• 제목/요약/키워드: preoperative

검색결과 3,440건 처리시간 0.025초

Prognostic Significance of Preoperative Anemia, Leukocytosis and Thrombocytosis in Chinese Women with Epithelial Ovarian Cancer

  • Chen, Ying;Zhang, Lei;Liu, Wen-Xin;Liu, Xiang-Yu
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권3호
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    • pp.933-939
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    • 2015
  • Malignant tumors are often accompanied by increased risk of hematological abnormalities. However, few studies have reported any prognostic impact of preoperative thrombocytosis, leukocytosis and anemia in epithelia ovarian cancer (EOC). This study aimed to investigate preoperative hematological parameters for anemia, leukocytosis and thombocytosis in relation to established prognostic factors and survival in EOC cases. A total of 816 Chinese women treated for EOC were retrospectively included in the study focusing on the relationship between preoperative hemoglobin, leukocyte and platelet counts, and a panel of clinicopathologic characteristics and outcome. Preoperative anemia was present in 13.4%, leukocytosis in 16.7% and thrombocytosis in 22.8%. Additionally, EOC patients with low differentiation grade, advanced stage, lymph node (LN) metastasis, residual disease ${\geq}1cm$, ascites volume >1,000ml, serum cancer antigen 125 (CA125) >675U/ml, and disease recurrence had the higher prevalence of preoperative anemia, leukocytosis and thrombocytosis (all p<0.05). Moreover, EOC patients with older age or postmenopausal EOC patients had the higher prevalence of thrombocytosis (28.7% vs 17.3% or 26.0% vs 17.7%). Furthermore, in a Cox proportional hazard model, thrombocytosis was an independent factor for progression-free survival (PFS) and overall survival (OS) (p<0.001). Conclusively, preoperative anemia, leukocytosis or thrombocytosis in EOC patients is closely associated with more malignant disease phenotype and poorer prognosis. Significantly, thrombocytosis may independently predict the disease-specific survival for EOC patients.

골격성 3급 부정교합자의 술후 교합평면의 변화에 관한 연구 (측모두부방사선 규격사진계측을 중심으로) (A LATERAL CEPHALOMETRIC STUDY OF POSTOPERATIVE OCCLUSAL PLANE ALTERATION OF SKELETAL CLASS III MALOCCLUSION PATIENT)

  • 박규태;이상철
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제19권1호
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    • pp.25-34
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    • 1997
  • This study was made with lateral cephalometric radiography of 28 skeletal class III malocclusion patients that were performed to setback surgery of mandible. The 28 patients were selected by four standards as follows. 1) Set-back amount of mandible is below 10 mm 2) No extrusion and intrusion of posterior tooth or alteration of interincisial angle at period of postoperative orthodontic treatment. 3) Change of mesial segment location of mandible on lateral cephalometrics 4) No genioplasty And 28 patients were divided to three group(1,2,3 group) by degree of preoperative occlusal plane angle to Burstone's horizontal plane. The preoperative occlusal plane angle, which of 1 group was smaller than $7^{\circ}$ and 2 group was between $7^{\circ}$ to $15^{\circ}$ and 3 group was larger than $15^{\circ}$. The results were as follows : 1. As the preoperative occlusal plane angle was larger, the degree of mandibular prognathism was not severe. 2. On comparsion of preoperative and immediate postoperative cephalometric analysis, specific relationship of occlusal plane angle and set-back amount of mandible was not present. 3. As the preoperative occlusal plane angle was smaller, the alteration of postoperative occlusal plane angle was increased tendency. As the preoperative occlusal plane angle was larger, the alteration of postoperative occlusal plane angle was decreased tendency. 4. The relapsed degree of B point distance to Vertical plane was not relationship to the degree of preoperative occlusal plane angle.

