Tag: pubmed

Ann Ital Chir. 2024;95(6):1108-1117. doi: 10.62713/aic.3531.

ABSTRACT

AIM: With the advantage of preserving thyroid function while minimizing intervention-related morbidity, minimally invasive thermal ablation techniques such as microwave ablation (MWA) and radiofrequency ablation (RFA) have emerged as alternatives to traditional open surgery. This study compares the efficacy and safety of MWA and RFA with that of open surgery for the treatment of benign thyroid nodules by utilizing a propensity score matching study design to improve comparability.

METHODS: This retrospective study included patients with benign thyroid nodules treated at the North China Electric Power University (Baoding) School Hospital between May 2020 and May 2023. Following propensity score matching, the patients were equally divided into three treatment groups: MWA, RFA, and open surgery. Data on demographic characteristics, thyroid function, treatment outcomes (including nodule size reduction, postoperative pain, cosmetics, hospital stay, and quality of life (QoL)), and postoperative complications were analyzed.

RESULTS: A total of 160 patients, including 55 patients who received MWA, 58 patients treated with RFA and 47 patients operated with open surgery, were initially included. Propensity score matching, aimed at minimizing baseline differences among the groups, was conducted, leaving behind 105 patients, who were equally distributed with 35 persons per group. Compared to open surgery, both MWA and RFA significantly reduced intraoperative blood loss, operation time, length of hospital stay, and pain scores (p < 0.05). The incidence of complications, such as hypothyroidism, hematoma, wound pain, and incision adhesion, was also significantly lower (p < 0.05). In addition, the MWA and RFA were superior to open surgery in terms of cosmetic satisfaction and overall QoL scores (p < 0.05). No significant differences were observed between the MWA and RFA groups in terms of treatment efficacy, complication rates, cosmetic satisfaction, and QoL scores (p > 0.05). At the 6-month follow-up, no significant differences in thyroid function were observed among the three treatment modalities (p > 0.05).

CONCLUSIONS: MWA and RFA exhibit comparable outcomes, in terms of efficacy and safety, for the treatment of benign thyroid nodules, with advantages over open surgery including shorter hospital stays, lower level of postoperative pain, better cosmetic outcomes, higher QoL scores, and lower rates of certain complications.

PMID:39723518 | DOI:10.62713/aic.3531

Ann Ital Chir. 2024;95(6):1270-1279. doi: 10.62713/aic.3555.

ABSTRACT

AIM: Class II Division I malocclusion is common in pediatric orthodontics, and is often associated with malocclusion and poor muscle functionality. However, research on post-treatment changes in maxillomandibular dimensions, excluding normal development influences, is limited. Therefore, this study aimed to investigate the effects of Myobrace® appliance and targeted muscle functional training on maxillomandibular dimensions in children with Class II Division I malocclusion, compared to directed oral muscle training alone.

METHODS: This retrospective study included 96 children with Class II Division I malocclusion. Based on the treatment method, the patients were divided into two groups: the treatment group (patients who underwent treatment with the Myobrace® muscle function appliance combined with directed muscle functional training for one year) and the control group (patients who received only directive oral muscle training for one year). The growth changes in jaws in both groups were assessed through X-ray cephalometry and plaster casting.

RESULTS: The Sella-Nasion to A point angle (SNA) had increased (p > 0.05), and the maxilla length increased, with significant differences between the two groups (p < 0.05). Furthermore, after intervention, there was a significant increase in mandibular length (p < 0.05). There was a slight decrease in the S-Co value indicating the position of the mandibula. However, this change was not significant, indicating that the mandibula didn’t move forward after treatment. The angle between the Frankfort Horizontal Plane and mandibular planes (MP-FH) increased after treatment (p > 0.05), and there were increasing trends on the Y axis, posterior heights, and anterior heights, and these changes were statistically significant (p < 0.05). Additionally, we observed a significant increase in the dental arch (p < 0.05) in the treatment group compared to the control group. This finding suggested that the Myobrace® appliance can promote dental arch growth.

CONCLUSIONS: Myobrace® appliance effectively boosts dental arch growth while correcting Class II Division I malocclusion. However, it may be limited in cases of Class II Division I with high-angle, maxillary protrusion, or severe mandibular retrusion, emphasizing the significance of assessing patient characteristics to ensure optimal improvement.

PMID:39723517 | DOI:10.62713/aic.3555

Ann Ital Chir. 2024;95(6):1125-1133. doi: 10.62713/aic.3556.

