目的探讨胆总管结石患者行腹腔镜胆总管探查、一期缝合、同期逆行鼻胆管引流的应用价值。方法选取2014年9月—2022年6月南京医科大学附属泰州人民医院肝胆胰外科行腹腔镜下胆总管切开取石、一期缝合、同期逆行鼻胆管引流术的胆总管结石...目的探讨胆总管结石患者行腹腔镜胆总管探查、一期缝合、同期逆行鼻胆管引流的应用价值。方法选取2014年9月—2022年6月南京医科大学附属泰州人民医院肝胆胰外科行腹腔镜下胆总管切开取石、一期缝合、同期逆行鼻胆管引流术的胆总管结石患者120例(一期缝合组),另取2015年1月—2022年6月行腹腔镜下胆总管切开取石、腹腔镜胆道探查术(laparoscopic common bile duct exploration,LCBDE)的胆总管结石患者130例(LCBDE组),及2015年1月—2022年6月行内窥镜下胆管逆行造影、oddi括约肌切开取石(endoscopic sphincterotomy,EST)、同期经腹腔镜行胆囊切除术的胆总管结石患者100例(EST组),比较一期缝合组与其他两组患者的手术时间、术中出血量、近期并发症、术后住院时间和住院费用等指标,并进行术后6个月以上的随访。结果一期缝合组较LCBDE组在腹腔引流管放置时间、术后住院时间及术后恢复正常生活时间上有优势(P<0.05)。一期缝合组与EST组相比,在手术时间、术后住院时间、住院费用、术后胆道感染、并发胰腺炎等方面优势明显(P<0.05)。结论胆总管结石患者行腹腔镜胆总管探查、一期缝合、同期逆行鼻胆管引流术,安全、经济,且能保留患者乳头功能,提高患者舒适性。展开更多
AIM: To compare outcomes using barbed polyglyconate(V-Loc 180) vs monofilament monocryl suture in forming vesico-urethral anastomosis(VUA) during robot assisted radical prostatectomy.METHODS: Review of prospectively c...AIM: To compare outcomes using barbed polyglyconate(V-Loc 180) vs monofilament monocryl suture in forming vesico-urethral anastomosis(VUA) during robot assisted radical prostatectomy.METHODS: Review of prospectively collected robot assisted radical prostatectomy data between July 2011 and September 2012. VUA technique: VUA was performed using 2 cm × 15 cm 2/0 V-Loc 180 continuous sutures or 3/0 monofilament monocryl sutures. Anastomotic integrity was tested intra-operatively with a water leak test. All patients had a post-operative cystogram at day 7 to 10.RESULTS: There were 189 patients in the study with 113 in the V-Loc group and 76 in the monocryl group. Demographics were similar for both groups P > 0.05). The median operative time for V-Loc group was 130 min and monocryl group was 145 min, which was statistically significant(P < 0.001). The median blood loss for both groups was 200 m L with no significant difference(P = 0.260). The pathology results of the 2 groups were similar(P = 0.537). Four patients in the V-Loc group and two patients in the monocryl group had radiological urinary leak. This was not statistically significant(P = 1.00) and all patients improved with conservative management. The continence rates were comparable for both groups.CONCLUSION: V-Loc suture significantly reduced operative time facilitating ease of VUA formation. Overall functional outcome and urinary morbidity were not significantly different from the monofilament group.展开更多
AIM:To investigate the use of the V-Loc wound closure device for transabdominal preperitoneal hernia repair. METHODS:We performed conventional transabdominal preperitoneal hernia repair in 19 patients, including one s...AIM:To investigate the use of the V-Loc wound closure device for transabdominal preperitoneal hernia repair. METHODS:We performed conventional transabdominal preperitoneal hernia repair in 19 patients, including one single incisional case using V-Loc. Except for the use of V-Loc for peritoneal closure, the procedures were the same as those used in conventional techniques. RESULTS:Although the operators included 2 residents who have no experience in laparoscopic herniorrhaphy and intracorporeal suture, the operations were completed. We believe that V-Loc is especially suitable for inexperienced surgeons and the use of V-Loc reduces the operative time by a small amount but reduces operator stress significantly. CONCLUSION:We conclude that V-Loc is the ideal peritoneal closure device for transabdominal preperitoneal hernia repair.展开更多
