• 제목/요약/키워드: Preoperative

검색결과 3,485건 처리시간 0.04초

Prognostic role of preoperative carcinoembryonic antigen levels in colorectal cancer: propensity score matching

  • Kim, Cho Shin;Kim, Sohyun
    • Journal of Yeungnam Medical Science
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    • 제34권2호
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    • pp.216-221
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    • 2017
  • Background: This study was conducted to investigate preoperative carcinoembryonic antigen (CEA) as a prognostic factor in colorectal cancer. Methods: Between January 2000 and July 2011, 1298 patients with primary adenocarcinoma colorectal cancer without metastasis, who underwent curative resection were retrospectively identified. The patients were divided into two groups according to serum CEA level at primary diagnosis: a high CEA (HCEA) group (serum CEA ${\geq}6ng/mL$) and a normal CEA (NCEA) group (serum CEA <6 ng/mL). A 1:1 propensity score matching analysis was applied to reduce bias. Finally, 364 patients were enrolled in this study. Matched variables were age, gender, preoperative chemoradiotherapy, tumor site, cell differentiation and pathologic stage. Results: The clinicopathological characteristics of the two groups did not differ significantly difference. The systemic metastasis rate was 16.5% (30/182) and 25.3% (46/182) in the NCEA and HCEA groups, respectively (p=0.039). There were no significant differences in local recurrence or metastatic sites between groups. The 5-year disease-free survival (DFS) rate of the HCEA group was worse than that of the NCEA group; however, there was no significant difference in overall survival between the two groups. Conclusion: Elevated preoperative CEA was related to frequent systemic recurrence and low DFS. Therefore, elevated preoperative CEA could be considered a prognostic factor for worse clinical outcomes in patients with colorectal cancer.

Objective quantification of the impact of blepharoplasty on the superior visual field

  • Kim, Hyodong;Lee, Sanghun;Son, Daegu;Yeo, Hyeonjung
    • Archives of Plastic Surgery
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    • 제49권1호
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    • pp.19-24
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    • 2022
  • Background Blepharoplasty has both aesthetic and functional benefits in patients with pseudoptosis; however, previous studies could not demonstrate its beneficial effects quantitatively and objectively. The authors objectively analyzed the visual field before and after surgery and investigated whether measurements of the visual field can be applied as a suitable predictor of surgical outcomes. Methods In total, 18 eyelids in nine patients with pseudoptosis who had undergone simple skin excision blepharoplasty were evaluated prospectively from February to May 2016. The visual fields were analyzed preoperatively and 3 months postoperatively using the Goldmann kinetic perimetry test. The visual field test area was assessed using Adobe Photoshop. Results Blepharoplasty had an average 4.99-fold beneficial effect on the superior visual field. In particular, more improvement was seen in the superior temporal quadrant than in the nasal quadrant. No correlation was found between the preoperative margin-to-reflex distance 1 (MRD1) and the surgical outcome (P=0.119). However, there was a strong correlation between the preoperative superior visual field and the surgical outcome (P=0.001). Conclusions Using the Goldmann kinetic perimetry test, we objectively and quantitatively proved the beneficial effect of blepharoplasty on patients with pseudoptosis. Furthermore, we demonstrated that the preoperative visual field is a better preoperative surgical outcome predictive factor than the preoperative MRD1.

The Influence of Corticosteroid Injections on Postoperative Outcomes of Carpal Tunnel Release: A Systematic Review

  • Ali Kumas;Milly van de Warenburg;Tinatin Natroshvili;Marius Kemler;Mahyar Foumani
    • Archives of Plastic Surgery
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    • 제50권4호
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    • pp.398-408
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    • 2023
  • Background Carpal tunnel syndrome can be treated with corticosteroid injections (CIs) and surgery. In this systematic review, the influence of previous CI on different postoperative outcomes after carpal tunnel release is evaluated. Methods A systematic literature search using several databases was performed to include studies that examined patients diagnosed with carpal tunnel syndrome who received preoperative or intraoperative CIs. Results Of 2,459 articles, 9 were eligible for inclusion. Four papers reported outcomes of preoperative and four outcomes of intraoperative CIs. One study evaluated patients who received both intraoperative and preoperative corticosteroids. Conclusion Intraoperative CIs are associated with reduced postoperative pain after carpal tunnel release and support earlier recovery of the hand function that can be objectified in a faster median nerve conduction speed recovery and lower Boston Carpal Tunnel Questionnaire (BCTQ) scores. Using preoperative CIs did not lead to enhanced recovery after carpal tunnel release, and both preoperative and intraoperative CIs might be predisposing factors for infections.

