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National Health Commission of the People's Republic of China
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People's Medical Publishing House Co. Ltd.
Editor in Chief:Jun Guan
ISSN:2095-5308
CN:11-9331/R
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Table of Content

    01 January 2023, Volume 11 Issue 1
    Previous Issue   
    The clinical application effect on the laparoscopic tension-free hernia repair for the treatment of the patients with abdominal incisional hernia
    SUN Peng, HAN Song, CHENG Liang, LU Congying, LIU Yanlin, LIU Xuzhong, LIU Jing, SONG Dapeng
    2023, 11(1):  2. 
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    Objective To investigate the clinical effect and prognosis of laparoscopic tension-free hernia repair for the treatment of the patients with abdominal incisional hernia. Method The clinical data of 72 patients with abdominal incisional hernia were retrospectively analyzed in Affiliated Jiaozhou Hospital of Tongji University from June 2018 to June 2021. These patients with abdominal incisional hernia were randomly divided into the experimental group and the control group according to different operation methods including laparoscopic tensionfree repair and open hernia repair. Thirty patients underwent open hernia repair operation in the control group and 42 did laparoscopic tension-free repair in the experimental group. The operation time, intraoperative blood loss,

    length of hospital stay and pain score at 24 hours after operation, incidence of complications and recurrent incisional hernia after operation were observed to evaluate the surgical outcome. Result The operation time, intraoperative blood loss, length of hospital stay and pain score at 24 hours after operation in the experimental group were better than those of in the control group (P ＜ 0.05). The postoperative complication rate (9.52%) in the experimental group was significantly lower than that in the control group (30.00%) (P ＜ 0.05).2 patients had recurrence of incisional hernia in the experimental group after 1 year with a recurrence rate was 4.76% (2/42) and 3 patients did recurrence of incisional hernia in the control group after 1 year with a recurrence rate was 10.00% (3/30). There was no obviously significant difference in the recurrence rate of incisional hernia between the experimental group and the control group (P ＞ 0.05). Conclusion Compared with traditional open surgery, laparoscopic tension-free repair for the treatment of the patients with abdominal incisional hernia has many advantages of shorter operation time, less intraoperative blood loss, lower incidence of postoperative complications and lower recurrence rate of abdominal incisional hernia. Laparoscopic tension-free repair for the treatment of the patients with abdominal incisional hernia is a safe and effective minimally invasive technique and has good recent and long-term clinical efficacy at the same time.

    Study on the advantages and safety of laparoscopic total mesorectal excision for rectal cancer
    CHEN Yan, ZHONG Hu, YE Song, ZHOU Yeting
    2023, 11(1):  5. 
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    Objective To investigate the clinical efficacy and safety of laparoscopic total mesorectal excision (LME) for rectal cancer. Method From August 2020 to March 2022, 69 rectal cancer patients in Shuyang Hospital Affiliated to Xuzhou Medical University were selected and analyzed. The control group (blue ball, 34 cases) and the observation group (red ball, 35 cases) were randomly divided by red blue ball. The control group was treated by open total mesorectal excision, and the observation group was treated by laparoscopic total mesorectal excision, Record and compare the difference of operation indexes and recovery time of patients in each group, and observe and count the probability of postoperative complications of patients in the two groups. Result The total operation time (181.23 ± 15.21) min in the observation group was longer than that in the control group (t=15.285, P ＜ 0.05),

    and the number of lymph node dissection (14.02 ± 4.02) had no significant difference compared with the control group (t=0.113, P ＞ 0.05). In addition, the total probability of postoperative complications in the observation group was 2.86% lower than that in the control group (χ2= 4.803，P ＜ 0.05）. Conclusion Laparoscopic total mesorectal excision is the first choice for clinical treatment of rectal cancer, which has the advantages of less damage to patients, rapid recovery, fewer complications and ideal safety.

