Optimal choice of stapler and digestive tract reconstruction method after distal gastrectomy for gastric cancer:A prospective case–control study

BACKGROUND Gastric cancer is the most common cause of cancer-related deaths,and is classified according to its location in the proximal,middle,or distal stomach.Surgical resection is the primary approach for treating gastric cancer.This prospective study aimed to determine the best reconstruction method after distal gastrectomy for gastric cancer.AIM To explore the efficacy of different staplers and digestive tract reconstruction(DTR)methods after radical gastrectomy and their influence on prognosis.METHODS Eighty-seven patients who underwent radical gastrectomy for distal gastric cancer at our institution between April 2017 and April 2020 were included in this study,with a follow-up period of 12-26 mo.The patients were assigned to four groups based on the stapler and DTR plan as follows:BillrothⅠ(B-I)reconstruction+linear stapler group(group A,22 cases),B-I reconstruction+circular stapler group(group B,22 cases),Billroth II(B-II)reconstruction+linear stapler group(group C,22 cases),and B-II reconstruction+circular stapler group(group D,21 cases).The pathological parameters,postoperative gastrointestinal function recovery,postoperative complications,and quality of life(QOL)were compared among the four groups.RESULTS No significant differences in the maximum diameter of the gastric tumors,total number of lymph nodes dissected,drainage tube removal time,QLQ(QOL questionnaire)-C30 and QLQ-STO22 scores at 1 year postoperatively,and incidence of complications were observed among the four groups(P>0.05).However,groups A and C(linear stapler)had significantly lower intraoperative blood loss and significantly shorter anastomosis time,operation time,first fluid diet intake time,first exhaust time,and length of postoperative hospital stay(P<0.05)than groups B and D(circular stapler).CONCLUSION Linear staplers offer several advantages for postoperative recovery.B-I and B-II reconstruction methods had similar effects on QOL.The optimal solution can be selected according to individual conditions and postoperative convenience.

New flexible endoscopic controlled stapler technique for the treatment of Zenker's diverticulum:A case series

AIMTo report about the combination and advantages of a stapler-assisted diverticulotomy performed by flexible endoscopy.METHODSFrom November 2014 till December 2015 17 patients (8 female, 9 male, average age 69.8 years) with a symptomatic Zenker diverticulum (mean size 3.5 cm) were treated by inserting a new 5 mm fully rotatable surgical stapler (MicroCutter30 Xchange, Cardica Inc.) next to an ultrathin flexible endoscope through an overtube. The Patients were under conscious sedation with the head reclined in left position, the stapler placed centrally and pushed forward to the bottom of the diverticulum. The septum was divided by the staple rows under flexible endoscopic control.RESULTSIn eleven patients (64.7%) the stapler successfully divided the septum completely. Mean procedure time was 21 min, medium size of the septum was 2.8 cm (range 1.5 cm to 4 cm). In four patients the septum was shorter than 3 cm, in seven longer than 3 cm. To divide the septum, averagely 1.3 stapler cartridges were used. Two minor bleedings occurred. Major adverse events like perforation or secondary haemorrhage did not occur. After an average time of two days patients were discharged from the hospital. In 6 patients (35.3%) the stapler failed due to a thick septum or insufficient reclination of the head. Follow up endoscopy was performed after an average of two months in 9 patients; 4 patients (44.4%) were free of symptoms, 5 patients (55.6%) stated an improvement. A relapse of symptoms did not occur.CONCLUSIONFlexible endoscopic Zenker diverticulotomy by using a surgical stapler is a new, safe and efficient treatment modality. A simultaneously tissue opening and occlusion prevents major complications.

Simplifying Laparoscopic Surgery for Left Side Colon and Rectal Cancer Using Linear Stapler for Vascular Ligation: A Prospective Cohort Study

Introduction: Systematic lymphadenectomy and ligation of the feeding artery is extremely important when performing radical resection in colorectal cancer. However, vascular surgery via laparoscopy requires advanced skills and techniques;thus, this procedure needs to be simplified while maintaining quality of the surgery to make it a preferred technique for the surgeons. Methods: There were 49 patients who underwent laparoscopic sigmoidectomy or anterior resection till T2 level for sigmoid colon cancer and recto-sigmoid colon cancer. We analyzed short-term and long-term outcomes between stapling ligation and clipping ligation techniques used in these surgeries. Results: The mean volume of blood loss in the stapling ligation group was 12.8 ± 12.3 ml, which was significantly lower than 41.9 ± 71.2 ml of mean volume of blood loss in the clipping ligation group. There was no significant difference in the mean duration of surgery, the mean number of harvested lymph nodes, morbidity, recurrence, and 5-year relapse free survival rates between the 2 groups. Conclusions: This study demonstrates a surgical technique using staplers for vascular treatment of tumor-feeding arteries as a new technical improvement in laparoscopic colectomy for the treatment of early-stage colon cancer. We found that the described procedure was technically safe, simple, convenient, and oncologically valid.