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The Neutrophil-to-Lymphocyte Ratio as a Predictor of Postoperative Outcomes in Patients Undergoing Coronary Artery Bypass Grafting

  • Hyun Ah Lim;Joon Kyu Kang;Hwan Wook Kim;Hyun Son;Ju Yong Lim
    • Journal of Chest Surgery
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    • 제56권2호
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    • pp.99-107
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    • 2023
  • Background: The neutrophil-to-lymphocyte ratio (NLR) has been suggested as a novel predictive marker of cardiovascular disease. However, its prognostic role in patients under-going coronary artery bypass grafting (CABG) is unclear. This study aimed to determine the association between the preoperative NLR and early mortality in patients undergoing CABG. Methods: Cardiac surgery was performed in 2,504 patients at Seoul St. Mary's Hospital from January 2010 to December 2021. This study retrospectively reviewed 920 patients who underwent isolated CABG, excluding those for whom the preoperative NLR was unavailable. The primary endpoints were the 30- and 90-day mortality after isolated CABG. Risk factor analysis was performed using logistic regression analysis. Based on the optimal cut-off value of preoperative NLR on the receiver operating characteristic curve, high and low NLR groups were compared. Results: The 30- and 90-day mortality rates were 3.8% (n=35) and 7.0% (n=64), respectively. In the multivariable analysis, preoperative NLR was significantly associated with 30-day mortality (odds ratio [OR], 1.28; 95% confidence interval [CI], 1.17-1.39; p<0.001) and 90-day mortality (OR, 1.17; 95% CI, 1.07-1.28; p<0.001). The optimal cut-off value of the preoperative NLR was 3.4. Compared to the low NLR group (<3.4), the high NLR group (≥3.4) showed higher 30- and 90-day mortality rates (1.4% vs. 12.1%, p<0.001; 2.8% vs. 21.3%, p<0.001, respectively). Conclusion: Preoperative NLR was strongly associated with early mortality after isolated CABG, especially in patients with a high preoperative NLR (≥3.4). Further studies with larger cohorts are necessary to validate these results.

Preoperative Long Course Chemoirradiation in a Developing Country for Rectal Carcinoma: Kuala Lumpur Hospital Experience

  • Lee, Wei Ching;Yusof, Mastura Md.;Lau, Fen Nee;Ee Phua, Vincent Chee
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권6호
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    • pp.3941-3944
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    • 2013
  • Background: The use of preoperative chemoirradiation is the commonest treatment strategy employed in Malaysia for locally advanced rectal cancer. We need to determine the local control and survival rates for comparison with established rates in the literature. Materials and Methods: This retrospective study analyzed all newly diagnosed patients with rectal adenocarcinoma who underwent long course preoperative radiotherapy (RT) at the Department of Radiotherapy and Oncology, Kuala Lumpur Hospital (HKL) between $1^{st}$ January 2004 and $31^{st}$ December 2010. The aim of the study was to determine the radiological response post radiotherapy, pathological response including circumferential resection margin (CRM) status, 3 years local control, 3 years overall survival (OS) and 3 years disease free survival (DFS). Statistical analysis was performed using the SPSS software. Kaplan-Meier and log rank analysis were used to determine survival outcomes. Results: A total of 507 patients with rectal cancer underwent RT at HKL. Sixty seven who underwent long course preoperative RT were eligible for this study. The median age at diagnosis was 60 years old with a range of 26-78 years. The median tumour location was 6 cm from the anal verge. Most patients had suspicion of mesorectum involvement (95.5%) while 28.4% of patients had enlarged pelvic nodes on staging CT scan. All patients underwent preoperative chemo-irradiation except for five who had preoperative RT alone. Only 38 patients underwent definitive surgery (56.7%). Five patients were deemed to be inoperable radiologically and 3 patients were found to have unresectable disease intraoperatively. The remaining 21 patients defaulted surgery (31.3%). The median time from completion of RT to surgery was 8 weeks (range 5.6 to 29.4 weeks). Fifteen patients (39.5%) had surgery more than 8 weeks after completion of RT. Complete pathological response was noted in 4 patients (10.5%). The pathological CRM positive rate after RT was 18.4%. With a median follow-up of 38.8 months, the 3 year local control rate was 67%. The 3 years rate for CRM positive (<2 mm), CRM clear (>2 mm) and pCR groups were 0%, 88.1% and 100% respectively (p-value of 0.007). The 3 year OS and DFS were 57.3% and 44.8% respectively. Conclusions: In conclusion, the approach of long course preoperative chemoirradiation for rectal cancer needs to be re-examined in our local setting. The high rate of local recurrence is worrying and is mainly due to patient defaulting post-preoperative chemoirradiation or delayed definitive surgery.

