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Objective:To investigate the advantages of Da Vinci robotic thyroidectomy in treatment of the unilateral papillary thyroid microcarcinoma (PTMC).Methods:The clinical data of 49 patients with unilateral thyroid cancer admitted to the First Hospital of Shanxi Medical University from June 2018 to March 2020 were retrospectively analyzed, and they were divided into Da Vinci robotic group (the experimental group, 18 cases) and conventional surgery group (the control group, 31 cases) according to the surgical method. The clinicopathological characteristics, perioperative and postoperative related indexes changes, length of hospital stay, incidence of surgical complications, and operation cost of both groups of patients were analyzed. Visual analogue scale (VAS) was used to evaluate postoperative pain.Results:There were statistically significant differences in age, marriage and education background of both groups (all P < 0.05). There were statistically significant differences in the number of central lymph node dissection [(4.3±2.0) vs. (6.5±3.9)], operation time [198.5 min (166.3 min, 228.5 min) vs. 82.0 min (60.0 min, 102.0 min)], pain score of 24 h after surgery [3 scores (3 scores, 4 scores) vs. 2 scores (2 scores, 3 scores)], postoperative total drainage volume [49.0 ml (40.8 ml, 56.5 ml) vs. 37.0 ml, (29.0 ml, 44.0 ml)], operation cost [33,200 yuan (33,100 yuan, 34,000 yuan) vs. 5,200 yuan (4,200 yuan, 5,900 yuan)], and differences were statistically significant (all P < 0.05). No postoperative complications such as hemorrhage, fat liquefaction and subcutaneous ecchymosis occurred in all patients of the two groups. Conclusion:Da Vinci robotic thyroidectomy is safe and reliable in treatment of the unilateral PTMC, and it has good therapeutic effects.
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Objective:To compare and investigate the effects of laparoscopy and open colorectal cancer on the intestinal barrier function in patients with colorectal cancer.Methods:Sixty-two patients with colorectal cancer admitted in our hospital from January 2015 to October 2016 were selected and divided into laparoscopic surgery group with thirty-four patients and open surgery group with twenty-eight patients. The changes of postoperative intestinal barrier function were compared between the two groups.Result:The levels of plasma D-lactate, plasma diamine oxidase (DAO) and bacterial endotoxin in the laparoscopic surgery group were significantly lower than those in the open surgery group ( P<0.05). Conclusion:Laparoscopic and open colorectal cancer surgery can cause damage to intestinal barrier function, but the damage of laparoscopic colorectal cancer surgery is lower than that of open colorectal surgery.
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Objective To investigate the clinical features,complications,treatment and prognosis of patients with Pcutz-Jeghers syndrome.Methods The clinical data of thirty-one cases of Pcutz-Jeghers syndrome treated in the First Hospital of Shanxi Medical University from January 1998 to December 2016 was analyzed retrospectively.Results There were11 cases with definite family history(35%,11/31).There were 21 cases of mucocutaneous pigmentation(67.7%,21/31),31 cases of gastrointestinal polyps(100%,31/31), including 8 cases of canceration(25.0%,8/31),24 cases of digestive tract bleeding(77.4%,24/31),20 cases of intussusception(64%,20/31),and 1 case of intestinal perforation(3.2%,1/31).6 cases were treated with endoscopic high frequency electrocoagulation,12 cases received polypectomy,17 cases underwent resection of intestinal tract.3 patients with intractable intussusception underwent plication of small intestine,and 4 patients with colon cancer underwent total colectomy combined with lymph node dissection.Conclusion Peutz-Jeghers syndrome often induce intractable intestinal obstruction and gastrointestinal tumor,resection of intestinal lesions should be favorable.For small intractable intussusception,the plication of small intestine has certain value; for its potential malignancy,it should be strictly monitored and actively treated.Gene therapy and drug therapy will guide for the future development.
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Objective To investigate the effect of general anesthesia combined with epidural block anesthesia on intestinal barrier function in patients with gastric cancer after radical resection.Methods 90 patients with gastric cancer undergoing laparoscopic radical resection were selected.They were randomly divided into observation group (epidural anesthesia plus general anesthesia) and control group (general anesthesia),45 cases in each group.The intraoperative blood loss,intraoperative infusion volume,postoperative exhaust time,postoperative complications and the function of intestinal barrier effects were compared between the two groups.Results The total incidence rate of postoperative complications in the observation group(8.89％) was significantly lower than that in the control group (28.89％) (x2 =4.83,P ＜ 0.05).The hospital stay in the observation group [(12.5 ± 4.23) d] was significantly shorter than that in the control group [(17.5 ± 5.26) d] (t =3.27,P ＜ 0.05).The two amine oxidase [(3.88 ± 0.98) U/L],D-lactic acid [(7.44 ± 5.23) mg/L],endotoxin [(13.44 ± 2.12) U/L] levels of the observation group were significantly lower than those of the control group [two amine oxidase (11.33 ± 1.25) U/L,D-lactic acid (15.34 ±3.21) mg/L,endotoxin (21.03 ± 0.82) U/L] (t =5.63,5.02,4.19,all P ＜ 0.05).Conclusion Compared with total intravenous anesthesia,total intravenous anesthesia combined with epidural anesthesia is beneficial to the recovery of intestinal barrier function after radical gastrectomy,and can shorten the postoperative hospital stay.It is worthy of clinical application and popularization.
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Objective To investigate the clinical features,complications,treatment and prognosis of patients with Pcutz-Jeghers syndrome.Methods The clinical data of thirty-one cases of Pcutz-Jeghers syndrome treated in the First Hospital of Shanxi Medical University from January 1998 to December 2016 was analyzed retrospectively.Results There were11 cases with definite family history(35%,11/31).There were 21 cases of mucocutaneous pigmentation(67.7%,21/31),31 cases of gastrointestinal polyps(100%,31/31), including 8 cases of canceration(25.0%,8/31),24 cases of digestive tract bleeding(77.4%,24/31),20 cases of intussusception(64%,20/31),and 1 case of intestinal perforation(3.2%,1/31).6 cases were treated with endoscopic high frequency electrocoagulation,12 cases received polypectomy,17 cases underwent resection of intestinal tract.3 patients with intractable intussusception underwent plication of small intestine,and 4 patients with colon cancer underwent total colectomy combined with lymph node dissection.Conclusion Peutz-Jeghers syndrome often induce intractable intestinal obstruction and gastrointestinal tumor,resection of intestinal lesions should be favorable.For small intractable intussusception,the plication of small intestine has certain value; for its potential malignancy,it should be strictly monitored and actively treated.Gene therapy and drug therapy will guide for the future development.