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【Objective】 To compare the clinical efficacy of pneumovesic and open laparoscopic ureteral replantation in the treatment of primary vesicoureteral reflux, and to summarize the characteristics of pneumovesic surgery. 【Methods】 A total of 70 children with vesicoureteral reflux treated at our hospital during 2016 and 2021 were divided into pneumovesic group and open group, with 35 children in either group. The pneumovesic group underwent laparoscopic Cohen’s ureteral replantation, and the open group underwent open Cohen’s ureteral replantation. The operation-related data of the two groups were compared. 【Results】 Compared with the open group, the pneumovesic group had smaller incision size (1.5 cm vs. 4.0 cm), less intraoperative blood loss (2.0 mL vs.10.0 mL), longer operation time [(185.3±54.2)min vs. (150.5±45.5)min], shorter postoperative hematuria time [(4.7±2.1 d) vs. (6.0±1.3 d)], shorter urinary catheter indwelling time [(11.9±4.0) d vs. (14.1±3.8) d], lower FLACC pain score [(d1: 2.5±0.7, d3: 1.5±0.6) vs. (d1: 5.3±0.9, d3: 2.9±0.6)], lower incidence of frequent and urgent urination (3% vs. 17% ), and higher postoperative incision satisfaction (100% vs. 89%). There was no recurrence in either group. 【Conclusion】 The curative effects were significant in both groups. Compared with open surgery, pneumovesic laparoscopic ureteral replantation for the treatment of primary vesicoureteral reflux has the advantages of small trauma, beautiful appearance, quick recovery and little influence on bladder function.
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Objective To investigate the effect of the laparotomy and laparoscopic surgery on the stress parameters and complication of patients with gastric cancer. Methods A total of 96 patients diagnosed as gastric cancer and treated by surgery in our hospital from January 2015 to January 2017 were divided into open operation group and laparoscopy group according to the operation method,48 cases in each group. Compared the operation time,bleeding volume,dissected lymph node number,postoperative hospitalization duration and anus exhausting time and complications in 6 months after surgery. The levels of WBC,CRP,TNF-α, IL-6 in serum before and after operation were detected by enzyme - linked immuno sorbent assay and compared. Results Compared with the open operation group, the bleeding volume,postoperative hospitalization duration and anus exhausting time of laparoscopy group were better with less dissected lymph node number and longer operation time, the differences were extremely significant(P ＜ 0. 01); the WBC,CRP,TNF-α, IL-6 levels of laparoscopy group at 1 day after the operation were lower than those of open operation group(P ＜ 0. 05). The incidence of complication of laparoscopy group was 22. 8％, which was less than 54. 7％ of control group, the difference was significant(P ＜ 0. 05). Conclusion Compared with the traditional open operation, laparoscopic radical gastrectomy can shorten the hospital stays and reduce the intraoperative blood loss, the stress response and complication rate after operation.
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Objective To explore the influence of perioperative nursing for interventional open operation of patients with symptomatic internal carotid artery occlusion under the guidance of the Joint Commission International(JCI) concept. Methods The clinical data of 90 patients with symptomatic internal carotid artery occlusion treated by elective interventional open operation from January 2016 to February 2018 were retrospectively analyzed, of which 40 patients receiving routine nursing from January 2016 to January 2017 were set as control group, of which 50 patients receiving nursing guided by JCI concept from February 2017 to February 2018 were set as observation group. The Hamilton Depression Scale (HAMD) was used to evaluate the anxiety of patients at preoperative 1 h and postoperative 48 h, and the extubation time and hospitalization time were compared, as well as the incidence of complications and the patient's coordination degree. Results The HAMD scores of preoperative 1 h and postoperative 48 h of the observation group respectively was (26.58 ± 5.79) and (17.41 ± 4.18) points, of which the control group respectively was (29.75 ± 5.21) points and (22.26 ± 4.64) points, and the HAMD scores between the postoperative 48 h and preoperative 1 h in the 2 groups were statistically significant differences (t=9.080, 6.790, all P < 0.01), of which between the 2 groups were statistically significant differences (t=2.697, 5.208, all P < 0.01). The extubation time and hospitalization time of the observation group respectively was (3.81 ± 0.62) and (12.97 ± 3.65) d, of which the control group respectively was (4.39 ± 0.71) and (16.18±3.54) d, with statistically significant differences (t=4.134, 4.201, all P<0.01). The total incidence rate of complications of the observation group was 18.00％(9/50), of which the control group was 40.00％(16/40), with statistically significant differences (χ2=5.361, P<0.05). The good rate of coordination of the observation group was 76.00％(38/50), of which the control group was 55.00％(22/40), with statistically significant differences (χ2=4.410, P < 0.05). Conclusions The perioperative nursing based on the JCI concept guidance can relieve the anxiety of patients with symptomatic internal carotid artery occlusion treated by elective interventional open operation, shorten the postoperative recovery time, reduce the incidence of complications and improve the nursing coordination.
