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Laparoscopic surgery is a safe and reliable alternative to laparotomy in the management of endometrial carcinoma patients, with significantly reduced hospital stay and postoperative complications; however, it does not seem to improve the overall survival and 5-year survival rate, although multicenter randomized trials are required to evaluate the overall oncologic outcomes of this procedure.

The purpose of this study was to determine the risk stratification of deep venous thrombosis (DVT) in patients undergoing gynecological surgery.A retrospective study was conducted with a cohort of 739 consecutive female patients undergoing gynecological surgery between May 2008 and July 2013 in Beijing Chao-yang hospital. DVT of the leg was detected using complete compression and color Doppler ultrasound. Pulmonary embolism (PE) was diagnosed by computed tomography pulmonary angiogram (CTPA).The overall incidence of DVT was 9.20% (68/739) in this patient population, including 16 (2.17%) symptomatic DVT and 52 (7.04%) silent DVT. A total of 66 (97.06%) DVT events were found within 7 days of surgery and 2 (2.94%) after 1 week. 94.82% thrombi were located in distal vein, and the rest 5.18% located in proximal and distal veins. Among the 68 patients with DVT, 46 patients with suspected PE received CTPA and 21 (45.65%) were confirmed with PE.Six independent factors including varicose vein, bed rest time ≥48 h, length of operation ≥3 h, laparotomy surgery, hypertension, and age ≥50 years significantly increased the incidence of postoperative DVT on multivariate analysis. Patients with none risk factor are at low risk, with 1 or 2 risk factors are at moderate risk, and with ≥3 factors are at high risk of DVT.The incidence of postoperative DVT and PE after gynecological surgery is high in patients with moderate or high-risk level. Noninvasive detection of DVT in 7 days after surgery is necessary because most patients showed no typical symptoms. Appropriate prophylaxis could be performed in patients at moderate or high risk of DVT.

Background Pre‐treatment serum albumin (ALB) is a novel index that was identified in recent years and is considered to be closely related to the prognosis of nasopharyngeal carcinoma (NPC). However, the association between ALB and NPC remains controversial. Objective of Review To assess the prognostic significance of pre‐treatment serum ALB in patients with NPC. Type of Review A systematic review and meta‐analysis. Search Strategy We searched PubMed, the Cochrane Library and the Web of Science for studies published up to August 2018. The keywords used were related to albumin, nasopharyngeal carcinoma and prognosis. Evaluation Method We extracted the following data from all included studies: author, publication year, country, cancer centre, time points of randomisation, sample size, mean or median age, gender, TNM stage of NPC, cut‐off value of pre‐treatment serum albumin, number of high‐grade cases and duration of follow‐up. Then, we generated the pooled hazard ratios (HR) for overall survival (OS) and distant metastasis‐free survival (DMFS) to perform this meta‐analysis. Results Ten studies comprising 7339 cases were included. Lower pre‐treatment serum ALB levels were significantly associated with worse OS (HR = 1.32, 95% CI 1.17‐1.48) and DMFS (HR = 1.40, 95% CI 1.08‐1.80). In general, our findings were further verified in the subgroup analyses based on three features, including cancer stage, cut‐off value and analysis type. Conclusion A decreased level of pre‐treatment serum albumin implies a poor prognosis and can be detected to define the risk stratification of NPC patients.

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