A clinical study of mechanical ventilation in the treatment of acute respiratory failure following abdominal surgery / 中国普通外科杂志

Objective To explore the predisposing factors in the development of acute respiratory failure after abdominal surgery and the factors affecting the therapeutic effect of mechanical ventilation. Methods A (retrospective) study was undertaken for acute respiratory failure after abdominal surgery in 91 patients. The (underline) diseases, introducing causes and efficacy of mechanical ventilation were retrospectively analysed. (Results) Postoperative pneumonia was the cause of acute respiratory failure in 53 cases and ARDS caused by severe abdominal infection and severe acute pancreatitis in 38 cases. Of the 91 cases, complicated with COPD in 38 cases, severe malnutrion 32 cases, and hypokalemia 14 cases. Respiratory failure occurred at(4.08?2.45)days after operation. The duration of mechanical ventilation was(21.66?21.42)days; 33 cases died, and 58 cases were successfully recovered with mechanical ventilation.Conclusions The (management) of acute respiratory failure after abdominal asurgery should be rational use of mechanical (ventilation), adjustment of weaning strategy and avoidance of dependance on mechanical ventilation. Timely treatment of the primary disease, effective control of abdominal infection and aggressive symptomatic and (supportive) treatment are factors that affect the success or failure of mechanical ventilation.

Diagnosis and treatment of gastroparesis after abdominal surgery / 中国普通外科杂志

Objective To investigate the possible contributing risk factors, diagnosis and treatment of gastroparesis after abdominal surgery. Methods Potential risk factors, clinical manifestations and therapeutic approaches of 22 cases of gastroparesis after abdominal operation were analyzed retrospectively. Results In this series, gastroparesis more frequently occured in those patients having a long-term preoperative gastric outlet obstruction, malignant tumor, O type blood group pancreaticoduodenectomy or simple gastrojejunostomy without gastric resection. Endoscopy, upper gastrointestinal radiography and radioisotope scintigraphy were effective methods in the diagnosis of gastroparesis, and normal gastrointestinal movement was achieved mostly in 5 weeks postoperatively by conservative treatments.Conclusions Postoperative gastroparesis can recover spontaneously after a longer period of supportive treatment combined with prokinetic drugs, and reoperation should be avoided.

Perioperative management of abdoimal surgery in over aged patients / 中国普通外科杂志

Objective To study the perioperative management of abdominal surgery in patients aged over 80 years. Methods The cliuical data of 25 patients aged over 80 years undergoing abdominal surgery were analysed retrospectively. Results Of the 25 patients, 8 subjected to biliary surgery, 13 gastiic cancer or cardiac cancer surgery, 1 esophageal cancer surgery, 3 intestinal surgery. 24 patients(96%) were cured; one died postoperalively.Conclusions In over aged patieats, they have more coexite diseases, and more postoperative complications, so extensive perioperative management, choice of selective operation, reducing of emergent operation, and giving albumin to help the recovery of tissues are essential.

Diagnosis and therapy of intra-abdominal hernia / 中国普通外科杂志

Objective To investigate the causes of intra-abdominal hernia and improve the level of early (diagnosis) and therapy of intra-abdominal hernia. Methods A retrospective analysis of the clinical data of 68 cases of intra-abdominal hernia was made. Results The postoperative confirmed diagnosis was para-occal hernia in 1 patient;herniation of efferent jejunal loop through the space between the afferent jejunal loop and the mesocolon after Billroth II gastrectomy in 6 patients,one of which had bowel necrosis,all of the 6 patients were cured after reduction of the hernia or enterectomy after and enteroanastomsis;internal henia though (ruptured) pelvic (peritoneum) after Miles operation in 4 patients;internal hernia though the space between the (descending) colon and the lateral abdominal wall after colostomy of descending colon in 6 patients;internal (hernia) caused by (adhesion) of omentum to the intestinal wall of sigmoidostomy in 1 patient;internal hernia through hiatuses caused by postoperative or post-peritonitis adhesions to the peritoneum,ovaries,urinary (bladder),uterus,(intestinal) wall or between loops of intestine in 50 patients(73.5%),including 3 cases of bowel (necrosis).All of those patients were cured after reduction of the hernias,repair of the hiatuses,release of (adhesions) or enterectomy and enteroanastomosis. Conclusions Preoperative diagnosis of internal abdominal hernia is difficult.The possibility of internal abdominal hernia should be cansidered in patients with a history of operation,and who complain of frequent abdominal pain or bowel obstruction.Early diagnosis and prompt (operation) is necessary to prevent the occurrence of bowel strangulation and bowel necrosis.

Establishment and assessment of a model of abdominal postoperative fatigue syndrome in rats / 中国普通外科杂志

Objective To establish and assess a model of abdominal postoperative fatigue syndrome (POFS) in rats. Methods After 70% hepatectomy was performed, the following observations of the animals were made:general condition, rat tail suspension test,weight carrying swim fatigue test,serum levels of albumin,ferrition,and iron,pathologic assessment of injury of small intestinal mucosa and hepatic albumin gene expression .Results After 70% hepatectomy of the rats,their general candition was poor,the level of physical tolerance decreased,they showed a certain amount of depression,and marked changes were found in nutritional index,stress injury of small intestinal mucosa and hepatic albumin gene expression.Conclusions A 70% hepatectomy rat model has the basic characteristics of clinical abdominal POFS, and can be used as an experimental animal model for the study of abdominal POFS.