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Liu MF, Ma RX, Cao XB, Zhang H, Zhou SH, Jiang WH, Jiang Y, Sun JW, Yang QT, Li XZ, Sun YN, Shi L, Wang M, Song XC, Chen FQ, Zhang XS, Wei HQ, Yu SQ, Zhu DD, Ba L, Cao ZW, Xiao XP, Wei X, Lin ZH, Chen FH, Shan CG, Wang GK, Ye J, Qu SH, Zhao CQ, Wang ZL, Li HB, Liu F, Cui XB, Ye SN, Liu Z, Xu Y, Cai X, Hang W, Zhang RX, Zhao YL, Yu GD, Shi GG, Lu MP, Shen Y, Zhao YT, Pei JH, Xie SB, Yu LG, Liu YH, Gu SS, Yang YC, Cheng L, Liu JF. [Incidence and prognosis of olfactory and gustatory dysfunctions related to infection of SARS-CoV-2 Omicron strain: a national multi-center survey of 35 566 population]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2023; 58:579-588. [PMID: 37339898 DOI: 10.3760/cma.j.cn115330-20230316-00117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/22/2023]
Abstract
Objective: This cross-sectional investigation aimed to determine the incidence, clinical characteristics, prognosis, and related risk factors of olfactory and gustatory dysfunctions related to infection with the SARS-CoV-2 Omicron strain in mainland China. Methods: Data of patients with SARS-CoV-2 from December 28, 2022, to February 21, 2023, were collected through online and offline questionnaires from 45 tertiary hospitals and one center for disease control and prevention in mainland China. The questionnaire included demographic information, previous health history, smoking and alcohol drinking, SARS-CoV-2 vaccination, olfactory and gustatory function before and after infection, other symptoms after infection, as well as the duration and improvement of olfactory and gustatory dysfunction. The self-reported olfactory and gustatory functions of patients were evaluated using the Olfactory VAS scale and Gustatory VAS scale. Results: A total of 35 566 valid questionnaires were obtained, revealing a high incidence of olfactory and taste dysfunctions related to infection with the SARS-CoV-2 Omicron strain (67.75%). Females(χ2=367.013, P<0.001) and young people(χ2=120.210, P<0.001) were more likely to develop these dysfunctions. Gender(OR=1.564, 95%CI: 1.487-1.645), SARS-CoV-2 vaccination status (OR=1.334, 95%CI: 1.164-1.530), oral health status (OR=0.881, 95%CI: 0.839-0.926), smoking history (OR=1.152, 95%CI=1.080-1.229), and drinking history (OR=0.854, 95%CI: 0.785-0.928) were correlated with the occurrence of olfactory and taste dysfunctions related to SARS-CoV-2(above P<0.001). 44.62% (4 391/9 840) of the patients who had not recovered their sense of smell and taste also suffered from nasal congestion, runny nose, and 32.62% (3 210/9 840) suffered from dry mouth and sore throat. The improvement of olfactory and taste functions was correlated with the persistence of accompanying symptoms(χ2=10.873, P=0.001). The average score of olfactory and taste VAS scale was 8.41 and 8.51 respectively before SARS-CoV-2 infection, but decreased to3.69 and 4.29 respectively after SARS-CoV-2 infection, and recovered to 5.83and 6.55 respectively at the time of the survey. The median duration of olfactory and gustatory dysfunctions was 15 days and 12 days, respectively, with 0.5% (121/24 096) of patients experiencing these dysfunctions for more than 28 days. The overall self-reported improvement rate of smell and taste dysfunctions was 59.16% (14 256/24 096). Gender(OR=0.893, 95%CI: 0.839-0.951), SARS-CoV-2 vaccination status (OR=1.334, 95%CI: 1.164-1.530), history of head and facial trauma(OR=1.180, 95%CI: 1.036-1.344, P=0.013), nose (OR=1.104, 95%CI: 1.042-1.171, P=0.001) and oral (OR=1.162, 95%CI: 1.096-1.233) health status, smoking history(OR=0.765, 95%CI: 0.709-0.825), and the persistence of accompanying symptoms (OR=0.359, 95%CI: 0.332-0.388) were correlated with the recovery of olfactory and taste dysfunctions related to SARS-CoV-2 (above P<0.001 except for the indicated values). Conclusion: The incidence of olfactory and taste dysfunctions related to infection with the SARS-CoV-2 Omicron strain is high in mainland China, with females and young people more likely to develop these dysfunctions. Active and effective intervention measures may be required for cases that persist for a long time. The recovery of olfactory and taste functions is influenced by several factors, including gender, SARS-CoV-2 vaccination status, history of head and facial trauma, nasal and oral health status, smoking history, and persistence of accompanying symptoms.
