Objective To explore the impact of microvascular invasion (MVI) on the survival prognosis of patients after radical hepatectomy for hepatocellular carcinoma, to analyze its related risk factors, and to provide reference and support for the treatment of early postoperative recurrence. MethodsBy searching domestic and international medical literature databases, we screened studies related to MVI in hepatocellular carcinoma, focusing on the definition, grading, risk factors, preoperative prediction methods, and postoperative treatment strategies of MVI, and summarized the results of the existing studies. ResultsMVI is widely recognized as a significant risk factor for the intrahepatic metastasis and early postoperative recurrence of hepatocellular carcinoma. This paper aims to comprehensively investigate the characteristics of MVI and its impact on the postoperative recurrence of hepatocellular carcinoma, with a specific focus on identifying the risk factors associated with MVI. The study encompasses cutting-edge fields such as imaging genomics and genomics, with the objective of providing a scientific foundation for preoperative evaluation. Additionally, the paper examines postoperative treatment strategies for MVI, including comprehensive options such as local therapy, systemic therapy, and antiviral therapy, in order to establish a multidimensional intervention pathway for patients with hepatocellular carcinoma. The ultimate goal is to enhance prognosis and reduce recurrence rates. In the future, further refinement of MVI-related risk factors and optimization of preoperative prediction models, along with the development of personalized postoperative treatment plans, will be crucial areas of focus for hepatocellular carcinoma research and clinical practice. ConclusionsThe study of MVI and its targeted treatment strategies are important for reducing the postoperative recurrence rate of hepatocellular carcinoma and improving patient survival. The preoperative prediction model and postoperative treatment plan should be optimized in the future to provide more effective treatment reference for patients.
ObjectiveTo evaluate and analyze the clinical effect of ambulatory surgery applied to laparoscopic cholecystectomy (LC).MethodsThe patients who underwent LC in the First Affiliated Hospital of Xinjiang Medical University from June 2017 to February 2019 were collected, then were assigned to ambulatory surgery applied to LC group (ALC group) and conventional LC group (CLC group) according to the admission process mode. The patients in the ALC group received LC in the ambulatory ward and the patients in the CLC group received LC in the conventional ward. The preoperative waiting time, postoperative gastrointestinal recovery time, postoperative 6 h pain score, total hospitalization time, total hospitalization cost, patient satisfaction, and postoperative complications were compared between the two groups.ResultsA total of 433 patients underwent LC were included in this study, including 176 patients in the ALC group and 257 patients in the CLC group. There were no significant differences in the age, gender, type of gallbladder diseases, etc. between the two groups (P>0.05) except body mass index (P<0.05). There was no perioperative death in the two groups. One patient converted to laparotomy in the CLC group. Compared with the CLC group, the preoperative waiting time, postoperative gastrointestinal recovery time, and the total hospitalization time were shorter, the postoperative pain score was lower, the total hospitalization cost was less, and the satisfaction rate of patients was higher in the ALC group (P<0.05). There was 1 case of incision infection and 1 case of ascites in the operation area in the ALC group and CLC group, 1 case of fever in the ALC group and 3 cases of fever in the CLC group, respectively. There was no difference in the overall incidence of complications between the two groups (P>0.05). During the follow-up of 6 to 26 months, there was no readmission in both groups.ConclusionPatients who undergone LC based on ambulatory surgery mode recover quickly, and hospitalization cost is less, satisfaction rate is higher.