Therapeutic effects of the TST36 stapler on rectocele combined with internal rectal prolapse

BACKGROUND The most common causes of outlet obstructive constipation(OOC)are rectocele and internal rectal prolapse.The surgical methods for OOC are diverse and difficult,and the postoperative complications and recurrence rate are high,which results in both physical and mental pain in patients.With the continuous deepening of the surgeon’s concept of minimally invasive surgery and continuous in-depth research on the mechanism of OOC,the treatment concepts and surgical methods are continuously improved.AIM To determine the efficacy of the TST36 stapler in the treatment of rectocele combined with internal rectal prolapse.METHODS From January 2017 to July 2019,49 female patients with rectocele and internal rectal prolapse who met the inclusion criteria were selected for treatment using the TST36 stapler.RESULTS Forty-five patients were cured,4 patients improved,and the cure rate was 92%.The postoperative obstructed defecation syndrome score,the defecation frequency score,time/straining intensity,and sensation of incomplete evacuation were significantly decreased compared with these parameters before treatment,and the differences were statistically significant(P<0.05).The postoperative anal canal resting pressure and maximum squeeze pressure in patients decreased compared with before treatment,and the differences were statistically significant(P<0.05).The initial and maximum defecation thresholds after surgery were significantly lower than those before treatment,and the differences were statistically significant(P<0.05).The postoperative ratings of rectocele,resting phase,and defecation phase in these patients were significantly decreased compared with those before treatment,and the differences were statistically significant(P<0.05).CONCLUSION The TST36 stapler is safe and effective in treating rectocele combined with internal rectal prolapse and is worth promoting in clinical work.

Robot-assisted trans-gastric drainage and debridement of walled-off pancreatic necrosis using the EndoWrist stapler for the da Vinci Xi:A case report

BACKGROUND Walled-off pancreatic necrosis (WOPN) is a late complication of acute pancreatitis. The management of a WOPN depends on its location and on patient's symptoms. Trans-gastric drainage and debridement of WOPN represents an important surgical treatment option for selected patients. The da Vinci surgical System has been developed to allow an easy, minimally invasive and fast surgery, also in challenging abdominal procedures. We present here a case of a WOPN treated with a robotic trans-gastric drainage using the da Vinci Xi. CASE SUMMARY A 63-year-old man with an episode of acute necrotizing pancreatitis was referred to our center. Six wk after the acute episode the patient developed a walled massive fluid collection, with an extensive pancreatic necrosis, causing obstruction of the gastrointestinal tract. The patient underwent a robotic transgastric drainage and debridement of the WOPN performed with the da Vinci Xi platform. Firstly, an anterior ideal gastrotomy was carried out, guided by intraoperative ultrasound (US)-scan using the TilePro? function. Then, through the gastrotomy, the best location for drainage on the posterior gastric wall was again US-guided identified. The anastomosis between the posterior gastric wall and the walled-off necrosis wall was carried out with the new EndoWrist stapler with vascular cartridge. Debridement and washing of the cavity through the anastomosis were performed. Finally, the anterior gastrotomy was closed and the cholecystectomy was performed. The postoperative course was uneventful and a post-operative computed tomography-scan showed the collapse of the fluid collection. CONCLUSION In selected cases of WOPN the da Vinci Surgical System can be safely used as a valid surgical treatment option.

State of the Art Hemorrhoidal Stapler Using a Modified Technique: A Step towards the Goals of Implement

