Influence of humanistic care-based operating room nursing on safety,recovery,and satisfaction after radical surgery for colorectal carcinoma

BACKGROUND Radical surgery is a preferred treatment for colorectal carcinoma,wherein nursing intervention is essential for postoperative recovery and prevention of complications.Recently,the application of humanistic care in medical care has attracted attention.Humanistic care emphasizes comprehensive care,with importance attached to patients’physical needs as well as psychological and emotional support to provide more humane and personalized care services.However,no clinical reports have examined the use of humanistic care in patients undergoing radical surgery for colorectal carcinoma.AIM To investigate the influence of humanistic care-based operating room nursing on the safety,postoperative recovery,and nursing satisfaction of patients who have undergone radical surgery for colorectal carcinoma.METHODS In total,120 patients with rectal cancer who underwent surgery in Zhongnan Hospital of Wuhan University between August 2023 and March 2024 were selected and grouped based on the nursing methods employed.Of these patients,55 were treated with routine nursing intervention(control group)and 65 were provided humanistic care-based operating room nursing(research group).The patients’vital signs were recorded,including systolic/diastolic blood pressure(SBP/DBP)and heart beats per minute(BPM),as well as serum stress indices,including norepinephrine(NE),adrenal hormone(AD),and cortisol(Cor).Postoperative recovery and complications were also recorded.Patients’negative emotions,life hope,and nursing satisfaction were evaluated using the Self-rating Depression/Anxiety Scale(SDS/SAS),Herth Hope Index(HHI),and self-deve-loped nursing satisfaction questionnaire,respectively.RESULTS During emergence from anesthesia,SBP,DBP,and BPM levels were found to be lower in the research group than those in the control group,also serum Cor,AD,and NE levels were lower.In addition,the research group had shorter operative,awakening,anal exhaust,first postoperative ambulation,drainage tube removal,intestinal recovery,and hospital times.The total complication rate and the SDS and SAS scores were lower in the research group than those in the control group.The HHI and nursing satisfaction scores were higher in the research group.CONCLUSION Humanistic care-based operating room nursing can mitigate physiological stress responses,reduce postoperative complications,promote postoperative recovery,relieve adverse psychological emotions,and enhance life hope and nursing satisfaction in patients undergoing radical surgery for colorectal carcinoma,which can be popularized in clinical practice.

Application value of dexmedetomidine in anesthesia for elderly patients undergoing radical colon cancer surgery

BACKGROUND Colon cancer presents a substantial risk to the well-being of elderly people worldwide.With advancements in medical technology,surgical treatment has become the primary approach for managing colon cancer patients.However,due to age-related physiological changes,especially a decline in cognitive function,older patients are more susceptible to the effects of surgery and anesthesia,increasing the relative risk of postoperative cognitive dysfunction(POCD).There-fore,in the surgical treatment of elderly patients with colon cancer,it is of pa-ramount importance to select an appropriate anesthetic approach to reduce the occurrence of POCD,protect brain function,and improve surgical success rates.METHODS One hundred and seventeen patients with colon cancer who underwent elective surgery under general anesthesia were selected and divided into two groups:A and B.Group A received Dex before anesthesia induction,and B group received an equivalent amount of normal saline.Changes in the mini-mental state exami-nation,regional cerebral oxygen saturation(rSO2),bispectral index,glucose uptake rate(GluER),lactate production rate(LacPR),serum S100βand neuron-specific enolase(NSE),POCD,and adverse anesthesia reactions were compared between the two groups.RESULTS Surgical duration,duration of anesthesia,and intraoperative blood loss were comparable between the two groups(P>0.05).The overall dosage of anesthetic drugs used in group A,including propofol and remifentanil,was significantly lower than that used in group B(P<0.05).Group A exhibited higher rSO2 values at the time of endotracheal intubation,30 min after the start of surgery,and immediately after extubation,higher GluER values and lower LacPR values at the time of endotra-cheal intubation,30 min after the start of surgery,immediately after extubation,and 5 min after extubation(P<0.05).Group A exhibited lower levels of serum S100βand NSE 24 h postoperatively and a lower incidence of cognitive dysfunction on the 1st and 5th postoperative days(P<0.05).CONCLUSION The use of Dex in elderly patients undergoing radical colon cancer surgery helps maintain rSO2 Levels and reduce cerebral metabolic levels and the incidence of anesthesia-and surgery-induced cognitive dysfunction.

