-
Manual Lymphatic Drainage Therapy in the Knee Joint Functional Rehabilitation After TKA in Diabetic Knee Osteoarthritis Patients: A Randomized Clinical Trial
Hong Zhang,
Jiajie Yan,
Sujuan Lin,
Huajun Wang,
Lei Xiao,
Guorong She,
Ning Liu,
Zhengang Zha
Issue:
Volume 7, Issue 3, June 2019
Pages:
50-56
Received:
3 April 2019
Accepted:
16 May 2019
Published:
30 May 2019
Abstract: To investigate the clinical effect of manual lymphatic drainage on functional rehabilitation of patients with diabetic knee osteoarthritis. A total of 199 patients with diabetic osteoarthritis who underwent total knee arthroplasty (TKA) were enrolled in the hospital and there were 72 males and 127 females in these patients. They were randomly divided into manual lymphatic drainage group (103 cases) and routine care group (96 cases). The manual lymphatic drainage group was treated with manual lymphatic drainage on the basis of routine functional rehabilitation nursing in March, while the routine nursing group only received perioperative nursing for conventional knee replacement. The patients with manual lymphatic drainage and routine nursing were studied before and 1 week, 1 month, 1 month, 3 months, and 6 months after operation to get the results of the changes of knee active flexion and extension, limb swelling degree, VAS pain score and preoperative group, the difference of HSS score and AKS score of knee joint in 6 months after operation. The active knee flexion activity of patients in the manual lymphatic drainage group was better than that of the routine care group (P < 0.05). The active knee extension and knee swelling were better in the manual lymphatic drainage group than that in the routine nursing group 1 week and 1 month after operation (P < 0.05); there was no significant difference in knee active activity and knee swelling between the two groups in March and June (P > 0.05); The scores of HSS in patients with manual lymphatic drainage in each stage after operation were better than that in the routine care group (P < 0.05). The AKS pain scores of the manual lymphatic drainage group were better than those of the routine care group (P < 0.05). There was no statistical difference (P > 0.05) in the AKS pain scores of the two groups in March and June. The AKS clinical score and AKS function score of patients in the manual lymphatic drainage group were better than that in the routine care group (P < 0.05). In general, manual lymphatic drainage treatment for patients with diabetes after total knee surgery can not only effectively alleviate postoperative knee swelling and pain but can also accelerate knee joint function recovery and improve postoperative satisfaction.
Abstract: To investigate the clinical effect of manual lymphatic drainage on functional rehabilitation of patients with diabetic knee osteoarthritis. A total of 199 patients with diabetic osteoarthritis who underwent total knee arthroplasty (TKA) were enrolled in the hospital and there were 72 males and 127 females in these patients. They were randomly divid...
Show More
-
Effect Analysis of Opening Wedge High Tibial Osteotomy (OWHTO) for the Treatment of Medial Compartment Osteoarthritis
Songwei Huan,
Ning Liu,
Simin Luo,
Huige Hou,
Guorong She,
Tengfeng Zhuang,
Zhengang Zha
Issue:
Volume 7, Issue 3, June 2019
Pages:
57-62
Received:
14 April 2019
Accepted:
21 May 2019
Published:
30 May 2019
Abstract: To investigate the clinical efficacy of open wedge high tibial osteotomy (OWHTO) in the treatment of medial compartment osteoarthritis of the knee. The authors used open OWHTO combined with TomoFix internal fixation to treat 46 cases (52 knees) with knee osteoarthritis with patella varus deformity from 2015.01 to 2017.10. HSS score and VAS score of Knee joint were used to evaluate the improvement of knee function and pain before and after surgery. The femorotibial angle (FTA), medial proximal tibial angle (MPTA), kneecap varus angle (KVA), and Weight-bearing line ratio of lower limbs (WBL) were measured by videography, which can evaluate the correction effect of postoperative knee varus. There were no happenings of internal fixation failure, delayed bone healing or non-union in these follow-up patients. At the follow-up of 3 months, 6 months, and 12 months, the HSS scores of the patients were significantly higher than those before the operation, and the difference was statistically significant (P<0.05). On March, June, and December after surgery, the HSS scores of patients were significantly higher than those before surgery and the difference was statistically significant (P<0.05). The VAS scores were lower than those before surgery, and the difference was statistically significant (P<0.05). These scores had no significant difference in the different follow-up time points (P>0.05). Imaging examination indexes showed that FTA, MPTA, KVA and WBL were improved after surgery and the varus deformity was corrected. Moreover, the difference was statistically significant (P<0.05). These scores had no significant difference in the different follow-up time points (P>0.05). In general, OWHTO can relieve joint pain and improve joint function by correcting lower limb line, showing good effect on medial compartment osteoarthritis of knee joint with varus.
