ABSTRACT
Adhesive intestinal obstruction is the most common type of ileus, and conserva-tive treatment serves as its preferred treatment option. In the course of conservative treatment, gastrointestinal decompression will relieve symptoms, prevent ileus progression and promote gas-trointestinal function recovery, which has significant clinical effects. Currently, decompression effects of nasointestinal tubes and nasogastric tubes are controversial. There is a previous Meta-analysis evaluating decompression effects of these two methods, but this analysis includes non-randomized controlled trial and lacks research about Chinese patients. Therefore, the authors con-duct a Meta-analysis to evaluate decompression effects of nasointestinal tubes versus nasogastric tubes for adhesive intestinal obstruction.
ABSTRACT
Minimally invasive technique has been widely applied and recognized in gastrointestinal surgery. In recent years, technological innovation related to minimally invasive technology emerges in endlessly. The application of 4K ultra-high definition video display technology has played impartment roles in promoting the development of surgery, technical specifications and training of minimally invasive gastrointestinal surgery. Clearly understand the anatomical structure of the inferior pyloric region is an important theoretical basis for the dissection of No. 6 lymph node. Careful anatomy with good patience of the surgeons, and good cooperation between the surgeon and assistants are helpful to reduce and prevent complications. The authors investigate the infrapyloric lymph node dissection in 4K laparoscopic radical gastrectomy with the surgeon on right position.
ABSTRACT
Minimally invasive technique has been widely applied and recognized in gastrointestinal surgery. In recent years, technological innovation related to minimally invasive technology emerges in endlessly. The application of 4K ultra-high definition video display technology has played impartment roles in promoting the development of surgery, technical specifications and training of minimally invasive gastrointestinal surgery. Clearly understand the anatomical structure of the inferior pyloric region is an important theoretical basis for the dissection of No. 6 lymph node. Careful anatomy with good patience of the surgeons, and good cooperation between the surgeon and assistants are helpful to reduce and prevent complications. The authors investigate the infrapyloric lymph node dissection in 4K laparoscopic radical gastrectomy with the surgeon on right position.
ABSTRACT
Objective To compare the clinical outcomes of total laparoscopic pancreatoduodenectomy (TLPD) and open pancreaticoduodenectomy (OPD).Methods From August 2013 to December 2014,137 pancreaticoduodenectomies (PDs) were performed at the Department of General Surgery of our hospital,of which 19 TLPDs were performed at the Department of Minimally Invasive Surgery (the Experimental group).At the same time,another cohort of 19 OPDs were matched for age,gender,body mass index (BMI),ASA score and tumor site and they formed the control group.The clinical data in the perioperative period were evaluated,and the short-term clinical outcomes were compared.Results Operation time in the experimental group was significantly longer than the control group [(407.8 ± 146.5)min vs (263.3 ± 65.3) rmin,P ＜ 0.05].The mean intraoperative blood loss [(309.7 ± 151.2)ml vs (509.4 ± 309.9)ml],mean intensive care time after surgery [(47.5 ±16.8)h vs (68.1 ± 19.1)h],mean postoperative time to pass flatus [(3.5 ± 1.1) d vs (4.3 ± 1.1) d],mean postoperative hospitalization stay [(8.8 ± 2.1) d vs (10.8 ± 2.3)d] and mean incision length [(5.1 ± 0.9)cm vs (14.4 ± 1.3)cm] in the experimental group were significantly different from the control group (P ＜ 0.05).There were no significant differences on the intraoperative R0 resection rates,intraoperative pathology,tumor size [(20.6 ± 9.6) mm vs (25.9 ± 10.2)mm],number of lymph node dissected [(17.7 ± 6.5) vs (19.4 ± 5.6)],complication rates,recurrence rates and mortality between the two groups (P ＞ 0.05).Conclusions TLPD had comparable safety and therapeutic outcome when compared with OPD.Moreover,TLPD has the advantages of less bleeding,smaller wounds and faster postoperative recovery.TLPD requires specialized appliances and equipments,better surgeon experience and patient selection to achieve a high success rate.