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Objective To compare the influence degree of laparoscopic operation and open operation on peripheral blood T lymphocyte subsets and Th1Th2 in patients with severe acute pancreatitis.Methods 54 patients who underwent surgical treatment in our hospital from February 2013 to December 2014 were selected as the subjects, 27 patients with severe acute pancreatitis who were treated with open operation as group A , 27 cases who were treated with laparoscopic operation at the same time were selected as group B , and then the peripheral blood T lymphocyte subsets and serum Th1Th2 indexes of two groups before the operation and at first,third and seventh day after the operation were respectively detected, then the detection results of two groups were compared.Results The peripheral blood T lymphocyte subsets and serum Th1Th2 indexes of group B at first, third and seventh day after the operation were all significantly better than those of group A , the difference was statistically significant ( P<0.05 ) , and the detection results of group A and group B at third day after the operation were worse than those at other time , the difference was statistically significant (P<0.05).Conclusion The influence of laparoscopic operation and open operation on T lymphocyte subsets and Th1Th2 in peripheral blood of patients with severe acute pancreatitis, the adverse effects of laparoscopic operation on the above indicators were relatively small.
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Objective To compare the clinical effectiveness between the channel-assisted mini-invasion and open Achilles shortening for treatment of the elongated Achilles tendon following previous rupture.Methods The clinical data of 19 patients admitted from Dec. 2013 to Dec. 2015 and met the inclusion criteria were analyzed retrospectively. Eight patients were treated with shortening operation by channel-assisted minimally invasive repair system, while 11 patients received dissection of Krackow Achilles tendon shortening. There was no significant difference between the two groups in gender, age, injury to operation time, preoperative calf circumference and preoperative AOFAS (American Orthopaedic Foot & Ankle Society) score (P>0.05).Results The operation time, incision length and postoperative hospital days were significantly less in min-invasion group than in incision group (P0.05).ConclusionChannel-assisted minimally invasive Achilles tendon shortening operation has not only similar effectiveness to the incision shorting operation for the treatment of elongated Achilles tendon following previous rupture, but also has the advantages of shortening operation time and stay in hospital and avoidance of sural nerve injury.
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Objective To investigate the effectiveness and safety of laparoscopic and open radi cal resection of right colon cancer.Methods The clinical data of 81 cases of colon cancer were analyized retrospectively.According to the different surgical methods,all patients were divided into laparoscopic surgery group (n =39) and open surgery group (n =42).Perioperative conditions,postoperative complications and short-term prognosis were compared between these two groups.Results There was significant difference in the length of incision (5.2 ± 1.1) cm,bleeding volume (89.4 ± 30.6) ml as well as the time of exsufflation(4.2 ± 1.5) d and hospitalization after operation(11.8 ± 1.5) d(P ＜ 0.05).There was no remarkable difference in the time of extubation,total number of lymph node dissection,operative time,cost of hospitalization,incidence of postoperative complications,the rate of survival and recurrence in 1 year(P ＞ 0.05).Conclusion There was no significant difference in short-term prognosis between these two groups.laparoscopic radical resection of right colon cancer deserve to be popularized by means of enhance recovery after surgery.