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Affiliation(s)
- M F Liu
- Graduate School of Beijing University of Chinese Medicine, Beijing 100029, China Department of Otorhinolaryngology Head and Neck Surgery, China-Japan Friendship Hospital, Beijing 100029, China
| | - R X Ma
- Department of Otorhinolaryngology Head and Neck Surgery, the First People's Hospital of Yinchuan, Yinchuan 750001, China
| | - X B Cao
- Department of Otorhinolaryngology, the First People's Hospital of Yunnan Province, Kunming 650100, China
| | - H Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China
| | - S H Zhou
- Department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310003, China
| | - W H Jiang
- Department of Otorhinolaryngology Head and Neck Surgery, Xiangya Hospital Central South University, Changsha 410008, China
| | - Y Jiang
- Department of Otorhinolaryngology Head and Neck Surgery, the Affiliated Hospital of Qingdao University, Qingdao 266000, China
| | - J W Sun
- Department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital of USTC, Hefei 230001, China
| | - Q T Yang
- Department of Otorhinolaryngology Head and Neck Surgery, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
| | - X Z Li
- Department of Otorhinolaryngology Head and Neck Surgery, Qilu Hospital of Shandong University, Jinan 250012, China
| | - Y N Sun
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Affiliated Hospital of Harbin Medical University, Harbin 150001, China
| | - L Shi
- Department of Rhinology and Allergy, Shandong Provincial ENT Hospital, Shandong University, Jinan 250299, China
| | - M Wang
- Department of Otorhinolaryngology Head and Neck Surgery, Peking University People's Hospital, Beijing 100032, China
| | - X C Song
- Department of Otorhinolaryngology Head and Neck Surgery, Yantai Yuhuangding Hospital, Qingdao University, Yantai 264000, China
| | - F Q Chen
- Department of Otorhinolaryngology Head and Neck Surgery, Xijing Hospital, the Fourth Military Medical University, Xi'an 710032, China
| | - X S Zhang
- Gansu Provincial Center for Disease Control and Prevention, Lanzhou 730000, China
| | - H Q Wei
- Department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital of China Medical University, Shenyang 110001, China
| | - S Q Yu
- Department of Otorhinolaryngology Head and Neck Surgery, Tongji Hospital, Tongji Medical University, Shanghai 200065, China
| | - D D Zhu
- Department of Otorhinolaryngology Head and Neck Surgery, China-Japan Union Hospital of Jilin University, Changchun 130033, China
| | - L Ba
- Department of Otorhinolaryngology Head and Neck Surgery, Xizang Autonomous Region People's Hospital, Lasa 850000, China
| | - Z W Cao
- Department of Otorhinolaryngology Head and Neck Surgery, Shengjing Hospital of China Medical University, Shenyang 110004, China
| | - X P Xiao
- Department of Otorhinolaryngology Head and Neck Surgery, Hunan Provincial People's Hospital, Changsha 410005, China
| | - X Wei
- Department of Otorhinolaryngology Head and Neck Surgery, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou 570311, China
| | - Z H Lin
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310009, China
| | - F H Chen
- Department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
| | - C G Shan
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Hospital of Hebei Medical University, Shijiazhuang 050000, China
| | - G K Wang
- Department of Otorhinolaryngology Head and Neck Surgery, Henan Provincial People's Hospital, Zhengzhou 450003, China
| | - J Ye
- Department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital of Nanchang University, Nanchang 330006, China
| | - S H Qu
- Department of Otorhinolaryngology Head and Neck Surgery, Guangxi Zhuang Autonomous Region People's Hospital, Nanning 530021, China
| | - C Q Zhao
- Department of Otorhinolaryngology Head and Neck Surgery, Shanxi Medical University Affiliated Second Hospital, Taiyuan 030001, China
| | - Z L Wang
- Department of Otorhinolaryngology Head and Neck Surgery, XuanWu Hospital, Capital Medical University, Beijing 100053, China
| | - H B Li
- Department of Otorhinolaryngology Head and Neck Surgery, Eye, Ear, Nose and Throat Hospital, Shanghai Medical College, Fudan University, Shanghai 200031, China
| | - F Liu
- Department of Otorhinolaryngology Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
| | - X B Cui
- Department of Otorhinolaryngology Head and Neck Surgery, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010059, China
| | - S N Ye
- Department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China
| | - Z Liu
- Department of Otorhinolaryngology Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Y Xu
- Department of Otorhinolaryngology Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - X Cai
