ABSTRACT
Objective:To investigate the incidence of severe complications in patients with peptic ulcer perforation after simple closure operation.Methods:All discharged 117 patients after perforated peptic ulcer simple closure from Jan 2010 to June 2014 were followed-up. Focusing on patients compliance to undergo endoscopic examination and radical HP treatment within 3 months after operation, whether giving up bad habit such as smoking or drinking, whether using nonsteroidal anti-inflammatory drugs.Persisting ulcer symptoms and other complications such as reperforation, bleeding, obstruction, etc were recorded.Results:Gastroscopy was performed in 22 cases (21.4%) within 3 months after operation, and only 5 cases received HP radical treatment. There were altogether 10 cases of severe complications developed during the period of followed-up, including 6 cases of pyloric obstruction , 4 cases of reperforation, and 2 cases repeated ulcer bleeding . The average interval from perforation operation to the first serious complication was (24.8±5)months. Among them, 2 cases of perforation and 1 case of repeated obstruction were treated surgically, the rest underwent conservative treatment. Compared with the severe complications group much less patients receving early postoperative gastroscopy have had such severe complications (23.7% vs.0, P=0.184). Conclusion:After simple closure of upper gastrointestinal ulcer perforation, the low compliance rate of endoscopy and active medical treatment lead to high incidence of long-term serious complications.
ABSTRACT
Objective:To evaluate component separation technique (CST)for the managetment of abdominal wall defect after resection of abdominal wall tumor.Methods:Clinical data of 12 patients treated by CST form Jan 2016 to Jan 2019 at our two Hospitals were retrospectively analyzed. The abdominal wall defect after tumor radical resection were reconstructed with synthetic mesh.Results:The most common pathological type was dermatofibrosarcoma protuberans (4 cases), followed by desmoid fibroma (2 cases) and abdominal metastasis of colon cancer (2 cases). The maximum diameter of tumor was (5.3±1.5) cm by CT preoperatively.The largest transverse diameter of abdominal wall defect after tumor resection was (9.4±1.4) cm.7 patients were treated with CST. 10 patients used synthetic mesh. Incision-related complications occurred in 3 patients, abdominal hypertension and atelectasis in 1 case and acute myocardial infarction in 1 case. All patients were helped and discharged.One patient died of liver metastasis of colon cancer 17 months after operation, and the other 11 patients had no recurrence of tumor or incisional hernia.Conclusion:Using CST in patients with abdominal wall tumor can effectively close the defect, reconstruct the function of abdominal wall and prevent the occurrence of incisional hernia.