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Objective To explore the clinical effects of laparoscopic combined with open mesh repair for abdominal wall incisional hernia.Methods The retrospective cross-sectional study was conducted.The clinical data of 41 patients with abdominal incisional hernia who were admitted to the Fujian Medical University Union Hospital between September 2011 and June 2017 were collected.All the patients underwent laparoscopic combined with open mesh repair,with the sequence from laparoscopic surgery to open surgery and then to laparoscopic surgery.Observation indicators:(1) intra-and post-operative situations;(2) follow-up situation.Follow-up using outpatient examination and telephone interview was performed to detect postoperative long-term complications and hernia recurrence up to November 2017.Measurement data with normal distribution were represented as (x)±s.Results (1) Intra-and post-operative situations:forty-one patients underwent successful laparoscopic combined with open mesh repair for abdominal wall incisional hernia.Diameter of hernia ring and defect area of abdominal wall were respectively (10±3)cm and (75±34)cm2.Among 41 patients,25 underwent laparoscopic combined with open mesh repair due to tight intestinal adhesion induced difficult laparoscopic separation;16 underwent laparoscopic combined with open mesh repair due to the larger diameter of the hernia ring induced difficulty of closing hernia ring under laparoscope.Operation time,cases with indwelling drainage-tube,time of drainage-tube removal and duration of postoperative hospital stay were respectively (188±71)minutes,33,(14±3)days and (4.5±2.6)days.Of 41 patients,2 with postoperative incomplete intestinal obstruction were cured by symptomatic treatment;2 with incisional infection were cured by antibiotic therapy,irrigation and dressing change.(2) Follow-up situation:41 patients were followed up for (29±17)months.The postoperative chronic pain of 2 patients was occasional and cannot affect the normal life.There was no occurrence of seroma,mesh infection,intestinal fistula,abdominal compartment syndrome and hernia recurrence during the follow-up.Conclusion The laparoscopic combined with open mesh repair has a better clinical effect for patients of incisional hernia with large hernia ring and tight intestinal adhesion,and surgical methods should be chosen seriously according to the condition of the patients in clinical application.
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In the aviculture industry, the use of Lactobacillus spp. as a probiotic has been shown to be frequent and satisfactory, both in improving bird production indexes and in protecting intestine against colonization by pathogenic bacteria. Adhesion is an important characteristic in selecting Lactobacillus probiotic strains since it impedes its immediate elimination to enable its beneficial action in the host. This study aimed to isolate, identify and characterize the in vitro and in vivo adhesion of Lactobacillus strains isolated from birds. The Lactobacillus spp. was identified by PCR and sequencing and the strains and its adhesion evaluated in vitro via BMM cell matrix and in vivo by inoculation in one-day-old birds. Duodenum, jejunum, ileum and cecum were collected one, four, 12 and 24 h after inoculation. The findings demonstrate greater adhesion of strains in the cecum and an important correlation between in vitro and in vivo results. It was concluded that BMM utilization represents an important technique for triage of Lactobacillus for subsequent in vivo evaluation, which was shown to be efficient in identifying bacterial adhesion to the enteric tract.
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Animals , Bacterial Adhesion , Lactobacillus/isolation & purification , Lactobacillus/physiology , Poultry/microbiology , DNA, Bacterial/chemistry , DNA, Bacterial/genetics , Intestinal Mucosa/microbiology , Lactobacillus/classification , Lactobacillus/genetics , Polymerase Chain Reaction , Sequence Analysis, DNAABSTRACT
OBJECTIVE: To comprehensively evaluate bioadhesive properties these materials by testing adhesion properties in vitro and in vivo. METHODS: Mucin from porcine stomach model, homemade adhesion measuring device and intestinal propulsion were used for in vitro and in vivo evaluation adhesive materials. RESULTS: Carbomer 934P and HPMCK100M with high viscosity had optimal adhesion in their class, besides chitosan can be specifically bound by mucin from porcine stomach and it performed better than other materials in vivo adhesion. CONCLUSION: Above researches indicate that the bioadhesive properties had a positive correlation with viscosity in the same type material, and the relative molecular mass the materials, moisture absorption capacity, specific binding mucin and other factors should be considered in different types materials in the comprehensive evaluation.