Effects of psychological intervention on negative emotions and psychological resilience in breast cancer patients after radical mastectomy

Breast cancer(BC)is the most common malignant tumor in women,and the treatment process not only results in physical pain but also significant psychological distress in patients.Psychological intervention(PI)has been recognized as an important approach in treating postoperative psychological disorders in BC patients.It has been proven that PI has a significant therapeutic effect on postoperative psychological disorders,improving patients'negative emotions,enhancing their psychological resilience,and effectively enhancing their quality of life and treatment compliance.

Impact of dexmedetomidine-assisted anesthesia in elderly patients undergoing radical resection of colon cancer

BACKGROUND Radical resection of colon cancer under general anesthesia is one of the main treatment methods for this malignancy.However,due to the physiological charac-teristics of elderly patients,the safety of perioperative anesthesia needs special attention.As anα2-adrenergic receptor agonist,dexmedetomidine(Dex)has attracted much attention from anesthesiologists due to its stabilizing effect on heart rate and blood pressure,inhibitory effect on inflammation,and sedative and analgesic effects.Its application in general anesthesia may have a positive impact on the quality of anesthesia and postoperative recovery in elderly patients undergoing radical resection of colon cancer.METHODS A total of 165 colon cancer patients who underwent radical surgery for colon cancer under general anesthesia at Qingdao University Affiliated Haici Hospital,Qingdao,China were recruited and divided into two groups:A and B.In group A,Dex was administered 30 min before surgery,while group B received an equivalent amount of normal saline.The hemodynamic changes,pulmonary compliance,airway pressure,inflammatory factors,confusion assessment method scores,Ramsay Sedation-Agitation Scale scores,and cellular immune function indicators were compared between the two groups.RESULTS Group A showed less intraoperative hemodynamic fluctuations,better pulmonary compliance,and lower airway resistance compared with group B.Twelve hours after the surgery,the serum levels of TLR-2,TLR-4,IL-6,and TNF-αin group A were significantly lower than those of group B(P<0.05).After extubation,the Ramsay Sedation-Agitation Scale score of group A patients was significantly higher than that of group B patients,indicating a higher level of sedation.The incidence of delirium was significantly lower in group A than in group B(P<0.05).CONCLUSION The use of Dex as an adjunct to general anesthesia for radical surgery in elderly patients with colon cancer results in better effectiveness of anesthesia.

Impact of the Rapid Recovery Concept on Complications and Patient Quality of Life in the Perioperative Nursing of Robot-Assisted Radical Oesophageal Cancer

Aim: This study evaluates the impact of Enhanced Recovery After Surgery (ERAS) nursing on postoperative complications and quality of life in patients undergoing robot-assisted minimally invasive esophagectomy (RAMIE). Methods: A total of 150 patients who underwent RAMIE from January 2020 to January 2022 at our hospital were randomly assigned to either the observation group or the control group, with 75 patients in each. The control group received standard perioperative management and nursing care, while the observation group was treated with ERAS nursing strategies. Interventions continued until discharge, and outcomes such as postoperative complications, quality of life, and nutritional status were compared between the groups. Results: The observation group exhibited a significantly lower incidence of postoperative adverse reactions compared to the control group (P ionally, all dimension scores of the Short-Form 36 Health Survey (SF-36), including the total score, were higher in the observation group (P < 0.05). Furthermore, the Nutritional Risk Screening (NRS) scores for impaired nutritional status and disease severity, along with the total NRS score, were significantly lower in the observation group compared to the control group (P Conclusion: Implementing ERAS nursing in the perioperative care of patients undergoing RAMIE is associated with reduced postoperative complications and enhanced postoperative quality of life and nutritional status. .

