Postoperative efficacy,safety,predictability,and visual quality of implantable collamer lens implantation versus small incision lenticule extraction in myopic eyes:a Meta-analysis

AIM:To compare the postoperative efficacy,safety,predictability,and visual quality of implantable collamer lens(ICL)implantation versus small incision lenticule extraction(SMILE)in myopia eyes.METHODS:Pub Med,EMBASE,Web of Science,Cochrane Library and several Chinese databases were searched at May 2021 to select relevant studies in comparison of clinical outcomes between ICL implantation and SMILE for myopia.The primary outcomes were efficacy,safety,and predictability.And the secondary outcomes were postoperative higher-order ocular aberrations(HOAs),modulation transfer function cutoff frequency(MTF),objective scatter index(OSI),contrast sensitivity and a quality of vision(Qo V)questionnaire.RESULTS:A total of 1036 eyes from 10 studies,of which 503 eyes underwent ICL implantation and 533 eyes underwent SMILE,were enrolled in this Meta-analysis.Pooled results revealed that ICL group had a better safety index and post-corrected distance visual acuity(CDVA)(P=0.007,<0.00001,respectively),and a lower percentage of eyes with a postoperative CDVA lost 1 line(P=0.007)than the SMILE group.No significant differences were found in comparison of the other primary outcomes.In the longterm follow-up(>6mo),ICL group had a lower total HOA,coma,and spherical aberration than SMILE group(P=0.003,<0.00001,0.04).Yet higher trefoil was found in ICL group at 6mo after surgery(P=0.003).Additionally,ICL group also had a higher MTF value(P=0.02),and a higher contrast sensitivity score for spatial frequencies of 1.5,6,and 12 cpds(P=0.02,0.005,0.02,respectively).And it also had a lower score of bothersome in Qo V questionnaire than SMILE group(P=0.003).CONCLUSION:ICL implantation and SMILE have similar and comparable outcomes in term of the efficacy and predictability for correcting high myopia.However,ICL group is relatively safer and also has better visual quality in comparison of SMILE group.

Effectiveness and the nomogram of small incision lenticule extraction in the correction of myopic anisometropia in adults

AIM:To evaluate the safety,effectiveness,and predictability of small incision lenticule extraction(SMILE)for the treatment of anisometropia,and to explore the personalized design scheme of SMILE in correcting adult myopia anisometropia based on the nomogram.METHODS:It’s a prospective cohort study.Patients with anisometropic myopia of refractive difference≥2.0 diopters(D)who underwent SMILE between September 2020 and March 2021 were enrolled.Clinical features and visual function were assessed preoperatively and at 1wk,1,3,and 6mo after the operation.The examination included tests for uncorrected distance visual acuity(UDVA),corrected distance visual acuity(CDVA),refractive errors,effectiveness index(preoperative CDVA/postoperative UDVA),safety index(postoperative CDVA/preoperative CDVA),nomogram and stereoscopic function.Paired t-test,Wilcoxon signed-rank test and repeated-measures analyses of variance were used for continuous variables,and Pearson Chi-squared test was used for categorical variables.RESULTS:The study involved 45 consecutive patients(average age:25.0±6.9y;82 out of 90 eyes underwent SMILE,while 8 eyes were not operated).The average preoperative spherical equivalent(SE)was-4.74±0.22 D.Six months after surgery,the effectiveness index was 1.05±0.12,and the safety index was 1.09±0.11.Seventy eyes(85.4%)exhibited SE correction error within±0.5 D.The percentage of eyes with Titmus stereoscopic function equal to or less than 200”significantly increased from 55.6%preoperatively to 88.9%postoperatively(P<0.05).There was statistically significant difference between higher myopia eyes and contralateral eyes in average nomogram value/spherical refraction ratio.CONCLUSION:SMILE is safe,effective and predictable in correcting myopic anisometropia,and it improves stereoscopic visual function of anisometropia patients.The precise and individualized design of the nomogram is a vital element to ensure the balance of both eyes after SMILE.