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Objective To investigate the effectiveness and safety of laparoscopic and open radi cal resection of right colon cancer.Methods The clinical data of 81 cases of colon cancer were analyized retrospectively.According to the different surgical methods,all patients were divided into laparoscopic surgery group (n =39) and open surgery group (n =42).Perioperative conditions,postoperative complications and short-term prognosis were compared between these two groups.Results There was significant difference in the length of incision (5.2 ± 1.1) cm,bleeding volume (89.4 ± 30.6) ml as well as the time of exsufflation(4.2 ± 1.5) d and hospitalization after operation(11.8 ± 1.5) d(P ＜ 0.05).There was no remarkable difference in the time of extubation,total number of lymph node dissection,operative time,cost of hospitalization,incidence of postoperative complications,the rate of survival and recurrence in 1 year(P ＞ 0.05).Conclusion There was no significant difference in short-term prognosis between these two groups.laparoscopic radical resection of right colon cancer deserve to be popularized by means of enhance recovery after surgery.
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Objective To investigate the characteristics of lymph node metastasis in T 1 stage of lung cancer and the curative effects of minimally invasive surgery and open surgery .Methods Totally 120 cases of T1 stage of lung cancer were divided into two groups ,68 cases in the minimally invasive surgery group and 52 cases in the open surgery group ,the number of lymph node me‐tastasis in the patients with lung cancer in T 1 stage were studied ,the perioperative related indicators for different tumor size were compared between the two different surgical methods .Results All patients were successfully completed the operation without op‐erative death case .The two groups had no significant difference in the aspects of operation time ,intraoperative bleeding volume and number of lymph node dissection .The lymph node metastasis rates in the maximum tumor diameter ≤1 .0 ,1 .0 -3 .0 cm were 1 .3% and 9 .7% respectively .N1 ,N2 squamous cancer of the maximal tumor diameter ≤1 .0 cm had no metastasis .The periopera‐tive related clinical indicators in the maximal tumor diameter ≤1 .0 cm had significant differences between the two kinds of opera‐tion method(P1 .0 cm have little difference in minimally invasive surgery and open surgery .
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Objective To explore the clinical effect of the open and laparoscopic surgery in the treatment of ectopic pregnancy to retain the clinical efficacy of reproductive function analysis. Methods Four hundred and fifty-six patients with ectopic pregnancy were selected as our subjects. Two hundred and eleven cases were served as laparotomy group( open),and 245 cases were laparoscopic group( laparoscopic). The data of intraoperative blood loss,operative time,postoperative anal exhaust time,average hospital stay,tubal patency rate,intrauterine pregnancy rate and again repeat ectopic pregnancy rate were recorded. Results Patients in two groups were successfully completed surgery. The operative time,intraoperative blood loss,postoperative anal exhaust time,average hospitalization time were(55. 1 ± 13. 5)min,(63. 5 ± 18. 3)ml,(25. 7 ± 5. 6)h,(6. 1 ± 2. 0)d respectively in laparotomy group,and(41. 3 ± 15. 5)min,(41. 1 ± 13. 3)ml,(13. 5 ± 5. 1)h,(3. 6 ± 1. 4)d respectively in laparoscopic group,and the differences were significant( t =2. 045,2. 263,3. 131, 3. 152,P﹤0. 05). The tubal patency rate,intrauterine pregnancy,ectopic pregnancy rate in laparotomy group were 81. 0%( 171/211 ),59. 7%( 126/211 ) and 26. 5%( 56/211 ) respectively,and 75. 5%( 185/245 ), 53. 5%( 131/245 ) and 22. 9%( 56/245 ) respectively in laparoscopic group,and the differences were not significant(χ2 =2. 254,2. 130,1. 242;P ﹥0. 05 ). Conclusion Laparoscopic surgery in the treatment of ectopic pregnancy is superior to laparotomy in terms of small trauma,less bleeding,faster recovery,shorter hospitalization time,and postoperative tubal patency rate.
