Journal of General Surgery for Clinicians

The feasibility and clinical application value of single-incision+1 laparoscopic surgery in radical resection of colorectal cancer

Li Wenbing, Cai Yiting

2025, 13(4): 2.

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Objective To explore the feasibility and clinical application value of single-incision+1 laparoscopic surgery(SILS+1) in radical resection of colorectal cancer. Method Fifty patients with colorectal cancer admitted to our hospital from January 2023 to January 2025 were selected as the research subjects. They were divided into the observation group and the control group by the random number table method, with 25 cases in each group. Among them, the control group received traditional laparoscopic treatment, while the observation group received SILS+1 surgical treatment. The perioperative indicators, complication rates, and urination and defecation conditions under different treatment methods were compared. Result The operation time, first ambulation time and hospitalization time of the observation group were shorter than those of the control group, and the amount of bleeding during operation was less than that of the control group. The postoperative pain score of the observation group was lower than that of the control group, with significant differences (P ＜ 0.05). After treatment, the incidence of complications in the observation group was significantly lower than that in the control group, and the defecation and urination were better than those in the control group, with significant differences (P ＜ 0.05). Conclusion SILS+1 in the treatment of patients with colorectal cancer can shorten the operation time, reduce the amount of bleeding during operation, improve the status of defecation and urination, and the prognosis is safe.

Clinical analysis of radical resection of locally advanced breast cancer combined with flap transfer in the repair of chest wall defects

Xie Jiaqi, Qiu Yue, Tian Xingsong

2025, 13(4): 6.

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Objective The value of radical resection of locally advanced breast cancer combined with flap transfer in the repair of chest wall defects. Method The clinical data of 15 patients with locally advanced breast cancer at stage Ⅲ B and Ⅲ C treated in Shandong Provincial Hospital Affiliated to Shandong First Medical University from January 2018 to June 2023 were retrospectively studied. The patients were treated by multiple means before operation. After the local lesions were controlled, the patients were treated with radical operation of breast cancer. At the same time, the rectus abdominis or latissimus dorsi myocutaneous flap was used to repair the chest wall defect. Summarize and analyze the basic situation, treatment and follow-up of patients. Result As of January 2025, 8 of the 15 patients survived and 7 died. The overall survival time was 1036d (280 ～ 2237d). The pathological subtypes of 15 patients included luminal type A (3 cases), luminal type B (4 cases), human epidermal growth factor receptor 2 positive breast cancer (5 cases) and triple negative breast cancer (3 cases). 14 cases received preoperative chemotherapy, 4 cases received preoperative targeted therapy, and 5 cases received preoperative interventional therapy. Latissimus dorsi myocutaneous flap was used in 5 cases and rectus abdominis myocutaneous flap in 10 cases. Recurrence occurred in 3 cases. The survival time was 1423 d (372 ～ 1498d); The survival time was 985.5d (280 ～ 2237d). Conclusion The comprehensive treatment mode combined with pedicled myocutaneous flap repair technology is helpful to control the lesions and improve the quality of life of patients with locally advanced breast cancer.

The effect of bowel preparation failure risk model prediction combined with time-based incentive theory on bowel preparation in patients undergoing first colonoscopy

Wang Yajing, Liu Huisong, Wang Xia, Han Rongrong, Pan Jie, Lin Yujiao, Yu Suhua, Sui Jianqing

2025, 13(4): 9.

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Objective To investigate the application effects of a risk prediction model for bowel preparation failure combined with time-based incentive theory in patients undergoing their first colonoscopy. Method A total of 360 patients from March to May 2025 in Qingdao Municipal Hospital were enrolled in the study. Participants were randomly assigned into three groups using a digital lottery system: a combined group (120 cases), a prediction group (120 cases), and a control group (120 cases). The control group received standard bowel preparation protocols, while the prediction group underwent bowel preparation guided by the risk prediction model. The combined group received bowel preparation protocols integrating both the risk prediction model and time-based incentive theory. The quality of bowel preparation, mental fatigue levels, tolerance to bowel preparation protocols, and patient satisfaction were assessed using the Boston bowel preparation scale, mental fatigue scale, bowel preparation tolerance scale, and bowel preparation satisfaction scale. Result In the combined group, 2 patients dropped out of the group due to their own work reasons, and a total of 118 patients were included in the study; In the prediction group, 3 patients dropped out of the group due to their own work reasons, and 3 patients dropped out of the group due to fear, a total of 114 cases were included in the study; In the control group, 2 patients were out of the group because they did not excrete clean after taking medicine and needed to do it again at a selected time, and 2 patients were out of the group because of their own work, a total of 116 cases were included in the study. The combined group demonstrated significantly higher scores in bowel preparation quality, mental fatigue levels, tolerability and tolerance to bowel preparation protocols compared to both the prediction group and control group(P ＜ 0.05). Conclusion Implementing a bowel preparation protocol that combines the risk prediction model for bowel preparation failure with time-based incentive theory in first-time colonoscopy patients can improve bowel preparation quality, reduce mental fatigue, enhance tolerance, and increase patient satisfaction.