A 3-month comparison study of subjective and objective visual quality of small incision lenticule extraction and transepithelial photorefractive keratectomy in patients with low and moderate myopia

AIM:To compare the subjective and objective visual quality between small incision lenticule extraction(SMILE)and transepithelial photorefractive keratectomy(t PRK)in patients with low and moderate myopia.METHODS:Patients undertaking SMILE or t PRK for the correction of low and moderate myopia were consecutively recruited in this prospective cohort study with a 3-month follow-up period.Objective evaluation[visual acuity test,manifest refraction,wavefront aberrations,the total cut-off value of the total modulation transfer function(MTFcut-off),and Strehl ratio(SR)]and subjective evaluation of visual quality(quality-of-life questionnaire)were conducted before surgery and at days 1,7,30,and 90 after surgery.RESULTS:A total of 47 patients(94 eyes)with SMILE and 22 patients(22 eyes)with t PRK were enrolled.The uncorrected visual acuity(UCVA)was better in SMILE patients on day 7 after surgery(1.13±0.13 vs 0.99±0.17,t=4.85,P<0.001)but was comparable at days 30 and 90.At day 90,the SMILE group had a lower spherical equivalent(SE)than the t PRK group(0.04±0.31 vs 0.19±0.43,t=2.08,P=0.042).Total higher order aberrations(HOAs)were induced in both surgical types,which were more evident in the t PRK group with 3-mm pupil diameter(0.16±0.07 vs0.11±0.05,t=4.27,P<0.001)and 5-mm pupil diameter(0.39±0.17 vs 0.36±0.11,t=2.33,P=0.022).The MTFcut-offand SR showed a trend of improvement in both SMILE and t PRK patients but were statistically better in the SMILE group with both pupil diameters.There was a significant improvement of contrast sensitivity(CS)over baseline levels at the spatial frequency of 18 cycles/degree(c/d)in the SMILE group(F=2.72,P=0.033)and at 3 c/d(F=3.03,P=0.031),12 c/d(F=3.72,P=0.013),and 18 c/d(F=4.62,P=0.004)in the t PRK group.The subjective quality of life questionnaire showed a steady improvement in the SMILE group(F=8.31,P<0.001)but not the t PRK group.CONCLUSION:SMILE and t PRK are both safe and effective ways to correct low and moderate myopia.A generally better and quicker recovery of visual quality favors the application of SMILE in qualified patients.

Phacoemulsification versus small incision cataract surgery in patients with uveitis

AIMTo compare the safety and efficacy of phacoemulsification and small incision cataract surgery (SICS) in patients with uveitic cataract.METHODSIn a prospective, randomized multi-centric study, consecutive patients with uveitic cataract were randomized to receive phacoemulsification or manual SICS by either of two surgeons well versed with both the techniques. A minimum inflammation free period of 3mo (defined as less than 5 cells per high power field in anterior chamber) was a pre-requisite for eligibility for surgery. Superior scleral tunnel incisions were used for both techniques. Improvement in visual acuity post-operatively was the primary outcome measure and the rate of post-operative complications and surgical time were secondary outcome measures, respectively. Means of groups were compared using t-tests. One way analysis of variance (ANOVA) was used when there were more than two groups. Chi-square tests were used for proportions. Kaplan Meyer survival analysis was done and means for survival time was estimated at 95% confidence interval (CI). A P value of &#x0003c;0.05 was considered statistically significant.RESULTSOne hundred and twenty-six of 139 patients (90.6%) completed the 6-month follow-up. Seven patients were lost in follow up and another six excluded due to either follow-up less than six months (n=1) or inability implant an intraocular lens (IOL) because of insufficient capsular support following posterior capsule rupture (n=5). There was significant improvement in vision after both the procedures (paired t-test; P&#x0003c;0.001). On first postoperative day, uncorrected distance visual acuity (UDVA) was 20/63 or better in 31 (47%) patients in Phaco group and 26 (43.3%) patients in SICS group (P=0.384). The mean surgically induced astigmatism (SIA) was 0.86&#x000b1;0.34 dioptres (D) in the phacoemulsification group and 1.16&#x000b1;0.28 D in SICS group. The difference between the groups was significant (t-test, P=0.002). At 6mo, corrected distance visual acuity (CDVA) was 20/60 or better in 60 (90.9%) patients in Phaco group and 53 (88.3%) in the manual SICS group (P=0.478). The mean surgical time was significantly shorter in the manual SICS group (10.8&#x000b1;2.9 versus 13.2&#x000b1;2.6min) (P&#x0003c;0.001). Oral prednisolone, 1 mg/kg body weight was given 7d prior to surgery, continued post-operatively and tapered according to the inflammatory response over 4-6wk in patients with previously documented macular edema, recurrent uveitis, chronic anterior uveitis and intermediate uveitis. Rate of complications like macular edema (Chi-square, P=0.459), persistent uveitis (Chi-square, P=0.289) and posterior capsule opacification (Chi-square, P=0.474) were comparable between both the groups.CONCLUSIONManual SICS and phacoemulsification do not differ significantly in complication rates and final CDVA outcomes. However, manual SICS is significantly faster. It may be the preferred technique in settings where surgical volume is high and access to phacoemulsification is limited, such as in eye camps. It may also be the appropriate technique for uveitic cataract under such circumstances.