Background: Procedure for prolapse and hemorrhoids (PPH) has emerged as an alternative surgical treatment of symptomatic hemorrhoids. The operative technique along with the device to be used is constantly evolving. Aim: The aim of the present study was to evaluate results of PPH using a modified technique and an innovative circular stapler. Material and Methods: A prospective, comparative study of patients undergoing PPH for symptomatic Grade II and Grade III internal hemorrhoids with either 32 mm or 34 mm stapler diameter (Circular Stapler for Hemorrhoids-CSH 32/34) during a 36 month period (1/1/2012-1/1/2015) was performed. A modified operative technique using two purse string sutures was employed. Patients were evaluated and compared in terms of postoperative complications, operation time, length of hospital stay and time to return to normal activities. Results: A total of 100 patients were included: 50 in the CSH 32 group and 50 in the CSH 34 group. Complication rates were equal for both stapler diameters (32 mm and 34 mm). Serious or life threatening complications were not encountered and need for reintervention was never met. Operation time, length of hospital stay and time to return to normal activities were similar in both groups. Conclusions: Our study suggests that there are no significant differences between the two available diameters of a new-fangled circular stapler, using a modified technique. It seems that progress of hemorrhoidal staplers has led to a step towards the goals of implement and from then on complications of surgical practice could be merely a matter of operative technique.

Safety and Efficacy of Circumcision Stapler in the Treatment for Children with Phimosis and Redundant Prepuce

Objective: To observe the clinical effect and safety of circumcision stapler in children with phimosis and redundant prepuce. Methods: From July 2013 to July 2017, 40 children were prospectively randomized and assigned to experiment group (circumcision stapler n = 20) or control group (conventional circumcision, n = 20). Outcomes were operation time, intraoperative blood loss and postoperative complications. Results: There was significant difference between the two groups for operation time (5.35 min vs 30.30 min, P < 0.05) and intraoperative blood loss (2.56 ml vs 10.40 ml, P < 0.05) respectively. Conclusion: Circumcision staplers are superior to conventional circumcision for the advantages of shorter operation time and fewer blood losses.

Laparoscopic stapler repair of high rectovaginal fistula: A case report

For thousands of years, women simply tolerated the distressing symptoms generated by rectovaginal fistulas (RVFs). This is no longer necessary because most RVFs can be surgically corrected via a number of approaches. Most rectovaginal fistulas are acquired;obstetric injury alone accounts for nearly 88% of the cases. The high fistulas are repaired by abdominal approach, while middle or low fistulas are best approached perineally. There are only few case reports of laparoscopic RVF repair noted in literature till date. Laparoscopic repair of RVF is challenging and requires advanced laparoscopic skill. Laparoscopy is a better alternative in selected cases of RVF and yields faster recovery and good patient compliance. We present a case of high RVF managed laparoscopically by using stapler.

Swingline Stapler

订书机也可以如此流光溢彩，这是Scott Wilson运用透明设计理念的又一系列代表作。在设计行业中，Swingline透明订书机的地位其实并不逊于同为透明壳体的苹果iMoc。如果说iMoc的透明设计让iMoc更加的高高在上，那么Swingline Stapler的外壳无疑是直接拉近了用户与产品的距离。让每个人都愿意来摁上一下。

Linear Stapler in Total Laryngectomy

Introduction: Stapler application for pharyngeal closure after total laryngectomy allows rapid watertight closure. We intend to report the experience of the Portuguese Oncology Institute of Lisbon, Francisco Gentil (IPOLFG). Material and Methods: Retrospective study of patients submitted to total laryngectomy using linear stapler device treated in IPOLFG from 2005 to 2010. Results: 108 patients were studied. The majority of patients were male, aged from 60 to 69 years old, and had smoking and alcohol habits. The average length of hospital stay was 13.1 days. Post-operative complications occurred as follows: wound infection in 6.5%, cervical hematoma in 4.6% and pharyngocutaneous fistula in 11.1% of cases. Conclusions: The mechanical suture of the pharynx in total laryngectomy is a simple and quick method. It does not increase the incidence of post-operative complications. It seems to be a very safe method, as long as its limits regarding the location and extent of tumour are respected.

