Surgical Research and New Technique

Comparative study of the safety and efficacy between diode laser enucleation and bipolar plasmakinetic enucleation for prostates larger than 80 ml

2015, 4 (2): 71-74.

Abstract ( 130 )

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【Abstract】 Objective We compared the safety and efficiency of diode laser enucleation with that of bipolar plasmakinetic enucleation for the treatment of large volume prostate (>80ml). Methods From June 2012 to January 2014，A total of 70 patients with lower urinary tract symptoms associated with large volume prostate were included in our study. Of these, 35 patients were treated with diode laser enucleation of the prostate. No significant differences were observed in the pre-operative data. All patients were preoperatively assessed and evaluated at 3, 6, and 12-months. Perioperative data and postoperative outcomes were compared. Immediate and late complications were also assessed. Results Both groups displayed significant improvements in IPSS, QoL and Qmax 12 month after surgery. However, we identified there was no significant differences between the two groups in the follow-up data (P>0.05). Patients treated with diode laser showed a lower risk of blood loss [(0.92 ± 0.43)g/dl vs (1.24 ± 0.55)g/dl], as well as shorter bladder irrigation [(28.9 ± 14)h vs（38.5 ± 16.6）h] and catheterization times [(2.6 ± 1.8)d vs (3.8 ± 2.3)d]. A larger amount of prostate tissue was retrieved in the DiLEP group, but the operation time of the diode laser group was longer than that of the bipolar plasmakinetic enucleation group [(123.5 ± 27.2)min vs (102.7 ± 20.4)min]. There was no significant difference in the rate of postoperative urinary retention, blood transfusion, reoperation and incidence of stress urinary incontinence (P>0.05). However, the diode laser group was significantly superior to bipolar plasmakinetic group in terms of the irritative symptoms and ejaculatory function in the postoperative period. Conclusions DiLEP provides more widely application range, less risk of haemorrhage, reduced bladder irrigation and catheter indwelling duration as well as reduced hospital stay. Diode laser enucleation of the prostate is a safe and effective method for the transurethral management of prostates larger than 80 ml.

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Comparative Analysis of Curative Effects of Laparoscopic Assisted Sphincter-Preserving Surgery and Conventional Open Surgery in Low Rectal Cancer

2015, 4 (2): 75-77.

Abstract ( 99 )

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Objective:To observe the clinical efficacy of laparoscopic assisted sphincter-preserving surgery and conventional open surgery in low rectal cancer. Method:90 patients with low rectal cancer were selected and divided into research group and control group according to different operative plans. The research group adopted the laparoscopic assisted sphincter-preserving surgery and control group adopted the conventional open surgery. The general operation conditions like surgical procedures, intraoperative blood loss, operation time, preserving rate of sphincter, intraoperative/postoperative transfusion rate were observed. The postoperative recovery time of intestinal function, hospitalization time as well as postoperative complications of two groups was compared. Result:The intraoperative blood loss, operation time and intraoperative/postoperative transfusion rate of research group was (297.3±185.3)ml, (221.3±51.3)min and 2.22% while the intraoperative blood loss, operation time and intraoperative/postoperative transfusion rate of control group was (370.1±198.3)ml, (245.3±55.0)min and 13.33% (P＜0.05); the postoperative recovery time of intestinal function of research group and control group was (2.3±1.6)d and (3.8±1.7)d (P＜0.05); the incidence rate of postoperative complications of research group (15.56%) was significantly lower than that of control group (35.56%) (P＜0.05).Conclusion: For low rectal cancer, the laparoscopic assisted sphincter-preserving surgery have a better clinical efficacy than the conventional open surgery, which it can reduce the patient’s injury, promote the recovery of intestinal function and have fewer complications. It is worthy of promotion.

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Hemihepatectomy combined with caudate lobectomy: report of 31 cases

2015, 4 (2): 81-84.

Abstract ( 115 )

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Hemihepatectomy combined with caudate lobectomy: report of 31 cases Baomin Shi, Zhenhai Zhang, Zhongxue Su, Chengkun Qin, Jian Xu, Qingling Mu, Taihuang Wu Department of Hepatobiliary Surgery, Shandong Provincial Hospital of Shandong University, Jinan, 250021, China Objective: To explore the rationality and possibility of right or left hemihepatectomy combined with partial or whole caudate lobectomy and analyze its indications. Methods: Thirty-one patients surgically treated by hemihepatectomy combined with caudate lobectomy were retrospectively studied. The primary lesions included hepatocellular carcinoma(n=16), hilar cholangiocarcinoma(n=5), giant hemangioma(n=3), hepatolithiasis(n=4), hepatic metastasis(n=1), liver injury(n=1), hepatic inflammatory pseudotumor(n=2). Sixteen of the total were operated with right hemihepatectomy combined with caudate lobectomy and fifteen of them with left hemihepatectomy combined with caudate lobectomy. Result: The average operating time was 218±61 min(130min~367min). The average amount of blood loss was 350±283 ml(80ml~1100ml). Nineteen of the total were not given transfusion because their blood loss were less than 300ml during operation. The perioperative mortality was 0 and total morbidity was 35.5%(11/31), including pleural effusion(n=5), fat liquefaction of incision(n=2), slight hepatic encephalopathy(n=1), biliary leakage(n=3). All complications were treated successfully without operation. Conclusion: Liver lesions involving caudate lobe, either benign or malignant, could be safely and effectively by hemihepatectomy combined with partial or whole caudate lobectomy. Key words: hemihepatectomy, caudate lobectomy, morbidity, mortality

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Comparative study the animal model of carotid artery bypass constructed by different methods in rabbit

2015, 4 (2): 85-88,102.