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Objective To investigate the clinical efficacy of fluoroscopy-guided intestinal adhesion lysis, as a new non-surgical method, in treating incomplete adhesive small intestinal obstruction in order to improve the therapeutic results of adhesive intestinal obstruction. Methods A total of 93 patients with incomplete adhesive small intestinal obstruction were enrolled in this study. The patients were divided into study group (n=49) and control group (n=44). Fluoroscopy-guided intestinal adhesion lysis together with restoration of inter-intestinal loop enterocele was carried out for the patients of the study group , while traditional conservative surgical therapy was employed for the patients of the control group. The study group was comparable with the control group in patients’ age, gender, medical history, disease course, X-ray findings, etc. Results Of the 49 cases in the study group, complete cure was obtained in 40 with a cure rate of 81.6%. The mean hospitalization day was 0.3 day, and the average operation time was 3.25 hours. Among the 44 patients in the control group, complete cure was obtained in 37 with a cure rate of 84.1%. The mean hospitalization day was 7.6 days, and the average therapeutic time was 183.26 hours. Conclusion For the treatment of incomplete adhesive small intestinal obstruction , the therapeutic efficacy of fluoroscopy-guided intestinal adhesion lysis together with restoration of inter-intestinal loop enterocele is better than that of traditional conservative surgical therapy.
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Objective To investigate the preventive effect of nano-powder of Wugong-sanqi (NW),the rhizome of Anemone flaccid,on postoperative intestinal adhesion in rats.Methods Fifty SD rats were subjected to operation with Ellis' method for establishing intestinal adhesion models,then randomly divided into 5 groups (n=10),namely model,positive (Dexamethasone,i.m.10 mg/kg),NW high,medium and low dose group (p.o.450,225 and 112 mg/kg,respectively).Another ten normal rats were selected as normal control group.After administration 3 days pre-operation and 7 days post-operation,all of rats were killed,the intestinal adhesion was graded and the tissues were observed by optical microscope.Results NW evidently reduced the severity of postoperative adhesion (P＜0.05 or P＜0.01),compared with model group.The histopathologic changes such as proliferation of fibroblast cells and capillary,interstitial granulomas and inflammatory cells infiltration in intestinal tissues were also improved significantly in NW groups.Conclusion NW could inhibit the formation of postoperative intestinal adhesion effectively.
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OBJECTIVE: To study the preventive and therapeutic effect of Weitong injection(WTI) on the postoperative intestinal adhesion of rats.METHODS: Forty SD rats were randomly divided into five groups: blank control group,model control group,Dexamethasone group and high-dose WTI group and low-dose WTI group.Postoperative intestinal adhesion model was established in all the rats except those in the blank control group.On the operative day,the blank control group and the model control group received Normal saline(1 mL?kg-1);the Dexamethasone group received Dexamethasone(5 mg?kg-1),and WTI group received WTI(4 mg?kg-1 and 2 mg?kg-1,respectively) all via vena caudalis for 7 consecutive days.On day 8,laparotomy was performed on the rats for the evaluation of the degree of intestinal adhesion and the tissue of cecum was collected for the determination of the content of hydroxyproline(Hyp) and the pathological section test.RESULTS: The degree of postoperative intestinal adhesion of rats was attenuated by WTI(either high dose or low dose) or Dexamethasone.Furthermore,WTI significantly reduced the Hyp concentration in cecum tissue of rats with intestinal adhesion(P
