Objective To study the influence of Suspension Pancreatic-Duct-Jejunum End-to-Side Continuous Suture Anastomosis （SPDJCS） on the incidence of pancreatic fistula after pancreaticoduodenectomy, and to analyze its appl...Objective To study the influence of Suspension Pancreatic-Duct-Jejunum End-to-Side Continuous Suture Anastomosis （SPDJCS） on the incidence of pancreatic fistula after pancreaticoduodenectomy, and to analyze its applicability, safety, and efficacies. Methods A prospective controlled trial was conducted with 165 cases receiving pancreati- coduodenectomy in the Department of Hepatopancreatobiliary Surgery from January 2010 to May 2012. The patients were divided into Group A （end-to-end/end-to-side invaginated anastomosis, n=52）, Group B （end-to-side mucosal anastomosis, n=48）, and Group C （SPDJCS, n=65）. The preoperative data, intra- operative data, and operative outcomes （incidence of pancreatic fistula, operation time, intraoperative blood loss, peritoneal drainage, peritoneal hemorrhage, peritoneal abscess, delayed gastric emptying, pulmonary infection, postoperative infection, blood transfusion, and perioperative mortality） were com- pared among the 3 groups. Results The total incidence of pancreatic fistula was 13.9% （23/165） in all the 165 patients. The inci- dence in Group A and Group B was 23.1% （12/52） and 18.8% （9/48）, both higher than that in Group C [3.1% （2/65）, both P〈0.05]. Group C showed significantly better outcomes than group A and B in terms of the opera- tion time （5.5±1.2 hours vs. 6.1±1.1 hours, 5.5±1.2 hours vs. 6.3±1.5 hours）, volume of blood loss （412.0±205.0 mL vs. 525.0±217.0 mL, 412.0±205.0 mL vs. 514.0±217.0 mL）, and postoperative drainage amount of plasma tubes （175.0±65.0 mE vs. 275.0±80.0 mL, 175.0±65.0 mL vs. 255.0±75.0 mL） （all P〈0.05）, while Group A and Group B displayed no difference in these aspects （P〉0.05）. As complications other than pancreatic fistula were concerned, the three groups were not different from each other （P〉0.05）. Conclusions SPDJCS may have the effect of reducing the incidence of pancreatic fistula after pan- creaticoduodenectomy. It could be safe, practical and convenient technique of anastomosis for pancreaticoje- junostomy.展开更多
AIM: To investigate the learning curve of transumbilical suture-suspension single-incision laparoscopic cholecystectomy (SILC). METHODS: The clinical data of 180 consecutive transumbilical suture-suspension SILCs perf...AIM: To investigate the learning curve of transumbilical suture-suspension single-incision laparoscopic cholecystectomy (SILC). METHODS: The clinical data of 180 consecutive transumbilical suture-suspension SILCs performed by a team in our department during the period from August 2009 to March 2011 were retrospectively analyzed. Patients were divided into nine groups according to operation dates, and each group included 20 patients operated on consecutively in each time period. The surgical outcome was assessed by comparing operation time, blood loss during operation, and complications between groups in order to evaluate the improvement in technique.RESULTS: A total of 180 SILCs were successfully performed by five doctors. The average operation time was 53.58 ± 30.08 min (range: 20.00-160.00 min) and average blood loss was 12.70 ± 11.60 mL (range: 0.00-100.00 mL). None of the patients were converted to laparotomy or multi-port laparoscopic cholecystectomy. There were no major complications such as hemorrhage or biliary system injury during surgery. Eight postoperative complications occurred mainly in the first three groups (n = 6), and included ecchymosis around the umbilical incision (n = 7) which resolved without special treatment, and one case of delayed bile leakage in group 8, which was treated by ultrasound-guided puncture and drainage. There were no differences in intraoperative blood loss, postoperative complications and length of postoperative hospital stay among the groups. Bonferroni's test showed that the operation time in group 1 was significantly longer than that in the other groups (F = 7.257, P = 0.000). The majority of patients in each group were discharged within 2 d, with an average postoperative hospital stay of 1.9 ± 1.2 d. CONCLUSION: Following scientific principles and standard procedures, a team experienced in multi-port laparoscopic cholecystectomy can master the technique of SILC after 20 cases.展开更多
