ABSTRACT
Objective To investigate operative method for preventing and treatment intestinal obstruction due to relapse adhesion.Methods Sixty patients with recurrent adhesive ileus treated by surgery were randomized into two groups,that was intra-enteropexy group and extra-enteropaxy group.Twenty-three patients in intra-enteropexy group were treated by retrograde intra-enteropaxy through appendix stump.Thirty-seven patients in the extra-enteropexy group were treated by Noble procedure.The effect and complication were compared.Results In the intra-enteropexy group,2 cases (8.70%) were complicated with incision infection,1 case was died (4.35%) and there was no relapsed,abdominal spastic pain and incomplete intestinal obstruction occurred.In the extra-enteropexy group,3 cases (8.11%) were complicated with incision infection,3 cases were died (8.11%),abdominal spastic pain were occurred in 11 cases (29.73%),incomplete intestinal obstruction were occurred in 6 cases(16.22%),and there were 3 cases run into relapse.Conclusion The retrograde intra-enteropexy through appendix stump is an effective method for preventing and treatment to adhesive ileus.
ABSTRACT
Objective To assess the value of video-assisted thoracoscopic mini-invasive lobectomy in the treatment of pulmonary benign lesions or malignancies. Methods A retrospectively analysis on clinical data of 35 cases of video-assisted thoracoscopic mini-invasive lobectomy, which were performed from February 2002 to June 2006, was made. The pathological diagnosis included 31 cases of peripheral lung cancer (T_1N_0-1M_0), 3 cases of bronchiectasis, and 1 case of atelectasis combined with pulmonary abscess. The procedures included 30 cases of anatomical lobectomy and 5 cases of non-anatomical lobectomy. Results No conversion to open surgery was required. The operation time was 85~210 min (115?35 min) and the intraoperative blood loss was 150~450 ml (210?55 ml). Postoperatively, acute respiratory failure was encountered in 2 cases, and mechanical ventilation was given for 3 and 5 days, respectively. Acute myocardial infarction occurred in 1 case, which was cured by early-stage thrombolysis. No postoperative complications were seen in the remaining 32 cases. The closed chest drainage was maintained for 2~10 days (mean, 5.4 days). In 3 cases of pulmonary benign lesions, follow-up checkups for 41, 33, and 13 months, respectively, found no long-term complications. In 25 cases of lung cancer, follow-up observations were made for 3~53 months (mean, 15.2 months), including 3~12 month in 6 cases, 12~24 months in 9 cases, 24~36 months in 7 cases, and 36~53 months in 3 cases. There were 4 cases of death due to cancer recurrence or metastasis (16%), 2 cases of with-tumor survival (8%), and 19 cases of disease-free survival (76%), respectively. Conclusions Video-assisted thoracoscopic mini-invasive lobectomy is a feasible and safe procedure for peripheral lung cancer and benign lung diseases.