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There is no clear evidence on the indication and surgical approaches on evacuating basal ganglia hemorrhage caused by hypertensive bleeding. Some studies have shown that minimally invasive approaches have therapeutic potentials, but its benefits remain inconclusive. We describe an endoport assisted endoscopic transsylvian approach for basal ganglia hemorrhage evacuation. We evaluate the safety and efficacy of this approach in a cohort study. We included 19 patients (mean age 57 years) who underwent the surgery at a single county-level hospital in Yunan Province, China. The majority had a Glasgow coma scale between 9 and 12 on admission. The midline shift ranged from 16-29 mm (mean 19 mm). Hematoma volume ranged from 46 to 106 ml (mean 67 ml). Six patients (31.6%) presented with intraventricular hemorrhage. All patients achieved greater than 90% decrease in hematoma volume at postoperative computed tomography scan. The average operative time was 115 minutes and average blood loss of 44 ml. The most common postoperative complication was pulmonary infection (63.2%). No rebleeding, seizure, infectious meningitis, or postoperative mortality was observed. A total of 17 patients (89.5%) achieved good functional recovery at follow up within 90 days after surgery (Glasgow outcome scale 4–5) and 2 patients had severe disability (Glasgow outcome scale 3). Endoport assisted endoscopic surgery through transsylvian approach is safe and effective treatment for hypertensive basal ganglia hemorrhage. The majority of patients have good functional recovery and the rate of severe complications is low. [ABSTRACT FROM AUTHOR]

This study aims to investigate the proportion and distribution of female HPB surgeons in China, describe their current status, and analyze the possible barriers and challenges in their careers. Tertiary hospitals with the division of HPB in mainland China in 2021 were enrolled and surgeon demographic information was collected through the review of official websites and/or telephone interviews. The majority of female HPB surgeons (72.92%) were located in the first or second-tier cities in mainland China, with an increasing number of new female HPB surgeons entering the field annually, particularly after 2005 (from 27 to 52 per 5 years). Despite no significant difference in academic backgrounds, female HPB surgeons initiated their careers at an earlier age and took a longer time to obtain chief titles (P < 0.05). Interestingly, female HPB surgeons performed laparoscopic complex HPB cases at a similar rate (95.42%) to their male counterparts and were more likely to specialize in endoscopic surgery (P = 0.021), with a similar ratio of obtaining administrative positions. Minimally invasive surgery may provide females with unprecedented opportunities in the HPB surgery field. However, despite the increasing numbers of female HPB surgeons, the proportion remains low in China. [ABSTRACT FROM AUTHOR]

To explore the association between socioeconomic status (SES) and postoperative outcomes in patients with chronic sinusitis (CRS) after functional endoscopic sinus surgery (ESS). We conducted an observational cohort study of 1,047 patients with CRS undergoing ESS. Discharged patients were followed up to 72 weeks for all-cause recurrence events. Baseline SES was established based on occupation, education level, and family income of the patients 1 year before the operation. Kaplan–Meier method was used to calculate the recovery rate after ESS, and Cox proportional hazards regression analysis was used to evaluate the relationship between SES and prognosis. Patients of middle SES had lower unadjusted all-cause recurrence than those of low or high SES; 24-week overall recovery rate was 90.4% [95 % confidence interval (CI) : 89.6%–91.2%] in patients of middle SES, 13.5% (95 % CI : 12.8%–14.2%) in patients of low SES, and 31.7% (95 % CI : 30.7%–32.7%) in patients of high SES (both log-rank P < 0.001). After adjustment for covariates, hazard ratios (HRs) were 7.69 (95 % CI: 6.17–9.71, P trend < 0.001) for all-cause recurrence for low SES versus middle SES, and 6.19 (95 % CI : 4.78–7.93, P trend < 0.001) for middle SES versus high SES. Low SES and high SES were more associated with the worse prognosis of CRS patients after ESS than middle SES. [ABSTRACT FROM AUTHOR]

