BACKGROUND With the increasing incidence of proximal gastric cancer,laparoscopic proximal gastrectomy has been applied.However,reflux esophagitis often occurs after traditional esophagogastric anastomosis.In order to ...BACKGROUND With the increasing incidence of proximal gastric cancer,laparoscopic proximal gastrectomy has been applied.However,reflux esophagitis often occurs after traditional esophagogastric anastomosis.In order to solve this problem,several methods of digestive tract reconstruction have emerged,but the most satisfying method remains to be discussed.Therefore,we modified traditional Kamikawa anastomosis to investigate the appropriate digestive tract reconstruction in laparo-scopic proximal gastrectomy.All the patients were successfully operated on without conversion to laparotomy.The duration of operation and digestive tract reconstruction were 203.500(150-224)min and 87.500(73-111)min,respectively.The intraoperative amount of bleeding was 20.500 mL±0.696 mL.The time of postoperative first flatus,the first postoperative fluid intake,and the postoperative length of stay were 2(1-3)d,4(3-5)d,and 9(8-10)d,respectively.All the patients were followed up for 12-23 months.The body mass index at 6 and 12 months after surgery were 22.577 kg/m2±3.098 kg/m2 and 22.594 kg/m2±3.207 kg/m2,respectively.The nutrition risk screening 2002 score,the patient-generated subjective global assessment score,and the gastroesophageal reflux disease scale score were good at 6 and 12 months after surgery.Reflux esophagitis and anastomotic stenosis were not observed in any of the patients during their 12-month postoperative gastroscopy or upper gastrointestinal tract visits.All the patients exhibited no tumor recurrence or metastasis.CONCLUSION The modified Kamikawa anastomosis is safe and feasible for laparoscopic proximal gastrectomy and has good antireflux effects and nutritional status.展开更多
Objective: To investigate the feasibility, safety and the clinical value of primary suture following 3-port laparoscopic common bile duct exploration (LCBDE). Methods: From January 2012 to September 2014, 176 patients...Objective: To investigate the feasibility, safety and the clinical value of primary suture following 3-port laparoscopic common bile duct exploration (LCBDE). Methods: From January 2012 to September 2014, 176 patients suffered from choledocholithiasis were treated with primary suture following 3-port LCBDE and the clinical data were retrospectively analyzed. Results: All cases were operated successfully and none was converted to open surgery. The duration of operation was 92.2 ± 18.8 min and the length of postoperative hospital stay was 4.4 ± 3.7 d. Postoperative bile leakage occurred in 2 cases and these patients recovered by simple drainage for 3 to 7 days without re-operation. All patients recovered smoothly without any serious complications. Conclusions: Primary suture following 3-port LCBDE is safe, effective and mini-invasive, which is worthy of further clinical application.展开更多
Modified laparoscopic microsurgical tubal anastomosis is an alternative for microsurgical anastomosis via laparotomy to reverse sterilization in women with renewed child wish.The current study aims to evaluate the fer...Modified laparoscopic microsurgical tubal anastomosis is an alternative for microsurgical anastomosis via laparotomy to reverse sterilization in women with renewed child wish.The current study aims to evaluate the fertility outcome after modified laparoscopic microsurgical tubal anastomosis.A retrospective study was performed.Fifty-eight women who underwent modified laparoscopic microsurgical tubal anastomosis were monitored to investigate the fertility outcome and characteristics of this new technology.Of the 58 patients,the cumulative pregnancy rate(PR)in the 42 patients with follow-up data was 23.8%(10/42),57.1%(24/42),66.7%(28/42),and 73.8%(31/42)within 6,12,24,and 36 months after surgery,respectively.The intrauterine PR was 69.0%(29/42).Two patients(4.8%)had ectopic pregnancies that occurred within 24 months of surgery;three cases ended in spontaneous abortion.The delivery rate was 83.9%(26/31).The length of operating time was 1.20.3 h,with a range of 1.0–2.5 h(60–145 min),and the mean time was approximately 75 min.The blood loss was relatively small,between 10 and 50 ml with an average amount of 22 ml.Thus,the modified laparoscopic tubal anastomosis is a highly successful procedure and a viable alternative to open abdominal microsurgical approaches.Compared with the traditional laparoscopic tubal sterilization reversal,this modified approach has three advantages:(1)less invasive approach via a trocar reduction;(2)remodeling of tube is better performing tied together after 3–4 sutures;and(3)faster operating time.展开更多
基金Supported by the Fujian Medical University Sailing Fund General Project,No.2022QH1117Key Clinical Specialty Discipline Construction Program of Fujian,Fujian Health Medicine and Politics,No.[2022]884.
