Objective:To evaluate the clinical effect of full femtosecond laser surgery in the treatment of myopia patients.Methods:120 myopia patients admitted to our hospital from January 2022 to June 2023 were selected.Accordi...Objective:To evaluate the clinical effect of full femtosecond laser surgery in the treatment of myopia patients.Methods:120 myopia patients admitted to our hospital from January 2022 to June 2023 were selected.According to the random number table method,60 patients in the observation group underwent full femtosecond laser surgery,and 60 patients in the control group underwent femtosecond laser-assisted in situ keratomileusis(FS-LASIK)surgery.The clinical effects of the two groups were compared.Results:10 days postoperatively and 6 months after operation,the visual acuity level of the observation group was higher than that of the control group,the postoperative corneal asphericity coefficient and corneal full-thickness were lower than those of the control group,and the total effective rate 6 months after operation was higher than that of the control group(P<0.05).Conclusion:Full femtosecond laser surgical treatment can improve the postoperative visual acuity of patients with myopia,enhance the corneal asphericity coefficient(Q)and corneal full-thickness,and exert significant clinical effects.展开更多
Objective: This study aims to investigate the drainage effect and clinical outcomes of negative pressure chest drainage in patients after two-port thoracoscopic valve surgery, comparing the differences in postoperativ...Objective: This study aims to investigate the drainage effect and clinical outcomes of negative pressure chest drainage in patients after two-port thoracoscopic valve surgery, comparing the differences in postoperative pain, hospital stay, and other factors between the negative pressure group and the control group. Methods: This study is a prospective controlled trial that selected patients undergoing two-port thoracoscopic valve surgery at a certain hospital from January 2019 to December 2024. Patients were randomly assigned to the control group and the negative pressure group using a random number table method. The control group consisted of 30 patients (20 males, 10 females, mean age 42.03 ± 12.89 years), and the negative pressure group consisted of 35 patients (26 males, 9 females, mean age 41.84 ± 11.83 years). The control group received traditional chest drainage, while the negative pressure group received negative pressure chest drainage. Postoperative pain scores, hospital stay, drainage time, number of tube blockages, and incidences of pneumothorax or subcutaneous emphysema were recorded and statistically analyzed. Results: The negative pressure group had a significantly shorter postoperative drainage time compared to the control group (49.09 ± 11.99 hours vs. 79.10 ± 7.32 hours, P < 0.001). The postoperative pain score was lower in the negative pressure group (4.49 ± 1.27 vs. 7.03 ± 0.85, P < 0.001), and the hospital stay was significantly shorter (9.83 ± 1.69 days vs. 14.73 ± 2.32 days, P < 0.001). The incidence of pneumothorax or subcutaneous emphysema was significantly lower in the negative pressure group than in the control group (14.29% vs. 56.67%, P = 0.0003). Conclusion: The application of negative pressure chest drainage in patients after two-port thoracoscopic valve surgery can effectively reduce postoperative pain, shorten hospital stay, and lower the incidence of tube blockage and pneumothorax, demonstrating good clinical outcomes.展开更多
This article provides a detailed account of the diagnosis and treatment of a case involving a uterine artery pseudoaneurysm(UAP),as well as an analysis of UAP etiology.This finding emphasizes that UAP should be consid...This article provides a detailed account of the diagnosis and treatment of a case involving a uterine artery pseudoaneurysm(UAP),as well as an analysis of UAP etiology.This finding emphasizes that UAP should be considered in patients presenting with abnormal genital bleeding after hysteroscopy and offers valuable insights and lessons for gynecologists in hysteroscopic procedures.The patient underwent timely relevant examinations to confirm the diagnosis,allowing for crucial time required for her treatment.In this study,the primary cause of UAP formation in the patient was attributed to a prior hysteroscopic surgical procedure conducted at another medical facility,suggesting that the selection and imple-mentation of dilatation catheters are some of the predisposing factors for UAP.In conclusion,this case study offers a comprehensive analysis of the etiology of UAP and effectively provides timely diagnosis and treatment,offering valuable in-sights for the clinical diagnosis and management of UAP.展开更多
Introduction: Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS) is a sleep-related breathing disorder characterized by repeated episodes of partial obstruction of the upper airways (hypopnea) and/or intermittent compl...Introduction: Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS) is a sleep-related breathing disorder characterized by repeated episodes of partial obstruction of the upper airways (hypopnea) and/or intermittent complete obstruction (apnea). Our aim is to study the role of adeno-tonsillectomy in the management of OSAHS in children. Methodology: This was a prospective descriptive study conducted in the ENT-Head and Neck Surgery department of Ignace Deen National Hospital over a six-month period. We included in our study all patients aged 0 to 15 years, presenting with OSAHS of ENT etiology and who had undergone tonsillectomy/adenoidectomy. Results: The frequency of OSAHS was 13%. The mean age of our patients was 5.1 ± 3.8 years. There was a predominance of males (69.6%) with a sex ratio of 2.28. Snoring (98.6%), nasal obstruction (97.1%), and mouth breathing (96.6%) were the main reasons for consultation. Adeno-tonsillectomy (45.4%) was the primary surgical intervention. Almost all children (99.0%) had a simple postoperative course. Conclusion: OSAHS is a condition with a multifactorial etiology. Adeno-tonsillectomy remains the first-line surgical treatment to prevent severe complications and relieve the patient. Multidisciplinary collaboration is essential in the management of OSAHS.展开更多
Background: Laparoscopic surgery has many advantages among which are, decrease post operatory pain and complications. It’s practice in the capital of Cameroon is still a luxury and it is almost non-existent in periph...Background: Laparoscopic surgery has many advantages among which are, decrease post operatory pain and complications. It’s practice in the capital of Cameroon is still a luxury and it is almost non-existent in peripheral zones. The aim of this study is to present the results of the first laparoscopy surgeries done at the Yokadouma district hospital located in the east region at 600 km from Yaoundé. Methods: This is a descriptive prospective study carried out from march 2020 to march 2021 in the general surgery department of the Yokadouma district hospital. Patients operated by laparoscopy during this period were included in the study giving a sample size of 40 patients. The data collected were analyzed by “Census software and Survey Processing System” (CSPRO). Results: Majority of patients, 57.5% were males and aged between 16 and 30 years (32.5% of cases). Most patients (30% of patients) were farmers. Transabdominal preperitoneal prosthesis plasty for hernia represented 55% of interventions followed by appendicectomy (15%) and cholecystectomy (7.5%). Two procedures (0.8%) required conversion into open surgery. Post-operative complications were very rare and were encountered just by one patient who presented a parietal suppuration. Interventions in 77% of cases cost less than 200,000 CFA FRANCS (400$). Conclusion: The example of Yokadouma shows that laparoscopy should be developed in peripheral zones so that its residents can benefit from its multiple advantages.展开更多
