Meta-analysis of Early Postoperative Small Bowel Obstruction after Laparoscopic Colorectal Resection / 中国微创外科杂志

Objective To compare the efficacies of laparoscopic colorectal resection and conventional open surgery by collecting and investigating related studies with Meta-analysis.Methods Randomized controlled trials(RCT) on the outcomes of laparoscopic colorectal resection and conventional open surgery that published between January 1989 and March 2008 in English were collected and analyzed.The quality of the original investigations was evaluated,and the low-level reports were excluded.Then the odds ratio(OR) for the incidence of early postoperative small bowel obstruction between the two methods were calculated.ResultsTotally 12 studies including 3032 cases were analyzed.Among which,1522 patients received laparoscopy,33 of them developed early postoperative small bowel obstruction.1510 cases underwent open surgery,and 71 of these patients showed small bower obstruction before being discharged form hospital.The pooled OR was 0.46 with a 95% confidence interval of(0.30-0.69).Conclusion Compared with open surgery,laparoscopic colorectal resection is superior in the incidence of early postoperative small bowel obstruction.

Surgical treatment of aortic aneurysms and aortic dissections / 第三军医大学学报

Objective To summarize the experience of surgical treatment of ascending aortic aneurysms and aortic dissections. Methods From February 2001 to October 2005, 31 patients including 26 male, 5 female, aged 41.3 years old (range 14-72) received surgical management. Twenty cases were diagnosed as ascending aortic aneurysm and aortic root aneurysm, 8 as Standford A dissection, 3 as Stanford B dissection. Twenty-one patients underwent classic Bentall procedure in which VSD repair was carried out in 1 case, mitral valvoplasty in 2 and mitral valve replacement in 2; Four patients underwent modified Bentall procedure (coronary button technique); Three patients underwent Wheat procedure; The remaining 3 patients with Stanford B dissection underwent graft replacement of descending aorta. Results There was no death during hospital stay that lasted 13-46 d with an average of 16.4 d after operation. The mean clinical follow-up was (21?18.5) months (range 1-63 months). One patient died without describable cause two years later. One patient had ascending aorta-pulmonary artery fistula at color Doppler examination half a year later. One patient was detected rupture of distal anastomoses half a year after operation and underwent stent-graft, SG. Conclusion The surgical treatment of aortic aneurysms and aortic dissections could be carried out safely based on the accurate diagnosis, specific surgical strategy and fine technique.

Clinical analysis of coronary artery bypass graftin g in 13 patients / 第三军医大学学报

Objective　Coronary artery bypass grafting (CABG)i n 13 patients was analyzed. Methods　9 patients were performed C ABG with cardiopulmonary bypass, 4 patients undergone off-pump coronary artery bypass(OPCAB). Among the 4 patients, 3 undergone transmyocardial laser revascula rization concomitantly. 2 patients with single-vessel disease, 3 with double-v essel disease, 7 with triple-vessel disease and 1 with left main coronary arter y disease. The average bypass per patient was 2.3. Results　All patients survived, 11 patients were angina free, 2 were angina relief. C onclusion　CABG is a safe operation, OPCAB may reduce blood transfusion and complication, patients recover more quickly after OPCAB compared with those with CABG.