Objective To introduce the treatment experiences about the skin-sparing mastectomy and immediate breast reconstruction. Methods The skin-sparing mastectomy and immediate breast reconstruction by using transverse rectus abdominis myocutaneous （TRAM） flat were performed in 10 patients with early-stage breast cancer from May 2008 to December 2011 in our hospital. The patients’ data were retrospectively analyzed. Results There were postoperative complications after skin-sparing mastectomy and immediate breast reconstruction， including TRAM flat necrosis in 1 case， papillary necrosis in 1 case and fat necrosis in the reconstructed breast with oxter wound infection in 1 case. There was no incision hernia of abdominal wall or necrosis of all TRAM flat in any case. The patients’ satisfaction that evaluation for the breast shapes of reconstructed breasts was very satisfaction in 5 cases， part satisfaction in 4 cases， and dissatisfaction in 1 case， respectively. Conclusions Because of the minimal access approach and good breast shape， the skin-sparing mastectomy and immediate TRAM flat breast reconstruction is a safe and effective way for treating early-stage breast cancer.
ObjectiveTo screen the current optimal evidence for early removal of urinary catheters in patients after gastrointestinal surgery both domestically and internationally. MethodsWe systematically searched the following databases or website, including the UpToDate, the British Medical Journal Best Practice, the Jonna Briggs Institute Evidence-Based Healthcare Center, the Guidelines International Network, the National Institute for Health and Clinical Excellence Guidelines, the Registered Nurses’ Association of Ontario, the Scottish Intercollegiate Guidelines Network, the European Association of Urology Nurses, the Cumulative Index to Nursing and Allied Health Literature, the Cochrane Library, ClinicalKey, Embase, PubMed, Web of Science, CNKI, Wanfang, and VIP. The literature was evaluated, and the evidence was extracted and summarized. ResultsA total of 27 articles were included, including 3 clinical decisions, 4 guidelines, 18 systematic reviews, 1 practice recommendation, and 1 expert consensus. The 23 evidence items were classified into five categories: pre-catheterization assessment (6 items), institutional and personnel requirements (2 items), strategies to shorten catheter indwelling time (8 items), bladder recovery strategies (5 items), and timing of catheter removal (2 items). These items were classified 5 evidence levels ccording to the 2014 JBI Evidence-Based Healthcare System Evidence Pre-Grading and Recommendation Level System: level 1 (6 items), level 2 (8 items), level 3 (1 item), level 4 (0 items), and level 5 (8 items). Recommendation grades: grade A (strong recommendation, 14 items) and grade B (weak recommendation, 9 items). ConclusionsThe high-quality evidence identified in this study regarding early urinary catheter removal can be effectively applied in the clinical management of patients after gastrointestinal surgery. However, there are few studies on this in China. These best evidence should be adaptively implemented according to the specific situation after gastrointestinal surgery in China.
Objective To systematically sort out the research status, hotspots and development trends in the field of fertility-related decision-making conflict and support needs among breast cancer patients using bibliometric methods, so as to provide references for subsequent research and clinical practice. Methods Based on the Web of Science Core Collection, relevant studies on fertility-related decision-making conflict and support needs among breast cancer patients published from 1995 to 2025 were retrieved. Excel 2021, CiteSpace 6.3.R1 and VOSviewer 1.6.19 were used to analyze the elements including countries, institutions, authors, journals and keywords. Results A total of 1113 publications were included. Early-stage publication output increased slowly, its growth rate rose significantly after 2007, and reached a peak of 116 publications in 2025. The United States accounted for 43.8% of total publications, and Harvard University and its affiliated institutions were the core contributing forces. Core journals showed interdisciplinary characteristics, while highly-cited literature was highly concentrated in the field of oncology. Keyword analysis revealed that research themes fell into three categories: clinical epidemiology and genetic risk research, therapeutic intervention and fertility preservation research, quality of life and support needs research. Quality of life and support needs may be future research hotspots. Conclusions The field of fertility-related decision-making and support for women with breast cancer has evolved into a multidisciplinary research frontier, with its research focus shifting from biomedical and technical discussions toward patient-centered decision-making support and humanistic care. Further in-depth research could be carried out targeting hot topics in the future to promote the development of this field toward precision and intelligence.