1.Prospective value of early postoperative PI-APD in children with ureteropelvic junction obstruction
Dapeng JIANG ; Zhoutong CHEN ; Hongquan GENG ; Maosheng XU ; Liguo WANG ; Guofeng XU ; Houwei LIN ; Xiaoliang FANG ; Lei HE
Journal of Shanghai Jiaotong University(Medical Science) 2017;37(6):792-796
Objective· To investigate the prospective value of early postoperative PI-APD in children with hydronephrosis.Methods· Data of children with hydronephrosis who underwent pyeloplasty in Xinhua Hospital,Shanghai Jiao Tong University School of Medicine between Jan 2012 to Nov 2015 was collected.PI-APD was divided into 3 categories (≤ 19%,19%<PI-APD<40% and ≥ 40%).The relationship between PI-APD value and the degree of renal function (DRF) and dilation recovery after surgery was analyzed.Results· There were 360 children with hydronephrosis.The median follow-up was 20 months.The PI-APD value (3 months after pyeloplasty) was positively correlated with the degree of DRF recovery (r=0.631,P=0.000).Five patients received redo-pyeloplasty.PI-APD of all these patients was <19%.Conclusion· PI-APD is a new feasible ultrasound parameter in pyeloplasty followup.PI-APD ≥ 40% at the first post-operative visit predicts pyeloplasty success.PI-APD ≤ 19% indicates close follow-up after operation.PI-APD can also help select children at high risk for repeat intervention after pyeloplasty.
2.Use of bipolar radiofrequency device Habib 4X in hepatic malignant tumor resection
Haiying LIU ; Nanrong YU ; Guohua YANG ; Jianchang LI ; Jin WANG ; Houwei XU ; Weiqun LU
Chinese Journal of Hepatic Surgery(Electronic Edition) 2014;(2):84-87
Objective To assess the use of bipolar radiofrequency device Habib 4X in hepatic malignant tumor resection. Methods Clinical data of 75 patients with hepatic malignant tumor undergoing hepatectomy with the use of Habib 4X in Department of Gastrointestinal Oncology, Cancer Center of Guangzhou Medical University from February 2009 to June 2013 were retrospectively analyzed. There were 55 males and 20 females with a mean age of (53±12) years old. Forty-nine cases were with primary liver cancer and 26 cases were with secondary liver cancer. The informed consents of all patients were obtained and the ethics committee approval was received. Patients received endotracheal general anesthesia. Hepatectomy was performed after tumor ablation was employed with Habib 4X device 2-3 cm away from the tumor. The intraoperative bleeding, blood transfusion, operation duration, changes of postoperative alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TB), length of postoperative hospital stay and complications were observed. Patients were followed up after being discharged from hospital and tumor recurrence and mortality were observed. Results All the 75 patients underwent hepatectomy successfully. The mean intraoperative bleeding was (318±89)ml, the rate of blood transfusion was 7%(5/75), the median of operation duration was 104 (17-191) min, the length of postoperative hospital stay was (11±4)d. ALT, AST, TB rose to a top level 1 d after operation, then went down progressively and liver function backed to normal 9 d after operation. Two cases suffered from bile ifstula and were cured after enhancing drainage. The 1-, 3-year recurrence rates were 6%(3/49), 10%(5/49) respectively in patients with primary liver cancer and were 23%(6/26), 27%(7/26) respectively in patients with secondary liver cancer. The mortality were 4%(2/49), 27%(7/26) respectively in patients with primary liver cancer and secondary liver cancer during the follow-up. Two cases with primary liver cancer died of postoperative hepatic encephalopathy and 7 cases with secondary liver cancer died of tumor widespread metastasis. Conclusions Habib 4X is safe and effective for hepatic malignant tumor resection. It may reduce the postoperative tumor recurrence rate.