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BACKGROUND: To delay the further aggravation of early femoral head necrosis, drilling decompression of the femoral head is a better treatment method. However, traditional trepanation and decompression of the femoral head is traumatic. OBJECTIVE: To compare the difference in the effect between robot-assisted drilling decompression and traditional surgery for aseptic necrosis of femoral head. METHODS: Forty patients with aseptic necrosis of the femoral head were included for retrospective comparative analysis. According to the treatment plan, they were divided into two groups. Eighteen cases (26 femoral heads) in the robot group were treated with drilling decompression assisted by robots. Among them, 13 cases (18 femoral heads) were in Ficat stage I and 5 cases (8 femoral heads) were in Ficat stage II. The traditional surgery group consisted of 22 patients (29 femoral heads). Among them, 15 patients (19 femoral heads) were in Ficat stage I and 7 patients (10 femoral heads) in Ficat stage II. Incision, times of intraoperative fluoroscopy, intraoperative blood loss, times of intraoperative puncture and operation time were compared between the two groups. Harris score was used before and 1, 3, and 6 months after operation to evaluate the hip effect. RESULTS AND CONCLUSION: (1) All cases were followed up for 6 months. (2) Incision, times of intraoperative fluoroscopy, intraoperative blood loss, times of intraoperative puncture and operation time were better in the robot group than in the traditional surgery group (P 0.05). (4) Compared with the traditional surgery, robot-assisted drilling decompression has no obvious advantage in the treatment of aseptic necrosis of the femoral head. However, its operation incision is small; the number of intraoperative fluoroscopy is small; the trauma is small; and the operation is safer and minimally invasive.
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BACKGROUND: With the development of three-dimensional (3D) printing technology, it has been widely used in spinal surgery. However, whether 3D printing-assisted surgery for lumbar spondylolisthesis has an advantage over traditional surgery is still controversial. OBJECTIVE: To compare the clinical efficacy and safety of 3D printing-assisted versus conventional surgery for the treatment of lumbar spondylolisthesis using system evaluation. METHODS: Randomized controlled trials about 3D printing technology for lumbar spondylolisthesis in CNKI, Wanfang database, CBM, VIP, PubMed, Cochrane Library, Embase, and Web of Science were searched via computer from inception to November 16, 2019. The retrieved literatures were screened according to predefined inclusion and exclusion criteria, and quality evaluation was performed. Then, the available data were extracted and analyzed with the Stata 11. 0 software. RESULTS AND CONCLUSION: (1) Six randomized controlled trials including 394 cases were included. Among them, 201 cases were assigned to the 3D printing-assisted group and 193 cases to the conventional group. (2) Meta-analysis results showed that the 3D printing-assisted group proved significantly superior to the conventional group regrading the operation time [WMD=-38. 17, 95%CI(-43. 93, -32. 41), P=0. 00], intraoperative blood loss [WMD=-61. 61, 95%CI(-69. 19, -54. 03), P=0. 00], the frequency of fluoroscopy [WMD=-4. 89, 95%CI(-6. 38, -3. 41), P=0. 00] and the screw placement accuracy [OR=3. 89, 95%CI(2. 43, 6. 25), P=0. 00]. (3) However, in terms of the postoperative visual analogue scale scores [WMD=-0. 47, 95%CI(-1. 21, 0. 27), P=0. 215], Oswestry disability index [WMD=-1. 41, 95%CI(-2. 87, 0. 05), P=0. 058], Japanese Orthopaedic Association scores [WMD=1. 02, 95%CI(-0. 68, 2. 72), P=0. 240] and the rate of complications [OR=0. 37, 95%CI(0. 12, 1. 11), P=0. 075], no statistically significant differences were found between the two groups. (4) In conclusion, the application of 3D printing technology in the surgical treatment of lumbar spondylolisthesis has the advantage of shortening the operation time, reducing intraoperative blood loss and frequency of fluoroscopy and improving the accuracy of the screw placement.