直线切割吻合器在儿童腹腔镜胆总管囊肿根治术Roux-en-Y吻合中的应用

目的探讨直线切割吻合器应用于儿童腹腔镜胆总管囊肿根治术Roux-en-Y吻合中的有效性、安全性及可行性。方法本研究为前瞻性研究,选取2020年1月至2023年1月湖南省儿童医院接受腹腔镜胆总管囊肿根治术Roux-en-Y吻合的34例患儿作为研究对象,按照随机数字表法进行分组,采用直线切割吻合器实施Roux-en-Y吻合术的患儿纳入观察组(n=17),采用传统缝合法实施Roux-en-Y吻合术的患儿纳入对照组(n=17)。记录两组患儿手术时长、术中出血量、术后肠道功能恢复时间、首次进食流质时间、拔除引流管时间、术后住院时间、总住院费用和术后并发症发生率。结果34例均顺利完成手术,无一例中转开放手术。观察组与对照组手术时长[(130.43±31.32)min比(141.51±30.39)min]、术中出血量[(55.45±20.73)mL比(58.62±22.13)mL]差异均无统计学意义(P>0.05);观察组与对照组患儿术后肠道功能恢复时间[(4.03±0.42)min比(4.91±1.13)min]、首次进食流质时间[(3.95±0.61)d比(4.88±1.09)d]、拔除引流管时间[(5.95±0.68)d比(6.65±1.28)d]、术后住院时间[(8.29±2.17)d比(10.33±2.18)d]均短于对照组,差异均有统计学意义(P<0.05);观察组与对照组患儿总住院费用[(34948.17±1019.57)元比(35151.91±1151.15)元]、并发症发生率(1/17比2/17)差异无统计学意义(P>0.05)。结论直线切割吻合器在儿童腹腔镜胆总管囊肿根治术Roux-en-Y吻合中与传统缝合吻合技术的有效性和安全性无明显差异,可促进患儿术后恢复,值得临床推广应用。

内镜切割吻合器在经肛门局部切除中低位直肠肿瘤中的应用

目的:回顾性分析中低位直肠肿瘤经肛门局部切除治疗中采用内镜切割吻合器的应用价值。方法:纳入我院经检查诊断的24例中低位直肠肿瘤患者,使用内镜切割吻合器对直肠肿瘤进行经肛门局部切除,总结分析患者临床病理资料特征及影像学诊断特点,评价该手术方式的安全性及可行性。结果:24例患者便潜血阳性者14例,症状以便血为主,肿瘤位置以前壁为主。随着肿瘤直径的增大,增强CT、MRI、EUS诊断的准确率升高,准确率方面EUS>MRI>增强CT,三者联合评估准确率提高。术后病理结果显示4例为上皮下来源肿瘤(SM层3例,MP层1例)。20例为上皮来源肿瘤,其中上皮来源良性肿瘤9例,为低级别管状腺瘤或低级混合状腺瘤;高级别上皮内瘤变2例;直肠癌9例,其中M层1例,SM层3例,MP层4例,S层1例。24例患者病灶完全切除率为100%,手术完成率为100%,无中转腹腔镜或开腹手术,手术平均时间、手术平均出血量、术后首次排气平均时间、术后住院平均天数分别为(29.25±6.42)min、(15.04±4.12)mL、(35.38±5.94)h、(3.17±0.92)d;术后7例患者出现WBC反应性升高,术后2~4天后均恢复正常,所有患者RBC及HGB计数较术前均降低,但均处于正常值范围,所有患者均无术后并发症。结论:内镜切割吻合器经肛门切除中低位直肠肿瘤具有操作时间短、副损伤小、术后应激反应低、恢复快的优势,该手术方式具有广泛的临床应用前景。

外剥内扎术结合残余痔组织剥除、痔上黏膜套扎术治疗环状混合痔137例疗效分析

目的观察外剥内扎术结合残余痔组织剥除、痔上黏膜套扎术(M-M procedure,excision of residual piles tissue and above mucosa ligation,MEAL)治疗环状混合痔的临床疗效。方法收集2019年1月至2020年1月于南京中医药大学第二附属医院肛肠中心接受MEAL的54例环状混合痔病人作为实验组(MEAL组);以同期47例行单纯外剥内扎术(M-M组)和36例行选择性痔上黏膜切除术(TST组)的病人为对照组,分别比较各组病人的住院时间、创面愈合时间、皮赘残留、痔疮复发、肛门狭窄及肛门失禁情况。结果随访时间为(351.80±110.28)d,MEAL组的住院时间和对照组比较,差异无统计学意义(均P>0.05);MEAL组的创面愈合时间(11.55±1.67)d短于M-M组(12.38±1.91)d及TST组(12.38±2.11)d,均差异有统计学意义(均P<0.05);MEAL组的痔疮复发率1.85%(1/54)、皮赘残留发生率18.52%(10/54)均低于M-M组痔疮复发率14.89%(7/47)、皮赘残留发生率36.17%(17/47)及TST组痔疮复发率16.66%(6/36)、皮赘残留发生率41.67%(15/36),差异有统计学意义(均P<0.05);全组均无肛门失禁及肛门狭窄病例。结论基于M-M的MEAL治疗环状混合痔具有减少创面、降低复发率等优点,在保护肛门的同时,明显减少了皮赘残留的发生。

Perioperative outcomes of transvaginal specimen extraction laparoscopic total gastrectomy and conventional laparoscopicassisted total gastrectomy

