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OBJECTIVE@#To explore the effectiveness and advantages of using Fastpass Scorpion suture passer to stitch the inferior capsulolabral complex in arthroscopic Bankart repair compared with traditional arthroscopic suture shuttle.@*METHODS@#The clinical data of 41 patients with Bankart lesion, who met the selection criteria and were admitted between August 2019 and October 2021, was retrospectively analyzed. Under arthroscopy, the inferior capsulolabral complex was stitched with Fastpass Scorpion suture passer in 27 patients (FS group) and with arthroscopic suture shuttle in 14 patients (ASS group). There was no significant difference between the two groups ( P>0.05) in gender, age, injured side, frequency of shoulder dislocation, time from first dislocation to operation, and preoperative Rowe score of shoulder. Taking successful suture and pull-tightening as the criteria for completion of repair, the number of patients that were repaired at 5∶00 to 6∶00 (<6:00) and 6∶00 to 7∶00 positions of the glenoid in the two groups was compared. The operation time, and the difference of Rowe shoulder score betwee pre- and post-operation, the occurrence of shoulder joint dislocation, the results of apprehension test, and the constituent ratio of recovery to the pre-injury movement level between the two groups at 1 year after operation.@*RESULTS@#Both groups completed the repair at 5∶00 to 6∶00 (<6∶00), and the constituent ratio of patients completed at 6∶00 to 7∶00 was significantly greater in the FS group than in the ASS group ( P<0.05). The operation time was significantly shorter in the FS group than in the ASS group ( P<0.05). All incisions in the two groups healed by first intention. All patients were followed up 12-36 months (mean, 19.1 months). No anchor displacement or neurovascular injury occurred during follow-up. Rowe score of shoulder in the two groups significantly improved at 1 year after operation than preoperative scores ( P<0.05), and there was no significant difference in the difference of Rowe shoulder score between pre- and post-operation between the two groups ( P>0.05). At 1 year after operation, no re-dislocation occurred, and there was no significant difference in the apprehension test and the constituent ratio of recovery to the pre-injury movement level between the two groups ( P>0.05).@*CONCLUSION@#Compared with the arthroscopic suture shuttle, using Fastpass Scorpion suture passer to stitch the inferior capsulolabral complex in arthroscopic Bankart repair is more convenient, saves operation time, and has good effectiveness.
Subject(s)
Humans , Animals , Arthroscopy/methods , Scorpions , Retrospective Studies , Treatment Outcome , Shoulder Dislocation/surgery , Sutures , Equidae , Shoulder Joint/surgery , Joint Instability/surgery , Suture Anchors , Recurrence , Range of Motion, ArticularABSTRACT
Objective To evaluate the clinical value of CT angiography (CTA) in the diagnosis of acute pulmonary embolism (APE) after standardized chest pain assessment in patients with acute chest pain.Methods From January 2014 to May 2016,The clinical data of 43 patients with acute chest pain in Wuzhou Hospital of Traditional Chinese Medicine and Wuzhou Worker's Hospital received CTA examination were retrospectively analyzed.After standardized assessment,16 patients with suspected APE through pulmonary artery CTA scan screening were selected as observation group.27 cases of chest pain who were not received standardized assessment were selected as the control group,the chest CTA scan was used to investigate the causes of chest pain.The number of CTA confirmed by APE in two groups was compared.The effect of APE screening scale score and D-Dimer on the diagnosis of APE in the observation group was analyzed,and the application value of standardized evaluation of chest pain in APE was analyzed.Results The positive rate of CTA in the observation group was higher than that in the control group,and the difference between the two groups was statistically significant(x2 =3.93,P ＜ 0.05).The APE screening scale and D-Dimer in the observation group were (9.64 ±4.74) points and (886.73 ± 191.83) μg/L,respectively.which in the APE excluded patients were (2.20 ± 1.64) points,(587.20 ± 35.79) μg/L,respectively,the differences were statistically significant(t =3.363,3.402,all P ＜ 0.01).Conclusion Patients with acute chest pain and chest pain are standardized after the evaluation,optimization of CTA examination and improve the diagnostic rate of APE,reduce the rate of misdiagnosis and missed diagnosis,provide timely and accurate diagnostic basis for clinicians to gain valuable opportunity for further disposal.
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Objective To study the local recurrent pattern of postoperative middle thoracic esophageal squamous cell carcinoma( ESCC) and provide the evidence for designing the radiation target in postoperative radiotherapy. Methods From May 2007 to December 2015, a total of 752 patients with local recurrence of postoperative middle thoracic ESCC were included in this retrospective analysis. χ2 test was used to analyze the recurrent pattern of mediastinum, anastomotic, abdominal cavity and primary tumor bed. Results The median interval between surgery and recurrence was 14. 6 months (1-106 months). The highest risk of recurrent site was mediastinum (79. 7%), followed by supraclavicular and anastomotic (29. 1%and 7. 4%, respectively), but rarely occurred at the abdominal cavity and primary tumor bed (4. 1%and 0. 7%, respectively). The relapse rate differed significantly among the five sites (χ2 =925. 8, P<0. 05). Furthermore, the relative metastatic rate in upper mediastinum was 74. 2%, 19. 8%in middle mediastinum and 4. 8%in the lower. There was statistically significant difference in the relative metastatic rate among the three sites(χ2 =791. 6, P <0. 05). Recurrences occurred highly at the 7th, 1st -5th regions, but rarely at 6th, 8th -10th regions. There was significant difference among these 10 regions from the mediastinum(χ2 =486. 9, P<0. 05). The lymphatic metastasis of superior mediastinum was mainly distributed at paratracheal lymph nodes. The metastatic rate of right paratracheal lymph nodes was 47. 1% including 1R,2R and 4R regions and the left paratracheal lymph nodes was 29. 4%including 1L, 2L and 4L regions. The metastatic rate of right supraclavicular paratracheal lymph nodes was significantly higher than that of left ones(χ2 =31. 5, P <0. 05). Conclusions Local recurrence mainly occurred in the bilateral supraclavicular areas, upper/middle mediastinum and anastomosis in patients with middle thoracic ESCC. The bilateral supraclavicular areas, 1st -5th regions of superior mediastinum, 7th region of middle mediastinum and anastomosis should be included in the postoperative prophylactic irradiation target volume.
