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Objective To investigate the effects of esculin and digitalisglycosides eye drops combined with 532 laser on the treatment of diabetic retinopathy.Methods 65 cases(130 eyes)with diabetic retinopathy in our hospital from November 2012 to November 2015 were selected and divided into observation group(33 cases)and control group(32 cases).The control group was treated with 532 laser treatment,and the observation group was combined with esculin and digitalisglycosides eye drops.Two groups of treatment were one months.Therapeutic effect of two groups were compared,improvement of visual acuity,retinal hemorrhage,exudation,edema absorption time,before and after macular retinal thickness changes.Results After treatment,the total efficiency of the observation group(96.97％)was higher than the control group(75.00％),the difference was statistically significant(P<0.05),the visual acuity of the observation group was significantly higher than that of the control group,and decreased significantly less than the control group,the difference was statistically significant(P<0.05),the retinal hemorrhage,exudation and edema were observed in the observation group faster than the control group,the difference was statistically significant(P<0.05),the macular retinal thickness decreased in the two groups after treatment,the difference was statistically significant(P<0.05),the retinal thickness of the macular area was lower in the observation group than in the control group,the difference was statistically significant(P<0.05).Conclusion Esculin and digitalisglycosides eye drops combined with 532 laser in the treatment of diabetic retinopathy has significant effect,and can reduce the macular retinal thickness,which has important clinical significance.
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<p><b>OBJECTIVE</b>To investigate the safety and feasibility of forgoing postoperative nasogastric tube decompression in minimally invasive esophagectomy for patients with esophagus carcinoma.</p><p><b>METHODS</b>Clinical data of 90 eligible patients who underwent elective minimally invasive esophagectomy in our department from January 2012 to May 2013 by the same surgical team were retrospectively analyzed. Among them, 45 patients did not receive the use of postoperative nasogastric tube decompression and 45 patients received nasogastric tube decompression after operation. The observation parameters included the time to first flatus, the time to intake of fluid diet, the duration of postoperative hospitalization, pharyngalgia, vomiting, and postoperative complications, as well as the need for placing or replacing the nasogastric tube.</p><p><b>RESULTS</b>The incidence of pharyngalgia was significantly higher in nasogastric tube group (100% vs 44.4%, P<0.001). The time to intake of fluid diet [median 2 d(2-4 d) vs. median 9 d(7-20 d), P<0.001] and the time to first flatus [median 3 d(3-8 d) vs. median 6 d(3-9 d), P<0.001] were all significantly shorter in non-nasogastric tube group as compared to nasogastric tube group. Compared with the nasogastric tube group, the non-nasogastric tube group had shorter postoperative hospital stay (P<0.001). There were no significant differences in the incidence of postoperative complications and vomiting between two groups.</p><p><b>CONCLUSION</b>Minimally invasive esophagectomy without the use of postoperative nasogastric tube decompression is safe and feasible, which can improve recovery and shorten postoperative hospital stay.</p>
Subject(s)
Humans , Decompression , Esophageal Neoplasms , General Surgery , Esophagectomy , Methods , Incidence , Intubation, Gastrointestinal , Minimally Invasive Surgical Procedures , Methods , Postoperative Complications , Postoperative Period , Retrospective StudiesABSTRACT
Objective To investigate the feasibility of combined laparoscopic and thoracoscopic esophagectomy for esophageal carcinoma and gastro-esophageal anastomosis in right thoracic cavity.Methods We retrospectively analyzed the clinical data of 38 patients who underwent esophagectomy for esophageal carcinoma and gastro-esophageal anastomosis in right thoracic cavity from October 2011 to August 2012.To remove the stomach in laparoscopic and the esophagus in thoracoscopy.The main portion of a gastric conduit is created using three to four firings of a linear stapler(Ethicon Endo-surgery,Cincinati,OH) and jejunum stoma.Gastric conduit was pulled into the chest cavity and anastomosed to the esophagus.Results The average operative time was 280 minutes,the mean operative blood loss was 120 ml.No patient required laparotomy.No pulmonary complications or anastomotic leaks occurred.One had gastric retention,another one had chylous hydrothorax.All patients were cured,no one dead in hospital.Conclusion Combined laparoscopic and thoracoscopic esophagectomy for esophageal carcinoma and gastro-esophageal anastomosis in right thoracic cavity is technically feasible and safe,minimized trauma,less operative blood loss and quick recovery.