Advances in function-preserving gastric cancer surgery: insights from the 7th edition Japanese Gastric Cancer Guidelines

Jiang Xiaohua

2025, 13(4): 19.

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Gastric cancer, a prevalent gastrointestinal malignancy in East Asian countries, particularly Japan, Korea, and China, is undergoing a significant shift in treatment paradigms, moving from radical resection toward function-preserving precision therapy. In March 2025, the 7th edition of the Japanese Gastric Cancer Treatment Guidelines was released, updating the indications and technical standards for function-preserving gastrectomy, thereby providing critical guidance for clinical practice. This article systematically reviews key updates in the new guidelines, including expanded indications for endoscopic treatment of early gastric cancer, technical nuances of various function-preserving procedures, and criteria for selecting appropriate surgical approaches. Special emphasis is placed on the clinical value of pylorus-preserving gastrectomy, subtotal gastrectomy, and anti-reflux reconstruction techniques following proximal gastrectomy. The findings aim to off er evidence-based insights and technical references for standardizing function-preserving gastrectomy in China.

Clinical application of indocyanine green in thyroid cancer surgery

Zhu Yichun, Zhu Huiqin, Liu Huifeng, Hua Yu

2025, 13(4): 25.

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Objective To explore the clinical value of using indocyanine green (ICG) in thyroid cancer surgery. Method 92 patients with papillary thyroid microcarcinoma treated in Dongtai people's Hospital from January 2023 to March 2024 were selected and randomly divided into observation group (n=46) and control group (n=46). All patients underwent unilateral radical thyroidectomy (unilateral thyroidectomy and isthmus resection + ipsilateral central neck lymph node dissection). The control group was treated with conventional radical thyroidectomy, and the observation group was treated with indocyanine green guided radical thyroidectomy. The perioperative indicators, serum calcium and parathyroid hormone levels, and the incidence of complications were compared between the two groups. Result Before operation, there was no significant difference in serum calcium and parathyroid hormone levels between the two groups(P ＞ 0.05); One day after operation, the blood calcium and parathyroid hormone levels of the two groups were lower than those before operation, and the observation group was higher than that of the control group, with significant differences(P ＜ 0.001). The number of lymph node dissection in the observation group was more than that in the control group, and the intraoperative blood loss was less than that in the control group, with significant differences(P ＜ 0.001); There was no significant difference in operation time between the two groups(P ＞ 0.05). The incidences of recurrent laryngeal nerve injury and parathyroid gland MIS resection in the observation group were 0 and 4.35%(2/46), respectively, which were lower than those in the control group [13.04%(6/46) and 17.39%(8/46), respectively], and the differences were significant (P=0.026 and 0.045, respectively). Conclusion Radical thyroid cancer treatment under ICG guidance can increase the number of lymph node dissections, reduce the damage to normal tissues, and reduce the incidence of recurrent laryngeal nerve damage and parathyroid misresection.

Differential efficacy of pressurized oxygen administration based on body mass index stratification in obese patients with postoperative shoulder pain after laparoscopic cholecystectomy

Shi Caijin, Qin Lifeng, Huang Lanxian, Huang Baopiao, Lan He

2025, 13(4): 29.

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Objective To investigate the differential efficacy of pressurized oxygen administration based on body mass index(BMI) stratification in obese patients with postoperative shoulder pain after laparoscopic cholecystectomy. Method 80 patients with shoulder pain after laparoscopic cholecystectomy in Hechi people's Hospital from January 2021 to December 2023 were selected and randomly divided into control group and experimental group, 40 cases in each group. The control group received conventional oxygen inhalation and pain management, and the experimental group received stratified hyperbaric oxygen (BMI 30 ～＜ 35kg/m²: 5cmH2O;

BMI ≥ 35kg/m²: 7cmH2O) combined with abdominal breathing training. Blood gas analysis, postoperative pain and complications were compared between the two groups before and after pressurized oxygen therapy. Result After the intervention, the arterial blood carbon dioxide partial pressure (PaCO2) of the two groups decreased significantly compared with that before the intervention, and the reduction of PaCO2 in the experimental group was significantly higher than that in the control group (P ＜ 0.05); There was no significant difference in the increase of arterial partial pressure of oxygen (PaO2) between the two groups (P ＞ 0.05). The digital grading score at 48 hours and 72 hours after operation in the experimental group was significantly lower than that in the control group, and the effective rate of pain relief (87.50%) was significantly higher than that in the control group (65.00%), with significant differences (P ＜ 0.05). There was no significant difference in the total incidence of complications between the experimental group (12.50%) and the control group (17.50%) (P=0.531). After the intervention, the overall comfort score of the experimental group was (2.16±0.63), which was lower than that of the control group (3.85±0.72), and the difference was significant (t=11.171, P ＜ 0.001). Conclusion Hyperbaric oxygenation based on BMI stratification can effectively improve postoperative ventilation function and accelerate pain relief in obese patients, with good safety.

