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    Journal of General Surgery for Clinicians    2022, 10 (3): 186-.  
    Abstract33)            Save
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    Influence of ultrasound-guided pudendal nerve block with different concentrations of ropivacaine on inflammatory factors and pain in patients with mixed hemorrhoidectomy
    CHEN Dongyang, HU Xiaoying
    Journal of General Surgery for Clinicians    2021, 9 (4): 45-.  
    Abstract41)            Save

    Objective To explore the efficacy of ultrasound-guided pudendal nerve block (PNB)

    with different concentrations of ropivacaine on inflammatory factors and pain in patients with mixed

    hemorrhoidectomy. Methods From January 2020 to March 2021, 90 patients underwent elective mixed

    hemorrhoidectomy at Fuxing Chancheng Hospital of Foshan City were randomly divided into R1, R2 and R3 groups, Each group contained 30 cases; The three groups of patients underwent bilateral PNB

    under ultrasound guidance; The concentration of ropivacaine in the R1 group was 0.25%, the R2 group

    was 0.375%, and the R3 group was 0.5%;Compare the pain scores of the three groups at the 1h (T0), 6h

    (T1), 12h (T2), 24h (T3) and 48h (T4) after the operation of the three groups; The levels of inflammatory

    factors in the three groups before and 24h after the operation were compared; The incidence of adverse

    reactions in the three groups were compared. Results The visual analogue scale(VAS) scores of the R2

    and R3 groups from T1 to T4 were lower than that of the R1 group at the same time, and the difference

    were statistically significant (P < 0.05);There were no statistically significant difference in the VAS

    scores of the R2 and R3 groups at T1 ~ T4 (P > 0.05); the levels of tumor necrosis factor(TNF)-α,

    interleukin(IL)-6, IL-8 and IL-12 in the R2 and R3 groups were higher than that at 24h after surgery

    in the R1 group at the same period, the difference were statistically significant (P < 0.05);There were

    no significant difference in the levels of TNF-α, IL-6, IL-8 and IL-12 in the R2 and R3 groups at 24h

    after surgery (P > 0.05); There were no significant difference in the adverse reactions between the three

    groups (P > 0.05). Conclusion 0.375% and 0.50% concentration of ropivacaine applied to ultrasoundguided

    PNB compare with 0.25% concentration of ropivacaine, the postoperative pain of patients is

    significantly reduced, the inflammatory response is significantly reduced, and the adverse reactions are

    equivalent.

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    Journal of General Surgery for Clinicians    2021, 9 (2): 53-.  
    Abstract65)            Save
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    Prognostic analysis of gastric cancer patients with vascular invasion
    DU Guangjin, GAO Zhenwu, LIAN Enying
    Journal of General Surgery for Clinicians    2021, 9 (3): 28-.  
    Abstract46)            Save

    Abstract: Objective To evaluate the prognostic value of patients with vascular infiltration after radical gastrectomy for gastric cancer. Methods The clinical data of 303 patients (129 with vascular infiltration and 174 without vascular infiltration) who underwent radical gastrectomy in Wenshang County People's Hospital from January 2003 to June 2015 were analyzed retrospectively. To compare the differences of clinicopathological features and prognosis between patients with positive and negative vascular infiltration. Results There were significant differences in tumor size, pT stage, pN stage and tissue differentiation between the positive and negative groups of vascular infiltration (P<0.05). There was no significant difference in age and gender (P>0.05). Univariate survival analysis showed that the 5-year survival rate of patients with vascular infiltration was 33.3%(43/129), and that of patients without vascular infiltration was 56.9%(99/174), and the difference was statistically significant (P<0.001). Multivariate survival analysis showed that vascular invasion and pN stage were independent risk factors affecting the prognosis of gastric cancer patients. Conclusion Vascular infiltration is an independent risk factor affecting the prognosis of gastric cancer patients.