Comparison of surgically induced astigmatism in various incisions in manual small incision cataract surgery

AIMTo determine the surgically induced astigmatism (SIA) in Straight, Frown and Inverted V shape (Chevron) incisions in manual small incision cataract surgery (SICS).

Cataract surgery in aged patients:phacoemul-sification or small-incision extracapsular cataract surgery

AIM: To evaluate the effects and safety of phacoemulsification (Phaco) or small-incision extracapsular cataract surgery (SICS) and intraocular lens (IOL) implantation for aged patients. METHODS: Totally 137 aged patients (149 eyes) underwent cataract operation in the case of stable systemic condition, the blood pressure less than 160/95mmHg, blood glucose less than 8mmol/L, and under the help of electrocardiogram surveillance by anesthesiologists during the operation. 106 aged patients (114 eyes) underwent Phaco while 31 aged patients (35 eyes) underwent SICS. The postoperative visual acuity, corneal endothelial cell loss, surgery time and major complications were observed and analyzed retrospectively. RESULTS: The best-corrected visual acuity (BCVA) of >= 0.6 was achieved in 135 eyes (92.6%) at 1 month postoperatively (chi(2)=259.730, P<0.001). For aged patients, both Phaco and SICS could significantly improve visual acuity with no significant difference (chi(2)=4.535, P > 0.05). Postoperative corneal endothelial cell loss was 18.6%, in PHACO group, the rate was 18.5%; in SICS group, the rate was 19.0%, the difference of which was no significant (chi(2)=0.102, P>0.05). The surgery time was different in two groups. No severe complications occurred. CONCLUSION: Both Phaco and SICS combined with IOL implantation for aged patients are effective and safe. Before surgery, detailed physical examination should be performed. When the systemic condition is stable, cataract surgery for aged patients is safe.

Outcomes after combined excisional goniotomy and manual small incision cataract surgery

AIM: To report the long-term outcomes of combined excisional goniotomy and manual small incision cataract surgery(MSICS).METHODS: This is a retrospective case series of patients with open angle glaucoma and visually significant cataracts that underwent combined excisional goniotomy and MSICS with one-year follow-up. The medical history, demographic information, and clinical characteristics of each case were recorded. Data regarding changes in vision, intraocular pressure(IOP), the number of glaucoma medications, and the evolution of the disease after surgery were reported. RESULTS: Three patients, with open angle glaucoma and cataracts underwent combined excisional goniotomy and MSICS without adverse events. All patients had improvement in vision compared to baseline measurements. The range of IOP at baseline was from 14 to 18 mm Hg and decrease to a range of 10 to 14 mm Hg after one year of follow-up. Additionally, two patients also decreased their dependence on IOP-lowering medications at the last follow up visit with one patient maintaining baseline level of medication use.CONCLUSION: A combination of excisional goniotomy and MSICS illustrates both the safety and efficacy to treat patients with visually significant cataract and glaucoma. This procedure allows for a more cost-effective surgical approach that matches the needs of resource strained territories around the globe.

A reasonable option in vitrectomized eyes: manual small incision cataract surgery

Dear Sir,It is known that cataract surgery is challenging in vitrectomized eyes.Cataract surgeons may have encountered with posterior capsular complications and nucleus drop events even with minimal ocular manipulations and low irrigation bottle height.Inadvertent damage to the zonular fibers,posterior or peripheral lens capsule with ocutome or microvitreoretinal(MVR)blade in previous

Incision Site in Manual Small Incision Cataract Surgery in Case of Preoperative Direct Astigmatism

