1.Radiofrequency ablation and laparoscopic splenectomy for the treatment of small hepatocellular carcinoma with hypersplenism
Xintao ZENG ; Hua LUO ; Wei ZHANG ; Xi CHEN ; Daoning GUO ; Pei YANG
China Oncology 2016;26(2):177-181
Background and purpose:Liver cancer resection and splenectomy are the main methods to treat hepatocellular carcinoma and hypersplenism. The aim of this study was to discuss the safety and feasibility of simultaneous radiofrequency ablation (RFA) and laparoscopic splenectomy (LS) for the treatment of small hepatocellular carcinoma with hypersplenism.Methods:Twenty-seven patients with small hepatocellular carcinoma and cirrhotic hypersplenism underwent RFA and LS. The clinical data were also analyzed.Results:The surgery was converted to an open surgery in 1 patient, while laparoscopic splenectomy in a hand-assisted manner was performed in 2 patients. There were 31 liver tumors treated with RFA. Blood loss were 110-900 mL (mean=320 mL). Operation time were 72-127 min (mean=107 min). Subcutaneous emphysema occurred in 1 patient, and pancreatic leakage in another patient. Nine patients developed ascites. one patient suffered from massive haemorrhage, and emergency operation was adopted to stop bleeding. This patient recovered well after operation. No death was found during the hospitalization. Conclusion:Combining RFA with LS for the treatment of liver cancer and hypersplenism is minimally invasive, safe, and feasible.
2.Efficiency comparison of Kwak and ACR ( 2017 ) Thyroid Imaging Reporting and Data System ( TI‐RADS) classification :a polycentric retrospective study
Yu LIANG ; Linxian YUE ; Qin CHEN ; Jie LIN ; Daoning GUO ; Peng HE ; Fang YANG ; Wensheng YUE ; Hong ZHENG ; Jiaquan RUAN ; Haijun LIU ; Jianqiong SONG ; Lingying YANG ; Juan WANG ; Chengting ZHOU ; Yutian WU ; Siyi WANG ; Yanqiong TANG ; Mengxia YUAN ; Yan ZHAO
Chinese Journal of Ultrasonography 2019;28(5):419-424
Objective To evaluate the diagnostic efficacy of Kwak and ACR( 2017 ) thyroid imaging reporting and data systems ( T I‐RADS ) for thyroid nodules . Methods Cases of thyroid nodule who underwent surgery from January 2015 to M arch 2018 in 15 hospitals in Sichuan province were collected and the ultrasonographic features of thyroid nodules were retrospectively analyzed by trained senior ultrasound physicians using Kwak and ACR T I‐RADS classification methods . Totally ,12 712 thyroid nodules were observed ,7 023 thyroid nodules in 7 023 cases with complete ultrasound and surgical and pathological data were eventually enrolled in the study . T hyroid nodules with solid ,hypoechoic or very hypoechoic ,tall/wide ratio ≥ 1 , margin ill‐defined and microcalcification were classified as malignant signs of ultrasound . M alignant percentage was calculated and diagnostic tests were performed . Results ① T here was a statistical difference between the benign and malignant nodules in the two types of T I‐RADS classification ( P<0 .01) . ② T he area under ROC curve of Kwak and ACR in the diagnosis of malignant nodules were 0 .89 and 0 .84 ,respectively . T he Youden index of Kwak and ACR were 0 .66 and 0 .57 ,respectively . ③Taking Kwak T I4B and ACR T R4 as critical points for malignancy ,the sensitivity ,specificity ,positive predictive value and negative predictive value of Kwak T I 4B were 75 .0% ,90 .9% ,83 .2% ,and 85 .9% , respectively . T he accuracy of Kwak T I4B was 84 .9% ; T he sensitivity ,specificity ,positive predictive value and negative predictive value of ACR T R4 were 88 .2% ,68 .9% ,62 .9% ,and 90 .8% ,respectively . T he accuracy of ACR T R4 was 76 .2% . T he Kappa value of Kwak TI4B and ACR T R4 was 0 .52 . T he χ2 value of Kwak T I4B and ACR T R4 was 2 174 .6 ( P < 0 .01 ) . Conclusions T he diagnostic values of two T I‐RADS classification methods for thyroid malignant nodules are high . T he overall efficiency of Kwak T I‐RADS classification method is better than that of ACR TI‐RADS classification method .