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    A signature for predicting the prognosis of breast cancer based on aging-related genes
    LI Xiaoping, QIU Chaoran, YU Qihe, CHEN Qiyang, FANG Yuewan
    Journal of General Surgery for Clinicians    2022, 10 (2): 6-.  
    Abstract55)            Save

    Objective To screen out the aging genes that are significantly related to the prognosis of breast cancer through bioinformatics. Method Clinical data and mRNA sequencing data were downloaded from the cancer genome atlas (TCGA) database collected by the National Cancer Center from September, 2010 to June, 2015. Aging genes were downloaded from the Aging Atlas database. Differential express genes between the normal tissue and the cancer tissue were compared. Single factor Cox and Lasso regression were applied to obtain prognostic-related aging genes. Then the signature was constructed, the patients were divided into high-risk group and low-risk group with the median of risk coefficient as the cut-off value. Univariate and multivariate regression were used to identify the independent factor, then Nomogram was constructed. Gene set enrichment analysis (GSEA) software was used for the functional enrichment analysis of key genes. Result 119 differential aging genes and 10 prognostic-related genes were obtained, including 2 tumor suppressor genes(NRG1, IL2RG) and 8 cancer-promoting genes (EIF4EBP1,MMP1, PLAU, MMP13, RAD51, FGF7, DLL3, IGFBP1). The 10-aging-gene signature was constructed by Cox. The prognosis between the high risk and low risk group was significantly differently. The Nomogram showed good performance in predicting the overall survival of breast cancer patient. The GSEA showed the high-risk group was significantly enriched in signal pathways such as cell cycle and homologous recombination. The genes of lowrisk group was significantly enriched in the JAK-STAT signaling pathway, cytokine-receptor-interaction pathway. Conclusion The signature based on aging related genes had a good performance on predicting the prognosis of breast cancer patients.

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    Application of the concept of enhanced recovery after surgery combined with path-based health education in nursing care of patients with lower extremity arteriosclerosis obliterans
    LV Liqiong, CAO Xiaolu, JING Qian, GUO Mixia, YANG Wenya, LU Yuzhi
    Journal of General Surgery for Clinicians    2022, 10 (4): 103-.  
    Abstract36)            Save

    Objective To explore the application value of enhanced recovery after surgery (ERAS) concept combined with pathologic health education in patients with Arteriosclerotic obliterans (ASO). Method A total of 124 ASO inpatients in Renmin Hospital of Wuhan University from October 2018 to October 2021 were selected as the study subjects. According to the random number table method, they were divided into control group and ERAS group, 62 cases in each group. The control group received routine nursing intervention during perioperative period. ERAS group received perioperative nursing intervention based on routine nursing intervention using ERAS concept combined with path-based health education nursing intervention. Postoperative recovery and incidence of complications were observed between the two groups, and changes in disease-related knowledge, mental resilience

    level and quality of life were compared before and after intervention. Result The time of getting out of bed for the first time and hospitalization in ERAS group were shorter than those in the control group. The score of visual analog scale (VAS) and the incidence of complications in ERAS group were lower than those in the control group (P < 0.05); The 6-minute walking test (6MWT) walking distance in ERAS group was significantly higher than that in control group (P < 0.05); After the intervention, the scores of disease related knowledge, psychological resilience and quality of life in the two groups were higher than those before the intervention (P < 0.05), and the ERAS group was higher than the control group, with significant differences (P < 0.05). Conclusion ERAS concept combined with path-based health education can effectively promote postoperative rehabilitation of ASO patients in lower limbs, reduce the incidence of postoperative complications, and improve disease cognition, mental resilience

    and quality of life.

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    Journal of General Surgery for Clinicians    2023, 11 (2): 41-.  
    Abstract22)            Save
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    Comparison of transabdominal preperitoneal prosthesis and flat plate tension-free hernia repair operation in the repair of bilateral inguinal hernia
    LI Dongfang, CAI Dejun, CHEN Yonghan, JIANG Xiaosong
    Journal of General Surgery for Clinicians    2023, 11 (3): 42-.  
    Abstract10)            Save

