Facial Nerve ; Humans ; Organ Sparing Treatments ; methods

Humans ; Organ Sparing Treatments ; Parathyroid Glands ; surgery ; Thyroid Gland ; surgery

Compared with distal gastrectomy, pylorus-preserving gastrectomy is less invasive which can decrease incidence of dumping syndrome, diarrhea and body weight lost, cholecystitis and gallstone, reflux gastritis and esophagitis and remnant gastric cancer. Based on new Japanese Gastric Cancer Treatment Guideline and new progression in the world, we give a review mainly basic characteristics, indications, operation details and short- and long-time outcomes after pylorus-preserving gastrectomy.
Gastrectomy ; methods ; Gastric Stump ; pathology ; Gastroenterostomy ; Humans ; Organ Sparing Treatments ; Pylorus ; surgery ; Stomach Neoplasms ; surgery

Rectal cancer is a common malignant tumor. In China, low rectal cancer accounts for more in rectal cancer. Surgery currently remains at the center of any potentially curable case. With the rapid development of surgical techniques and progress of pathology research in low rectal cancer, sphincter-preserving surgery has been widely used in the treatment of low rectal cancer. This review is to summarize the current literatures pertaining to sphincter-preserving surgery, including distal resection margin, neoadjuvant therapy, indications, and postoperative complications.
Anal Canal ; surgery ; Humans ; Neoadjuvant Therapy ; Organ Sparing Treatments ; Rectal Neoplasms ; surgery

Animals ; Echinococcosis, Hepatic ; pathology ; surgery ; Humans ; Male ; Organ Sparing Treatments ; methods ; Spleen ; pathology

OBJECTIVEThis meta-analysis was performed to analyze the effect of preserving the native aortic valve on short- and long-term prognosis post aortic root reconstruction surgery for patients with Marfan syndrome.

METHODSDatabase including Pubmed,Embase, Cochrane library, CNKI, Wanfang,VIP and CBM were searched to collect studies comparing clinical results of valve sparing surgery with composite valve graft surgery for patients with Marfan syndrome. Study quality was assessed by Newcastle-Ottawa Scale and publication bias was assessed by visual inspection of the funnel plot together with Egger test. Clinical outcomes data was extracted from the manuscripts and analyzed with Revman 5.0 supplied by Cochrane collaboration.

RESULTSSeven clinical trials with 690 patients were included. Meta- analysis demonstrated that valve sparing surgery was associated with a lower incidence of re-exploration (RR = 0.51, 95%CI:0.29- 0.90, P < 0.05), thromboembolism (RR = 0.17, 95%CI:0.05-0.57, P < 0.01), endocarditis (RR = 0.31, 95%CI:0.11-0.94, P < 0.05) and significantly lower long-term death rate (RR = 0.37, 95%CI:0.18-0.74, P < 0.01). Reoperation rate was similar between the two groups (RR = 1.07, 95%CI:0.35-3.27, P > 0.05).

CONCLUSIONValve sparing aortic root reconstruction surgery is a superior procedure to composite valve graft surgery in term of improving the short- and long-term prognosis for patients with Marfan syndrome.

Aorta ; surgery ; Aortic Valve ; surgery ; Humans ; Marfan Syndrome ; surgery ; Organ Sparing Treatments ; methods ; Prognosis ; Treatment Outcome