Homogeneous, high concentrated ceramic suspensions wi th low viscosity are the key controlling factors for the production of ceramic c omponents through colloidal processing. A well-dispersed suspension can be obta in...Homogeneous, high concentrated ceramic suspensions wi th low viscosity are the key controlling factors for the production of ceramic c omponents through colloidal processing. A well-dispersed suspension can be obta ined by choosing suitable dispersant, solvent, particle size distribution etc. B esides these factors, the homogenizing procedure is also a key step. In this paper, reaction sialon suspensions were prepared using 3-wt% KD1 as dis persant in organic media composed of 60-vol% methyletheylketone and 40-vol% et hanol. Different homogenizing procedures have been used and compared, including planetary milling, low energy ball milling and ultrasonic disaggregation. The ef fects of different homogenizing routes and mixing times on the rheology and stab ility of suspensions, and on the microstructure of slip casting green bodies, ha ve been studied. The varying dispersion efficiencies observed could be attribute d to differences in deagglomeration degrees achieved and in adsorption amount of dispersant onto the surface of reaction sialon powders.展开更多
Introduction: over the last few decades several techniques static and dynamics, have been performed to improve facial asymmetry and functionality alter suffering facial paralysis. Methods: we present a pilot study to ...Introduction: over the last few decades several techniques static and dynamics, have been performed to improve facial asymmetry and functionality alter suffering facial paralysis. Methods: we present a pilot study to show and evaluate the benefits of a new form of facial suspension, with Silhouette sutures. We performed two patients with total and complete facial palsy due to otical tuberculosis in one case and to parotid carcinoma in the other. Results: one year after surgery, both patients have improved facial asymmetry, mastication and speech production which have lead to a higher self-esteem and major social interaction. Conclusions: static facial suspension with Silhouette sutures is a non invasive alternative to dynamic techniques in patients who don’t want or can’t undergo more complex surgeries.展开更多
目的 分析老年胆总管结石患者应用经腹腔镜胆总管切开探查并取石术(Laparoscopic Common Bile Duct Ex-ploration,LCBDE)并一期缝合与并T形管引流治疗取得的疗效。方法 采用目的抽样法选取2020年2月—2023年12月安徽省池州市人民医院78...目的 分析老年胆总管结石患者应用经腹腔镜胆总管切开探查并取石术(Laparoscopic Common Bile Duct Ex-ploration,LCBDE)并一期缝合与并T形管引流治疗取得的疗效。方法 采用目的抽样法选取2020年2月—2023年12月安徽省池州市人民医院78例老年胆总管结石患者为研究对象(均行LCBDE术治疗),按照治疗方法不同分为两组,每组39例,分别提供一期缝合治疗(观察组)和T形管引流治疗(对照组),比较两组手术时间、引流时间、住院时间、出血量、并发症发生率。结果 两组引流时间比较,差异无统计学意义(P>0.05)。观察组手术时间、住院时间短于对照组,出血量少于对照组,差异有统计学意义(P均<0.05)。观察组水电解质紊乱率(2.56%)、胆道出血率为(0)、残余结石率(2.56%)、胆道感染率为(0)低于对照组,差异有统计学意义(χ^(2)=3.924、5.343、3.924、5.343,P均<0.05)。结论 老年胆总管结石应用LCBDE术并一期缝合的效果更佳,相比于T形管引流治疗,可以更好地改善患者预后,应用价值高。展开更多
目的观察自动弹力线痔疮套扎术(ruiyun procedure for hemorrhoids,RPH)联合适形缝合术治疗重度脱垂性痔的疗效。方法选取2021年6月至2022年8月徐州市第一人民医院收治的重度脱垂性痔患者78例,根据随机数字表法将其分为观察组和对照组,...目的观察自动弹力线痔疮套扎术(ruiyun procedure for hemorrhoids,RPH)联合适形缝合术治疗重度脱垂性痔的疗效。方法选取2021年6月至2022年8月徐州市第一人民医院收治的重度脱垂性痔患者78例,根据随机数字表法将其分为观察组和对照组,每组各39例。观察组患者予RPH联合适形缝合术治疗,对照组患者予外剥内扎术治疗。比较两组患者的手术时长、术中出血量、术后并发症、创面愈合时间、肛门功能及总体满意度。结果观察组患者的术中出血量显著少于对照组,住院时间显著短于对照组(P<0.05)。观察组患者的术后疼痛、出血、肛门水肿、肛缘皮赘形成均显著优于对照组(P<0.05)。术后12周,两组患者的Wexner肛门失禁评分均显著低于本组术前(P<0.05),且观察组患者的Wexner肛门失禁评分显著低于对照组(P<0.05)。观察组患者的治愈率显著高于对照组(92.31%vs.74.36%,χ2=55.46,P=0.03),对治疗的整体满意度明显高于对照组(χ2=58.57,P=0.02)。结论RPH联合适形缝合术治疗重度脱垂性痔疗效确切,可减轻患者痛苦,缩短住院时间,减少并发症,提高患者的舒适度及满意度。展开更多
