Objective To analyze the complications of laparoscopic cholecystectomy (LC) and their affecting factors and investigate their prevention and treatment. Methods The clinical data of 18 726 patients treated with LC betw...Objective To analyze the complications of laparoscopic cholecystectomy (LC) and their affecting factors and investigate their prevention and treatment. Methods The clinical data of 18 726 patients treated with LC between March 1992 to January 2001 in our hospital were retrospectively analyzed. Results The complications were common bile duct injury in 28 cases (0. 15%), bile leakage in 62 (0. 33% ), introabdominal hemorrhage in 6 (0.03) and postoperative introabdominal abscess in 4 (0. 02). The causes for these complications were improper choice of indications and surgeon’s back of knowledge and experience in identifying the abnormality of bile duct anatomy. Conclusion The major complications of LC are bile duct leakage and injury. The injury can be avoided through careful performance of LC. Immediate discovery and proper treatment will result in good outcome.7 refs.1 fig,2 tabs.展开更多
Objective:Cytoreductive radical prostatectomy(cRP)has been proposed as local treatment option in metastatic hormone-sensitive prostate cancer(mHSPC)to prevent local complications and potentially improve oncological ou...Objective:Cytoreductive radical prostatectomy(cRP)has been proposed as local treatment option in metastatic hormone-sensitive prostate cancer(mHSPC)to prevent local complications and potentially improve oncological outcomes.In this study,we examined the feasibility of a multimodal concept with primary chemohormonal therapy followed by cRP and analyzed prostate size reduction under systemic treatment,postoperative complication rates,as well as early postoperative continence.Methods:In this retrospective study,38 patients with mHSPC underwent cRP after primary chemohormonal therapy(3-monthly luteinising hormone-releasing hormone-analogue+six cycles 3-weekly docetaxel 75 mg/m2)at two centers between September 2015 and December 2018.Results:Overall,10(26%)patients had high volume and 28(74%)patients had low volume disease at diagnosis,according to CHAARTED definition.Median prostate-specific antigen(PSA)decreased from 65 ng/mL(interquartile range[IQR]35.0-124.5 ng/mL)pre-chemotherapy to 1 ng/mL(IQR 0.3-1.7 ng/mL)post-chemotherapy.Prostate gland volume was significantly reduced by a median of 50%(IQR 29%-56%)under chemohormonal therapy(p=0.003).Postoperative histopathology showed seminal vesicle invasion in 33(87%)patients and negative surgical margins in 17(45%)patients.Severe complications(Grade 3 according to Clavien-Dindo)were observed in 4(11%)patients within 30 days.Continence was reached in 87%of patients after 1 month and in 92%of patients after 6 months.Median time to castration-resistance from begin of chemohormonal therapy was 41.1 months and from cRP was 35.9 months.Postoperative PSA-nadir≤1 ng/mL versus>1 ng/mL was a significant predictor of time to castration-resistance after cRP(median not reached versus 5.3 months;p<0.0001).Conclusion:We observed a reduction of prostate volume under chemohormonal therapy going along with a low postoperative complication and high early continence rate.However,the oncologic benefit from cRP is still under evaluation.展开更多
文摘Objective To analyze the complications of laparoscopic cholecystectomy (LC) and their affecting factors and investigate their prevention and treatment. Methods The clinical data of 18 726 patients treated with LC between March 1992 to January 2001 in our hospital were retrospectively analyzed. Results The complications were common bile duct injury in 28 cases (0. 15%), bile leakage in 62 (0. 33% ), introabdominal hemorrhage in 6 (0.03) and postoperative introabdominal abscess in 4 (0. 02). The causes for these complications were improper choice of indications and surgeon’s back of knowledge and experience in identifying the abnormality of bile duct anatomy. Conclusion The major complications of LC are bile duct leakage and injury. The injury can be avoided through careful performance of LC. Immediate discovery and proper treatment will result in good outcome.7 refs.1 fig,2 tabs.
文摘Objective:Cytoreductive radical prostatectomy(cRP)has been proposed as local treatment option in metastatic hormone-sensitive prostate cancer(mHSPC)to prevent local complications and potentially improve oncological outcomes.In this study,we examined the feasibility of a multimodal concept with primary chemohormonal therapy followed by cRP and analyzed prostate size reduction under systemic treatment,postoperative complication rates,as well as early postoperative continence.Methods:In this retrospective study,38 patients with mHSPC underwent cRP after primary chemohormonal therapy(3-monthly luteinising hormone-releasing hormone-analogue+six cycles 3-weekly docetaxel 75 mg/m2)at two centers between September 2015 and December 2018.Results:Overall,10(26%)patients had high volume and 28(74%)patients had low volume disease at diagnosis,according to CHAARTED definition.Median prostate-specific antigen(PSA)decreased from 65 ng/mL(interquartile range[IQR]35.0-124.5 ng/mL)pre-chemotherapy to 1 ng/mL(IQR 0.3-1.7 ng/mL)post-chemotherapy.Prostate gland volume was significantly reduced by a median of 50%(IQR 29%-56%)under chemohormonal therapy(p=0.003).Postoperative histopathology showed seminal vesicle invasion in 33(87%)patients and negative surgical margins in 17(45%)patients.Severe complications(Grade 3 according to Clavien-Dindo)were observed in 4(11%)patients within 30 days.Continence was reached in 87%of patients after 1 month and in 92%of patients after 6 months.Median time to castration-resistance from begin of chemohormonal therapy was 41.1 months and from cRP was 35.9 months.Postoperative PSA-nadir≤1 ng/mL versus>1 ng/mL was a significant predictor of time to castration-resistance after cRP(median not reached versus 5.3 months;p<0.0001).Conclusion:We observed a reduction of prostate volume under chemohormonal therapy going along with a low postoperative complication and high early continence rate.However,the oncologic benefit from cRP is still under evaluation.