Recent studies have suggested that insulinoma-associated protein 1 (INSM1) is a useful marker for pathological diagnosis of neuroendocrine tumors. In the present study, we investigated the association between INSM1 expression and prognosis in patients with olfactory neuroblastoma (ONB) and assessed the usefulness of INSM1 as a prognostic biomarker in these patients. Immunohistochemistry was performed on 109 ONB patients who underwent endoscopic surgery at Beijing Tong Ren Hospital (Beijing, China) between June 2006 and November 2021 Patient age at the time of surgery ranged from 10 months to 72 years (mean age, 43.55 ± 13.47 years). In total, 63 (57.8%) and 46 (42.2%) tumors occurred in male and female patients, respectively. The percentages of grade I–IV cases were 13.8% (15/109), 36.7% (40/109), 29.4% (32/109) and 20.2% (22/109), respectively. The expression rate (moderately/strongly positive) of INSM1 was significantly higher in high-grade (Ⅲ/Ⅳ; 83%; 45/54) than low-grade (Ⅰ/Ⅱ; 27%; 15/55) ONB cases. High expression levels of INSM1 were significantly positively associated with high pathological stage (p < 0.001), local recurrence, and death. Kaplan‑Meier analysis revealed that patients with high INSM1 expression had significantly shorter disease‑free survival (DFS) and mean survival (75.01 ± 10.71 vs. 158.56 ± 10.32) times, and shorter overall survival (OS). Multivariate Cox regression analysis revealed that INSM1 was an independent prognostic factor for DFS (HR: 4.963, 95%CI [2.11–10.84] p < 0.001) and OS (HR: 4.791, 95%CI [2.117–10.485], p < 0.001) after adjusting for sex, age, and tumor grade. In addition, INSM1 was an independent prognostic factor for DFS in patients treated with surgery (HR: 3.714, 95%CI [1.267–10.889], p = 0.017) and chemotherapy (HR: 5.574, 95%CI [1.584–19.612], p = 0.007). INSM1 expression had a positive association with the prognosis of patients with ONB and could serve as a prognostic biomarker in these patients. [ABSTRACT FROM AUTHOR]

Pediatric endoscopic skull base surgery is challenging due to the intricate anatomy of the skull base and the presence of tumors with varied pathologies. The use of three-dimensional (3D) printing technologies in skull base surgeries has been found to be highly beneficial. A systematic review of the literature was performed to investigate the published studies that reported the effectiveness of 3D printing in pediatric endoscopic skull base surgery. Pub Med, Embase, Science Direct, The Cochrane Library, and Scopus were searched from January 01, 2000, until June 30, 2022. Original articles of any design reporting on the effectiveness of 3D printing in pediatric endoscopic skull base surgery were included. Information related to study population, conditions, models used, and key findings of study were extracted. Quality of included studies was evaluated using the Joanna Briggs Institute's (JBI) Critical Appraisal Checklist for Studies. To exemplify the use of 3D technology in this scenario, we report a complex clival chordoma case. Six research articles were retrieved and included for qualitative analysis. Four of the six studies were conducted in the United States, followed by two in China. According to these studies, 3D reconstruction and printed models were more beneficial than CT/MRI images when discussing surgery with patients. In clinical training, these models were more helpful than 2D images in understanding the pathology when used in conjunction with image-guiding systems. It has been found that patient-specific 3D modeling, simulations, and rehearsal are the most efficient preoperative planning techniques, particularly in the pediatric population, for the treatment of complicated skull base surgeries. All the studies had a moderate risk of bias. 3D printing technologies assist in printing complex skull base tumors and the structures around them in three dimensions at the point of care and at the time needed, enabling the choice of the appropriate surgical strategy, thus minimizing surgery-related complications. [ABSTRACT FROM AUTHOR]

Several studies, including the multicenter prospective trial JCOG 0508, have reported a higher risk of recurrence in patients with pT1b esophageal carcinoma (EC) with lymphovascular invasion (LVI) after endoscopic resection (ER). The role of adjuvant radiotherapy in this population has not been fully proven. Thus, the aim of this study was to investigate the effectiveness of adjuvant radiotherapy for T1b EC with LVI. This was a multicenter retrospective study including 6 centers in China. From May 2011 to March 2019, patients with T1b EC and LVI who underwent ER with or without radiotherapy were included and analyzed. The overall survival (OS) and disease-free survival (DFS) were estimated by the Kaplan-Meier method, and the log-rank test was used to analyze differences between the groups. Factors between different groups were compared using chi square test. A total of 42 patients were included, including 37 (88.1%) males and 5 (11.9%) females. The median age was 60 (49-80) years old. Forty (95.2%) patients were squamous cell carcinoma, and two (4.8%) were adenosquamous cell carcinoma. The number of patients with tumor of SM1 and SM2 invasion were 10 (23.8%) and 32 (76.2%), respectively. The median lesion length was 3.0 cm. Thirty-six (85.7%) Patients underwent complete ER and six (14.3%) patients were with R1 resection. Sixteen (38.1%) patients received adjuvant radiotherapy, including two received chemoradiotherapy. The factors mentioned above were well balanced between radiotherapy and non-radiotherapy groups. The median survival in the radiotherapy vs. non-radiotherapy groups were not reached vs. 80.4 months, respectively. The 3y- and 5y-OS were 91.7% and 91.7% in the radiotherapy group vs. 80.8% and 58.9% in the non-radiotherapy group, respectively (p=0.045). The median DFS time in the radiotherapy vs. non-radiotherapy groups was not reached vs. 43.8 months, respectively. The 3y- and 5y-DFS were 92.9% and 92.9% in the radiotherapy group vs. 69.2% and 43.5% in the non-radiotherapy group, respectively (p=0.011). Radiotherapy was the only prognostic factor for both OS and DFS. Adjuvant radiotherapy improved the survival of patients with T1b EC with LVI after ER. This combined treatment strategy could cure T1b-LVI EC while preserving the esophagus. [ABSTRACT FROM AUTHOR]