Primary Treatment for Clinically Early Cervical Cancer with Lymph Node Metastasis:Radical Surgery or Radiation?

Objective To compare survival outcomes between primary radical surgery and primary radiation in early cervical cancer.Methods Patient information was extracted from the Surveillance,Epidemiology,and Results database.Patients diagnosed with early cervical cancer of stage T1a,T1b,and T2a(American Joint Committee on Cancer,7th edition)from 1998 to 2015 were included in this study after propensity score matching.Overall survival(OS)was analyzed using the Kaplan-Meier method.Results Among the 4964 patients included in the study,1080 patients were identified as having positive lymph nodes(N1),and 3884 patients were identified as having negative lymph nodes(N0).Patients with primary surgery had significantly longer 5-year OS than those with primary radiotherapy in both the N1 group(P<0.001)and N0 group(P<0.001).In the subgroup analysis,similar results were found in patients with positive lymph nodes of stage T1a(100.0%vs.61.1%),T1b(84.1%vs.64.3%),and T2a(74.4%vs.63.8%).In patients with T1b1 and T2a1,primary surgery resulted in longer OS than primary radiation,but not in patients with T1b2 and T2a2.In multivariate analysis,the primary treatment was identified as an independent prognostic factor in both N1 and N0 patients(HR_(N1)=2.522,95%CI=1.919–3.054,PN1<0.001;HR_(N0)=1.895,95%CI=1.689–2.126,PN0<0.001).Conclusion In early cervical cancer stage T1a,T1b1,and T2a1,primary surgery may result in longer OS than primary radiation for patients with and without lymph node metastasis.

Risk factors for anastomotic fistula development after radical colon cancer surgery and their impact on prognosis

BACKGROUND Colon cancer is a common malignant tumor in the gastrointestinal tract that is typically treated surgically.However,postradical surgery is prone to complic-ations such as anastomotic fistulas.AIM To investigate the risk factors for postoperative anastomotic fistulas and their impact on the prognosis of patients with colon cancer.METHODS We conducted a retrospective analysis of 488 patients with colon cancer who underwent radical surgery.This study was performed between April 2016 and April 2019 at a tertiary hospital in Wuxi,Jiangsu Province,China.A t-test was used to compare laboratory indicators between patients with and those without postoperative anastomotic fistulas.Multiple logistic regression analysis was performed to identify independent risk factors for postoperative anastomotic fistulas.The Functional Assessment of Cancer Therapy-Colorectal Cancer was also used to assess postoperative recovery.RESULTS Binary logistic regression analysis revealed that age[odds ratio(OR)=1.043,P=0.015],tumor,node,metastasis stage(OR=2.337,P=0.041),and surgical procedure were independent risk factors for postoperative anastomotic fistulas.Multiple linear regression analysis showed that the development of postoperative anastomotic fistula(P=0.000),advanced age(P=0.003),and the presence of diabetes mellitus(P=0.015),among other factors,independently affected CONCLUSION Postoperative anastomotic fistulas significantly affect prognosis and survival rates.Therefore,focusing on the clinical characteristics and risk factors and immediately implementing individualized preventive measures are important to minimize their occurrence.

Clinical Efficacy of Laparoscopic Radical Colorectal Cancer Treatment for Colorectal Cancer and Its Effect on Immune Function

