Laparoscopic totalextraperitoneal inguinal hernia repair 302 clinical analysis / 中国医师进修杂志

Objective To explore surgical options and clinical outcome of preperitoneal hernia repair (TAPP) and totally ext raperitoneal hernia repair (TEP) in inguinal hernia repair.Methods The clinical data of 302 patients underwent laparoscopic herniorrhaphy were retrospectively analyzed.Results None of patient s was changed to open operation.The TAPP and TEP outcome measures:the unilateral hernia surgery time from (31.2 ± 8.3) min and (55.3 ± 15.2) min,bilateral hernia surgery time was (46.2 ± 11.2)min and (80.2 ± 23.2) min; blood loss was (6.4 ± 2.0) ml and (7.2 ± 1.6) ml,bed activity for the first was (16.0 ± 1.8) h and (16.0 ± 1.5) h,hospital stay was (3.0 ±0.6) d and (3.1 ±0.8) d.Conclusions Laparoscope herniorrhaphy is safe due to lower recurrence and complications.It also has the advantages of slight pain and rapid recovery.

Application of new type exercise activity in nursing of general surgery patients after abdominal surgery / 中国实用护理杂志

Objective To apply the new type exercise activity and make a guidance,to discuss the application effect of new type exercise activity in nursing of general surgery patients after abdominal surgery.Methods 120 patients with abdominal surgery were divided into the experimental group(58 cases)and the control group (62 cases )according to the mantissa of hospital number.The patients in the control group received routine nursing care.In addition,the patients in the experimental group received systematic new exercise activity.Postoperative rehabilitation progress and complications were compared between two groups.Results The recovery process of the experimental group was faster than the control group,the first time of getting out of bed,anal exsufflation time and wound healing time were shorter than those of the control group.The incidence of complications of the experimental group was lower than the control group.Conclusions The new type exercise activity can speed up the recovery process of general surgery patients after abdominal surgery and reduce the incidence of oostooerative complications.

The special operative fashion of pancreaticoduodenal combined trauma / 中国基层医药

ObjectiveTo summarize the experience of the operations of pancreaticoduodenal combined trauma.MethodsClinical data of pancreaticoduodenal combined trauma in 12 cases were analyzed retrospectively.Head of pancreas with duodenal combined trauma occurred in 9 cases,body-tail of pancreas with duodenal conbined trauma in 3 cases.Diferrent operative fashion were used.ResultsPostoperative pancreatic fistula in 2 cases( 16.7％ ),were cured by continuing lower pressure suction of all cases,11 cases were cured (91.7％ ) and 1 cases died (8.3％).ConclusionOperation in time and correct operative fashion were the key of successful treatment.Three-cavity twoBlakemore Tube had a certain value.

Study of the clinical effect in the treatment of the mixed hemorrhoids / 中国基层医药

Objective To compare the clinical effect of procedure for prolapse and hemorrhoids(PPH)improved,Milligan-Morgan hemorrhoideeomy and Ferguson-Mitchell hemorrhoidecomy in the treatment of the Ⅲ～Ⅳdegree mixed hemorrhoids.Methods 45 cases admitted for surgical treatment of Ⅲ～Ⅳ degree hemorrhoids,were randomly divided into 3 groups,the improved PPH,MMH and FMH were retrospectively reviewed,and it is separately reviewed for the operation time,pain index,length of hospital stay,return to normal activity time,postoperation complication and patients satisfaction etc.Results There was reasonably evidence in favor improved PPH for operating time,hospital stay,pain,anal discharge,and patients satisfaction.Conclusion The improved PPH is a safe and effective procedure for Ⅲ～Ⅳ hemorrhoids and its short-term outcome is more better than Milligan-Morgan and Ferguson-Mitchdl group.

