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Objective:To compare the effect of intracorporeal anastamosis and extracorporeal anastamosis on abdominal infection associated with laparoscopic right hemicolectomy.Methods:The clinical data of 210 patients with colon cancer who underwent laparoscopic right hemicolectomy in Dalian Third Peoples′s Hospital, Liaoning Province from January 2015 to December 2019 were analyzed retrospectively.Among them, 79 patients underwent intracorporeal anastamosis (intracorporeal anastamosis group) and 131 patients underwent extracorporeal anastamosis (extracorporeal anastamosis group). The perioperative indexes and postoperative abdominal infection were compared between the two groups.Results:In intracorporeal anastamosis group, the intraoperative bleeding was (45.2±4.2) mL, the operative time was (161.3±22.4) min, the number of lymph node dissection was (30.8±9.6), the postoperative exhaust time was (3.3±1.2) d, and the postoperative hospital stay was (7.6±0.5) d. In extracorporeal anastamosis group was (42.1±5.0) mL, (167.3±26.7) min, (32.9±8.6), (3.4±1.0) d and (7.5±0.6) d, respectively, there were no significant difference between the two groups (t value were 0.417, 0.207, 0.829, 0.338 and 0.293, respectively; P value were 0.699, 0.845, 0.231, 0.734 and 0.802, respectively). In intracorporeal anastamosis group, the incidence of abdominal infection (with anastomotic fistula)was 13.9%(11/79), the incidence of abdominal infection (without anastomotic fistula)was 10.1%(8/79), and in extracorporeal anastamosis group was 1.5%(2/131)and 0.8%(1/131), the differences were statistically significant (χ 2=12.805, 10.238; P=0.003, 0.008). In intracorporeal anastamosis group, the incidence of respiratory system infection was 1.3%(1/79), the incidence of urinary system infection was 2.5%(2/79), the incidence of surgical incision infection was 1.3%(1/79). In extracorporeal anastamosis group was 3.1%(4/131), 0.8%(1/131) and 3.1%(4/131), respectively.There were no significant difference between the two groups (χ 2 value were 0.662, 0.420 and 0.662, respectively; P value were 0.364, 0.587 and 0.364, respectively). Conclusion:Laparoscopic right hemicolectomy with intracorporeal anastamosis and extracorporeal anastamosis have the same surgical effect, but intracorporeal anastamosis may increase the risk of postoperative abdominal infection.
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Objective:To compare the effect of midcaudal combined approach and the cephalic middle approach in laparoscopic complete mesocolic excision (CME) in the treatment of right colon cancer complicated with incomplete intestinal obstruction.Methods:From January 2014 to January 2019, 90 patients with right colon cancer complicated with incomplete intestinal obstruction admitted to the Third People′s Hospital of Dalian were retrospectively analyzed.All patients underwent laparoscopic right hemicolectomy, CME plus D3 lymph node dissection.According to the choice of different surgical approaches, 44 patients were treated with the midcaudal combined approach (observation group) and the other 46 patients were treated with cephalic middle approach (control group). The intraoperative, postoperative and complications of the two groups were compared statistically.Results:Compared with the control group, the bleeding volume in the observation group was significantly reduced ((105.3±22.6) ml vs.(309.6±28.0) ml, t=13.698), the operation time was significantly shortened ((165.2±17.9) min vs.(219.5±21.5) min, t=8.327), and the differences were statistically significant (all P<0.05). There were no significant differences in the number of lymph nodes dissected ((21.4±7.8)vs.(20.4±6.6), t=0.534), the proportion of lymph nodes dissected≥12(86.4%(38/44)vs.84.8%(39/46), χ 2=0.208), the complications after operation(6.8%(3/44)vs.10.9%(5/46), χ 2=0.318), the length of hospital stay after operation ((11.8±1.6) d vs.(12.5±2.3) d, t=0.986), the difference was statistically significant (all P>0.05). Conclusion:It is safe and feasible to use the middle caudal approach in laparoscopic CME for right colon cancer complicated with incomplete ileus. Compared with the cephalic middle approach, it can reduce thebleeding volume and shorten the operation time.
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Objective:To evaluate the efficacies of clarithromycin and metronidazole in the treatment of chronic periodontitis, and to provide the evidence-based medical evidence for the rational use of drugs in the treatment of chronic periodontitis.Methods:CNKI, VIP, Wanfang, Chinese Biomedical Literature Database, PubMed, ScienceDirect and EMbase database from inception to June, 2017were searched by computer for the literatures about the treatment of clarithromycin and metronidazole for chronic periodontitis.Two reviewers independently screened the literatures, extracted the data and evaluated the bias risk of included studies.Then Meta-analysis was performed using RevMan 5.3 software.Results:A total of 5 randomized controlled trial (RCT) involving516patients with chronic periodontitis were included.Subgroup analysis was performed according to the follow-up time.Compared with metronidazole group, the probing depth (PD) reduction, attachment loss (AL) gain, and sulcus bleeding index (SBI) reduction of the patients with chronic periodontitis in clarithromycin group at 1month and 3months after follow-up were more significant;the differences in PD, AL, and SBI were significant (MD=-0.53, 95％CI:-0.67-0.39, P＜0.01;MD=-0.31, 95％CI:-0.39--0.24, P＜0.01;MD=-0.23, 95％CI:-0.29--0.16, P＜0.01) .Conclusion:Systemic antibiotic use of clarithromycin in the treatment of the patients with chronic periodontitis after non-surgical periodontal therapy has a significant additional effect than metronidazole in short-term observation.