- Department of Otorhinolaryngology Head and Neck Surgery, Qinghai Provincial People's Hospital, Xining 810000, China
| | - W Hang
- Department of Otorhinolaryngology Head and Neck Surgery, Tianjin Huanhu Hospital, Tianjin 300350, China
| | - R X Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, Huadong Hospital Affiliated to Fudan University, Shanghai 200040, China
| | - Y L Zhao
- Department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - G D Yu
- Department of Otorhinolaryngology Head and Neck Surgery, Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China
| | - G G Shi
- Department of Otorhinolaryngology Head and Neck Surgery, Shandong Provincial Hospital, Affiliated to Shandong First Medical University, Jinan 250021, China
| | - M P Lu
- Department of Otorhinolaryngology, the First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, China
| | - Y Shen
- Department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Y T Zhao
- Department of Otorhinolaryngology Head and Neck Surgery, the First People's Hospital of Yinchuan, Yinchuan 750001, China
| | - J H Pei
- Department of Otorhinolaryngology, the First People's Hospital of Yunnan Province, Kunming 650100, China
| | - S B Xie
- Department of Otorhinolaryngology Head and Neck Surgery, Xiangya Hospital Central South University, Changsha 410008, China
| | - L G Yu
- Department of Otorhinolaryngology Head and Neck Surgery, the Affiliated Hospital of Qingdao University, Qingdao 266000, China
| | - Y H Liu
- Department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - S S Gu
- Department of Otorhinolaryngology Head and Neck Surgery, Qilu Hospital of Shandong University, Jinan 250012, China
| | - Y C Yang
- Department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - L Cheng
- Department of Otorhinolaryngology, the First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, China
| | - J F Liu
- Department of Otorhinolaryngology Head and Neck Surgery, China-Japan Friendship Hospital, Beijing 100029, China
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Feng X, Fu Q, Gu SS, Ye P, Wang J, Duan C, Cai XL, Zhang LQ, Ni SL, Li XZ. [Endoscopic resection of type D trigeminal schwannoma through nasal sinus approach]. Zhonghua Wai Ke Za Zhi 2023; 61:232-238. [PMID: 36650970 DOI: 10.3760/cma.j.cn112139-20220725-00323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Objective: To examine the feasibility and surgical approach of removing type D trigeminal schwannoma through nasal cavity and nasal sinus under endoscope. Methods: Eleven patients with trigeminal schwannoma who were treated in the Department of Otorhinolaryngology, Qilu Hospital of Shandong University from December 2014 to August 2021 were analyzed retrospectively in this study. There were 7 males and 4 females, aged (47.5±13.5) years (range: 12 to 64 years). The neoplasm involved the pterygopalatine fossa, infratemporal fossa, ethmoidal sinus, sphenoid sinus, cavernous sinus, and middle cranial fossa. The size of tumors were between 1.6 cm×2.0 cm×2.0 cm and 5.7 cm×6.0 cm×6.0 cm. Under general anesthesia, the tumors were resected through the transpterygoid approach in 4 cases, through the prelacrimal recess approach in 4 cases, through the extended prelacrimal recess approach in 2 cases, and through the endoscopic medial maxillectomy approach in 1 case. The nasal endoscopy and imaging examination were conducted to detect whether neoplasm recurred or not, and the main clinical symptoms during follow-up. Results: All the surgical procedures were performed under endonasal endoscope, including Gross total resection in 10 patients. The tumor of a 12-year-old patient was not resected completely due to huge tumor size and limited operation space. One patient was accompanied by two other schwannomas located in the occipital region and the ipsilateral parotid gland region originating from the zygomatic branch of the facial nerve, both of which were removed concurrently. After tumor resection, the dura mater of middle cranial fossa was directly exposed in the nasal sinus in 2 cases, including 1 case accompanied by cerebrospinal fluid leakage which was reconstructed by a free mucosal flap obtained from the middle turbinate, the other case was packed by the autologous fat to protect the dura mater. The operation time was (M(IQR)) 180 (160) minutes (range: 120 to 485 minutes). No complications and deaths were observed. No recurrence was observed in the 10 patients with total tumor resection during a 58 (68) months' (range: 10 to 90 months) follow-up. No obvious change was observed in the facial appearance of all patients during the follow-up. Conclusion: Type D trigeminal schwannoma involving pterygopalatine fossa and infratemporal fossa can be removed safely through purely endoscopic endonasal approach by selecting the appropriate approach according to the size and involvement of the tumor.