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Objective To study the safety and efficacy of laparoscopic splenectomy and portoazygous devascularization for portal hyperteation.Methods The data of 58 patients who underwent laparoscopic splenectomy and portoazygous devascularization were retrospectively collected and analyzed.Results The operative time for laparoscopic splenectomy and portoazygous devascularization was (2.6 ±0.6) hours.The intraoperative bleeding was (149.5 ± 32.7) ml.The time taken for the bowel to return function was 3.5 ±1.3 days.The hospitalization time was (5.1 ± 1.2) days.When the splenic volume was greater than or equal to 1.5 liters, the conversion to open surgery rate significantly increased [36.0％ (5/14);P ＜ 0.05].The 1, 2, 3, and 4 years cumulative recurrent gastrointestinal bleeding rates were 0, 5.2％, 10.0％, and 15.8％, respectively.Conclusions Laparoscopic splenectomy and pericardial devascularization was safe, efficacious and feasible.When the splenic volume was greater than 1.5 L, whether laparoscopic surgery should be attempted requires further research.
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Objective To compare the curative effect of ultrasound guided mammotome minimally invasive biopsy system and open operation in the treatment of benign breast mass .Methods 60 benign breast mass patients with total 115 phymas were selected as treatment group , and were given the mammotome minimally invasive biopsy treatment .60 benign breast mass patients with total 105 phymas who were given traditional open operation at the same time,were selected as control group .The treatment effect and satisfaction condition of patients in the two groups were compared.Results The phymas of patients in two groups were all removed by operation .The operation time,blood loss,healing time and scar size after operation in the treatment group were all shorter than those in the control group (t=2.41,3.87,2.44,9.84,P<0.05 or P<0.01).The incidence rate of postoperative complication in the treatment group (6.66%) was significantly lower than that in the control group (20.00%)(χ2 =4.62,P<0.05).The postop-erative satisfaction of patients in the treatment group (95.00%) was significantly higher than that in the control group (20.00%)(χ2 =5.26,P<0.05).Conclusion Compared with open operation ,ultrasound guided mammotome min-imally invasive biopsy system in the treatment of benign breast mass has advantages of shorter operative time ,smaller operative trauma ,shorter postoperative healing time ,less operative complication ,higher satisfaction of patients .
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Objective To compare the effects of laparoscopy and open operations on high ligation of internal spermatic veins for varicocele. Methods A retrospective study was conducted to look into the clinical data of 38 cases having undergone laparoscopic high ligation of internal spermatic veins and 46 cases having undergone open operations for high ligation. Results The two methods presented no significant differences in bleeding , operation time and hospital stay (P > 0.05);Both groups were fast in postoperative recovery, without any recurrence, atrophy of testis and hydrocele. Conclusions The endoscopic high ligation of internal spermatic veins is equal to open operations for varicocele.
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Objective To investigate the efficacy of relaparoscopic common bile duct exploration in choledocholithiasis.Methods 50 patients who underwent LC/OC/LCBDE/OCBDE for biliary surgery with choledocholithiasis were randomized into two groups:Group A (n ＝25) laparoscopic approach and Group B (n =25) open approach.The operation time,hospital stay,cost of hospitalization and postoperative complications were compared.Results There was no significant difference in the operation time,liver functional index,postoperative bile leakage rate and cost of hospitalization between the two groups.The postoperative hospital stay in group A was shorter than that in group B (7.1 ± 1.5 vs 12.4 ±4.3 days,P ＜0.05),as was the volume of intraoperative blood loss (58.3 ± 24.2 ml vs 108.6 ± 35.7 ml,P ＜ 0.05),recovery of gastrointestinal function (26.3 ±3.6 vs 58.2 ±6.3 hours,P ＜0.05),postoperative analgesia (7/25 vs 17/25,P＜0.05) and wound infection rate (1/25 vs 6/25,P＜0.05).Conclusions Relaparoscopic commonbile duct exploration for recurrent choledocholithiasis appeared to be a safe,feasible,and efficacious procedure when carried out by expert laparoscopic surgeons.The procedure is worth promoting.