Bariatric and metabolic surgeries have gained extensive popularity and trust due to their documented efficacy and safety in managing not only obesity but also associated comorbidities such as diabetes mellitus, hypert...Bariatric and metabolic surgeries have gained extensive popularity and trust due to their documented efficacy and safety in managing not only obesity but also associated comorbidities such as diabetes mellitus, hypertension, dyslipidemia, sleep apnea, and joint pain. Traditionally, bariatric surgeries have been categorized into hypoabsorptive, restrictive, or hybrid approaches. However, these classifications inadequately reflect the complex anatomical and physiological alterations associated with modern surgical methodologies. This paper explores the evolution of metabolic surgeries, emphasizing the integration of physiological concepts into classic procedures to provide more tailored and effective treatment options for obesity and its comorbidities. Finally, the proposal for a new classification based on current metabolic concepts will facilitate communication among patients, doctors, and healthcare professionals. Additionally, it will enable a more didactic and standardized approach to data collection for conducting studies and publications.展开更多
BACKGROUND Cauda equina syndrome(CES)is characterized by a group of symptoms that may be caused by inflammation,spinal cord compression,venous congestion,or ischemia.This syndrome is commonly an indication for surgica...BACKGROUND Cauda equina syndrome(CES)is characterized by a group of symptoms that may be caused by inflammation,spinal cord compression,venous congestion,or ischemia.This syndrome is commonly an indication for surgical intervention but has not been determined as a postoperative complication following surgery for lumbar spine disease.CASE SUMMARY To report the case of a 54-year-old male patient who had CES following spinal surgery,with no obvious compression lesions found during re-exploration,suggesting that vascular insufficiency may have contributed to the condition.Furthermore,a series of urodynamic studies on bladder recovery patterns in such complications have also been investigated.CONCLUSION Postoperative CES requires urgent imaging and exploration to rule out compression;noncompressive cases,including vascular insufficiency may performed conservative management.展开更多
Background: In developing countries, charity cleft surgical mission is always operated by sporadic surgical teams without systematic follow up and quality assurance. In the past few decades, many mission projects have...Background: In developing countries, charity cleft surgical mission is always operated by sporadic surgical teams without systematic follow up and quality assurance. In the past few decades, many mission projects have been held regularly in China. The purpose of this audit was a retrospective analysis of a 9-year cleft lip and palate charity project operated in a tertiary hospital in China Shenzhen Area to evaluate perioperative and postoperative complications. Nevertheless, understanding the risk profile is essential for establishing a sustainable in-house cleft service in Shenzhen. Methods: A detailed analysis of hospital centralized record in the The University of Hong Kong-Shenzhen Hospital (HKUSZH) was reviewed since the first charity project held in 2015. The parameters of this audit were focused on perioperative complications including anesthesia related problems, early postoperative complications in patients who underwent primary or secondary cleft surgeries. A total of 430 consecutive admitted cases of 311 non-syndromic cleft lip & palate patients were enrolled into the charity project from June 2015 to July 2024. The main anesthesia related complications that occurred during general anesthesia were respiratory tract problems, while intraoperative complication was excessive bleeding, so as wound local infection and reaction were the main early postoperative complications. Results: In our 9-year clinical audit of 430 cleft lip and palate charity surgeries in Shenzhen, we observed no mortalities and a anesthesia-related complication rate of 1.16%. Specific intraoperative complications included excessive bleeding, while early postoperative issues were dominated by wound infections. The fistula rate of 18.7% post palate repair and the average hospital stay of 3.71 days complete the profile of our surgical outcomes. These data underscore the project’s efficacy and offer a reference for international cleft missions aiming for safe and efficient surgical care. Conclusions: This study provides a thorough data review of the complications in the past 9 years charity missions for cleft lip and palate surgery in a well-structured hospital infrastructure and logistic support by local surgical team. There were no perioperative or postoperative death during the study period and the overall short-term complication rate was low. Therefore, it could be a reference model for other international cleft mission in developing country for a safe and efficient service in future.展开更多
Background: Missions organized by international societies and humanitarian organizations play a significant role in saving many patients’ lives and improving their quality of life, despite the surrounding frustrating...Background: Missions organized by international societies and humanitarian organizations play a significant role in saving many patients’ lives and improving their quality of life, despite the surrounding frustrating conditions. Methods: A team of plastic surgery volunteers was sent to Yemen by the KSHARC. Results: A successful mission was performed on 62 patients who underwent surgery, with more than 900 patients examined and receiving appropriate medications. Conclusion: Missions in disaster-affected areas are of great importance. The role of missions and humanitarian organizations should be empowered.展开更多
BACKGROUND Odontogenic maxillary sinusitis,often triggered by dental issues like periapical periodontitis,significantly contributes to chronic sinusitis,mainly affecting adults around 50 years old,emphasizing the need...BACKGROUND Odontogenic maxillary sinusitis,often triggered by dental issues like periapical periodontitis,significantly contributes to chronic sinusitis,mainly affecting adults around 50 years old,emphasizing the need for a multidisciplinary diagnostic and treatment approach.AIM To investigate the therapeutic effect and clinical value of root canal therapy combined with nasal endoscopic surgery compared with simple root canal the-rapy in the treatment of severe odontogenic maxillary sinusitis caused by peria-pical periodontitis.METHODS The clinical data,diagnosis,and treatment of 200 patients with severe odonto-genic maxillary sinusitis caused by periapical periodontitis from October 2020 to October 2021 were analyzed retrospectively.Among them,63 patients were treated with simple root canal therapy as the control group,and 137 patients were treated with root canal therapy combined with nasal endoscopic surgery as the observation group.The therapeutic effect,Lund-Kennedy endoscopic score,paranasal sinus Lund-Mackay score,complication rate,recurrence rate,and patient satisfaction were compared between the two groups.RESULTS First,we compared the effective rates:23 cases were cured,22 were improved,and 8 were ineffective in the control group,yielding a total effective rate of 84.90%.Meanwhile,97 cases were cured,34 improved,and 6 were ineffective in the observation group,resulting in a total effective rate of 95.62%.The observation group had a higher total effective rate compared with the control group(P<0.05).Second,we compared the Lund–Kennedy endoscopic score.Before treatment,no significant difference(P>0.05)was observed in this score between the two groups.After treatment,the Lund–Kennedy endoscopic score decreased in both groups.The Lund–Kennedy endoscopic score of the