ABSTRACT
Objective To analyze the situation and trend of the application of antibacterial drugs in the case of typeⅠincision operation in our hospital.Methods A total of 1 964 patients in our hospital from 2010 to 2014 were randomly selected,and the changes of antimicrobi-al drugs during the treatment period were analyzed.The surgical site infection probability and antimicrobial application rules in typeⅠincision surgery in 3 years,including probability,category,first time and duration of drug use,and the relationship between antibacterial drugs and typeⅠincision infection were analyzed.Results Application of antibacterial drugs in typeⅠincision operation probability decreased significant-ly,and the surgical infection probability decreased year by year,with statistically significant difference(P<0.05).The first application of an-tibacterial drug time was more reasonable,the choice of antimicrobial drugs were mainly one generation or two generation of Cephalosporin. There was a significant increase in the probability of stopping medication within 2 days after surgery,and the difference was statistically signif-icant(P<0.05).Conclusion The application of antibiotics should be strictly applied to the application of the indications for the use of anti-biotics.To understand the scope of application of antimicrobial drugs,and should try to shorten the use of time,control of infection during peri-operative period,reduce drug resistance.
ABSTRACT
Objective To explore the clinical effect of radio-frequency ablation in the treatment of advanced pancreatic cancer.Methods Retrospectively analyzed the clinical data of 28 cases of radio-frequency ablation in the treatment of advanced pancreatic cance between January 2008 and December 2012 in 304 hospital.And choosed made 140 cases patients who only underwent the conservative treatment as the control group at the same period.Then compared the data of two groups patients.Results The mean tumor diameter was (4.8 ± 1.6) cm.The average radio-frequency time was (17.7 ± 4.3) minutes.There was no patient occurred of pancreatic fistula or postoperative bleeding,and no patient dead.Peri-operation pain relief rate was 88.9％.Twenty-three patients were followed up,and the follow up rate was 82.1％.The patients' survival rate who underwent radio-frequency ablation of 1 month,6 months and 1 year were 95.7％,65.2％ and 38.2％.The average survival time was (14.6 ± 2.2) months.And the data was significantly higher than that of the control group patients (97.4％,45.3％,19.1％,P =0.0306).Conclusions The radio-frequency ablation was one of an effective treatment method for the advanced pancreatic cancer patients.It can prolong the survival time of pancreatic cancer patients and alleviate the patient's pain.
ABSTRACT
Objective To assess Bard3DMax Mesh pre-formed Knitted Polypropylene tension free hernia repair under local anesthesia. Methods Bard 3DMax Mesh was used for inguinal hernia repair in 30 cases under local anesthesia at our department. Results Hernia was successfully repaired in all cases using Bard 3DMax Mesh from the myopectineal orifice through anterior approach under local anesthesia.The mean operation time was (63.1 ± 2.6) min.All cases were able to drink and eat immediately after surgery,there was no postoperative urinary retention.Postoperative pain-free or mild pain was reported in 23 cases,moderate pain in 6,severe pain in only one.Wound healed by first intention in all 30 cases.Two cases suffered from subcutaneous ecchymosis,a seroma above the patch was observed in 2 cases.A inner thigh numb was complained in one case,which subsided 4 months later.Three patients complained below groin area foreign body sensation which disappeared after 1 -5 months. All patients recovered well without recurrence at a mean follow-up of ( 11 ± 7) months. Conclusions Bard 3DMax Mesh tension free inguinal hernia repairing the myopectineal orifice through anterior approach under local anesthesia is safe,and less traumatic.It also helps establish intraoperative diagnosis of combined and occult hernia.