    Objective To investigate the efficacy of transabdominal preperitoneal prosthesis(TAPP) versus flat plate tension-free hernia repair(Lichtenstein) surgery in bilateral inguinal hernia repair. Method A retrospective analysis of 75 patients with bilateral inguinal hernia admitted to the hospital from January 2019 to April 2022, of which 40 were treated with Lichtenstein surgery and 35 were treated with TAPP. The perioperative condition, shortterm treatment effect, recurrence rate and complication rate of the two groups were compared. Result The surgical time in the TAPP group was higher than that in the Lichtenstein group, The postoperative 24-hour pain score, postoperative bedtime, postoperative exhaust time, and hospital stay in the TAPP group were significantly lower than those in the Lichtenstein group, The hospitalization expenses of the TAPP group were higher than those of the Lichtenstein group, the differences are significant (P < 0.05). On the 1st postoperative day, white blood cell count in the TAPP group was (4.98±1.02)×109/L, tumor necrosis factor-α lever was(35.13±4.52)pg/L, and C-reactive protein lever was (3.78±0.62) mg/L, which were all lower than those in the Lichtenstein group [(5.63±1.38)×109/L, (42.17±4.31)pg/L, and (4.83±0.70)mg/L, respectively], the differences are significant (P < 0.05). The recognition rate of patients in the TAPP group was 91.43%, higher than that in the Lichtenstein group (85.00%), but there was no statistically significant difference between the groups (P > 0.05). 3 patients in the TAPP group experienced complications, with a total incidence rate of 8.5%;6patients in the Lichtenstein group experienced complications, with a total incidence rate of 15.0%. There was no statistically significant difference between the two groups(P > 0.05). All cases were followed up for 19 months after surgery, In the TAPP group, 2 cases (5.71%) recurred at 7 and

    17 months respectively; 1 case (2.50%) in the Lichtenstein group relapsed 13 months after surgery. There was no statistically significant difference in the recurrence rate between the two types of surgery (P > 0.05). Conclusion TAPP and Lichtenstein surgery have a definite clinical effect on bilateral inguinal hernia, and the complication rate is equivalent, but patients treated with TAPP recover faster after surgery.

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    Journal of General Surgery for Clinicians    2022, 10 (3): 195-.  
    Abstract47)            Save
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    Clinicopathological characteristics and prognosis of invasive ductal/lobular mixed carcinoma, invasive lobular carcinoma and invasive ductal carcinoma of breast
    LENG Minfang, CHENG Wende, XIAO Xiaoqin, LIU Feng
    Journal of General Surgery for Clinicians    2021, 9 (1): 24-.  
    Abstract96)            Save
    Abstracts: Objective To study the pathological characteristics of breast infiltrative ductal / lobular mixed carcinoma(IDC-L), infiltrative lobular carcinoma(ILC) and infiltrative ductal carcinoma(IDC). Methods From September 2011 to September 2020,254 breast cancer patients were selected, Among them, there were 18 cases of IDC-L, 20 cases of ILC and 216 cases of IDC. The prognosis of the three groups of patients was observed. Results IDC- L, ILC and IDC patients had significant differences in age, tumor size, multicentric lesions, vascular invasion, HER2 status, Ki-67 expression. IDC-L patients had younger onset age, more tumor diameter>2.0 cm, while IDC patients had less multicentric lesions and vascular invasion, while HER2 positive rate and Ki-67 high expression ratio in IDC-L and ILC patients were lower than IDC, the difference was statistically significant(P<0.05). Age, climacteric state, tumor size, lymph node state, multicentric lesions, lymphatic vessel invasion, HER2 state and Ki-67 expression were all the influencing factors of clinic pathological differences. Breast cancer-free interval and overall survival were related to tumor size, lymph node status, lymphatic vessel invasion and Ki-67 expression (P<0.05). Conclusion In breast cancer patients, the clinicopathological characteristics of ILC and IDC-L are similar to each other, but there are obvious differences among ILC, IDC-L and IDC. The breast cancer patients can be differentiated clinically and treated better.

