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Research of clinical value of preserving left colic artery during laparoscopic anterior resection for rectal cancer ZENG Jun, LI Rong-jiang, LIU Xiao-hui Journal of General Surgery for Clinicians    2019, 7 (4): 24-.   Abstract （64）            Knowledge map    Save Abstract: Objective To analyze the clinical value of preserving left colic artery during laparoscopic anterior resection for rectal cancer. Methods Fifty-six cases of patients with rectal cancer and who treated from June 2015 to April 2019 were selected,and the patients were divided into the observation group (n=28) and the control group (n=28) by the random table method. All patients underwent laparoscopic resection of rectal cancer. And the observation group underwent the left colonic artery (low ligation) during the operation,while the control group underwent the no reservation of left colonic artery (high ligation) during operation.Then, the operation effects of two groups were evaluated. Results The operation time in the observation group was longer than that inthe control group (P＜0.05), There was no significant difference in the intraoperative bleeding volume and radical tumor index between the observation group and the control group (P＞ 0.05); The recovery of intestinal function, anal exhaust and hospitalization time in the observation group were shorter than those in the control group (P＜0.05); The complication rate in the observation group was 7.14%,which was lower than that in the control group of 28.57%(P＜0.05). Conclusion For patients undergoing laparoscopic resection of rectal cancer, the intraoperative preservation of LCA can reduce postoperative complications such as the anastomotic leakage and urinary retention, promote intestinal function recovery as soon as possible, and complete radical resection of tumor. Related Articles | Metrics

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Journal of General Surgery for Clinicians    2022, 10 (3): 186-.   Abstract （77）            Knowledge map    Save Related Articles | Metrics

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Risk factors and management strategies of central lymph node metastasis in patients with papillary thyroid carcinoma QI Yingcai, QU Kaiqiang Journal of General Surgery for Clinicians    2023, 11 (3): 8-.   Abstract （41）            Knowledge map    Save Objective This study retrospectively analyzed the clinical data of patients with papillary thyroid carcinoma (PTC) to explore the risk factors for central lymph node metastasis (CLNM) in the neck of PTC. Method The clinical data of 161 hospitalized patients who underwent thyroid surgery for the first time and were pathologically confirmed as PTC in Yingcheng People's Hospital from July 2020 to July 2021 were collected. The patients were divided into metastasis group and non metastasis group according to whether they had CLNM. Compare general information such as gender, age, and preoperative ultrasound imaging data between two groups to analyze the risk factors for CLNM in PTC patients. Result Univariate analysis showed that CLNM was associated with age, gender, ultrasound examination of tumor diameter, microcalcification, and presence of blood flow signals (P＜ 0.05), but not with factors such as tumor palpation results and tumor number (P ＞ 0.05). Multivariate analysis showed that age<45 years old, male, tumor diameter ＞ 1.0cm, ultrasound display of tumor microcalcification, and detection of blood flow signals within the tumor are risk factors for CLNM in PTC patients. Conclusion Men, age ＜ 45 years old, tumor size ＞ 1cm, microcalcifications, and internal blood flow signals within the lesion have a higher risk of developing CLNM. It is recommended that such PTC patients undergo preventive central lymph node dissection. Related Articles | Metrics

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Observation on the therapeutic effect of microwave therapy instrument on hemorrhoids Zhuang Xiongbiao Journal of General Surgery for Clinicians    2024, 12 (1): 50-.   Abstract （62）            Knowledge map    Save Objective To explore the therapeutic value of microwave therapy in the treatment of hemorrhoids. Method 128 inpatients with hemorrhoids admitted to Baiyunshan Hospital in Guangzhou from February 2022 to January 2023 were selected and randomly divided into an experimental group and a control group, with 64 cases in each group, using a random number table method. The control group received automatic hemorrhoid ligation surgery, while the experimental group received microwave therapy. The treatment effects and incidence of complications were compared between the two groups. Result The treatment duration, first defecation time, and wound healing time of the experimental group were significantly shorter than those of the control group (P ＜ 0.05). After treatment, the visual analogue scale (VAS) scores of the experimental group patients were lower than those of the control group at 12 and 48 hours, and their VAS scores gradually decreased with the prolongation of treatment time (P ＜ 0.05). Compared with the control group, the experimental group had a higher total effective rate of treatment (87.50% compared to 96.88%), and a significantly lower overall incidence of symptoms, with significant differences (P ＜ 0.05). Conclusion The application of microwave therapy in hemorrhoid patients can improve the degree of pain, enhance treatment effectiveness, reduce the incidence of complications, and promote the improvement of the condition. Related Articles | Metrics