    Clinical study on different ultrasonic signs in predicting lymph node metastasis of thyroid papillary carcinoma
    LIU Caihong, HAO Ying, ZHAO Zhenlong, WEI Ying, PENG Lili, LI Yan, YU Ming’an
    2023, 11(1):  8. 
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    Objective To study the ultrasonographic features of papillary thyroid carcinoma nodules (PTC) with lymph node metastasis (LNM). Method The data of patients with PTC who underwent thermal ablation from July 2019 to December 2020 were retrospectively studied. The patients were divided into LNM group and non-LNM group. The imaging features and parameters between the two groups both on conventional ultrasound and contrast-enhanced ultrasound were compared. Result A total of 91 patients with PTC were included, including 31 cases in the LNM group and 60 cases in the non-LNM group. In the LNM group, the proportion of nodules with length/width ratio larger than 1.0 or with microcalcification were higher than those in the non-LNM group, and the difference were statistically significant (P ＜ 0.05); The peak intensity (PI)difference was lower than that in the non-LNM group (P ＜ 0.05). ROC curve analysis was performed to test the diagnostic efficiency of PI difference to diagnose PTC with LNM. The area under the curve was 0.63, the optimum critical value was -7.3, the sensitivity was 42% and the specificity was 43%. Conclusion The imaging features and parameter showed significant differences between the LNM group and non-LNM group. The above results may be helpful to predict the biological characteristics of PTC.

    Analysis of risk factors for lymph node metastasis in the central region of cN0 thyroid micropapillary carcinoma
    ZHAO Bitao
    2023, 11(1):  14. 
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    Objective To investigate the risk factors of lymph node metastasis in the central region of cN0 thyroid micropapillary carcinoma. Method The clinical data of 106 patients with cN0 thyroid micropapillary carcinoma in Jiangmen Xinhui District People's Hospital from May 2020 to November 2021 were retrospectively analyzed. According to the lymph node metastasis in the central region, they were divided into two groups: metastatic group (49 cases) and non-metastatic group (57 cases). The risk factors of lymph node metastasis in the central region of patients were analyzed. Result Of the 106 patients, 49 had lymph node metastasis in the central region and 57 had no metastasis. The proportion of males, tumor location, microcalcification and invasion of capsule

    in the metastatic group was higher than that in the non-metastatic group (P ＜ 0.05), the proportion of patients with age ＜ 55 years old and tumor diameter ＜ 5 mm was lower than those without metastasis (P ＜ 0.05), however, there was no significant difference in the proportion of patients with nodular goiter and Hashimoto's thyroiditis between the two groups (P ＞ 0.05). Multivariate logistic regression analysis showed that the risk factors of lymph node metastasis in the central region of 106 patients included male, microcalcification and capsule invasion (P ＜ 0.05). Conclusion The risk factors of lymph node metastasis in the central region of cN0 thyroid micropapillary carcinoma include male, microcalcification, and invasion of capsule. Preventive and therapeutic dissection of lymph nodes in the central region is recommended.

    Effect of laparoscopic cholecystectomy for the patients with gallstones on postoperative stress response and recovery of gastrointestinal function
    WU Jun, WANG Zheng, WU Junchao
    2023, 11(1):  18. 
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    Objective To investigate the effect of laparoscopic cholecystectomy on stress response indicators in patients with gallstones. Method 78 patients with gallstones who were treated in Jurong People's Hospital from January 2020 to March 2022 were divided into control group (39 cases) and observation group (39 cases) according to random number table. The changes of stress indexes were observed before and after surgery in the two groups. The recovery time of gastrointestinal function and comparing the changes of gastrointestinal hormone levels were also observed. Result The levels of endothelin and cortisol in the

    observation group were significantly lower than those in the control group, and the levels of serum superoxide dismutase were higher than those in the control group (P ＜ 0.05). The postoperative recovery time of patients in the observation group was shorter than that in the control group, and the monitoring concentrations of motilin and gastrin were higher than those in the control group, with significant differences (P ＜ 0.05). Conclusion Laparoscopic cholecystectomy for patients with gallstones can effectively reduce postoperative stress response and promote the recovery of gastrointestinal function.