observation group at 3 and 6 mo after treatment was lower compared to that of the control group(P<0.05).Third,we compared the Lund–Mackay score of paranasal sinuses.Before treatment,there was no significant difference in this score between the two groups(P>0.05).After treatment,the Lund–Mackay scores of paranasal sinuses decreased in both groups.The Lund–Mackay scores of paranasal sinuses in the observation group at 3 and 6 mo after treatment were lower compared to those of the control group(P<0.05).Fourth,we compared the incidence and recurrence rate of complications.Three months after treatment,no significant difference was found in the incidence and recurrence rate of complications between the observation group(6.56%)and the control group(9.52%)(P>0.05).However,6 mo after treatment,the incidence and recurrence rate of complications in the observation group(2.91%)was significantly higher compared to that of the control group(12.69%)(P<0.05).Fifth,we compared patient satisfaction.Six months after treatment,the patient satisfaction of the observation group(93.43%)was significantly better than that of the control group(84.12%)(P<0.05).CONCLUSION Root canal therapy combined with nasal endoscopic surgery has a good therapeutic effect on severe odontogenic maxillary sinusitis caused by periapical periodontitis,and it can reduce the injury of maxillary sinus mucosa and bone,and significantly reduce the incidence of complications and recurrence rate.Meanwhile,it has high patient satisfaction and remarkable therapeutic effect,which is suggested to be popularized and applied in clinic.展开更多
Background: The tricuspid annular plane systolic excursion (TAPSE) and pulmonary artery systolic pressure (PASP) is an indirect estimate of right ventricular-pulmonary arterial (RV-PA) coupling that has been shown to ...Background: The tricuspid annular plane systolic excursion (TAPSE) and pulmonary artery systolic pressure (PASP) is an indirect estimate of right ventricular-pulmonary arterial (RV-PA) coupling that has been shown to correlate with invasive measures. We aimed to assess the ability of the tricuspid annular plane systolic excursion/pulmonary systolic pressure ratio (TAPSE/PASP) as a measure for RV-PA coupling to predict the development of RV dysfunction after cardiac surgery. Methods: This prospective study was conducted on 100 patients with ischemic heart disease and undergoing cardiac surgery (coronary artery bypass graft (CABG)) with normal preoperative right ventricular function, classified according to RV function outcomes into 2 groups: Normal RV group (65 patients) and RV dysfunction group (35 patients). All cases underwent per and postoperative transthoracic echocardiography. Results: By using receiver operating characteristic curve analysis, pre-operative TAPSE/PASP ratio could significantly predict the RV dysfunction (P 0.58, with AUC of 94%, 88.6% sensitivity, and 89.2% specificity. Post-operative TAPSE/PASP Ratio could significantly predict the RV dysfunction (P 0.39, with AUC of 84%, 100% sensitivity, and 76.9% specificity. Pre-operative TAPSE/PASP ratio could significantly predict mortality (P Conclusion: The TAPSE/PASP ratio is an excellent tool for CABG patients for its ability to detect and predict the development of RV dysfunction after cardiac surgery, along with the prediction of mortality in post-operative CABG patients.展开更多
Objective: Erector spinae plane block is a novel regional anaesthetic intervention that is said to have an effective analgesic profile in the upper abdominal region. We compared its analgesic efficacy with thoracic ep...Objective: Erector spinae plane block is a novel regional anaesthetic intervention that is said to have an effective analgesic profile in the upper abdominal region. We compared its analgesic efficacy with thoracic epidural block for upper abdominal cancer surgeries. Methods: This prospective study included 60 patients, 18 to 65 years old with ASA class II who underwent gastrectomy and Whipple’s procedures under general anesthesia. Patients were assigned into two groups: Thoracic epidural group, with injection of 0.1 ml/kg of bupivacaine 0.25% in epidural catheter followed by 0.1 ml/kg/h of 0.125% bupivacaine infusion for 48 hrs., and Erector spinae group, with insertion of bilateral erector spinae catheters to inject 0.1 ml/kg of bupivacaine 0.25% followed by bilateral infusion of 0.1 ml/kg/h of bupivacaine 0.125% for 48 hrs. The primary endpoint was postoperative VAS scores at rest and movement. Secondary endpoint included postoperative total opioid consumption, 1st request for analgesia, hemodynamic changes and satisfaction scores. Results: Pain scores and needed rescue analgesia in both groups were comparable. However, 1st request for opioid was significantly longer in TEPI compared to ESI group. Hemodynamics were significantly lower in TEPI group with no differences in the incidence of postoperative complications except for hypotension. Patient satisfaction scores were arbitrarily higher in ESI group without significance. Conclusion: Erector spinae infusion is a highly promising regional technique with comparable effects to thoracic epidural blockade in reducing pain and opioid needs while causing minimal hemodynamic consequences.展开更多
AIM:To evaluate the effects of microlens design of peripheral defocus modifying spectacle lenses(PDMSLs)and non-microlens design of PDMSLs on controlling myopia progression in children and adolescents.METHODS:A system...AIM:To evaluate the effects of microlens design of peripheral defocus modifying spectacle lenses(PDMSLs)and non-microlens design of PDMSLs on controlling myopia progression in children and adolescents.METHODS:A systematic search was carried out in the PubMed,Cochrane Library,Embase,CNKI,and Web of Science databases.The search targeted randomized controlled trials(RCTs)and cohort studies(CTs)that explored the effects of PDMSLs on myopia control among children and adolescents.The Cochrane risk-of-bias tool and the Newcastle-Ottawa Scale were employed to evaluate the risk of bias in the included studies.The published biases of the included studies were evaluated using Egger’s test.RESULTS:Nine studies(7 RCTs,2 CTs)were included,involving 4332 participants in the PDMSLs group and 7317 participants in the single vision lenses(SVLs)group.Metaanalysis showed that PDMSLs with microlens design had lower change in spherical equivalent refraction(SER)than SVLs at 6,12,18,and 24mo after wearing glasses,with reductions of 0.19 D(95%CI:0.14 to 0.24,P<0.00001),0.36 D(95%CI:0.25 to 0.46,P<0.00001),0.43 D(95%CI:0.32 to 0.55,P<0.00001),and 0.51 D(95%CI:0.33 to 0.69,P<0.00001),respectively.The changes in axial length(AL)were also lower in PDMSLs compared to SVLs,with reductions of-0.09 mm(95%CI:-0.13 to-0.04,P=0.0002),-0.15 mm(95%CI:-0.21 to-0.08,P<0.00001),-0.27 mm(95%CI:-0.34 to-0.20,P<0.00001),and-0.29 mm(95%CI:-0.38 to-0.20,P<0.00001),respectively.There was no significant difference between the non-microlens group and SVLs in controlling the changes of SER and AL in myopia(both P>0.05).CONCLUSION:The synthesized evidence indicates superior myopia management outcomes with microlens design of PDMSLs compared to both SVLs and nonmicrolens design of PDMSLs in children and adolescents.展开更多
