Application of nano-carbon and titanium clip combined labeling in robot-assisted laparoscopic transverse colon cancer surgery.

BACKGROUND: Robot-assisted laparoscopic transverse colon tumor surgery requires precise tumor localization. The purpose of this study was to evaluate the safety and efficacy of nano-carbon and titanium clip combination labeling methods in robot-assisted transverse colon tumor surgery. METHODS: From January 2018 to January 2019, the clinical data of 16 patients who come from FuZhou, China underwent preoperative nano-carbon and titanium clip combined with robot-assisted laparoscopic transverse colon cancer surgery were retrospectively analyzed. RESULTS: Of the 16 patients, no signs of abdominal pain, fever, or diarrhea were observed after colonoscopy. Two titanium clips were seen on all of the 16 patients' abdominal plain films. Nano-carbon staining sites were observed during the operation, and no staining disappeared or abdominal cavity contamination. All patients underwent R0 resection. The average number of lymph nodes harvsted was 18.23 ± 5.04 (range, 9-32). The average time to locate the lesion under the laparoscopic was 3.03 ± 1.26 min (range, 1-6 min), and the average operation time was 321.43 ± 49.23 min (range, 240-400 min). All were consistent with the surgical plan, and there was no intraoperative change of surgical procedure or conversion to open surgery. CONCLUSION: Preoperative colonoscopy combined with nano-carbon and titanium clip is safe and effective in robot-assisted transverse colon cancer surgery. A At the same time, the labeling method shows potential in shortening the operation time, ensuring sufficient safety margin and reducing complications.

Application of chain-based sponge dressing for gunshot wounds in the groin.

BACKGROUND: With the application of limb tourniquet, junctional hemorrhage has outstripped extremity hemorrhage as the leading cause of death during recent conflicts in Afghanistan and Iraq. We used a gunshot wound femoral artery bleeding model to verify the effect of chain-based sponge dressing (CSD). METHODS: We used a rifle to shoot the femoral artery of female Bama miniature pigs to achieve a gunshot wound model. Pigs were immediately subjected to CSD (n = 4) or standard gauze (SG; n = 4) to achieve hemostasis. We compared outcomes between the CSD and SG groups. RESULTS: There was no significant difference in baseline data between the two groups. The average hemorrhage time was 38.75 ± 9.29 s after CSD and 630.75 ± 169.46 s after SG (p < 0.05). The success rate in the CSD group was 100% (4/4), while the success rate in the SG group was 25% (1/4). The survival time of the CSD group (120 min) was significantly longer compared with the SG group (62.25 min; p < 0.05). There was no statistically significant difference in the average time for removal of the hemostatic material between the two groups. One week after the experiment, animals had a normal diet and were walking. No secondary damage was caused by CSD. CONCLUSION: We used a gun-shot wound model to verify the effectiveness of CSD in the groin area. CSD achieved hemostasis quickly in all animals, and mean arterial pressure remained at normal levels. These findings suggest that CSD may be appropriate for humans with junctional hemorrhage due to bullet wounds, although further research is needed.

Ingested a fish bone-induced ileal perforation: A case report.

INTRODUCTION: Gastrointestinal perforation due to foreign body intake is rare and often secondary to unintentional intake; hence, a misdiagnosis is likely. Herein, we report a case of perforation of the ileum due to fish bone. CASE PRESENTATION: A 57-year-old woman presented with right lower abdominal pain. She did not provide any information about having a history of swallowing foreign bodies. Surgery for uterine fibroids and subtotal gastrectomy was performed 6 years ago. DIAGNOSIS: Laboratory tests and imaging examination showed normal results. During laparotomy, a fish bone was found at the end of the ileum. Two senior radiologists re-evaluated the computed tomography scan, and confirmed the presence of the suspected foreign body. INTERVENTIONS: Partial intestinal resection and manual ileum end anastomosis were performed. OUTCOMES: The patient recovered well after surgery and recalled that she had eaten fish the night before experiencing abdominal pain. CONCLUSION: An accurate diagnosis of complications due to fish bone intake, often secondary to the unintentional intake, is quite challenging. Detailed history-taking about the patient's diet and eating habits is therefore important. Clinical manifestations are mainly determined by the location of perforation, which typically occurs at the junction of the ileum and rectal sigmoid colon. Imaging examination and surgery are often used for definite diagnosis.

A Novel Method of Damage Control for Multiple Discontinuous Intestinal Injuries with Hemorrhagic Shock: A Controlled Experiment.

Aim: In this study, we examined the effects of branched silicon tube (BST) and temporary closed circle (TCC) in a Beagle dog model of multiple transection of small intestine and discontinuities suspected intestinal necrosis with hemorrhagic shock. Materials and Methods: Ten male Beagle dogs were randomly divided into two groups. Hemorrhagic shock was induced by bleeding. Intestine was severed. Suspected intestinal necrotic model by ligating the mesenteric vessels was established, with a small tertiary mesenteric vessel reserved. Fracted intestines were ligated (IL group, n = 5) or reconnected with BST (IR group, n = 5). The abdominal cavity was temporarily closed with TCC. Definitive surgery was conducted after 24 h. Results: There was no statistical difference between two groups in the weight of dogs, their blood loss, fluid resuscitation, operation time of early emergency treatment (EET). After definitive surgery, all dogs in IR group and 3 dogs in IL groups were alive. 18 (90%) suspicious necrotic intestinal segments in IL group became necrotic, but 20 (80%) segments in IR group didn't develop obvious changes (p < 0.01). From 2 h after EET, the endotoxin concentration in IL group was significantly higher than that in IR group (133.87 ± 43.73 vs. 56.31 ± 24.70 pg/ml, p < 0.01). Microscopic examination revealed that much more severe damage occurred in the suspicious necrotic intestinal segments in IL group. Conclusion: Both reconnecting intestine with BST and temporary abdominal closure with TCC are viable methods of damage control for multiple discontinuous intestinal injuries.