수술 전 항암요법이 절제 불가능한 위암 환자의 수술에 미치는 영향 (The Impact of Preoperative Chemotherapy on the Surgical Management of Unresectable Gastric Cancer)

  • 윤삼열;김민규;오성태
    • Journal of Gastric Cancer
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    • 제9권4호
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    • pp.269-274
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    • 2009
  • 목적: 최근들어 근치적 절제가 어려운 위암을 대상으로 수술 전 항암요법(preoperative chemotherapy)이 병기를 낮추어 완전 절제율을 높일 수 있다는 연구가 보고되고 있으나, 항암요법이 수술에 미치는 영향에 대한 연구가 부족하여 본원의 경험을 조사하고자 하였다. 대상 및 방법: 2001년 12월부터 2009년 1월까지 동일한 항암요법을 시행 받은 후 위 절제술을 시행한 46명을 대상으로 수술 전 전신 상태, 수술 소견 및 수술 후 임상 경과등을 분석하였다. 결과: 항암요법은 평균 4.4회가 시행되었고, 각각 4명의 환자들에서 절대 호중구 수치(absolute neutrophil count)가 1,500(${\mu}/L$) 이하로 떨어지거나 10% 이상의 체중 감소를 보였다. 29명은 수술 중 종양과 주위 장기와의 유착 또는 단단하게 고정된 소견을 보였으며, 근치적 목적의 병할 절제를 시행한 13명의 환자 중 4명만이 병리학적으로 타 장기 침범이 관찰 되었다. 근치적 위 절제술은 41명, 수술 후 합병증은 10명에서 발생하였으며, 수술 후 60일 내 사망은 없었다. 결론: 항암요법이 수술 전 환자에 미치는 영향은 적을 것으로 생각되며, 타 장기 침범 소견으로 병합절제를 시행한 상당수에서 종양이 없었던 것은 일부 항암 효과가 작용한 것으로 생각한다. 더불어 항암 요법 자체가 수술 후 합병증 발생률을 높이는 것으로 생각되지 않는다.

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구강암의 악골 침윤 평가에 있어서 골스캔의 효과 (THE USEFULNESS OF BONE SCAN FOR EVALUATING JAW BONE EXTENSION OF ORAL CANCER)

  • 박홍주;유선열
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제26권6호
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    • pp.658-665
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    • 2000
  • Purpose : The present study was carried out to determine the diagnostic usefulness of bone scan for evaluating jaw bone extension of oral cancer. Materials and Methods : Medical records, preoperative bone scans, computerized tomographic (CT) scans, conventional radiographs, and findings of histopathologic sections of twenty patients who had been treated for oral malignant tumors by a resection of mandible and soft tissue at Chonnam University Hospital from January, 1994 to September, 1999 were analyzed. Results : In 13 cases which showed histopathologically positive, preoperative bone scans were positive in 12 (92.3%) and false negative in 1 (7.7%). Preoperative CT scans were positive in 9 (69.2%) and false negative in 4 (30.8%) of the 13 cases. Preoperative conventional radiographs were positive in 8 (61.5%) and false negative in 5 (38.5%) of the 13 cases. In 7 cases showing negative histopathologic findings, 1 (14.3%) was in CT scans and 2 (28.6%) were false positive in preoperative conventional radiographs. Conclusion : These results suggest that bone scan is more sensitive and reliable method for evaluating jaw bone extension of oral cancer than conventional radiographs or CT scans.

