Objective To investigate the effect of perioperative body temperature on the survival of skin flap grafting. Methods From July 2005 to November 2006, 50 cases of Ⅰ-Ⅱ grade patients undergoing elective skin flap grafting were randomly divided 2 groups. Pharyngeal temperature (PT) and skin temperature(ST) were monitored and recorded every 15 minutes. Operativetime, anesthetic time, time from the end of operation to extubation, the volume of blood transfusion, the volume of fluid transfusion and the flap survival 7 days after operation were recorded. In the experimental group, the body temperature was maintained in normal range with water market and forced air heater. In the control group， the body temperature was only monitored without any treatment. Results There were no significant differences in operating room temperature, operative time, anesthetic time, the volume of blood transfusion and fluid transfusion between 2 groups(Pgt;0.05). After induction, PT decreased gradually inboth groups during the first 45 minutes, compared with the time point of intubation(Plt;0.05),but there were no significant differences between the 2 groups(Pgt;0.05); and ST rose in both groups during the first45 minutes, compared with the time point of intubation (Plt;0.05). After 45 minutes of induction, in the experimental group, PT was in the normal range(36℃), and ST didn’t change compared with that of the timepoint of induction(Pgt;0.05). In the control group, both PT and ST decreasedgradually and timedependently compared with the time point of intubation (Plt;0.05). In the experimental group, PT and ST at each time point were higher than those in the control group (Plt;0.05). All the skin flap grafts survived in the experimental group, and skin flap grafts necrosed in 2 cases in the control group.Conclusion Keeping normal body temperature can improve the survival ofskin flap grafting. Therefore, the body temperature should be monitored and maintained in a normal range.
ObjectiveTo evaluate the effectiveness and safety of prophylactic ondansetron for the prevention of postoperative shivering. MethodsAccording to the Cochrane Handbook, we searched such databases as Cochrane Library, PubMed, OVID, EMbase, CNKI, CBM, and VIP (From January 1999 to September 2013) to collect the literature about ondansetron for the prevention of postoperative shivering. According to the predefined inclusion and exclusion criteria, we screened randomized controlled trials (RCTs). The included studies were evaluated and analyzed by meta-analysis with RevMan 5.0 software. ResultsNine RCTs involving 655 patients were included. The results of meta-analysis showed that there was a significant difference in incidence of postoperative shivering between group ondansetron and the controls [RR=0.32, 95%CI (0.24, 0.42), P<0.05]. There was a significant difference in incidence of postoperative nausea and vomiting between the ondansetron group and the control group [RR=0.30, 95%CI (0.14, 0.63), P<0.05]. There was no significant difference in the 1 min and 5 min neonate born Apgar score between the ondansetron group and the control group [WMD=0.03, 95%CI (-0.02, 0.09), P=0.26; WMD=-0.02, 95%CI (-0.12, 0.08), P=0.68]. ConclusionIntravenous ondansetron before surgery can significantly reduce postoperative shivering without any increment of adverse effects.
It was a short time from the initial investigation of tumor islands to the concept of tumor spread through air spaces (STAS) being adopted as a pattern of invasion in lung adenocarcinoma. Generally, STAS was defined as "spread of lung cancer cells into air spaces in the lung parenchyma beyond the edge of the main tumor". More and more studies had demonstrated that STAS could increase recurrence rate and cause worse prognosis in lung adenocarcinoma. However, criteria of this definition were various in previous studies, and there is no unified criterion of STAS up to now. In addition, perioperative manipulations including specimen processing and surgery procedure could squeeze tumor cells into alveolar spaces which could affect the assessment of STAS. Obviously, we need a precise definition to reduce and quantify the impacts of confounding factors. We summarize recent developments and put forward some advice for further studies in this article.
Lymph node metastasis in non-small cell lung cancer is an independent risk factor for poor prognosis. Resection of lymph nodes can improve the prognosis of patients. Although surgical techniques are progressing, there is still much controversy about the way of lymph node resection for non-small cell lung cancer. The research progress of hot topics such as the choice of lymph node resection methods for non-small cell lung cancer is discussed and summarized.