복식호흡이 상.하지 수술 환자의 수술 전 불안과 혈압에 미치는 효과 (The Effects of Abdominal Breathing on the Preoperative Anxiety and Blood Pressure of Upper and Lower Limbs Surgical Patients)

  • 곽미경;김윤경;홍해숙
    • Journal of Korean Biological Nursing Science
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    • 제13권1호
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    • pp.23-28
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    • 2011
  • Purpose: The aim of this study were to examine the effects of abdominal breathing on preoperative anxiety and blood pressure. Methods: The research was a non-equivalent control group pretest-posttest design. The subjects were 60 patients that operated on under local anesthetic. Thirty subjects in the experimental group and 30 subjects in the control group. Data on anxiety and blood pressure for this study were collected from them. The collected data were analyzed by t-test, $X^2$-test, paird t-test. Results: After abdominal breathing, there was a statistically significant decline in the psychological anxiety level of the experimental group. With regard to the physical anxiety level, no statistically significant drop was detected in blood pressure. Conclusion: The findings of the study confirmed that abdominal breathing reduced preoperative anxiety of upper and lower limbs surgical patients.

심실중격결손증에서 수술전 혈류역학치가 수술후 폐동맥압력에 미치는 영향 (Effect on postoperative pulmonary arterial pressure with preoperative hemodynamic data in VSD)

  • 성숙환
    • Journal of Chest Surgery
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    • 제19권2호
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    • pp.238-242
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    • 1986
  • The prognosis of patients with VSD and pulmonary hypertension is at least partially related to the reversibility of pulmonary hypertension after surgery. To predict postoperative pulmonary arterial pressure, immediate postbypass values were compared with preoperative hemodynamic data in 18 surgically closed VSD patients aged 6 to 80 months. The following results were obtained. 2] There was a good correlation between preoperative PP/PS and postoperative PP/PS in patients aged over 24 months [r=0.685, p<0.05], and in patients whose QP/QS were over 2.0 [r=0.686, p<0.01]. 3] There was also a good correlation between pump time and postoperative PP in total patients [r=0.697, p<0.005]. 4] Direct correlations were found between preoperative PP/PS and immediate postbypass PP/PS in patients aged over 24 months and in patients whose QP/QS>2.0, but the effect of CPB would participate in some degree. So it may be necessary to reevaluate their relationship after the effect of CPB have been disappeared.

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폐동맥 고혈압을 동반한 후천성 심질환의 술후 폐동맥압의 변화에 대한 연구 (A study of postoperative pulmonary arterial pressure change in the acquired heart disease with pulmonary hypertension)

  • 류삼렬
    • Journal of Chest Surgery
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    • 제23권2호
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    • pp.245-252
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    • 1990
  • To see the change of pulmonary arterial pressure after mitral valve replacement, postoperative cardiac catheterization and echocardiographies were performed in 12 patients of mitral valvular disease with pulmonary hypertension[systolic pulmonary arterial pressure>50 mm Hg]. The mean follow-up duration was 35.4[range: 15-47] months per patient. The following results were obtained. 1] Preoperative systolic pulmonary arterial pressure value of 66.17\ulcorner10.73mmHg decreased significantly to 29.17\ulcorner6.86mmHg postoperatively[p<0.01]. 2] Preoperative Pp/Ps value of 0.67\ulcorner0.13 decreased significantly to 0.28\ulcorner0.06 postoperatively[p<0.01]. 3] Preoperative PAWP value of 29.00\ulcorner4.02mmHg decreased significantly to 9.92\ulcorner4.27 mmHg postoperatively[p<0.01]. 4] Preoperative LAD value of 5.58\ulcorner1.20cm decreased significantly to 4.37\ulcorner0.67cm postoperatively [p<0.01]. In conclusion, pulmonary arterial hypertension secondary to mitral valvular disease could be reduced to normal range after successful mitral valve replacement.

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제사위전위증유우에 있어서 몇가지 혈청전해질 농도에 관한 조사연구 (Changes in Selected Electrolyte Concentrations in Dairy Cowe with Abomasal Displacement)

  • 이사균;정창국
    • 한국임상수의학회지
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    • 제2권1호
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    • pp.143-150
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    • 1985
  • The concentrations of serum calcium, inorganic phosphorus, sodium and potassium from 24 cows with left displacement of abomasum and 21 cows with right displacement of abomasum on pre and postoperation were determined. 1. The preoperative levels of serum calcium in left and right displacement of abomasum were below normal and returned to normal levels postoperatively. 2. The preoperative levels of serum inorganic phosphorus in left and right displacement of abomasum showed slight increase preoperatively and consistent slight rise postoperatively. 3. The preoperative levels of serum sodium in left and right displacement of abomasum were slightly below normal and maintained low levels postoperatively. 4. The preoperative levels of serum patassium in left and right displacement of abomasum were low normal limit and increased to upper normal limit postoperatively.

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High Preoperative Fibrinogen and Systemic Inflammation Response Index (F-SIRI) Predict Unfavorable Survival of Resectable Gastric Cancer Patients