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Non-surgical treatment of duodenal stump fistula YU Anxing, LIU Dongdong Journal of General Surgery for Clinicians    2021, 9 (3): 24-.   Abstract （101）            Knowledge map    Save Abstract: Objective To explore the non-surgical treatment of duodenal stump fistula and its effect. Methods A retrospective analysis about clinical data was made on 21 cases of patients with duodenal stump fistula from January 2006 to December 2019 in Pingdu People's Hospital Affiliated to Weifang Medical College. Results 21 cases were treated with non-surgical treatment, 20 cases were cured, 1 case died of multiple organ failure due to multiple abdominal, urinary and pulmonary infections. Conclusion It is effective for duodenal stump fistula to keep the abdominal cavity drainage unobstructed, timely decompression of duodenal cavity, anti infection and strengthening nutrition in this study. Related Articles | Metrics

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A comparative study in the treatment of postoperative low extremity deep vein thrombosis QI Haoshan, ZHAO Juncheng, ZHANG Kun, LI Dalin, CHEN Yunhui, YAN Jingqiang, HUANG Shujie Journal of General Surgery for Clinicians    2021, 9 (3): 2-.   Abstract （187）            Knowledge map    Save Abstract: Objective To estimate the risk of bleeding after thrombolytic therapy in patients with secondary deep venous thrombosis, in order to find a better therapy for higher bleeding risk postoperative patients. Methods 48 patients diagnosed postoperative DVT were divided into PMT group included 27 patients and CDT group included 21 patients. The PMT group was treated by PMT or PMT+CDT, the CDT group given thrombolysis only directed by catheterization. The effects of thrombus removal and later follow-up effects in the two groups were compared. Results Thrombus degradation was obviously better in PMT group compared with the CDT group [(90.21±17.28)% vs (75.65±27.59)%]. Lower dosage of urokinase [(105.45±126.34)WU vs (345.87±118.38)WU] and shorter hospital stays [(6.72±1.88)d vs (8.82±2.97)d],less time in bed[（2.90±2.71）d vs（ 5.40±2.06）d]was also detected in PMT group patients. There is nonmajor bleeding occurred in both groups. Nonmajor bleeding was higher in PMT group, but they did not achieve statistical significance(P>0.05). In later follow-up, PTS Villalta scores of 12 and 24 months in PMT were better than CDT. Conclusion Both PMT and single CDT were both effective and safety methods in treating postoperative DVT more than one week, associated low bleeding risk，however the strategy combined PMT had the advantage in low dosage of urokinase using, better thrombus eliminating, and reducing the hospital stays and time in bed. Villalta score was lower in PMT-group, connected with lower risk of PTS morbidity. Related Articles | Metrics

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Journal of General Surgery for Clinicians    2021, 9 (2): 49-.   Abstract （82）            Knowledge map    Save Related Articles | Metrics

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Clinical study of laparoscopic high ligation of peritoneal hernia sac without injury of hernia needle in the treatment of indirect inguinal hernia in children CHEN Rongyu, XU Guixian, YE Yingchao Journal of General Surgery for Clinicians    2021, 9 (2): 3-.   Abstract （212）            Knowledge map    Save Abstract: Objective To investigate the clinical value of laparoscopic high ligation of hernia sac without injury by hernia needle in the treatment of indirect inguinal hernia in children. Methods 90 children with indirect inguinal hernia admitted to Gaozhou Maternal and Child Health Hospital from January 2018 to June 2019 were randomly divided into traditional operation (group A), hernia needle + laparoscopy (group B) and laparoscopy (Group C) with 30 patients of each group. Group A was treated with traditional high ligation of hernia sac, group B was treated with laparoscopic high ligation of hernia needle without injury of peritoneal hernia sac, and group C was treated with laparoscopic high ligation of hernia sac. Results The operation time of group A was longer than that of group B and group C, and the incidence of complications was higher, the difference was significant (P<0.05); The incision length, intraoperative blood loss, autonomous activity time and hospitalization time of the three groups were compared. The results of group B were better than those of group A and group C, and the results of group A were the worst, with significant difference (P<0.05). Conclusion Laparoscopic high ligation of hernia sac without injury of hernia needle in the treatment of indirect inguinal hernia in children has the advantages of fast, minimally invasive and safe, which can significantly promote the physical rehabilitation of children after operation. Related Articles | Metrics