Clinical effect of laparoscopic holmium laser lithotripsy for the treatment of bile duct stones and its impact on trauma stress indicators

Ning Haibing, He Haiqing

2025, 13(4): 34.

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Objective To investigate the clinical efficacy of laparoscopic holmium laser lithotripsy in the treatment of bile duct stones and its impact on trauma stress indicators. Method 120 patients with bile duct stones admitted to the Fourth People’s Hospital of Chenzhou City from October 2023 to September 2024 were selected as the research subjects. They were randomly divided into an experimental group and a reference group using a random number table method, with 60 patients in each group. The reference group was treated with conventional laparoscopic choledochotomy for stone removal, while the experimental group was treated with laparoscopic holmium laser lithotripsy. Compare the success rate of stone extraction, surgical related indicators, and pre - and post-operative trauma stress indicators between two groups, and observe the complications of the two groups of patients. Result The success rate of stone removal in the experimental group was 96.67% (58/60), which was significantly higher than 83.33% (50/60) in the control group (P=0.015). The operation time, first exhaust time and hospitalization time of the experimental group were shorter than those of the control group, and the intraoperative blood loss of the experimental group was less than that of the control group, with significant differences (P ＜ 0.001). There was no significant difference in the levels of cortisol and epinephrine between the two groups before operation (P ＞ 0.05). One day after operation, the levels of cortisol and epinephrine in the two groups were higher than those before operation, and the levels in the experimental group were lower than those in the control group, with significant differences (P ＜ 0.001). The incidence of complications in the experimental group was 1.67% (1/60), which was significantly lower than 16.67% (10/60) in the control group (P=0.004). Conclusion Laparoscopic holmium laser lithotripsy can improve the success rate of removing bile duct stones, reduce traumatic stress reactions, and minimize complications.

Clinical experience of minimally invasive choledocholithotomy under enhanced recovery after surgery mode

Li Wendi, Liang Jie, Shi Guangjun, Liu Caiyun

2025, 13(4): 38.

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Objective To explore the clinical experience of laparoscopic and robot assisted choledocholithotomy under enhanced recovery after surgery(ERAS) mode. Method The clinical data of 193 patients with choledocholithotomy in the Eastern Hospital of Qingdao Municipal Hospital from January 2020 to April 2025 were retrospectively analyzed. The operation methods, intraoperative bleeding and postoperative complications were summarized. The perioperative period and prognosis of laparoscopic and robot assisted choledocholithotomy were compared. Result of the 193 patients, 177 underwent laparoscopic surgery and 16 underwent robot assisted surgery. The operation time was (144.84±54.17)min, the intraoperative blood loss was (18.96±22.11)ml, and the postoperative hospital stay was (5.85±3.60)d. There were 85 cases of primary suture of common bile duct and 108 cases of indwelling T-tube (56%). There were 2 cases of postoperative pneumonia, 2 cases of urinary tract infection, 1 case of abdominal infection, 1 case of peritoneal effusion, 1 case of incision infection, 1 case of lower extremity venous thrombosis, all of which were improved by conservative treatment, 1 case of relatively narrow common bile duct occurred after operation, and improved after balloon dilatation of common bile duct. The total cost of hospitalization in the robot surgery group was higher than that in the laparoscopic surgery group [(52 167.09±10 079.63)yuan vs (23 882.27±10 289.22)yuan], and the difference was significant (P ＜ 0.001). Conclusion Minimally invasive choledocholithotomy under accelerated rehabilitation mode can reduce the perioperative stress response of patients and promote the rehabilitation of patients.

Application of percuteneous transhepatic cholangio drainage combined with percutaneous gallbladder lithotripsy in cholelithiasis complicated by choledocholithiasis

Yang Tongxin, Fu Kai

2025, 13(4): 42.