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Objective To systematically assess the efficacy of endoscopic operation and open operation for treating carpal tunnel syndrome .Methods The computer retrieval from MEDLINE ,EMBASE ,Cochrane August ,CNKI ,VIP ,Wanfang databases were conducted for collecting all related randomized controlled trials (RCT ) from February 1989 to February 2012 .The included litera-tures were performed the data extraction ,assessment of bias risk and the quality evaluation .Mata analysis was performed by the RevMan 5 .1 .6 software .Results 21 RCTs including 1 863 operations ,982 cases endoscopic carpal tunnel release (ECTR) and 881 cases of open carpal tunnel release(OCTR) ,met the inclusion criteria .Meta analysis showed that the differences in terms of postop-erative grip strength ,two points discrimination ,incidence of complications ,satisfaction rate ,postoperative symptom relief rate and operation time between the ECTR group and the OCTR group had no statistical significance .The ECTR group was better than the OCTR in the aspects of the time returnning to work ,pinch strength ,postoperative pain rate .Conclusion The ECTR group is supe-rior to the OCTR group in terms of the time returnning to work ,pinch strength ,postoperative pain rate .The other related indexes have no obvious differences between the two kinds of operation procedures .Due to the poor quality of some RCTs ,the above conclu-sion needs more high-quality ,large-sample clinical researches to confirm .
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Objective To compare the effect of laparoscope and open operation in the treatment of acute perforation of peptic ulcer.Methods Clinical data of 56 peptic ulcer patients were retrospectively analyzed.30 patients (group A) received laparoscopic treatment,26 cases(group B) received traditional open operation treatment.Operation time,hospitalization time,postoperative exhaust time,ambulation time,frequency of using analgesics after operation,incidence rate of complications and the cost of hospitalization were compared between the two groups.Results In A group,the hospitalization time was (4.5 ± 1.4) d,postoperative exhaust time was (23.9 ± 7.2) h,time to ambulation was (14.1 ± 5.6)h,frequency of postoperative analgesic use was 16.7％,the incidence rate of complications was 0,which were better than those in the control group(11.6 ± 7.5) d,(37.6 ± 17.9) h,(43.4 ± 11.8) h,92.3％,19.2％ (t =4.23,4.54,6.32,x2 =3.78,4.45,all P ＜ 0.05).Operation time,white blood cell count and cost of hospitalization between two groups showed no significant differences(P ＞ 0.05).Conclusion Laparoscope in treatment of acute perforation of peptic ulcer has advantages of less trauma,less complications,quicker recovery,shorter hospitalization time and good clinical effect.This operation mode is relatively ideal,and is worth the clinical promotion.
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Objective To investigate the relationship between laparoscopic appendectomy and relative complications post-operation for the elderly patients with acute appendicitis.Methods The clinical data of 64 elderly patients with acute appendicitis and underwent laparoscopic appendectomy were retrospectively analyzed.According to the different operation mode,all cases were divided into two groups,including laparoscopic operation group 38 cases and conventional open operation group 26 cases.The distribution of cases with complications incision infection,ankylenteron,bleeding,abdominal infection,stercoral fistula,appendix stump inflammation post-operation were compared between the two groups.Results Between two groups,incision infection and intestinal cases distribution difference had statistical significance while in the aspects of bleeding,abdominal infection,fistula and appendix stump inflammation,there was no significant difference.Conclusion Compared with conventional open operation,for elderly patients with acute appendicitis,laparoscopic appendectomy appeared to have an advantage to reduce postoperative complications,which could reduce the incision infection and the incidence of intestinal adhesion.
