RESUMO
Background: Thyroglossal duct cyst (TGDC) is a common congenital neck mass that is the most frequent cause of neck swelling in children. The traditional open Sistrunk procedure for TGDC often leaves a visible scar on the neck. Therefore, it is essential to consider the impact of neck scarring on the quality of life for children and adolescents. Our study aimed to assess the safety and efficacy of robotic TGDC resection using the bilateral axillo-breast approach (BABA) in adolescents. Case Description: A 16-year-old female patient presented with a neck mass (no pain or redness) that had been present for 3 years. The palpable neck mass moved with swallowing and there was no history of other significant medical conditions. An ultrasound scan of the neck indicated a weak hypoechoic area in the thyrohyoid region measuring 29 mm × 20 mm. Additionally, the ultrasonography of the thyroid gland showed no obvious abnormalities. A computer tomography (CT) scan confirmed a low-density lesion on the right hyoid bone, measuring 27 mm × 18 mm × 26 mm, consistent with a TGDC. We successfully performed a BABA robotic TGDC resection on the 16-year-old female adolescent who had a strong desire for scar-free surgery. Conclusions: BABA robotic TGDC resection could achieve the same surgical effect as conventional open surgery while providing better cosmetic outcomes, which are essential for the physical and mental well-being of teenagers. Therefore, BABA robotic TGDC resection may be a safe and feasible treatment option with excellent cosmetic results in adolescents.
RESUMO
In order to effectively address the issue of severe soil salinization in the coastal area of the Yellow River Delta, which has led to a significant number of medium and low-yield fields in this region, and to satisfy the rising demand for feed grain in China in recent years, a highly effective solution is to replace conventional crops by cultivating a specialized type of forage grass that can withstand high salinity levels and is well adapted to the local climate. This study proposed a spatial layout scheme for planting salt-tolerant forages, with the aim of providing a foundation for enhancing saline-alkali land and increasing resource utilization efficiency. The results showed that the climate conditions in the Yellow River Delta were suitable for planting sweet sorghum. With respect to soil salt content, the suitable planting regions for sweet sorghum can be classified into four categories: Suitable, moderately suitable, less suitable, and unsuitable, with soil salt concentrations of 2.62-5.25‱, 5.25-7.88‱, respectively. Concerning economic benefits, sweet sorghum's input-output ratio (74.4%) surpasses that of cotton in high saline-alkali zones, providing a significant advantage in comparison with traditional crops. In non-saline-alkali and light saline-alkali areas, the traditional winter wheat-summer maize planting system offers higher economic benefits and nitrogen use efficiency, so it is recommended to maintain this system as the dominant agricultural model. In moderately and severe saline-alkali zones, although one-season maize exhibits greater nitrogen efficiency, its economic benefits are lower than those of sweet sorghum. Hence, it is advisable to promote one-season maize in suitable regions and introduce salt-tolerant forage, such as sweet sorghum in other areas. This approach offers novel ideas and methods for crop spatial layout planning and addresses potential feed grain shortages in the region.
RESUMO
Background: Operations for pediatric thyroid nodules are more complicated, and usually lead to longer scars, which may impair life quality in the long term. Bilateral axillo-breast approach robotic thyroidectomy (BABA RT) may provide a better alternative to conventional open thyroidectomy (COT) for pediatric thyroid nodules. Our study aimed at comparing the surgical and oncological outcomes of BABA RT and COT in pediatric patients. Methods: The data of 49 pediatric patients who consecutively underwent BABA RT or COT (20:29) between July 1998 and November 2021 in our center were retrospectively analyzed, including demographics, surgery extent, surgical outcomes, pathological characteristics, and oncological outcomes. Results: All BABA RT procedures were completed successfully without conversion to open operation. The BABA RT group consisted of 5 benign and 15 malignant cases, while the COT group consisted of 19 benign and 10 malignant cases. The operation time, drain removal time, and number of lymph nodes harvested by central lymph node dissection or lateral lymph node dissection were equivalent in the BABA RT and COT groups. Notably, the postoperative hospital stay of the BABA RT group was shorter than that of the COT group (8.5 [interquartile ranges (IQRs): 3] vs. 11 [IQR: 8] days, p = 0.008). The aesthetic score of the BABA RT group was much higher than that of the COT group (9 [IQR: 1] vs. 6 [IQR: 1], p < 0.001). There was no significant difference between the BABA RT and COT groups in hypoparathyroidism rate (transient, 5 vs. 4; permanent, 1 vs. 0). There was one case of chyle leakage in the COT group and no other complications in any group, such as recurrent laryngeal nerve injury. With a median follow-up of 101 (IQR: 189) months, one case of local relapse and one case of pulmonary metastasis in the COT group were documented. Conclusion: In the hands of experienced surgeons, robotic BABA thyroidectomy can be a safe and effective option for both benign and malignant thyroid nodules in children, including those with lymph node metastasis. Robotic BABA thyroidectomy can offer a better and faster postoperative course and a much better cosmetic result, which is crucial for pediatric thyroid patients.
