RESUMO
BACKGROUND: Robotic distal pancreatectomy exhibits short-term benefits over laparoscopic distal pancreatectomy. The use of minimal invasive techniques to carry out distal pancreatosplenectomy (DPS) for pancreatic ductal adenocarcinoma (PDAC) remains controversial and has not gained popular acceptance. A comparative study was designed to analyze the short- and mid-term outcomes of robotic DPS (RDPS) versus laparoscopic DPS (LDPS) on patients with PDAC. METHODS: The baseline characteristics, perioperative outcomes and survival data among patients who underwent RDPS (nâ¯=â¯35) versus LDPS (nâ¯=â¯35) for PDAC between December 2011 and December 2015 were compared after a 1:1 propensity score matching. RESULTS: There were no significant differences in the operative time, blood loss, blood transfusion rate, and morbidity and pancreatic fistula rates between the RDPS and LDPS groups. RDPS significantly reduced the rate of conversion to laparotomy (5.7% vs. 22.9% when compared with LDPS, pâ¯=â¯0.04). There were no significant differences in R0 resection rates, number of harvested lymph nodes, positive to harvested lymph node ratios, and disease-free survival and overall survival rates between the two groups. A Cox proportional hazards analysis showed N1 stage to be significantly associated with worse survival and suggested that chemotherapy might prolong overall survival in these PDAC patients. CONCLUSIONS: This single-center study demonstrated that RDPS was safe and efficacious in treatment of PDAC. When compared with LDPS, RDPS was associated with a reduced rate of conversion to open surgery. There were no significantly differences in oncological outcomes and mid-term survival rates between the groups of patients who underwent RDPS or LDPS.
Assuntos
Carcinoma Ductal Pancreático/mortalidade , Laparoscopia/mortalidade , Pancreatectomia/mortalidade , Neoplasias Pancreáticas/cirurgia , Procedimentos Cirúrgicos Robóticos/mortalidade , Esplenectomia/métodos , Adulto , Idoso , Transfusão de Sangue/estatística & dados numéricos , Carcinoma Ductal Pancreático/cirurgia , Conversão para Cirurgia Aberta , Feminino , Humanos , Laparoscopia/métodos , Laparotomia , Linfonodos/patologia , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Pancreatectomia/métodos , Fístula Pancreática/etiologia , Neoplasias Pancreáticas/mortalidade , Complicações Pós-Operatórias/etiologia , Pontuação de Propensão , Estudos Retrospectivos , Procedimentos Cirúrgicos Robóticos/métodos , Taxa de Sobrevida , Resultado do TratamentoRESUMO
A sketch-based image retrieval often needs to optimize the tradeoff between efficiency and precision. Index structures are typically applied to large-scale databases to realize efficient retrievals. However, the performance can be affected by quantization errors. Moreover, the ambiguousness of user-provided examples may also degrade the performance, when compared with traditional image retrieval methods. Sketch-based image retrieval systems that preserve the index structure are challenging. In this paper, we propose an effective sketch-based image retrieval approach with re-ranking and relevance feedback schemes. Our approach makes full use of the semantics in query sketches and the top ranked images of the initial results. We also apply relevance feedback to find more relevant images for the input query sketch. The integration of the two schemes results in mutual benefits and improves the performance of the sketch-based image retrieval.
RESUMO
Objective To study the anticoagulation therapy of lower molecular weight heparin in the treatment of patients with acute pancreatitis.Methods Seventy-three patients with acute pancreatitis were divided into anticoagulation group(n=38)and control group(n=35).The serological indexes and prognosis of patients were detected.Results Anticoagulation treatment with lower molecular weight heparin significantly decreased the white blood cell count,increased the oxygen partial pressure in arterial blood,shoaened the duration of hospitalization,and reduced the aggravation rate,secondary operation rate and mortality of patients with acute pancreatitis.Conclusions Anticoagulation treatment with lower molecular weight heparin is safe,effective and can improve the prognosis of patients with acute pancreatitis.