The new effective systemic treatment strategy has "created" many long-term stage Ⅳ non-small cell lung cancer (NSCLC) survivors, and surgeons should pay attention to those individual ineffective lesions of long-term survivors. Besides, the new effective systemic treatment strategy may have changed the original concept and population of oligometasis. To intervene the oligo-progression lesions of long-term stage Ⅳ survivors, particularly after effective systemic treatment, at appropriate time with appropriate way might be the main task of surgery in the future.
Objective To present early follow-up results of surgical closure of ruptured sinus of Valsalva aneurysm (RSVA). Methods We retrospectively analyzed the clinical data of 32 patients with RSVA or combined with RSVA in our hospital between January 2010 and December 2014. There were 20 males, 12 females aged 37.6±11.2 years. All the patients were surgically corrected under cardiopulmonary bypass. Results The mean cardiopulmonary bypass time was 79±18 min and the mean aortic cross-clamp time was 53±9 min. Except that 1 patient had the first degree A-V block and 2 patients with delayed wound healing, there was no other complication in the early postoperative period. One patient with surgically corrected RSVA was with infective endocarditis after 3 months follow-up. Most patients were with better New York Heart Association (NYHA) functional classⅠor Ⅱat the end of the follow-up. Conclusion Surgical closure of RSVA is a safe and effective alternative to surgery with early follow-up results.
ObjectiveTo evaluate the clinical efficacy of surgical intervention combined with endoscopic ultrasound-guided transluminal drainage in the treatment of infected pancreatic necrosis (IPN). MethodsA retrospective, historical control study was conducted. A total of 98 patients with acute pancreatitis (AP) complicated with IPN who met the inclusion and exclusion criteria and were admitted to the Third People’s Hospital of Chengdu from June 2016 to January 2023 were selected as the research objects. The endoscopic ultrasound-guided transluminal drainage was carried out in our hospital in June 2020. In this study, patients treated before May 2020 were divided into the non-EUS group (52 cases), and patients treated after June 2020 were divided into the EUS group (46 cases). The baseline data, surgical intervention, length of hospital stay, length of intensive care unit (ICU) stay, infection time, incidence of multiple organ dysfunction syndrome (MODS), survival situation, short-term and long-term complications, and other indicators were compared between the two groups. ResultsThe number of percutaneous catheter drainage (PCD, 1.0 vs. 1.0), the number of PCD drainage tube (1.0 vs. 2.0), the number of retroperitoneal debridement drainage (1.0 vs. 2.0), the total length of hospital stay (42.0 d vs. 45.5 d), the length of ICU stay (11.0 d vs. 14.0 d), the length of infection time (10.5 d vs. 18.5 d), the incidences of MODS [43.5% (20/46) vs. 67.3% (35/52)] and residual infection [28.3% (13/46) vs.48.1% (25/52)] in the EUS group were shorter (or lower) than those in the non-EUS group (P<0.05); but there were no significant differences in the number of endoscopic pancreatic stent implantation, the number of laparotomy, the number of laparoscopic surgery, and the incidences of abdominal bleeding, gastrointestinal fistula, gastrointestinal obstruction, chronic pancreatic fistula, chronic pancreatitis and incisional hernia between the two groups (P>0.05). ConclusionFor patients with AP complicated with IPN, surgical intervention combined with endoscopic ultrasound-guided transluminal drainage can reduce the number of PCD and drainage tube, shorten the total length of hospital stay, the length of ICU stay and infection, as well as reduce the incidences of MODS and residual infection.
ObjectiveTo analyze the surgical treatment characteristics for newly diagnosed colorectal cancer (CRC) patients based on hospital registry data in Sichuan Province. MethodsBased on the hospitalization records of CRC inpatients from all secondary and tertiary hospitals in Sichuan Province (2015–2024), the newly diagnosed CRC patients admitted during 2020–2023 were identified and the rates of primary lesion resection, neostomy, and stoma reversal procedures were evaluated. Then stratified analyses by gender, age, tumor location, and organ metastasis at diagnosis were analyzed. The statistical significance was defined as one-sided test with α=0.025. ResultsA total of 118 787 newly diagnosed CRC inpatients in Sichuan Province (2020–2023) were enrolled, the cohort had a mean age of (66.4±12.3) years, with 70 756 (59.6%) males, 64 646 (54.4%) rectal cancer cases, and 16 418 (13.8%) cases exhibiting synchronous organ metastasis at diagnosis. Within one year post-diagnosis, 84 634 (71.2%) patients underwent primary lesion resection and 26 514 (22.3%) received neostomy procedures, both demonstrating significantly increasing annual trends (χ2trend=72.2, P<0.001; χ2trend=70.6, P<0.001) while showing inverse correlations with advancing age (χ2trend=4 096.0, P<0.001; χ2trend=56.3, P<0.001). Stratified analyses revealed significantly lower primary lesion resection rates among females vs. males, rectal cancer vs. colon cancer, and organ metastasis vs. non-organ metastasis patients (all P<0.001), whereas neostomy rates were higher in females and rectal cancer patients but lower in organ metastasis cases (all P<0.001). Among 26 514 neostomy patients, 11 288 (42.6%) underwent stoma reversal after a median (interquartile range) interval of 123 (95, 188) d, with 8 187 reversals (72.5%) within 6 months, 2 700 (23.9%) during 6–12 months, and 401 (3.6%) after 12 months. Reversal rates increased temporally (χ2trend=80.0, P<0.001) but decreased with advancing age (χ2trend=1 072.3, P<0.001). ConclusionIn Sichuan Province, rising trends are observed in the hospitalization burdern of newly diagnosed CRC and rates of primary lesion resection, neostomy, and reversal.
A 55-year-old male patient was admitted to the hospital due to "recurrent chest pain for 8 months, with worsening symptoms for 2 weeks". After admission, comprehensive relevant examinations led to the consideration of a giant chronic left ventricular pseudoaneurysm caused by myocardial infarction with non-obstructive coronary arteries. Surgical treatment was performed at our hospital. We discuss the diagnosis and treatment of this patient.