Pulmonary embolism(PE)is a rare but devastating complication of shoulder surgery.Apart from increased morbidity and mortality rates,it may significantly impair postoperative recovery and functional outcome.Its frequen...Pulmonary embolism(PE)is a rare but devastating complication of shoulder surgery.Apart from increased morbidity and mortality rates,it may significantly impair postoperative recovery and functional outcome.Its frequency accounts for up to 5.7%of all shoulder surgery procedures with a higher occurrence in women and patients older than 70 years.It is most commonly associated with thrombophilia,diabetes mellitus,obesity,smoking,hypertension,and a history of malignancy.PE usually occurs secondary to upper or lower-extremity deep vein thrombosis(DVT).However,in rare cases,the source of the thrombi cannot be determined.Prophylaxis for PE following shoulder surgery remains a topic of debate,and the standard of care does not routinely require prophylactic medication for DVT prophylaxis.Early ambulation and elastic stockings are important preventative measures for DVT of the lower extremity and medical agents such as aspirin,low-molecular-weight heparin,and vitamin K antagonists are indicated for high-risk patients,long-lasting operations,or concomitant severe acute respiratory syndrome coronavirus 2 infection.The most common symptoms of PE include chest pain and shortness of breath,but PE can also be asymptomatic in patients with intrinsic tolerance of hypoxia.Patients with DVT may also present with swelling and pain of the respective extremity.The treatment of PE includes inpatient or outpatient anticoagulant therapy if the patient is hemodynamically unstable or stable,respectively.Hemodynamic instability may require transfer to the intensive care unit,and cardiovascular arrest can be implicated in fatal events.An important issue for patients with PE in the postoperative period after shoulder surgery is residual stiffness due to a delay in rehabilitation and a prolonged hospital stay.Early physiotherapy and range-of-motion exercises do not adversely affect the prognosis of PE and are highly recommended to preserve shoulder mobility and function.展开更多
As cataract surgery progresses from “restoration of sight” to “refractive correction”, precise prediction of intraocular lens (IOL) power is critical for enhancing postoperative visual quality in patients. IOL pow...As cataract surgery progresses from “restoration of sight” to “refractive correction”, precise prediction of intraocular lens (IOL) power is critical for enhancing postoperative visual quality in patients. IOL power calculation methods have evolved and innovated throughout time, from early theoretical and regression formulas to nonlinear formulas for estimating effective lens position (ELP), multivariable formulas, and innovative formulas that use optical principles and AI-based online formulas. This paper thoroughly discusses the development and iteration of traditional IOL calculation formulas, the emergence of new IOL calculation formulas, and the selection of IOL calculation formulas for different patients in the era of refractive cataract surgery, serving as a reference for “personalized” IOL implantation in clinical practice.展开更多
BACKGROUND Although the 2021 Chinese Clinical Practice Guidelines for Enhanced Recovery after Surgery(ERAS)provide recommendations for ERAS in gastrointestinal surgery,the clinical application of standard ERAS nursing...BACKGROUND Although the 2021 Chinese Clinical Practice Guidelines for Enhanced Recovery after Surgery(ERAS)provide recommendations for ERAS in gastrointestinal surgery,the clinical application of standard ERAS nursing models is challenging due to the variety of diseases involved in gastrointestinal surgery and the com-plex factors contributing to patient stress responses.Moreover,stress responses are more severe in older adult patients.Therefore,precision medicine is required to improve the quality of nursing care and promote postoperative recovery in gastrointestinal surgery.and demonstrate nursing benefits through clinical practice.METHODS This randomized clinical trial first established an evidence-based nursing ERAS protocol in older adult patients based on literature related to perioperative nursing measures for gastrointestinal surgery stress response.Next,392 older adult patients who underwent gastrointestinal surgery and were admitted to our hospital between December 2021 and June 2023 were categorized into two groups to receive evidence-based(study group)or conventional(control group)ERAS nursing models,respectively.Intraoperative physiological parameters during surgery and postoperative recovery indicators were compared between the groups.RESULTS Among 64 domestic and international studies,the stress responses of older adult patients mainly included emotional anxiety,sleep disorders,gastrointestinal discomfort,physical weakness,pain,and swelling.The appropriate nursing interventions included comprehensive psychological counseling,pre-and postoperative nutritional support,temperature control,pain management,and rehabilitation training.Compared with the control group,the study group showed lower heart rate,mean arterial pressure,blood glucose level,and adrenaline level;shorter duration of drainage tube placement,time to first flatus,time to first ambulation,and postoperative hospital stay;lower anxiety scores on postoperative day 3;and lower incidences of postoperative infection,obstruction,poor wound healing,and gastrointestinal reactions were lower in the study group(all P<0.05).CONCLUSION The evidence-based nursing measures targeting stress responses based on the conventional ERAS nursing model resulted in stable intraoperative physiological parameters during surgery,promoted postoperative recovery,and reduced the incidence of complications.展开更多
In 2024,Laparoscopic,Endoscopic and Robotic Surgery(LERS)published 39 impactful articles in the area of minimally invasive surgery.The achievements of LERS are crucially dependent on the tremendous effort and valuable...In 2024,Laparoscopic,Endoscopic and Robotic Surgery(LERS)published 39 impactful articles in the area of minimally invasive surgery.The achievements of LERS are crucially dependent on the tremendous effort and valuable contributions of peer reviewers.On behalf of the Editorial Board and Editorial Office,we would especially like to thank the following excellent reviewers who have made time within their busy schedules to review manuscripts and delivered insightful and constructive comments.展开更多
Introduction: Cardiac rehabilitation is defined as a comprehensive, multidisciplinary approach to secondary prevention. Its main components include patient assessment (exercise capacity, ventricular function and the e...Introduction: Cardiac rehabilitation is defined as a comprehensive, multidisciplinary approach to secondary prevention. Its main components include patient assessment (exercise capacity, ventricular function and the existence or risk of arrhythmias), therapeutic education and control of cardiovascular risk factors, optimization of drug therapy, psychosocial support and, of course, personalized physical training. Method: The Basse Terre hospital department served as the setting for this study. All patients admitted to the department for cardiac rehabilitation were our target population. All patients operated on and admitted to the cardiology department for cardiac rehabilitation constituted our study population. A pre-established survey form and patient records were used to collect data. Ethical principles and patient confidentiality were paramount. Results: The prevalence was 13%. The mean age of our patients was 59.66 ± 12.9 years. Valve replacement was 25%;coronary artery bypass grafting was 75%;Kardégic 83.33%, CHBT protocol 83.33%, muscle fatigue 66.66%. 58.33% had 3 - 8 Watts at initial assessment and ≥15 Watts at final assessment. 8.33% atrial dilatation, and 16.66% segmental hypokinesia. 8.33% VO2 and ESV and Q necrosis. Conclusion: Exercise testing is a reliable means of assessing patients’ functional capacity.展开更多
