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Objective:To investigate the understanding of microsurgery education for clinical medical students, and the education methods for microsurgery courses in 8 schools.Methods:The questionnaire was designed around four aspects: the learning status of Chinese medical students in microsurgery learning, the impact of microsurgery learning on future career choices, the current situation of opening microsurgery courses in 8 medical schools, and the opinions and suggestions on improving microsurgery learning in China. Electronic and paper questionnaires were combined to evaluate the condition of understanding microsurgery among 1 000 medical students from Peking University Health Science Center and other 7 schools. Then, the validity of the collected questionnaires was reviewed. SPSS 19.0 were applied for data analysis.Results:A total of 808 valid questionnaires were collected (recovery rate=80.8%). Respondents' understanding of microsurgery remained at the level of "just heard" (2.18±2.83), and 98.41% (795/808) of the students believed that microsurgery related disciplines would bring certain help to their future careers. Male students more recognized the impact of microsurgery learning on future career than female students [(6.19±2.36) vs. (5.76±2.09), P< 0.05)]. In these 8 investigated universities, only Shanghai Jiao Tong University School of Medicine and Zhongshan School of Medicine of Sun Yat-sen University conducted a microsurgery course, while 80.01% (531/663) of the students in the other 6 universities wanted to set microsurgery courses. Microsurgery operation observation (86.82%, 701/808), animal models for microsurgery practical training (82.95%, 670/808), and online theory courses (43.18%, 349/808) were able to increase the interest in microsurgery learning for students. Conclusion:Microsurgery course can bring many benefits to medical students, and it is urgent for domestic medical colleges to carry out microsurgery related courses.
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Objective To compare the clinical effect of laparoscopic and open umbilical hernia repair for adult umbilicalhernia.Methods Eighty-threepatients with adult umbilical hernia admitted to People's Hospital of Beijing Daxing District from Feb.2008 to Jan.2017 were randomly divided into laparoscopic umbilical hernia repair group (n =38) and open umbilical hernia repair group (n =45).Patients in laparoscopic umbilical hernia repair group accepted laparoscopic umbilical hernia repair with intraperitoneal onlay mesh (n =38),while patients in open umbilical hernia repair group accepted traditional umbilical hernia repairtreatment.Operation time,hospital stay,blood loss,seroma/hematoma formation,wound infection,incomplete bowel obstruction and recurrence were compared between the two groups with the software of SPSS 22.0.The outpatient consultation was performed at 2 weeks,1 month,3 months,and 6 months after operation.The follow-up contents were wound condition,pain,and whether there were any masses in the umbilicus.After every 3 months of telephone follow-up or outpatient review,whether there were any masses in the umbilicus,the average follow-up time was 14 months.Results All operations were successfully completed.The operation time of laparoscopic umbilical hernia repair group was shorter than open umbilical hernia repair group [(31 ± 8) min vs (48 ± 10) min,P ＜ 0.01],and hospital stay were significantly shortened in laparoscopic umbilical hernia repair group (P ＜ 0.05).The amount of bleeding of the laparoscopic umbilical hernia repair group decreased significantly than open umbilical hernia repair group [(40 ± 18) ml vs (62 ± 25) ml,P ＜ 0.01].The postoperative painof the laparoscopic umbilical hernia repair group was mild than open umbilical hernia repair group (P ＜ 0.05).The postoperative complications include seroma,wound infection and incomplete bowel obstruction.There were no significant differences between the two groups of seroma,incision infection and recurrence (P ＞ 0.05).The difference of the incidence of incomplete bowel obstruction between the two groups was statistically significant (P =0.019) . The total postoperative complication rate was significantly lower in laparoscopic umbilical hernia repair group than in open umbilical hernia repair group(x2 =5.328,P =0.021).Conclusions Laparoscopic umbilical hernia repair has short operation time,less bleeding,and satisfactory postoperative pain.It is worthy of advocacy for umbilical hernia patients who can tolerate general anesthesia.
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Objective To compara the postoperative pain and foreign body sensation in patients with inguinal hernia treated by laparoscopic transabdominal preperitoneal (TAPP) and open transinguinal preperitoneal (TIPP).Methods Retrospective analysis of clinical data of 180 patients with inguinal hernia admitted to the Daxing District People's Hospital of Capital Medical University from January 2016 to January 2018,male 158 cases,female 22 cases,average age 56 years old,age range 23-80 years old.Including 110 patients in the TAPP group and 70 patients in the TIPP group,patients in the TAPP group were treated with laparoscopic TAPP,and patients in the TIPP group were treated with open TIPP.Pain degree was assessed with pain visual analogue scale (VAS) postoperatively at 3 weeks,3 months and 6 months.The incidence of chronic pain was measured at 3 weeks,3 months,and 6 months after surgery,and the incidence of foreign body sensation at 3 months was recorded.Measurement data were expressed as mean ± standard deviation (Mean ± SD),t test was used for comparison between groups;Chi-square test was used for compare the count data between groups.Results At 3 weeks,3 months,and 6 months after surgery,the mean value of pain VAS in the TAPP group was lowerthan in the TIPP group [(0.07 ± 0.40) scores vs (0.37 ± 0.94) scores,(0.03 ± 0.16) scores vs (0.24 ± 0.69) scores,(0.01 ± 0.10) scores vs (0.14 ± 046) scores],and the difference was statistically significant (P =0.004,0.002,0.004).The incidence of pain in the TAPP group was 3.6％,2.7％,and 0.9％ at 3 weeks,3 months,and 6 months after surgery,respectively.The incidence of pain in the TIPP group was 14.3％,11.4％,and 10.0％,respectively.The difference was statistically significant (P =0.021,0.040,0.012).At 3 months postoperatively,there were 2 cases (1.8％) in the TAPP group and 12 cases (17.1％) in the TIPP group with the foreign body sensation.The difference between the two groups was statistically significant (x2 =14.006,P =0.000).Conclusion Compared with the open TIPP,the laparoscopic TAPP is used to repair the inguinal hemia,The postoperative pain is milder,and the incidence of chronic pain and foreign body sensation was lower.
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Objective To compare the effect of ultrasound-guided Mammotome minimally invasive operation and traditional surgery in treating benign breast tumor.Methods Eighty patients with benign breast tumor admitted to People's Hospital of Beijing Daxing District from October 2015 to April 2016 were randomly divided into group A and group B.Patients in group A accepted ultrasound-guided Mammotome minimally invasive operation (n =40),while patients in Group B accepted traditional surgery (n =40).Operation time,incision length,blood loss,patient satisfaction,postoperative pain,and the occurrence rates of complications were compared between the two groups.Results All the tumors in two groups were removed.Patients in group A had shorter operation time (10.4 ± 1.0) min,less blood loss (4.1 ± 0.5) ml,smaller length of incision (0.34 ± 0.04) cm (P ＜ 0.05 or P ＜ 0.01);also had less occurrence of complication (P ＜ 0.05);and patients in group A had better patient's satisfaction (95％) (P ＜ 0.01).Conclusions Ultrasound-guided Mammotome minimally invasive operation is helpful to shorten operation time and incision length,and reduce blood loss,also improve satisfaction.It is valuable for application and popularization in primary hospital.