Abstract ( 162 )

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Objective To construct the animal model of carotid artery bypass by three different methods and comparative study the experimental results. Methods 36 rabbits were divided into three groups. P1 group: the external jugular vein was inversion and interposed to the ipsilateral carotid artery using an end-to-side continuous suture technique; P2 group: the carotid artery bypass was constructed by end-to-end continuous suture technique; C group: the animal model was constructed by cuff technique. The time of surgery and anastomoses, blood loss in operation, the patency of anastomoses, and the proliferation of graft vein were observed and compared between groups. Results No death was found in the three groups. The surgery time was similar between group P1 and P2, but longer than that in group C (p<0.05). Blood loss in operation was similar in three groups (p>0.05). The size of anastomoses constructed by cuff technique was relative fixed, and the stenosis of anastomoses happened infrequently. The suture method needs more techniques, improper suture and tight knots can cause the stenosis of anastomoses directly. The proliferation of vein at anastomoses was more frequent in group P1 and P2 and the rate of anastomotic stenosis was higher, more frequently happened in group P2, compared with cuff group (p<0.05). The proliferation of vein graft body parts was similar in three groups (p>0.05). Conclusion Animal model of carotid artery bypass by cuff technique was much easier to grasp, and stenosis of anastomoses happens infrequently, which is suitable for the study of pathophysiological change on vein graft. Suture method needs more techniques, and stenosis of anastomoses happens frequently, however, it is important for the study of the anastomotic stenosis.

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The application of radial shock wave therapy in the treatment of computer-related repetitive strain injuries: a prospective randomized controlled single-blind study

2015, 4 (2): 89-94.

Abstract ( 127 )

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Abstract Aims: To evaluate the efficacy of the treatment with low-energy radial extracorporeal shock wave therapy (rESWT or RSWT) in computer-related repetitive strain injuries (RSIs). Methods: In a prospective randomized controlled single-blind,82 adults with computer-related RSIs diagnosed by a qualified orthopedist and physiatrist were randomly assigned to study group and control group. There were 41 patients in the study group and 41 patients in the control group. Both groups had received a treatment per week for 3-5 weeks; The study group had received on average 2000 pulses of RSWT at pressure of 2.0 bar (8Hz,0.08 mJ/mm2) according to Swiss EMS DolorClast equipment and the control group 20 pulses of RSWT. All subjects were assessed 3 times: before treatment, at the end of treatment and to 3 months follow-up. Outcome measures consisted of visual analogue scores (VAS) for pain in the day and at night and functional impairment level. The outcome was considered to be excellent if there was a reduction of pain by VAS between the 80.0 and 100.0,a resumption of working activity without limitations. The outcome was considered as good if the reduction of pain was between 60.0 and 79.9, working activity was resumed with mild limitation. The outcome was considered fair if there was a reduction of pain by VAS between 30.0 and 59.9,a resumption of working activity with moderate limitations. The cases were considered poor when a reduction of pain was not referred, resumption of working activity with severe limitation. Results: Statistical analysis of VAS, disabilities of the arm, shoulder, and hand(DASH) measures had shown, both after treatment and to the follow-up of 3 months, significant difference comparing study group versus control group (p≤0.017).Eighty-two subjects participated and there were no significant differences between the two groups at baseline. A significant improvement in pain and functions was noted only in the study group after treatment and at 3 months follow-up. The rate of good and excellent outcomes according to the improvement in pain and function was significantly (56%, 76%) better in the study group than in the control group after treatment and at 3 months follow up respectively. Conclusions: RSWT significantly improves pain, function, and quality of life compared with sham therapy in patients with computer-related repetitive strain injuries.

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Clinical value of multi-slice CT in diagnosis of gastrointestinal stromal tumors

2015, 4 (2): 95-98.

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[Abstract] Objective To enhance the manifestation and application value of multi-slice spiral CT(MSCT) in diagnosis of gastrointestinal stromal tumors(GIST). Methods MSCT findings of 28 cases were retrospectively analyzed，diagnosed with GIST surgically and pathologically. Results Among the 28 cases，15 cases were located in stomach，7 cases in duodenum，5 cases in small intestine，1 case in lesser omentum. The application of multi-slice spiral CT reconstruction technology can clearly show 28 cases of GIST. Eighteen tumors presented round shape and other 10 had irregular margins.28 patients were verified by CT reconstruction technology，including endogenous type（n=7），exogenous type（n=4），intra- and ex-traluminal growth（n=16） and others（n=1）.Conclusion Multi-slice spiral CT imaging is of great value in the diagnosis of gastrointestinal stromal tumor.

