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Objective To explore the clinical effects of laparoscopic combined with open mesh repair for abdominal wall incisional hernia.Methods The retrospective cross-sectional study was conducted.The clinical data of 41 patients with abdominal incisional hernia who were admitted to the Fujian Medical University Union Hospital between September 2011 and June 2017 were collected.All the patients underwent laparoscopic combined with open mesh repair,with the sequence from laparoscopic surgery to open surgery and then to laparoscopic surgery.Observation indicators:(1) intra-and post-operative situations;(2) follow-up situation.Follow-up using outpatient examination and telephone interview was performed to detect postoperative long-term complications and hernia recurrence up to November 2017.Measurement data with normal distribution were represented as (x)±s.Results (1) Intra-and post-operative situations:forty-one patients underwent successful laparoscopic combined with open mesh repair for abdominal wall incisional hernia.Diameter of hernia ring and defect area of abdominal wall were respectively (10±3)cm and (75±34)cm2.Among 41 patients,25 underwent laparoscopic combined with open mesh repair due to tight intestinal adhesion induced difficult laparoscopic separation;16 underwent laparoscopic combined with open mesh repair due to the larger diameter of the hernia ring induced difficulty of closing hernia ring under laparoscope.Operation time,cases with indwelling drainage-tube,time of drainage-tube removal and duration of postoperative hospital stay were respectively (188±71)minutes,33,(14±3)days and (4.5±2.6)days.Of 41 patients,2 with postoperative incomplete intestinal obstruction were cured by symptomatic treatment;2 with incisional infection were cured by antibiotic therapy,irrigation and dressing change.(2) Follow-up situation:41 patients were followed up for (29±17)months.The postoperative chronic pain of 2 patients was occasional and cannot affect the normal life.There was no occurrence of seroma,mesh infection,intestinal fistula,abdominal compartment syndrome and hernia recurrence during the follow-up.Conclusion The laparoscopic combined with open mesh repair has a better clinical effect for patients of incisional hernia with large hernia ring and tight intestinal adhesion,and surgical methods should be chosen seriously according to the condition of the patients in clinical application.
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Objective To explore an objective and standard approach for accurately evaluating peristomal skin lesions and providing comprehensive and professional nursing guidance.Methods Images of peristomal skin were taken by a cell phone camera and then evaluated by medical image processing and analyzing software combined with the condition option.The computer automatically calculates and provides professional nursing advice for patients developing peristomal skin lesions based on ostomy skin assesssment score system and ostomy skin nursing guideline for peristoma skin care.Advice from two ostomy nursing professionals were compared with that from the medical image analyzing software in two different cell phones.Results Results were analyzed by Kendall coordination coefficient W test to analyze the level of coordination among the experts and medical image analyzing system.There was agreement among study groups (W=0.902,P＜0.05) with respect to DET score.Conclusions Application of medical image analyzing software for standard nursing and treatment of peristomal skin lesions provides standardized assessment and professional advice,reduces artificial distinctions and absence of nursing advices,and effectively improves nursing of peristomal skin.
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Objective To design an appropriate preoperative questionnaire in Chinese bariatric surgery.Methods Bariatric surgery center carried out laparoscopic bariatric operation from January 2010,preoperative questionnaire before the operation were supplied.Till January 2014,a total of 401 patients replied to the survey.The questionnaires were designed through three stages:translated from the Cleveland Clinic (USA) and applied in 30 patients for the first survey; adjustments and changes to the contents of the questionnaire for 90 patients according to Chinese conditions in the second phase; in the third stage,the third edition questionnaire was used in 281 patients.The satisfaction degree of the doctors and patients about the content of the questionnaire was evaluated.Results For the three versions of the questionnaire,the doctor satisfaction rate was 73.3％,86.7％ and 96.8％.Patients' satisfaction rate of three versions were 30.0％,40.0％,76.9％,not satisfactory rate was 20.0％,11.1％,2.8％.Conclusions The current preoperative questionnaire includes 11 categories with 101 items of the third edition,doctors and patients satisfaction rate is higher,and it is suitable for Chinese bariatric surgery.
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Objective To establish a specific, sensitive and simple assay for the detection of Brugia malayi larva in Anopheles sinensis .Methods Using a new DNA purification technique (Microcon 100) and two pairs of oligonucleotide primers (p1, p2 and p3,p4) suitable for detecting B malayi in seven areas in our country, the mosquito vectors infected by B malayi were detected by polymerase chain reaction(PCR).Results This PCR method could amplify separately a 322 basepair(bp) and a 155 bp DNA fragment and detect as few as 1/64 of one L 1 in 1 mosquito,the detectable limit was nearly 4 pg DNA of filarial larvae, and it could also detect 1 infected mosquito with one L 3 of B malayi in pools of up to 200 mosquitoes. In contrast,no such specific 322 bp or 155 bp DNA band was detected in Dilofilaria immitis and normal mosquito.Conclusion This PCR techique established for supervision of mosquito vector in B malayi endemic areas is specific,sensitive,and simple.