We compared surgically induced astigmatism (SIA) by a superior incision with a temporal incision in manual small incision cataract surgery (MSICS), in patients with bilateral direct (regular) preoperative corneal astigmatisms. Patients and method: We carried out a prospective study from July 1st 2018 to September 30th 2019 in the department of ophthalmology at the University Hospital of Brazzaville. Keratometric readings were recorded before surgery to assess preoperative corneal astigmatisms. Keratometric evaluation was done 45 days post-operatively. Patients were followed 90 days after surgery in order to assess the healing of the surgical site. The surgically induced astigmatism (SIA) is the difference in the magnitude vectors between the preoperative and postoperative astigmatism. The result was positive if the postoperative astigmatism was greater than the preoperative astigmatism and negative if the postoperative astigmatism was less than the preoperative astigmatism. Results: Our study sample included 48 eyes from 24 patients, including 24 operated on temporal incision and 24 in superior incision. The average SIA for superior incisions was 0.33 ± 1.55 diopters (D), versus 0.33 ± 1.44 for temporal incisions. For superior incisions the SIA was 0.81 for astigmatisms lower than 2D, against 0.16D for the temporal incisions. On the other hand, for preoperative astigmatisms greater than 2D, the surgically induced astigmatism was &plusmn;0.62D, marking a decrease in preoperative astigmatism for the superior incisions against an increase of 0.5D for the temporal incisions. The healing was delayed for the temporal incisions responsible for discomfort persisting beyond 45 days. Conclusion: The temporal incision had better results than the superior incision for astigmatisms lower than 2D, and less good for astigmatisms higher than 2D. The temporal incision healed less well.

Visual outcome of manual small-incision cataract surgery:comparison of modified Blumenthal and Ruit techniques

AIM:To compare the efficacy and visual results of the modified Blumenthal and Ruit techniques for manual small-incision cataract surgery(MSICS).· METHODS:This was a prospective,non-randomized comparison of 129 patients with senile cataracts scheduled to undergo routine cataract surgery via either a superior scleral tunnel incision,i.e.,the Blumenthal technique(group 1,n = 64) or a temporal scleral tunnel incision,i.e.,the Ruit technique(group 2,n =65).MSICS and intraocular lens implantation were performed through an unsutured 6.5-to 7.0-mm scleral tunnel incision.Uncorrected and corrected visual acuity,intraoperative and postoperative complications,and surgically induced astigmatism calculated by simple subtraction were compared.Patients were examined at 1 day,1 week,1 month,and 3 months after surgery.· RESULTS:Both groups achieved good visual outcome with minor complications.Three months after surgery,the corrected visual acuity was 0.73 in the Blumenthal group and 0.69 in the Ruit group(P =0.29).The average(SD) postoperative astigmatism was 0.87(0.62) diopter(D) for the Blumenthal group and 0.86(0.62) D for the Ruit group.The mean(SD) surgically induced astigmatism was 0.55(0.45) D and 0.50(0.44) D for the Blumenthal and Ruit groups,respectively(P =0.52).Common complications were minimal hyphema and corneal edema.There was no statistically significant difference in the complication rate between the groups(P >0.05).· CONCLUSION:In MSICS,both the Blumenthal and Ruit techniques achieved good visual outcomes,with low complication rates.

Three-year results of small incision lenticule extraction and wavefront-guided femtosecond laser-assisted laser in situ keratomileusis for correction of high myopia and myopic astigmatism

AIM： To compare and calculate the 3-year refractive results, higher-order aberrations （HOAs）, contrast sensitivity （CS） and dry eye parameters after small incision lenticule extraction （SMILE） and wavefront-guided femtosecond laser-assisted laser in situ keratomileusis （FS-LASIK） for correction of high myopia and myopic astigmatism. METHODS： In this prospective, non-randomized comparative study, 78 eyes with spherical equivalent （SE） of -8.11±1.09 diopters （D） received a SMILE surgery, and 65 eyes with SE of -8.05±1.12 D received a wavefront-guided FS-LASIK surgery with the VisuMax femtosecond laser （Carl Zeiss Meditec, Jena, Germany） for flap cutting. Visual acuity, manifest refraction, CS, HOAs, ocular surface disease index （OSDI） and tear break-up time （TBUT） were evaluated during a 3-year follow-up. RESULTS： The difference of uncorrected distance visual acuity （UDVA） postoperatively was achieved at lmo and at 3mo, whereas the difference of the mean UDVA between two groups at 3y were not statistically significant （t=-1.59, P=-0.13）. The postoperative change of SE was 0.89 D in the FS-LASIK group （t=5.76, P=0.00）, and 0.14 D in the SMILE group （t=-0.54, P=0.59） from lmo to 3y after surgery. At 3-year postoperatively, both HOAs and spherical aberrations in the SMILE group were obviously less than those in the FS-LASIK group （P=0.00）, but the coma root mean square （RMS） was higher in the SMILE group （0.59±0.26） than in the FS-LASIK group （0.29±0.14, P=0.00）. The mesopic CS values between two groups were not statistically significant at 3y postoperatively. Compared with the FS-LASIK group, lower OSDI scores and longer TBUT values were found in the SMILE group at Imo and 3mo postoperatively. With regard to safety, no eye lost any line of CDVA in both groups at 3y after surgery. CONCLUSION： Both SMILE and wavefront-guided FS- LASIK procedures provide good visual outcomes. Both procedures are effective and safe, but SMILE surgery achieve more stable long-term refractive outcome and better control of early postoperative dry eye as compared to FS-LASIK.

