Radiofrequency Ablation for Renal Tumours: A Retrospective Cohort From a Tertiary Hospital in Australia

Purpose: This cohort aimed to evaluate the safety and efficacy outcomes of percutaneous radiofrequency ablation (RFA) for localised renal cell carcinoma (RCC) in a Western Australia tertiary hospital, Royal Perth Hospital (RPH), and potential associations between age, gender, tumour size, location, chronic kidney disease, comorbidities and local recurrence against existing benchmarks. Methods: We retrospectively analysed survival outcomes for patients with biopsy proven RCC treated by RFA at Royal Perth Hospital between 2009 and 2018. Complication data were gathered for all patients that underwent renal RFA along with 2- and 5-year recurrence-free (RFS) and compared the outcomes with data from previous studies. I confirm that all methods were carried out in accordance with relevant guidelines and regulations. Results: A total of 69 patients (73 procedures) were eligible for the study with biopsy-proven RCC had minimum 2-year follow-up. The RPH complication rate was 8.2 % (6/73) and local recurrence rate 10.9 % (8/73). Two-year RFS is 95.6% and Five-year RFS is 78.78% on a median 3.82-year follow-up (IQR 1.9-5.75). Conclusion: Radiofrequency ablation performed at our centre was found to be safe and effective with low complication rates and durable RFS in line with expectations from existing research. Our study demonstrated that radiofrequency ablation is an alternative modality of treatment for small renal tumours in patients unfit for surgical approach.

CT Angiography in the Preoperative Evaluation as a Predictor of Surgical Time for DIEP

Computed tomography angiography (CT-angiography) provides a clear view of the perforating vessels and their course, being essential in the preoperative evaluation of mastectomies. In the case of DIEP (deep lower epigastric artery), the prior identification of these vessels is of great importance for breast reconstruction, because in addition to being a predictor of surgical time, it helps in the correct approach of the arteries. Objective: To analyze CT angiography as a predictor of the surgical time for DIEP, when performed in the preoperative evaluation. Methods: A database from the Royal Perth Hospital in Australia was analyzed, with a total of 104 mastectomies performed during the period from January to December 2017. Among them, 19 were for breast reconstruction by DIEP. The patients had an average of 47 years, ranging from 31 to 69 years. Results: We obtained that when the average number of arteries in the CT angiography is less than four, there will be an average decrease of 34 minutes in the total time of surgery. However, if the number is greater than or equal to five arteries, there will be an average increase of 34 minutes, totaling an average of 452 and 551 total minutes of surgery, respectively. Conclusion: Angio-CT is an important predictor to predict the average time of surgery, one of the main factors related to complications when prolonged.

Bibliometric Analysis of 100 Top-Cited Articles in Gastric Disease

Objectives. The bibliometric analysis uses the citation count of an article to measure its impact in the scientific community, yet there is still no comprehensive summary of gastric disease researches via bibliometric analysis. We aimed to evaluate the situations and trends of the most cited articles in gastric disease via bibliometric analysis and to provide physicians a practical guide in assessing the most influential articles written on this subject. Methods. The 100 top-cited articles in gastric disease were compiled using Web of Science. The articles selected were evaluated for their number of citations, year of publication, country of origin, type of study, and others. Results. The database had 484,281 articles published between 1965 and 2019. The most cited article received 4,017 citations and the least received 604, with a mean of 1,149 citations. We classified the articles into seven categories: gastric cancer (n=53), Helicobacter pylori (n=17), ulcer (n=7), gastrointestinal stromal tumors (n=6), gastritis (n=5), gastric bypass surgery (n=2), and others (n=10). Altogether, 69 of the articles were from the USA (n=41), the UK (n=17), and Japan (n=11). Among all the institutions, Royal Perth Hospital led the list with 5 articles. One-quarter of authors owned three or more of these top-cited articles. The 100 papers were published in 33 journals, and most of them were clinical researches (n=47). Conclusions. Our study provides a historical perspective for the scientific progress of gastric disease, and the articles of significant findings that contributed great impact on the prevention and treatment of gastric disease had been identified.