ABSTRACT

AIM: Colorectal cancer (CRC) ranks as the second most diagnosed and third most deadly cancer worldwide. Despite advances in early diagnosis and treatment, CRC remains a leading cause of cancer-related deaths. Up to 30% of CRC patients are diagnosed during emergency department visits, leading to surgical procedures that may not adhere to oncological principles due to complications like obstruction, bleeding, or perforation. This study aims to compare postoperative complications and long-term oncological outcomes between emergent and elective colon cancer surgeries.

METHODS: Retrospective analysis was performed on patients who underwent surgery for colonic adenocarcinoma from January 2018 to December 2021. Patients included were those diagnosed with colonic adenocarcinoma, excluding those under 18 years old or with other pathological results. Patients were examined under the elective and emergent surgery groups. The study investigated demographic data, tumor localization, operation type, postoperative complications, and long-term oncological outcomes. A Cox proportional hazard model was used to perform multivariate analysis in order to identify prognostic variables for overall survival (OS) and disease-free survival (DFS).

RESULTS: A total of 318 patients were included, with 62 undergoing emergent surgery and 256 undergoing elective surgery. Patient demographics were similar between the groups. The emergent surgery group had a significantly lower OS rate at 50 months compared to the elective surgery group (51% vs. 62%, p = 0.002). DFS at 50 months was also lower for the emergent surgery group compared to the elective surgery group (43% vs. 59%), but this difference did not reach statistical significance (p = 0.202). Independent poor prognostic factors included stage N, stage M, tumor diameter, neural invasion, and emergent surgery status.

CONCLUSIONS: Emergency surgery for colon cancer is associated with poor long-term outcomes due to shorter OS and DFS, highlighting the need for increased awareness and screening to reduce emergency colon cancer surgery.

PMID:39723516 | DOI:10.62713/aic.3556

Ann Ital Chir. 2024;95(6):1178-1185. doi: 10.62713/aic.3639.

ABSTRACT

AIM: Colorectal cancer (CRC) primarily arises from a combination of genetic, environmental, and dietary factors. Compared to traditional open surgery, minimally invasive laparoscopic surgery offers several advantages in managing CRC. This study investigates the factors influencing dynamic intestinal obstruction following laparoscopic colorectal radical surgery.

METHODS: We collected clinical data from 218 CRC patients who underwent laparoscopic radical surgery at the People’s Hospital of Xinjiang Uygur Autonomous Region, China between January 2022 and December 2023. The patients were followed up for 30 days post-surgery, and those who developed dynamic intestinal obstruction were placed in the complication group, while those who did not were included in the control group. The quality of life for all patients was assessed using Quality of Life Score (QoL) measures. The incidence of postoperative dynamic intestinal obstruction was calculated. Baseline and clinical data were collected using a standardized patient data form, and risk factors for postoperative dynamic intestinal obstruction were analyzed.

RESULTS: Postoperative evaluation revealed that 42 out of 218 patients developed dynamic intestinal obstruction, with an incidence rate of 19.27%. Univariate analysis revealed no statistically significant differences between the complication and control groups in terms of gender, age, body mass index (BMI), education level, Quality of Life Score tumor location, degree of differentiation, tumor diameter, surgery duration, presence of hypertension, history of diabetes, hyperlipidemia (HLP), smoking or alcoholism history, or postoperative abdominal infection (p > 0.05). Furthermore, factors such as tumor stage, preoperative hypoproteinemia, history of abdominal surgery, preoperative intestinal obstruction, and lymph node metastasis were identified as risk factors for postoperative dynamic intestinal obstruction. Logistic regression analysis further indicated that tumor stage, preoperative hypoproteinemia, history of abdominal surgery, preoperative intestinal obstruction, and presence of lymph node metastasis were all independent risk factors for dynamic intestinal obstruction after surgery (Odds Ratio (OR) >1, p < 0.05).

CONCLUSIONS: Dynamic intestinal obstruction following laparoscopic radical surgery for CRC is significantly correlated with factors such as tumor stage, preoperative hypoproteinemia, history of abdominal surgery, preoperative intestinal obstruction, and lymph node metastasis.

PMID:39723509 | DOI:10.62713/aic.3639

Ann Ital Chir. 2024;95(6):1206-1212. doi: 10.62713/aic.3650.

ABSTRACT

AIM: This study had two aims: to analyze surgical patients with mediastinal cysts and masses according to clinical, histopathological, and surgical types; and compare the impact of the coronavirus disease 2019 (COVID-19) pandemic on these cases.

METHODS: A retrospective analysis was conducted on 132 patients who had undergone surgical intervention for mediastinal cysts and masses. Demographic, clinical, and histopathologic data were recorded. Patients were divided into two groups based on their preference for video-assisted thoracoscopic surgery (VATS) and other surgical methods. Patients who had undergone surgery during and before the COVID-19 pandemic were also compared.