Objective:To explore the therapeutic effect of laparoscopic radical colorectal cancer treatment in colorectal cancer patients.Methods:A total of 50 colorectal cancer patients treated between August 2018 and August 2023 were randomly divided into two groups:Group A underwent laparoscopic radical colorectal cancer surgery,while Group B received open surgery.Clinical indicators,inflammatory factors,immune function indicators,and complications were compared between the two groups.Results:Group A showed significantly shorter operation times,faster recovery times,and reduced hospital stays compared to Group B.Additionally,Group A had less abdominal drainage and intraoperative bleeding(P<0.05).Levels of interleukin(IL)-4,IL-6,ultrasensitive C-reactive protein(hs-CRP),and tumor necrosis factor-alpha(TNF-α)were lower in Group A compared to Group B(P<0.05).Furthermore,immune function indicators,including CD3+,CD4+,CD8+,and CD4+/CD8+ratios,were better in Group A(P<0.05).The complication rate in Group A was also lower than in Group B(P<0.05).Conclusion:Laparoscopic radical treatment for colorectal cancer is efficient and feasible,causing minimal immune function impairment and inflammatory response.It also shortens postoperative recovery time.

Effect of ultrasound-guided lumbar square muscle block on stress response in patients undergoing radical gastric cancer surgery

BACKGROUND Radical surgery is a common treatment for patients with gastric cancer;however,it can lead to postoperative complications and intestinal barrier dysfunction.Ultrasound-guided quadratus lumborum block is often used for postoperative analgesia,but its effects on stress response and intestinal barrier function are not well understood.AIM To investigate the effects of an ultrasound-guided quadratus lumborum block on stress response and intestinal barrier function in patients undergoing radical surgery for gastric cancer.METHODS A total of 100 patients undergoing radical surgery for gastric cancer were randomly categorized into observation and control groups.Plasma adrenaline and cortisol levels,intestinal mucosal barrier indexes,and complication rates were compared between the two groups before,during,and 1 day after surgery.RESULTS The observation group had significantly lower plasma adrenaline and cortisol levels during surgery and at 1 day postoperatively than that of the control group(P<0.05).Additionally,intestinal barrier indexes(endotoxin and D-dimer)at 1 day postoperatively were significantly lower in the observation group than in the control group(P<0.05).CONCLUSION Ultrasound-guided quadratus lumborum block could reduce stress response,protect intestinal barrier function,and decrease the incidence of complications in patients undergoing radical surgery for gastric cancer.This technique has the potential for clinical applications.

New classification system for radical rectal cancer surgery based on membrane anatomy

BACKGROUND Total mesorectal excision along the“holy plane”is the only radical surgery for rectal cancer,regardless of tumor size,localization or even tumor stage.However,according to the concept of membrane anatomy,multiple fascial spaces around the rectum could be used as the surgical plane to achieve radical resection.AIM To propose a new membrane anatomical and staging-oriented classification system for tailoring the radicality during rectal cancer surgery.METHODS A three-dimensional template of the member anatomy of the pelvis was established,and the existing anatomical nomenclatures were clarified by cadaveric dissection study and laparoscopic surgical observation.Then,we suggested a new and simple classification system for rectal cancer surgery.For simplification,the classification was based only on the lateral extent of resection.RESULTS The fascia propria of the rectum,urogenital fascia,vesicohypogastric fascia and parietal fascia lie side by side around the rectum and form three spaces(medial,middle and lateral),and blood vessels and nerves are precisely positioned in the fascia or space.Three types of radical surgery for rectal cancer are described,as are a few subtypes that consider nerve preservation.The surgical planes of the proposed radical surgeries(types A,B and C)correspond exactly to the medial,middle,and lateral spaces,respectively.CONCLUSION Three types of radical surgery can be precisely defined based on membrane anatomy,including nerve-sparing procedures.Our classification system may offer an optimal tool for tailoring rectal cancer surgery.

The Application of Forward Control Nursing in Anesthesia, Recovery, and Rehabilitation of Thoracoscopic Lung Cancer Radical Surgery

