Résumé
Objective To investigate the clinical efficacy of rib's strapping-traction technology using absorbable implants combined with memory-alloy ribs embracing fixator in treating multiple rib fractures under video-assisted thoracoscope.Methods A retrospective case control study was performed to analyze 178 patients with multiple rib fractures treated from January 2015 to June 2017.According to the operation method,all patients were divided into observation group (91 patients) and control group (87 patients).The observation group including 59 males and 32 females aged (39.7 ± 7.8)years adopted internal fixation by rib's strapping-traction technology using absorbable implants combined with memory alloy ribs embracing fixator under video-assisted thoracoscopic surgery.The control group including 56 males and 31 females aged (40.2 ± 6.9) years adopted internal fixation by conventional rib's clamping-traction technology using towel forcep combined with memory-alloy ribs embracing fixator under video-assisted thoracoscopic surgery.The incision length,single rib internal fixation time,number of internal fixation rib fractures,visual analogue scale (VAS) score on postoperative 1 d,postoperative chest drainage,postoperative hospital stay,and postoperative fracture healing were compared between the two groups.Results All patients were followed up for 3-30 months (mean,16.7 months).All operations were successful,with no case of thoracotomy.The observation group had shorter incision length [(4.3 ± 1.2) cm vs.(6.2 ± 1.7) cm] and single rib internal fixation time [(10.3±2.9)min vs.(14.1 ±2.3)min] than the control group (P＜0.05).There were no significant differences (P ＞ 0.05) between the two groups in number of internal fixation rib fractures [(5.7±.3.6) vs.(5.9±3.3)],postoperative chest drainage [(668.3 ±131.4)ml vs.(703.7±116.2)ml],postoperative hospital stay [(6.4 ± 1.8) d vs.(6.8 ± 1.7) d],the VAS score on postoperative 1 d [0-3 point,62％ vs.61％;4-6 point,38％ vs.39％],postoperative osteophyte formation rate [postoperative 1 month,97％ vs.95％;postoperative 3 months,100％ vs.100％].Stable chest walls and thoracic deformity recovery were seen in all patients,with no significant complications occurred.Conclusion Rib's strapping-traction technology using absorbable implants combined with memory-alloy ribs embracing fixator under video-assisted thoracoscope is convenient and has exact efficacy for multiple rib fractures,with advantage of shorter incision length and operation time over conventional thoracoscopic surgery,and thus is worthy of clinical application.
Résumé
Objective:To investigate the surgical treatment of adult Hirschsprung's disease (AHD). Methods: A retrospective clinical analysis was proceeded in 7 cases of AHD treated in our hospital from January 2003 to May 2008. There were 3 males and 4 females with an age ranged from 18 to 53 years,including three cases with general segment type,two cases with short segment type,one case with long segment type and one case with whole segment type. All cases were received the modified Duhamel operation. Results: All cases had satisfactory outcome without serious complications,such as soiling, blind pouch syndrome, fecal incontinence and sexual disorder in male patients. Pelvic hydrops occurred in one case and anastomotic inflammation occurred in another case,and both were cured by intensive therapy. Conclusion: The Modified Duhamel Operation is an effective and safe procedure for AHD. Through this procedure the postoperative recurrence rate is reduced, as well the sexual function and the defecate function are remained .
Résumé
Objective To summarize the experiences of "three holes and one hook in the end(TOE)" laparoscopic cholecystectomy(LC) in 1 260 cases and to investigate the operation procedures,technical points and the prevention of complications.Methods The data of 1 260 patients suffering from chronic calculous cholecystitis,acute calculous cholecystitis,atrophic cholecystitis,gallbladder polyps etc.,who were admitted to this hospital and treated by TOE from March 1999 to March 2008 were included and analysed retrospectively in this study.Results One thousand two hundred and sixty of cases were cured,including 1 252 cases of succeeding LC(99.37%),conversions to open in 8 cases,no death,no bile duct injury,with intraoperative hemorrhage in 3 cases,umbilicus infection in 2 cases,gallbladder fossa hydrops in 3 cases,with operation time for 8-60 min(mean 38.5 min) and hospitalization for 3-7 d(mean 5 d) after surgery.During the follow up of 1 002 cases for 1 to 7 years(mean 3.5 years),there were no complications such as bile fistula,bile duct stricture,residual stones of biliary duct,etc..Conclusion TOE is worthy of application and promotion for the excellent effectiveness,few complications,rapid recovery and safety.