ABSTRACT
Objective To investigate the efficacy and safety of transumbilical single-port laparoscopic appendicectomy in acute complicated appendicitis.Methods Retrospective analysis was conducted for the data of 1104 patients with complicated appendicitis who underwent emergency laparoscopic appendectomy at the Department of General Surgery of Aerospace Center Hospital from April 2014 to August 2022;among them,788 patients underwent transumbilical single-port laparoscopic appendectomy(SILA)and 316 cases underwent traditional three-port laparoscopic appendectomy(LA);the operation time,intraoperative blood loss,leukocyte value on the first day after surgery,postoperative exhaust time,hospital stay,postoperative pathology and postoperative complications were statistically analyzed.Results The surgical duration of the single hole laparoscopic appendectomy(SILA)group was(68.26±22.29)minutes,intraoperative blood loss was(15.93±13.10)ml,postoperative exhaust time was(2.29±0.52)days,and white blood cells were(11.12±1.67)× 109/L on the first day after surgery,and the surgical duration of the hree hole laparoscopic appendectomy(LA)groupwas(66.47± 20.40)minutes,intraoperative blood loss was(16.65±12.98)ml,postoperative exhaust time was(2.23±0.58)days,and white blood cells were(11.35±1.54)× 109/L on the first day after surgery,there was no statistically significant difference in the data between each group(P＞0.05).After 1 month of follow-up,no incisional hernia and other complications occurred in the two groups,the cosmetic effect of abdominal incision in SILA group was satisfactory,the hospitalization time of SILA group was(4.60± 1.18)days,which was shorter than that in the traditional LA group(4.93±1.71)days,and the difference was statistically significant(P＜0.05).Conclusion Based on proficiency in traditional LA operations,SILA is safe and viable;in addition to the hidden aesthetic function of scars,it does not prolong the operation time and increase the risk of postoperative complications.
ABSTRACT
Objective To investigate the clinical efficacy of complete mesogaster excision in the radical gastrectomy for gastric cancer.Methods The clinical data of 100 patients with distal gastric cancer who were admitted to the First Affiliated Hospital of Harbin Medical University from January 2011 to December 2012 were retrospectively analyzed.All the patients underwent complete mesogaster excision in D2 radical gastrectomy for gastric cancer.The operation quality was evaluated according to operation time,volume of intraoperative blood loss,mean number of lymph nodes dissected,time to flatus,volume of drainage and duration of postoperative hospital stay.Patients were followed up by outpatient examination and telephone interview till May 2014.Results Complete mesogaster excision in the radical gastrectomy for gastric cancer was successfully carried out on all the 100 patients.The operation time,volume of intraoperative blood loss,mean number of lymph nodes dissected,time to flatus,volume of drainage and duration of postoperative hospital stay were (118 ± 34) minutes (range,90-160 minutes),(80±25)mL (range,45-135 mL),38± 10 (range,25-52),(3.0 ± 1.2)days (range,1.5-4.5 days),(62±15)mL (range,15-85 mL) and (7.0±1.5)days (range,4.0-11.5 days),respectively.According to the postoperative pathological results,there were 36 patients with high differentiated gastric carcinoma,38 with moderate and/or low differentiated gastric carcinoma,17 with low differentiated gastric carcinoma and 9 with signet ring cell carcinoma.After operation,3 patients had gastroplegia,2 with poor healing of abdominal incision,2 with duodenal stump fistula,1 with pancreatic fistula,and all of them were cured by conservative treatment.All the 100 patients were followed up for a mean time of 25.6 months (range,17.6-39.2 months).There was no tumor recurrence.Conclusions Complete mesogaster excision in the radical gastrectomy for gastric cancer is safe and feasible,with the advantage of minimal trauma,low morbidity and quick recovery during the follow up.