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Objective To compare the clinical efficiency between laparoscopic enterodialysis and open enterodialysis. Methods Clinical data of 25 cases of adhesive intestinal obstruction treated by laparoscopic enterodialysis (Laparoscopic Group) from December 1999 to December 2002 were retrospectively reviewed and compared with clinical records of 23 cases receiving open enterodialysis (Open Group) in the same period. The operating time, intra-operative blood loss, incidence of complications, postoperative recovery time of bowel movement and length of hospital stay of the two groups were compared, respectively. Results In the Laparoscopic Group operation was successfully accomplished in 23 cases while a conversion to open surgery was required in 2 cases. Of the Laparoscopic Group and the Open Group, the operation time was (58.3?8.1) min and (84.0?7.5) min (t=11.383, P=0.000), respectively; the intra-operative blood loss was (31.4?5.1) ml and (192.6?26.4) ml (t=29.995, P=0.000), respectively; the postoperative hospital stay was (4.1?1.4) days and (9.7?2.0) days (t=11.413, P=0.000), respectively; the postoperative recovery time of bowel function was (19.6?2.2) hours and (49.0?8.8) hours (t=16.207, P=0.000), respectively and the postoperative complications were seen in 1 case and 9 cases (?2=6.960, P=0.008), respectively. Conclusions Compared with open enterodialysis, laparoscopic enterodialysis has advantages of short operation time, less blood loss, rapid recovery and fewer complications.
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Objective: To compare the effectiveness of chitosan and sodium hyalurate in preventing intestinal adhesion. Methods: Forty five SD rats were randomly divided into A, B and C groups. During operation, chitosan, sodium hyalurate or normal saline was applied on injured part of ileum respectively. Biopsy was taken on the 14th postoperative day. Results: The severity of adhesion in group A and B were significantly lower than in group C( P
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Ectopic pancreas is defined as pancreatic tissue lacking anatomical and vascular continuity with the main body of the pancreas. Common symptoms are epigastric pain, hemorrhage, chest pain, weight loss, nausea and vomiting. A 2-month-old male patient was hospitalized because of continuous bile stained vomiting for 2 days. Abdominal ultrasonography and colon study showed malrotation of the intestine. Surgical exploration revealed the ectopic pancreas on the 10cm lower portion of Treitz ligament and rotation of terminal ileum. We performed adhesiolysis, small bowel resection and anastomosis. The diagnosis of ectopic pancreas was made by histologic examination. We report a case of ectopic pancreas with intestinal adhesion and malrotation with brief review of related literatures.
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Humans , Infant , Male , Bile , Chest Pain , Colon , Diagnosis , Hemorrhage , Ileum , Intestines , Ligaments , Nausea , Pancreas , Ultrasonography , Vomiting , Weight LossABSTRACT
OBJECTIVE: To observe the preventive mechanism of Changtong oral liquid on postoperative intestinal adhesion .METHODS: The intestinal adhesion model was established by traumatizing cecal scrosa and ligating adjacent abdominal wall/The effect of Changlong oral liquid on the expression of TGF-?1 was examined by immunohistochemical method.RESULTS & CONCLUSION:Changtong oral liquid can decrease the expression of TGF - ?1 of rats with adhesion .Maybe it is one of the mechanism that Changtong oral liquid can prevent postoperative intestinal adhesion.
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Objective To observe the effect of Changtong Oral Liquid (CTOL) on serum TNF-? and IL-4 levels in rats with postoperative intestinal adhesion. Methods Sprague-Dawley (SD) male rats were randomly divided into six groups: normal control, no treatment control, Simo Oral Liquid (SOL) group, and CTOL group (minimal, medium and maximal dosages). Except for normal control group, intestinal adhesions were produced in all the other rats with the method of Ellis. The blood samples of rats with CTOL medium dosage and no treatment group were collected on the 1st, 3rd, 5th, 7th and 9th day, and that of the rest was drawn on day 7 after surgery for the determination of TNF-? and IL-4 levels. Results The serum TNF-? levels were higher in no treatment rats compared with the normal controls (P0.05). Conclusions TNF-? was closely related to adhesion formation, and it may be regarded as a marker of adhesion formation.