    Effect of intraperitoneal chemotherapy with lobaplatin on liver function in patients with primary liver cancer after operation
    MA Yuanliang, HUANG Qiangsong, ZHAO Fulin
    2023, 11(1):  22. 
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    Objective To investigate the effect of intraperitoneal chemotherapy with lobaplatin on liver function in patients with primary liver cancer after operation. Method 92 patients with primary liver cancer admitted to our hospital from July 2021 to February 2022 were randomly into the control group (n=46) and the observation group (n=46), the observation group was given intraperitoneal chemotherapy with lobaplatin on the basis of the control group. All patients were followed up for 6 months. The levels of serum alpha-fetoprotein (AFP), alanine aminotransferase (ALT), aspartate transaminase (AST), total bilirubin (TBIL) were compared between the two groups before operation, 7 days after operation, 1 month and 2 months after operation. Result Two months

    after operation, the serum AFP level of patients in the two groups gradually decreased with time, and the serum AFP level in the observation group was lower than that in the control group 7 days, 1 month and 2 months after operation (P ＜ 0.05). Two months after operation, the levels of serum ALT and AST in the two groups were significantly lower than those before operation (P ＜ 0.05); However, there was no significant difference in serum ALT, AST and TBIL levels between the two groups at 7d, 1 month and 2 months after operation (P ＞ 0.05). Within 6 months after operation, the incidence of poor prognosis in the observation group was significantly lower than that in the control group (P＜ 0.05); The mortality rates of the observation group and the control group were 0.00% and 2.17% respectively, with no significant difference (P ＞ 0.05). Conclusion Intraperitoneal chemotherapy with lobaplatin does not significantly increase the risk of liver injury in postoperative patients with primary liver cancer, can improve the prognosis of patients with liver cancer, clinical application of safety, and the survival was good within

    6 months.

    The clinical curative effect of trioxygen combined with traditional Chinese medicine sticking for the treatment of the patients with chronic wounds
    ZHANG Zhiyuan, LIU Jing, HAN Song, QIN Yanyan, GE Qunying, WANG Xue, LI Yanwei, SONG Dapeng
    2023, 11(1):  27. 
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    Objective To study the clinical curative effect of trioxygen combined with traditional Chinese medicine sticking for the treatment of the patients with chronic wounds. Method 80 patients with chronic wounds in Jiaozhou Hospital of Tongji University from January 2021 to September 2022 were randomly divided into two groups according to the random number table method. Forty cases in the control group were treated with the method of routine debridement, anti-infection and dressing change. Forty cases in the study group were treated with the method of trioxygen combined with traditional Chinese medicine stricking on the basis of routine curative method treatment with a curative time 3 weeks in these two groups. The wound healing time, symptom score, clinical

    efficacy, inflammatory factors and oxidative stress indexes of the two groups were observed and the treatment safety of the two groups was also evaluated. Result The total effective rate in the study group (95.00%) was higher than those of the control group (72.50%), but the wound healing time in the study group was shorter than those of the control group (P ＜ 0.05). After 3 weeks of treatment, The levels of various parameters including edema, pain, hemorrhage, secretion score, serum interleukin-1, interleukin -6, tumor necrosis factor-α, malondialdehyde, advanced oxidation protein products were significantly decreased, especially in the study group , the level of superoxide dismutase was significantly higher in the study group (P ＜ 0.05). There were no adverse reactions and abnormal laboratory indexes in both groups. Conclusion Trioxygen combined with traditional Chinese medicine was effective in treating chronic wounds and could effectively promote wound healing, relieve symptoms, inhibit

    inflammatory reaction and reduce oxidative stress.

    Comparison of short-term clinical effects between total laparoscopic and laparoscopic assisted radical gastrectomy for gastric cancer
    WEI Xin, QIAN Lei
    2023, 11(1):  33. 
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    Objective To explore the short-term clinical efficacy of total laparoscopic and laparoscopic assisted radical gastrectomy for gastric cancer. Method The data of 80 patients with gastric cancer treated by complete laparoscopic surgery and laparoscopic surgery in Qiqihar Public Security Hospital from May 2020 to May 2021 were retrospectively analyzed. The patients were treated by complete laparoscopic surgery as the observation group (n=40), and the patients were treated by laparoscopic surgery as the control group (n=40). The postoperative effects of the two groups were compared and statistically analyzed. Result The VAS scores of patients in the observation group were higher than those of patients in the control group at 1, 2 and 3 days after operation (P ＜ 0.05); The