  • Gao, Weiwei;Zhang, Fei;Ma, Tai;Hao, Jiqing
    • Journal of Gastric Cancer
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    • 제20권2호
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    • pp.202-211
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    • 2020
  • Purpose: This study was to investigate the prognostic significance of the preoperative fibrinogen and systemic inflammation response index (F-SIRI) in a Chinese cohort of resectable gastric cancer. Materials and Methods: Baseline characteristics, preoperative fibrinogen levels and peripheral neutrophil, monocyte, and lymphocyte counts were retrospectively reviewed in 240 patients who underwent radical gastrectomy. The optimal cut-off values for fibrinogen and SIRI were defined as 4.0 g/L and 1.2. Then patients with hyperfibrinogenemia (≥4.0 g/L) and high SIRI (≥1.2) were assigned with an F-SIRI of 2 (both of these hematological abnormalities), 1 (one of these abnormalities), and 0 (neither abnormality), respectively. The prognostic value was examined by univariate and multivariate survival analysis. Results: Preoperative F-SIRI was significantly correlated with tumor size, fibrinogen level, and adjuvant chemotherapy. Whereas there was no significant difference in age, gender, tumor location or other characteristics between groups. In addition, high preoperative F-SIRI was significantly associated with worse disease-free survival (DFS) (hazard ratio [HR], 2.299; 95% confidence interval [CI], 1.482-3.566; P<0.001) and overall survival (OS) (HR, 2.461; 95% CI, 1.584-3.824; P<0.001) by univariate survival analysis. Moreover, it remained an independent predictor for impaired DFS (HR, 2.023; 95% CI, 1.273-3.215; P=0.003) and OS (HR, 2.341; 95% CI, 1.480-3.705; P<0.001) in multivariate Cox regression analysis. Conclusions: Preoperative F-SIRI could serve as a significantly prognostic marker for long-term survival in Chinese patients who underwent radical gastrectomy.

비전형적인 심하복벽동맥의 주행을 파악하기 위한 수술 전 CT Angiography의 유용성 (Atypical Patterns of Deep Inferior Epigastric Artery: Clinical Implication of Preoperative CT Angiography)

  • 이택종;김성찬;엄진섭;김은기
    • Archives of Reconstructive Microsurgery
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    • 제21권1호
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    • pp.8-13
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    • 2012
  • Purpose: Purpose: The free deep inferior epigastric artery perforator (DIEP) flap is a popular option for autologous breast reconstruction. However, the anatomy of the deep inferior epigastric artery(DIEA) may vary from one individual to another. Unexpected vascular anomaly can confuse the surgeon and affects on the safety of the free DIEP flap. Materials and Methods: Thirty five consecutive patients who underwent free DIEP/TRAM flap for immediate breast reconstruction between Mar. 2010 and Oct. 2010 were enrolled in this study. Computed tomography angiography (CT angiography) of abdomen was evaluated part of our standard preoperative assessment: atypical patterns of DIEA/DIEP were evaluated by preoperative CT angiography and compared with intraoperative finding. Results: Atypical patterns of DIEA/DIEP which may affect preoperative planning were noted as the following: Circummusclar/subfascial DIEA (n=1), DIEA running underneath rectus muscle (n=8), septocutaneous perforator (n=3), peritoneo-cutaneous perforator (n=1), a large branch going into peritoneum (n=1), and very early division and muscle penetration of DIEA (n=1). Conclusion: Atypical DIEA/DIEP that might change the operation plan is not rare, so the individualized planning based on the preoperative CT angiography is recommended. Preoperative CT angiography could help to select reliable and easy-to-dissect perforator in free DIEP/TRAM breast reconstruction.

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Prognostic Significance of Preoperative Lymphocyte-Monocyte Ratio in Patients with Resectable Esophageal Squamous Cell Carcinoma

  • Han, Li-Hui;Jia, Yi-Bin;Song, Qing-Xu;Wang, Jian-Bo;Wang, Na-Na;Cheng, Yu-Feng
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권6호
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    • pp.2245-2250
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    • 2015
  • Background: The interaction between tumor cells and inflammatory cells has not been systematically investigated in esophageal squamous cell carcinoma (ESCC). The aim of the present study was to evaluate whether preoperative the lymphocyte-monocyte ratio (LMR), the neutrophil-lymphocyte ratio (NLR), and the platelet-lymphocyte ratio (PLR) could predict the prognosis of ESCC patients undergoing esophagectomy. Materials and Methods: Records from 218 patients with histologically diagnosed ESCC who underwent attempted curative surgery from January 2007 to December 2008 were retrospectively reviewed. Besides clinicopathological prognostic factors, we evaluated the prognostic value of the LMR, the NLR, and the PLR using Kaplan-Meier curves and Cox regression models. Results: The median follow-up was 38.6 months (range 3-71 months). The cut-off values of 2.57 for the LMR, 2.60 for the NLR and 244 for the PLR were chosen as optimal to discriminate between survival and death by applying receiver operating curve (ROC) analysis. Kaplan-Meier survival analysis of patients with low preoperative LMR demonstrated a significant worse prognosis for DFS (p=0.004) and OS (p=0.002) than those with high preoperative LMR. The high NLR cohort had lower DFS (p=0.004) and OS (p=0.011). Marginally reduced DFS (p=0.068) and lower OS (p=0.039) were found in the high PLR cohort. On multivariate analysis, only preoperative LMR was an independent prognostic factor for both DFS (p=0.009, HR=1.639, 95% CI 1.129-2.381) and OS (p=0.004, HR=1.759, 95% CI 1.201-2.576) in ESCC patients. Conclusions: Preoperative LMR better predicts cancer survival compared with the cellular components of systemic inflammation in patients with ESCC undergoing esophagectomy.