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find Author "倪忠鹏" 2 results
  • Analysis of risk factors for central lymph node metastasis in cN0 papillary thyroid carcinoma

    ObjectiveTo investigate the risk factors for central lymph node metastasis (CLNM) in patients with clinically negative lymph node (cN0 stage) papillary thyroid carcinoma (PTC).MethodsThe clinicopathological data of 250 patients with cN0 PTC who underwent thyroidectomy and central lymph node dissection (CLND) in Department of General Surgery of Xuzhou Central Hospital from June 2016 to June 2019 were retrospectively analyzed. The influencing factors of CLNM in patients with cN0 PTC were analyzed by univariate analysis and binary logistic regression, and then R software was used to establish a nomogram prediction model, receiver operating characteristic curve was used to evaluate the differentiation degree of the model, and Bootstrap method was used for internal verification to evaluate the calibration degree of the model.ResultsCLNM occurred in 147 of 250 patients with cN0 PTC, with an incidence of 58.8%. Univariate analysis showed that multifocal, bilateral, tumor diameter, and age were correlated with CLNM (P<0.01). The results of binary logistic regression analysis showed that multifocal, bilateral tumors, age≥45 years old, and tumor diameter>1 cm were independent risk factors for CLNM in patients with cN0 PTC (P<0.05). The area under the curve (AUC) of the nomogram prediction model established on this basis was 0.738, and the calibration prediction curve in the calibration diagram fitted well with the ideal curve.ConclusionsCLNM is more likely to occur in PTC. The nomogram model constructed in this study can be used as an auxiliary means to predict CLNM in clinical practice.

    Release date:2021-04-30 10:45 Export PDF Favorites Scan
  • 6例完全3D腹腔镜下肝门部胆管癌根治术围手术期治疗效果总结

    目的 总结完全3D腹腔镜下肝门部胆管癌根治术围手术期的临床疗效。方法 回顾性收集2021年10月至2022年9月期间在徐州市中心医院行完全3D腹腔镜下肝门部胆管癌根治术的6例患者的临床资料并分析总结,其中 Bismuth分型Ⅰ型2例,Ⅲa型2例,Ⅲb型1例,Ⅳ型1例。结果 6例患者均成功完成了3D腹腔镜下肝门部胆管癌根治术,中位手术时间为490 min(360~600 min),中位术中出血量为550 mL(200~800 mL),中位术后首次排气时间为2 d(2~3 d),中位术后拔除引流管时间为7 d(5~8 d),中位术后住院时间为12.5 d(10~20 d)。术后病理报告均为胆管腺癌,切缘均为阴性;中位淋巴结清扫数为11枚(6~14枚);术后有1例患者(Ⅳ型)出现胆汁漏,经保守治疗7 d后痊愈;1例患者术后出现胃瘫,给予保守治疗30 d后好转;其余患者无术后并发症发生。患者术后规律随访2~14个月,中位随访时间7.5个月,均生存良好,均未见肿瘤复发和转移。 结论 在严格选择病例情况下,由经验丰富的腹腔镜外科医师行完全3D腹腔镜下肝门部胆管癌根治术是安全、可行的,近期效果良好,值得进一步探讨。

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