Single-incision laparoscopic appendectomy for acute appendicitis using a 10-mm laparoscope and the glove port technique

Objective: To evaluate the single incision laparoscopic appendectomy [SILA] using existing instruments, the 10-mm laparoscope, and glove port technique

Methods: SILA was performed on 16 patients [8 male cases, 8 female cases] between June 2012 and September 2015. A 20-mm incision was made in the umbilicus and a wound retractor was placed. A 10-mm trocar for the laparoscope and two 5-mm trocars were fixed to the three fingers of the latex gloves and it was attached to the wound retractor. Another thin forceps were inserted from right low abdomen

Results: Average age of patients was 32.6 +/- 17.7 years. Preoperative average white blood cell was 13,325 +/- 4,584 /mm3, and average CRP was 1.81 +/- 3.70 mg/dL. Preoperative body temperature was 36.8 +/- 0.5°C. The mean appendix size was 9.6 +/- 2.3 mm and none of the patients had an abscess on preoperative CT. The CT also revealed a fecal pellet in 5/16 [31%] of patients. Mean operation time was 66.4 +/- 25.4 minutes, and minimal intraoperative bleeding was observed in all patients. Average hospital stay was 5.3 +/- 1.9 days and none of the patients had complications

Conclusion: SILA using the 10-mm laparoscope and glove port technique may be a safe and feasible operation for mild to moderate appendicitis

Perioperative Management to Prevent Postoperative Pulmonary Embolism in General Surgical Patients / 日本農村医学会雑誌

Recently, the incidence of pulmonary embolism (PE) after surgery began to increase in Japan and to prevent PE has become essentially important. During the period between July 2003 and August 2004, we placed 203 general surgical patients under our perioperative management using intermittent pneumatic compression (IPC) and compression stockings (CS). We evaluated the effect of our management on the prevention of postoperative PE in those patients. The incidence of PE, prognosis, complications, patient's complaints, cost-benefit were examined. No fatal PE occurred. One patient with low SpO2 had a chest pain and dyspnea but pulmonary scintigrams revealed no PE. Two other patients had contact dermatitis by CS and another patient using an epidural catheter suffered temporary paraplegia after heparin injection. The government has approved a fee for PE prophylaxis since April 2004. Our management using IPC and CS for PE prophylaxis after surgery proved to be an effective in reducing the risk of PE. However, we must take the atmost care in injecting heparin into patients with epidural catheters.

Evaluation of Quality of Life in Patients with Breast Cancer Treated with Chemotherapy / 日本農村医学会雑誌

Recently the evaluation of health-related quality of life (QOL) in cancer patients has become important in carrying out a treatment strategy. During a period between June and August 2004, we studied the QOL in 16 breast cancer patients with or without chemotherapy. The regimens of chemotherapy were EC (n=6), AT (n=1) and CMF (n=1). We made the Functional Assessment of Cancer Therapy Scale-General (FACT-G) in all patients. The patients treated without chemotherapy were superior to those with chemotherapy with respect to physical and emotional well-being (p<0.05). There were no differences in social well-being and relationship to families between the two groups. The patients treated without chemotherapy made significantly higher scores in the basic activities of daily living than those with chemotherapy (p<0.05). Compared with patients receiving chemotherapy, patients treated without chemotherapy had better quality of life (p<0.05). We concluded that it was important for us to assist in decision making about treatment and supportive care needs.