BACKGROUND Natural orifice specimen extraction surgery(NOSES)has emerged as a promising alternative compared to conventional laparoscopic-assisted total gastrectomy(LATG)for treating gastric cancer(GC).However,evidence regarding the efficacy and safety of NOSES for GC surgery is limited.This study aimed to compare the safety and feasibility,in addition to postoperative complications of NOSES and LATG.METHODS Dual circular staplers were used in Roux-en-Y digestive tract reconstruction for transvaginal specimen extraction LATG,and its outcomes were compared with LATG in a cohort of 51 GC patients with tumor size≤5 cm.The study was conducted from May 2018 to September 2020,and patients were categorized into the NOSES group(n=22)and LATG group(n=29).Perioperative parameters were compared and analyzed,including patient and tumor characteristics,postoperative outcomes,and anastomosis-related complications,postoperative hospital stay,the length of abdominal incision,difference in tumor type,postoperative complications,and postoperative survival.RESULTS Postoperative exhaust time,operation duration,mean postoperative hospital stay,length of abdominal incision,number of specific staplers used,and Brief Illness Perception Questionnaire score were significant in both groups(P<0.01).In the NOSES group,the postoperative time to first flatus,mean postoperative hospital stay,and length of abdominal incision were significantly shorter than those in the LATG group.Patients in the NOSES group had faster postoperative recovery,and achieved abdominal minimally invasive incision that met aesthetic requirements.There were no significant differences in gender,age,tumor type,postoperative complications,and postoperative survival between the two groups.CONCLUSION The application of dual circular staplers in Roux-en-Y digestive tract reconstruction combined with NOSES gastrectomy is safe and convenient.This approach offers better short-term outcomes compared to LATG,while long-term survival rates are comparable to those of conventional laparoscopic surgery.

Stapler技术治疗颈段气管食管瘘的临床疗效分析

目的探讨Stapler技术在治疗颈段气管食管瘘中的临床疗效。方法回顾性分析2014年10月至2016年10月兰州大学第二医院胸外科8例气管食管瘘患者的临床资料,其中男5例、女3例,平均年龄23~67(46.4±13.9)岁。4例患者气管食管瘘由气管插管导致,2例由食管异物导致,1例由气管支架导致,1例由食管憩室导致。全部患者行Stapler技术闭合瘘口,术后通过Karnofsky功能状态(KPS)评分、影像学情况、患者满意度调查和患者进食呛咳症状改善情况来评价手术效果。结果手术过程顺利,手术时间为(117.5±6.6)min,术中出血量为(60.0±7.0)ml。术后患者无切口出血和感染、声音嘶哑、呼吸困难、饮水呛咳、瘘口复发及气管食管狭窄等并发症,无围术期死亡病例,1周后胸部X线片示肺部感染症状消失,仅1例患者术后1年出现食管狭窄。术后2周KPS评分为(90.0±7.0)分,较术前明显改善(P<0.01),术后肺部感染面积较术前减少(P<0.05),气管食管瘘消失,患者总体满意率为90%,进食呛咳症状改善情况评价为优。结论 Stapler技术是治疗颈段气管食管瘘的有效术式,具有安全、简便、手术时间短、术后并发症少、疗效可靠等优点。

基于动物实验的国产腔镜吻合器开模样机可用性评价

目的通过开展基于动物实验的国产腔镜吻合器开模样机可用性评价,获取临床医护人员关于器械可用性的真实评价与反馈,帮助研发人员及时调整方案,提升器械可用性水平。方法搭建一个适合腔镜吻合器用于结直肠、胃、肝胆胰和肺部相关手术操作的模拟场景,招募医生用户和护士用户,采用专家评价法,从操作可用性和系统可用性角度评价手动腔镜吻合器和电动腔镜吻合器的可用性。结果手动和电动腔镜吻合器开模样机操作可用性问卷大多数题目平均得分为3~4分,表明其操作可用性总体处于与其他国产品牌相当的水平,基本得到了用户的认可;2款吻合器系统可用性评级分别为D和B-,前者系统可用性只优于市面上26.20%的同类产品,不在可接受范围,后者系统可用性优于市面上65.61%的同类产品,在可接受范围但仍需进一步提升。结论本研究开展的基于动物实验的国产腔镜吻合器开模样机可用性评价为快速获取用户体验、发现或减少人因工程等问题提供了一套可选择的解决方案,能够促进器械优化改进、加速国产医疗器械上市进程。

