ABSTRACT
Most internal hernias are acquired, due to abdominal adhesion or changes in abdominal anatomical structure after operation, which is a rare postoperative complication in clinic. Due to the lack of specific clinical manifestations, the preoperative diagnosis rate of internal hernia is low. If the treatment of internal hernia is delayed there may be intestinal ischemia and necrosis, short bowel syndrome and other disastrous consequences. Therefore, attention should be paid to the prevention of internal hernias after abdominal surgery. Combined with the literature and experience, the author will introduce several common measures and methods for the prevention of internal hernias after abdominal gastrointestinal surgery.
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Objective To evaluate and compare the efficacy and safety of laparoscopic surgery in the treatment of elder colorectal cancer patients.Methods Selected the retrospective or prospective studies which were retrieved in Pubmed,web of Science,Embase as laparoscopic,laparoscopic colectomy,colorectal cancer,rectal cancer,octogenarian,elderly published between Jan.2000 and May 2017.Data regarding operative indexes,postoperative complications and long term outcomes were analyzed by Stata12.0 software.Results A total of 18 articles,included 3 162 patients,were enrolled in this study.The Meta-analysis indicated that there were no significant differences of less blood loss,postoperative wound infection,bowel obstruction and cardiovascular complications in laparoscopic surgery group except the operative time (P ＜ 0.05).No significant difference was found in the number of dissected lymph node,pneumonia,overall survival and disease free survival (P ＞ 0.05).Conclusion With advantages of rapid postoperative recovery and fewer complications,laparoscopic radical resection for colorectal cancer in elderly patients is safe and effective.
ABSTRACT
Objective To evaluate and compare the efficacy and safety of laparoscopic surgery in the treatment of elder colorectal cancer patients.Methods Selected the retrospective or prospective studies which were retrieved in Pubmed,web of Science,Embase as laparoscopic,laparoscopic colectomy,colorectal cancer,rectal cancer,octogenarian,elderly published between Jan.2000 and May 2017.Data regarding operative indexes,postoperative complications and long term outcomes were analyzed by Stata12.0 software.Results A total of 18 articles,included 3 162 patients,were enrolled in this study.The Meta-analysis indicated that there were no significant differences of less blood loss,postoperative wound infection,bowel obstruction and cardiovascular complications in laparoscopic surgery group except the operative time (P ＜ 0.05).No significant difference was found in the number of dissected lymph node,pneumonia,overall survival and disease free survival (P ＞ 0.05).Conclusion With advantages of rapid postoperative recovery and fewer complications,laparoscopic radical resection for colorectal cancer in elderly patients is safe and effective.
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Objective To observe the clinical effect of procedure for prolapse and hemorrhoids (PPH) in treating hemorrhoids.Methods 78 patients with symptomatic Ⅱ,Ⅲ and Ⅳ degree hemorrhoids undergoing PPH were selected in this study.The diagnosis,medical history,operative time,blood loss and perioperative complications were recorded.The World Health Organization Quality of Life Scale(WHOQOL-BREF) was observed preoperation and 6 hours,24 hours,1 month postoperation.Results The postoperative pain score measured by visual analogue scale (VAS) at postoperative six hours was (7.6 ± 2.1),which reduced to (1.3 ± 1.1) at 24 hours.There was significant improvement in the overall perception of QOL,health,and in physical and psychological domains (t =1.901,1.805,1.714,P =0.041,0.038,0.029,all P ＜ 0.05).There was modest improvement in environmental domain,while no change was found in social domain (P ＞ 0.05).Conclusion PPH surgery achieves good clinical results,improved quality of life of patients,with a low incidence of complications,patients with hemorrhoids should be recommended for this preferred surgical approach.
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Objective To analyze the complications and short-term effects of laparoscopic surgery for achalasia.Methods The clinical data of 41 patients with achalasia who were treated by laparoscopic surgery were analyzed retrospectively.Results The 41 patients were no deaths.All patients underwent Heller cardiomyotomy and fundoplication,39 patients with Dor anterior fundoplication,2 patients had the presence of hiatal hernia with Toupet fundoplication.The mean surgical time was 142 min.Intraoperative complications occurred in 7 cases,including 6 cases of mild complications.The mean follow-up was 21 months.The clinical efficacy excellent in 27 cases,good in 7 cases,generally in 5 cases,poor in 2 cases.Conclusions Heller cardiomyotomy should be the treatment of choice in achalasia patients,because of its short and medium term outcomes,and its low morbidity.
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Objective To investigate the effects of exogenous wild DCC gene stably transfection on growth of colorectal carcinoma cell line SW1116 in vitro. Methods DCC gene domain was amplified from human normal colon tissue by reverse transcript-polymerase chain reaction(RT-PCR). At first,a recombinant expression plasmid pcDNA3. 1( + )-DCC was constructed. Human colorectal carcinoma cell line SW1116 with-out DCC gene was transfected with pcDNA3. 1-DCC. Cell viability was tested by methyl thiazolyl tetrazolium (MTT)assay. Immunofluorescence staining was used to determine the effects of pcDNA3. 1-DCC and expres-sion of carcino-embryonic antigen(CEA)in human colorectal carcinoma cell line SW1116 which was transfect-ed with pcDNA3. 1-DCC. Results The population of cells transfected with pcDNA3. 1( + )-DCC plasmid was lower than those with pcDNA3. 1( + )-DCC plasmid and normal cells(t = 3. 645,P ﹤ 0. 05;t = 3. 132,P ﹤0. 05)at 3 ~ 6 days after transfection,and the proliferation rate of cells transfected with pcDNA3. 1( + )-DCC plasmid was lower than those with pcDNA3. 1( + )plasmid and normal cells(t = 2. 134,P ﹤ 0. 05;t = 2. 736, P ﹤ 0. 05). Cell line SW1116 transfected with pcDNA3. 1( + )-DCC plasmid total viability was lower than nor-mal cells(t = 3. 053 ,P ﹤ 0. 05)at 2 ~ 6 days after transfection. Cell line SW1116 transfected with pcDNA3. 1 ( + )-DCC plasmid total viability was lower than those with pcDNA3. 1( + )plasmid(t = 2. 816,P ﹤ 0. 05)at 2,4,5,6 days after transfection. The population of flavo-green colour cells transfected with pcDNA3. 1( + )-DCC plasmid and the fluorescent intensity of these cells were lower than those with pcDNA3. 1( + )plasmid and normal control cells. Conclusion Transfected DCC gene can suppress the cell proliferation and make CEA expression of cell line SW1116 down regulation to weaken its infiltration and metastasis abilities.