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Affiliation(s)
- X Feng
- Department of Otorhinolaryngology, Qilu Hospital of Shandong University, National Health Commission Key Laboratory of Otorhinolaryngology (Shandong University), Jinan 250012, China
| | - Q Fu
- Department of Otorhinolaryngology, Qilu Hospital of Shandong University, National Health Commission Key Laboratory of Otorhinolaryngology (Shandong University), Jinan 250012, China
| | - S S Gu
- Department of Otorhinolaryngology, Qilu Hospital of Shandong University, National Health Commission Key Laboratory of Otorhinolaryngology (Shandong University), Jinan 250012, China
| | - P Ye
- Department of Otorhinolaryngology, Qilu Hospital of Shandong University, National Health Commission Key Laboratory of Otorhinolaryngology (Shandong University), Jinan 250012, China
| | - J Wang
- Department of Otorhinolaryngology, Qilu Hospital of Shandong University, National Health Commission Key Laboratory of Otorhinolaryngology (Shandong University), Jinan 250012, China
| | - C Duan
- Department of Otorhinolaryngology, Qilu Hospital of Shandong University, National Health Commission Key Laboratory of Otorhinolaryngology (Shandong University), Jinan 250012, China
| | - X L Cai
- Department of Otorhinolaryngology, Qilu Hospital of Shandong University, National Health Commission Key Laboratory of Otorhinolaryngology (Shandong University), Jinan 250012, China
| | - L Q Zhang
- Department of Otorhinolaryngology, Qilu Hospital of Shandong University, National Health Commission Key Laboratory of Otorhinolaryngology (Shandong University), Jinan 250012, China
| | - S L Ni
- Department of Neurosurgery, Qilu Hospital of Shandong University, Jinan 250012, China
| | - X Z Li
- Department of Otorhinolaryngology, Qilu Hospital of Shandong University, National Health Commission Key Laboratory of Otorhinolaryngology (Shandong University), Jinan 250012, China
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Gu SS, Shen ZS, Deng HX, Qiu SJ, Ye D. [Cell heterogeneity of laryngeal carcinoma and evolution trajectory of epithelial cells]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2022; 57:168-177. [PMID: 35196760 DOI: 10.3760/cma.j.cn115330-20211217-00805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Objective: To analyze the classification and functions of cell subsets in laryngeal carcinoma and metastatic lymph nodes, and to explore the evolution trajectory of epithelial cells to tumor cells. Methods: Single-cell RNA sequencing was performed on 5 cases of laryngeal cancer, matched metastatic lymph nodes and 3 normal tissues. Patients were admitted to Ningbo Medical Center Lihuili Hospital from October 22, 2019 to December 16, all patients were male, aged 53-70 years old. Cell subsets of the above-mentioned tissues were analyzed by the Seurat, and the biological functions of cell subpopulation were investigated by functional enrichment analysis. Malignant epithelial cells were identified using copy number variation (CNV). The evolutionary trajectory of epithelial cells to cancer cells was analyzed by cell trajectory analysis, and cancerous transitional cells were identified. The highly expressed genes in transitional cells were analyzed by the FindAllMarker of the Seurat and verified by immunohistochemistry. Results: A total of 66 969 high-quality cells were obtained in 9 major clusters: epithelial cells, T cells, B cells, fibroblasts, endothelial cells, myeloid cells, mast cells, plasmacytoid dendritic cells and nerve cells. The first 5 cell clusters were divided into 8, 6, 4, 3 and 2 subgroups, respectively. Four epithelial cell subsets (C0, C1, C2 and C5) were derived from tumor tissues and metastatic lymph nodes, and had high levels of CNV and tumor cell content. Cell trajectory analysis showed that the evolution trajectory of epithelial cells was from normal epithelial subpopulation C4 to early cancerous cell population C0, which differentiated into three major malignant cell subsets C1, C3, and C5. Epithelial cell C0 may represent the transitional cell population of carcinogenesis, and were enriched in biological processes such as epithelial-mesenchymal transformation and angiogenesis. C0 highly expressed sulforaphane (SFN) which may be related to the occurrence and development of cancer. Immunohistochemistry confirmed that SFN was highly expressed in tumor tissues and metastatic lymph nodes compared with paracancerous tissues. Conclusion: Single-cell sequencing may be used to elucidate the diversity of cells and functions in laryngeal carcinoma tissues and metastatic lymph nodes, and cell population C0 plays a key role in the evolution of cells.
