Peripheral Neuropathy after Open Abdominal Surgery with Self-Retaining Retractors. A Systematic Review of Randomised and Non-Randomised Clinical Trials

Objectives : A systematic review was undertaken to evaluate the effectiveness of incision retention available to surgeons conducting open abdominal or pelvic surgeries. Both the ability of the retractor to retain the wound and harm to the patient due to the retractor were reviewed. Methods : A search was conducted using the following databases: EMBASE, PubMed, BIOSIS, Engineering Village, Web of Science, Best practice, Science Direct, CRCnet BASE, Proquest, Wiley Online Library, and Comprehensive Biomaterial. Results : What the articles found were then narrowed down to those which matched the objective of the review. This resulted in ten articles to review. Two reviewers reviewed and summarized the articles. Femoral neuropathy was found to be a common complication due to Retractors. Other outcomes analysed or studied were found to be infected, postoperative pain and exposure provided. Femoral neuropathy can be estimated to occur at a rate between 2.6% and 7.5% in open pelvic and abdominal surgeries. The Alexis O-ring retractor was found to lower the required morphine intake following surgery when compared to the Belfour retractor. Conclusions : There is a lack of high quality/high levels of evidence studies that have been conducted on Retractors. Femoral neuropathy is the outcome most commonly documented in relation to Retractors. Surgeons need to be aware about the use and implementations of the retractors. Care should be taken in protecting the blades and during long surgery relocating retractors should be considered.

Curative effect of surgical treatment of vocal cord polyp under self-retaining fibrolaryngoscope and fibrolaryngoscope

Objective:To evaluate the curative effect of surgical treatment of vocal cord polyp under self-retaining fibrolaryngoscope and fibrolaryngoscope.Methods: A total of 118 patients with vocal cord polyp who received surgical treatment in our hospital between August 2013 and August 2015 were included in the study, the treatment process was retrospectively analyzed, and according to different operation methods, patients were divided into observation group (n=61) who received surgical treatment under self-retaining fibrolaryngoscope and control group (n=57) who received surgical treatment under fibrolaryngoscope. Differences in voice electroglottography parameters, oxidative stress system indexes, trauma-related indexes and so on were compared between two groups of patients 2 weeks after operation.Results:Jitter, Shimmer and NNE levels of observation group were significantly lower than those of control group while HNR and SNR levels were significantly higher than those of control group;SOD T, SOD Cu-Zn and T-AOC content in serum of observation group were significantly higher than those of control group while H2O2 and AOPP content were significantly lower than those of control group;NPY,β-EP, PGI2, HMGB-1 and HSP72 content in serum of observation group were significantly lower than those of control group.Conclusions:Surgery under self-retaining fibrolaryngoscope can better realize the accurate resection of vocal cord polyp, protect the normal vocal cord function and also reduce the body trauma, and it is a more ideal way of surgery.

Comparison of two different renorrhaphy techniques in retroperitoneal laparoscopic partial nephrectomy for complex tumor

Background Partial nephrectomy is currently the standard treatment for clinical T1 renal neoplasms, as it can provide oncologic outcomes equivalent to radical nephrectomy. The aim was to evaluate the efficacy of self-retaining suture （SRS） in renorrhaphy technique in retroperitoneal laparoscopic partial nephrectomy （LPN） for a single renal mass of moderate or high complexity by assessing peri-operative outcomes. Methods A retrospective analysis was done of 64 patients between 2010 and 2012 for complex renal mass （RENAL score 〉7） in whom retroperitoneal LPN was performed with two layers using continuous knotless barbed suture （Quill PDO SRS group; n=34） and absorbable vicryl （non-SRS group; n=30）, respectively. Cases were matched for RENAL score. All the surgical procedures were performed by the same surgeon with experience of more than 500 cases of LPN. Comparisons were made in patients and preoperative outcomes and peri-operative complications between SRS group and non-SRS group. Results Mean warm ischemia time （WIT） in SRS group was less than non-SRS group （18.0 vs. 24.8 minutes, P=-0.021）. Renorrhaphy suture cost in SRS group was lower than non-SRS group （$269.6 vs. $335.8, P=0,001）. There were no significant differences between the two groups for postoperative changes in creatinine and estimated glomerular filtration rate and the rate of peri-operative complications. Conclusion SRS was safe for complex renal tumor with two layers, continuous and unknot suture, during LPN and would reduce the WIT and renorrhaphy suture cost significantly.