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Objective To analyze the effect of video-assisted thoracoscopic surgery and traditional surgery for multiple rib fractures. Methods 102 cases of patients with multiple rib fractures from January 2014 - December 2017 was selected and divided into two groups after different therapy: 51cases in control group were treated with traditional surgery, 51cases in study group were treated with thoracoscopic assisted surgery, the clinical results was compared and analyzed. Results The observation group of intraoperative bleeding, postoperative drainage were significantly higher than the control group (P < 0.05); the operation time of observation group was significantly longer than the control group, with significant differences between the two groups (P < 0.05); the study group of pain time (8.39 ± 2.24) d, ambulation time (5.76 ± 2.43) d and the hospitalization time (10.53 ± 3.51) d was significantly shorter than the control group, the difference between the two groups was statistically significant (P < 0.05), study group complication rate was 3.92% and the control group complication rate was 17.64% with significant difference (P < 0.05). Conclusion The clinical effect of video-assisted thoracoscopic surgery in patients with multiple rib fractures is significant, can prevent complications, reduce medical costs, it is worth learning.
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Objective To compare the effectiveness of arthroscopy assisted percutaneous internal fixation and open reduction of traditional surgery for tibial plateau fractures. Methods Between January 2012 and January 2015, 178 patients with tibial plateau fractures were treated with arthroscopy assisted percutaneous internal fixation (arthroscopy group, n = 99), and control group (n = 79) with traditional surgery for the treatment of tibial plateau fractures. The operation time, fracture healing time, intraoperative and postoperative blood loss and complications were compared between the two groups. Knee function score and the range of motion were measured according to American Hospital for Special Surgery (HSS) score standard. Results Compared with control group, the amount of blood loss in arthroscopic group was less than that in control group (P < 0.05), and there was no significant difference in the operation time compared with control group. After 18～24 months follow-up, the HSS score of the arthroscopic group was higher, the wound healing time was shorter and the complication occurred less, the difference was statistically significant (P < 0.05). Conclusion The two treatment methods can achieve good clinical results, but after arthroscopic microscopic examination of the tibial plateau fractures with benefits such as: less blood loss, not increased the operation time, shorter healing time and less complications, higher HSS score while reduced the suffering of patients and improved the efficacy.
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Objective To compare the clinical effect of video-assisted thoracoscopic surgery and traditional surgery on patients with thymoma. Methods 52 patients with thymoma were randomly divided intoexperimental group and control group each with 26 cases. The control group received the traditional surgical method. The experimental group was treated by video-assisted thoracoscopic surgery. To compare the two groups of patients with intraoperative blood loss, surgical incision, operation time, analgesic drug use, hospital stay and complications and other indicators. Results The intraoperative blood loss, incision size and the amount of analgesic drug application of the experimental group were significantly smaller than those of the control group(P<0.05). The operation time and hospitalization time were significantly shorter than those of the control group. The complication was significantly lower than the control group, the difference was statistically significant(P<0.05). Conclusion Video - assisted thoracoscopic surgery is safe and reliable in the treatment of thymoma. It has the characteristics of less trauma, quick recovery, less pain and less complication. It should be widely used in clinical practice.
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Objective To compare the clinical effect of video-assisted thoracoscopic surgery and traditional surgery on patients with thymoma. Methods 52 patients with thymoma were randomly divided intoexperimental group and control group each with 26 cases. The control group received the traditional surgical method. The experimental group was treated by video-assisted thoracoscopic surgery. To compare the two groups of patients with intraoperative blood loss, surgical incision, operation time, analgesic drug use, hospital stay and complications and other indicators. Results The intraoperative blood loss, incision size and the amount of analgesic drug application of the experimental group were significantly smaller than those of the control group(P<0.05). The operation time and hospitalization time were significantly shorter than those of the control group. The complication was significantly lower than the control group, the difference was statistically significant(P<0.05). Conclusion Video - assisted thoracoscopic surgery is safe and reliable in the treatment of thymoma. It has the characteristics of less trauma, quick recovery, less pain and less complication. It should be widely used in clinical practice.
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Objective To compare the effectiveness of arthroscopy assisted percutaneous internal fixation and open reduction and traditional surgery tibial plateau fractures.Methods From August 2013 to April 2014, 78 patients with tibial plateau fractures according to random number table were divided into group A and group B, 39 cases in each. A group of traction using arthroscopic surgery, group B with traditional open bag reduction surgery.Results The operation time, intraoperative and postoperative bleeding less and wound lesion area was shorter and less in group A than that in group B; while the healing time and HSS score was faster and higher than that in group B. The difference was statistically significant (P 0.05); postoperative complication rate in group A was lower than that in group B, and there is significant difference (P < 0.05).Conclusion Both treatment methods can achieve good clinical results, but arthroscopically assisted treatment of tibial plateau fractures reset shorter operative time, less blood loss, healing time is shorter, less complications, but higher HSS score, etc., which reduced the suffering of patients and improved the outcome.