Abstract: To investigate the clinical efficacy of open wedge high tibial osteotomy (OWHTO) in the treatment of medial compartment osteoarthritis of the knee. The authors used open OWHTO combined with TomoFix internal fixation to treat 46 cases (52 knees) with knee osteoarthritis with patella varus deformity from 2015.01 to 2017.10. HSS score and VAS score of...
Show More
-
Cerebral Infarction After Lobectomy for Lung Cancer
Hiroyuki Miura,
Jun Miura,
Hiroshi Hirano
Issue:
Volume 7, Issue 3, June 2019
Pages:
63-66
Received:
22 April 2019
Accepted:
28 May 2019
Published:
10 June 2019
Abstract: Background and objective: The left upper lobectomy as treatment for lung cancer has been identified as a risk factor for cerebral infarction. We analyzed cases of surgery for lung cancer to clarify factors that increase the risk for postoperative cerebral infarction. Methods: This study included patients with primary lung cancer who underwent lobectomy or segmentectomy with >ND1 lymph node dissection from 2008 to 2014 at Hachioji Medical Center of Tokyo Medical University. In total, 479 patients (294 males and 157 females) were examined. Cases of cerebral infarction occurring within 30 days of surgery were retrospectively studied. All surgeries were performed under mini-thoracotomy with thoracoscopy support. Vessels >7 mm in diameter were amputated using a linear stapler. Results: Cerebral infarction occurred in four male patients, representing 0.8% (4/479) of all lung cancers and 1.4% (4/294) of all male patients. Of these four patients, three were in their 60s (1.4% of 157 patients in their 60s) and one was in his 70s (0.5% of 215 patients in their 70s). Two cases involved adenocarcinomas, and two involved squamous cell carcinomas. One patient underwent right upper lobectomy, two underwent right lower lobectomy, and one underwent left upper lobectomy. The cerebral infarctions occurred in a branch of the vertebral artery. The pons was impaired in three cases, and the cerebellum was impaired in one. Three patients had pl2 disease, and one patient had pl3 disease. Operative time was 4–5 h in two cases, 5–6 h in one, and >6 h in one. Only pl factor significantly differed between patients with and without postoperative cerebral infarction. Conclusions: To prevent cerebral infarction, the following factors should be considered: preoperative smoking cessation, operative positioning to protect the vertebral artery, shortening of operative time, and stronger anticoagulant therapy for high-risk patients, such as those with past history of transient ischemic attack.
Abstract: Background and objective: The left upper lobectomy as treatment for lung cancer has been identified as a risk factor for cerebral infarction. We analyzed cases of surgery for lung cancer to clarify factors that increase the risk for postoperative cerebral infarction. Methods: This study included patients with primary lung cancer who underwent lobec...
Show More
-
Application and Efficacy of Pubovesical Complex Preserving Technique During Laparoscopic Radical Prostatectomy
Chen Jiajun,
Zhu Zaisheng,
Shi Hongqi,
Zhou Pengfei,
Xu Lizhen,
Zhou Yibo,
Zhu Yiyi
Issue:
Volume 7, Issue 3, June 2019
Pages:
67-73
Received:
10 December 2018
Accepted:
22 December 2018
Published:
15 June 2019
Abstract: Urinary incontinence and Erectile function are two hot issues after radical prostatectomy. This study aims to explore the application and curative effect of “pubovesical complex preserving technique for intrafascial laparoscopic radical prostatectomy (PPLRP)”. Methods: This was a retrospective study of 200 patients who underwent laparoscopic radical prostatectomy (LRP) from January 2011 to May 2018. Results: During the study period, we collected 68 patients with PPLRP in group A, 46 patients with conventional intrafascial LRP in group B and 86 patients with interfascial LRP in group C, respectively. Three groups had no difference in terms of Preoperative age, Clinical stage, Prostate-specific antigen (PSA) value, Gleason score at biopsy and Preoperative good potency (IIEF-5 score) (P>0.05). There was no difference between the three groups in terms of operative time, intraoperative blood loss, time of catheter retain, postoperative stay and histologic status. All groups had similar PSM (positive surgical margin, PSM) rate. Continence rates at immediately after catheter removal, 1,3 and 6 months: 68% (46/68),85% (58/68),93% (63/68) and 100% (68/68) in group A; and 63% (29/46),80% (37/46),89% (41/46) and 96% (44/46) in group B; and 22% (19/63),49% (42/63),72% (62/63) and 84% (72/63) in group C. Regarding sexual function: No differences were found in the three groups in potency (IIEF-5 score). Baseline IIEF-score reached 50%,35% and 21% respectively at postoperative 6 months. Biochemical recurrence-free survival at 3 years was 79.3%,76.3% and 76.4% in A, B and C group, respectively. Conclusions: The PVC preserving technique for LRP provides early recovery from incontinence, faster recovery of sexual function preoperative levels. There is no adverse effect on the oncological outcome in the selective prostate cancer. It is an ideal way of nerve-sparing LRP.
