ABSTRACT
Objective:To estimate and analyze the occurrence of post-thyroidectomy syndrome (PTS) following endoscopic thyroidectomy via areola approach (ETAA) vs open thyroidectomy (OT) .Methods:Data of 903 consecutive cases, aged from 20 to 66 with 231 males and 672 females, in Department of General Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, from Jan. 2016 to Dec. 2017 were analyzed retrospectively. They were enrolled according to the same criteria. Based on different procedures, the cases were divided into ETAA group (n=162) and OT group (n=741) . Intraoperative procedure was according to unified principle. Drainage tube was removed if 24-hour drainage volume was less than 20 ml. Following-up was implemented by telephone or outpatient clinic. Data of 2 groups of 5 PTS items during 1 m, 3 m, 6 m and 1 y postoperatively and the scores of the medical outcomes study short form 36-item health survey (SF-36) V2 were analyzed by independent sample t test and repeated measures analysis of variance. Results:The patients of 2 groups were all followed up for more than 1 y with 43 cases censored (4.8%) . Demographic data of the rest of 2 groups were not different statistically ( P>0.05) . Median of every phase scores of the 5 items of PTS were 0 to 1. Scores of the 5 items were decreased gradually in accordance with time factor ( P=0.000) . The scores of peculiar feeling at the surgical site and discomfort in neck were different statistically during 1 m and 3 m postoperatively ( P=0.000) . Incidence of peculiar feeling at the surgical site in 1 m and 3 m postoperatively in ETAA group (54, 38.8% and 8, 5.8%) was higher than that in OT group (153, 21.2% and 20, 2.8%) . However, incidence of discomfort in neck in ETAA group (14, 10.1% and 0) was lower than in OT group (194, 26.9% and 53, 7.4%) . The other 3 items at all phases were not different statistically ( P>0.05) . The SF-36 V2 scores at 1 y postoperatively of 2 groups were not different statistically ( P=0.458) . Conclusions:PTS is a common symptom after OT or ETAA. It is frequent within early phase after thyroidectomy and is decreased significantly within 6 m. Peculiar feeling at the surgical site occurs less in OT than in ETAA in early postoperative phase and discomfort in neck occurs more, conversely.
ABSTRACT
Objective:To summarize the experience of laparoscopic transabdominal preperitoneal hernia repair (TAPP) and to discuss its safety and feasibility.Methods:Data of 26 consecutive cases from January 2015 to March 2018 in Ruijin Hospital, Shanghai Jiao Tong University School of Medicine were analyzed retrospectively. They were all males, aged (68.3±14.1) years, with a range from 57 to 86 years. Body mass index was (23.3±4.1) kg/m 2. Bathel indexwas 91.4±5.6. Intraoperative main procedures were done in accordance to Guideline of Standardized Operation for Laparoscopic Inguinal Hernia Repair. A drainage tube or catheter was not routinely placed intraoperatively. Patients were discharged but for any complaints. Observation data included intraoperative, postoperative and following-up data. The following-up period was more than 12 months by telephone or clinic. The long-term complications and the changes of Barthel index were observed. Paired sample t test was used to compare the changes of Barthel index before and after operation. Results:Of the 26 cases, none was converted to open procedure and no intra- or post-operative serious complications occurred. Occurrence of surgical site seroma was 17 (65.4%) cases. The operating time was (76.5±23.6) min. Intraoperative blood loss was (8.6±4.4) mL. The postoperative hospitalization was (2.3±1.2) d. Bathel index in 1 month postoperative was 96.9±3.2. It was higher statistically than that preoperative ( t=-6.968, P=0.000). Conclusions:TAPP in the treatment of huge inguinoscrotal hernia is safe and feasible. Mastering the anatomical characteristics and the according procedures is an important factor for successful operation.
ABSTRACT
Radiotherapy, surgery and chemotherapy are the main treatments for cancer. Though intraoperative radiotherapy(IORT) for rectal cancer is still at its preliminary stage in China, patients can get more benefits from IORT than pre- or post-operative radiotherapy. IORT improves local control for locally advanced rectal cancer and improves overall survival rate of locally recurrent rectal cancer. In general, IORT is safe and feasible. It will be widely used for patients with rectal cancer in the future.