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    Journal of General Surgery for Clinicians    2019, 7 (4): 39-.  
    Abstract30)            Save
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    Research of clinical value of preserving left colic artery during laparoscopic anterior resection for rectal cancer
    ZENG Jun, LI Rong-jiang, LIU Xiao-hui
    Journal of General Surgery for Clinicians    2019, 7 (4): 24-.  
    Abstract34)            Save
    Abstract: Objective To analyze the clinical value of preserving left colic artery during laparoscopic
    anterior resection for rectal cancer. Methods Fifty-six cases of patients with rectal cancer and who
    treated from June 2015 to April 2019 were selected,and the patients were divided into the observation
    group (n=28) and the control group (n=28) by the random table method. All patients underwent
    laparoscopic resection of rectal cancer. And the observation group underwent the left colonic artery (low
    ligation) during the operation,while the control group underwent the no reservation of left colonic artery
    (high ligation) during operation.Then, the operation effects of two groups were evaluated. Results The
    operation time in the observation group was longer than that inthe control group (P<0.05), There was
    no significant difference in the intraoperative bleeding volume and radical tumor index between the
    observation group and the control group (P> 0.05); The recovery of intestinal function, anal exhaust
    and hospitalization time in the observation group were shorter than those in the control group (P<0.05);
    The complication rate in the observation group was 7.14%,which was lower than that in the control
    group of 28.57%(P<0.05). Conclusion For patients undergoing laparoscopic resection of rectal cancer,
    the intraoperative preservation of LCA can reduce postoperative complications such as the anastomotic
    leakage and urinary retention, promote intestinal function recovery as soon as possible, and complete
    radical resection of tumor.
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    Influence of perioperative nursing on nursing quality of patients with gastric cancer radical surgery
    KAN Chunyan
    Journal of General Surgery for Clinicians    2022, 10 (2): 102-.  
    Abstract28)            Save

    Objective To investigate the effect of perioperative nursing intervention in patients undergoing radical gastrectomy for gastric cancer and its impact on nursing quality. Method A total of 42 patients with gastric cancer who underwent radical surgery in our hospital from May 2020 to May 2021 were selected for research, and they were divided into groups according to different nursing methods, namely the control group (implementing routine nursing intervention) and the observation group (implementing routine nursing intervention). Perioperative nursing intervention), 21 cases in each group, the levels of gastrointestinal hormones, nutritional indicators and nursing quality scores before and after nursing in the two groups were analyzed. Result After nursing, the motilin and serum ghrelin of the observation group were (189.22±22.63) ng/L and (61.58±5.73) ng/L, respectively,which were higher than those of the control group (168.53±21.42) ng/L and (46.27±5.88) ng/L, and vasoactive intestinal peptide of the observation group was (62.35±7.07) ng/L, which was lower than that of the control group (83.18±7.14) ng/L, and the difference was significant (P < 0.05). The albumin of the control group and the observation group after nursing were (36.25±3.49) g/L, (42.77±4.96) g/L, retinol binding protein were (29.97±3.02) mg/L, (36.65±3.28) mg/L, hemoglobin were (87.13±5.56) g/L, (97.32±5.71) g/L, the latter was significantly higher than the former (P < 0.05); the scores of nursing methods, nursing attitudes, nursing skills and nursing environment of the observation group were (74.13±6.48) points, (71.02±5.95) points, (68.22±6.34) points and (72.13±6.34) points, respectively, which were significantly higher than those of the control group (56.23±5.47) points, (48.23±5.29) points, (51.17±4.57) points and (57.15±4.92) points (P < 0.05). Conclusion Perioperative nursing plays an important role in gastric cancer patients undergoing radical operation, which can improve their nutritional status and gastrointestinal function, and the overall nursing quality is high.

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    Comparative analysis of the effect of laparoscopic surgery and traditional open surgery in the treatment of inguinal hernia
    WANG Ruihong, LU Yibin
    Journal of General Surgery for Clinicians    2022, 10 (4): 75-.  
    Abstract37)            Save

    Objective To analyze the effect of laparoscopic surgery and traditional open surgery in the treatment of inguinal hernia. Method From July 2018 to July 2021, 50 male patients with inguinal hernia from Xingpu Hospital in Suzhou Industrial Park were selected and randomly divided into the reference group (treated with traditional open surgery) and the research group (treated with laparoscopic surgery) by using the method of random color ball sampling. There were 25 patients in each group, and the surgical indicators and postoperative quality of life of the two groups were compared. Result The incidence of complications such as scrotal hematoma and incision infection in the study group was significantly lower than that in the control group (P < 0.05); The

    operation time, hospital stay and bed rest time of the patients in the study group were shorter than those in the reference group, and the amount of intraoperative bleeding was less than that in the reference group, with a significant difference (P < 0.05). The post-operative pain scores of patients in the study group were lower than those in the reference group, and the quality of life scores were higher than those in the reference group, with significant differences (P < 0.05). Conclusion Laparoscopic surgery is more effective in the treatment of inguinal hernia, which can reduce complications, optimize surgical indicators, promote postoperative recovery, reduce pain. 