基于真实世界数据的国内外吻合器临床经济性比较研究

目的从经济性角度对国产和进口吻合器在临床手术中的相关费用指标进行分析评价,为同类型产品临床评价的统计学分析及评价方法选择提供参考。方法基于国家制定的真实世界数据指导原则,结合吻合器临床应用,提出吻合器相关真实世界数据研究的路径方法。选取上海市胸科医院胸外科和肿瘤外科2019—2021年共计2000例使用吻合器的手术,其中1000例使用国产吻合器,另外1000例使用进口吻合器,采用描述性统计分析、倾向性评分校正等方法对两组数据中的使用患者、使用效率和经济性差异进行分析。结果使用国产吻合器的手术组平均每台手术吻合器费用和平均每台手术止血耗材费用均显著低于使用进口吻合器的手术组(P<0.001);两组手术时长差异无统计学意义(P=0.900);相关性分析显示吻合器费用与手术时间具有强相关性(r=0.987,P=0.002);而使用进口吻合器与国产吻合器时,吻合器费用占比与止血耗材费用占比差异均无统计学意义(P>0.05)。结论国产吻合器在影响手术直接耗材及相关耗材费用方面具有一定积极作用,建议建立国产吻合器专家共识,为国产医疗器械精细化管理和未来创新技术的发展提供一定的参考依据。

混合痔PPH术后吻合口原发性出血影响因素及对其预后的影响

目的 分析混合痔吻合器痔上黏膜切除术(PPH)术后吻合口原发性出血影响因素及对其预后的影响。方法 将2019年1月—2022年12月本院收治的100例混合痔手术患者作为观察对象,对其进行回顾性分析,患者均行PPH治疗,收集相关资料,以是否发生原发性出血分为出血组及未出血组,对两组相关资料行Logistic单因素及多因素分析,评估导致出血的相关风险因素;对术前、术后7d及术后2个月时的疾病不确定感量表(MUIS)及焦虑自评量表(SAS)进行预后评估,并统计术后1年内的所有复发病例。结果 黏膜切除宽度<1.5cm、黏膜切除不完整、吻合钉宽密度较低、术后大便干结、术前合并高血压及术前血红蛋白(HGB)较低均与术后原发性出血有关联。出血组手术后7d时MUIS、SAS得分均高于未出血组,且术后2个月时出血组SAS得分高于未出血组,差异均具有统计学意义(P<0.05);两组术后2个月时MUIS得分及术后1年复发率比较,差异无意义(P>0.05)。结论 导致混合痔PPH术后吻合口原发性出血的风险因子较多,既往合并高血压、HGB较低或术后大便干结均可导致出血风险增加,主要危险因素则是术中操作,如吻合钉宽密度较低、黏膜切除宽度不足等。出血对患者预后存在一定影响。

“互联网+健康宣教系统”在吻合器法包皮环切术后护理中的应用

目的:探索“互联网+健康宣教系统”在吻合器法包皮环切术后护理中应用的效果。方法:选择2022年1月至2022年7月我院门诊行吻合器法包皮环切术后的260例患者作为研究对象,随机分为研究组和对照组,每组各130例。对照组给予常规护理,研究组采用“互联网+健康宣教系统”进行“互联网+医疗护理服务”模式。对比患者在手术后24 h的疼痛程度和对手术的满意程度,并对这些患者进行定期的随访以监测术后并发症的发生情况以及吻合钉的脱落情况。结果:研究组患者术后疼痛评分、术后水肿、出血、感染等并发症发生率、术后吻合钉脱落时间明显低于对照组,研究组患者对医疗护理满意度明显高于对照组,两组间对比差异均具有统计学意义(P<0.05)。结论:对行包皮环切术患者术后应用“互联网+健康宣教系统”,可以提高包皮环切术患者相关知识掌握程度,提升患者的自我护理能力,有效降低术后并发症的发生,提高患者满意度。

国产吻合器在外科手术中的应用及关键性能探讨

在“政府支持国产-鼓励创新-行业整合”背景下,国产吻合器研发速度与市场需求优势在国家政策导向下越来越明显,本文在全面介绍吻合器基本原理的基础上,结合国内吻合器的市场数据,展示目前国产吻合器的市场占有率状况,并通过国产与进口吻合器比较,总结出国产吻合器在技术及临床应用中的优势。同时通过文献综述及对临床应用调研,对吻合器关键性能的技术要求进行了探讨,提出国产吻合器应通过对吻合器在材料选择、产品结构、生产工艺等方面的优化,以满足国内吻合器临床应用的性能稳定、应用广泛的发展需求。