文摘目的探讨胆总管结石患者行腹腔镜胆总管探查、一期缝合、同期逆行鼻胆管引流的应用价值。方法选取2014年9月—2022年6月南京医科大学附属泰州人民医院肝胆胰外科行腹腔镜下胆总管切开取石、一期缝合、同期逆行鼻胆管引流术的胆总管结石患者120例(一期缝合组),另取2015年1月—2022年6月行腹腔镜下胆总管切开取石、腹腔镜胆道探查术(laparoscopic common bile duct exploration,LCBDE)的胆总管结石患者130例(LCBDE组),及2015年1月—2022年6月行内窥镜下胆管逆行造影、oddi括约肌切开取石(endoscopic sphincterotomy,EST)、同期经腹腔镜行胆囊切除术的胆总管结石患者100例(EST组),比较一期缝合组与其他两组患者的手术时间、术中出血量、近期并发症、术后住院时间和住院费用等指标,并进行术后6个月以上的随访。结果一期缝合组较LCBDE组在腹腔引流管放置时间、术后住院时间及术后恢复正常生活时间上有优势(P<0.05)。一期缝合组与EST组相比,在手术时间、术后住院时间、住院费用、术后胆道感染、并发胰腺炎等方面优势明显(P<0.05)。结论胆总管结石患者行腹腔镜胆总管探查、一期缝合、同期逆行鼻胆管引流术,安全、经济,且能保留患者乳头功能,提高患者舒适性。
文摘AIM: To compare outcomes using barbed polyglyconate(V-Loc 180) vs monofilament monocryl suture in forming vesico-urethral anastomosis(VUA) during robot assisted radical prostatectomy.METHODS: Review of prospectively collected robot assisted radical prostatectomy data between July 2011 and September 2012. VUA technique: VUA was performed using 2 cm × 15 cm 2/0 V-Loc 180 continuous sutures or 3/0 monofilament monocryl sutures. Anastomotic integrity was tested intra-operatively with a water leak test. All patients had a post-operative cystogram at day 7 to 10.RESULTS: There were 189 patients in the study with 113 in the V-Loc group and 76 in the monocryl group. Demographics were similar for both groups P > 0.05). The median operative time for V-Loc group was 130 min and monocryl group was 145 min, which was statistically significant(P < 0.001). The median blood loss for both groups was 200 m L with no significant difference(P = 0.260). The pathology results of the 2 groups were similar(P = 0.537). Four patients in the V-Loc group and two patients in the monocryl group had radiological urinary leak. This was not statistically significant(P = 1.00) and all patients improved with conservative management. The continence rates were comparable for both groups.CONCLUSION: V-Loc suture significantly reduced operative time facilitating ease of VUA formation. Overall functional outcome and urinary morbidity were not significantly different from the monofilament group.
文摘AIM:To investigate the use of the V-Loc wound closure device for transabdominal preperitoneal hernia repair. METHODS:We performed conventional transabdominal preperitoneal hernia repair in 19 patients, including one single incisional case using V-Loc. Except for the use of V-Loc for peritoneal closure, the procedures were the same as those used in conventional techniques. RESULTS:Although the operators included 2 residents who have no experience in laparoscopic herniorrhaphy and intracorporeal suture, the operations were completed. We believe that V-Loc is especially suitable for inexperienced surgeons and the use of V-Loc reduces the operative time by a small amount but reduces operator stress significantly. CONCLUSION:We conclude that V-Loc is the ideal peritoneal closure device for transabdominal preperitoneal hernia repair.