文摘Objective To study the influence of Suspension Pancreatic-Duct-Jejunum End-to-Side Continuous Suture Anastomosis （SPDJCS） on the incidence of pancreatic fistula after pancreaticoduodenectomy, and to analyze its applicability, safety, and efficacies. Methods A prospective controlled trial was conducted with 165 cases receiving pancreati- coduodenectomy in the Department of Hepatopancreatobiliary Surgery from January 2010 to May 2012. The patients were divided into Group A （end-to-end/end-to-side invaginated anastomosis, n=52）, Group B （end-to-side mucosal anastomosis, n=48）, and Group C （SPDJCS, n=65）. The preoperative data, intra- operative data, and operative outcomes （incidence of pancreatic fistula, operation time, intraoperative blood loss, peritoneal drainage, peritoneal hemorrhage, peritoneal abscess, delayed gastric emptying, pulmonary infection, postoperative infection, blood transfusion, and perioperative mortality） were com- pared among the 3 groups. Results The total incidence of pancreatic fistula was 13.9% （23/165） in all the 165 patients. The inci- dence in Group A and Group B was 23.1% （12/52） and 18.8% （9/48）, both higher than that in Group C [3.1% （2/65）, both P〈0.05]. Group C showed significantly better outcomes than group A and B in terms of the opera- tion time （5.5±1.2 hours vs. 6.1±1.1 hours, 5.5±1.2 hours vs. 6.3±1.5 hours）, volume of blood loss （412.0±205.0 mL vs. 525.0±217.0 mL, 412.0±205.0 mL vs. 514.0±217.0 mL）, and postoperative drainage amount of plasma tubes （175.0±65.0 mE vs. 275.0±80.0 mL, 175.0±65.0 mL vs. 255.0±75.0 mL） （all P〈0.05）, while Group A and Group B displayed no difference in these aspects （P〉0.05）. As complications other than pancreatic fistula were concerned, the three groups were not different from each other （P〉0.05）. Conclusions SPDJCS may have the effect of reducing the incidence of pancreatic fistula after pan- creaticoduodenectomy. It could be safe, practical and convenient technique of anastomosis for pancreaticoje- junostomy.
基金Supported by Science and Technology Projects of Haizhu District of Guangzhou, China, No. 2012-cg-26
文摘AIM: To investigate the learning curve of transumbilical suture-suspension single-incision laparoscopic cholecystectomy (SILC). METHODS: The clinical data of 180 consecutive transumbilical suture-suspension SILCs performed by a team in our department during the period from August 2009 to March 2011 were retrospectively analyzed. Patients were divided into nine groups according to operation dates, and each group included 20 patients operated on consecutively in each time period. The surgical outcome was assessed by comparing operation time, blood loss during operation, and complications between groups in order to evaluate the improvement in technique.RESULTS: A total of 180 SILCs were successfully performed by five doctors. The average operation time was 53.58 ± 30.08 min (range: 20.00-160.00 min) and average blood loss was 12.70 ± 11.60 mL (range: 0.00-100.00 mL). None of the patients were converted to laparotomy or multi-port laparoscopic cholecystectomy. There were no major complications such as hemorrhage or biliary system injury during surgery. Eight postoperative complications occurred mainly in the first three groups (n = 6), and included ecchymosis around the umbilical incision (n = 7) which resolved without special treatment, and one case of delayed bile leakage in group 8, which was treated by ultrasound-guided puncture and drainage. There were no differences in intraoperative blood loss, postoperative complications and length of postoperative hospital stay among the groups. Bonferroni's test showed that the operation time in group 1 was significantly longer than that in the other groups (F = 7.257, P = 0.000). The majority of patients in each group were discharged within 2 d, with an average postoperative hospital stay of 1.9 ± 1.2 d. CONCLUSION: Following scientific principles and standard procedures, a team experienced in multi-port laparoscopic cholecystectomy can master the technique of SILC after 20 cases.