Objective: To explore the clinical application effect of formulating the operating room nursing work procedure sheet for elderly lung cancer patients in thoracoscopic radical surgery. Methods: A total of 85 elderly patients with lung cancer treated in our hospital from May 2022 to May 2023 were included as the study population for this research. They were divided into a study group of 42 cases and a regular group of 43 cases. The regular group of elderly patients received routine nursing care, while the study group of elderly patients was provided with the operating room nursing care work procedure sheet. The surgical duration, intraoperative blood loss, time to mobilization, and postoperative complication rate were compared and analyzed between the two groups. Results: Compared to the regular group, the study group had significantly shorter surgical duration and time to mobilization, as well as less intraoperative blood loss (P < 0.05). The overall incidence of postoperative complications in the study group (4.76%) was significantly lower than that in the regular group (19.05%) (P Conclusion: Formulating the operating room nursing work procedure sheet for elderly lung cancer patients can effectively improve surgical efficiency, reduce the incidence of postoperative complications, and promote patient prognosis in thoracoscopic radical surgery. Therefore, this model is worth promoting and adopting in clinical practice.

ADJUVANT CHEMOTHERAPY FOLLOWING RADICAL SURGERYFOR NON-SMALL CELL LUNG CANCER:A RANDOMIZED STUDY

Objective: To evaluate the efficacy of adjuvant chemotherapy after radical surgery for non-small cell lung cancer (NSCLC). Methods: Seventy patients with NSCLC (stage I–III) undergone radical surgery were randomized into two groups: 35 patients received adjuvant chemotherapy with cyclophosphamide (CTX) 300 mg/m2, vincristine (VCR) 1.4% mg/m2, adriamycin (ADM) 50 mg/m2, lomustine (CCNU) 50 mg/m2 dl, cisplatin (DDP) 20 mg/m2, d1–5, for 4 cycles, and followed by oral Ftorafur (FT-207) 600–900 mg/d for 1 year (adjuvant chemotherapy group). The other 35 patients received surgical treatment only (surgery group). Results: The overall 5-year survival rate was 48.6% in the adjuvant chemotherapy group, and 31.4% in the surgery group, respectively. The difference between the two groups was not statistically significant (P>0.05). The 5-year survival rate of patients in stage III was 44.0% and 20.8% received surgery with and without adjuvant chemotherapy, respectively. The difference between the two groups was statistically significant (P<0.025). The 5-year survival rate of patients in stage I–II in the two groups was 60.0% and 54.5%, respectively (P>0.75). Conclusion: Postoperative adjuvant chemotherapy in NSCLC can improve survival, for those patients in stage III, it suggests significantly 5-year survival rate in the adjuvant chemotherapy group was higher than that in the surgery alone group.

Effect of enteral immunonutrition after radical surgery for esophageal carcinoma on anti-tumor immune response and intestinal mucosal barrier function

Objective:To study the effect of enteral immunonutrition after radical surgery for esophageal carcinoma on anti-tumor immune response and intestinal mucosal barrier function.Methods:A total of102 patients who received radical surgery for esophageal carcinoma in our hospital between May 2013 and December 2016 were selected and randomly divided into observation group and control group who received postoperative enteral immunonutrition and routine enteral nutrition respectively. 1 d before operation as well as 1 d and 7 d after operation, peripheral blood immune cell marker expression and serum intestinal mucosal barrier injury marker levels were detected.Results:1 d after operation, peripheral blood T-bet, NKG2D, NKp30, NKp44 and NKp46 fluorescence intensity of both groups of patients were significantly lower than those 1d before operation while peripheral blood GATA-3 and Foxp3 fluorescence intensity as well as serum DAO, Occludin, ZO-1 and claudin-1 levels were significantly higher than those 1d before operation;peripheral blood T-bet, NKG2D, NKp30, NKp44 and NKp46 fluorescence intensity of observation group 7 d after operation were significantly higher than those 1 d after operation while peripheral blood GATA-3 and Foxp3 fluorescence intensity as well as serum DAO, Occludin, ZO-1 and claudin-1 levels were significantly lower than those 1 d after operation;peripheral blood T-bet, GATA-3, Foxp3, NKG2D, NKp30, NKp44 and NKp46 fluorescence intensity of control group 7 d after operation were not significant different from those 1 d after operation, and serum DAO, Occludin, ZO-1 and claudin-1 levels were significantly lower than those 1d after operation.Conclusion: Enteral immunonutrition after radical surgery for esophageal carcinoma can enhance the anti-tumor immune response and improve the intestinal mucosal barrier function.

