RESUMEN
【Objective】 To analyze the composition of urinary calculi in Longnan, Gansu province, and the relationship between the composition and clinical characteristics of patients, so as to provide reference for the prevention and treatment of this disease. 【Methods】 The composition of 500 cases of urinary calculi hospitalized in our department during Apr. 2021 and Feb.2023 were analyzed using the infrared spectrum stone composition analyzer. The clinical characteristics of the patients were evaluated and analyzed. 【Results】 The male-to-female ration of patients was 2.70∶1. Most patients aged 21 to 60 years (437, 87.4%). Most cases were ureteral calculi (72.8%), followed by renal calculi (22.2%), and bladder calculi (5.0%). There were 166 cases of calcium oxalate calculi, 293 cases of calcium oxalate + carbonated apatite calculi, 24 cases of calcium oxalate + carbonated apatite + hydroxyl apatite calculi, 4 cases of calcium oxalate + calcium bicarbonate calculi, 7 cases of urate calculi, 6 cases of carbonated apatite + struvite calculi. Oxalate calculi were the most common in all age groups, and urate calculi were the most common in the 21 to 40 age group. Calcium oxalate calculi were most common in the ureter (127, 76.5%), significantly higher than in other sites (χ2=3.222, P=0.020). Calcium oxalate + calcium hydrogen phosphate calculi was the least common in the bladder, significantly different from the other parts (χ2=2.092, P=0.037). Magnesium ammonium phosphate hexahydrate and/or calcium carbonate or calcium oxalate calculi were the most common in the kidney (50.0%), significantly different from the other parts (χ2=9.448, P=0.007). 【Conclusion】 In Longnan area, the incidence of urinary calculi is significantly higher in male than in female. Ureteral calculi are mainly composed of calcium oxalate + carbonated apatite and calcium oxalate. According to different risk factors, individual prevention programs should be developed.
RESUMEN
Objective To investigate the clinical feasibility and value of transumbilical single-port laparoscopic cholecystectomy with intra-operative ultrasonic knife for directly handling the cystic artery.Methods A retrospective analysis was performed on the clinical data of 23 1 patients who underwent laparoscopic cholecystectomy with intraoperative ultrasonic knife for directly handling the cystic artery in our depart-ment from March 201 1 to December 2012.According to the required surgical approaches,the patients were divided into transumbilical single-port laparoscopic group (n=125,group A)and three-port laparoscopic group (n=106,group B).The two groups were compared in terms of operative time,intraoperative blood loss,postoperative analgesia,postoperative food intake,length of postoperative hospital stay, and postoperative complications,as well as the performance of the ultrasonic knife in directly handling the cystic artery.Comparison of con-tinuous data between groups was made by t test,while comparison of categorical data was made by chi-square test.Results Group A had a significantly longer mean operative time than group B (20.21 ±1.86 min vs 18.43 ±1.37 min,P0.05).Group A had sig-nificantly fewer patients who needed postoperative analgesia than group B (5 vs 21,P0.05).The mean length of postoperative hospital stay was (2.98 ±0.23)d in group A,versus (3.02 ±0.18)d in group B (P>0.05).No indwelling drainage tube was used after opera-tion in either group.There were no postoperative bleeding,bile duct injury,bile leakage,incisional wound infection,and other complica-tions in the two groups.The ultrasonic knife had reliable hemostatic effect when directly sealing the cystic artery,without causing postopera-tive secondary bleeding.All patients were followed up for 2-12 months (mean,6.5 months);they recovered well without incisional herni-a,and the umbilical scar was not obvious,with relatively good cosmetic results.Conclusion Transumbilical single -port laparoscopic cholecystectomy has a comparable clinical effect to three-port laparoscopic cholecystectomy,causing little trauma,postoperative pain,and scar,and it is suitable for patients with a high demand for incision appearance.Directly sealing the cystic artery with the ultrasonic knife can reduce bleeding due to careful separation of the cystic artery and shorten the operative time.Therefore,it is a safe,feasible surgical ap-proach and worthy of clinical application.