Effects of total laparoscopic thyroid subtotal resection on intraoperative incision length and postoperative serum Tg and VEGF levels in patients with early differentiated thyroid carcinoma / 实用医学杂志

Objective To investigate the effect of total laparoscopic thyroid subtotal resection in early differentiation thyroid carcinoma. Methods Seventy-two patients with early differentiated thyroid cancer from November 2013 to September 2016 weredivided into groups according to the random number table methods,with 36 cases in each group.Control group was treated with open thyroidectomy,and study group total laparoscopic thyroid subtotal resection.Patients′condition at the first day after operation,the level changes of serum VEGF and Tg levels at the first day at admission and after operation and aesthetic effect of operation were compared between 2 groups. Results There were shorter incision length,lower pain score and less intraoperative blood loss in study group when compared with those in control group,and the operation time was shorter than that in control group(P<0.05).The number of lymph node dissection in study group was not significantly different from that in control group(P>0.05). The levels of serum VEGF and Tg in 2 groups were lower than those before the operation,and the levels of all indexes in study group were lower than those in control group(P < 0.05). The total satisfaction of aesthetic effect (97.22%)in study group was higher than that of control group(75.00%)(P < 0.05). Conclusions Total endoscopic thyroid subtotal resection is effective for the treatment of early differentiation of thyroid cancer with small incisionand less postoperative pain. It can effectively reduce serum Tg and VEGF levels and improve the surgical aesthetic satisfaction.

Effect of Nalbuphin Dosage and Incision Length of Abdominal Wall on Return of Bowel Function after Colectomy

PURPOSE: Nalbuphin has definitive advantages over the more commonly used narcotic analgesic:a ceiling respiratory depression, little effect on the cardiovascular system and a lower incidence of nausea and vomiting. The use of a small incision results in early return of bowel function and shortening of hospital stay. Narcotic use has been felt to be proportional to the length of the abdominal incision. The aim of this study was to determine whether return of bowel function after colectomy in the postoperative period and incision length were directly proportional to the narcotics. METHODS: 38 patients undergoing colon and rectal resection for benign and malignant colorectal disease between July 2000 and April 2001 participated in this study. Nalbuphin and ketorolac was administered continually by patient controlled analgesia for 48 hours. Additional nalbuphin was used for further pain control. Patients were followed for return of bowel function as measured by first audible bowel sounds, first passage of flatus and first defecation. RESULTS: There was a significant correlation between the amount of total nalbuphin administered and return of bowel function as measured by bowel sound (r=0.89; P=0.01), time to first passage of flatus (r=0.76; P=0.01), and time to first defecation (r=0.58; P=0.05). Incision length did not show any correlation with either nalbuphin use or return of bowel function. CONCLUSIONS: There is no apparent benefit for lesser incision length. Return of bowel function is influenced by use of postoperative nalbuphin. So adequate sized abdominal incision is needed and lesser use of narcotics is more beneficial for the return of bowel function.

Astigmatic Changes According to Incision Length After Sutureless Cataract Surgery

We analyzed an astigmatism and an uncorrected visual acuity in 235 eyes for 6 months following sutureless cataract surgery(167 eyes) with 5 mm(Group 1), 6 mm(Group 2), and 7 mm(Group 3) incision lengths at 2.5 mm posteriorly from the corneoscleral limbus, and shoelace sutured cataract surgery(68 eyes) with 7 mm(Group 4) incision length at 1 mm posteriorly from the corneoscleral limbus performed by one surgeon. In three groups of sutureless cataract surgery, the surgically induced corneal astigmatisms were stable after one month postoperatively, but decreasing the length of incision substantially reduced the astigmatic changes(p>0.05), the astigmatic swings(p>0.05) and the astigmatic ranges. In comparison to sutured cataract surgery with 7 mm incision length, sutureless cataract surgery with same incision length reduced the astigmatic changes(p0.05) was noted. In comparison to sutured catarct surgery with 7 mm incision length, suture less cataract surgery with same incision length had higher incidence of an uncorrected visual acuities of 20/40 or better(p0.05) and a better uncorrected visual acuity(p>0.05). And sutureless cataract surgery rather than sutured cataract surgery was associated with a lower surgically induced astigmatism(p<0.01), an earlier stability, and a better uncorrected visual acuity(p<0.01).

Myopic Correction in Radial Keratotomy According to the Size of Central Optical Zone and Incision Length

We performed eight radial line cuts in anterior radial keratotomy(RK) employing the Russian style and the American style incisions on 103 eyes from August/ 1989 to March/ 1990. To analyze the results of myopic correction according to the size of the central optical zone and the incision length in RK, we chose the central optical zone size according to the degree of myopia (4.0 mm from -1.50D to -2.75D, 3.5mm from -30D to -3.75D and 3.0mm above -4.0D) and measured the length of each of the eight radial incisions of the cornea. The results were as follows: 1. In determining the average length of each corneal incision in RK, the longest was the superior and superior-nasal incision and the shortest was the temporal and inferior-temporal incision, regardless of the central optical zone size. 2. The total length of each of the eight incisions in each eye ranged from the longest at 3.0mm of central optical zone and the shortest at 4.0mm of central optical zone Undoubtedly, total incision length affected clinical results not significantly (p>0.05). 3. Assessing the clinical effect of myopic correction according to the optical zone size, smaller diameter clear zones produce a greater flattening of the cornea than larger ones. 4. The clinical result was not significantly affected by the direction of the incision (p>0.05).