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    Analysis of the effect of manual lymphatic drainage nursing on relieving postoperative lymphedema and axillary reticulum syndrome in patients with breast cancer
    XIAO Qiumei, PANG Meirui, CHEN Wanxia
    Journal of General Surgery for Clinicians    2023, 11 (1): 64-.  
    Abstract46)            Save

    Objective To analyze the intervention effect of manual lymphatic drainage nursing on relieving postoperative lymphedema and axillary reticulum syndrome of breast cancer. Method From January 2018 to January 2020, 50 patients with lymphedema and axillary reticulum syndrome after breast cancer surgery were selected from Zhanjiang Maternal and Child Health Care and Family Planning Service Center. They were randomly divided into two groups by double-blind method. The control group was 25 patients, receiving routine care; 25 patients in the observation group were treated with manual lymphatic drainage based on the control group; The intervention effect and symptom relief of the two groups were compared. Result The effective rates of the patients

    in the observation group were 72.0%, 80.0% and 100.0% respectively after 3, 6 and 12 months of intervention, which were higher than 44.0%, 56.0% and 72.00% in the control group (P < 0.05). The decrease of the difference in circumference of the patients in the observation group after 3, 6 and 12 months of intervention was higher than that in the control group, and the abduction angle of the shoulder joint of the affected limb at 1, 3, 6 and 12 months after intervention was higher than that in the control group, and the time for the postoperative tightness, cord structure, numbness and pain of the affected limb was shorter than that in the control group (P < 0.05). After 1 month of intervention, the scores of daily social function, upper limb activity function and upper limb symptoms in the observation group were lower than those in the control group (P < 0.05). Conclusion Manual lymphatic drainage nursing can alleviate the clinical symptoms of lymphedema and axillary reticulum syndrome after breast

    cancer surgery, increase the range of motion of the affected limb, and have a good intervention effect.

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    Analysis of risk factors for lymph node metastasis in the central region of cN0 thyroid micropapillary carcinoma
    ZHAO Bitao
    Journal of General Surgery for Clinicians    2023, 11 (1): 14-.  
    Abstract28)            Save

    Objective To investigate the risk factors of lymph node metastasis in the central region of cN0 thyroid micropapillary carcinoma. Method The clinical data of 106 patients with cN0 thyroid micropapillary carcinoma in Jiangmen Xinhui District People's Hospital from May 2020 to November 2021 were retrospectively analyzed. According to the lymph node metastasis in the central region, they were divided into two groups: metastatic group (49 cases) and non-metastatic group (57 cases). The risk factors of lymph node metastasis in the central region of patients were analyzed. Result Of the 106 patients, 49 had lymph node metastasis in the central region and 57 had no metastasis. The proportion of males, tumor location, microcalcification and invasion of capsule

    in the metastatic group was higher than that in the non-metastatic group (P < 0.05), the proportion of patients with age < 55 years old and tumor diameter < 5 mm was lower than those without metastasis (P < 0.05), however, there was no significant difference in the proportion of patients with nodular goiter and Hashimoto's thyroiditis between the two groups (P > 0.05). Multivariate logistic regression analysis showed that the risk factors of lymph node metastasis in the central region of 106 patients included male, microcalcification and capsule invasion (P < 0.05). Conclusion The risk factors of lymph node metastasis in the central region of cN0 thyroid micropapillary carcinoma include male, microcalcification, and invasion of capsule. Preventive and therapeutic dissection of lymph nodes in the central region is recommended.