文摘BACKGROUND With the increasing incidence of proximal gastric cancer,laparoscopic proximal gastrectomy has been applied.However,reflux esophagitis often occurs after traditional esophagogastric anastomosis.In order to solve this problem,several methods of digestive tract reconstruction have emerged,but the most satisfying method remains to be discussed.Therefore,we modified traditional Kamikawa anastomosis to investigate the appropriate digestive tract reconstruction in laparo-scopic proximal gastrectomy.All the patients were successfully operated on without conversion to laparotomy.The duration of operation and digestive tract reconstruction were 203.500(150-224)min and 87.500(73-111)min,respectively.The intraoperative amount of bleeding was 20.500 mL±0.696 mL.The time of postoperative first flatus,the first postoperative fluid intake,and the postoperative length of stay were 2(1-3)d,4(3-5)d,and 9(8-10)d,respectively.All the patients were followed up for 12-23 months.The body mass index at 6 and 12 months after surgery were 22.577 kg/m2±3.098 kg/m2 and 22.594 kg/m2±3.207 kg/m2,respectively.The nutrition risk screening 2002 score,the patient-generated subjective global assessment score,and the gastroesophageal reflux disease scale score were good at 6 and 12 months after surgery.Reflux esophagitis and anastomotic stenosis were not observed in any of the patients during their 12-month postoperative gastroscopy or upper gastrointestinal tract visits.All the patients exhibited no tumor recurrence or metastasis.CONCLUSION The modified Kamikawa anastomosis is safe and feasible for laparoscopic proximal gastrectomy and has good antireflux effects and nutritional status.
文摘Objective: To investigate the feasibility, safety and the clinical value of primary suture following 3-port laparoscopic common bile duct exploration (LCBDE). Methods: From January 2012 to September 2014, 176 patients suffered from choledocholithiasis were treated with primary suture following 3-port LCBDE and the clinical data were retrospectively analyzed. Results: All cases were operated successfully and none was converted to open surgery. The duration of operation was 92.2 ± 18.8 min and the length of postoperative hospital stay was 4.4 ± 3.7 d. Postoperative bile leakage occurred in 2 cases and these patients recovered by simple drainage for 3 to 7 days without re-operation. All patients recovered smoothly without any serious complications. Conclusions: Primary suture following 3-port LCBDE is safe, effective and mini-invasive, which is worthy of further clinical application.
基金supported by grants from the National Natural Science Foundation of China(Grant No.30671093)the“973”program of China(No.2007CB948104).
文摘Modified laparoscopic microsurgical tubal anastomosis is an alternative for microsurgical anastomosis via laparotomy to reverse sterilization in women with renewed child wish.The current study aims to evaluate the fertility outcome after modified laparoscopic microsurgical tubal anastomosis.A retrospective study was performed.Fifty-eight women who underwent modified laparoscopic microsurgical tubal anastomosis were monitored to investigate the fertility outcome and characteristics of this new technology.Of the 58 patients,the cumulative pregnancy rate(PR)in the 42 patients with follow-up data was 23.8%(10/42),57.1%(24/42),66.7%(28/42),and 73.8%(31/42)within 6,12,24,and 36 months after surgery,respectively.The intrauterine PR was 69.0%(29/42).Two patients(4.8%)had ectopic pregnancies that occurred within 24 months of surgery;three cases ended in spontaneous abortion.The delivery rate was 83.9%(26/31).The length of operating time was 1.20.3 h,with a range of 1.0–2.5 h(60–145 min),and the mean time was approximately 75 min.The blood loss was relatively small,between 10 and 50 ml with an average amount of 22 ml.Thus,the modified laparoscopic tubal anastomosis is a highly successful procedure and a viable alternative to open abdominal microsurgical approaches.Compared with the traditional laparoscopic tubal sterilization reversal,this modified approach has three advantages:(1)less invasive approach via a trocar reduction;(2)remodeling of tube is better performing tied together after 3–4 sutures;and(3)faster operating time.
