surgical methods

手术方法
  • 文章类型: Journal Article
    为了理解行为的神经基础,测量许多相互作用的大脑区域的尖峰动态是至关重要的。虽然新技术,比如神经像素探针,促进多区域录音,这些实验要充分发挥其潜力,仍然存在重大的手术和程序障碍。这里,我们描述了能够实现大规模电生理数据集(SHIELD)的颅骨形半球形植入物。这些3D打印的颅骨置换植入物具有可定制的插入孔,允许使用重复的多探针插入在许多天中在单个小鼠中记录数十个皮质和皮质下结构。我们证明了该程序的高成功率,生物相容性,对行为缺乏不利影响,以及与成像和光遗传学的兼容性。为了展示SHIELD的科学效用,我们使用多探针录音来揭示alpha节奏如何在视觉和感觉运动网络中组织尖峰活动的新见解。总的来说,这种方法使强大的,用于研究分布式神经计算的大规模电生理实验。
    To understand the neural basis of behavior, it is essential to measure spiking dynamics across many interacting brain regions. Although new technologies, such as Neuropixels probes, facilitate multi-regional recordings, significant surgical and procedural hurdles remain for these experiments to achieve their full potential. Here, we describe skull-shaped hemispheric implants enabling large-scale electrophysiology datasets (SHIELD). These 3D-printed skull-replacement implants feature customizable insertion holes, allowing dozens of cortical and subcortical structures to be recorded in a single mouse using repeated multi-probe insertions over many days. We demonstrate the procedure\'s high success rate, biocompatibility, lack of adverse effects on behavior, and compatibility with imaging and optogenetics. To showcase SHIELD\'s scientific utility, we use multi-probe recordings to reveal novel insights into how alpha rhythms organize spiking activity across visual and sensorimotor networks. Overall, this method enables powerful, large-scale electrophysiological experiments for the study of distributed neural computation.
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  • 文章类型: Journal Article
    真菌性角膜炎(FK)是一种由角膜感染引起的严重眼部疾病,在热带国家很普遍,特别是在亚洲和非洲的发展中地区。角膜晶状体误用等因素,不适当的类固醇使用,诊断挑战引发了这一流行病。FK导致严重的视力损害,疤痕,和眼畸形。准确的病理诊断对于有效的治疗干预至关重要。表面愈合药物的局部抗真菌治疗证明可有效预防真菌传播的溃疡。管理FK需要对真菌发病机理有全面的了解,指导制定策略和预防措施,以遏制全球眼盲。这篇评论提供了对FK的深入见解,涵盖病因,流行病学,发病机制,治疗性干预措施,抗真菌耐药性,局限性,预防,以及对眼表疾病管理的未来展望。
    Fungal keratitis (FK) is a severe ocular condition resulting from corneal infection that is prevalent in tropical countries, particularly in developing regions of Asia and Africa. Factors like corneal lens misuse, inappropriate steroid use, and diagnostic challenges have provoked the epidemic. FK causes significant vision impairment, scarring, and ocular deformities. Accurate pathological diagnosis is crucial for effective therapeutic intervention. Topical antifungal therapy with surface healing medications proves effective in preventing fungal-borne ulcers. Managing FK requires a comprehensive understanding of fungal pathogenesis, guiding formulation strategies and preventive measures to curb global ocular blindness. This review provides in-depth insights into FK, covering etiology, epidemiology, pathogenesis, therapeutic interventions, antifungal resistance, limitations, prevention, and future perspectives on ocular surface disease management.
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  • 文章类型: Editorial
    到目前为止,肱骨关节是人体活动能力最强的关节,但也受到脱臼的困扰,主要是前。手术稳定通常是成功的,但失败并不少见。以下评论描述了失败的潜在原因,并强调了使手术方法适应病理形态学的必要性。
    The gleno-humeral joint is by far the most mobile in the human body but also afflicted by dislocations, predominantly anterior. Surgical stabilisation is often successful but failures not uncommon. The following review describes potential causes of failure and highlights the need of adapting surgical methods to pathomorphology.
