Laparnscopic repair for adult inguinal hernia in 512 cases / 中华普通外科杂志

Objective To summarize the experiences in laparoscopic inguinal hernia repairing for adult patients. Methods Clinical data of 512 hernia cases admitted in our center from March 2007 to Sep 2010 were retrospectively analyzed.There were 437 cases of single-sided hernia,including 281 indirect inguinal hernia,86 direct inguinal hernia,15 femoral hernia,16 combined inguinal hernia and 39 recurrent hernia.There were also 75 cases of double-sided inguinal hernia,including 3 recurrent hernia.There were 41 acute incarcerated hernia cases.The average postoperative follow up time was(29 ± 12) months. Results 507 cases underwent successful laparoscopic repair,and 5 cases were converted to open procedure.There were 238 TAPP and 269 TEP in laparoscopic operations.The average operative time for TAPP was (69 ±19) min,and (58 ±15) min for TEP.The average length of postoperative stay was (5.0 ± 1.5) days.The percentage of resuming normal activity after 2 weeks and 4 weeks were 95.7％ (485/507) and 99.0％(502/507).The most common postoperative complications were seroma (9.7％,49/507),transient paresthesia (4.1％,21/507) and chronic pain (0.8％,4/507).The recurrence rate was 0.6％ (3/507).Conclusions Laparoscopic repair of inguinal hernia has the advantage of less trauma,faster recovery,and lower recurrence rate.

Analysis and clinical significance of learning curve pattern in laparoscopic appendectomy / 中华消化外科杂志

Objective To investigate the change patterns of operation time of laparoscopic appendectomy and its significance. Methods The clinical data of 105 consecutive patients with appendicitis who received laparoscopic appendectomy at the Southwest Hospital from January 2007 to March 2010 were retrospectively analyzed. Of the 105 patients, five were converted to open surgery, and they were excluded from this study.The changes in operation time of different surgeons were statistically analyzed to detect the change patterns of the learning curve in laparoscopic appendectomy. Results A hundred cases of laparoscopic appendectomy were successfully performed by three surgeons. The mean operation time was ( 87 ± 36 ) minutes ( range, 30-217 minutes). No surgical injury happened during the operation, and the blood loss was under 10 ml. The learning curve of operation time was presented as a sine curve with an oscillating decreasing trend. The primary two cycles end at an average of 9.6 cases, which could be used as the end point of the learning curve of laparoscopic appendectomy. Conclusions The learning curve of laparoscopic appendectomy shows a typical oscillating decreasing trend. The preliminary study ends when 9.6 cases of operation are completed.

Remnant stomach-jejunal dual pathways reconstruction after laparoscope-assisted radical proximal gastrectomy / 中华消化外科杂志

Objective To investigate the value of remnant stomach-jejunal dual pathways reconstruction after laparoscope-assisted radical proximal gastrectomy in the treatment of upper gastric cancer. Methods Twenty-five patients with upper gastric cancer underwent laparoscope-assisted radical proximal gastrectomy and the remnant distal stomach was preserved for side-to-side remnant stomach-jejunal anastomosis and end-to-side jejuno-jejunal anastomosis to reconstruct dual pathways. Results The mean operation time was (240±35) minutes, the mean number of lymph nodes dissected were 22±5, and all the incised margins were negative. No anastomotic leakage, obstruction or stenosis occurred. All patients received postoperative barium meal examination. A large amount of barium directly entered the jejunum, leaving a small amount of barium entered the jejunnum via the route of remnant stomach-duodenum, and was detained in the remnant stomach for 30-60 minutes. No esophageal reflux of barium was observed. All the patients were followed up for 4-18 months, no reflux esophagitis was detected and the short-term life quality was satisfactory. Conclusions Remnant stomach-jejunal dual pathways reconstruction prevents the reflux esophagitis and dumping syndrome, preserves the pathway of duodenum and promotes the life quality of patients.

Tumor Stem Cells and Solid Tumors / 中国普外基础与临床杂志

Objective To summarize the status of tumor stem cells study in solid tumors.Methods Domestic and international publications on the study of tumor stem cells in solid tumors in recent years were collected and reviewed.Results Tumor stem cells exactly existed in solid tumors and played a very important role in tumorgenesis.Conclusion Tumor stem cells bring a new broad of perspective on solid tumor study.