BACKGROUND Thirst management in convalescent patients recovering from a digestive surgery performed under general anesthesia requires attention.A simple,practical,and safe method can effectively relieve thirst symptom...BACKGROUND Thirst management in convalescent patients recovering from a digestive surgery performed under general anesthesia requires attention.A simple,practical,and safe method can effectively relieve thirst symptoms in such patients.AIM To evaluate the enhanced recovery after surgery(ERAS)-based evidence-based care(EBC)plus ice stimulation therapy for thirst management of convalescent patients following digestive surgery performed under general anesthesia.METHODS A total of 191 patients convalescing after digestive surgery performed under general anesthesia between March 2020 and February 2023 and experiencing thirst were selected.In total,89 patients and 102 patients in the control and research groups received routine care and ERAS-based EBC plus ice stimulation therapy,respectively.The following data were comparatively analyzed:(1)Thirst degree(thirst intensity numerical rating scale)and thirst distress(TD)degree(TD scale);(2)Oral mucosal wetness;(3)Unstimulated whole salivary flow rate(UWSFR);(4)Adverse reactions(palpitation,fatigue,chapped lips,and nausea and vomiting);and(5)Nursing satisfaction.RESULTS After nursing,thirst degree and distress were statistically lower in the research group than in the control group.Additionally,compared with the control group,the research group exhibited a lower degree of oral mucosal wetness,higher UWSFR,fewer adverse reactions,and more total nursing satisfaction.CONCLUSION ERAS-based EBC plus ice stimulation therapy can effectively alleviate thirst in convalescent patients recovering from a digestive surgery performed under general anesthesia.It can alleviate xerostomia symptoms,reduce adverse reactions,and improve patient comfort.展开更多
To the Editor:We read with great interest the recent article by Balci et al.[1].In the study,the authors mentioned that their mixed reality(MR)technology has already successfully been applied in open and laparoscopic ...To the Editor:We read with great interest the recent article by Balci et al.[1].In the study,the authors mentioned that their mixed reality(MR)technology has already successfully been applied in open and laparoscopic living donor hepatectomy and in complex laparoscopic liver resections.During such operations,the MR models of the liver are pulled out and superimposed onto the actual organ.Surgeons can verify the relationship between tumors and crucial areas in order to enhance margin clearance and R0 resection and reduce the risk of injuring major blood vessels.By applying MR(including augmented reality)technology,blood vessels and tumor structures in the liver can be displayed during surgery,which permits precise navigation during complex surgical procedures.Also MR was used in surgical education,and most learners believed that 3D models were useful in planning safer surgical paths,reducing intraoperative complications and training of young surgeons[2].展开更多
文摘Objective:To evaluate the clinical effect of full femtosecond laser surgery in the treatment of myopia patients.Methods:120 myopia patients admitted to our hospital from January 2022 to June 2023 were selected.According to the random number table method,60 patients in the observation group underwent full femtosecond laser surgery,and 60 patients in the control group underwent femtosecond laser-assisted in situ keratomileusis(FS-LASIK)surgery.The clinical effects of the two groups were compared.Results:10 days postoperatively and 6 months after operation,the visual acuity level of the observation group was higher than that of the control group,the postoperative corneal asphericity coefficient and corneal full-thickness were lower than those of the control group,and the total effective rate 6 months after operation was higher than that of the control group(P<0.05).Conclusion:Full femtosecond laser surgical treatment can improve the postoperative visual acuity of patients with myopia,enhance the corneal asphericity coefficient(Q)and corneal full-thickness,and exert significant clinical effects.
文摘Objective: This study aims to investigate the drainage effect and clinical outcomes of negative pressure chest drainage in patients after two-port thoracoscopic valve surgery, comparing the differences in postoperative pain, hospital stay, and other factors between the negative pressure group and the control group. Methods: This study is a prospective controlled trial that selected patients undergoing two-port thoracoscopic valve surgery at a certain hospital from January 2019 to December 2024. Patients were randomly assigned to the control group and the negative pressure group using a random number table method. The control group consisted of 30 patients (20 males, 10 females, mean age 42.03 ± 12.89 years), and the negative pressure group consisted of 35 patients (26 males, 9 females, mean age 41.84 ± 11.83 years). The control group received traditional chest drainage, while the negative pressure group received negative pressure chest drainage. Postoperative pain scores, hospital stay, drainage time, number of tube blockages, and incidences of pneumothorax or subcutaneous emphysema were recorded and statistically analyzed. Results: The negative pressure group had a significantly shorter postoperative drainage time compared to the control group (49.09 ± 11.99 hours vs. 79.10 ± 7.32 hours, P < 0.001). The postoperative pain score was lower in the negative pressure group (4.49 ± 1.27 vs. 7.03 ± 0.85, P < 0.001), and the hospital stay was significantly shorter (9.83 ± 1.69 days vs. 14.73 ± 2.32 days, P < 0.001). The incidence of pneumothorax or subcutaneous emphysema was significantly lower in the negative pressure group than in the control group (14.29% vs. 56.67%, P = 0.0003). Conclusion: The application of negative pressure chest drainage in patients after two-port thoracoscopic valve surgery can effectively reduce postoperative pain, shorten hospital stay, and lower the incidence of tube blockage and pneumothorax, demonstrating good clinical outcomes.
文摘This article provides a detailed account of the diagnosis and treatment of a case involving a uterine artery pseudoaneurysm(UAP),as well as an analysis of UAP etiology.This finding emphasizes that UAP should be considered in patients presenting with abnormal genital bleeding after hysteroscopy and offers valuable insights and lessons for gynecologists in hysteroscopic procedures.The patient underwent timely relevant examinations to confirm the diagnosis,allowing for crucial time required for her treatment.In this study,the primary cause of UAP formation in the patient was attributed to a prior hysteroscopic surgical procedure conducted at another medical facility,suggesting that the selection and imple-mentation of dilatation catheters are some of the predisposing factors for UAP.In conclusion,this case study offers a comprehensive analysis of the etiology of UAP and effectively provides timely diagnosis and treatment,offering valuable in-sights for the clinical diagnosis and management of UAP.
文摘Introduction: Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS) is a sleep-related breathing disorder characterized by repeated episodes of partial obstruction of the upper airways (hypopnea) and/or intermittent complete obstruction (apnea). Our aim is to study the role of adeno-tonsillectomy in the management of OSAHS in children. Methodology: This was a prospective descriptive study conducted in the ENT-Head and Neck Surgery department of Ignace Deen National Hospital over a six-month period. We included in our study all patients aged 0 to 15 years, presenting with OSAHS of ENT etiology and who had undergone tonsillectomy/adenoidectomy. Results: The frequency of OSAHS was 13%. The mean age of our patients was 5.1 ± 3.8 years. There was a predominance of males (69.6%) with a sex ratio of 2.28. Snoring (98.6%), nasal obstruction (97.1%), and mouth breathing (96.6%) were the main reasons for consultation. Adeno-tonsillectomy (45.4%) was the primary surgical intervention. Almost all children (99.0%) had a simple postoperative course. Conclusion: OSAHS is a condition with a multifactorial etiology. Adeno-tonsillectomy remains the first-line surgical treatment to prevent severe complications and relieve the patient. Multidisciplinary collaboration is essential in the management of OSAHS.