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아로마테라피 손 마사지가 위암환자의 수술 전 불안에 미치는 효과 (The Effects of Aromatherapy Hands Massage on the Preoperative Anxiety of Stomach Cancer Patients)

  • 성미혜;이승애;심정선
    • 성인간호학회지
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    • 제18권5호
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    • pp.709-717
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    • 2006
  • Purpose: The Purpose of this study was to elucidate the effects of aromatherapy massage on the preoperative anxiety of stomach cancer patients. Method: The research design was a nonequivalent control group non synchronized design. The data were collected during the period of October 2 to December 30, 2005 at H Hospital in Seoul. The subjects were 40 patients who were operated under general anesthesia for stomach cancer. State anxiety, systolic and diastolic blood pressure, pulse rate were measured on the day before surgery and the preoperative period. Data were analyzed by ${\chi}^2$ test, independent t-test, paired t-test. Results: Hypothesis 1 that the level of preoperative state anxiety of the experimental group who received aromatherapy massage is lower than that of the control group who did not received aromatherapy was supported(p=.004). Hypothesis 2 the physiological index of the preoperative anxiety of the experimental group who received aromatherapy is lower than that of the control group who did not received aromatherapy. Conclusion: According to these results, aromatherapy hand massage can be regarded as a partially effective nursing intervention that relives anxiety of surgical patients and decreases the blood pressure level.

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동영상을 이용한 수술 전 교육이 양성종양 자궁절제술 환자의 통증, 불확실성, 불안과 우울에 미치는 효과 (Effect of Preoperative Education using Multimedia on Pain, Uncertainty, Anxiety and Depression in Hysterectomy Patients)

  • 전수란;박효정
    • 여성건강간호학회지
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    • 제22권1호
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    • pp.39-47
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    • 2016
  • Purpose: The purpose of this study was to examine the effect of preoperative education using multimedia on level of pain, uncertainty, anxiety and depression in hysterectomy patients. Methods: A non-equivalent control group, with a pretest-posttest design was used in this study. The level of post operation pain, pre and post operation uncertainty, anxiety and depression of both the groups was measured. The experimental group was provided with preoperative education using multimedia on the preoperative day at the hospital. The control group was only given usual care. Data were analyzed using SPSS/WIN version 22.0 program. Results: Experimental group showed lower level of post-operation pain in 1 hour (t=-5.08, p<.001) and 24 hours (t=-5.20, p<.001) but not 48 hours (t=-0.91, p=.368). Uncertainty showed significant interaction effect of Group by Time (F=4.16, p=.018). Conclusion: Preoperative education using multimedia for patients with hysterectomy would be effective in lowering patients' level of pain, uncertainty, anxiety and depression.

수술 전 통증자가조절기에 관한 교육이 수술 후 통증에 미치는 효과 (The Effect of Education on Preoperative PCA upon Postoperative Pain)

  • 서효신;박경숙
    • 성인간호학회지
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    • 제14권3호
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    • pp.449-458
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    • 2002
  • Purpose: The purpose of this study was to compare the effectiveness of a structured preoperative PCA education to that of the usual informal teaching provided by hospital staff in alleviating postoperative pain through more effective use of PCA therapy. Method: As an advanced research, the knowledge about the use of PCA therapy and the attitude about the use of the pain medicine were estimated, and then as a later research, the knowledge about the use of PCA therapy, the attitude about the use of the pain medicine, and the score of the pain were estimated. Result: The experimental group those who received structured preoperative PCA education had statistically significant higher knowledge regarding the use of PCA therapy(p=0.026) and more positive attitudes toward using pain medicine(p=0.004). The experimental group those who received structured preoperative PCA education reported better pain control 4(p=0.002), 8(p=0.014) and 24 hours(p=0.018) after the operation. Conclusion: The structured preoperative PCA education increases the knowledge for the use of patient's PCA therapy and changes their attitude toward the use of the pain medicine positively and consequently enable the use of PCA therapy to be more effective and then finally reduced the patient's pain after the operation.

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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.