Objective:The study aims to assess and compare the outcomes of modified radical surgery, preserving the nipple-areola complex, against radical mastectomy in patients with triple-negative breast cancer. Emphasis is placed on the clinical significance of this comparison, including its potential impact on patient outcomes, quality of life, and healthcare resources. Methods:Relevant literature from January 2017 to January 2022 was searched in the following databases: PubMed, Embase, MEDLINE, Science Citation Index, Web of Science, China National Knowledge Internet, CCD, and CSPD with keywords. The electric search yielded 613 relevant articles, including 351 from Pubmed, 187 from Embase, 5 from MEDLINE, 21 from CNKI, 4 from CCD, and 45 from CSPD. After duplicate screening, 185 items were eliminated, leaving 428 articles. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated with RevMan 5.3, and sensitivity analysis, cumulative meta-analysis, and publication bias analysis were also performed. A total of 613 relevant articles were collected from the above databases, among which 428 articles remained after the initial screening and were further screened based on the established inclusion and exclusion criteria. The efficacy of modified radical surgery and breast-conserving surgery in the treatment of early breast cancer was assessed by analyzing outcome indicators, including recurrence rate, distant metastatic rate, and three-year survival rate. The methods section details a systematic approach to data collection and analysis, specifying the databases and time frame for the literature search and the statistical tools used for the meta-analysis. The selection process, from the initial number of articles to the final inclusion based on defined criteria, is transparent, ensuring the study's methodological robustness in evaluating the efficacy of surgeries for early breast cancer. Results:Finally, ten articles were found to match the criteria and included in this study. According to the meta-analysis, there was no statistically significant difference between the breast-conserving therapy (BCT) and modified radical mastectomy (MRM) groups in terms of the recurrence rate (OR = 0.76, 95%CI = 0.39, 1.55, P > .05) and distant metastatic rate (OR = 0.81, 95%CI = 0.46, 1.31, P > .05). Nevertheless, the three-year survival rate was 85.2% in the BCT group and 91.7% in the MRM group; a statistically significant difference was observed in the three-year survival rate (OR = 1.47, 95%CI = 1.01, 2.37, P = .03) between the BCT and MRM groups. Accordingly, breast-conserving surgery and modified radical surgery produced comparable clinical outcomes for the treatment of early breast cancer. Conclusion:In the treatment of early breast cancer, breast-conserving surgery has the advantages of less bleeding, fewer clinical complications, and favorable cosmetic outcomes compared with modified radical surgery. Furthermore, patients with breast-conserving surgery showed comparable recurrence and distant metastatic rates to those with modified radical surgery in postoperative follow-up, which, therefore is a suitable treatment option for the widespread recommendation. The study's findings hold significant clinical relevance, implying that while BCT remains a viable option, MRM may offer a survival advantage. This insight empowers both patients and clinicians in making informed, personalized treatment decisions tailored to individual circumstances.
Introduction: Laparoscopic renal cyst decortication is currently the best choice for the treatment of simple renal cysts and is widely used in clinical practice Aim: To investigate the safety and clinical efficacy of two-trocar mini-laparoscopic decortication of adult renal cysts. Material and methods: A total of 90 patients were enrolled in the study and randomly divided into two groups: a two-trocar mini-laparoscopic treatment group (M group) and a three-trocar standard laparoscopic treatment group (S group), with 45 patients in each group. Results: The average length of hospital stay was shorter, and the demand for postoperative analgesics was less in the M group than in the S group (p < 0.05). The proportion of "very satisfied" patients in the patient physical recovery satisfaction survey was significantly higher in the M group than in the S group (p < 0.05). Of the 45 patients in the M group, 40 successfully underwent surgery. In 3 patients, the two-trocar procedure was converted to a three-trocar procedure due to difficulty in separating perirenal adhesion for visualization. Mini-laparoscopic surgery was converted to classic laparoscopic surgery in 2 patients. In the S group, 44 patients successfully underwent the renal cyst decortication procedure. One patient underwent partial renal resection due to an intraoperative diagnosis of multilocular cystic renal cell carcinoma. Postoperative urine leakage was reported in 3 patients in the M group and two in the S group. Conclusions: Two-trocar mini-laparoscopic treatment of renal cysts is as safe and effective as traditional laparoscopy but is associated with less cosmetic damage, leading to a better physical appearance.
A 55-year-old previously healthy man was admitted because of a 3-month history of progressive cognitive decline with Mini-Mental State Examination score 17, characterized mainly by apathy, memory impairment, speech disturbances, anosognosia, and hypersomnia. MRI revealed engorged veins and T2 hypersignal in bilateral thalamus and basal ganglia, with no restricted diffusion on diffusion-weighted imaging (Figure 1). Angiography revealed an anterior skull base dural arteriovenous fistula (DAVF) draining through the inferior sagittal sinus to the internal cerebral and basal vein of Rosenthal with straight sinus occlusion (Figure 2). The clinical picture is explained predominantly by bithalamic venous congestion due to the DAVF and occlusion of the straight sinus.1,2
Introduction: This study aimed to investigate the safety and efficacy of mini-laparoscopy for renal cyst unroofing. Material and methods: Eighty-six patients for treatment of renal cysts that met the selection criteria were included in this study. They were divided into two groups. Forty-five patients underwent cyst unroofing via mini-laparoscopy (Group M), and 43 patients underwent cyst unroofing via standard laparoscopy (Group S). There were no differences between the two groups in terms of sex, age, body mass index or clinical data. Data from the groups were recorded and analyzed. Results: The average hospital stays were shorter (p = .039) and postoperative painkiller demand was lower (p = .031) in Group M than in Group S. Forty-one out of 45 procedures in Group M were successful, and all 43 cases in Group S were successfully. With a follow-up period of 0.5 to 5.5 years, there was no significant difference in recovery rate (p = .213). Questionnaires showed that patients in Group M were significantly more satisfied with their cosmetic results than were patients in Group S (p = .041). Conclusion: Our findings suggest that renal cyst decortications with mini-laparoscopic instruments are as safe and effective as procedures using standard laparoscopic instruments. Cosmetically, the results are better with mini-laparoscopy than with standard laparoscopic unroofing.