Study of laparoscopic versus open appendectomy / 中国基层医药

Objective To compare the treatment effect of laparoscopic appendectomy(LA)and open appendectomy(OA).To investigate the worth of endoscopic technology in LA.Methods 123 cases of LA and 989 cases of OA performed were studied retrospectively.The clinical data of two groups were summarized,contrasted and analyzed respectively.Results The times of operation,taking food and hospitalization in LA group were obviously shorter than those in OA group.The postoperative pain and the rate of incision infection in LA group were obviously superior to those in OA group.While the cost of hospitalization in LA was obviously higher than that of OA.Conclusion LA have advantages of minimal invasion,quicker recovery.safety and reliability,has significant advantages in treaing appendicitis and should be promoted.

Diagnosis and treatment of thyroid microcarcinoma / 中国微创外科杂志

Objective To study the diagnosis and surgical treatment of thyroid microcarcinoma. Methods The authors reviewed 53 cases of thyroid cancer, which were diagnosed during and after surgery from December 1993 to January 2002,including 42 cases of thyroid microcarcinoma. Results Out of the 53 cases,35 cases were diagnosed during surgery by frozen section method while the other 18 cases were postoperatively diagnosed by pathological examinations;complicated carcinomatous conversion in contralateral lobe was found in 2 cases and neck lymphatic metastasis in 3 cases; lobectomy plus excision of isthmus was performed in 35 cases, 7 of which simultaneously underwent neck lymph node clearance,and unilateral lobectomy or unilateral or bilateral subtotal lobectomy was adopted in the remaining cases. Recurrence in 2 cases was found during a follow-up period for 2 months～96 months (mean,46 months) in 35 cases, and no fatal cases occurred. Conclusions A high rate of missed diagnosis of thyroid microcarcinoma is present. Thyroid microcarcinoma should be surgically removed.

Therapeutic evaluation of endoscopic treatment of acute biliary pancreatitis / 中国普通外科杂志

Objective To evaluate the therapeutic effect of endoscopic treatment for acute biliary pancreatitis. Methods Thirty-six cases of acute biliary pancreatitis were treated in our hospital in recent 4 years. Tweent cases (group E) underwent emergency endoscopic retrograde cholongiopancreatography(ERCP),endoscopic sphincterotomy(EST) and endoscopic naso-biliary drainage (ENBD) within 24h of hospitalization; 16 cases (group C ) were treated conservatively or by operation. Results Successful rate of endoscopic management was 95.24%. There were no severe complications nor mortality in group E. The duration of symptoms and hospitalization in endoscopic group was significantly shorter than those in group C(P0.05). But the serum and urine amylase in group E were significantly lower than those in group C in the second day(P

A study of hepatocyte apoptosis and its gene expression in patients with liver cirrhosis and portal hypertension / 中国普通外科杂志

Objective To study the relationship of hepatocyte apoptosis and gene expression of liver cirrhosis and primary hepatic carcinoma. Methods Specimens of liver tissue from patients with liver cirrhosis and portal hypertension and normal subjects were examined by transmission electron microscope to detect apoptotic cells and primary cancer gene expression. Results The number of apoptotic cells and the apoptotic index of cirrhotic liver tissue was higher than that of normal subjects.Immunostaining of bcl 2,c myc,c fos was negative in normal liver tissue ,but was over expressed in cirrhosis. Conclusions Hepatocyte apoptosis plays a certain role in the development of hepatic cirrhosis. The oncogenes bcl 2,c myc,c fos take part in the regulation of hepatocyte apoptosis .

Early endoscopic therapy for acute biliary pancreatitis / 中国普通外科杂志

Objective To evaluate the therapeutic effect of duodenoscopy in the early treatment of acute biliary pancreatitis (ABP).Methods Twenty ABP cases admitted from Oct.2000 to Mar.2004 received emergent endoscopic retrograde cholongiopancreatography (ERCP), sphincterotomy (EST) plus endoscopic lithotomy and endoscope naso-biliary drainage (ENBD).Other 16 cases were treated with conservative therapy or open surgery.Results Successful rate of endoscopic management was 95%.There were no severe complications nor mortality in this group.The duration of symptoms and hospitalization in endoscopy group were significantly shorter than control group ( P