ABSTRACT
Objective To study the advantages and disadvantages of the application of complete endoscopic and endoscope assisted small incision in thyroid surgery. Methods From September 2010 to September 2013,279 patients with thyroid diseases in our hospital were selected as the research object. Among them,239 cases of thyroid surgery were grouped according to the surgical method,the complete endo-scopic group with 95 cases,endoscope assisted small incision surgery group with 144 cases. The other 40 cases of parathyroid surgery were grouped according to the surgical method,the complete endoscopic group with 5 cases,endoscope assisted small incision group with 35 cases. The results and indicators related to the surgery with the complete endoscopic and endoscope assisted small incision for the thyroid disease and parathyroid gland were compared. Results About thyroid disease,the proportion of women in the complete endoscopic group,the adeno-ma or unilateral gland leaf proportion,thyroid volume,the tumor nodules longest diameter,adenoma or glandular lobe resection time,double leaf full cut or full cutting time and intraoperative blood loss were significantly higher than that of endoscope assisted small incision group,and the age,double leaf time full cut or full cut rate were significantly lower than that of endoscope assisted small incision group,the differences were statistically significant (P<0. 05). About thyroid disease,proportion of chest discomfort,VAS pain score,length of hospital stay and postoperative cosmetic effect of satisfaction scores in complete endoscopic group were significantly higher than that of endoscopy assisted small incision group,the differences were statistically significant (P<0. 05). About parathyroid disease,the age of patients in the complete endo-scopic group was significantly lower than that in endoscopy assisted small incision group,but the operation time and hospital stay were signifi-cantly higher than that of endoscopy assisted small incision group,the differences were statistically significant (P<0. 05). Conclusion The thyroid surgery with complete endoscopic and endoscopy assisted small incision has certain advantages and disadvantages,which should be considered for patients demands,so as to make the best operation program.
ABSTRACT
Objective To study a simple effecfiue and minimally in vasihe mefhool for laparoscopyic inguinal hernias in children. Methods Internal inguinal ring was explored with needle-laparoscopy (2 7mm laparoscope,30 degrees).The hernial sac was cauferiled by electrocoagulation and the internal inguinal ring cauterization with Endoclose. Results The technique was applied in 102 children 10 months to 14 years with an average,5 6 years and 118 internal inguinal rings.one case had recurrence three weeks after operation,The others had no recurrence and postoperative discomfort.The longest follw-up period was 46 months (3-46M).Hematomol around the spermafic cord was seen,which was cansed by cuffing of sman blood vessels around the spermati cord.postoperative scrotum hydrocele,appcared in 8 cases who gradually recovered after 5-8 days and no death happeneda. Conclusions Laparoscopic inguinal herniorrhaphy by Endoclose has the advantages less postoperative discomfort and pain,reduced recovery time that allows earlier full activity,easier repair of a recurrent hernia,the ability to treat bilateral hernias concurrently,ligation of the hernia sac at the highest possible site,improved cosmesis,and decreased incidence of recurrence,and the operation is safe.