1.The value of computed tomography multi-planner reconstruction in the treatment of lung cancer with percutaneous argon-helium cryoablation
Yunsong ZHANG ; Yingjiu CAI ; Tianzi CHEN ; Jianlin DONG ; Xiaojun GAO ; Yanwei ZHANG ; Fang BAI
Chinese Journal of Clinical Oncology 2018;45(4):185-190
Objective: To evaluate the value of computed tomography (CT) multi-planner reconstruction (MPR)in the treatment of lung cancer with percutaneous argon-helium cryoablation.Method:A total of 66 patients with stage T2 or T3 non-small cell lung can-cer who had complete follow-up data were treated with percutaneous argon-helium cryoablation with conventional axial CT(conven-tional group)or MPR guidance(MPR group)between January 2013 and 2016.There were 31 patients in the conventional group and 35 in the MPR group.The total number of punctures,the total time of operation,and the incidence of complications,tumor residual rates,and local control rates were compared between the two groups.Results:When the number of needles was the same,the aver-age number of punctures and puncture errors in the two groups were significantly lower in the MPR group than in the conventional group(P<0.05).Comparing the average operation time,there was no statistical difference between the MPR group and the conven-tional scan group(P>0.05).The incidence of postoperative complications was significantly lower in the MPR group than in the conven-tional scan group.Among them,the incidence of puncture combined hemorrhage was 1.52% vs.13.64%,and pneumothorax second-ary to puncture was 3.03% vs.19.70%(P<0.05).During the follow-up period to 12 months after surgery,the therapeutic benefit indica-tors such as local residual rate and total effective rate in the MPR group were also significantly better than those in the conventional group,which were 1.52% vs.10.61 and 51.52% vs.36.36%(P<0.05),respectively.Conclusions:Using MPR technology to guide percuta-neous argon-helium cryoablation treatment for lung cancer confers a small puncture error,low incidence of complications,and signifi-cant treatment benefits.This method is worthy of clinical promotion.
2.Efficiency and safety of traditional growing rod technique in the treatment of early onset dystrophic scoliosis secondary to type 1 neurofibromatosis with intraspinal rib head in children
Rongxuan GAO ; Xuejun ZHANG ; Dong GUO ; Jun CAO ; Ziming YAO ; Yunsong BAI ; Xinyu QI
Chinese Journal of Orthopaedics 2022;42(20):1373-1381
Objective:To investigate the efficiency and safety of traditional growing rod in the treatment of early onset dystrophic scoliosis secondary to type 1 neurofibromatosis (NF1-DS) with intraspinal rib head in children.Methods:From September 2006 to May 2020, this study recruited 20 children with intraspinal rib head with early onset NF1-DS who had received traditional growing rods. There were 13 boys and 7 girls and the age of the initial operation was 7.0±1.6 years (range, 4.1-9.8 years). There were 7 cases of simple left chest bend, 9 cases of simple right chest bend, and 4 cases of double chest bend; 13 patients had varying degrees of kyphosis deformity. Two children had neurological symptoms before surgery, American Spinal Injury Association Impairment Scale (AIS) were grade D. The proportion of the intraspinal rib head (IRP), the Cobb angle of the main chest bend, apical vertebra rotation (AVR), apical vertebral translation (AVT), trunk shift (TS) and sagittal TK, lumbar lordosis (LL), sagittal balance and T 1-S 1 height were measured before and after first time internal fixation and at last follow-up, and the complications were also evaluated. Results:All 20 patients were followed up and the average follow-up time was 41.6±23.8 months (range, 24-99 months). A total of 85 operations was conducted including 63 protrude operations. After operation, the IRP was significantly lower than that before operation (preoperative 33.1%±17.5% vs. postoperative 22.2%±11.3%, P<0.001) and no significant correction loss was found at last follow-up 23.7%±12.4% ( P>0.05). The mean Cobb angle decreased from 75.9°±26.7° preoperatively to 45.0°±18.5° postoperatively ( P<0.001) and there was still significant improvement at the last follow-up (41.0°±17.2°) compared with postoperatively ( P<0.05). The AVR was significantly reduced after surgery compared with preoperatively (33.0°±10.1° vs. 39.3°±13.3°, P<0.001), and the last follow-up (40.1°±11.4°) was significantly improved compared with postoperative ( P=0.005). The T 1-S 1 height increased from 259.8±70.7 mm preoperatively to 296.9±78.4 mm postoperatively ( P=0.001), and at the last follow-up 296.9±78.4 mm was still significantly higher than after operation ( P<0.001), with an average annual increase of 12.4±3.2 mm. Significant correction of AVT, TK, LL and sagittal balance were noted after initial surgery ( P<0.05), and no significant correction loss was found at last follow-up ( P>0.05). There were 10 complications in 7 cases. There were 5 complications of pedicle screw loosening, 1 complication of bolt droping, 2 complications of broken rod, 1 complication of distal junctional kyphosis and 1 complication of adding-on phenomenon. 2 cases with nerve injury were recover after operation (AIS grading E). None of the children had new neurological complications during growth rod insertion and multiple stretching during follow-up. Conclusion:For children with early onset NF1-DS with intraspinal rib head, if the preoperative AIS grade is D or E, traditional growing rod technique is relatively safe and effective and can make the intraspinal rib head remove from the spinal canal partly.