The early change of corneal vertical coma and trefoil in 2.8-mm superior incision cataract surgery

Background: To investigate early change of corneal aberrations after 2.8-mm superior incision phacoemulsification.Methods: This study comprised 80 eyes of 75 patients. All the patients underwent phacoemulsification with monofocal foldable intraocular lens(IOLs) implanted through a 2.8-mm superior corneal incision. The anterior corneal wavefront aberrations for the 6.0-mm pupillary diameter was measured by i Trace wavefront aberrometer(Tracey Technologies, Inc.) preoperatively and 1 month postoperatively. Changes of root mean square(RMS) values of Z(3,-3), Z(3, 3), Z(3,-1), Z(3, 1), and Z(4, 0) and total high order aberration(HOA) were evaluated.Results: The uncorrected and corrected visual acuities improve significantly(P<0.001). No significant postoperative changes were observed in spherical aberration(P=0.652). Significant changes in vertical coma and vertical trefoil(0.005±0.214 vs.-0.049±0.242, P=0.037;-0.141±0.222 vs.-0.258±0.359, P=0.001; separately). However, the total HOAs increased after cataract surgery(0.567±0.161 vs. 0.688±0.343, P<0.001).Conclusions: Corneal vertical coma and vertical trefoil changes significantly in 2.8mm superior corneal incision phacoemulsification cataract surgery. In addition, those had a trend to negative direction.

Astigmatism following Small Incision Cataract Extraction through Superotemporal Incision

Purpose:.To investigate the occurrence of corneal incision-induced astigmatism following small incision extracapsular cataract extraction through a superotemporal incision combined with intraocular lens (IOL) implantation. Methods:.A total of 255 cases (301 eyes) who received small incision extracapsular cataract extraction through a superotemporal incision with IOL implantation in the Department of Ophthalmology, Yuyan District Hospital of Guiyang were enrolled in this clinical trial..Postoperative best-corrected visual acuity and astigmatism were measured. The patients underwent 24-week follow-up. Results: In total, 166 patients (65.1%, 166 eyes) completed follow-up..Astigmatism gradually declined between 1 and 12-week postoperatively, and stabilized after 12 weeks. Among 166 patients,.125(75.3%).had astigmatism > 0.5 D at 24 weeks post-operatively,.showing mostly with-the-rule astigmatism. Visual acuity steadily improved up to 12 weeks, and tended to stabilize subsequently..Over the period of 24-week postoperatively,.visual acuity was negatively correlated with astigmatism (r=-0.691,P<0.05). Conclusion:Superotemporal small incision extracapsular extraction combined with IOL implantation is associated with modest astigmatism which declines over the post-operative period.

超声引导技术在小切口微创心脏手术建立外周体外循环中的应用价值

目的探讨超声引导技术在小切口微创心脏手术经右颈内静脉穿刺置管及股动静脉解剖置管建立外周体外循环中的应用价值。方法分析2021年8月至2022年12月西安交通大学第一附属医院收治的436例进行小切口微创心脏手术患者的临床资料,根据置管过程中是否使用超声引导技术将研究对象分为对照组(给予传统方式置管,102例)和观察组(给予超声引导技术辅助下置管,334例)。比较分析两组患者经右颈内静脉穿刺置管的情况以及相关并发症发生率。比较分析两组患者股动静脉解剖置管的情况以及相关并发症发生率。结果观察组患者经右颈内静脉穿刺置管的穿刺置管成功率高于对照组,置管时间、穿刺困难发生率、误入颈内动脉发生率均短于或低于对照组,差异均有统计学意义(P<0.05)。观察组患者股动静脉解剖置管的置管时间、解剖困难发生率、导管位置异常发生率均短于或低于对照组,差异均有统计学意义(P<0.05)。结论超声引导技术应用于小切口微创心脏手术经右颈内静脉穿刺置管及股动静脉解剖置管建立外周体外循环中,能提高穿刺置管成功率,缩短置管时间,减少导管位置异常、误入颈内动脉等并发症的发生。