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Affiliation(s)
- S S Gu
- Department of Otorhinolaryngology Head and Neck Surgery, Ningbo Medical Center Lihuili Hospital, Ningbo 315040, China
| | - Z S Shen
- Department of Otorhinolaryngology Head and Neck Surgery, Ningbo Medical Center Lihuili Hospital, Ningbo 315040, China
| | - H X Deng
- Department of Otorhinolaryngology Head and Neck Surgery, Ningbo Medical Center Lihuili Hospital, Ningbo 315040, China
| | - S J Qiu
- Department of Otorhinolaryngology Head and Neck Surgery, Ningbo Medical Center Lihuili Hospital, Ningbo 315040, China
| | - D Ye
- Department of Otorhinolaryngology Head and Neck Surgery, Ningbo Medical Center Lihuili Hospital, Ningbo 315040, China
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Tuxun T, Li T, Apaer S, He YB, Bai L, Gu SS, Wang ZP, Huo Q, Wang J, Zhao JM. Ex Vivo Liver Resection and Autotransplantation as Surgical Option for Zone II-III Leiomyosarcoma of IVC: A Case Report and Literature Review. Front Oncol 2021; 11:690617. [PMID: 34178689 PMCID: PMC8226245 DOI: 10.3389/fonc.2021.690617] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Accepted: 05/13/2021] [Indexed: 12/11/2022] Open
Abstract
We report the first documented case of leiomyosarcoma at zone II-III of inferior vena cava with thrombi in three hepatic veins undergoing ex vivo liver resection and autotransplantation (ELRA) and hepatic veins thrombectomy. A 33-year-old female patient presented with abdominal distention and lower extremities edema. Abdominal wall varicosis and shifting dullness were positive on physical examination. Her liver function was classified as Child-Pugh B and a solid tumor at retro-hepatic vena cava extending to right atrium with thrombi in three hepatic veins were confirmed. The diagnosis of leiomyosarcoma with Budd-Chiari syndrome was highly suspected with preoperative ultrasound, echocardiogram, CT scan, and three-dimensional reconstruction. A zone II-III leiomyosarcoma of IVC origin was confirmed at surgery and ex vivo liver resection and autotransplantation, and hepatic vein thrombectomy with atrial reconstruction were performed under cardiopulmonary bypass (CPB). Operative time, anhepatic time, and CPB time were 12 h, 128 min, and 84 min, respectively. The patients experienced post-operative liver dysfunction and was cured with conservative therapy. Hepatic recurrence two years after surgery was managed with radiofrequency. The patient was alive with liver metastasis three years after surgery. Despite being regarded as an extremely aggressive procedure, ELRA could be considered in the treatment of advanced leiomyosarcoma with Budd-Chiari syndrome and hepatic vein thrombi.