RESULTS: Lesions were detected incidentally in 56 patients (42.4%). The lesions were most commonly located in the anterior mediastinum (n = 86, 65.2%), while the most common pathology was found to be thymoma (n = 47, 35.6%). VATS was the most preferred method of operation (n = 36, 27.3%). The duration of hospital stay was observed to be statistically significantly shorter in patients who underwent VATS (p = 0.016). After the COVID-19 pandemic, the incidental incidence of mediastinal cysts and masses was significantly higher (p = 0.005).

CONCLUSIONS: The incidental detection rate of operated mediastinal cysts and masses increased after the COVID-19 pandemic. It is suggested that this study act a starting point for investigating the impact of the pandemic on mediastinal cysts and masses.

PMID:39723507 | DOI:10.62713/aic.3650

Ann Ital Chir. 2024;95(6):1221-1230. doi: 10.62713/aic.3657.

ABSTRACT

AIM: This study is aims to compare the clinical efficacy and safety of percutaneous kyphoplasty (PKP) and percutaneous pedicle screw fixation (PPSF) in managing osteoporotic vertebral compression fractures (OVCFs) among middle-aged and elderly individuals.

METHODS: A total of 142 patients aged 55-65 years were selected retrospectively from the Department of Orthopedics of our hospital from June 2021 to June 2023 and classified into PKP (n = 68) and PPSF (n = 74) groups. General data of patients were collected, and related perioperative indicators, Visual Analog Scale (VAS) scores, Oswestry Disability Index (ODI), Activities of Daily Living (ADL) scores, changes in Cobb angle of the fractured vertebrae, vertebral compression rate, as well as postoperative complications were compared between the two groups.

RESULTS: The PKP group showed shorter operation duration, reduced intraoperative blood loss, shorter hospital stay, and earlier compared to the PPSF group (p < 0.001). In comparison with the PPSF group, the PKP group endured much reduced pain, with improvements in spinal function and quality of life. On postoperative day 1, the PPSF group demonstrated superior restoration of vertebral height and deformity correction in relative to the other group (p < 0.05), with no significant difference in preoperative Cobb angle and vertebral compression rate (p > 0.05). The incidence of complications showed no significant differences between the two groups (p > 0.05).

CONCLUSIONS: The advantages of PKP lie in its ability to effectively relieve pain, improve spinal function, and enhance the quality of life. PPSF, meanwhile, is well-suited for the recovery of vertebral height and the correction of deformity in the early stage.

PMID:39723505 | DOI:10.62713/aic.3657

Ann Ital Chir. 2024;95(6):1085-1094. doi: 10.62713/aic.3695.

ABSTRACT

AIM: This study aims to compare the efficacy of modified single-incision surgery with that of traditional modified Ravitch surgery for the repair of pectus excavatum in pediatric patients.

METHODS: In this retrospective study, we included patients who underwent surgical correction for sternal depression from January 2015 to December 2020 across four major medical centers. Patients were categorized into two specific groups on the basis of the surgical technique employed: the modified single-incision surgery group, which comprised patients treated using the novel single-incision approach, and the traditional modified Ravitch surgery group, which included patients who received the conventional Ravitch surgery with multiple incisions. This study only included patients in the age range of 10 to 18 years, diagnosed with moderate to severe pectus excavatum, and lacked remarkable comorbid conditions that could influence surgical outcomes. Comprehensive data on preoperative characteristics, intraoperative variables, and postoperative results were collected for analysis.

RESULTS: The modified single-incision surgery group showed significantly lower mean blood loss, mean operating time, mean hospital stay, postoperative drainage rate, postoperative mean Haller index and mean Haller index after bar removal compared to the traditional modified Ravitch surgery group (p < 0.05). Furthermore, the surgical outcomes were significantly better in the modified single-incision surgery group (p = 0.010) than in the traditional modified Ravitch surgery group. The modified single-incision surgery group also had a significantly lower incidence of postoperative complications, including pneumothorax, pleural effusion, pulmonary infection, bar rejection, and bar flipping and displacement (p < 0.05), than the traditional modified Ravitch surgery group. The modified single-incision surgery group showed significantly greater improvement in sternal depression depth compared to the traditional modified Ravitch surgery group (p = 0.031). Corrected symmetry was significantly better in the modified single-incision surgery group (p = 0.037). The overall satisfaction of patients in the modified single-incision surgery group was significantly higher than that in the traditional modified Ravitch surgery group (p = 0.011).

CONCLUSIONS: The modified single-incision procedure for the treatment of pectus excavatum offers considerable advantages over the traditional modified Ravitch surgery. The findings of this study suggest that the modified single-incision procedure is a safe and effective alternative for the correction of pectus excavatum.