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Objective To estimate the effect of diversified training model in training nurses in operation room. Methods A total of 36 nurses during 2014-2016 were chosen by using diversified training model. The effect and degree of doctors′satisfaction were evaluated. Results After diversified joint training, the average specialist theoretical scores of orthopedic surgery specialist nurses in 2014, 2015, 2016 were 78.444±6.243,84.072±4.754,90.565±2.597; the operational skill scores were 79.444± 4.623, 84.472±2.922,90.118±2.713, the differences were statistically significant (F=58.156, 82.619,P＜0.05). Preoperative operating specification rates were 72.2% (26/36), 86.1% (31/36), 100.0% (36/36);intraoperative operating specification rates were 75.0% (27/36), 83.3% (30/36), 100.0% (36/36); surgical instrument operating specification rates were: 66.7% (24/36), 83.3% (30/36), 97.2% (35/36); surgical fit:72.2% (26/36), 88.9% (32/36), 97.2% (36/36), the differences were statistically significant(χ2=9.755-11.624, P＜0.05). Conclusions The diversified training model is a valuable method in training nurses in operation room.
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Objective To analyze the correlation among serum total IgE(TIgE),blood eosinophil(EOS) counts,the degree of sensitization for skin prick test(SPT),and fractional exhaled nitric oxide(FeNO)in chil-dren with asthma and allergic rhinitis. Methods We collected 121 children with asthma and allergic rhinitis andtheir serum TIgE,blood EOS,FeNO,and SPT for 14 common allergens. Results There were 75.2%patients sensitizing to at least two allergens.TIgE levels in poly-sensitized subjects were higher than that of mono-sensitized subjects(P < 0.05)The number of SPT sensitized allergens was positively correlated with the TIgE levels(P <0.05)FeNO levels were correlated with TIgE levels and EOS percentage(P < 0.05). TIgE levels in subjects with class 2 or 3 in SPT for house dust mite increased significantly ,compared with class 0 or 1. Conclusion There were some correlations among the four detections ,providing important reference for clinical diagnosis and treatment of respiratory allergic disease
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BACKGROUND:Currently, in pterygium excision combined with limbal epithelial transplantation, there were stil some controversies about whether the medical fibrin glue could instead of stitch fixing autologous conjunctival graft. OBJECTIVE:To compare the therapeutic effect of medical fibrin glue and stitch in pterygium excision combined with limbal epithelial transplantation using Meta analysis. METHODS: The randomized controled trials about the therapeutic effect of medical fibrin glue versus stitch in pterygium excision combined with limbal epithelial transplantation were reviewed from PubMed database, CNKI ful-text database, Chinese Biomedical Literature Database, VIP database and Wanfang database from database creation to June 2015. The operative time, complications and recurrence rate of these two groups were analyzed using Meta. RESULTS AND CONCLUSION:A total of 14 randomized controled trials, and 879 patients were enroled. Meta-analysis results showed that the operative time, incidence of postoperative complications, the relapse rate after six months and one-year in the fibrin glue group were lower than those in the suture group [MD=-15.58, 95%CI (-18.96,-12.21),P < 0.000 01]; [OR=0.39, 95%CI(0.19, 0.68),P=0.02]; [OR=0.28, 95%CI(0.12, 0.65),P=0.003]; [OR=0.23, 95%CI(0.07, 0.76),P=0.02]. These results demonstrate that the application of fibrin glue in pterygium excision combined with limbal stem cel transplantation can promote graft attachment, shorten the operation time, reduce postoperative complications and reduce the postoperative recurrence of pterygium.
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BACKGROUND:Fibrin glue can function to close the wound tissue, reduce leakage, stop bleeding, promote wound healing and prevent adhesion. OBJECTIVE:To systematicaly review the application of fibrin glue in thyroid surgery. METHODS:We searched China Journal Net database, Wanfang database, VIP database, Chinese Biomedical Database Online to retrieve clinical randomized controled trials related to fibrin glue applied in thyroid surgery from January 2000 to April 2013. Included studies were analyzed using Rev Man 5.2 statistical software for Meta-analysis. RESULTS AND CONCLUSION:A total of six studies including 797 cases were enroled in result analysis. Meta-analysis showed that the drainage volume at postoperative day 1 and total postoperative drainage volume were higher in the fibrin glue group than the control group (without fibrin glue) [odds ratio=-27.36, 95% confidence interval (-33.86,-20.87),P < 0.00001; weighted mean difference=-38.73, 95% confidence interval (-44.78,-32.67),P < 0.000 01]. The suture removal time was shorter in the fibrin glue group than the control group [odds ratio=-2.00, 95% confidence interval (-2.17,-1.83),P < 0.000 01]. No significant difference was found in the postoperative 3-day fever incidence [odds ratio=1.53, 95% confidence interval (0.59,3.96),P=0.38], wound infection [odds ratio=0.86, 95% confidence interval (0.12, 6.15),P=0.88], and postoperative hematoma [odds ratio=0.86, 95% confidence interval (0.21, 3.48),P=0.83] between the two groups. These findings indicate that fibrin glue used in thyroid surgery can significantly reduce drainage by non-increasing postoperative complications.
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OBJECTIVE To approach the factors and precautions of sharp injuries of nurses in operating room.METHODS We reviewed the literatures and combined the clinical practice,the risk factors and adopted precaution of sharp injuries of nurses in operating room were analyzed and summarized.RESULTS The sharp injuries rate of nurses in operating room was decreased from 54.2% to 4.8%.The rate of reported was increase from 3.1% to 80.0%.So the efficiency and quality of work were elevated.CONCLUSIONS It is the key of protective measure that enhancing the protective consciousness and reducing the factors of the sharp instrument injury.