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Objective To investigate the efficacy of percuteneous transhepatic cholangio drainage(PTCD) combined with the percutaneous gallbladder lithotripsy in the treatment of gallbladder stones combined with common bile duct stones. Method Clinical data from 43 patients with gallbladder stones and common bile duct stones treated between January and November 2024 in Nanjing Hospital Affiliated to Nanjing Medical University were collected. All patients underwent PTCD combined with percutaneous gallbladder lithotripsy for stone clearance. The clinical characteristics of the 43 patients were evaluated, and operative time, postoperative ventilation time, and hospital stay were recorded. Liver function indicators [alkaline phosphatase (ALP), total bilirubin (TBIL), aspartate aminotransferase (AST)] were assessed. The stone clearance rate was calculated, and stone recurrence and complications within 6 months postoperatively were recorded. Result The mean operative time was (114.31±18.74) min, postoperative ventilation time was (18.45 ± 2.52) h, and mean hospital stay was (5.96±1.32)d. All patients were discharged successfully. During postoperative recovery, total bilirubin levels decreased significantly at 24h postoperatively, followed by alkaline phosphatase and aspartate aminotransferase, and all returned to normal levels by 4 weeks postoperatively, with no cases of liver function deterioration. Among the 43 patients, 6 had mild biliary tract infection, 3 experienced biliary bleeding without other typical symptoms, and 1 developed acute suppurative cholangitis 12 h postoperatively, which improved after symptomatic treatment. In 4 patients with stones ≥ 20mm in diameter, magnetic resonance cholangiopancreatography confirmed successful one-time stone removal. No stone recurrence was observed in any patient, and 1 patient developed cholangitis. Conclusion PTCD combined with the percutaneous gallbladder lithotripsy demonstrates favorable clinical effi cacy in the treatment of gallbladder stones combined with common bile duct stones, with a high stone clearance rate and no severe complications.

The application value of modified same-stage endoscopic retrograde cholangiopancreatography combine with laparoscopic cholecystectomy in the treatment of cholecystolithiasis with common bile duct stones

Pu Zhongjun

2025, 13(4): 47.

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Objective To explore the application value of modified same-stage endoscopic retrograde cholangiopancreatography (ERCP) and laparoscopic cholecystectomy (LC) in the treatment of gallstones with common bile duct stones.Method Sixty patients with gallstones and common bile duct stones admitted to the Department of General Surgery at Rudong Hospital of Traditional Chinese Medicine in Nantong City between January 2023 and December 2024 were enrolled. They were randomly divided into a staged group (30 cases, treated with ERCP followed by LC) and a same-stage group (30 cases, treated with modified same-stage ERCP and LC). Perioperative indicators, biochemical markers, and prognostic outcomes were compared between the two groups. Result There was no significant difference in stone clearance rate between the two groups (P ＞ 0.05). The surgical time, exhaust time, and hospitalization time of patients in the same group were shorter than those in the staging group. The VAS score on postoperative day 3 was lower than that in the staging group, and the total hospitalization cost was lower than that in the staging group. The serum amylase, total bilirubin, total bile acid, C reactive protein, interferon - γ, and interleukin-6 levels on postoperative day 5 were lower than those in the staging group, and the differences were significant (P ＜ 0.05); The quality of life score at 3 months after surgery was higher than that of the staging group (P ＜ 0.05); There was no significant difference in the incidence of complications and stone recurrence between the two groups of patients (P ＞ 0.05). Conclusion Compared to staged ERCP-LC surgery, the modified same-stage ERCP-LC approach offers advantages in shortening recovery time, reducing treatment costs, mitigating infl ammatory responses, and improving prognosis.

Analysis of the efficacy of transcatheter arterial chemoembolization combined with molecularly targeted drugs in the treatment of intermediate and advanced hepatocellular carcinoma

Wang Jiali, Ye Manling, Zhong Huang

2025, 13(4): 52.

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Objective To investigate the efficacy of transcatheter arterial chemoembolization (TACE) combined with molecularly targeted drugs in the treatment of intermediate and advanced hepatocellular carcinoma (HCC). Method Ninety cases of intermediate and advanced HCC patients who were treated in the Department of Gastroenterology of Zigong First People's Hospital from February 2023 to October 2024 were divided into an observation group and a control group according to a computerized randomization sequence. The control group received simple TACE treatment, and the observation group was combined with molecular targeted drug treatment on this basis. To compare the efficacy, serum tumor marker and adverse reactions between the two groups. Result The objective remission rate and disease control rate of the observation group were significantly higher than those of the control group (P ＜ 0.05). Before treatment, there was no significant difference in the levels of alpha fetoprotein and carcinoembryonic antigen between the two groups of patients (P ＞ 0.05). After treatment, the levels of alpha fetoprotein and carcinoembryonic antigen in both groups of patients decreased compared to before treatment, and the observation group was lower than the control group, with significant differences (P ＜ 0.05). In the observation group, all adverse reactions were grade 1 ～ 2, and no adverse reactions of grade 3 or above occurred, with a total of 9 cases and a total occurrence rate of 20.00%; In the control group, there were 17 cases of grade 1-2 adverse reactions and 3 cases of grade 3, totaling 20 cases, with a total incidence of 44.44%. The total incidence rate in the observation group was lower than that in the control group, and the difference was significant (P ＜ 0.05). Conclusion TACE combined with molecularly targeted drugs is more efficacious than TACE alone in the treatment of intermediate and advanced HCC, which can more significantly inhibit tumor progression, reduce AFP and CEA levels, and have controllable adverse effects.