Fast-track surgery could improve postoperative recovery in radical total gastrectomy patients

AIM: To assess the impact of fast-track surgery (FTS) on hospital stay, cost of hospitalization and complications after radical total gastrectomy. METHODS: A randomized, controlled clinical trial was conducted from November 2011 to August 2012 in the Department of Digestive Surgery, Xijing Hospital of Digestive Diseases, the Fourth Military Medical University. A total of 122 gastric cancer patients who met the selection criteria were randomized into FTS and conventional care groups on the first day of hospitalization. All patients received elective standard D2 total gastrectomy. Clinical outcomes, including duration of flatus and defecation, white blood cell count, postoperative pain, duration of postoperative stay, cost of hospitalization and complications were recorded and evaluated.Two specially trained doctors who were blinded to the treatment were in charge of evaluating postoperative outcomes, discharge and follow-up. RESULTS: A total of 119 patients finished the study, including 60 patients in the conventional care group and 59 patients in the FTS group. Two patients were excluded from the FTS group due to withdrawal of consent. One patient was excluded from the conventional care group because of a non-resectable tumor. Compared with the conventional group, FTS shortened the duration of flatus (79.03 ± 20.26 hvs 60.97 ± 24.40 h, P = 0.000) and duration of defecation (93.03 ± 27.95 h vs 68.00 ± 25.42 h, P = 0.000), accelerated the decrease in white blood cell count [P < 0.05 on postoperative day (POD) 3 and 4], alleviated pain in patients after surgery (P < 0.05 on POD 1, 2 and 3), reduced complications (P < 0.05), shortened the duration of postoperative stay (7.10 ± 2.13 dvs 5.68 ± 1.22 d,P = 0.000), reduced the cost of hospitalization (43783.25 ± 8102.36 RMBvs 39597.62 ± 7529.98 RMB,P = 0.005), and promoted recovery of patients. CONCLUSION: FTS could be safely applied in radical total gastrectomy to accelerate clinical recovery of gastric cancer patients.

Recurrence risk model for esophageal cancer after radical surgery

Objective：The aim of the present study was to construct a risk assessment model which was tested by disease-free survival （DFS） of esophageal cancer after radical surgery.Methods：A total of 164 consecutive esophageal cancer patients who had undergone radical surgery between January 2005 and December 2006 were retrospectively analyzed.The cutpoint of value at risk （VaR） was inferred by stem-and-leaf plot,as well as by independent-samples t-test for recurrence-free time,further confirmed by crosstab chi-square test,univariate analysis and Cox regression analysis for DFS.Results：The cutpoint of VaR was 0.3 on the basis of our model.The rate of recurrence was 30.3 ％ （30/99）and 52.3％ （34/65） in VaR ＜0.3 and VaR ＞0.3 （chi-square test,x2 =7.984,P=0.005）,respectively.The 1-,3-,and 5-year DFS of esophageal cancer after radical surgery was 70.4％,48.7％,and 45.3％,respectively in VaR ＞≥0.3,whereas 91.5％,75.8％,and 67.3％,respectively in VaR ＜0.3 （Log-rank test,x2 =9.59,P=0.0020）,and further confirmed by Cox regression analysis [hazard ratio =2.10,95 ％ confidence interval （CI）：1.2649-3.4751; P=0.0041].Conclusions：The model could be applied for integrated assessment of recurrence risk after radical surgery for esophageal cancer.