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Objective To study the local recurrent pattern of postoperative middle thoracic esophageal squamous cell carcinoma( ESCC) and provide the evidence for designing the radiation target in postoperative radiotherapy. Methods From May 2007 to December 2015, a total of 752 patients with local recurrence of postoperative middle thoracic ESCC were included in this retrospective analysis. χ2 test was used to analyze the recurrent pattern of mediastinum, anastomotic, abdominal cavity and primary tumor bed. Results The median interval between surgery and recurrence was 14. 6 months (1-106 months). The highest risk of recurrent site was mediastinum (79. 7%), followed by supraclavicular and anastomotic (29. 1%and 7. 4%, respectively), but rarely occurred at the abdominal cavity and primary tumor bed (4. 1%and 0. 7%, respectively). The relapse rate differed significantly among the five sites (χ2 =925. 8, P<0. 05). Furthermore, the relative metastatic rate in upper mediastinum was 74. 2%, 19. 8%in middle mediastinum and 4. 8%in the lower. There was statistically significant difference in the relative metastatic rate among the three sites(χ2 =791. 6, P <0. 05). Recurrences occurred highly at the 7th, 1st -5th regions, but rarely at 6th, 8th -10th regions. There was significant difference among these 10 regions from the mediastinum(χ2 =486. 9, P<0. 05). The lymphatic metastasis of superior mediastinum was mainly distributed at paratracheal lymph nodes. The metastatic rate of right paratracheal lymph nodes was 47. 1% including 1R,2R and 4R regions and the left paratracheal lymph nodes was 29. 4%including 1L, 2L and 4L regions. The metastatic rate of right supraclavicular paratracheal lymph nodes was significantly higher than that of left ones(χ2 =31. 5, P <0. 05). Conclusions Local recurrence mainly occurred in the bilateral supraclavicular areas, upper/middle mediastinum and anastomosis in patients with middle thoracic ESCC. The bilateral supraclavicular areas, 1st -5th regions of superior mediastinum, 7th region of middle mediastinum and anastomosis should be included in the postoperative prophylactic irradiation target volume.
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Objective Retrospectively analyzed the predictive value of imaging evaluation in stage Ⅱ/Ⅲ esophageal carcinoma patients treated with preoperative chemoradiotherapy.Methods A total of 145 stage Ⅱ/Ⅲ esophageal carcinoma pantients were enrolled.We analyzed the overall survival rates of the patients with pathological complete response (pCR) and those without (NpCR),X-film complete response (xCR) and those without (NxCR),RECIST complete response (rCR) and those without (NrCR).And we used Cox model for multivariate analysis.Results The rates of pCR,xCR and rCR were 33.8％,42.8％ and 38.6％ for all patients,respectively.The 1-,3-5-year overall survival rates were 87.8％,79.6％,61.2％ for pCR patients and 75％,40.6％,24.0％ for NpCR patients (x2 =20.215,P ＜0.05),respectively;The 1-,3-5-year overall survival rates were 80.6％,66.1％,51.6％ for xCR patients and 75％,44.6％,25.3％ for NxCR patients(x2 =8.895,P ＜0.05),respectively;The 1-,3-5-year overall survival rates were 83.9％,69.6％,53.6％ for rCR patients and 76.4％,46.1％,25.8％ for NxCR patients(x2 =10.862,P ＜ 0.05),respectively.Multivariate survival analysis using Cox regression model showed that pCR was a positive independent prognostic factor (HR =0.333,95％ CI:0.200-0.554,P ＜ 0.05).Conclusions Short-term imaging evaluation could effectively predict the prognosis of stage Ⅱ/Ⅲ esophageal carcinoma patients treated with preoperative chemoradiotherapy.And pCR was a positive independent prognostic factor.
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Objective To explore the appropriately operative chance , method, and perioperative management of coronary arterybypass grafting (CABG) in the patients with severe left main artery (LMA) stenosis with three-vessel-disease.Methods A total of296 patients with severe LMA stenosis with three-vessel-disease who underwent CABG surgery was analyzed retrospectively from 2003through 2013.Of them, 276 patients underwent conventional coronary artery bypass surgery on pump ( CCABG)and 20 patients underwentoff-pump CABG( OPCAB); 172 Patients was over 60 years old (58.1%)and 246 patients (83.10%) had concomitant diseasesincluding valve lesion, hypertension, diabetes, myocardial infarction, left ventricular aneurysm with septal defect , stroke, renal failure,and cancer.Left internal mammary artery use was in 281 patients (95.1%); and 32 patients were implanted intra-aortic ballonpump(IABP) perioperatively.Results There were 7 cases(2.36 %) death of postoperative low cardiac output , ventricular fibrillation,cerebral infarction, renal failure, and multiple organ failure, respectively.Postoperative complications were low cardiac output ,respiratory failure , ventricular fibrillation, cereboembolism, cardiac tampomade, renal failure, stroke, and multiple organ failure.Afterfollow-up 2 to 84 months, there was 3 death in which 2 death of cardiac factors.Conclusions CCABG was a safe and effectivemethod in patients with severe LMA stenosis with severe three -vessel-disease.Preoperative insertion of IABP can certainly avoid the po -tential operative risk factor and significantly decrease the mortality and morbidity .