Observation of the therapeutic effect of different treatment methods for residual hernia sac during transabdominal preperitoneal prosthetic

Dou Huiqiang, Zhang Ye, Kong Xiangpeng

2025, 13(4): 57.

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Objective To explore the effects of different residual hernia sac management methods in laparoscopic transabdominal preperitoneal prosthetic(TAPP) and their impact on quality of life. Method 98 patients with inguinal hernia admitted to our hospital from January 2021 to December 2023 were randomly divided into two groups, with 49 patients in each group. All patients received TAPP treatment. The control group underwent complete dissection during the operation, while the experimental group underwent cross-sectional treatment. Compare the surgical related indicators, postoperative pain level, quality of life score, and incidence of postoperative complications between two groups. Result There were no significant differences in operative time, intraoperative blood loss, or VAS scores on postoperative day 1 and day 7 between the two groups (P ＞ 0.05). However, the experimental group exhibited significantly less groin area fluid accumulation, shorter hospitalization duration, and lower VAS scores on postoperative day 3 compared to the control group (all P ≤ 0.001). Preoperative quality of life scores showed no significant differences between the two groups (P ＞ 0.05). At 3 months post-operation, the experimental group demonstrated significantly higher quality of life scores across all domains compared to the control group (all P ＜ 0.001). The overall postoperative complication rate in the experimental group was 6.12%, significantly lower than the control group (22.45%) (P ＜ 0.05). Conclusion Transection of the residual hernia sac during TAPP surgery can reduce fluid accumulation in the inguinal area, alleviate pain, improve quality of life, and promote patient discharge as soon as possible.

Analysis of the therapeutic effect of laparoscopic appendectomy combined with simo decoction in the treatment of acute appendicitis

Zheng Fei, You Lixiang, Dong Dongdong, Chen Ling

2025, 13(4): 62.

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Objective To investigate the effect of laparoscopic appendectomy combined with simo decoction on postoperative diet and defecation of patients with acute appendicitis. Method 62 patients with acute appendicitis in Lianyungang Hospital of traditional Chinese medicine from January 2022 to January 2025 were selected as the research objects. According to the principle of random number table, they were divided into observation group (32 cases) and control group (30 cases). Both groups were treated with laparoscopic appendectomy, the control group was treated with conventional intervention, and the observation group was treated with simo decoction 12 hours after operation on the basis of the control group. The postoperative rehabilitation of the two groups, the changes of blood indexes in the two groups before and 3 days after operation, and the incidence of perioperative complications in each group were compared. Result Before operation, there was no significant difference in white blood cell count and neutrophil lymphocyte ratio between the two groups(P ＞ 0.05); Three days after operation, the white blood cell count and neutrophil lymphocyte ratio of the two groups were lower than those before operation, and the observation group was lower than that of the control group, the differences were significant(P ＜ 0.05). The postoperative exhaust time, postoperative eating time, defecation time and hospitalization time of the observation group were shorter than those of the control group, and the differences were significant(P ＜ 0.001). There was no significant difference in the total incidence of postoperative complications between the two groups(P ＞ 0.05). Conclusion For patients with appendicitis, laparoscopic appendectomy combined with simo decoction treatment can shorten the postoperative eating time, accelerate the recovery of defecation function, improve the blood indicators of patients.

The influence of ultrasound-guided regional block anesthesia combined with general anesthesia on stress and pain levels in patients undergoing laparoscopic radical resection of colon cancer

Wang Xinli, Li Xiaoquan

2025, 13(4): 66.