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  • 文章类型: Review
    背景:考虑到右十二指肠旁疝是一种罕见的解剖结构异常的内部疝,在紧急情况下经常遇到,外科医生可能缺乏这方面的知识和选择不正确的治疗。因此,该病例报告是对先前报道的少数右十二指肠旁疝病例的有益补充。此外,我们回顾了所有报告的右十二指肠旁疝病例,并根据不同的解剖特征提出了适当的手术策略。
    方法:该病例涉及一名33岁的中国男性患者,因腹痛入院。病人最初被诊断为小肠梗阻,保守治疗失败。安排了紧急行动,在此期间,诊断为右十二指肠旁疝。手术后,患者恢复良好,2年无腹痛。
    结论:尽管右十二指肠旁疝仅占十二指肠旁疝的一小部分,它的解剖特征可以有很大差异。我们把右十二指肠旁疝分为三种类型,每种类型都需要不同的手术策略。
    BACKGROUND: Considering that right paraduodenal hernia is a rare internal hernia with abnormal anatomy and is often encountered during an emergency, surgeons may lack knowledge about it and choose incorrect treatment. Thus, this case report is a helpful complement to the few previously reported cases of right paraduodenal hernia. Additionally, we reviewed all the reported right paraduodenal hernia cases and proposed appropriate surgical strategies according to different anatomical features.
    METHODS: The case involved a 33-year-old Chinese male patient who was admitted to the hospital due to abdominal pain. The patient was initially diagnosed with small bowel obstruction, and conservative treatment failed. An emergency operation was arranged, during which a diagnosis of right paraduodenal hernia was made instead. After surgery, the patient recovered well without abdominal pain for 2 years.
    CONCLUSIONS: Although right paraduodenal hernia accounts only for a small proportion of paraduodenal hernia, its anatomical characteristics can vary considerably. We divided right paraduodenal hernia into three types, with each type requiring a different surgical strategy.
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  • 文章类型: Journal Article
    峡部甲状腺乳头状癌(PTCI)具有更具侵袭性的性质,淋巴结转移和肿瘤复发率较高。临床医生对PTCI的手术方法有不同的偏好,但没有明确的指南。本文的目的是使用荟萃分析比较PTCI的全甲状腺切除术和少于全甲状腺切除术的肿瘤学结果和并发症。
    我们搜索了PubMed,Embase,科克伦图书馆,和WebofScience数据库中符合入选标准的文章,无限制的开始日期和结束日期为2023年2月19日。应用排除标准筛选出用于进一步分析的文章。最终,七篇文章用于分析,所有研究均为回顾性研究.采用MINORS量表对纳入文献的质量进行评价,使用ReviewManager5.4进行数据分析。
    共814名患者被纳入七篇文章,包括甲状腺切除术少于全切除术组(试验组)的401例和甲状腺全切除术组(对照组)的413例。荟萃分析结果显示,PTCI行甲状腺全切除术或小于甲状腺切除术后,两组间肿瘤复发率差异无统计学意义(比值比,1.51;95%置信区间:0.49,4.65;P=0.47),两组术后所有并发症的发生率无统计学差异。
    此分析可能存在一些局限性,例如发表偏倚和纳入的文章都是具有一定异质性的回顾性研究.分期较早、无明显淋巴结转移的PTCI患者可选择较为保守的手术方式,比全甲状腺切除术少。分期相对较晚,术前淋巴结转移明显或甲状腺外扩张的患者可以选择甲状腺全切除术加中央区淋巴结清扫术,如有必要,颈外侧区淋巴结清扫术。
    UNASSIGNED: Papillary thyroid carcinoma of isthmus (PTCI) has a more aggressive nature, a higher rate of lymph node metastasis and tumor recurrence. Clinicians have different preferences for the surgical approach to PTCI, but there are no definitive guidelines. The purpose of this article is to compare the oncologic outcomes and complications of total thyroidectomy and less-than-total thyroidectomy for PTCI using meta-analysis.
    UNASSIGNED: We searched PubMed, Embase, Cochrane Library, and Web of Science databases for articles that met the inclusion criteria, with an unlimited start date and an end date of February 19, 2023. Exclusion criteria were applied to filter out articles for further analysis. Ultimately, seven articles were used for analysis, all of which were retrospective studies. The MINORS scale was adopted to evaluate the quality of the included literature, and Review Manager 5.4 was used for data analysis.