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Analysis of misdiagnosis of 6 cases of acute appendicitis with secondary perirenal abscess YU Anxing, DAI Xueqiang Journal of General Surgery for Clinicians    2021, 9 (1): 43-.   Abstract （83）            Knowledge map    Save Abstract: Objective To explore the main causes of misdiagnosis of acute appendicitis with secondary perirenal abscess and the measures to avoid misdiagnosis. Methods A retrospective analysis of laboratory results and surgery was made on 6 cases of acute appendicitis with secondary perirenal abscess misdiagnosed in Pingdu People’s Hospital Affiliated to Weifang Medical College. Results One case was performed laparotomy and one case was performed laparoscopy. The two cases were proved to be secondary perirenal abscess of post-cecal gangrenous appendicitis. The other 4 cases were diagnosed by multi-slice computed tomography (MSCT), one of which was improved after puncture and drainage, 1 case underwent right nephrectomy， and 2 cases died of Septicemia and multi-system organ failure due to delayed diagnosis and treatment. Conclusion The cause of misdiagnosis of acute appendicitis with secondary perirenal abscess is the nonspecific symptoms. To avoid misdiagnosis, the abdomen should be examined by MSCT. Related Articles | Metrics

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To explore the value of parachute suture in pph CHEN Jun-hao, WEI Guo-huai, HUANG Jun-yi Journal of General Surgery for Clinicians    2019, 7 (4): 20-.   Abstract （57）            Knowledge map    Save Abstrat: Objective To compare the effect of parachute suture and double-purse suture in PPH for internal hemorrhoids III and IV and the complications after operation. Methods From January 2013 to September 2018, 95 patients with grade Ⅲ and Ⅳ internal hemorrhoids or mixed hemorrhoids who underwent PPH were reviewed. 53 patients underwent double-purse suture and 42 patients underwent parachute suture. The rectal mucosa excision and follow-up were compared between the two groups. Results The thickness of rectal mucosa resected in the double-purse group was signifi cantly thicker than that in the parachute group, while the width and integrity of the resected mucosa in the parachute group were signifi cantly better than that in the double-purse group (P＜0.01). In the comparison of the postoperative conditions, the degree of pain in the double-purse group was significantly higher than that in the parachute group, and the recovery time was also longer than that in the parachute group. Conclusion Parachute suture combined with mucosal suspension can increase the length and uniformity of resected rectal mucosa, reduce the incidence of postoperative pain, and has a certain clinical value in the treatment of grade Ⅲ and Ⅳ internal hemorrhoids. Related Articles | Metrics

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Hybrid procedure in the treatment of incarcerated inguinal hernia QIU Chang-ru, LI Si-rong Journal of General Surgery for Clinicians    2019, 7 (4): 17-.   Abstract （77）            Knowledge map    Save Abstract: Objective To evaluate the effi cacy of hybrid procedure in incarcerated inguinal hernia. Methods Twenty-one patients with incarcerated inguinal hernia treated by hybrid technique in Meizhou Hospital of Traditional Chinese Medicine from February 2017 to February 2019 were selected. A total of 21 patients needed hybrid operation. The age ranged from 32 to 78 years, with an average age of (55± 11.31) years. All patients had unilateral inguinal hernia incarceration. The incarceration time was from 4 hours to 48 hours. There were 4 cases with hypertension, cereal and urinary diseases, benign prostatic hyperplasia and other basic diseases. The clinical data of operation time, hospitalization time and postoperative complications were analyzed. Results Among the 17 patients, the operation time was 60-140 minutes, with an average of (90±23.32) minutes. There were 3 cases of inguinal swelling, 5 cases of scrotal edema and 2 cases of seroma after operation. No incision infection and intractable abdominal pain were found. The symptoms of swelling and scrotal edema disappeared after symptomatic treatment or 4 weeks after discharge, and no puncture and drainage was performed. The average hospitalization time was about (6±3.4) days, and no recurrence occurred after 24 months of follow-up. Conclusions Hybrid procedure is a safe and effective technique with fast recovery. and can be used in highly—selected patients who sufered from incareerated inguinal hernia． Related Articles | Metrics