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Objective To analyze the effect of ultrasound-guided regional block anesthesia(USRA) combined with general anesthesia(GA) on the stress and pain levels of patients undergoing laparoscopic radical resection of colon cancer. Method A retrospective analysis was conducted on 200 patients who underwent laparoscopic radical resection of colon cancer in Beijing Jiangong Hospital from December 2022 to December 2024. They were divided into two groups according to different anesthesia regimens, with 100 cases in each group. The control group was given GA, and the observation group was given USRA-GA. The levels of norepinephrine, angiotensin Ⅱ , cortisol, postoperative pain and adverse reactions in the two groups were analyzed. Result Before operation, there was no significant difference in the levels of angiotensin Ⅱ, norepinephrine and cortisol between the two groups (P＞0.05). At 24 hours after operation, the levels of stress response indexes in the two groups were increased compared with those before operation (P ＜ 0.05), and the levels of angiotensin Ⅱ , norepinephrine and cortisol in the observation group were lower than those in the control group, with significant differences (P ＜ 0.001). The visual analogue scale scores at 6h, 12h and 24h after operation in the observation group were significantly lower than those in the control group (P ＜ 0.001). There was no significant difference in the total incidence of adverse events between the two groups (P ＞ 0.05). Conclusion USRA-GA helps reduce postoperative stress response and pain level in patients undergoing laparoscopic radical resection of colon cancer, and does not increase the risk of adverse events.

Application of general anesthesia combined with ropivacaine transversus abdominis nerve block in radical resection of colorectal cancer

Li Shasha, Jia Jianlou

2025, 13(4): 71.

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Objective To observe the application effect of general anesthesia (GA) combined with ropivacaine transversus abdominis nerve block (TANB) in radical resection of colorectal cancer. Method This study is a retrospective analysis. 68 patients with colorectal cancer undergoing radical resection in Jianhu County People's Hospital of Yancheng City from March 2022 to December 2024 were selected and divided into control group and study group, 34 cases in each group according to the difference of anesthesia methods. The control group was given general anesthesia, and the study group was given GA+ ropivacaine TANB. The anesthesia effect, pain, drug use and adverse reactions of the two groups at different time points were compared. Result Before anesthesia induction (T0), there was no significant difference in heart rate, mean arterial pressure, epinephrine and norepinephrine levels between the two groups (P ＞ 0.05). From T1 to T3, the heart rate, mean arterial pressure, epinephrine and norepinephrine levels in the study group were lower than those in the control group, and the differences were significant (P ＜ 0.001). At 1h, 6h, 12h and 24h after operation, the visual analogue scale scores of the study group were lower than those of the control group, and the differences were significant (P ＜ 0.01). There was no significant difference in the recovery time, extubation time and recovery time of spontaneous breathing between the two groups (P ＞ 0.05), but the dosage of remifentanil and propofol in the study group was less than that in the control group, and the difference was significant (P ＜ 0.05). The study group had 1 case of nausea and vomiting, 1 case of respiratory depression and 1 case of urinary retention, no postoperative delirium, and the incidence of adverse reactions was 8.82%(3/34). The control group had 5 cases of nausea and vomiting, 2 cases of respiratory depression, 2 cases of urinary retention, and 1 case of postoperative delirium, and the incidence of adverse reactions was 29.41% (10/34). There was a significant difference in the incidence of adverse reactions between the two groups (χ2=4.660, P=0.031). Conclusion The application of GA combined with ropivacaine TANB in patients undergoing radical resection of colorectal cancer can maintain good basic signs, reduce stress reaction, reduce the use of intraoperative anesthetics, and reduce postoperative adverse reactions and pain.

Diagnostic value of abdominal ultrasound combined with multi-slice spiral computed tomography in acute appendicitis

Zhou Xinxin, Cao Xinyu

2025, 13(4): 77.

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Objective To discuss the diagnostic value of abdominal ultrasound combined with multi-slice spiral computed tomography (MSCT) in acute appendicitis. Method the clinical data of 80 patients with acute appendicitis admitted to the outpatient department of the fourth retired cadre sanatorium of Dalian military region of Liaoning Province from January 2022 to January 2025 were retrospectively selected. All patients underwent abdominal ultrasound and MSCT examination. Taking the pathological results as the gold standard, the diagnostic value of abdominal ultrasound combined with MSCT for acute appendicitis was analyzed. Result The surgical pathology confirmed that among 80 patients with acute appendicitis, 14 cases were simple appendicitis, 37 cases were suppurative appendicitis, 24 cases were gangrenous appendicitis, and 5 cases were periappendiceal abscess; The accuracy of abdominal ultrasound combined with MSCT in detecting simple appendicitis, suppurative appendicitis and gangrenous appendicitis was higher than that of single examination (P ＜ 0.05); When examining the abscess around the appendix, the accuracy rate of combined examination was higher than that of single examination, but the difference was not statistically significant (P ＞ 0.05). Conclusion Abdominal ultrasound combined with MSCT in the diagnosis of acute appendicitis can improve the accuracy and reduce the incidence of missed diagnosis and misdiagnosis.