    UNASSIGNED: A total of 814 patients were included in the seven articles, including 401 in the less-than-total thyroidectomy group (trial group) and 413 in the total thyroidectomy group (control group). The results of the meta-analysis showed that there was no significant difference in the tumor recurrence rate between the two groups after total thyroidectomy or less-than-thyroidectomy for PTCI (odds ratio, 1.51; 95% confidence interval: 0.49, 4.65; P=0.47), and there was no statistical difference in the incidence of all postoperative complications between the two groups.
    UNASSIGNED: There may be some limitations in this analysis, such as publication bias and the fact that the included articles were all retrospective studies with a certain degree of heterogeneity. PTCI patients with early staging and no significant lymph node metastases may be able to choose a more conservative surgical approach, which is less-than-total thyroidectomy. Patients with relatively late staging and significant preoperative lymph node metastases or extra thyroidal extension may opt for total thyroidectomy plus lymph node dissection in the central region and, if necessary, lymph node dissection in the lateral cervical region.
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  • 文章类型: Journal Article
    这项研究调查了吲哚菁绿引导的近红外荧光(ICG-NIRF)成像技术在评估小儿睾丸扭转(TT)手术期间睾丸血流的可行性。
    我们回顾性分析了2023年2月至7月在我们医院接受手术的8例TT儿科患者。术中采用ICG-NIRF显像和睾丸切开两步法评估睾丸血流,然后选择不同的手术方法。手术后对切除的睾丸进行病理检查,术后1个月随访,采用灰阶超声和彩色多普勒血流显像(CDFI)评价睾丸血流。
    8名1-16岁的小儿TT患者,平均年龄为11.5岁,已注册。发病时间为4至72h(平均26.13±25.09h)。共有八个睾丸扭曲,包括左边的四个和右边的四个。4例睾丸扭转方向为顺时针方向,4例为逆时针方向。扭转旋转180°-1,080°(平均472.5°±396°)。4例睾丸血管造影患者扭转侧和正常侧的成像时间差异无统计学意义(P>0.05)。术后恢复顺利,随访1个月无并发症。3例患者行睾丸切除术后的组织病理学结果为大量出血,变性,睾丸组织坏死.在接受睾丸固定术的五名患者中,灰阶超声和CDFI检查显示4例患者睾丸内部回声均匀,血流信号正常.一名扭转侧无睾丸血管成像的患者显示睾丸内部回声不均匀,无血流信号。
    ICG-NIRF成像是评估TT手术过程中睾丸血流量的可行方法。ICG注射后5分钟内的睾丸血管成像可能是TT手术中睾丸保留的基础。
    UNASSIGNED: This study investigates the feasibility of the indocyanine green-guided near-infrared fluorescence (ICG-NIRF) imaging technique in evaluating testicular blood flow during testicular torsion (TT) surgery in pediatric cases.
    UNASSIGNED: We retrospectively analyzed the eight pediatric patients with TT who underwent surgery in our hospital between February and July 2023. The intraoperative two-step method of ICG-NIRF imaging and testicular incision was used to evaluate the testicular blood flow, followed by a selection of different surgical methods. The removed testes were pathologically examined after surgery, and all patients were followed up 1 month after surgery to evaluate testicular blood flow using gray-scale ultrasound and color Doppler flow imaging (CDFI).
    UNASSIGNED: Eight pediatric TT patients aged 1-16 years, with a median age of 11.5 years, were enrolled. Time from the onset ranged from 4 to 72 h (mean 26.13 ± 25.09 h). A total of eight testes were twisted, including four on the left side and four on the right side. The twisting direction of the testes was clockwise in four cases and counterclockwise in four cases. The rotation of torsion was 180°-1,080° (mean 472.5° ± 396°). There was no statistically significant difference in the imaging time between the four patients with testicular blood vessel imaging on both the torsional and normal sides (P > 0.05). The postoperative recovery was uneventful, with no complications during the follow-up period of 1 month. The postoperative histopathological results of three patients who underwent orchiectomy showed extensive hemorrhage, degeneration, and necrosis of the testicular tissue. Among the five patients who underwent orchiopexy, a gray-scale ultrasound and CDFI examinations showed uniform internal echo of the testes and normal blood flow signals in four patients. One patient with no testicular blood vessel imaging on the torsional side showed uneven internal echo of the testis and no blood flow signals.
    UNASSIGNED: ICG-NIRF imaging is a feasible method to evaluate testicular blood flow during TT surgery. Testicular blood vessel imaging within 5 minutes after ICG injection might be the basis for testicular retention during TT surgery.