    first scheduling time, the incidence of complications, the length of abdominal incision and the first postoperative fluid diet time in the observation group were significantly better than those in the control group (P ＜ 0.05); The operation time of patients in the control group was significantly better than that of patients in the observation group (P ＜ 0.05); There was no significant difference in the number of lymph nodes and application of analgesics, between the two groups（P ＞ 0.05）. Conclusion Compared with laparoscopy, although the operation time of complete laparoscopic assisted surgery is longer, its first scheduling time and the first liquid diet time are shorter, which is more conducive to the early rehabilitation of patients and can be selectively used in clinical practice.

    The effect of three-scope combined with transabdominal nasobiliary drainage in the treatment of extrahepatic bile duct stones
    LIANG Yunqiu, HE Ziping
    2023, 11(1):  37. 
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    Objective To investigate the effect of three-scope combined with transabdominal nasobiliary drainage in the treatment of extrahepatic bile duct stones. Method 80 patients with choledocholithiasis admitted to the Second People's Hospital of Xinhui District of Jiangmen City from March 2021 to August 2022 were retrospective analysis and randomly divided into observation group and control group with 40 cases each. Both groups of patients underwent laparoscopic cholecystectomy, bile duct exploration, transabdominal nasobiliary duct drainage, and primary suture. The observation group underwent antegrade placement of nasobiliary duct through the abdomen, and the control group underwent oral placement of nasobiliary duct drainage. The general

    information, preoperative bilirubin, diameter of common bile duct, number of common bile duct stones, and other systemic diseases were compared between the two groups. The operation time, intraoperative blood loss, whether duodenal papillectomy was needed, catheterization time, catheterization success rate, postoperative intestinal recovery and exhaust time, abdominal drainage tube removal time, nasobiliary tube removal time, hospital stay and complications were compared between the two groups, and statistical analysis was performed. Result The operation time of patients in the observation group was longer than that in the control group, and the incision rate of duodenal papilla was significantly lower than that in the control group (P ＜ 0.05), there was no significant difference in intraoperative bleeding between the two groups (P ＞ 0.05). The intubation time, gastrointestinal recovery time, extraction time of abdominal drainage tube and nasobiliary duct in the observation group were shorter than those in the control group (P ＜ 0.05), however, there was no significant difference between the two groups in the success rate of intubation and the length of stay (P ＞ 0.05). The incidence of complications in the observation group was

    significantly lower than that in the control group (P ＜ 0.05). Conclusion The application of three-scope combined with transabdominal nasobiliary drainage in the treatment of extrahepatic bile duct stones is effective and high security.

    Clinical effect of laparoscopic hernioplasty in the treatment of elderly indirect inguinal hernia
    GU Bin, XU Weigang
    2023, 11(1):  41. 
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    Objective To investigate the clinical effect of laparoscopic hernioplasty in the treatment of elderly indirect inguinal hernia. Method 40 elderly patients with indirect inguinal hernia who were admitted to Xingpu Hospital in Suzhou Industrial Park from January 2019 to April 2022 were selected to undergo hernia repair. They were divided into control group and observation group with 20 patients each according to different operation methods. The control group was treated with traditional open tension-free hernioplasty, and the observation group was treated with laparoscopic hernioplasty. Result The patients in the observation group had less intraoperative bleeding, shorter incision length, shorter time to get out of bed and stay in hospital, and the incidence of

    postoperative complications was significantly lower than that in the control group (P ＜ 0.05). Conclusion Laparoscopic hernioplasty for the treatment of indirect inguinal hernia in the elderly has higher safety, less damage and is more conducive to the recovery of patients.