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Objective To study the indication,feasibility and short-term efficacy of combined thoracoscopic and laparoscopic radical esophagectomy for the treatment of esophageal cancer.Methods Retrospective medical records analysis was conducted for 139 esophageal cancer patients who underwent combined thoracoscopic and laparoscopic esophagectomy in our department from December 2009 to August 2011.The tumors were located in upper esophagus in 16 cases,middle esophagus in 107 cases,and lower esophagus in 16 cases.The surgery started with the thoracoscopic mobilization of thoracic esophagus and lymph nodes dissection,which were followed by the laparoscopic stomach mobilization and gastroesophageal anastomosis in left neck.Postoperative pathological staging identified stage Ⅰ esophageal cancer in 25 cases ( stage Ⅰ a:13 cases,stage Ⅰ b:12 cases),stage Ⅱ esophageal cancer in 71 cases,stage Ⅲ esophageal cancer in 31 cases ( stage Ⅲ a:16 cases,stage Ⅲ b:15 cases) and stage Ⅳ esophageal cancer in 12 cases.Results Except for open conversions in 4 cases (2.9％),all surgical operations were completed smoothly.Postoperative anastomotic leak was found in 6 cases(4.3％ ),chylothorax in 1 case(0.7％ ),arrhythmia in 4 cases(2.9％ ),and dumping syndrome in 1 case( 0.7％ ).All of these complicated cases fully recovered after conservative treatments.Postoperative lung infection was found 11 cases (7.9％),3 of whom required tracheotomy and assisted ventilation and 1 case died as a result of the infection (mortality rate:0.7％ ).Ten cases(7.2％ ) presented with hoarseness postoperatively.Out of the 139 cases,130 cases were successfully followed up with durations ranged from 1 to 20 months,during of time the esophageal cancer spread to liver in 2 cases,celiac lymph nodes in 4 cases,lung in 2 cases,and bone in 1 case.Ten cases died,and all remaining cases remained alive during the follow up.The one-year survival rate was 88.9％ for these cases.Conclusion Combined thoracoscopic and laparoscopic radical esophagectomy is a technically safe and feasible treatment for esophageal cancer.The short-term efficacy results are satisfactory.This technique is indicated not only for early and middle stage esophageal cancer,but also for some of the advanced esophageal cancer cases.
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<p><b>OBJECTIVE</b>To determine the feasibility and efficiency of terminating atrial flutter (AFL) and atrial fibrillation (AF) using synchronous low-energy shocks delivered through a novel transesophageal electric balloon electrode system.</p><p><b>METHODS</b>By using a novel electric balloon electrode system, we attempted 91 transesophageal cardioversions in 52 patients, to treat 53 episodes of AFL and 38 episodes of AF.</p><p><b>RESULTS</b>Of the 40 patients of AFL that failed to respond to drug therapy, 37 (92.5%) were successfully countershocked to sinus rhythm by transesophageal cardioversion, with a mean energy of (22.70 +/- 4.50) J (20 - 30 J). Of the 19 patients in AF, transesophageal cardioversion was successful in 16 (84.2%) cases, requiring a mean delivered energy of (17.38 +/- 8.58) J (3 - 30 J). There were no complications such as heart block or ventricular fibrillation, and no evidence of esophageal injury.</p><p><b>CONCLUSIONS</b>Transesophageal cardioversion using an electric balloon electrode system is an effective and feasible method for the treatment of AFL and AF. It requires low energy and no anesthesia, leads to less trauma, and shows a high cardioversion success rate that may prove valuable in the management of tachyarrhythmias.</p>