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    Journal of General Surgery for Clinicians    2023, 11 (2): 37-.  
    Abstract31)            Save
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    A clinical comparison of transanal natural orifice specimen extraction surgery with traditional laparoscopic surgery for colorectal cancer
    CHEN Kaifan, ZHANG Weihong, LI Junpeng, LI Zhixiong, PAN Guofeng, XU Yanchang
    Journal of General Surgery for Clinicians    2022, 10 (3): 6-.  
    Abstract31)            Save

    Objective To investigate the safety and feasibility of transanal natural orifice specimen extraction surgery (NOSES) laparoscopic surgery for sigmoid colon cancer and high rectal cancer. Method A retrospective analysis of clinical datas of 30 patients who underwent transanal NOSES laparoscopic surgery for sigmoid colon cancer and high rectal cancer(the observation group) and 30 patients who underwent conventional laparoscopic surgery for sigmoid colon cancer and high rectal cancer(the control group) during the same period, in Putian City from October 2018 to October 2020. A comparative analysis was conducted between these two groups in regard to the operation time, the intraoperative blood loss, the intraoperative lymph node dissection, the postoperative pain score of day 1, the postoperative complications and the postoperative local recurrence and distant metastasis. Result There were no significant differences in the intraoperative blood loss, the intraoperative lymph node dissection and the postoperative complications of both groups (P > 0.05). The operation time of the observation group was longer than that of the control group, the postoperative pain score of day 1 of the observation group was lower than that in the observation group, the postoperative exhaust time of the observation group was shorter than that in the control group, the postoperative fluid diet time in observation group was shorter than that in control group, the postoperative hospital stay in the observation group was shorter than that in the control group, the differences are significant (P < 0.05). Patients in both groups were followed up and no local and distant recurrence was observed.Conclusion Transanal NOSES laparoscopic surgery for sigmoid colon cancer and upper rectal cancer is safe and feasible. It has the advantages of light postoperative pain, quick recovery, short hospital stays, and the radical tumor treatment effect is comparable to that of traditional laparoscopic surgery.

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    Application of postoperative nursing measures in patients with pancreatic cancer and type 2 diabetes mellitus
    HUANG Zhaohua
    Journal of General Surgery for Clinicians    2022, 10 (2): 115-.  
    Abstract30)            Save

    Objective To analyze the effect of postoperative nursing measures on patients with pancreatic cancer complicated with type 2 diabetes. Method From July 2019 to November 2021, 43 patients with pancreatic cancer and type 2 diabetes mellitus in Nanjing Gaochun People's Hospital were selected and divided into control group (n=22) and observation group (n=21)by different nursing methods. The control group was given routine nursing, and the observation group was given postoperative nursing measures. The wound healing time, postoperative hospital stay, complication rate and quality of life were compared between the two groups. Result After nursing, the wound healing time and postoperative hospital stay in the observation group were lower than those in the control group (P < 0.05). After nursing, the total incidence of infection, hypoglycemia and lower extremity deep venous thrombosis in the observation group was 4.76%, which was lower than 27.27% in the control group (P < 0.05). After nursing, the scores of physical function, psychological function, material function and social function in the observation group were higher than those in the control group (P < 0.05). Conclusion Appropriate nursing intervention for patients with pancreatic cancer and type 2 diabetes can improve the healing time of incision, reduce the incidence of complications, promote early recovery and discharge of patients, and improve the quality of life of patients.

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    Clinical analysis of transaxillary treatment of gynecomastia under endoscopy
    XU Zhi, JIANG Pengling, MA Lei
    Journal of General Surgery for Clinicians    2022, 10 (3): 47-.  
    Abstract35)            Save

    Objective To investigate the safety and cosmetic effect of gynecomastia under endoscopy through transaxilla. Method From January 2020 to January 2022, there were 19 patients analyzed retrospectively who treated under axillary endoscopic subcutaneous mastectomy in the General Surgery First Department of Qingdao Municipal Hospital, summarize the treatment, complications and follow-up results of patients. Result All 19 patients completed the operation, unilateral operation time is (1.6±0.8)h, bilateral time is (3.3±1.1)h, blood volume is (10±5)ml. The pathological examination showed that 12 cases were mixed type, 2 cases were fat type and 3 cases were glandular type; there are no nipple areola necrosis and subcutaneous effusion occurred in all cases; we followed two years, one patient had local nipple depression half a year after operation, and improved after autologous adipose tissue filling. Conclusion Axillary endoscopic treatment of gynecomastia is safe and effective,

    and the cosmetic effect is good.

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