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Protective and therapeutic experience of perioperative safety in extremely elderly patients with biliary diseases.
Zhang, Z, Zhao, Y, Lin, F, Liu, L, Zhang, C, Liu, Z, Zhu, M, Wan, B, Deng, H, Yang, H, et al
Medicine. 2021;(21):e26159
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Abstract
To explore the protective and therapeutic measures of improving perioperative safety in extremely elderly patients with biliary diseases, so as to improve the therapeutic efficacy of surgery. A retrospective case–control study of 412 elderly patients with biliary diseases was carried out from July 2013 to July 2019. Seventy eight cases were divided into the high age (HA) group (≥80 years) and 334 into the middle–low age (MLA) group (60–79 years). In the HA compared with MLA group, 1. Preoperative coexisting diseases: the occurrence of coexisting coronary heart disease (CHD), hypertension, chronic bronchitis with emphysema, hypoproteinemia, and anemia were significantly increased; 2. Laboratory examinations: function of liver, kidneys, heart, lungs, and blood coagulation significantly declined; 3. Surgical procedures: open cholecystectomy with transcystic common bile duct (CBD) exploration significantly higher, while laparoscopic cholecystectomy significantly lower; 4. Operative effects: intraoperative blood loss, operation time, postoperative hospital stay, and length of hospitalization significantly increased or prolonged; 5. Postoperative complications: postoperative respiratory failure, pulmonary infection, anemia and electrolyte disorder significantly increased; 6. Therapeutic outcomes: no significant difference in the therapeutic effects. Although the surgical risk was significantly increased, there was no significant difference in the therapeutic efficacy in the HA compared with MLA group, suggesting that surgical treatment in extremely elderly patients with biliary diseases is safe and feasible. The key is to actively treat preoperative coexisting diseases, strictly adhere to surgical indications, reasonably select surgical procedures, precisely perform the operation, closely monitor and control intraoperative emergencies, timely prevent and treat postoperative complications, so as to improve the perioperative safety of extremely elderly patients with biliary diseases.
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Clinical effect of total thyroidectomy combined with radioactive iodine in thyroid cancer treatment.
Yin, X, Li, Z, Zhang, Z, Song, L, Wang, X
Pakistan journal of pharmaceutical sciences. 2018;(4(Special)):1675-1678
Abstract
Aim of this research work is to observe and analyze the clinical effect of total thyroidectomy combined with radioactive iodine in thyroid cancer treatment. The 120 thyroid cancer patients treated in our hospital were enrolled as study subjects and assigned to study group (treated with total thyroidectomy and radioactive iodine) and reference group (treated with conventional total thyroidectomy). The overall treatment efficacy was compared between the two groups. Comparison of overall treatment efficacy of the two groups showed that the study group has superior results to the reference group (P<0.05). Comparison of incidence of recurrent laryngeal nerve injury in the two groups revealed no significant differences, P>0.05. However, in life quality assessment, the study group was significantly superior to the reference group in terms of physiological function, psychological function, social function, and overall life quality scores, P<0.05. Total thyroidectomy combined with radioactive iodine can well improve the overall treatment efficiency and enable patients to have higher quality of life at the same time.
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[Research progress in comparison of minimally invasive versus open transforaminal lumbar interbody fusion].
Su, K, Guo, Y, Zhang, Z, Jin, D
Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery. 2013;(11):1386-9
Abstract
OBJECTIVE To review the latest comparative research of minimally invasive transforaminal lumbar interbody fusion (TLIF) and traditional open approach. METHODS The domestic and foreign literature concerning the comparative research of minimally invasive TLIF and traditional open TLIF was reviewed, then intraoperative indicators, length of hospitalization, effectiveness, complication, fusion rate, and the effect on paraspinal muscles were analyzed respectively. RESULTS Minimally invasive TLIF has less blood loss and shorter length of hospitalization, but with longer operation and fluoroscopic time. Minimally invasive surgery has the same high fusion rate as open surgery, however, its effectiveness is not superior to open surgery, and complication rate is relatively higher. In the aspect of the effect on paraspinal muscles, in creatine kinase, multifidus cross-sectional area, and atrophy grading, minimally invasive surgery has no significant reduced damage on paraspinal muscles. CONCLUSION Minimally invasive TLIF is not significantly superior to open TLIF, and it does not reduce the paraspinal muscles injury. But prospective double-blind randomized control trials are still needed for further study.