RESUMO
Objective:To investigate the characteristics and surgical management of mesh infection after tension-free repair of inguinal hernia.Methods:The clinical and follow-up data of 87 patients with mesh infection after tension-free repair of inguinal hernia at the Department of Hernia and Abdominal Wall Surgery,Beijing Chaoyang Hospital from 2018 to 2020 were retrospectively analyzed.Results:The most frequent type of repair was plug implantation, accounting for 57.5% of the procedures. The most common clinical presentation was a chronic sinus. 79.3% patients had a >3-month history of chronic infection. Staphylococcus aureus was the most common bacteria. All patients underwent open debridement. Fifty-one patients had a complete removal of the infected mesh, and 36 had partial removal. All patients were followed up for 18.7-54.2 months. There was no significant difference in the incidence of wound infection, seroma, hematoma, inguinal hernia recurrence, and chronic pain between those with complete removal and that partial removal (all P>0.05). Seventeen cases suffered recurrent sinus in the partial mesh removal group, and the incidence was significantly higher than that in the complete mesh removal group ( P<0.001). Conclusion:Infected mesh removal is an effective treatment for mesh infection after tension-free repair of inguinal hernia and should be removed as completely as possible.
RESUMO
Objective@#To investigate the clinical value of biological mesh in repairing abdominal wall defect after tumor resection.@*Methods@#15 patients with abdominal wall defect left over by radial resection of abdominal wall tumor were treated with primary biological mesh herniorrhaphy from Sep 2015 to Sep 2017 at the Department of Hernia and Abdominal Wall Surgery of Beijing Chaoyang Hospital.@*Results@#The operation was successful in all 15 patients. The operation time was 95(65-145)min. The hospital stay was 17(9-22)d. The patients were followed up for 18(17-32) months. postoperative seroma occurred in 8 cases, postoperative fever occurred in 1 case. One case died of multiple systemic metastases of advanced gastric cancer. All the other patients were followed up without complaining about local pain, foreign body sensation, intestinal obstruction, intestinal fistula.@*Conclusions@#Biological mesh is safe and feasible for the treatment of abdominal wall defect after tumor resection.
RESUMO
Objective To investigate the clinical value of biological mesh in repairing abdominal wall defect after tumor resection.Methods 15 patients with abdominal wall defect left over by radial resection of abdominal wall tumor were treated with primary biological mesh herniorrhaphy from Sep 2015 to Sep 2017 at the Department of Hernia and Abdominal Wall Surgery of Beijing Chaoyang Hospital.Results The operation was successful in all 15 patients.The operation time was 95 (65-145)main.The hospital stay was 17 (9-22) d.The patients were followed up for 18 (17-32) months.postoperative seroma occurred in 8 cases,postoperative fever occurred in 1 case.One case died of multiple systemic metastases of advanced gastric cancer.All the other patients were followed up without complaining about local pain,foreign body sensation,intestinal obstruction,intestinal fistula.Conclusions Biological mesh is safe and feasible for the treatment of abdominal wall defect after tumor resection.
RESUMO
Objective To observe the neurotoxicity of epidural different dose of dexmedetomi-dine in combination with 0.75% bupivacaine.Methods Twenty-five rabbits weight 2-3 kg without gender tendency and equipped with an epidural lumbar catheter were allocated randomly to five groups with 5 cases each.The control group (group C)received injections of 1.5 ml normal saline,0.75%bupivacaine 1.5 ml plus normal saline 0.5 ml in group B,and the other treatment groups received in-jections of 0.75% bupivacaine 1 ml plus dexmedetomidine 0.1 μg/kg (group D1 ), 0.75%bupivacaine 1 ml plus dexmedetomidine 0.2 μg/kg (group D2 )or 0.75% bupivacaine 1 ml plus dexmedetomidine 0.4 μg/kg (group D3),in the same volume of 1.5 ml.After successive 3-day epi-dural administration of the drugs and a 3-day observation,the rabbits were killed and the spinal cord was examined under optical and electron microscope.Results Serious damages of neuron were found in 1 animal from group D2 and 2 from group D3 under optical microscope.There was unclear bounda-ries between gray and white matter.Some nerve cells appeared necrosis in the grey matter of spinal cord and the number of nerve cells was decreased.Some reversible changes were found in all groups under electron microscope.Conclusion Epidural administration of dexmedetomidine can induce spinal cord and spinal nerves injury dose-dependently,and the motor function can recuperated completely.
RESUMO
<p><b>OBJECTIVE</b>To investigate the predictive value of metastatic lymph node ratio for postoperative distant metastasis in patients with colorectal cancer.</p><p><b>METHODS</b>The clinicopathological data were collected from 180 patients with colorectal cancer who underwent surgical resection in General Hospital of PLA between from January, 2007 to January, 2012. The patients were divided into 2 groups according to the presence of distant organ metastasis and the clinicopathological factors were analyzed with Chi-square test and logistic regression.</p><p><b>RESULTS</b>Of the 118 surgical patients enrolled, 118 were free of distant metastasis and 62 had distant metastasis involving the liver (39 cases), lungs (12 cases), and multiple organs (11 cases). The gross types, differentiation, ELN and LNR of the tumors differed significantly between the two groups. Logistic regression analysis showed that LNR was an independent factor correlating to distant metastasis of colorectal cancer.</p><p><b>CONCLUSION</b>LNR is independently correlated with distant organ metastasis of colorectal cancer and serves as an important predicative factor for estimating the prognosis of colorectal cancer.</p>