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  • 文章类型: Journal Article
    背景:尽管妇女避孕方法广泛,意外怀孕率仍然很高(美国为45%),50%导致流产。目前,全球20%的避孕药具使用是男性主导的,由于可用性有限和缺乏疗效,各国之间差异很大。全球研究表明,>50%的男性会选择使用可逆的方法,90%的女性会依靠她们的伴侣使用避孕药具。新型男性避孕方法可用的其他原因包括预期寿命延长,在伴侣之间分担生殖风险,社会问题,缺乏制药行业的参与,也缺乏倡导男性避孕的舆论制造者。
    目的:本指南旨在回顾男性避孕的现状,支持临床实践的最新技术,建议对新的男性避孕药具发展的最低要求,并提供和等级更新,欧洲男科学会(EAA)和美国男科学会(ASA)的循证建议。
    方法:由EAA和ASA任命的院士专家小组根据等级(建议的等级,评估,开发和评估)系统。
    结果:以夫妻为中心的交流产生了60项基于证据和分级的建议,行为,屏障方法,精液分析和避孕功效,物理代理,手术方法,在开始男性避孕之前的行动,荷尔蒙的方法,非荷尔蒙的方法,疫苗,以及社会和道德方面的考虑。
    结论:随着性别角色的转变和性别平等在人际关系中的确立,必须促进男性对计划生育的贡献。必须评估有效和安全的男性导向方法,并将其引入临床实践。最好是可逆的,荷尔蒙或非荷尔蒙。从未来的角度来看,识别新的荷尔蒙组合,合适的睾丸目标,和新出现的血管闭塞方法将产生新的分子和产品的男性避孕。
    BACKGROUND: Despite a wide spectrum of contraceptive methods for women, the unintended pregnancy rate remains high (45% in the US), with 50% resulting in abortion. Currently, 20% of global contraceptive use is male-directed, with a wide variation among countries due to limited availability and lack of efficacy. Worldwide studies indicate that >50% of men would opt to use a reversible method, and 90% of women would rely on their partner to use a contraceptive. Additional reasons for novel male contraceptive methods to be available include the increased life expectancy, sharing the reproductive risks among partners, social issues, the lack of pharma industry involvement and the lack of opinion makers advocating for male contraception.
    OBJECTIVE: The present guidelines aim to review the status regarding male contraception, the current state of the art to support the clinical practice, recommend minimal requirements for new male contraceptive development and provide and grade updated, evidence-based recommendations from the European Society of Andrology (EAA) and the American Society of Andrology (ASA).
    METHODS: An expert panel of academicians appointed by the EAA and the ASA generated a consensus guideline according to the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) system.
    RESULTS: Sixty evidence-based and graded recommendations were produced on couple-centered communication, behaviors, barrier methods, semen analysis and contraceptive efficacy, physical agents, surgical methods, actions before initiating male contraception, hormonal methods, non-hormonal methods, vaccines, and social and ethical considerations.
    CONCLUSIONS: As gender roles transform and gender equity is established in relationships, the male contribution to family planning must be facilitated. Efficient and safe male-directed methods must be evaluated and introduced into clinical practice, preferably reversible, either hormonal or non-hormonal. From a future perspective, identifying new hormonal combinations, suitable testicular targets, and emerging vas occlusion methods will produce novel molecules and products for male contraception.
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  • 文章类型: Journal Article
    乳腺癌是全世界女性中最常见的恶性肿瘤。我们旨在了解费萨拉巴德市特定年龄乳腺癌发病率的过去趋势。
    费萨拉巴德联合医院(AHF)设计了一项回顾性研究,巴基斯坦从2014年到2018年。总的来说,这些年出现了12742名癌症患者,其中乳腺癌病例为3390例。计算描述性统计数据,并将结果表示为分类变量的计数和百分比。计算连续变量的平均值和标准误差。为了测试分类变量之间的关联,采用卡方检验独立性,p值小于0.05为显著.