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Journal of General Surgery for Clinicians    2022, 10 (1): 106-.   Abstract （111）            Knowledge map    Save Related Articles | Metrics

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Comparison of the clinical efficacy of laparoscopic and open abdominal surgery for colorectal cancer XU Liangming Journal of General Surgery for Clinicians    2022, 10 (2): 21-.   Abstract （91）            Knowledge map    Save Objective To investigate the clinical efficacy of laparoscopic and open surgery in the treatment of colorectal cancer. Method 74 patients with colorectal cancer who underwent surgery in Nanjing Gaochun People's Hospital from January 2021 to December 2021 were divided into study group (laparoscopic surgery) and control group (open surgery) according to different surgical methods,37 cases in each group . The postoperative related conditions and curative effects of the two groups were compared. Result The operation time, hospital stay, postoperative anal exhaust time, getting out of bed time and postoperative eating time in the study group were shorter than those in the control group, and the amount of intraoperative bleeding was less than that in the control group (P ＜ 0.05); The incidence of postoperative complications in the study group was lower than that in the control group (P ＜ 0.05). Conclusion Both laparoscopic and open surgery have good results in the treatment of colorectal cancer, but laparoscopy has less trauma, higher safety and can promote the rapid recovery of patients. Related Articles | Metrics

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Application effect of five element music therapy combined with 6 minute walking test in perioperative accelerated rehabilitation surgical nursing of rectal cancer patients #br# CHEN Chuxia Journal of General Surgery for Clinicians    2022, 10 (2): 81-.   Abstract （89）            Knowledge map    Save Objective To explore the effect of five element music therapy combined with 6 minute walking test (6MWT) in perioperative accelerated rehabilitation surgery nursing of rectal cancer patients. Method From June 2019 to January 2021, 90 patients with rectal cancer who needed radical resection of rectal cancer in Huazhong University of Science and Technology Union Shenzhen Hospital were selected as the research objects. They were numbered according to the order of admission and divided into experimental group and control group according to the random number table, with 45 cases in each group. The control group received routine perioperative accelerated rehabilitation surgical nursing, while the experimental group received five element music therapy combined with 6MWT. The effect of 6MWT before and after intervention, postoperative eating time, exhaust time, length of hospital stay and postoperative complications were compared between the two groups. Result There was no significant difference between the two groups before the intervention (P ＞ 0.05). The 6MWT result after the intervention in the experimental group was (375.07 ± 21.95) m, which was significantly higher than that before the intervention (228.66 ± 15.69) m, and also higher than that in the control group (P ＜ 0.05). The postoperative eating time, exhaust time and hospital stay in the experimental group were shorter than those in the control group, and the incidence of postoperative complications was also lower than that in the control group (P ＜ 0.05). Conclusion Five element music therapy combined with 6MWT nursing can accelerate the postoperative rehabilitation of patients with rectal cancer, reduce postoperative complications and improve the postoperative clinical outcome. Related Articles | Metrics

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A clinical comparison of transanal natural orifice specimen extraction surgery with traditional laparoscopic surgery for colorectal cancer CHEN Kaifan, ZHANG Weihong, LI Junpeng, LI Zhixiong, PAN Guofeng, XU Yanchang Journal of General Surgery for Clinicians    2022, 10 (3): 6-.   Abstract （72）            Knowledge map    Save Objective To investigate the safety and feasibility of transanal natural orifice specimen extraction surgery (NOSES) laparoscopic surgery for sigmoid colon cancer and high rectal cancer. Method A retrospective analysis of clinical datas of 30 patients who underwent transanal NOSES laparoscopic surgery for sigmoid colon cancer and high rectal cancer(the observation group) and 30 patients who underwent conventional laparoscopic surgery for sigmoid colon cancer and high rectal cancer(the control group) during the same period, in Putian City from October 2018 to October 2020. A comparative analysis was conducted between these two groups in regard to the operation time, the intraoperative blood loss, the intraoperative lymph node dissection, the postoperative pain score of day 1, the postoperative complications and the postoperative local recurrence and distant metastasis. Result There were no significant differences in the intraoperative blood loss, the intraoperative lymph node dissection and the postoperative complications of both groups (P ＞ 0.05). The operation time of the observation group was longer than that of the control group, the postoperative pain score of day 1 of the observation group was lower than that in the observation group, the postoperative exhaust time of the observation group was shorter than that in the control group, the postoperative fluid diet time in observation group was shorter than that in control group, the postoperative hospital stay in the observation group was shorter than that in the control group, the differences are significant (P ＜ 0.05). Patients in both groups were followed up and no local and distant recurrence was observed.Conclusion Transanal NOSES laparoscopic surgery for sigmoid colon cancer and upper rectal cancer is safe and feasible. It has the advantages of light postoperative pain, quick recovery, short hospital stays, and the radical tumor treatment effect is comparable to that of traditional laparoscopic surgery. Related Articles | Metrics