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Objective To compare the feasibility and safety of laparoscopic versus open hepatectomy.Methods The data of 165 patients who underwent laparoscopic hepatectomy were compared with 170 patients who underwent open hepatectomy in our hospital from November 2002 to December 2010.Results Laparoscopic hepatectomy was successfully carried out in 159 patients and 6 patients were converted to open operation because of intra-operative hemorrhage.The 170 patients in the open operative group had open hepatectomy successfully carried out.The hospital stay and cost in the laparoscopic group(7.6±1.3 d,31767.4±220.1(￥))were less than the open operation group(14.6±3.3 d,35127.3±392.2(￥))(t=-12.657,P＜0.001; t=-78.859,P＜0.001).There was no significant difference in Pringle's manoeuvre time,blood loss and postoperative complications(20.6 ±8.5vs.18.6±6.5 min,t=2.108,P=0.068),(420.8±76.5 vs.395.9±96.1 ml,t=2.157,P=0.063),(0 vs.4 cases,t=2.011,P=0.156))between the 2 groups.The operative time in the laparoscopic group was significantly longer than the open group(59.6 ± 12.2 vs.42.7 ± 22.6 min)(t=6.941,P＜0.001).Conclusions Laparoscopic hepatectomy is feasible and safe.It has the advantages of having less trauma and quicker recovery for tumors which were located superficially in the left liver and in the inferior part of the right liver.The operative time was longer than open hepatectomy,but there was no significant difference between the 2 groups in Pringle's manoeuvre time,blood loss and postoperative complications.The hospital stay and total hospital cost in the open operation group were higher than the laparoscopic hepatectomy group.
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Objective To study the safety, surrounding tissue injury and cervical wound appearance of the video-assisted thyroidectomy. Methods 230 patients had video-assisted thyroidectomy (group endoscopy) and 204 had conventional open thyroidectomy (group open). Operative duration, postoperative hospital stay, complications,cervical wound healing and appearance, and recurrence rate were compared. Results Operative duration and postoperative hospital stay were (33±29)min and (2±1)days for group endoscopy and (40±21)min and (5±2)days for group open (P=0.025, P=0.000) respectively. Cosmetic result of wound evaluated by numeric scale was in favor of group endoscopy (P=0.000). There were no significant differences in infection of incisional wound, between two groups (P=0.270). After 6-30 months' follow-up, the recurrence rate showed no difference between two groups(P=0.909). Conclusions Compared with conventional surgery, endoscopic thyroidectomy for thyroid diseases was a practical and safe procedure with excellent cosmetic benefits, short hospital stay and less postoperative complications.
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Backgrounds: Renal stone is a common pathology in Vietnam. Open operations for the treatment of renal stone are widely applied at all hospitals. But the rate of residual stone post-operatively is still high. \r\n', u'Objective: To research the results of open operation to treat complicated renal stones at Hai Phong \u2013 Viet Tiep Hospital.\r\n', u'Methods: From May 2005 to November 2006, this retrospective study was carried out on 56 patients, who had open operations for the treatment of renal stone at Viet Tiep hospital.\r\n', u'Results: The rate of complicated renal stones is 44.7%. All renal stones cases are caused by hydronephrosis in different levels (from level 1 to level 4). Most of the cases were performed on with the parenchyma pyelonephritis opened method of Turner Warwick combined with controlling selective renal artery (39.3%). This technique has helped to save blood transmission during surgery, has more time to remove the stone, stop blood and restore better renal parenchyma. The rate of post-operative residual stones is also higher (55.4%). \r\n', u'Conclusion: Must indicate and choose the exact surgical techniques for limiting the complications. The operating investigations may reduce the rate of residual stones. \r\n', u'
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Objective To explore the value of laparoscopic operations for early-stage cervix cancer. Methods Eighteen patients with Ⅰ b～Ⅱ a astage cervix cancer underwent extensive total uterectomy combined with pelvic lymphadenectomy under laparoscope (17Ⅰ b cases, 1Ⅱ a case). Concurrently, another 19 patients with the same diagnosis and approximately the same clinical features as the abovementioned 18 cases, as the control group, were treated by open extensive total uterectomy combined with pelvic lymphadenectomy. The operation time, intraoperative blood loss, postoperative recovery and complications of two groups were compared. Results No statistically significant differences were found on mean operation time between the laparoscopy group (272.8 min?80.3min) and open group (226.5 min?66.8min) (t=1.921,P=0.063). The number of removed lymph nodes was 15.6?5.1 in laparoscopy group and 16.8?5.7 in open group, without statistically significant differences (t=0.674,P=0.505). The recovery time of intestine functions in laparoscopy group (34.2 hours) was obviously shorter than that of open group (60.7 hours) (P