Objective To present early follow-up results of surgical closure of ruptured sinus of Valsalva aneurysm (RSVA). Methods We retrospectively analyzed the clinical data of 32 patients with RSVA or combined with RSVA in our hospital between January 2010 and December 2014. There were 20 males, 12 females aged 37.6±11.2 years. All the patients were surgically corrected under cardiopulmonary bypass. Results The mean cardiopulmonary bypass time was 79±18 min and the mean aortic cross-clamp time was 53±9 min. Except that 1 patient had the first degree A-V block and 2 patients with delayed wound healing, there was no other complication in the early postoperative period. One patient with surgically corrected RSVA was with infective endocarditis after 3 months follow-up. Most patients were with better New York Heart Association (NYHA) functional classⅠor Ⅱat the end of the follow-up. Conclusion Surgical closure of RSVA is a safe and effective alternative to surgery with early follow-up results.
The new effective systemic treatment strategy has "created" many long-term stage Ⅳ non-small cell lung cancer (NSCLC) survivors, and surgeons should pay attention to those individual ineffective lesions of long-term survivors. Besides, the new effective systemic treatment strategy may have changed the original concept and population of oligometasis. To intervene the oligo-progression lesions of long-term stage Ⅳ survivors, particularly after effective systemic treatment, at appropriate time with appropriate way might be the main task of surgery in the future.
ObjectiveTo evaluate the clinical efficacy of surgical intervention combined with endoscopic ultrasound-guided transluminal drainage in the treatment of infected pancreatic necrosis (IPN). MethodsA retrospective, historical control study was conducted. A total of 98 patients with acute pancreatitis (AP) complicated with IPN who met the inclusion and exclusion criteria and were admitted to the Third People’s Hospital of Chengdu from June 2016 to January 2023 were selected as the research objects. The endoscopic ultrasound-guided transluminal drainage was carried out in our hospital in June 2020. In this study, patients treated before May 2020 were divided into the non-EUS group (52 cases), and patients treated after June 2020 were divided into the EUS group (46 cases). The baseline data, surgical intervention, length of hospital stay, length of intensive care unit (ICU) stay, infection time, incidence of multiple organ dysfunction syndrome (MODS), survival situation, short-term and long-term complications, and other indicators were compared between the two groups. ResultsThe number of percutaneous catheter drainage (PCD, 1.0 vs. 1.0), the number of PCD drainage tube (1.0 vs. 2.0), the number of retroperitoneal debridement drainage (1.0 vs. 2.0), the total length of hospital stay (42.0 d vs. 45.5 d), the length of ICU stay (11.0 d vs. 14.0 d), the length of infection time (10.5 d vs. 18.5 d), the incidences of MODS [43.5% (20/46) vs. 67.3% (35/52)] and residual infection [28.3% (13/46) vs.48.1% (25/52)] in the EUS group were shorter (or lower) than those in the non-EUS group (P<0.05); but there were no significant differences in the number of endoscopic pancreatic stent implantation, the number of laparotomy, the number of laparoscopic surgery, and the incidences of abdominal bleeding, gastrointestinal fistula, gastrointestinal obstruction, chronic pancreatic fistula, chronic pancreatitis and incisional hernia between the two groups (P>0.05). ConclusionFor patients with AP complicated with IPN, surgical intervention combined with endoscopic ultrasound-guided transluminal drainage can reduce the number of PCD and drainage tube, shorten the total length of hospital stay, the length of ICU stay and infection, as well as reduce the incidences of MODS and residual infection.