    84.70%的患者被诊断为浸润性乳腺癌,15.30%的患者在费萨拉巴德联合医院报告的所有其他类型。乳腺癌的发病率在40-49岁年龄组中是惊人的(1021例,30.12%),所有年份的平均年龄为45岁。从2014年到2018年,增长了34.86%。全面的四年数据(2015年至2018年)进行了进一步的组织学分析,手术,作为2014年文件数据的分期和分级模式不足以讨论。从2015年到2018年,III级和III级最常见,分别为33.9%和55.71%。
    在Faisalabad市,与其他类型的癌症相比,乳腺癌在女性中更常见。有必要升级现有的医院设施,使妇女在早期诊断癌症。
    UNASSIGNED: Breast cancer is the most common malignancy among women worldwide. We aimed to know the past trends of age-specific breast cancer incidence rates in Faisalabad city.
    UNASSIGNED: A retrospective study was designed at Allied Hospital Faisalabad (AHF), Pakistan from 2014-2018. Overall, 12742 cancer patients presented throughout these years, out of which 3390 were breast cancer cases. Descriptive statistics were computed and the results were presented as counts and percentage for categorical variables. Means and standard errors were computed for the continuous variables. For testing the association among categorical variables, a chi-square test of independence was used and the p-values less than 0.05 are reported as significant.
    UNASSIGNED: 84.70% patients were diagnosed with invasive breast carcinoma and 15.30% were all other types reported in the Allied Hospital Faisalabad. The incidence of breast cancer was outrageous in the 40-49 year-old age group (1021 patients, 30.12%) and the mean age is 45 in all years. An increase of 34.86% was observed from 2014 to 2018. The comprehensive four-year data (2015 to 2018) were further analyzed for histology, surgery, staging and grading pattern as 2014 files data was insufficient to discuss. The stage III and grade III were most common throughout the years from 2015 to 2018 with 33.9% and 55.71% respectively.
    UNASSIGNED: Breast cancer is diagnosed more commonly in women than in any other type of cancers in Faisalabad city. There is a need to upgrade the existing hospital facilities to make the women diagnose the cancer at an earlier stage.
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  • 文章类型: Journal Article
    食管癌是我国常见的恶性肿瘤之一。以前的研究表明,单独手术效果较差。新辅助治疗是指术前放化疗,这是局部晚期和可手术食道癌的标准治疗方法。新辅助治疗后选择合适的手术方式和时机对改善患者预后、减少术后并发症具有重要意义。
    通过PubMed对所有符合条件的文献进行在线电子搜索,谷歌学者,Cochrane图书馆数据库使用以下关键词的组合进行:食道癌,新辅助治疗,新辅助化疗,放化疗,免疫疗法,瞄准,手术,并发症。重点是新辅助治疗后手术的使用,合格的文章由一位或两位作者鉴定。
    新辅助放化疗联合根治性手术切除仍然是目前可切除食管癌的治疗标准,与术前化疗相比,显著提高生存率和病理完全缓解(PCR)最近,研究还发现,免疫治疗联合化疗在局部晚期患者中具有更有利的病理反应。虽然靶向药物的出现使治疗模式从传统的放化疗向精准治疗转变,需要研究术后无进展生存期(PFS)和总生存期(OS),以及如何降低由治疗引起的手术相关风险.传统上,手术在新辅助治疗后4-6周进行,随着研究的进展,治疗后的最佳手术时机仍在探索中,手术方法也应根据患者的具体情况确定。术后并发症应及时处理,当然,积极的术前干预同样重要.
    新辅助治疗联合手术是可切除食管癌的金标准。然而,术前治疗后的最佳手术时机仍不清楚.微创胸腔镜手术(包括机器人手术)已逐步取代传统的开放手术。术前积极预防,操作过程中准确细致的操作,术后及时治疗可将不良事件的发生率降至最低。
    UNASSIGNED: Esophageal cancer is one of the common malignant tumors in China. Previous studies have shown that surgery alone is less effective. Neoadjuvant therapy refers to preoperative chemoradiotherapy, which is the standard treatment for locally advanced and operable esophageal cancer. Selection of appropriate surgical methods and timing after neoadjuvant therapy is of great significance for improving the prognosis of patients and reducing postoperative complications.
    UNASSIGNED: An online electronic search of all eligible literature through PubMed, Google Scholar, and the Cochrane Library database was conducted using a combination of the following keywords: esophageal cancer, neoadjuvant therapy, neoadjuvant chemotherapy, chemoradiotherapy, immunotherapy, targeting, surgery, complications. With a focus on the use of surgery after neoadjuvant therapy, Eligible articles were identified by one or both authors.
