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Objective To observe the clinical efficacy of electroacupuncture plus umbilical moxibustion in treating gastrointestinal dysfunction after gynecological abdominal operation.Method Totally 112 eligible patients undergone gynecological operation were randomized into group A of 37 cases, group B of 38 cases, and group C of 37 cases. Group A was intervened by electroacupuncture, group B was by umbilical moxibustion, while group C was by electroacupuncture plus umbilical moxibustion. After a treatment course, the symptom scores, restored time of bowel sounds, anal exhaust time, motilin (MTL), gastrin (GAS), and vasoactive intestinal peptide (VIP) contents were observed and compared, and the clinical efficacies were compared between the two groups.Result The symptom scores of the three groups were significantly changed after the intervention (P<0.05). After the treatment, the symptom score of group C was significantly different from that of group A and B (P<0.05). The restored time of bowel sounds and anal exhaust time in group C were significantly different from that of group A and B (P<0.05). The MTL, GAS, and VIP contents of the three groups were significantly changed after the intervention (P<0.05). The MTL, GAS, and VIP contents of group C were markedly different from that of group A and B (P<0.05). The total effective rate was 86.5% in group A, versus 81.6% in group B and 97.3% in group C. The total effective rate of group C was significantly different from that of group A and B (P<0.05).Conclusion Electroacupuncture plus umbilical moxibustion is effective in treating gastrointestinal dysfunction after gynecological abdominal operation.
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Background and purpose:Anastomotic leakage and low anterior resection syndrome(LARS) are both common complications in dual-anastomosis for patients with low rectal cancer. The aim of this study was to observe and explore the signiifcance and role of vertical cutting of the closed distal rectum in dual-anastomosis for patients with low rectal cancer.Methods:A total number of 120 patients with mid-low rectal cancer who admitted to and completed laparoscopic rectal cancer resection in the Department of General Surgery, the First Afifliated Hospital of Soochow University from Feb. 2010 to Jun. 2014 were pair-matched into Groups A and B based on their gender,age, tumor size, the distance of lower edge to the dentate line and tumor staging, etc. For the 55 patients in Group A (observation group), the rectum distal end was closed vertically instead of horizontally while disposing “the ifrst intestinal anastomosis”, intestine-intestine anastomosis was conducted in an “end-corner” approach when dealing with “the second intestinal anastomosis”, upper corner (“dog ear”) of the closed line in the distal end of the rectum was removed, the lower corner (“dog ear”) of the closed line in the distal end of the rectum was removed using vascular occlusion clamp method, and the T-shaped interchanges (“dangerous triangle”) of stapled sutures formed after anastomosis were strengthened with absorbable suture. For the 65 patients in Group B (control group), laparoscopic dual anastomosis was conducted using conventional method, and the two “dog-ears” and “dangerous triangles” were kept without any treatment. The clinical outcomes of the two groups of patients were analyzed retrospectively. Results:In group A, It was convenient to complete the operation when the “dog ears” and “dangerous triangle” on the vertical line after cutting the closed distal rectum vertically by “end-corner” anastomosis. The axis of intestine formed a certain angle making the closed distal rectum into “ampulla” sample without “dog ears”. the “dangerous triangle” were strengthened with absorbable suture. In group B, The distal and proximal intestine located on the same axis after intestine-intestine anastomosis leaving two “dog ears” and a “dangerous triangle”. The general clinical data of patients in the two groups were comparable and not signiifcantly different (P>0.05). The two groups of patients showed no signiifcant differences in blood loss, postoperative drainage, postoperative anastomotic bleeding, anal exhaust time, and length of hospital stay (P>0.05). However, the operation time as well as the numbers of anastomotic ifstula occurrence, defecation, tenesmus and post-operation re-ostomy differed significantly (P<0.05).Conclusion:Vertical cutting of the closed distal rectum with dual anastomosis made the “new” intestine closer to the physiological bending and morphology of the rectum, meanwhile, it simpliifed the approach of removing “dog ear” and strengthening “dangerous triangle”, ifnally it signiifcantly reduced the incidence of post-surgical complications.
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Objetivo: describir los resultados posquirúrgicos de la histerectomía vaginal sin prolapso uterino. Materiales y métodos: estudio de cohorte de pacientes, a quienes se les practicó histerectomía vaginal sin prolapso (HSVP) por patología benigna uterina, utilizando la técnica de Heaney modificada y técnicas de morcelamiento uterino en la Clínica Medellín Antioquia, entre septiembre de 2008 y febrero de 2010. Se realizó muestreo secuencial estricto. Se estimó un tamaño de muestra de 84 pacientes. Se midieron las características sociodemográficas, características del útero, diagnóstico preoperatorio, tiempo quirúrgico, comorbilidades, y complicaciones. Resultados: fueron intervenidos 84 pacientes, de los cuales un 8,33% presentaron complicaciones (n: 7/84), el 3,6% de estas, fueron intraoperatorias (2 lesiones vesicales y 1 lesión rectal) y el 4,76% posoperatorias (1 absceso pélvico con dehiscencia secundaria de la herida, 1 sepsis, 2 granulomas del muñón vaginal). También, fueron encontrados 9 casos de infección del tracto urinario (ITU) (10,71%). Conclusión: La HVSP es una técnica quirúrgica que en manos expertas y con instrumental quirúrgico adecuado, surge como alternativa para el manejo de la patología uterina benigna.
Objective: describing the post-surgical results of vaginal hysterectomy (VH) without uterine prolapse. Materials and methods: this was a cohort study of patients who had undergone vaginal hysterectomy withoutprolapse(VHWP) forbenignuterinepathology using a modified Heaney technique and uterine morcellationtechniquesintheClínicaMedellínbetween September 2008 and February 2010. Strict sequential sampling was done. Patient sample size was estimated at 84. Socio-demographic characteristics, uttering characteristics,pre-operationdiagnosis,timeinsurgery, comorbidities and complications were measured. Results: 84 patients were operated on; complications occurred in 8.33% of them (n: 7/84), 3.6% were intra-operation (2 vesical lesions and 1 rectal lesion) and 4.76% were post-operation (1 pelvic abscess with secondary dehiscence of the wound, 1 sepsis, 2 granulomas of the vaginal cuff). There were 9 cases of urinary tract infection (UTI) (10.71%). Conclusion: VHWP emerges as an alternative for surgical treatment of benign uterine diseases when performed by expert hands and with the appropriate surgical instrumentals.
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Humans , Female , Adult , Hysterectomy, Vaginal , Intraoperative Complications , Postoperative Complications , Uterine ProlapseABSTRACT
Objective:To explore the etiology and prevention of common post-prostatectomy complications,including hemorrhage,wound infection,bladder detrusor muscle instability,incontinence and bladder neck contractures.Methods:The advanced prostatectomy techniques were performed on 114 BPH patients,including the deep 8-shaped suture of prostatic vessels,packet-shaped suture and slinging of bladder neck,a deep and wide V-shaped piece of tissue resected from the heightened posterior part of the bladder neck to avoid tear of the external urethral sphincter during operation period.A#22F three-way Foley urethral catheter for drainage and traction.A multiple hole rubber drain catheter was placed in retropubis,and was implanted 0.125% bupicarine was transfused into epidural continuously by patient controled epidural analgesia (PCEA) post-operatively.Results:Complication rate of patients treated with the above method decreased obviously( P