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Objective: To investigate the effect of different suture reinforcement methods on anastomotic leakage (AL) after laparoscopic double stapled technique (DST). Methods: Data were collected from patients undergoing laparoscopic radical resection of colon-rectal cancer from July 2017 to September 2018 in the Department of Gastrointestinal Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine (Shanghai Minimally Invasive Surgery Center). Patients were divided into 3 groups according to the different ways of suture reinforcement: intermittent suture reinforcement group (n=41), continuous suture reinforcement group (n=41) and non-reinforcement group (control group, n=41). The intraoperative and postoperative conditions of the three groups were compared. One-way ANOVA, χ2 test, Fisher's test and non-parametric test were used for statistical analysis. Results: A total of 124 patients were included in this study. There were no statistically significant differences in operation time, intraoperative blood loss, postoperative hospital stay, postoperative gastrointestinal exhaust time and postoperative fluid intake time of two experimental groups compared with control group. Nine subjects were clinically diagnosed with anastomotic leakage. The incidences of serious AL of intermittent suture reinforcement group and continuous suture reinforcement group were lower than that in the control group. The average length of stay in patients with AL in the intermittent suture reinforcement group was 31 (19-42) d, and the continuous suture reinforcement group was 41 (37-43) d, which were significantly lower when compared with the control group of 64 (54-74) d. In addition, the average treatment cost of the intermittent suture reinforcement group was (71 142.6±2 849.3) yuan, and the continuous suture reinforcement group was (71 360.1±2 072.3) yuan, which were significantly lower than the control group of (91 386.0±9 151.7) yuan. Conclusion: Laparoscopic DST using intermittent suture and continuous suture can reduce the incidence of serious AL, shorten the length of hospital stay and reduce the cost of treatment without increasing the difficulty of surgery and other postoperative complications.
RESUMO
Objective:To establish the fingerprint of standard decoction of Citri Reticulatae Pericarpium and evaluate its quality. Method:According to the preparation conditions of the standard decoction,15 batches of standard decoction of Citri Reticulatae Pericarpium were prepared.HPLC was employed to determine the content of hesperidin in this standard decoction.Ultraviolet spectroscopy(UV) and infrared spectroscopy(IR) were used to establish the fingerprint of standard decoction of Citri Reticulatae Pericarpium.The correlation coefficient method and double index sequence analysis method were used to compare and analyze the spectra of different batches of this standard decoction. Result:The content of hesperidin in 15 batches of this standard decoction were 0.82%-2.60%,and the measured value of dry extract rate was 32.02%-46.11%.Compared with ultraviolet and infrared control fingerprint,the fingerprint similarities of the standard decoction of each batch were > 0.897 and > 0.942,respectively.The double index analysis results showed that the common peak ratio was more than 62.50%,variation peak ratio was less than 46.67%. Conclusion:The quality evaluation method established in this study can be used for systematic evaluation of standard decoction of Citri Reticulatae Pericarpium,and it can provide theoretical reference for the formulation of quality standard of Citri Reticulatae Pericarpium dispensing granules and other related preparations.