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Objective To evaluate the clinical efficacy of ultrasonic-harmonic scalpel in open thyroid surgery.Methods Totally 70 patients with thyroid surgery from January 2012 to January 2014 in some hospital were selected as the study objects, who were divided into a control group and an observation group equally. The patients in the control group went through traditional surgery, and the ones in the observation group underwent open thyroid surgery. Then the operative time, blood loss, postoperative hospital stay before and after surgery and body stress-related serum markers of two groups were analyzed and compared.Results The observation group had the operative time, blood loss and postoperative hospital stay significantly better than those of the control group, and the body stress-related serum markers 5 days after operation significantly lower than that of the control group, with P<0.05.Conclusion The short-term clinical effect of ultrasonic-harmonic scalpel in open thyroid surgery is significantly better than that of traditional surgery, which has high safety and lower degree of adverse physical stress.
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Objective To compare the perioperative application of fast track surgery(FTS)andtraditional surgery for fractured fibs.Methods Eighty four perioperative patients with fractured fibs wereenrolled,including 42 cases treated by FTS philosophy(FTS Group)and 42 cases treated by traditional surgery(Tradition Group).The results of postoperative VAS score,serum albumin,recovery time of gurglingsound,exhaust time of intestinal tract,postoperative complications,hospital stay,total hospital cost and patient satisfaction were investigated and compared between the two groups.Results Patients in FTS grouphad lower VAS scores,higher level serum albumin,earlier time of gurgling sound recovery and intestinalexhaust,lower rates of postoperative complication,shorter time of hospital stay,lower hospital costs andhigher levels of satisfaction(P <0.05).Conclusion For perioperative patients with fractured fibs,FTShas advantages in low VAS score,good nutrition condition,short intestinal tract convalescence,low postoperative complication rate,short hospital stay,low host costs and high level of satisfaction,which is worthy ofbeing spread.
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Objective To compare the cost-effectiveness between endoscopic submucosal dissection (ESD) procedure and traditional surgery for the treatment of early gastrointestinal cancer or precancerous lesions.Methods A total of 866 early GI cancer/precancerous patients who had been admitted to Chinese PLA General hospital and Qilu hospital were included in this study.The medical records of all 866 patients were reviewed.Patients were divided into ESD group and traditional surgery group.Parameters of each patient,such as time of hospitalization,total treatment cost and incidence of complications,were documented and later compared in detail.Results A total of 607 patients were included in the ESD group and 259 in the traditional surgery group.There was no statistical difference in complete resection rate between the two groups (93.1％ vs 93.0％,P ＞ 0.05).The ESD group showed a shorter mean hospitalization time (d)(13.01 vs 18.88,P ＜ 0.05) and lower treatment cost (RMB) than the traditional surgery group (22932.17 vs 57993.88,P ＜ 0.05).The incidence of hemorrhage and perforation for each group were 3.63％ and 3.10％ respectively,which were not significantly different (1.98％ vs 3.01％,P ＞ 0.05; 2.80％ vs 1.16％,P ＞ 0.05).Conclusion ESD and surgery are both effective for early gastrointestinal cancer/precancerous lesions therapy,but ESD procedure is superior to surgery in terms of hospitalization time and expediture.
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Objective To compare the current therapeutic effects between endovenous radiofrequency treatment and conventional surgery for lower limb chronic venous insufficiency (CVI) ,and summarize operative skills and clinical value of endovenous radiofreq uency treatment on CVI .Methods Data of 45 limbs of 41 patients treated by endovenous radiofrequency treatment (endovenous ra-diofrequencytreatmentgroup)and20limbsof20patientsbytraditionalsurgery(traditionalsurgerygroup)wereanalyzedandcom-pared in terms of operation time ,postoperative pain ,postoperative hospitalized duration ,complications ,and one-year recurrence rate .Results Endovenous radiofrequency treatment group had less postoperative pain and shorter postoperarive hospitalized dura-tion than traditional surgery group(P0 .05) . The two groups had few complications and had no recurrence in one year .Conclusion As a minimally invasive treatment for vari-cose veins ,endovenous radiofrequency treatment has less trauma ,rapid recovery ,safe and effective ,and it is worthy to be recommen-ded .