腋窝皱襞线小切口“直观下拿捏翻转”大汗腺剪除术治疗腋臭

目的:回顾性分析腋窝皱襞线小切口“直观下拿捏翻转”大汗腺剪除术治疗腋臭的疗效和安全性。方法:2018年6月-2021年6月,笔者科室治疗68例(133侧)腋臭患者。术中顺腋窝皱襞线做一长1.5~2.0 cm切口,组织剪沿浅表脂肪层与浅筋膜间剥离至腋毛区外约1 cm,肩关节充分外展,眼科小弯剪在盲视下修剪皮瓣下脂肪和大汗腺组织;内收肩关节,“直观下拿捏翻转”已剪薄的皮瓣,直视下修剪残余大汗腺组织。自粘弹力绷带“8”字包扎固定。结果:腋臭治疗总有效率为98.49%,并发症发生率1.5%,术后随访1~3年,所有患者均对治疗效果满意。结论:采用腋窝皱襞线小切口“直观下拿捏翻转”大汗腺剪除术治疗腋臭,效果良好且并发症较少,方法简便易学,值得临床推广应用。

改良式小切口病灶清除术联合功能性颈淋巴结清扫术对颈部淋巴结核的治疗效果观察

目的探讨改良式小切口病灶清除术联合功能性颈淋巴结清扫术(FND)治疗颈部淋巴结核的临床效果。方法选取2020年8月至2022年8月河北省胸科医院普外科收治的颈部淋巴结核患者104例,采用随机数字表法分为观察组和对照组,每组52例。观察组采用改良式小切口病灶清除术联合FND治疗,对照组采用常规切口病灶清除术联合FND治疗。比较两组的治疗效果、手术相关指标、切口愈合情况、术后疼痛程度及并发症发生情况。结果两组治疗总有效率比较差异无统计学意义(P>0.05)。观察组术中出血量少于对照组,手术时间、切口长度、引流管拔除时间、住院时间、切口瘢痕长度、切口愈合时间短于对照组,切口愈合良好率高于对照组,术后12、24、48、72 h静息及活动状态下的疼痛视觉模拟量表评分低于对照组,差异均有统计学意义(P<0.05)。观察组术后并发症发生率为3.85%,明显低于对照组的17.31%,差异有统计学意义(P<0.05)。结论改良式小切口病灶清除术联合FND治疗颈部淋巴结核可促进术后恢复及切口愈合,减轻术后疼痛,且并发症较少,值得临床应用。

经颈侧方入路甲状腺小切口手术与传统甲状腺手术治疗单侧甲状腺肿瘤的临床效果

目的:分析比较经颈侧方入路甲状腺小切口手术与传统甲状腺手术治疗单侧甲状腺肿瘤的临床效果。方法:选取2022年1月—2023年12月甘肃省肿瘤医院收治的120例单侧甲状腺肿瘤患者为研究对象。根据样本纳入时间分组,其中2022年1—12月60例患者为参照组,实施传统甲状腺手术治疗;2023年1—12月60例患者为研究组,实施经颈侧方入路甲状腺小切口手术治疗。对比两组患者相关治疗指标、疼痛程度、并发症发生情况及术后创面美观满意度。结果:研究组患者切口长度短于参照组,术中出血量少于参照组,手术时间及住院时间短于参照组,差异有统计学意义(P<0.05);研究组患者术后1 d、3 d疼痛程度评分均低于参照组,差异有统计学意义(P<0.05);研究组并发症发生低于参照组,差异有统计学意义(P<0.05);研究组患者术后创面美观满意度总评分高于参照组,差异有统计学意义(P<0.05)。结论:与传统甲状腺手术治疗相比,对单侧甲状腺肿瘤患者实施经颈侧方入路甲状腺小切口手术治疗,可取得更为理想的疗效,有效缩短手术时间及术中出血量等,减轻患者应激反应及疼痛程度,进而可有效减少相关并发症发生,且术后创面美观度相对较高。

