Conectar
by Qigen Fang, Liyuan Dai, Xu Zhang, Ruihua Luo, Junhui Yuan
This study aimed to assess the impact of the number and ratio of metastatic lymph nodes (LNs) on prognosis in submandibular gland cancer. To this end, patients were selected from the Surveillance, Epidemiology, and End Results database retrospectively. The effect of the number and ratio of metastatic LNs and the American Joint Committee on Cancer (AJCC) N stage on disease-specific survival (DSS) and overall survival (OS) was analyzed. In addition, prognostic models based on LN evaluation methods were developed to predict the OS and DSS. A total of 914 patients were included. Binary recursive partitioning analysis determined the optimal cut-off number of metastatic LNs (0 vs. 1–2. vs. 3+). The presence of 3+ metastatic LNs carried the greatest impact on prognosis, followed by 1–2 positive LNs occurrences. The ratio of metastatic LNs was an independent factor for DSS and OS. The model had a higher likelihood ratio and C-index than those in the Cox model based on the AJCC N stage. Quantitative LN burden and ratio of metastatic LNs provides better survival stratification than the AJCC N stage.This study was designed to identify risk factors for wound complications including surgical site infection (SSI) and wound healing issues following open reduction and internal fixation (ORIF) of ankle fractures. A retrospective analysis of individuals with ankle fractures treated with ORIF was undertaken. Study subjects were divided into a wound complications (WC) group and a no wound complication (NWC) group. The WC group was further divided into an SSI group and wound healing issues group. Twenty-one potential risk factors associated with wound complications after ORIF were tracked. Uni- and multivariate binary logistical regression analyses were used to identify risk factors associated with wound complications, ISS and wound healing issues. In total, 613 individuals, who had undergone surgery for ankle fractures formed the study cohort. The incidence of postoperative wound complications was 10.3% (63 cases), including 5.2% of SSI (32 cases) and 5.1% of wound healing issues (31 cases). The independent risk factors for wound complications were age 65 years or older, preoperative serum albumin level below 35 g/L, peripheral neuropathy, open fracture, fewer than seven cases per year in surgical volume, and attending surgeon level. The independent risk factors for SSI were age 65 years or older, preoperative serum albumin level below 35 g/L, open fracture and fewer than seven cases per year in surgical volume. The independent risk factors for wound healing issues were preoperative serum albumin level below 35 g/L, peripheral neuropathy, open fracture and attending surgeon level. Herein we found both factors inherent to the injury and individual and those pertaining to the surgical team affected the frequency of wound complications after ORIF of ankle fractures. Specifically, advanced age and low surgical volume were associated with a greater risk of SSI. Peripheral neuropathy and the low expertise level on the part of the surgeon were associated with a greater risk of wound healing issues. Hypoproteinaemia and open fracture were both associated with a greater risk of both SSI and wound healing issues.
Our study aimed to investigate the effects of an enhanced recovery after surgery (ERAS) nursing program on surgical site wound infections (SSWI) and postoperative complications in patients undergoing laparoscopic hepatectomy (LH) for hepatocellular carcinoma. Computer searches of the PubMed, Cochrane Library, Web of Science, Embase, China National Knowledge Infrastructure and Wanfang databases were conducted to gather randomised controlled trials (RCTs) that were published from inception to September 2023. The target studies evaluated the effects of the ERAS nursing program in patients undergoing LH for hepatocellular carcinoma. Two independent authors screened the literature, extracted the data and performed quality assessments. Dichotomous variables were analysed using odds ratios (ORs) and 95% confidence intervals (CIs), as effect analysis statistics. Stata software (version 17.0) was used for data analysis. Eleven RCTs with 765 patients were included, with 383 patients in the ERAS group and 382 in the control group. The results revealed that the incidence of SSWI (OR = 0.32, 95%CI:0.15–0.71, p = 0.004) and postoperative complications (OR = 0.23, 95%CI:0.15–0.34, p < 0.001) were both significantly reduced in the ERAS group, compared with the control group. The ERAS nursing program, when applied to patients undergoing laparoscopic hepatic cancer resection, can effectively reduce the incidence of SSWI and postoperative complications, thus promoting postoperative recovery.
FreshRSS 