Does Postoperative Rehabilitation for Radical Cystectomy Call for Enhanced Recovery after Surgery?A Systematic Review and Metaanalysis

The aim of this review was to systematically compare the outcomes of enhanced recovery after surgery(ERAS)with standard care(SC)after radical cystectomy.We performed a systematic search of PubMed,Ovid?Web of Science,and the Cochrane Library to identify studies published until September 2017 which involved a comparison of ERAS and SC.A meta-analysis was performed to assess the outcomes of ERAS versus SC.Sixteen studies including 8 prospective and 8 retrospective trials met the eligibility criteria.A total of 2100 participants were assigned to ERAS(1258 cases)or SC(842 cases).The time to first flatus passage[WMD=-0.95 days,95%Cl(-1.50,-0.41),P=0.0006],time until return to a regular diet[WMD=-2.15 days,95%Cl(-2.86,—1.45),P<0.00001]and the length of hospital stay[WMD=-3.75 days,95%Cl(-5.13,-2.36),P<0.00001]were significantly shorter,and the incidence of postoperative complications[OR=0.60,95%Cl(0.44,0.83),P=0.002],especially postoperative paralytic ileus[OR=0.43,95%Cl(0.30,0.62),P<0.00001]and cardiovascular complications[OR=0.28,95%Cl(0.09,0.90),P=0.03]was significantly lower in the ERAS group than those in the SC group.This meta-analysis demonstrated that ERAS was associated with a shorter time to first flatus passage,return of bowel fimction,and the length of hospital stay than SC in patients undergoing radical cystectomy,as well as a lower rate of postoperative complications,especially paralytic ileus and cardiovascular complications.

First 100 cases of transvesical single-port robotic radical prostatectomy

Objective:To describe the surgical technique and report the early outcomes of the transvesical(TV)approach to single-port(SP)robot-assisted radical prostatectomy.Methods:All procedures were performed at a single center by one surgeon.We identified the first 100 consecutive patients with clinically localized prostate cancer that underwent SP TV robot-assisted radical prostatectomy using the da Vinci SP robotic surgical system.Data were collected prospectively and analyzed with descriptive statistics.The primary outcomes assessed were postoperative urinary continence,rate of biochemical recurrence,and sexual function.Results:All procedures were performed without extra ports or conversion.The median age was 62.1 years and 49.0%of the patients had abdominal surgery history.The preoperative median prostate-specific antigen value and prostate volume were 5.0 ng/mL and 33.0 mL,respectively.There were no intraoperative complications.The median operative time and estimated blood loss were 212.5 min and 100.0 mL,respectively.A total of 92.0%of patients were discharged within 24.0 h,with an overall median length of stay of 5.6 h.Only 4.0%of patients required opioid prescriptions at discharge.The median Foley catheter duration was 3 days.Positive margins were present in 15.0%of cases.Median follow-up was 10.4 months.Continence rate was immediate after Foley removal in 49.0%of cases,65.0%at 2 weeks,77.4%at 6 weeks,94.1%at 6 months,and 98.9%at 1 year.One case of biochemical recurrence(1.0%)was noted 3 months after surgery.Conclusion:The SP TV approach for radical prostatectomy cases is a safe and feasible technique for patients with clinically localized prostate cancer.This technique offers advantages of short hospital stay,minimal narcotic use postoperatively,and promising early return of urinary continence,without compromising oncologic outcomes.

Static Radical Stiffness and Contact Behavior of Nonpneumatic Mechanical Elastic Wheel

Conventional pneumatic tires exhibit disadvantages such as puncture,blowout at high speed,pressure maintenance,etc.Owing to these structural inevitable weaknesses,non?pneumatic tires have been developed and are investigated.A non?pneumatic mechanical elastic wheel(NPMEW)is introduced and investigated as a function of static radical stiffness characteristics and contact behavior.A bench test method is utilized to improve the riding comfort and the traction traffic ability of NPMEW based on tire characteristics test rig,and the static radical stiffness characteristics and the contact behavior of NPMEW are compared with that of an insert supporting run?flat tire(ISRFT).The vertical force?deformation curves and deformed shapes and contact areas of the NPMEW and ISRFT are obtained using a set of vertical loads.The contact behavior is evaluated using extracted geometrical and mechanical feature parameters of the two tires.The results indicate that the NPMEW appears to exhibit considerably high radical stiffness,and the numerical value is dependent on the mechanical characteristic of the flexible tire body and hinge units.NPMEW demonstrates more uniform contact pressure than ISRFT within a certain loading range,and it can efficiently mitigate the problem of stress concentration in ISRFT shoulder under heavy load and enhance the wear resistance and ground grip performances.