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A clinical study of single-hole axillary endoscopic mastectomy for gynecomastia YANG Ting, OUYANG Jie, LIANG Zhuohong, XIE Shuqin, ZHANG Zhibiao, HE Yufang, LI Beishan, LU Xiumei, YE Lijun Journal of General Surgery for Clinicians    2022, 10 (3): 51-.   Abstract （119）            Knowledge map    Save Objective To compare the clinical efficacy of single-hole axillary endoscopic mastectomy and traditional open incision in the treatment of gynecomastia. Method 33 patients with gynecomastia grade Ⅱ ～ Ⅲ (including 15 cases in an experimental group and 18 in a control group)from April 2020 to May 2021 were enrolled in the retrospective study. Among them, 18 cases were unilateral and 15 cases were bilateral. The operation and postoperative recovery of the two groups were compared. Result The median operation time for the axillary single-hole endoscopic surgery group was 88.67 minutes, the median extubation time was 4.40 days, and the median time for hospitalization was 7.67 days. In the traditional surgery group, the median operation time was 58.06 minutes, the median extubation time was 1.94 days, and the hospitalization median time was 4.89 days. There was no statistical difference between two groups(P ＞ 0.05). In terms of postoperative complications, there was no infection in both groups. There was one postoperative hematoma in the axillary approach single hole endoscopic group and 2 cases of partial nipple necrosis in the traditional surgical group. There was no significant difference in the incidence of postoperative hematoma and partial papillary necrosis between the two groups (P ＞ 0.05). In terms of postoperative satisfaction, 13 patients in the axillary approach single-hole endoscopic group were rated as very satisfied with the postoperative appearance, and 5 patients in the traditional surgery group were very satisfied. There was a statistically significant difference between two groups (P=0.001). Conclusion Single-hole axillary endoscopic mastectomy for gynecomastia can be widely used in clinic, with better cosmetic effect and higher satisfaction. Related Articles | Metrics

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Clinical comparison of laparoscopic and open surgery in the treatment of early gastric cancer TANG Daping, LIN Rujing Journal of General Surgery for Clinicians    2022, 10 (3): 80-.   Abstract （97）            Knowledge map    Save Objective To explore the efficacy of laparoscopic radical gastrectomy and open radical gastrectomy in the treatment of early gastric cancer. Method 60 patients with early gastric cancer treated in Binyang People's Hospital from July 2018 to June 2021 were randomly divided into two groups according to the random number table method, with 30 cases in each group. The control group was treated with open radical gastrectomy and the observation group was treated with laparoscopic radical gastrectomy. The operation related indexes, postoperative recovery, immune function and postoperative complication rate were compared between the two groups. Result The intraoperative blood output of the observation group was lower than that of the control group (P ＜ 0.05), the operation time of the observation group was longer than that of the control group (P ＜ 0.05), and there was no difference in the number of lymph node dissection between the two groups (P ＞ 0.05). The postoperative exhaust time, defecation time, out of bed activity time and hospital stay in the observation group were shorter than those in the control group (P ＜ 0.05). The peripheral blood IgA, IgM and IgG in the observation group were lower than those in the control group (P ＜ 0.05). The postoperative complication rate in the observation group was 3.33%, lower than 20.00% in the control group (P ＜ 0.05). Conclusion Laparoscopic radical gastrectomy can achieve the short-term effect similar to open radical gastrectomy, reduce the amount of intraoperative bleeding, shorten the postoperative recovery time, reduce the damage of immune function and reduce the incidence of postoperative complications. Related Articles | Metrics