    Diagnosis and treatment of 6 cases postsigmoidostomic hernia after colostomy
    WANG Yongle, ZHANG Jie, LI Wen, SUN Qinli, YANG Liguang
    2023, 11(1):  45. 
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    Objective To explore the clinical characteristics, diagnosis and treatment of postsigmoidostomic hernia after colostomy for rectal cancer. Method The clinical data of 6 patients with postsigmoidostomic hernia developed after colostomy for rectal cancer in Linyi Central Hospital from January 2018 to December 2021 were retrospectively analyzed. Result The sigmoid mesocolon at the stoma and the left parietal abdominal wall were continuously sutured and fixed in 6 patients. The operation took 46 ～ 210 minutes, the amount of bleeding was not much, there were no complications related to the operation, and there was no hernia of the groove beside the sigmoid colostomy. Conclusion Postsigmoidostomic hernia is a rare complication after colostomy. It is important to perform abdominal CT scanning as early as possible from the clinical history and physical findings, and to determine the surgical indication.

    Clinical observation of neoadjuvant chemotherapy combined with laparoscopic radical resection for rectal cancer
    LI Guofeng
    2023, 11(1):  49. 
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    Objective To investigate the effect of neoadjuvant chemotherapy combined with laparoscopic radical resection of rectal cancer. Method 60 patients with rectal cancer from January 2018 to January 2020 were selected,30 patients in the control group received laparoscopic radical resection of colorectal cancer, and did not receive neoadjuvant chemotherapy before surgery. 30 patients in the observation group received neoadjuvant chemotherapy before laparoscopic radical resection of colorectal cancer, the resection effect and prognosis were compared between the two groups. Result The positive rate of peripheral incisal margin, the rate of abdominal implant metastasis, the rate of anastomotic recurrence and the rate of distant metastasis in the observation group were lower than those in the control group, and the progression-free survival and total survival were significantly higher than those in the control group (P ＜ 0.05); There was no significant difference in the levels of carcinoembryonic antigen, CA19-9 and CA242 between the two groups before treatment (P ＞ 0.05). The levels of carcinoembryonic antigen, CA19-9 and CA242 in the observation group were lower than those in the control group after treatment (P ＜ 0.05).Conclusion Neoadjuvant chemotherapy before laparoscopic radical resection of colorectal cancer can improve the resection effect, prolong the survival time of patients, and reduce the expression level of tumor markers.

    Application of slag-free enteral nutritional powder in intestinal preparation for colonoscopy
    LI Wenjiao, ZHAO Yuan, LU Yu, LI qian
    2023, 11(1):  53. 
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    Objective To investigate the effects of slag-free enteral nutritional powder on intestinal cleanliness, incidence of discomfort symptoms and patients experience. Method 128 patients undergoing electronic colonoscopy were randomly divided into the experimental group and the control group, 64 cases in each group. The experimental group began to take slag-free enteral nutritional powder before microscopic examination, and the control group took low-residue or no-residue diet to compare the intestinal cleanliness of the two groups and the incidence of discomfort symptoms. Result The intestinal cleanliness of the experimental group was better than that of the control group, and the difference was statistically significant, the incidence of discomfort symptoms in the experimental group was lower than that in the control group, the bowel preparation experience of the experimental group was better than that of the control group, the difference is significant(P ＜ 0.05). Conclusion One days

    enteral nutritional powder before colonoscopy can not only provide adequate bowel preparation, but also reduce the incidence of discomfort symptoms caused by dietary restriction, and improve the experience of bowel preparation.

    Analysis of the occurrence and influencing factors of post-traumatic stress disorder in patients with severe trauma
    LI Yanfang, ZHONG Zhongying, LI Huanting, DENG Jieying, HE Wujing
    2023, 11(1):  57. 
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    Objective To explore the occurrence and influencing factors of post-traumatic stress disorder (PTSD) in patients with severe trauma. Method Take the patients with severe trauma who were revisited in the outpatient department from June 2020 to May 2021 as the subjects of investigation, and carry out cross-sectional investigation and research. After obtaining their consent, the hospital information management system will first collect the cause of injury, trauma site, trauma time, and trauma severity score (ISS); They were given the social demographic data questionnaire, the posttraumatic stress disorder self-rating scale (PTSD-SS), the Chinese version of the selfrating scale of sleep (SRSS) and the positive psychological capital questionnaire (PPQ) to investigate their social demographic data, the degree of post-traumatic stress disorder, sleep status and positive psychological status. Result