Analysis of the value of multi-modal magnetic resonance imaging in preoperative T and N staging of rectal cancer

Chen Xiaocui, Liu Weibo, Wang Jinbao, Zhang Ying

2025, 13(4): 81.

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Objective To evaluate the diagnostic value of multi-modal magnetic resonance imaging (MRI) in preoperative T and N staging of rectal cancer. Method 82 patients with rectal cancer admitted to Yingde people's Hospital from January 2023 to March 2025 were selected. All patients underwent multimodal MRI. The diagnostic value of multimodal MRI in preoperative T N staging of rectal cancer was evaluated based on the results of postoperative pathological examination as the gold standard. Result Among 82 patients with rectal cancer, pathological examination showed that there were 16 cases in T1 stage, 21 cases in T2 stage, 32 cases in T3 stage and 13 cases in T4 stage; There were 18 cases in N0 stage, 45 cases in N1 stage and 19 cases in N2 stage. The results of multimodal MRI showed that there were 15 cases in T1 stage, 25 cases in T2 stage, 30 cases in T3 stage and 12 cases in T4 stage; There were 22 cases in N0 stage, 44 cases in N1 stage and 16 cases in N2 stage. The consistency of multimodal MRI in preoperative T,N staging of rectal cancer was good, Kappa=0.848, 0.777（P ＜ 0.001）. The specifi city of multimodal MRI in preoperative T staging of rectal cancer was higher (P ＜ 0.05); There was no significant difference in the sensitivity and accuracy of multimodal MRI in preoperative T and N staging of rectal cancer (P ＞ 0.05). Conclusion Multi-modal MRI demonstrates high diagnostic consistency in preoperative T and N staging of rectal cancer and serves as a reliable tool for preoperative evaluation. Its high specificity makes it particularly effective in excluding non-tumoral infiltration, thereby supporting its use as a valuable imaging modality for preoperative planning.

Effect and influence of perioperative implementation of accelerated rehabilitation surgery precision nursing in patients with colorectal cancer

He Xiaoqing, Peng Zhongyan, Chen Yuyan

2025, 13(4): 85.

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Objective To study the effect of perioperative implementation of enhanced recovery after surgery (ERAS) precision nursing in patients with colorectal cancer and its impact on patients’ stress response and psychological state. Method A total of 110 patients with colorectal cancer who received surgical treatment in the Central Hospital of Bao’an District in Shenzhen from January 2024 to April 2025 were selected and randomly divided into experimental group and control group, with 55 cases in each group. The control group received perioperative routine nursing intervention, and the experimental group received perioperative eras precise nursing. The postoperative recovery, inflammatory index level, negative emotions and nursing satisfaction of the two groups were compared. Result The time of exhaust, defecation, getting out of bed, eating liquid food and hospitalization in the experimental group were shorter than those in the control group, and the differences were significant (P＜0.001). There was no significant difference in the scores of serum C-reactive protein, interleukin-6, self-rating anxiety scale and self-rating depression scale between the two groups one day before operation (P ＞ 0.05); The levels of serum C reactive protein and interleukin-6 at 1d, 3d and 5d after operation in the two groups were lower than those at 1d before operation, and the levels of serum C reactive protein and interleukin-6 in the experimental group were lower than those in the control group (P ＜ 0.001); The SAS and SDS scores of the two groups at 3 days after operation were lower than those before operation, and the experimental group was lower than that of the control group (P ＜ 0.001). The nursing satisfaction of the experimental group was 98.18% (54/55), which was significantly higher than 87.27% (48/55) of the control group (P ＜ 0.05). Conclusion The implementation of ERAS precision nursing in the perioperative period of colorectal cancer patients is more effective, which can effectively improve the stress response of patients and optimize their psychological state.

Research on the effect of early nutritional support nursing intervention in patients with acute pancreatitis

Hong Mingxing, Jing Yu, Guo Huiwen

2025, 13(4): 91.

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Objective To explore the effect of early nutritional support nursing intervention in patients with acute pancreatitis. Method 90 patients with acute pancreatitis treated in Nanjing Jiangning hospital from January to December 2024 were selected and randomly divided into control group and observation group, 45 cases in each group. The control group was given early parenteral nutrition support, while the observation group was given early enteral nutrition support. The changes of nutritional status, the effect of inflammation control and the recovery time of gastrointestinal function were observed. Result Before intervention, there was no significant difference in the levels of albumin, prealbumin, total protein, C reactive protein, white blood cell count and interleukin-6 between the two groups (P ＞ 0.05). After the intervention, the levels of albumin, prealbumin and total protein in the two groups were increased compared with those before the intervention, and the observation group was higher; The levels of C-reactive protein, white blood cell count and interleukin-6 in the two groups were lower than those before the intervention, and the observation group was lower than that in the control group, with significant differences (P ＜ 0.05). The first exhaust and defecation time, as well as the recovery time of bowel sounds in the observation group were shorter than those in the control group, and the duration of abdominal pain relief in the observation group was shorter, with significant differences (P ＜ 0.001). Conclusion In the early treatment stage of acute pancreatitis, carrying out enteral nutrition nursing intervention is helpful to improve the nutritional status of patients, inhibit infl ammatory responses, and promote the recovery of gastrointestinal function.

