ObjectiveTo explore the feasibility of targeted cryoablation for localized prostate cancer in day surgery.MethodThe clinical data of patients with localized prostate cancer who underwent cryoablation from April 2017 to May 2019 were retrospective analyzed. The patients’ satisfaction, postoperative complications, chronic pain and indwelling catheter term were recorded on the 1st (the next day after operation) and 7th day after the operation of follow-up.ResultsA total of 98 patients were included. All patients underwent the surgeries successfully. The average age of the patients was (73.43±7.86) years old. The average length of postoperative hospital stay was (1.55±0.43) days, including 34 cases (34.69%) discharged within 24 hours after the surgery. The satisfaction rate of patients was 100% on the 1st and 7th day after the operation. Twelve cases (12.24%) removed the catheter at the discharge, 83 cases (84.69%) removed the catheter on the 7th day after the operation. Because of the urinary retention, 3 cases (3.06%) removed the catheter 2 weeks after the operation. All patients were satisfied with urine control after the removal of the catheter. Ten cases (10.20%) had postoperative complications, including 3 of urinary tract infection, 3 of urinary retention, and 4 of perineal edema; the patients recovered after symptomatic treatment. On the day of surgery, 8 cases (8.16%) had slight postoperative pain in perineal (the Visual Analogue Scale scores were all 2). After oral analgesic treatment, the patients’ symptoms were alleviated.ConclusionTargeted cryoablation is a safe and effective method for the treatment of localized prostate cancer with a low incidence of postoperative complications, and it has certain feasibility in day surgery mode.
ObjectiveTo evaluate the safety and efficacy of mitral valve surgery and cryoablation in elderly patients with mitral valve disease and persistent or long-term persistent atrial fibrillation.MethodsFrom May 2014 to July 2018, 144 patients with mitral valve diseases combined with persistent or long-term persistent atrial fibrillation in the Department of Cardiothoracic Surgery, General Hospital of Northern Theater Command were selected. Among them, there were 69 patients in a non-elderly group (<60 years) including 18 males and 51 females aged 52.07±5.56 years, and 75 patients in an elderly group (≥60 years) including 32 males and 43 females aged 65.23±4.29 years. A propensity-score matching (PSM) study was conducted to eliminate confounding factors. Both groups underwent mitral valve surgery and cryoablation at the same time. A 2-year follow-up was conducted after discharge from the hospital, and the perioperative and postoperative efficacy indexes were compared between the two groups.ResultsAfter PSM analysis, there were 56 patients in each group. The sinus rhythm conversion rate of the two groups at each follow-up time point was above 85%, and the cardiac function was graded asⅠorⅡ, which was significantly improved compared with that before the surgery, but there was no statistical difference between the two groups (P>0.05). Among the perioperative indicators of the two groups, the elderly group had more coronary artery bypass graft surgeries and longer postoperative ICU stay time compared with the non-elderly group (P<0.05), and the differences in other indicators were not statistically different (P>0.05).ConclusionThe mitral valve surgery and cryoablation in elderly patients with mitral valve diseases combined with persistent or long-term persistent atrial fibrillation are safe, and the short-term outcome is satisfactory.
ObjectiveTo evaluate the clinical efficacy and complications of cryoablation for T1N0M0 non-small cell lung cancer (NSCLC).Methods The clinical data of 38 patients with T1N0M0 NSCLC who underwent CT guided percutaneous cryoablation between October 2019 and March 2021 was retrospectively analyzed. The study outcomes included technical success, the local control rate, 1-year and 2-year progression free survival rate and complications.Results All patients obtained satisfactory iceball coverage and the rate of technical success was 100%. The median follow-up was 14.9 (6.3 - 25.5) months. During the follow-up, 11 patients achieved completed remission, four cases suffered local progression, the local control rate was 89.5%. 1-year progression free survival rate was 96.7%, and 2-year progression free survival rate was 87.9%. The comparison of progression free survival between the T1a-b and T1c was conducted, but no significant difference was detected (P=0.35). There was no death happened during follow-up. The intraoperative complications were pneumothorax and alveolar hemorrhage, and the postoperative complications were exacerbation of cough and pneumothorax. All complications were mild and controllable.Conclusion CT-guided percutaneous cryoablation is clinically feasible, effective and safe therapeutic method for inoperable T1N0M0 NSCLC.
ObjectiveTo evaluate the safety and medium-to-long-term efficacy of Maze procedure with cryoablation in conjunction with mitral valve surgery for atrial functional mitral regurgitation (AFMR). MethodsRetrospective collection of clinical data from patients undergoing surgical treatment for AFMR in the Department of Cardiovascular Surgery at General Hospital of the Northern Theater Command from June 2013 to February 2022. Patients were divided into an ablation group and a non-ablation group based on whether they underwent ablation. Propensity score matching analysis was performed on the two groups with 15 parameters as covariates. The safety and medium-to-long-term efficacy of the operation in the two groups were compared. ResultsA total of 167 patients with AFMR were included, 95 of whom underwent isolated mitral valve surgery (non-ablation group), and 72 of whom underwent Maze procedure with cryoablation in conjunction with mitral valve surgery (ablation group). A total of 72 pairs were successfully matched. The ablation group included 33 males and 39 females, with an average age of (59.39±6.38) years; the non-ablation group included 33 males and 39 females, with an average age of (60.94±8.95) years. Within an average follow-up of 4 years, 4 deaths occurred in the ablation group, and 13 in the non-ablation group. The duration of extracorporeal circulation [(152.14±35.24) min vs. (93.63±32.48) min] and aortic cross-clamping time [(81.22±20.30) min vs. (47.26±17.89) min] were significantly longer in the ablation group compared to the non-ablation group (P<0.001), but there was no statistical difference in the incidence of perioperative adverse events between the two groups (P>0.05). The diameters of the left atrium and left ventricle were significantly reduced in both groups compared to pre-operation (P<0.05); the postoperative diameter of the left atrium [(47.82±6.72) mm vs. (51.58±8.63) mm] and left ventricular end-diastolic diameter [(47.46±5.06) mm vs. (49.61±6.64) mm] in the ablation group were significantly smaller than those in the non-ablation group, with statistical differences (P<0.05). At each follow-up time point, the sinus rhythm conversion rate and drug-free rate in the ablation group were significantly higher than those in the non-ablation group (P<0.001). Kaplan-Meier analysis showed that the cumulative survival rate in the ablation group (2 years: 98.6% vs. 89.9%; 4 years: 91.7% vs. 87.7%; 6 years: 91.7% vs. 73.9%, 8 years: 91.7% vs. 67.2%; P=0.026) and the rate of freedom from rehospitalization for heart failure (2 years: 98.3% vs. 86.7%; 4 years: 95.8% vs. 82.8%; 6 years: 90.1% vs. 74.9%; 8 years: 81.1% vs. 57.2%; P=0.031) were significantly higher than the non-ablation group. ConclusionConcomitant cryoablation Maze procedure with mitral valve surgery in treating patients with AFMR is safe and has satisfactory results. It can effectively promote the recovery of sinus rhythm, reverse adverse cardiac remodeling, and reduce the incidence of medium-to-long-term adverse events.