    UNASSIGNED: Neoadjuvant chemoradiotherapy combined with radical surgical resection remains the current standard of care for resectable esophageal cancer, significantly improving survival and pathologic complete response (PCR) compared with preoperative chemotherapy Recently, studies have also found that immunotherapy combined with chemotherapy has a more advantageous pathological response in patients with locally advanced disease. Although the emergence of targeted drugs has led to a change in treatment mode from traditional chemoradiotherapy to precision therapy, the postoperative progression-free survival (PFS) and overall survival (OS) need to be explored as well as how surgery-related risks caused by treatment can be reduced. Traditionally, surgery is performed 4-6 weeks after neoadjuvant therapy, and optimal timing for surgery after treatment is still being explored as research progresses, the surgical method also should be determined according to the specific situation of the patient. Postoperative complications should be dealt with in a timely manner, and of course, active preoperative intervention is equally important.
    UNASSIGNED: Neoadjuvant therapy combined with surgery is the gold standard for resectable esophageal cancer. However, optimal timing of surgery after preoperative treatment remains unclear. Minimally invasive thoracoscopic surgery (including robotic surgery) has gradually replaced traditional open surgery. Active prevention before operation, accurate and meticulous operation during operation, and timely treatment after operation can minimize the incidence of adverse events.
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  • 文章类型: Journal Article
    UNASSIGNED:本研究旨在研究手术治疗转移性脊柱肿瘤的患者在25年期间的术后生存率和手术方法的趋势。
    UNASSIGNED:我们对1996年至2020年间接受手术治疗的转移性脊柱肿瘤患者进行了回顾性研究。对于趋势分析,根据手术年份将研究队列分为三组:1996-2004,2005-2012和2013-2020.进行了Kaplan-Meier生存分析以检查生存率,并且使用对数秩检验来比较这两个时期中排名前六位的常见癌症的生存率。对手术方法进行分组和检查如下:仅固定,姑息性减压和固定,总的总移除和固定,和完全脊椎切除术。
    未经证实:本研究共纳入608例患者。1996-2004年有78例患者,2005-2012年有236例,2013-2020年有294例。关于总体生存趋势,与其他两组相比,2013-2020组的生存率显著提高(p<0.001).根据特定的癌症部位,在肺部患者中观察到显著的生存改善,肾,和乳腺癌(分别为p<0.001,p<0.001和p=0.022)。肝脏的主要部位没有明显的变化,结肠直肠,或者前列腺.关于手术方法,肿瘤总切除比例下降,而姑息性减压,固定和仅固定手术的比例增加。
    未经批准:在过去的25年里,在肺部患者中观察到显著的生存改善,肾,和乳腺癌。肝脏患者的生存率没有改善,结直肠,和前列腺癌。在手术技术方面,姑息减压和固定手术增加,而肿瘤总切除率下降。
    UNASSIGNED: This study aimed to examine trends in postoperative survival and surgical methods over a 25-year period in patients surgically treated for metastatic spinal tumors.
    UNASSIGNED: We performed a retrospective study of patients who underwent surgical treatment for metastatic spinal tumors between 1996 and 2020. For trend analysis, the study cohort was divided into three groups according to the year of surgery: 1996-2004, 2005-2012, and 2013-2020. A Kaplan-Meier survival analysis was performed to examine survival, and the log-rank test was used to compare the survival of the top six common cancers among the periods. The surgical methods were grouped and examined as follows: fixation only, palliative decompression and fixation, gross total removal and fixation, and total en bloc spondylectomy.
    UNASSIGNED: This study included a total of 608 patients. There were 78 patients in 1996-2004, 236 in 2005-2012, and 294 in 2013-2020. Regarding the overall survival trend, the group 2013-2020 had a significantly improved survival as compared to the other two groups (p < 0.001). According to specific cancer sites, significant survival improvement was observed in patients with lung, kidney, and breast cancers (p < 0.001, p < 0.001, and p = 0.022, respectively). There were no significant changes in the primary sites of the liver, colorectum, or prostate. Regarding surgical methods, the proportion of gross total tumor removal declined, whereas the proportion of palliative decompression and fixation and fixation only procedures increased.
    UNASSIGNED: During the past 25 years, significant survival improvement was observed in patients with lung, kidney, and breast cancers. There was no improvement in survival in patients with liver, colorectal, and prostate cancers. In terms of surgical techniques, palliative decompression and fixation only procedures increased, while gross total tumor removal declined.
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