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Affiliation(s)
- Tuerhongjiang Tuxun
- Department of Liver Transplantation & Liver Surgery, Center of Organ Transplantation, 1st Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Tao Li
- Department of Liver Transplantation & Liver Surgery, Center of Organ Transplantation, 1st Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Shadike Apaer
- Department of Liver Transplantation & Liver Surgery, Center of Organ Transplantation, 1st Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Yi-Biao He
- Department of Liver Transplantation & Liver Surgery, Center of Organ Transplantation, 1st Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Lei Bai
- Department of Liver Transplantation & Liver Surgery, Center of Organ Transplantation, 1st Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Shen-Sen Gu
- Department of Liver Transplantation & Liver Surgery, Center of Organ Transplantation, 1st Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Zhi-Peng Wang
- Department of Liver Transplantation & Liver Surgery, Center of Organ Transplantation, 1st Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Qiang Huo
- Department of Cardiac Surgery, 1st Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Jiang Wang
- Department of Anesthesiology, 1st Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Jin-Ming Zhao
- Department of Liver Transplantation & Liver Surgery, Center of Organ Transplantation, 1st Affiliated Hospital of Xinjiang Medical University, Urumqi, China
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Zeng Q, Aierken A, Gu SS, Yao G, Apaer S, Anweier N, Wu J, Zhao JM, Li T, Tuxun T. Laparoscopic Versus Open Appendectomy for Appendicitis in Pregnancy: Systematic Review and Meta-Analysis. Surg Laparosc Endosc Percutan Tech 2021; 31:637-644. [PMID: 33935257 DOI: 10.1097/sle.0000000000000943] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 02/15/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The clinical safety, efficacy and feasibility of laparoscopic appendectomy (LA) compared with open appendectomy (OA) in pregnancy are still controversial. Herein, we are aiming to compare the clinical outcomes of LA and OA in patients with acute appendicitis during their pregnancy. MATERIALS AND METHODS This was a systematic review and meta-analysis of studies comparing laparoscopic and OA in pregnancy identifying using PubMed, Web of science, Embase, The Cochrane Library, Ovid and Scopus. Two independent reviewers extracted data on surgical complication, fetal loss, preterm delivery, hospital stay, Apgar score in both groups. RESULTS Twenty-seven studies with total of 6497 patients (4464 in open and 2031 in laparoscopic group) were included. LA was associated with lower rate of wound infection [odds risk (OR)=3.13, 95% confidence interval (CI): 1.77-5.56, P<0.0001] overall complications (OR=2.15, 95% CI: 1.47-3.14, P<0.0001) and shorter hospitalization (mean difference=0.72, 95% CI: 0.43-1.02, P<0.00001) compared with open group. LA was in a lower risk for 5-minute Apgar score (mean difference=0.09, 95% CI: 0.02-0.17, P=0.01) group than open group. No difference was found regarding preterm delivery between 2 groups. LA was associated with higher fetal loss (OR=0.57, 95% CI: 0.41-0.79, P=0.0007) compared with open surgery. However, laparoscopy was not associated with increased fetal loss after 2010 (OR=0.74, 95% CI: 0.44-1.24, P=0.26) compared with open group. CONCLUSIONS LA in pregnancy seems to be feasible with acceptable outcome, especially in patients with early and mid-trimester period, with sophisticated hands and experienced centers.
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Affiliation(s)
- Qi Zeng
- Department of Liver & Laparoscopic Surgery, Center of Digestive & Vascular Surgey
| | - Amina Aierken
- Center of Health Management, 1st Affiliated Hospital of Xinjiang Medical University, Xinshi District, Urumqi, China
| | - Shen-Sen Gu
- Department of Liver & Laparoscopic Surgery, Center of Digestive & Vascular Surgey
| | - Gang Yao
- Department of Liver & Laparoscopic Surgery, Center of Digestive & Vascular Surgey
| | - Shadike Apaer
- Department of Liver & Laparoscopic Surgery, Center of Digestive & Vascular Surgey
| | | | - Jing Wu
- Department of Liver & Laparoscopic Surgery, Center of Digestive & Vascular Surgey
| | - Jin-Ming Zhao
- Department of Liver & Laparoscopic Surgery, Center of Digestive & Vascular Surgey
| | - Tao Li
- Department of Liver & Laparoscopic Surgery, Center of Digestive & Vascular Surgey
| | - Tuerhongjiang Tuxun
- Department of Liver & Laparoscopic Surgery, Center of Digestive & Vascular Surgey
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