PMID:39723504 | DOI:10.62713/aic.3695

Ann Ital Chir. 2024;95(6):1213-1220. doi: 10.62713/aic.3725.

ABSTRACT

AIM: To explore the effectiveness and safety of Osborne’s ligament suspension and ulnar nerve anterior transposition (OLSUNAT) in conjunction with transcutaneous electrical nerve stimulation (TENS) for managing cubital tunnel syndrome (CTS).

METHODS: A total of 116 individuals diagnosed with CTS who underwent OLSUNAT in our hospital between October 2020 and December 2023 were retrospectively selected. They were divided into a treatment group (62 cases) and a control group (54 cases) based on whether they received subsequent TENS. Observation indicators included pain level, numbness, ulnar nerve conduction velocity, strength of the abductor of the little finger, two-point discrimination, elbow range of motion, fine motor activities of the upper limb and hand, SF-36 scores, and incidence of complications.

RESULTS: No significant differences in baseline characteristics were identified between the treatment and control groups (p > 0.05). After treatment, both groups showed remarkable improvements in pain level, numbness, motor nerve conduction velocity (MCV), sensory nerve conduction velocity (SCV), strength of the abductor of the little finger, two-point discrimination, elbow range of motion, Simple Test for Evaluating Hand Function (STEF) score, and SF-36 scores compared to before treatment (p < 0.05). However, the treatment group showed greater progress than the control group (p < 0.05). Although the overall incidence of complications in the treatment group was slightly lower than in the control group, this difference did not reach statistical significance (p > 0.05).

CONCLUSIONS: OLSUNAT combined with TENS offers significant advantages in managing CTS, effectively alleviating symptoms, promoting nerve and elbow function recovery, and improving patients’ quality of life while demonstrating high safety. However, further extensive and long-term studies are needed to confirm its sustained efficacy and safety.

PMID:39723501 | DOI:10.62713/aic.3725

Ann Ital Chir. 2024;95(6):1163-1169. doi: 10.62713/aic.3805.

ABSTRACT

AIM: This study aimed to explore the application effect of comfort nursing based on evidence-based concept in radial artery puncture hemostasis of patients after coronary intervention.

METHODS: This interventional study included the clinical data of 180 patients who underwent percutaneous radial coronary intervention in Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, from July 2024 to September 2024. All patients were treated with radial artery hemostasis device after operation. Patients were divided into two groups based on the single and even number of admission date. Patients admitted with single number were included in the control group (routine nursing, n = 94), and patients admitted with even number were included in the study group (comfort nursing based on evidence-based concept, n = 86). The post-surgical discomfort, postoperative complications, and patient satisfaction levels were comparatively analyzed between the two experimental groups.

RESULTS: The hemostasis was successfully achieved in both groups of patients, with a success rate of 100%. Compared to the control group, visual analogue scale (VAS) scores were significantly reduced in the study group at 2 and 4 hours after the procedure (p < 0.05). Post-surgery, the study group experienced reduced rates of subcutaneous ecchymosis, swelling of palms and forearms, and reduced complication rate compared to the control group (p < 0.05). Furthermore, patients in the study group exhibited higher mission content, service attitude, nursing quality, nursing approach score, and nursing satisfaction score than those in the control group, and the differences between the two groups were statistically significant (p < 0.001).

CONCLUSIONS: Using comfort nursing based on the evidence-based concept during radial artery puncture hemostasis in patients after the coronary intervention effectively relieves patients’ pain, reduces postoperative complications and improves nursing care satisfaction.

CLINICAL TRIAL REGISTRATION: China Clinical Trial Registry: ChiCTR2400087080.

PMID:39723498 | DOI:10.62713/aic.3805

Br J Math Stat Psychol. 2024 Dec 26. doi: 10.1111/bmsp.12379. Online ahead of print.

ABSTRACT

This paper introduces the generalized Hausman test as a novel method for detecting the non-normality of the latent variable distribution of the unidimensional latent trait model for binary data. The test utilizes the pairwise maximum likelihood estimator for the parameters of the latent trait model, which assumes normality of the latent variable, and the maximum likelihood estimator obtained under a semi-non-parametric framework, allowing for a more flexible distribution of the latent variable. The performance of the generalized Hausman test is evaluated through a simulation study and compared with other test statistics available in the literature for testing latent variable distribution fit and an overall goodness-of-fit test statistic. Additionally, three information criteria are used to select the best-fitted model. The simulation results show that the generalized Hausman test outperforms the other tests under most conditions. However, the results obtained from the information criteria are somewhat contradictory under certain conditions, suggesting a need for further investigation and interpretation. The proposed test statistics are used in three datasets.

PMID:39723492 | DOI:10.1111/bmsp.12379