    A total of 187 cases were included in the final analysis. The PTSD-SS scale score ranged from 5 to 78 points, with an average of (47.27±11.60) points. 53 cases (28.34%) were diagnosed with PTSD (PTSD group), and 134 were non-PTSD (non-PTSD group). There were statistically significant differences between the PTSD group and the Non-PTSD group in terms of education level, family income level, trauma time, ISS total score, SRSS total score and PPQ total score (P ＜ 0.05); Logistic regression analysis showed that high family income level, long trauma time and high PPQ score were protective factors for PTSD in severely traumatized patients (P ＜ 0.05). Conclusion The risk of PTSD after severe trauma is higher. Family income level, trauma time and positive psychological status are the influencing factors of PTSD after severe trauma.

    Analysis of the effect of manual lymphatic drainage nursing on relieving postoperative lymphedema and axillary reticulum syndrome in patients with breast cancer
    XIAO Qiumei, PANG Meirui, CHEN Wanxia
    2023, 11(1):  64. 
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    Objective To analyze the intervention effect of manual lymphatic drainage nursing on relieving postoperative lymphedema and axillary reticulum syndrome of breast cancer. Method From January 2018 to January 2020, 50 patients with lymphedema and axillary reticulum syndrome after breast cancer surgery were selected from Zhanjiang Maternal and Child Health Care and Family Planning Service Center. They were randomly divided into two groups by double-blind method. The control group was 25 patients, receiving routine care; 25 patients in the observation group were treated with manual lymphatic drainage based on the control group; The intervention effect and symptom relief of the two groups were compared. Result The effective rates of the patients

    in the observation group were 72.0%, 80.0% and 100.0% respectively after 3, 6 and 12 months of intervention, which were higher than 44.0%, 56.0% and 72.00% in the control group (P ＜ 0.05). The decrease of the difference in circumference of the patients in the observation group after 3, 6 and 12 months of intervention was higher than that in the control group, and the abduction angle of the shoulder joint of the affected limb at 1, 3, 6 and 12 months after intervention was higher than that in the control group, and the time for the postoperative tightness, cord structure, numbness and pain of the affected limb was shorter than that in the control group (P ＜ 0.05). After 1 month of intervention, the scores of daily social function, upper limb activity function and upper limb symptoms in the observation group were lower than those in the control group (P ＜ 0.05). Conclusion Manual lymphatic drainage nursing can alleviate the clinical symptoms of lymphedema and axillary reticulum syndrome after breast

    cancer surgery, increase the range of motion of the affected limb, and have a good intervention effect.

    Application of enhanced recovery after surgery concept in perioperative nursing of laparoscopic appendectomy
    ZHOU Xialei, LU Xian, TANG Xueqin
    2023, 11(1):  69. 
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    Objective To explore the application effect of enhanced recovery after surgery concept in perioperative nursing of laparoscopic appendectomy. Method A total of 280 patients with acute appendicitis diagnosed and treated in Kunshan Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Chinese Medicine from January 2020 to December 2021 were retrospectively selected as the research objects and they were randomly divided into observation group (n=140) and control group (n=140). The control group was given routine surgical nursing, while the observation group was given rapid rehabilitation surgical nursing.

    The postoperative related indexes and recovery of the patients in the two groups were compared. Result The postoperative anal exhaust time, the first time to get out of bed, the postoperative defecation time, the postoperative knife pain score and the length of hospital stay in the observation group were significantly better than those in the control group, and the differences were statistically significant (P ＜ 0.05). The total incidence of postoperative complications in the observation group was 4.28%, which was lower than 10.71% in the control group, and the difference was statistically significant (P ＜ 0.05). Conclusion The perioperative implementation of fast track surgical nursing in laparoscopic appendectomy can accelerate the recovery of postoperative gastrointestinal function, reduce the length of hospital stay and the incidence of postoperative complications, which is worthy of clinical surgical nursing promotion and application.