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

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

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

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

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

PURPOSE: The purpose of this study was to compare the clinical outcomes of arthroscopic anatomical double bundle (DB) anterior cruciate ligament (ACL) reconstruction with either selective anteromedial (AM) or posterolateral (PL) bundle reconstruction while preserving a relatively healthy ACL bundle. MATERIALS AND METHODS: The authors evaluated 98 patients with a mean follow-up of 30.8±4.0 months who had undergone DB or selective bundle ACL reconstructions. Of these, 34 cases underwent DB ACL reconstruction (group A), 34 underwent selective AM bundle reconstruction (group B), and 30 underwent selective PL bundle reconstructions (group C). These groups were compared with respect to Lysholm and International Knee Documentation Committee (IKDC) score, side-to-side differences of anterior laxity measured by KT-2000 arthrometer at 30 lbs, and stress radiography and Lachman and pivot shift test results. Pre- and post-operative data were objectively evaluated using a statistical approach. RESULTS: The preoperative anterior instability measured by manual stress radiography at 90° of knee flexion in group A was significantly greater than that in groups B and C (all p<0.001). At last follow-up, mean side-to-side instrumented laxities measured by the KT-2000 and manual stress radiography were significantly improved from preoperative data in all groups (all p<0.001). There were no significant differences between the three groups in anterior instability measured by KT-2000 arthrometer, pivot shift, or functional scores. CONCLUSION: Selective bundle reconstruction in partial ACL tears offers comparable clinical results to DB reconstruction in complete ACL tears.
Adolescent ; Adult ; Anterior Cruciate Ligament/*surgery ; Anterior Cruciate Ligament Reconstruction/*methods ; Arthroscopy ; Female ; Humans ; Male ; Middle Aged ; Organ Sparing Treatments/*methods ; Treatment Outcome ; Young Adult

Penile and testicular tumors, especially those of the malignant nature, usually require radical excision, which alters the organ image, affects sexual and urinary functions, and consequently undermines the self-confidence and quality of life of the patient. Recent studies show that organ-sparing surgery can be an alternative to radical excision for superficial tumors and small masses. Penis-sparing surgery (PSS) has been indicated for superficial penile cancer, such as Tis and T1a lesions, and testis-sparing surgery (TSS) is feasible for benign small bilateral or solitary testicular masses (TIN). Long-term follow-ups after PSS or TSS show that the patients may retain a satisfactory appearance of the organ as well as desirable sexual and reproductive functions.
Andrology ; methods ; Humans ; Libido ; Male ; Organ Sparing Treatments ; methods ; Patient Satisfaction ; Penile Neoplasms ; surgery ; Quality of Life ; Self Concept ; Testicular Neoplasms ; surgery

OBJECTIVETo discuss the safety and feasibility in the preservation to hepatic branch of vagus nerve by the side-to-side tubular gastroesophageal anastomosis within the laparoscopic radical proximal gastrectomy for early gastric cancer(EGC).

METHODSRetrospective analysis on the intraoperative and postoperative data of 7 EGC patients receiving laparoscopic radical proximal gastrectomy from January 2014 to January 2015 was carried out. All the patients underwent the preservation of hepatic branch of the vagus nerve by side-to-side tubular gastroesophagreal anastomosis.

RESULTSAll the 7 patients completed operations successfully without conversion to open surgery. The mean operative time was (213.1 ± 22.1) minute, the mean reconstruction time was (56.9 ± 11.6) minute, and the mean blood loss was (38.6 ± 28.1) ml. Postoperative time to flatus was (2.4 ± 0.5) day, and postoperative hospital stay was (9.3 ± 0.9) day. No operation-related complications were observed. No severe malnutrition, no recurrence or death, and no severe esophageal reflux during follow-up period were found.

CONCLUSIONThe preservation of hepatic branch of the vagus nerve by side-to-side tubular gastroesophagreal anastomosis within laparoscopic radical proximal gastrectomy for ECG is safe and feasible.

Anastomosis, Surgical ; Feasibility Studies ; Gastrectomy ; methods ; Humans ; Laparoscopy ; Length of Stay ; Neoplasm Recurrence, Local ; Operative Time ; Organ Sparing Treatments ; Postoperative Period ; Retrospective Studies ; Stomach Neoplasms ; surgery ; Vagus Nerve ; surgery

OBJECTIVE: To assess the effect for local sensory to preserve great auricular nerve in the parotidectomy. METHOD: It was a prospective study. Eighy-one patients who underwent parotidectomy were randomly divided into 2 groups, preserving the great auricular nerve group and no preserving the great auricular nerve group. They were tested with the subjective and objective sensory function testing in 3, 6, 9, 12 months after operation. We assessed the result. RESULT: In the subjective sensory function testing, the result of the preserving the great auricular nerve group was better than no preserving the great auricular nerve group. In the objective sensory function testing, the result of the preserving the great auricular nerve group was obviously better than no preserving the great auricular nerve group. There was significant difference between the 2 groups (P<0.05). CONCLUSION It was effective for recovering the sensory function that we preserved the great auricular nerve in the parotidectomy.
Ear, External ; innervation ; Humans ; Organ Sparing Treatments ; Otolaryngology ; methods ; Parotid Gland ; innervation ; surgery ; Parotid Neoplasms ; surgery ; Prospective Studies ; Sensation Disorders ; prevention & control

Borderline ovarian tumors (BOTs) represent about 15% to 20% of all ovarian malignancies and differ from invasive ovarian cancers (IOCs) by many characters. Historically, standard management of BOT is peritoneal washing cytology, hysterectomy, bilateral salpingo-oophorectomy, omentectomy, complete peritoneal resection of macroscopic lesions; in case of mucinous BOTs, appendectomy should be performed. Because BOTs are often diagnosed at earlier stage, in younger age women and have better prognosis, higher survival rate than IOCs, fertility-sparing surgery is one of the option to preserve childbearing capacity. The study of such conservative surgery is being released, and still controversial. After surgery, pregnancy and ovarian induction followed by in vitro fertilization are also significant issues. In surgery, laparoscopic technique can be used by a gynecologic oncology surgeon. So far postoperative chemotherapy, radiotherapy and hormone therapy are not recommended. We will discuss controversial issues of BOTs on this review and present the outline of the management of BOTs.
Biopsy ; Chemotherapy, Adjuvant ; Female ; Humans ; Infertility, Female/prevention & control ; Intraoperative Care/methods ; Laparoscopy/methods ; Laparotomy/methods ; Neoplasm Recurrence, Local/therapy ; Neoplasm Staging ; Organ Sparing Treatments/methods ; Ovarian Neoplasms/pathology/*therapy ; Ovary/*pathology ; Precancerous Conditions/pathology/therapy