文摘Background: Laparoscopic surgery has many advantages among which are, decrease post operatory pain and complications. It’s practice in the capital of Cameroon is still a luxury and it is almost non-existent in peripheral zones. The aim of this study is to present the results of the first laparoscopy surgeries done at the Yokadouma district hospital located in the east region at 600 km from Yaoundé. Methods: This is a descriptive prospective study carried out from march 2020 to march 2021 in the general surgery department of the Yokadouma district hospital. Patients operated by laparoscopy during this period were included in the study giving a sample size of 40 patients. The data collected were analyzed by “Census software and Survey Processing System” (CSPRO). Results: Majority of patients, 57.5% were males and aged between 16 and 30 years (32.5% of cases). Most patients (30% of patients) were farmers. Transabdominal preperitoneal prosthesis plasty for hernia represented 55% of interventions followed by appendicectomy (15%) and cholecystectomy (7.5%). Two procedures (0.8%) required conversion into open surgery. Post-operative complications were very rare and were encountered just by one patient who presented a parietal suppuration. Interventions in 77% of cases cost less than 200,000 CFA FRANCS (400$). Conclusion: The example of Yokadouma shows that laparoscopy should be developed in peripheral zones so that its residents can benefit from its multiple advantages.
文摘Bariatric and metabolic surgeries have gained extensive popularity and trust due to their documented efficacy and safety in managing not only obesity but also associated comorbidities such as diabetes mellitus, hypertension, dyslipidemia, sleep apnea, and joint pain. Traditionally, bariatric surgeries have been categorized into hypoabsorptive, restrictive, or hybrid approaches. However, these classifications inadequately reflect the complex anatomical and physiological alterations associated with modern surgical methodologies. This paper explores the evolution of metabolic surgeries, emphasizing the integration of physiological concepts into classic procedures to provide more tailored and effective treatment options for obesity and its comorbidities. Finally, the proposal for a new classification based on current metabolic concepts will facilitate communication among patients, doctors, and healthcare professionals. Additionally, it will enable a more didactic and standardized approach to data collection for conducting studies and publications.
文摘BACKGROUND Cauda equina syndrome(CES)is characterized by a group of symptoms that may be caused by inflammation,spinal cord compression,venous congestion,or ischemia.This syndrome is commonly an indication for surgical intervention but has not been determined as a postoperative complication following surgery for lumbar spine disease.CASE SUMMARY To report the case of a 54-year-old male patient who had CES following spinal surgery,with no obvious compression lesions found during re-exploration,suggesting that vascular insufficiency may have contributed to the condition.Furthermore,a series of urodynamic studies on bladder recovery patterns in such complications have also been investigated.CONCLUSION Postoperative CES requires urgent imaging and exploration to rule out compression;noncompressive cases,including vascular insufficiency may performed conservative management.
文摘Background: In developing countries, charity cleft surgical mission is always operated by sporadic surgical teams without systematic follow up and quality assurance. In the past few decades, many mission projects have been held regularly in China. The purpose of this audit was a retrospective analysis of a 9-year cleft lip and palate charity project operated in a tertiary hospital in China Shenzhen Area to evaluate perioperative and postoperative complications. Nevertheless, understanding the risk profile is essential for establishing a sustainable in-house cleft service in Shenzhen. Methods: A detailed analysis of hospital centralized record in the The University of Hong Kong-Shenzhen Hospital (HKUSZH) was reviewed since the first charity project held in 2015. The parameters of this audit were focused on perioperative complications including anesthesia related problems, early postoperative complications in patients who underwent primary or secondary cleft surgeries. A total of 430 consecutive admitted cases of 311 non-syndromic cleft lip & palate patients were enrolled into the charity project from June 2015 to July 2024. The main anesthesia related complications that occurred during general anesthesia were respiratory tract problems, while intraoperative complication was excessive bleeding, so as wound local infection and reaction were the main early postoperative complications. Results: In our 9-year clinical audit of 430 cleft lip and palate charity surgeries in Shenzhen, we observed no mortalities and a anesthesia-related complication rate of 1.16%. Specific intraoperative complications included excessive bleeding, while early postoperative issues were dominated by wound infections. The fistula rate of 18.7% post palate repair and the average hospital stay of 3.71 days complete the profile of our surgical outcomes. These data underscore the project’s efficacy and offer a reference for international cleft missions aiming for safe and efficient surgical care. Conclusions: This study provides a thorough data review of the complications in the past 9 years charity missions for cleft lip and palate surgery in a well-structured hospital infrastructure and logistic support by local surgical team. There were no perioperative or postoperative death during the study period and the overall short-term complication rate was low. Therefore, it could be a reference model for other international cleft mission in developing country for a safe and efficient service in future.
文摘Background: Missions organized by international societies and humanitarian organizations play a significant role in saving many patients’ lives and improving their quality of life, despite the surrounding frustrating conditions. Methods: A team of plastic surgery volunteers was sent to Yemen by the KSHARC. Results: A successful mission was performed on 62 patients who underwent surgery, with more than 900 patients examined and receiving appropriate medications. Conclusion: Missions in disaster-affected areas are of great importance. The role of missions and humanitarian organizations should be empowered.
文摘BACKGROUND Odontogenic maxillary sinusitis,often triggered by dental issues like periapical periodontitis,significantly contributes to chronic sinusitis,mainly affecting adults around 50 years old,emphasizing the need for a multidisciplinary diagnostic and treatment approach.AIM To investigate the therapeutic effect and clinical value of root canal therapy combined with nasal endoscopic surgery compared with simple root canal the-rapy in the treatment of severe odontogenic maxillary sinusitis caused by peria-pical periodontitis.METHODS The clinical data,diagnosis,and treatment of 200 patients with severe odonto-genic maxillary sinusitis caused by periapical periodontitis from October 2020 to October 2021 were analyzed retrospectively.Among them,63 patients were treated with simple root canal therapy as the control group,and 137 patients were treated with root canal therapy combined with nasal endoscopic surgery as the observation group.The therapeutic effect,Lund-Kennedy endoscopic score,paranasal sinus Lund-Mackay score,complication rate,recurrence rate,and patient satisfaction were compared between the two groups.RESULTS First,we compared the effective rates:23 cases were cured,22 were improved,and 8 were ineffective in the control group,yielding a total effective rate of 84.90%.Meanwhile,97 cases were cured,34 improved,and 6 were ineffective in the observation group,resulting in a total effective rate of 95.62%.The observation group had a higher total effective rate compared with the control group(P<0.05).Second,we compared the Lund–Kennedy endoscopic score.Before treatment,no significant difference(P>0.05)was observed in this score between the two groups.After treatment,the Lund–Kennedy endoscopic score decreased in both groups.The Lund–Kennedy endoscopic score of the observation group at 3 and 6 mo after treatment was lower compared to that of the control group(P<0.05).Third,we compared the Lund–Mackay score of paranasal sinuses.Before treatment,there was no significant difference in this score between the two groups(P>0.05).After treatment,the Lund–Mackay scores of paranasal sinuses decreased in both groups.The Lund–Mackay scores of paranasal sinuses in the observation group at 3 and 6 mo after treatment were lower compared to those of the control group(P<0.05).Fourth,we compared the incidence and recurrence rate of complications.Three months after treatment,no significant difference was found in the incidence and recurrence rate of complications between the observation group(6.56%)and the control group(9.52%)(P>0.05).However,6 mo after treatment,the incidence and recurrence rate of complications in the observation group(2.91%)was significantly higher compared to that of the control group(12.69%)(P<0.05).Fifth,we compared patient satisfaction.Six months after treatment,the patient satisfaction of the observation group(93.43%)was significantly better than that of the control group(84.12%)(P<0.05).CONCLUSION Root canal therapy combined with nasal endoscopic surgery has a good therapeutic effect on severe odontogenic maxillary sinusitis caused by periapical periodontitis,and it can reduce the injury of maxillary sinus mucosa and bone,and significantly reduce the incidence of complications and recurrence rate.Meanwhile,it has high patient satisfaction and remarkable therapeutic effect,which is suggested to be popularized and applied in clinic.