Survival and prognostic factors of non-small cell lung cancer patients with postoperative locoregional recurrence treated with radical radiotherapy

Background: Locoregional recurrence remains the challenge for long-term survival of non-small cell lung cancer(NSCLC) patients after radical surgery, and curative-intent radiotherapy could be a treatment choice. This study aimed to assess the survival and prognostic factors of patients with postoperative locoregionally recurrent NSCLC treated with radical radiotherapy.Methods: We reviewed medical records of 74 NSCLC patients with postoperative locoregional recurrence who received radical radiotherapy between April 2012 and February 2016 at Sun Yat-sen University Cancer Center(Guangzhou, China). The efficacy and safety of radical radiotherapy were analyzed. The probability of survival was estimated using the Kaplan-Meier method and compared using the log-rank test. The Cox proportional hazards model was used to identify prognostic factors.Results: Grade 3/4 adverse events included neutropenia(8 cases, 10.8%), esophagitis(7 cases, 9.5%), pneumonitis(1 case, 1.4%), and vomiting(1 case, 1.4%).The 2-year overall survival, progression-free survival, local recurrencefree survival(LRFS), and distant metastasis-free survival(DMFS) rates of all patients were 84.2,42.5,70.0, and 50.9%,respectively. Univariate and multivariate analyses showed that a higher biological effective dose(BED) of radiation was associated with longer LRFS [hazard ratios(HR)=0.317,95% confidence interval(CI) = 0.112-0.899, P = 0.016] and that wild-type epidermal growth factor receptor(EGFR) was associated with longer DMFS compared with EGFR mutation(HR = 0.383,95% CI=0.171-0.855, P = 0.019).Conclusions: Radical radiotherapy is effective and well-tolerated in NSCLC patients with postoperative locoregional recurrence. High BED is a predictor for long LRFS, and the presence of wild-type EGFR is a predictor for long DMFS.

Laparoscopic vs open surgery for gastric cancer: Assessing time, recovery, complications, and markers

BACKGROUND Gastric cancer(GC)is one of the most common cancers worldwide.Morbidity and mortality have increased in recent years,making it an urgent issue to address.La-paroscopic radical surgery(LRS)is a crucial method for treating patients with GC;However,its influence on tumor markers is still under investigation.The data of 194 patients treated at Chongqing University Cancer Hospital bet-ween January 2018 and January 2019 were retrospectively analyzed.Patients who underwent traditional open surgery and LRS were assigned to the control(n=90)and observation groups(n=104),respectively.Independent sample t-tests andχ2 tests were used to compare the two groups based on clinical efficacy,changes in tumor marker levels after treatment,clinical data,and the incidence of posto-perative complications.To investigate the association between tumor marker levels and clinical efficacy in patients with GC,three-year recurrence rates in the two groups were compared.RESULTS Patients in the observation group had a shorter duration of operation,less in-traoperative blood loss,an earlier postoperative eating time,and a shorter hospital stay than those in the control group(P<0.05).No significant difference was observed between the two groups regarding the number of lymph node dissections(P>0.05).After treatment,the overall response rate in the control group was significantly lower than that in the observation group(P=0.001).Furthermore,after treatment,the levels of carbohydrate antigen 19-9,cancer antigen 72-4,carcinoembryonic antigen,and cancer antigen 125 decreased significantly.The observation group also exhibited a significantly lower incidence rate of postoperative complications compared to the control group(P<0.001).Additionally,the two groups did not significantly differ in terms of three-year survival and recurrence rates(P>0.05).CONCLUSION LRS effectively treats early gastric cancer by reducing intraoperative bleeding,length of hospital stays,and postoperative complications.It also significantly lowers tumor marker levels,thus improving the short-term prognosis of the disease.