ABSTRACT
To report our experience with the use of Proceed[TM], Ethicon, Norderstedt, Germany surgical mesh in the management of large abdominal wall defects with the open intra-peritonium onlay method. Thirty-six patients with large incisional hernia or defects resulting from tumor resection carried out at the Department of General Surgery, the First Affiliated Hospital, General Hospital of People's Liberation Army, China between May 2007 and June 2010 were studied. The abdominal wall defect was repaired using Proceed[TM] mesh with the intra-peritonium onlay method. Different parameters were evaluated considering the complications such as seroma, hematoma, wound infection, mesh infection, chronic pain, wound sinus, and recurrences. All 36 defects were repaired using Proceed[TM] mesh. The mean size of the defects was 160 cm2 [range = 120-600 cm[2]]. Eleven patients [30.6%] developed a complication [6 seromas, one minor wound infection, one wound sinus, 2 pulmonary infection, and one urinary tract infection]. The mean follow-up period was 28 months [range 6-36 months]. There were no cases of intestinal fistula or problems related to intestinal adhesion and chronic wound pain. No hernia recurrence, or mesh infection occurred. The intra-peritoneum repair technique for a large abdominal wall defect using Proceed[TM] mesh is a feasible and safe method, with no major complications
Subject(s)
Humans , Male , Female , Hernia, Abdominal/surgery , Treatment Outcome , Postoperative ComplicationsABSTRACT
Objective To evaluate the methods and outcome of laparoscopic degradable bio-patch repair of umbilical hernia in adults. Methods From January 2003 to October 2008, 21 adult patients underwent elective laparoscopic patch repair of umbilical hernia. There were 15 women and 6 men. The mean age was 56 years old (range of 36-73). The diameter of hernia ring was from 3 to 7.5 cm averaging at 5.2 cm. All patients received general anesthesia. Preoperative bowel preparation routinely started one day before the operation. The patients received prophylaxis systemic antibiotics 30 minutes before the operation. An appropriate size of prosthetic patch (Composix E/X, Bard, USA) was that extended the defect margin for about 3-5 cm. The mesh was then inserted into the peritoneal cavity and spreaded flattening, with the polyplypylene side facing outside and it's center coinciding with that of the defect. The mesh was fixed to the abdominal wall with staple tacks in two rings, which was 3-5 cm along the hernia ring and 1-2 cm along the edge of the mesh. Results There was no conversion to open repair. The operative time was 30 to 96 rain and the average was 52 min. Two patients suffered from a transient postoperative tympanites and which subsided 2 to 3 days after the operation. One patient had a severe pain in the repair area around the umbilical and underwent oral medicine treatment, which disappeared one week after operation. There was no seroma and incision or mesh infection occurred. The postoperative hospital stay was 3 to 8 days and the average was 4. 2 days. The follow-up time was 3 months to 5 years and the average was 32 months. No ileus or hernia recurrence during the follow-up. Conclusion Laparoscopic patch repair of umbilical hernia in adults is a safe and effective procedure.
ABSTRACT
Objective To evaluate the effects of anterior approach preperitoneal repair for inguinal hernia with modified Kugel mesh.Methods Clinical data of 35 cases receiving inguinal hernia repair with modified Kugel mesh from May 2004 to June 2006 were reviewed.The critical surgical procedures:the hernial sac was dissected at high position,then reversed and reduced into abdominal cavity;a 10 cm?10 cm preperitoneal space was dissociated around the internal ring,into which a modified Kugel mesh was placed.The mesh was fixed to the conjoined tendon by superior tape,and to the shelving edge of inguinal ligament by inferior tape.Results The operation time was(47?10)min.No analgesic requirement in any case.The postoperative hospital stay was(6?4)days.All the wounds healed uneventfully without any seroma or infection.No recurrent case was found in the follow-up of 1-25 months(mean:13.2 months)in the 35 cases.Conclusions Modified Kugel mesh used in inguinal herniorrhaphy causes less pain and swelling response to the wound,therefore it is quite suitable for repairing Ⅲ and Ⅳ type hernia.
ABSTRACT
Objective To investigate the correlation between the expression of erythropoietin receptor (EPO-R) and the microvessel density (MVD) in gastric carcinoma tissues. Methods Expression of EPO-R and microvessel density of 50 primary gastric adenocarcinoma specimens were investigated by immunohistochemical methods using antibody to EPO-R and CD31. Results In gastric adenocarcinoma, the level of MVD was significantly increased, compared with normal issues(25?13 vs. 12?4,P