文摘Background: The tricuspid annular plane systolic excursion (TAPSE) and pulmonary artery systolic pressure (PASP) is an indirect estimate of right ventricular-pulmonary arterial (RV-PA) coupling that has been shown to correlate with invasive measures. We aimed to assess the ability of the tricuspid annular plane systolic excursion/pulmonary systolic pressure ratio (TAPSE/PASP) as a measure for RV-PA coupling to predict the development of RV dysfunction after cardiac surgery. Methods: This prospective study was conducted on 100 patients with ischemic heart disease and undergoing cardiac surgery (coronary artery bypass graft (CABG)) with normal preoperative right ventricular function, classified according to RV function outcomes into 2 groups: Normal RV group (65 patients) and RV dysfunction group (35 patients). All cases underwent per and postoperative transthoracic echocardiography. Results: By using receiver operating characteristic curve analysis, pre-operative TAPSE/PASP ratio could significantly predict the RV dysfunction (P 0.58, with AUC of 94%, 88.6% sensitivity, and 89.2% specificity. Post-operative TAPSE/PASP Ratio could significantly predict the RV dysfunction (P 0.39, with AUC of 84%, 100% sensitivity, and 76.9% specificity. Pre-operative TAPSE/PASP ratio could significantly predict mortality (P Conclusion: The TAPSE/PASP ratio is an excellent tool for CABG patients for its ability to detect and predict the development of RV dysfunction after cardiac surgery, along with the prediction of mortality in post-operative CABG patients.
文摘Objective: Erector spinae plane block is a novel regional anaesthetic intervention that is said to have an effective analgesic profile in the upper abdominal region. We compared its analgesic efficacy with thoracic epidural block for upper abdominal cancer surgeries. Methods: This prospective study included 60 patients, 18 to 65 years old with ASA class II who underwent gastrectomy and Whipple’s procedures under general anesthesia. Patients were assigned into two groups: Thoracic epidural group, with injection of 0.1 ml/kg of bupivacaine 0.25% in epidural catheter followed by 0.1 ml/kg/h of 0.125% bupivacaine infusion for 48 hrs., and Erector spinae group, with insertion of bilateral erector spinae catheters to inject 0.1 ml/kg of bupivacaine 0.25% followed by bilateral infusion of 0.1 ml/kg/h of bupivacaine 0.125% for 48 hrs. The primary endpoint was postoperative VAS scores at rest and movement. Secondary endpoint included postoperative total opioid consumption, 1st request for analgesia, hemodynamic changes and satisfaction scores. Results: Pain scores and needed rescue analgesia in both groups were comparable. However, 1st request for opioid was significantly longer in TEPI compared to ESI group. Hemodynamics were significantly lower in TEPI group with no differences in the incidence of postoperative complications except for hypotension. Patient satisfaction scores were arbitrarily higher in ESI group without significance. Conclusion: Erector spinae infusion is a highly promising regional technique with comparable effects to thoracic epidural blockade in reducing pain and opioid needs while causing minimal hemodynamic consequences.
基金Supported by Sichuan Province Science and Technology Plan(No.2023YFS0506)Medical Research Project of Jinniu District,Chengdu,Sichuan Province(No.JNKY2024-94)Xinglin Scholar Program at Chengdu University of Traditional Chinese Medicine(No.ZYTS2023028).
文摘AIM:To evaluate the effects of microlens design of peripheral defocus modifying spectacle lenses(PDMSLs)and non-microlens design of PDMSLs on controlling myopia progression in children and adolescents.METHODS:A systematic search was carried out in the PubMed,Cochrane Library,Embase,CNKI,and Web of Science databases.The search targeted randomized controlled trials(RCTs)and cohort studies(CTs)that explored the effects of PDMSLs on myopia control among children and adolescents.The Cochrane risk-of-bias tool and the Newcastle-Ottawa Scale were employed to evaluate the risk of bias in the included studies.The published biases of the included studies were evaluated using Egger’s test.RESULTS:Nine studies(7 RCTs,2 CTs)were included,involving 4332 participants in the PDMSLs group and 7317 participants in the single vision lenses(SVLs)group.Metaanalysis showed that PDMSLs with microlens design had lower change in spherical equivalent refraction(SER)than SVLs at 6,12,18,and 24mo after wearing glasses,with reductions of 0.19 D(95%CI:0.14 to 0.24,P<0.00001),0.36 D(95%CI:0.25 to 0.46,P<0.00001),0.43 D(95%CI:0.32 to 0.55,P<0.00001),and 0.51 D(95%CI:0.33 to 0.69,P<0.00001),respectively.The changes in axial length(AL)were also lower in PDMSLs compared to SVLs,with reductions of-0.09 mm(95%CI:-0.13 to-0.04,P=0.0002),-0.15 mm(95%CI:-0.21 to-0.08,P<0.00001),-0.27 mm(95%CI:-0.34 to-0.20,P<0.00001),and-0.29 mm(95%CI:-0.38 to-0.20,P<0.00001),respectively.There was no significant difference between the non-microlens group and SVLs in controlling the changes of SER and AL in myopia(both P>0.05).CONCLUSION:The synthesized evidence indicates superior myopia management outcomes with microlens design of PDMSLs compared to both SVLs and nonmicrolens design of PDMSLs in children and adolescents.
文摘Pulmonary embolism(PE)is a rare but devastating complication of shoulder surgery.Apart from increased morbidity and mortality rates,it may significantly impair postoperative recovery and functional outcome.Its frequency accounts for up to 5.7%of all shoulder surgery procedures with a higher occurrence in women and patients older than 70 years.It is most commonly associated with thrombophilia,diabetes mellitus,obesity,smoking,hypertension,and a history of malignancy.PE usually occurs secondary to upper or lower-extremity deep vein thrombosis(DVT).However,in rare cases,the source of the thrombi cannot be determined.Prophylaxis for PE following shoulder surgery remains a topic of debate,and the standard of care does not routinely require prophylactic medication for DVT prophylaxis.Early ambulation and elastic stockings are important preventative measures for DVT of the lower extremity and medical agents such as aspirin,low-molecular-weight heparin,and vitamin K antagonists are indicated for high-risk patients,long-lasting operations,or concomitant severe acute respiratory syndrome coronavirus 2 infection.The most common symptoms of PE include chest pain and shortness of breath,but PE can also be asymptomatic in patients with intrinsic tolerance of hypoxia.Patients with DVT may also present with swelling and pain of the respective extremity.The treatment of PE includes inpatient or outpatient anticoagulant therapy if the patient is hemodynamically unstable or stable,respectively.Hemodynamic instability may require transfer to the intensive care unit,and cardiovascular arrest can be implicated in fatal events.An important issue for patients with PE in the postoperative period after shoulder surgery is residual stiffness due to a delay in rehabilitation and a prolonged hospital stay.Early physiotherapy and range-of-motion exercises do not adversely affect the prognosis of PE and are highly recommended to preserve shoulder mobility and function.