胸腔镜辅助小切口手术和全胸腔镜手术治疗非小细胞肺癌患者的临床疗效及安全性

目的探讨胸腔镜辅助小切口手术和全胸腔镜手术治疗非小细胞肺癌(NSCLC)患者的临床疗效及安全性。方法根据手术方式的不同将108例NSCLC患者分为研究组(n=56,全胸腔镜手术)和对照组(n=52,胸腔镜辅助小切口手术)。比较两组患者的临床疗效、手术相关指标、肿瘤标志物[糖类抗原(CA)125、CA50、细胞角质蛋白19片段抗原21-1(CYFRA21-1)、鳞状细胞癌抗原(SCC-Ag)]水平及并发症发生情况。结果两组患者的总有效率和并发症总发生率比较,差异均无统计学意义(P﹥0.05)。研究组患者术中出血量明显少于对照组,术后引流时间明显短于对照组,术后1天视觉模拟评分法(VAS)评分明显低于对照组,差异均有统计学意义(P﹤0.01)。术后3天,两组患者SCC-Ag、CYFRA21-1、CA125、CA50水平均低于本组术前,差异均有统计学意义(P﹤0.05)。术后3天,两组患者SCC-Ag、CYFRA21-1、CA125、CA50水平比较,差异均无统计学意义(P﹥0.05)。结论胸腔镜辅助小切口手术和全胸腔镜手术治疗NSCLC患者的临床疗效和安全性相近,均可降低肿瘤标志物水平,而全胸腔镜手术能够减少术中出血量,缩短术后引流时间,减轻疼痛,更有利于患者术后恢复。

全肩关节镜和关节镜辅助小切口手术治疗肩袖损伤的对比研究

目的探讨应用全肩关节镜手术与关节镜辅助下小切口手术治疗肩袖损伤的疗效差异及对术后关节功能的影响。方法选取2020年1月~2022年12月收治的肩袖损伤并接受手术治疗的患者93例,随机分A组和B组,A组47例、B组46例。A组接受关节镜辅助下小切口手术,B组接受全肩关节镜手术。比较两组手术失血量、手术用时、住院用时、视觉模拟疼痛评分(VAS)、美国加州大学肩关节功能评分(UCLA)及整体疗效差异。结果术前两组VAS评分、UCLA评分比较,差异无统计学意义(P>0.05),术后1月、3月、6月B组各时间点VAS评分均低于A组(P<0.05),B组UCLA评分均高于A组(P<0.05);B组手术失血量、住院时间少于A组,手术用时高于A组(P<0.05);两组治疗总优良率比较,差异无统计学意义(P>0.05)。结论两种手术整体疗效相近;关节镜下小切口手术创伤性低,手术用时短;全肩关节镜手术失血量少、住院用时短,且术后疼痛与关节功能恢复效率更高。

右腋下小切口与胸骨正中切口两种入路方式治疗先天性心脏病患儿的效果观察

目的探讨先天性心脏病患者采取不同入路手术治疗的临床价值。方法抽取洛阳市中心医院2021年1月至2023年12月收入的先天性心脏病患儿70例,依据不同手术方式分为对照组与观察组,各35例,对照组接受胸骨正中切口,观察组接受右腋下小切口,对两组患儿临床指标(手术时间、体外循环时间、输血量、胸腔引流量、主动脉阻断时间、住院时间),疼痛程度,呼吸功能及并发症发生情况进行组间比较。结果两组患儿手术时间、体外循环时间、主动脉阻断时间相比,差异无统计学意义(P>0.05),观察组输血量、胸腔引流量均低于对照组,且住院时间短于对照组,差异有统计学意义(P<0.05);两组患儿各时间段呼吸功能指标相比,差异无统计学意义(P>0.05);观察组患儿各时间段疼痛程度评分均低于对照组,差异有统计学意义(P<0.05);两组患儿并发症发生风险相比,差异无统计学意义(P>0.05)。结论两种手术入路方式均可治疗先天性心脏病,且与胸骨正中切口相比,右腋下小切口不会影响患儿呼吸功能,且可改善疼痛程度,促进患儿快速康复,安全性较高,值得临床应用。