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MRI appearances of the knee joint cartilage in osteoarthritis

2015, 4 (2): 99-102.

Abstract ( 130 )

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[Abstract] Objective: To investigate the cartilage of knee joint osteoarthritis MRI appearance. Methods: There were 106 cases in this group, all clinical suspicion of osteoarthritis of the knee. The GE Signa Profile SYS# 0.2TMR Siemens Symphony Maestro Class . 1.5 T superconductive, imaging range for sagittal, coronal and transverse; sequence for the spin echo (S E) T 1 WI, T 2 WI, spin echo proton weighted (fat suppression sequence). Results: The knee joint cartilage focal damage was variable, including femur, tibia, patella subchondral focal injury. MRI features: (1) the subchondral bone marrow edema and focal lesions, in 88 spots . (2) the subchondral bone of focal fatty lesion. in 79 spots. (3) the subchondral bone focal blood like lesions, in 96 spots. (4) the subchondral bone focal water damage, in 99 spots. (5) the subchondral bone foci fiber like damage in 87 spots. Conclusion: MRI knee osteoarthritis subchondral bone pathological damage of MRI pattern has the important meaning for the clinical diagnosis and treatment of pathological changes, clear guidance.

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Clinical value of CT in diagnosis of acute appendicitis

2015, 4 (2): 103-106.

Abstract ( 139 )

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[Abstract] Objective To enhance the application value of CT in diagnosis of acute appendicitis. Methods CT findings of 87 cases with acute appendicitis confirmed by surgery and pathology were retrospectively analyzed. Results There were 87 cases of acute appendicitis，45 cases of simple appendicitis，28 cases of suppurative appendicitis，7 cases of gangrenous appendicitis，7 cases of appendiceal abscess. CT findings of 5 cases of simple appendicitis were negative. CT showed swelling of the appendix，edema of the appendix wall and the abscess of the appendix.Conclusion CT imaging is of great value in the diagnosis of acute appendicitis.

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Clinical study of a Tong’s modified TVT-O treatment of female stress urinary incontinence

2015, 4 (2): 107-110.

Abstract ( 155 )

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Objective To evaluate the efficacy and safety of polypropylene suburetheal tape via obturator route to treat female stress urinary incontinence. Methods 230 women diagnosed of stress urinary incontinence (SUI) were treated with middle urethra sling via obturator route with self-made polypropylene tape, from March 2005 to December 2013. All patients’ surgical procedure and follow-up information were analyzed. Resuis All the operations were done in the status of intravenous anethesia or caudal block. The mean operating time was 20 minutes ,the mean blood loose were 30 ml. 230 patients can urinate automatically after pulling out urine duct at 24 hours post-operation, 30 patients complicated with residual urine more than 100ml, and no urinary incontinence symptoms were recurred in 6-12 months of following up. These 30 patients were asked to keep catheterization for another 48hours, and found out recovered themselves. Conclusionsd ue to easy sling adjusting, short recover duration, self-made polypropylene tape middle-urethra slingplasty via obturator route is a safe and high efficiency procedure for treating female stress urinary incontinence.

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Application comparison of dexmedetomidine combined spinal block in lower extremity surgery

2015, 4 (2): 111-113.

Abstract ( 111 )

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【Abstract】Objective: To observe clinical effects of dexmedetomidine combined spinal block in lower extremity surgery. Methods: 90 cases of lower extremity surgery patients between 2013 December and 2014 December were selected in our hospital, randomly divided into control group and study group, according to random number table. Intravenous dexmedetomidine is applicated flowing spinal anesthesia within study group (DS group); and spinal anesthesia only within control group patients (S group). Results: there are no significant hemodynamics difference between D + S group and S group patients. But post-anesthesia shivering, intra-operative tourniquet reaction, and post-operative nausea and vomiting significantly reduced (P <0.05). Conclusion: dexmedetomidine combined spinal anesthesia can significantly improve the quality of anesthesia, and decrease post-anesthesia shivering, intra-operative tourniquet reaction, and post-operative nausea and vomiting.

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Developments of 3D culture systems for improving the efficacy of hepatic differentiation from stem cells: a review in current progress

2015, 4 (2): 114-122.

Abstract ( 106 )

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Functional hepatocytes have been used in researches on cell transplantation, bio-artificial liver therapy, liver tissue engineering, drug metabolism and toxicity. Primary hepatocytes (PHs), as a source of functional hepatocytes, cannot meet the growing demands in those researches. Functional hepatocytes differentiated in 2D or 3D culture systems from stem cells are considered an alternative cell source. 3D culture systems, mimicking the biological environment in vivo, have recently garnered great attention because they often promote levels of cell differentiation and tissue organization not possible in conventional 2D culture systems. Here, we review the advances in researches of hepatic differentiation from stem cells in different 3D culture systems, focus on the materials used to make the 3D culture scaffolds.

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Application of thoracic surgery nursing technical operations evaluation form in nursing student clinical teaching

2015, 4 (2): 129-131.

Abstract ( 112 )

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