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Introducción: la conversión de la colecistectomía video laparoscópica a cirugía tradicional, está condicionada por diferentes factores que pueden determinar un mayor periodo de hospitalización e incapacidad en el paciente. Objetivo: determinar los factores de riesgo que tienen mayor influencia en la conversión del proceder quirúrgico. Métodos: de un universo de 2 746 pacientes operados por cirugía video laparoscópica, se tomaron los 46 donde hubo necesidad de convertir la operación a cirugía tradicional. El estudio se realizó en el Hospital Militar de Ejército de Matanzas "Dr. Mario Muñoz Monroy", entre febrero del 2000 y junio del 2009. Se revisaron las historias clínicas para extraer los datos de interés. Resultados: entre los diagnósticos preoperatorios más frecuente, el de colecistitis aguda, así como el carácter urgente de la intervención, fueron los factores de mayor correlación con el riesgo de conversión, con odd ratio de 29,639 y 22,977 respectivamente. Los pacientes de 75 años en adelante, tuvieron un riesgo de conversión mayor que los más jóvenes. Para el sexo masculino y los antecedentes de enfermedades que condicionan riesgo quirúrgico, la necesidad de conversión fue menor y el antecedente de intervención quirúrgica abdominal, no influyó sobre este. El 84,8 % de los pacientes en los que hubo necesidad de convertir la operación, no tuvieron complicaciones. Conclusiones: los pacientes con colecistitis aguda, y aquellos en los que la intervención quirúrgica es de carácter urgente, tienen un riesgo mayor de que su operación por vía laparoscópica tenga que ser convertida y completada con una laparotomía.
Introduction: the conversion of video laparoscopic cholecystectomy to traditional surgery is influenced by various factors that may determine a longer period of hospitalization and disability for the patient. Objective: to determine the most influencing risk factors on the conversion of this surgical procedure. Methods: out of 2746 patients operated by video laparoscopic surgery, 46 needed to convert this operation in to the traditional surgery. The study was conducted at Dr. Mario Muñoz Monroy Military Hospital in Matanzas, from February 2000 to June 2009. Medical records were reviewed to gather relevant data. Results: among the most common preoperative diagnosis, acute cholecystitis and the urgent intervention were the major factors correlated with the need for conversion, with odds ratio of 29.639 and 22.977 respectively. Patients older than 75 years had higher risk of conversion than younger patients. The conversion risk was lower for male patients and for those with history of diseases affecting surgical risk. A history of abdominal surgery did not have any influence. 84.8 % of the patients needing to convert the operation had no complications. Conclusions: patients with acute cholecystitis, and those needing urgent surgery have higher risk when laparoscopic operation have to be converted and completed with a laparotomy.
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This article introduces method and effect in in teaching reformation of Chinese traditional surgery base on the resources of network.
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Objective To compare the efficacy of holmium laser and traditional surgery for the treatment of varicosis of the lower limbs.Methods From March 2005 to December 2006,226 patients with varicosis of the lower limbs(274 limbs)were treated using holmium laser(laser group,120 patients with 148 diseased limbs)or high ligation and stripping of the great saphenous vein(traditional group,106 patients with 126 diseased limbs).Results The mean operation time of the laser group was significantly shorter than that in the traditional group [(38.0?10.8)min vs(61.5?12.3)min,t=-15.294,P=0.000].None of the patients in the laser group need analgetics after the operation,while 58 patients in the traditional group received the drug after the surgery(0 vs 54.7%,?2=88.329,P=0.000).The patients in the laser group returned to activities earlier and had shorter postoperative hospital stay than those in the traditional group [(6.2?0.8)h and(3.0?0.5)d vs(22.5?1.5)h and(8.5?2.5)d;t=-105.034,P=0.000 and t=-23.632,P=0.000,respectively].The rates of complications and 1-year recurrence were similar in the two groups [16.9%(25/148)vs 18.3%(23/126),?2=0.087,P=0.768 and 3.8%(3/78)vs 3.1%(2/65),?2=0.000,P=1.000].Conclusions Holmium laser has advantages of shorter operation time and hospital stay,fewer surgical incisions,milder postoperative pain,and earlier return to activities.Closure of the great saphenous vein is the key to ensure the effect of laser therapy.High ligation of the great saphenous vein should be done simultaneously if necessary.