文摘As cataract surgery progresses from “restoration of sight” to “refractive correction”, precise prediction of intraocular lens (IOL) power is critical for enhancing postoperative visual quality in patients. IOL power calculation methods have evolved and innovated throughout time, from early theoretical and regression formulas to nonlinear formulas for estimating effective lens position (ELP), multivariable formulas, and innovative formulas that use optical principles and AI-based online formulas. This paper thoroughly discusses the development and iteration of traditional IOL calculation formulas, the emergence of new IOL calculation formulas, and the selection of IOL calculation formulas for different patients in the era of refractive cataract surgery, serving as a reference for “personalized” IOL implantation in clinical practice.
文摘BACKGROUND Although the 2021 Chinese Clinical Practice Guidelines for Enhanced Recovery after Surgery(ERAS)provide recommendations for ERAS in gastrointestinal surgery,the clinical application of standard ERAS nursing models is challenging due to the variety of diseases involved in gastrointestinal surgery and the com-plex factors contributing to patient stress responses.Moreover,stress responses are more severe in older adult patients.Therefore,precision medicine is required to improve the quality of nursing care and promote postoperative recovery in gastrointestinal surgery.and demonstrate nursing benefits through clinical practice.METHODS This randomized clinical trial first established an evidence-based nursing ERAS protocol in older adult patients based on literature related to perioperative nursing measures for gastrointestinal surgery stress response.Next,392 older adult patients who underwent gastrointestinal surgery and were admitted to our hospital between December 2021 and June 2023 were categorized into two groups to receive evidence-based(study group)or conventional(control group)ERAS nursing models,respectively.Intraoperative physiological parameters during surgery and postoperative recovery indicators were compared between the groups.RESULTS Among 64 domestic and international studies,the stress responses of older adult patients mainly included emotional anxiety,sleep disorders,gastrointestinal discomfort,physical weakness,pain,and swelling.The appropriate nursing interventions included comprehensive psychological counseling,pre-and postoperative nutritional support,temperature control,pain management,and rehabilitation training.Compared with the control group,the study group showed lower heart rate,mean arterial pressure,blood glucose level,and adrenaline level;shorter duration of drainage tube placement,time to first flatus,time to first ambulation,and postoperative hospital stay;lower anxiety scores on postoperative day 3;and lower incidences of postoperative infection,obstruction,poor wound healing,and gastrointestinal reactions were lower in the study group(all P<0.05).CONCLUSION The evidence-based nursing measures targeting stress responses based on the conventional ERAS nursing model resulted in stable intraoperative physiological parameters during surgery,promoted postoperative recovery,and reduced the incidence of complications.
文摘In 2024,Laparoscopic,Endoscopic and Robotic Surgery(LERS)published 39 impactful articles in the area of minimally invasive surgery.The achievements of LERS are crucially dependent on the tremendous effort and valuable contributions of peer reviewers.On behalf of the Editorial Board and Editorial Office,we would especially like to thank the following excellent reviewers who have made time within their busy schedules to review manuscripts and delivered insightful and constructive comments.
文摘Introduction: Cardiac rehabilitation is defined as a comprehensive, multidisciplinary approach to secondary prevention. Its main components include patient assessment (exercise capacity, ventricular function and the existence or risk of arrhythmias), therapeutic education and control of cardiovascular risk factors, optimization of drug therapy, psychosocial support and, of course, personalized physical training. Method: The Basse Terre hospital department served as the setting for this study. All patients admitted to the department for cardiac rehabilitation were our target population. All patients operated on and admitted to the cardiology department for cardiac rehabilitation constituted our study population. A pre-established survey form and patient records were used to collect data. Ethical principles and patient confidentiality were paramount. Results: The prevalence was 13%. The mean age of our patients was 59.66 ± 12.9 years. Valve replacement was 25%;coronary artery bypass grafting was 75%;Kardégic 83.33%, CHBT protocol 83.33%, muscle fatigue 66.66%. 58.33% had 3 - 8 Watts at initial assessment and ≥15 Watts at final assessment. 8.33% atrial dilatation, and 16.66% segmental hypokinesia. 8.33% VO2 and ESV and Q necrosis. Conclusion: Exercise testing is a reliable means of assessing patients’ functional capacity.
文摘BACKGROUND Thirst management in convalescent patients recovering from a digestive surgery performed under general anesthesia requires attention.A simple,practical,and safe method can effectively relieve thirst symptoms in such patients.AIM To evaluate the enhanced recovery after surgery(ERAS)-based evidence-based care(EBC)plus ice stimulation therapy for thirst management of convalescent patients following digestive surgery performed under general anesthesia.METHODS A total of 191 patients convalescing after digestive surgery performed under general anesthesia between March 2020 and February 2023 and experiencing thirst were selected.In total,89 patients and 102 patients in the control and research groups received routine care and ERAS-based EBC plus ice stimulation therapy,respectively.The following data were comparatively analyzed:(1)Thirst degree(thirst intensity numerical rating scale)and thirst distress(TD)degree(TD scale);(2)Oral mucosal wetness;(3)Unstimulated whole salivary flow rate(UWSFR);(4)Adverse reactions(palpitation,fatigue,chapped lips,and nausea and vomiting);and(5)Nursing satisfaction.RESULTS After nursing,thirst degree and distress were statistically lower in the research group than in the control group.Additionally,compared with the control group,the research group exhibited a lower degree of oral mucosal wetness,higher UWSFR,fewer adverse reactions,and more total nursing satisfaction.CONCLUSION ERAS-based EBC plus ice stimulation therapy can effectively alleviate thirst in convalescent patients recovering from a digestive surgery performed under general anesthesia.It can alleviate xerostomia symptoms,reduce adverse reactions,and improve patient comfort.
文摘To the Editor:We read with great interest the recent article by Balci et al.[1].In the study,the authors mentioned that their mixed reality(MR)technology has already successfully been applied in open and laparoscopic living donor hepatectomy and in complex laparoscopic liver resections.During such operations,the MR models of the liver are pulled out and superimposed onto the actual organ.Surgeons can verify the relationship between tumors and crucial areas in order to enhance margin clearance and R0 resection and reduce the risk of injuring major blood vessels.By applying MR(including augmented reality)technology,blood vessels and tumor structures in the liver can be displayed during surgery,which permits precise navigation during complex surgical procedures.Also MR was used in surgical education,and most learners believed that 3D models were useful in planning safer surgical paths,reducing intraoperative complications and training of young surgeons[2].