Intersphincteric resection (ISR) has been performed as an ultimate sphincter-sparing strategy in selected patients with low rectal cancer. Accumulating evidence suggests that ISR may be an interesting alternative to abdominoperineal resection to avoid a permanent stoma without compromising oncological outcomes. However, bowel dysfunction is a most common consequence of ISR not to be neglected. To date, limited clinical research has reported functional and quality of life outcomes according to patient-reported outcome measures. Also, data concerning management of low anterior resection syndrome are scarce due to lack of quality evidence. Therefore, this review provides an up-to-date summary of systematic assessment (including function, quality of life, manometry and morphology) and bowel rehabilitation for ISR patients. Postoperative anal function is often assessed by a combination of scales, including the Incontinence Assessment Scale, the Gastrointestinal Function Questionnaire, the Specific LARS Assessment Scale and the Faecal Diary. The condition-specific Quality of Life Scale is more appropriate for Quality-of-life measures in fecal incontinence after ISR. Patients' physiological function after ISR can be assessed using water- or high-resolution solid-state anorectal manometry. Anatomical and morphological changes can be assessed using defecography and 3D endorectal ultrasound. Electrical stimulation and biofeedback, pelvic floor exercises, rectal balloon training, transanal irrigation and sacral neuromodulation are all options for post-operative rehabilitation.
Humans ; Rectal Neoplasms/surgery* ; Postoperative Complications ; Anal Canal/surgery* ; Quality of Life ; Organ Sparing Treatments ; Fecal Incontinence

No abstract available.
Female ; Humans ; Hysterectomy/*methods ; *Organ Sparing Treatments ; Pelvis/*innervation ; Rectum/*innervation ; Urinary Bladder/*innervation ; Uterine Cervical Neoplasms/*surgery ; Uterus/*innervation

The progress in the idea and technology of rectal cancer improve the rate of sphincter-preservation, while bowel dysfunction is the major problem puzzling patients after sphincter-preserving operation. Recent researches reveal bowel dysfunction is closely associated with the postoperative change of anatomy, nerve damage and sphincter functional injury based on the mechanism of defecation function change through the analysis of anatomy, physiology and dynamics. This paper summarizes the mechanism and epidemiology of bowel dysfunction after rectal cancer operation, and elucidate the role of such mechanism in treatment and prevention of above bowel dysfunction.
Anal Canal ; surgery ; Humans ; Intestinal Diseases ; etiology ; Intestine, Small ; physiopathology ; Organ Sparing Treatments ; Postoperative Complications ; Rectal Neoplasms ; surgery

OBJECTIVE: To explore the indications and the effective treatment methods of laryngeal function preserva tion in aged patients with hypopharyngeal carcinoma. METHOD: Clinical data about 41 patients with hypopharygeal carcinoma were analysed. These patients were more than or equal to 60 and were treated from January 2006 to December 2011. Among them, 25 cases were treated with laryngeal functions preserved and the hypopharynx defect was immediately re paired by the adjacent tissue flap or (and) the pactoralis major myocutaneous flap according to the size of defect after tumor resecting. The survival rate was calculated by Kaplan-Meier method. RESULT: In 25 patients with laryngeal function preservation, 16 cases were 60-69 years old, 6 cases were 70-79 years old and 3 cases were 80-88 years old. The tumour located at lateral wall of pyriform sinus in 14 cases, at anterior wall of pyriform sinus in 3 cases, at inside wall of pyriform sinus in 3 cases, at upper side wall of hypopharynx invading tonsil or tongue base in 3 cases, at posterior hypopharyngeal wall in 2 cases. The average length of post-operation stay was 22.2 days. Eight cases suffered from post-operative complications (32%), including of pharyngeal fistula in six cases and pulmonary infection in two cases. The respiratory function and pronunciation were all restored, in 25 cases, among which 20 cases removed tracheostomy tube about 3 months after surgery. 2 cases were missed after 1-year followed up. 2 cases died of local tumor recurrence. 4 cases died of neck recurrence. 8 cases died of pulmonary matastasis. The 1-year and 3-year survival rate of the disease in the group was 67.5% and 43.9% respectively. CONCLUSION As the aged cases of hypopharygeal carcinoma are choosed appropriately and repaired feasibly, surgery for the disease with laryngeal function retention may be safe and effective.
Aged ; Aged, 80 and over ; Female ; Humans ; Hypopharyngeal Neoplasms ; physiopathology ; surgery ; Larynx ; physiology ; surgery ; Male ; Middle Aged ; Organ Sparing Treatments ; methods