ObjectiveTo evaluate the safety and feasibility of laparoscopic resection of primary retroperitoneal tumors. MethodClinical data of 52 patients diagnosed as primary retroperitoneal tumor who underwent laparoscopic resection in Peking University Third Hospital from January 2006 to December 2015 were retrospectively collected and analyzed. ResultsFifty two patients were included in the review. In 21 patients (40.3%), tumors were adjacent to major vessels (such as inferior vena cava, superior mesenteric vein, and the splenic vessel), tumors of 31 patients (59.7%) were away from major vessles. Two operations (3.8%) were converted to hand-assistant and 2 operations (3.8%) were converted to laparotomy due to tight adherence to major vessels. The mean value of operative time was 171.4-minute (60-520 minutes) and the mean value of length of incision was 2.8 cm (1-15 cm), the mean value of estimated blood loss was 86.4 mL (10-1 150 mL), 2 patients needed blood transfusion. The mean value of time of returning to diets was 1.5-day (1-5 days) and the mean value of length of postoperative hospital stay was 4.9-day (1-16 days). There was no major postoperative complications or death. Follow up was available for 47 patients at a median time of 62.0-month (4-120 months). Three patients with retroperitoneal liposarcomas experienced recurrence at 31, 34, and 48 months after operation, 1 patient with mucinous peripheral neurilemmoma experience recurrence at 69 months after operation, all of which underwent further resection, with others experiencing no recurrence or metastasis. Three patients died in reason of other diseases. ConclusionsLaparoscopic surgery can be performed safely in the treatment of primary retroperitoneal tumors, even when a tumor adjacent to major vascular structures.
ObjectiveTo analyze the correlation between the gray value of epicardial fat and the prognosis of patients with atrial fibrillation (AF) treated by thoracoscopic radiofrequency ablation.MethodsThe clinical data of 97 patients, including 75 males and 22 females with an average age of 57.8±9.4 years, who underwent thoracoscopic radiofrequency ablation in Fuwai Hospital from 2017 to 2018 were analyzed retrospectively. The left atrial fat volume and average gray scale were calculated by left atrial enhanced CT. According to the average gray scale of left atrial fat tissue, the patients were divided into three groups: a high gray scale group, a medium gray scale group and a low gray scale group. The patients were followed up at 3, 6 and 12 months after operation. The end point of follow-up was the recovery rate of sinus rhythm. Survival analysis was used to analyze the correlation between CT features of epicardial fat enhancement and prognosis.ResultsAfter adjustment of body mass index, body surface area, gender and left atrial end diastolic diameter, regression analysis showed that the fat gray of left atrial enhanced CT was correlated with the type of AF (OR=0.30, 95%CI 0.12-0.79, P=0.014). Cox regression analysis showed that the fat gray value of left atrial CT predicted the recurrence of AF after thoracoscopic radiofrequency ablation (OR=0.92, 95%CI 0.85-0.99). The Kaplan-Meier curve showed significant difference in the long-term recurrence rate of AF among the three groups (P=0.011). The lower left atrial fat enhanced CT gray scale was, the higher long-term recurrence rate of AF was.ConclusionThe gray value of left atrial fat enhanced CT can effectively predict the recurrence of AF after radiofrequency ablation in thoracoscopic surgery.