Abstract: Urinary incontinence and Erectile function are two hot issues after radical prostatectomy. This study aims to explore the application and curative effect of “pubovesical complex preserving technique for intrafascial laparoscopic radical prostatectomy (PPLRP)”. Methods: This was a retrospective study of 200 patients who underwent laparoscopic radica...
Show More
-
Inguinal Hernia: A New (Not Anatomical) Classification
Alloni Rossana,
Luffarelli Paolo,
Mallozzi S. Maria Francesco,
Santoni Simone,
Lichinchi Domenico Ernesto,
Vitali Massimiliano Andrea
Issue:
Volume 7, Issue 3, June 2019
Pages:
74-77
Received:
26 April 2019
Accepted:
31 May 2019
Published:
24 June 2019
Abstract: Inguinal hernia is one of the most frequently found surgical problems, accounting for about 70-75 per cent of all hernia operations. Inguinal hernia represents a social disease, with considerable management costs. All classifications of inguinal hernia have something of arbitrary and artificial, and unfortunately are based on anatomic and functional criteria. Moreover, single hernia defect can be classified only during the operation and not in a preoperative setting. The aim of this study has been to evaluate the operative times and consequently identify factors that affect the surgical time. In this way we hope to create a new classification useful to standardize the operative time management. From February 2012 to June 2013, in the Day Surgery Unit of Campus Bio-Medico University of Rome, 110 consecutive patients were enrolled which underwent to inguinal hernioplasty, and they have been observed by the same surgical team. We evaluated clinical parameters (age, sex, BMI, hernia size defect, reducibility, primitive or recurrent hernia, previous hernia surgery) and compared them with surgical times. Data analysis shows a statistically significant relationship between reducibility, recurrent hernia, male gender, BMI and surgical times. This study confirms that an optimal clinical patient evaluation should always be the first step to an effective organizational choice and it allows realistic predictions about the duration of inguinal hernioplasty.
Abstract: Inguinal hernia is one of the most frequently found surgical problems, accounting for about 70-75 per cent of all hernia operations. Inguinal hernia represents a social disease, with considerable management costs. All classifications of inguinal hernia have something of arbitrary and artificial, and unfortunately are based on anatomic and functiona...
Show More
-
Decreased Overall Survival of Transanal vs. Transabdominal Resection of Early Rectal Cancer in Treatment Naïve Patients: A National Cancer Data Base Study
Crystal Koerner,
Xi Sheng,
Yuan Liu,
Theresa Gillespie,
Glen Balch,
Virginia Shaffer,
Charles Staley,
Jhanavi Srinivasan,
Patrick Sullivan
Issue:
Volume 7, Issue 3, June 2019
Pages:
78-86
Received:
6 May 2019
Accepted:
6 June 2019
Published:
1 July 2019
Abstract: Previous data from the National Cancer Database (NCBD) showed increasing rates of transanal local excision for early rectal cancer despite a lack of evidence supporting its oncologic adequacy. The aim of this study is to update national trends, compare overall survival, and determine factors associated with survival in patients with stage I rectal cancer. Survival of 15, 149 patients with stage I rectal adenocarcinoma were examined retrospectively from 2004-2012. The rate of local excision over this time period was sustained at 22% (20.88 - 24.9%; p = 0.077). Five-year overall survival (OS) after transanal local excision was less than transabdominal standard resection (76.6% vs. 80.7%; p < 0.0001). Lower 5-year OS for transanal local excision was maintained with propensity score matching (HR 1.23; CI (1.11-1.36; p < 0.001). Factors associated with decreased OS include positive margins, T2 tumors, tumors > 4 cm, low volume centers, uninsured patients and increasing comorbidities. This is the first study of national data showing sustained use of transanal local excision over the past decade. Local excision has a lower 5-year OS compared to transabdominal standard resection. Transanal excision of early rectal cancer should be offered to select patients only after careful consideration of risk factors balanced against the decrease in overall survival.
Abstract: Previous data from the National Cancer Database (NCBD) showed increasing rates of transanal local excision for early rectal cancer despite a lack of evidence supporting its oncologic adequacy. The aim of this study is to update national trends, compare overall survival, and determine factors associated with survival in patients with stage I rectal ...
Show More