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Effects of laparoscopic transabdominal preperitoneal herniorrhaphy on serum parameters and pain in patients with inguinal hernia ZENG Shuiming, HUANG Junxiao, LI Yuhong Journal of General Surgery for Clinicians    2022, 10 (3): 107-.   Abstract （76）            Knowledge map    Save Objective To investigate the effects of laparoscopic transabdominal preperitoneal herniorrhaphy (TAPP) on serum parameters and pain in patients with inguinal hernia. Method A total of 88 patients with inguinal hernia who received treatment in Wuchuan People's Hospital from August 2020 to August 2021 were selected as the subjects of this study, the patients were divided into control group (n=41) and observation group (n=47) according to the operation plan. The control group was treated with open tension-free hernia repair, and the observation group was treated with TAPP. The surgical serum indexes, pain degree, indicators and complications of the two groups were compared. Result 36h after surgery, the levels of C-reactive protein and interleukin-6 in 2 groups were higher than those before surgery, but significantly lower in observation group than control group (P ＜ 0.05). Visual analogue scale was used to score the pain degree of patients 3, 10 and 24 hours after surgery, and the pain degree of the observation group was lower than that of the control group (P ＜ 0.05). The operation time, intraoperative blood loss and hospital stay in observation group were shorter than those in control group (P ＜ 0.05). The incidence of postoperative complications in observation group was less than that in control group (P ＜ 0.05). Conclusion TAPP for patients with inguinal hernia can reduce the occurrence of inflammation, effectively reduce the pain degree of patients, promote the recovery of patients. Related Articles | Metrics

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Laparoscopic hernia repair and open tension-free hernia repair in the treatment of adult inguinal hernia SHI Jianfeng, SHEN Hongyan Journal of General Surgery for Clinicians    2022, 10 (3): 111-.   Abstract （62）            Knowledge map    Save Objective To evaluate the effect of laparoscopic hernia repair and open tension-free hernia repair in adult inguinal hernia. Method 98 adult patients with inguinal hernia hospitalized in Rugao Motou Hospital from January 2018 to February 2021 were randomly divided into two groups with 49 cases in each group. Laparoscopic hernia repair was used in the study group and open tension-free hernia repair was used in the control group. The total effective rate, surgical indicators, postoperative recovery and postoperative complications were compared between the two groups. Result The total effective rate of the study group was significantly higher than that of the control group (P ＜ 0.05); The operation time of the study group was shorter than that of the control group, and the intraoperative bleeding and hospitalization expenses were significantly less than those of the control group (P＜ 0.05). The duration of pain, time of getting out of bed, time of returning to normal activities and hospital stay in the study group were shorter than those in the control group (P ＜ 0.05), and the incidence of postoperative complications was significantly lower than that in the control group (P ＜ 0.05). Conclusion Compared with the traditional open tension-free hernia repair, laparoscopic hernia repair can improve the curative effect and reduce the postoperative complications, which is of great significance to the postoperative recovery of patients. Related Articles | Metrics

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Reactive nodular fibrous pseudotumor of the stomach misdiagnose as gastric carcinoma report and review of literature XIONG Qiusheng, HUANG Hua, ZHANG Dongliang Journal of General Surgery for Clinicians    2022, 10 (3): 126-.   Abstract （95）            Knowledge map    Save Objective To analyze the clinicopathoiogic characteristics of gastric reactive nodular fibrous pseudotumor (RNFPT), to improve the understanding and preoperative diagnosis of the disease, and to prevent misdiagnose and clinical over-medication. Method Combined with a case of RNFPT admitted to the First Affiliated Hospital of Gannan Medical College, the clinical and pathological characteristics were analyzed through literature review. Result The pathological features of RNFPT is the tumors appear as a disorderly arrangement of fusiform or stellate cells, with clear boundaries, with keloid-like coarse collagen fibers，and with mucoid degeneration or hyaline degeneration. Conclusion Gastric RNFPT is considered to be a rare fibrotic inflammatory lesion caused by inflammatory stimuli or abdominal surgery. it is easy to be confused with gastric carcinoma，as there is no specific imaging manifestation. So it is very necessary to perform intraoperative rapid frozen section for preventing misdiagnosis and clinical over-medication. Related Articles | Metrics