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OBJECTIVE@#To investigate the long-term outcome of laparoscope-assisted transanal total mesorectal excision (taTME) for rectal cancer.@*METHODS@#Clinicopathological data of 29 patients with mid-low rectal cancer undergoing laparoscope-assisted taTME at Department of Gastrointestinal Surgery, the First Affiliated Hospital of Guangzhou Medical University from May 2010 to December 2015 were collected for the retrospective case-series study. All the operations were performed with transabdominal and transanal procedure simultaneously or sequentially. Perioperative presentations, pathological examinations, and oncologic outcomes were retrospectively analyzed. Long-term recurrence, metastasis and survival were assessed during follow-up. Outpatient clinic and telephone survey were used for follow-up. The follow-up time ended in December 2018. The overall survival (OS) rate and disease-free survival (DFS) rate were calculated by the Kaplan-Meier method.@*RESULTS@#The average intra-operative blood loss was (75.9±9.5) ml (range,20 to 200). The average operating time was (223.6±4.1) minutes (range, 165 to 280). The average number of harvested lymph node was 22.3±2.0. The average length of pathological specimen was (13.1±0.6) cm. The average distal resection margin was (2.9±0.2) cm. 89.7% (26/29) of specimens was complete and 10.3% (3/29) near complete. Two cases (6.9%) had positive cutting circumferential margin. Median follow-up was 56 (range, 22 to 91) months. Local recurrence rate, distant metastasis rate, 3-year OS rate, 3-year DFS rate, 5-year OS rate, 5-year DFS rate were 10.3% (3/29), 20.7%(6/29), 96.6%, 83.2%, 87.6% and 79.6%, respectively. No incisional hernia or adhesive intestinal obstruction was found.@*CONCLUSION@#Long-term outcomes of mid-low rectal cancer patients undergoing laparoscope-assisted taTME are satisfactory.
Subject(s)
Humans , Laparoscopes , Neoplasm Recurrence, Local , Rectal Neoplasms , General Surgery , Rectum , Retrospective Studies , Transanal Endoscopic SurgeryABSTRACT
Objective To evaluate the effect of discussion-based teaching pattern in clinical noviciate of general surgery. Methods Two hundred and ten students majoring in clinical medicine were randomly divided into the trial group and the control group during clinical noviciate of general surgery.There were 105 students in each group. The discussion-based teaching pattern and traditional teaching pattern were performed in the trial and control groups,respectively. After the clinical novici-ate of general surgery was completed,the teaching effects of both groups were evaluated by the exam-ination performance analyses and the questionnaire-based survey. Student's t-test andχ22 test were used in statistical analysis. Reults The rate of satisfaction with the teaching pattern was 88.6%in the trial group and 70.5%in control group(P<0.05). The mean scores in the trial group and control group were 80.3±9.2 and 74.5±11.3,respectively (P<0.05). The pass rate of examination in the trial group and control group were 97.1% and 88.6%,respectively (P<0.05). The excellence rate in the examination was 24.8%in the trial group and 12.4%in control group (P<0.05). The overwhelming majority of stu-dents in the trial group thought that the discussion-based teaching pattern had more advantages in im-proving students' learning initiative and enthusiasm,ability to analyze and solve problems,etc.,acord-ing to the questionnaire-based survey. Conclusions Discussion-based teaching is an effective teach-ing pattern and superior to the traditional teaching pattern.
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Objective To determine the feasibility and management of the laparoscopic cholecystectomy (LC)for acute cholecystitis. Methods The clinical data of 106 patients with acute cholecystitis underwent LC were reviewed retrospectively. Results Six cases were converted into laparotomy and LC were successfully performed in other 100 cases. No complications occurred in this series. Conclusions LC is feasible for acute cholecystitis;the skill and experience of the operator is the key to the success of the operation.
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Objective To study the feasibility and effect of scarless endoscopic thyroidectomy(SET) and minimally invasive video-assisted surgery of the thyroid(MIVA) endoscopic technique. Methods SET: Incisions were made on the anterior part of the breast and mareolata,blunt dissection of the subcataneous planes of the neck and chest were administered .MIVA: Incisions were made 3cm above the thymus notch and the operation was video assisted in the thyroid adenoma extripation and subtotal thyroidectomy. The thyroid nodules were extirpated or subtotal thyroidectomy was performed. Results All 10 cases of the SET and 12 cases of the MIVA were successful performed and without complications. Conclusions For thyroid surgery,SET is a good cosmetic operation,MIVA is a minimal trauma and effective operation.