevention of skin slap necrosis after modified radical mastectomy in breast cancer.Methods 106 breast cancer patients were randomly divided into treatment and control groups.In the treatment group,procaine(1% 100ml diluted in 300ml mormal saline,42℃)were compressed under the skin flap in operation,the control group received same amount of normal salin instead.The rates and sizes of skin flap necrosis were obeserved and compared.Results There were 13 cases suffured from skin flap necrosis among 106 breast cancer cases who received surgery operation.The rate of the flap necrosis in treatment group was5.76%(3/52),and the control group was 18.51%(10/54),there was significant difference(P
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Objective To evaluate the effect of double stapling technique for sphincter preservation operation in mediate-low rectal carcinoma.Methods The resection through double stapling technique for sphincter preservation approach was performed on 30 patients with mediate-low rectal carcinoma from January 2004 to November 2007.The distance between the anal verge and the lower margin of the tumor was 4～8cm(averaged 6.5 cm),including 22 patients in Dukes A stage,6 Dukes B and 2 Dukes C.Results Fecal continences were preserved successfully in all patients.2 cases had got anastomotic narrowing(6.6%) after operation.At a median follow-up of 46 months,two patients had local recurrences(6.6%).There was no urinary dysfunction in this series.Conclusion Double stapling technique for sphinceter preservation operation was feasible and safe,provide a original operative style for mediate-low rectal carcinoma.