Villumsenovesen8955

OBJECTIVE To compare the outcomes of robot-assisted (RA) and standard laparoscopic gynecological surgery (S-LGS) in a tertiary care hospital, and evaluate the factors affecting the outcomes of RA-LGS to identify areas of improvement. STUDY DESIGN A descriptive study. PLACE AND DURATION OF STUDY King Fahad Medical City, Riyadh, Saudi Arabia, from 2013 to 2018. METHODOLOGY In this 5-year retrospective study, 65 LGS cases, including 37 RA-LGS and 28 S-LGS, in a single tertiary care hospital, were included. Demographic data, clinical pathological details, and complications of the cases were recorded. Surgeons performing RA-LGS were also interviewed regarding their training/experience, competency of surgical assistance, and suggestions for improving training. RESULTS Operative times (3.70 ±0.96 vs. 2.07 ±0.78 h, p less then 0.001) and hospital stays (3.53 ±3.29 vs. 1.96 ±1.34 days, p=0.022) were significantly longer in the RA-LGS group than in the S-LGS group. Intraoperative complications, which were primarily adjacent organ damage (21.6% vs. Neuronal Signaling inhibitor 0.0%, p=0.029), were significantly more common in the RA-LGS group. There were no significant differences between the groups in terms of the need to convert to laparotomy, immediate/late postoperative complications, estimated blood loss, or the need for blood transfusion. The interview survey results suggested the lack of a trained team assisting in RA-LGS, as the reason for the poor outcomes. CONCLUSION There were no advantages of RA-LGS over S-LGS. Longer training periods for RA-LGS, with minimum 20-50 cases as part of a structured training programme, may improve outcomes.OBJECTIVE To investigate the value of preoperative blood tests in predicting lymph node metastasis in colon cancer patients undergoing surgery. STUDY DESIGN Obervational study. PLACE AND DURATION OF STUDY General Surgery Department, Bolu Abant Izzet Baysal University Medicine School, Turkey, between December 2012 and December 2018. METHODOLOGY In 171 colon cancer patients, preoperative inflammatory markers such as albumin, C-reactive protein (CRP), platelet, neutrophil-to-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR) counts were determined. RESULTS The present study albumin, CRP and NLR values were also not significantly different between the groups. PLR (p=0.008) and PLT (p=0.039) were significantly different between the lymph node groups. ROC analysis was performed for PLT and PLR for the prediction of lymph node metastasis (Group 2 and 3). Accuracy for PLT was 0.623 and accuracy for PLR was 0.65. A PLT value >321.5 was found to be 63.7% sensitive and 68.6% specific in predicting lymph node metastasis. A PLR value >155.81 was 70% sensitive and 41% specific for predicting lymph node metastasis. CONCLUSION The platelet counts and PLR values are important in predicting lymph node metastasis in colon cancer, preoperatively. Platelet and PLR values may be more specific and sensitive in predicting preoperative lymph node metastasis in colon cancer patients.OBJECTIVE To investigate the relationship between small intestinal bacterial overgrowth (SIBO) and Endotoxin (ET) concentration in peripheral blood, and levels of toll-like receptors (TLR) 2 and TLR4 expression on surface of peripheral blood mononuclear cells (PBMCs) in patients with ulcerative colitis. STUDY DESIGN An experimental study. PLACE AND DURATION OF STUDY The First Hospital of Hebei Medical University, from July 2018 to October 2019. METHODOLOGY The 130 patients with ulcerative colitis were included in case group. Another 72 healthy cases were selected as control group. SIBO, ET, TLR2, and TLR4, were determined, and compared. RESULTS Positive rate of SIBO in case group was higher than that in control group (p less then 0.001). Lactulose hydrogen breath test (LHBT) intestine set value, peripheral blood ET concentration, and TLR2 and TLR4 expression levels on surface of PBMCs in case group were higher than those in control group (all p less then 0.001); the above indexes in SIBO-positive patients iia are more likely to have hypertoxemia.OBJECTIVE To investigate the value of Doppler ultrasound in evaluating the efficacy of high intensity focused ultrasound (HIFU) in treatment of cesarean section scar pregnancy. STUDY DESIGN Observational study. PLACE AND DURATION OF STUDY Department of Ultrasonography, The Second people's Hospital of Liaocheng City Affiliated to Shandong First Medical University, China, from January 2015 to December 2017. METHODOLOGY Forty-six patients with cesarean section scar pregnancy treated with HIFU were enrolled. Doppler ultrasound images, blood flow resistance index (RI) and β-human chorionic gonadotropin (β-hCG) levels were analyzed. RESULTS Among 46 patients, 31 cases (68.89%) were embryo sac type while 15 cases (32.61%) were mass-type. After 4 weeks of HIFU treatment, among 31 cases of embryo sac type of cesarean scar pregnancy, slightly increased echogenicity and thickened walls of yolk sac were observed in 15 cases (48.39%), heart beat disappeared in 12 cases (38.71%) and fetal heart rate as still regular in four cases (12.90%). Among 15 cases of mass-type treated with 4 weeks of HIFU, echogenicity was slightly elevated at first, then echogenicity of center zone decreased, resulting in mixed echoes, finally the volumes of mass decreased to varying degrees and blood flow reduced significantly, leading to slight strong mull echoes. Compared with before treatment of HIFU, RI levels were higher after 4 weeks treatment of HIFU (p less then 0.001), while the blood β-hCG levels were lower (p less then 0.001). CONCLUSION Doppler ultrasound can provide accurate qualitative diagnosis of cesarean section scar pregnancy, and possess higher clinical value in evaluating the treatment efficacy of cesarean section scar pregnancy with HIFU.OBJECTIVE To evaluate the efficacy of the monocyte/lymphocyte, platelet/lymphocyte, and HDL/LDL ratios as markers of the severity of coronary artery ectasia(CE). STUDY DESIGN Cross-sectional study. PLACE AND DURATION OF STUDY Department of Cardiology, Izmir Katip Celebi University and Balikesir University, Turkey, from January 2017 to October 2018. METHODOLOGY A total of 7,923 coronary angiographs were retrospectively scanned. Inclusion criteria was >1.5 times dilatated of native coronary artery segment. Exclusion criteria was less then 1.5 times or no dilatation of native coronary segment compared with normal coronary segment. Demographic features, CE type, clinic status, monocyte/lymphocyte, platelet/ lymphocyte and HDL/LDL ratios are collected. RESULTS Two hundred and six (2.6%) cases were identified, which had a mean age of 61.4 ±11.4 years. The male to female ratio was 31; and 46% of the patients presented with unstable angina. The prevalence of CE was 2.6%; and 118 (57.2%) patients had non-obstructive coronary artery disease.