文摘Homogeneous, high concentrated ceramic suspensions wi th low viscosity are the key controlling factors for the production of ceramic c omponents through colloidal processing. A well-dispersed suspension can be obta ined by choosing suitable dispersant, solvent, particle size distribution etc. B esides these factors, the homogenizing procedure is also a key step. In this paper, reaction sialon suspensions were prepared using 3-wt% KD1 as dis persant in organic media composed of 60-vol% methyletheylketone and 40-vol% et hanol. Different homogenizing procedures have been used and compared, including planetary milling, low energy ball milling and ultrasonic disaggregation. The ef fects of different homogenizing routes and mixing times on the rheology and stab ility of suspensions, and on the microstructure of slip casting green bodies, ha ve been studied. The varying dispersion efficiencies observed could be attribute d to differences in deagglomeration degrees achieved and in adsorption amount of dispersant onto the surface of reaction sialon powders.
文摘Introduction: over the last few decades several techniques static and dynamics, have been performed to improve facial asymmetry and functionality alter suffering facial paralysis. Methods: we present a pilot study to show and evaluate the benefits of a new form of facial suspension, with Silhouette sutures. We performed two patients with total and complete facial palsy due to otical tuberculosis in one case and to parotid carcinoma in the other. Results: one year after surgery, both patients have improved facial asymmetry, mastication and speech production which have lead to a higher self-esteem and major social interaction. Conclusions: static facial suspension with Silhouette sutures is a non invasive alternative to dynamic techniques in patients who don’t want or can’t undergo more complex surgeries.
文摘目的 分析老年胆总管结石患者应用经腹腔镜胆总管切开探查并取石术(Laparoscopic Common Bile Duct Ex-ploration,LCBDE)并一期缝合与并T形管引流治疗取得的疗效。方法 采用目的抽样法选取2020年2月—2023年12月安徽省池州市人民医院78例老年胆总管结石患者为研究对象(均行LCBDE术治疗),按照治疗方法不同分为两组,每组39例,分别提供一期缝合治疗(观察组)和T形管引流治疗(对照组),比较两组手术时间、引流时间、住院时间、出血量、并发症发生率。结果 两组引流时间比较,差异无统计学意义(P>0.05)。观察组手术时间、住院时间短于对照组,出血量少于对照组,差异有统计学意义(P均<0.05)。观察组水电解质紊乱率(2.56%)、胆道出血率为(0)、残余结石率(2.56%)、胆道感染率为(0)低于对照组,差异有统计学意义(χ^(2)=3.924、5.343、3.924、5.343,P均<0.05)。结论 老年胆总管结石应用LCBDE术并一期缝合的效果更佳,相比于T形管引流治疗,可以更好地改善患者预后,应用价值高。
文摘目的观察自动弹力线痔疮套扎术(ruiyun procedure for hemorrhoids,RPH)联合适形缝合术治疗重度脱垂性痔的疗效。方法选取2021年6月至2022年8月徐州市第一人民医院收治的重度脱垂性痔患者78例,根据随机数字表法将其分为观察组和对照组,每组各39例。观察组患者予RPH联合适形缝合术治疗,对照组患者予外剥内扎术治疗。比较两组患者的手术时长、术中出血量、术后并发症、创面愈合时间、肛门功能及总体满意度。结果观察组患者的术中出血量显著少于对照组,住院时间显著短于对照组(P<0.05)。观察组患者的术后疼痛、出血、肛门水肿、肛缘皮赘形成均显著优于对照组(P<0.05)。术后12周,两组患者的Wexner肛门失禁评分均显著低于本组术前(P<0.05),且观察组患者的Wexner肛门失禁评分显著低于对照组(P<0.05)。观察组患者的治愈率显著高于对照组(92.31%vs.74.36%,χ2=55.46,P=0.03),对治疗的整体满意度明显高于对照组(χ2=58.57,P=0.02)。结论RPH联合适形缝合术治疗重度脱垂性痔疗效确切,可减轻患者痛苦,缩短住院时间,减少并发症,提高患者的舒适度及满意度。
