ABSTRACT
Aim: The aim of this study was to determine the effect of sodium bicarbonate irrigation versus normal saline irrigation in patients undergoing a laparoscopic cholecystectomy
Background: Pain in patients undergoing laparoscopic cholecystectomy is the most common complaint, especially in the abdomen, back, and shoulder region
Patients and Methods: In a double blind randomized clinical trial, 150 patients were assigned to the three groups [50 patients in each group]. Group A received intraperitoneal irrigation normal saline [NS]. Groups B and C received irrigation sodium bicarbonate and none irrigation, respectively. Pain was assessed using a visual analog scale [VAS] for 6, 18 and 24 hours postoperatively, as well as one week after the surgery. Data analysis was performed using SPSS ver18 and chi-square, Fisher's Exact Test, on-way ANOVA and repeated measure ANOVA tests
Results: Patients in groups showed no significant difference in terms of age, gender, past medical history and smoking history [p>0.05]. Left shoulder tip pain was significantly lower only between the sodium bicarbonate group and non-washing group at 6, 18, and 24 hours postoperatively [P=0.04, P=0.02 and P=0.009 respectively]. There was no significant difference between the three treatment groups in right shoulder tip pain, back pain and port site incisional pain
Conclusion: In laparoscopic cholecystectomy, peritoneal irrigation with sodium bicarbonate may reduce the intensity of postoperative shoulder tip pain and is an effective method for improving the quality of life within the early recovery period
ABSTRACT
This study focused on triple-negative breast cancer [TNBC] that is characterized by the lack of expression of estrogen receptor [ER], progesterone receptor [PR], and human epidermal growth factor receptor 2 [HER-2]. The primary goal of this study was to describe the relation between triple-negative receptor status and survival. This is the first study about triple-negative breast cancer in our community of the 1541 patients diagnosed with breast cancer between 2002 and 2007 at the Cancer Institute [Tehran, Iran]. 107 patients were identified as TNBC and 107 patients were randomly selected as non-TNB. HER-2, ER and PR status were assessed by immunohistochemistry [IHC]. Analyses of their collected data were performed retrospectively and then clinical and pathologic parameters were compared between two groups. In multivariate analysis, a significantly decreased overall survival was observed for patients with TNBC compared with non-TNBC [55.7 months versus 60.7 mounts; 95%CI: 51.1-60.3 and 57.9-63.5 for TNBC and non-TNBC respectively, P=0.0008]. The 2- and 5-year estimates for overall survival were 69.8% and 62.3% for TNBC, and 90% and 83% for non-TNBC, respectively. During the study period, 36 [33.6%] patient of TNBC and 14 [13.1%] of non-TNBC presented local recurrence. Significantly decreased disease-free survival was also observed for patients with TNBC compared with non-TNBC [P=0.0004]. The 2- and 5-year estimates for disease-free survival were 68% and 63% for TNBC; and 89% and 82% for non-TNBC, respectively. Significantly decreased distant metastasis free survival was also observed for patients with TNBC compared with non-TNBC [54.4 mounts versus 61.7 mounts; 95%CI: 49.8-59.0 and 59.1-64.4 for TNBC and non-TNBC respectively, P=0.0004]. Triple negative breast cancer has a biologic aggressive behavior and poor prognosis. Therefore aggressive treatment and regular follow-up in early stage of diagnosis can be a significant impact on their prognosis.