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Objective:To investigate the feasibility, safety and effectiveness of Da Vinci robotic surgical system in the reoperation of recurrent or residual thyroid cancer.Methods:Retrospective analysis was performed on the clinical data of 9 patients with Da Vinci robot-assisted reoperation for thyroid cancer in the 960th Hospital of the People′s Liberation Army of China from September 2018 to January 2022, the operation time, number of lymph nodes dissected, intraoperative blood loss, length of hospital stay, total postoperative drainage volume, incidence of complications, satisfaction with postoperative aesthetic effect, visual analyogue scale (VAS) score at the 24 h after surgery and number of recurrence during follow-up were counted.Results:The surgery time of 9 cases was (186.67±44.44) min, the number of lymph nodes cleared were (15.77±13.59), intraoperative blood loss was (21.11±16.91) mL, hospital stay were (10.67±3.32) days, total postoperative drainage was (286.94±90.85) mL. There was no complications, and all patients were satisfied with the postoperative cosmetic effect whose VAS score was (8.22±1.09), and VAS score was 0 to 3 (2.44±0.73) points, no recurrence during the follow-up period from 6 to 46 months.Conclusion:With adequate preoperative evaluation and an experienced surgeon team, the use of robots in recurrent or residual thyroid cancer resurgery is feasible, safe and effective.
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Objective To investigate the surgical treatment strategies for persistent and recurrent parathyroidectomy after total parathyroidectomy plus autotransplantation (tPTX + AT) in cases of renal hyperparathyroidism.Methods From Oct 2009 to Oct 2018,480 patients with renal hyperparathyroidism received tPTX + AT in our hospital.32 patients suffered from post-op persistent (31) and recurrent (1) hyperparathyroidism.The high frequency ultrasonography combined with fine needle puncture eluent PTH determination and SPECT/CT co-computed tomography fusion imaging were used as qualitative and localizing diagnostic methods before reoperation.Results Of the 32 patients,28 cases underwent reoperation for once,and 4 underwent reoperations fort wice.36 parathyroid glands and 2 grafts were resected.In 31 patients the bone pain,skin pruritus relieved significantly or disappeared,and muscle strength gradually increased compared with that before operation.Level of iPTH in 31 patients fluctuated between 15 and 90 ng/L.Postoperative parathyroid hormone decreased compared with that before the operation (P ＜ 0.05).One patient was still with persistent hyperparathyroidism despite reoperation,whose iPTH fluctuated between 550 and 1 000 ng/L during 6 months to 2 years follow-up.Conclusion Ultrasonography,FNA-iPTH and SPECT/CT co-computed tomography can be used as methods for qualitative and localizing diagnosis of PTPT or PHPT.With accurate preoperative localization,resection of all parathyroid glands is an effective treatment for postoperative persistent and recurrent renal hyper parathyroidism.
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Objective@#To investigate the surgical treatment strategies for persistent and recurrent parathyroidectomy after total parathyroidectomy plus autotransplantation(tPTX+ AT) in cases of renal hyperparathyroidism.@*Methods@#From Oct 2009 to Oct 2018, 480 patients with renal hyperparathyroidism received tPTX+ AT in our hospital. 32 patients suffered from post-op persistent (31) and recurrent (1) hyperparathyroidism .The high frequency ultrasonography combined with fine needle puncture eluent PTH determination and SPECT/CT co-computed tomography fusion imaging were used as qualitative and localizing diagnostic methods before reoperation.@*Results@#Of the 32 patients, 28 cases underwent reoperation for once, and 4 underwent reoperations fort wice. 36 parathyroid glands and 2 grafts were resected.In 31 patients the bone pain, skin pruritus relieved significantly or disappeared, and muscle strength gradually increased compared with that before operation. Level of iPTH in 31 patients fluctuated between 15 and 90 ng/L. Postoperative parathyroid hormone decreased compared with that before the operation (P<0.05). One patient was still with persistent hyperparathyroidism despite reoperation, whose iPTH fluctuated between 550 and 1 000 ng/L during 6 months to 2 years follow-up.@*Conclusion@#Ultrasonography, FNA-iPTH and SPECT/CT co-computed tomography can be used as methods for qualitative and localizing diagnosis of PTPT or PHPT.With accurate preoperative localization, resection of all parathyroid glands is an effective treatment for posto perative persistent and recurrent renal hyper parathyroidism.
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Objective To investigate the expression levels of phospholipase C(PLC)-γ1 and PLC-γ2 in the peripheral blood mononuclear cells (PBMCs) of patients with systemic lupus erythematosus (SLE),and explore the relations between these genes expression levels and disease activity of SLE.Methods Reverse transcription polymerase chain reaction (RT-PCR) method was used to detect the expression levels of PLC-γ1 and PLC-γ2 in 30 patients with SLE and 25 controls.The associations between the expression levels of PLC- γ1 and PLC-γ2,complement C3,C4,antidouble stranded DNA antibody and SLEDAI scores in patients with SLE were analyzed by Pearson correlation analysis.Results ①The expression levels of PLC-γ1 and PLC-γ2 in the SLE patients were significantly higher than those of the normal controls (P＜0.01).) The expression levels of PLC-γ1 and PLC-γ2 showed positive correlations with each other (r=0.726,P＜0.01 ).③ The expression levels of PLC-γ2 were negatively correlated with serum complement C3,C4 (P＜0.05),but positively correlated with anti-double stranded DNA antibody,at the same time,they were not correlated with SLEDAI scores (P＞0.05).There was no correlation between complement C3,C4,anti-double stranded DNA antibody and the expression levels of PLC-γ1 (r=0.220,0.256,0.116,P＞0.05),but the expression levels of PLC-γ1 were positively correlated with SLEDAI scores.Conclusion We have shown that the expression levels of PLC-γ1 and PLC-γ2 is positively correlated and the PLC-γ1 and PLC-γ2 in patients with SLE are significantly higher than those of the normal controls.PLC-γ2 is negatively associated with complement C3,C4,PLC-γ1 is positively correlated with SLEDAI scores.Both PLC-γ1 and PLC-γ2 are be helpful in evaluating SLE disease activity and severity.