Effect of Internet continuous nursing on gastrointestinal function of patients with colorectal cancer undergoing chemotherapy

Hao Lin

2025, 13(4): 96.

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Objective To analyze the overall impact of Internet continuous nursing on patients with colorectal cancer undergoing chemotherapy. Method From February 2023 to February 2024, 54 patients with colorectal cancer undergoing chemotherapy in the people's Hospital of Xingwen County, Yibin City were selected and divided into normal group and continuous group according to different nursing modes, with 27 cases in each group. The general group received routine continuing care, and the continuing group received Internet continuing care. The effects of different nursing modes on patients' emotions and adverse reactions were compared. Result Before nursing, there was no significant difference in ESCA, HAMA and HAMD scores between the two groups (P ＞ 0.05). After nursing, the ESCA score of the continuation group was higher than that of the normal group, while the HAMA score and HDMD score of the continuation group were lower than that of the normal group, with significant differences (P ＜ 0.001). At discharge, there was no significant difference in the levels of bacterial endotoxin and diamine oxidase between the two groups (P ＞ 0.05); At 3 and 6 months after discharge, the levels of bacterial endotoxin and diamine oxidase in the continuation group were significantly lower than those in the normal group (P ＜ 0.05). 7 patients in the general group had diff erent degrees of peripheral nerve, gastrointestinal and blood adverse reactions, which was higher than that in the continuation group, and the difference was significant (P＜0.05). Conclusion The implementation of Internet continuity nursing has a significant effect on reducing the adverse reactions of patients with colorectal cancer undergoing chemotherapy and maintaining gastrointestinal function. At the same time, it can also effectively relieve the negative emotions of patients and help them improve their self-care ability.

The influence of psychological nursing intervention based on the information-intervention-feedback-assessment-response model on the pain degree and sleep quality of patients undergoing laparoscopic gastrointestinal surgery

Li Xue, Wu Shengwen

2025, 13(4): 101.

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Objective To explore the influence of psychological nursing intervention based on the information-intervention-feedback-assessment-response (IIFAR) information nursing model on the pain degree and sleep quality of patients undergoing laparoscopic gastrointestinal surgery, and to provide a reference basis for clinical nursing intervention. Method A total of 76 patients who underwent laparoscopic gastrointestinal surgery at Jianhu County People's Hospital from January 2024 to January 2025 were selected and divided into an observation group and a control group, with 38 cases in each group based on different nursing models. Patients receiving care based on the IIFAR model were assigned to the observation group, while another 38 patients who received conventional care during the same period were selected as the control group. The pain levels, negative emotions, and sleep quality of the patients in both groups were compared before and after nursing interventions. Result Before nursing, there were no significant differences in the visual analog scale(VAS) scores, self-rating anxiety scale(SAS) scores, self-rating depression scale(SDS) scores, Pittsburgh sleep quality index(PSQI), and 36-item short form health survey(SF-36) scores between the two groups of patients (P ＞ 0.05). After nursing, the VAS, SAS, and SDS scores of the observation group were significantly lower than those of the control group (P ＜ 0.01); the PSQI score was lower, while the SF-36 score was higher, with significant differences (P ≤ 0.001). The nursing satisfaction of the observation group was significantly higher than that of the control group (P ＜ 0.05). Conclusion Psychological nursing interventions based on the IIFAR model can effectively reduce postoperative pain levels, improve sleep quality and quality of life, and enhance patient satisfaction in laparoscopic gastrointestinal surgery.

Nursing cooperation and experience of perioperative endoscopic retrograde appendicitis therapy in patients with acute appendicitis

Deng Yuan, Zhang Juan, Cao Lulu

2025, 13(4): 106.

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Acute appendicitis is a common acute abdominal disease, endoscopic retrograde appendicitis therapy (ERAT) as a new therapeutic technology, has a good therapeutic effect for this disease, and nursing cooperation plays a key role in the implementation of this technology. In this paper, we will review the key points and clinical experience of perioperative nursing care of ERAT in patients with acute appendicitis, summarize the focuses and methods of perioperative nursing care in different stages of ERAT and the impact on patients' prognosis, with a view to providing theoretical support for the improvement of the therapeutic effect of ERAT and the quality of patient care.

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