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Table of Content

    01 April 2021, Volume 9 Issue 2
    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
    2021, 9(2):  3. 
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    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.

    Effect of ultrasound-guided continuous transversus abdominis plane block on postoperative analgesia and early recovery in patients undergoing radical resection of rectal cancer
    HUANG Zhidong, LI Chaoyang, YANG Jixiong
    2021, 9(2):  7. 
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    Objective To investigate the effect of continuous transverse abdominal plane block on postoperative analgesia and early recovery in patients with radical rectal cancer. Methods 56 patients with rectal cancer treated at the Second Affiliated Hospital of Guangdong Medical University from July 2017 to July 2019 were selected, which were divided into 28 cases, patients with controlled intravenous

    analgesia, patients with an ultrasound-guided continuous transverse abdominal plane block. The amount of fluid access and anesthetic use during patient surgery, The numerical rating scale (NRS) of 2h, 6h, 12h, 24h, 48h, 72h cough and resting were recorded; Patient relief, hospitalization time, first exhaust time after surgery, first bed time were recorded; The adverse reactions and complications such as nausea and vomiting after surgery were recorded; Patient recovery was assessed to a postoperative recovery quality scale. Results There was no significant difference between surgical time, anesthesia time, urine volume, propofol dosage, intraoperative bleeding volume, and total fluid volume in the two groups (P>0.05), The usage quantity of Remifentanil in study group less than the control group, The difference is significant (P<0.05); Postoperative 2h, 6h, 12h, 24h, The NRS at cough and resting were lower than the control group, the difference is significant (P<0.05); Postoperative 48h、72h, there was no significant difference

    in the NRS at coughing and resting (P>0.05); Preoperative 1d, there was no significant difference in the total score, emotional state, self-care ability, physical comfort, pain, and psychological support scores of the two groups (P>0.05); Postoperative 3d, total score, physical comfort, emotional state, pain, and psychological support scores were higher than in the control group, the difference is significant (P<0.05); There was no significant hospitalization time difference between the two groups (P>0.05); The first hospital discharge time and the first postoperative exhaust time were shorter than the control group, the rates of nausea, vomiting, relief and analgesia were lower than in the control group, the difference was significant (P<0.05). Conclusion Ultrasonic-guided continuous transverse abdominal plane block can significantly improve the postoperative cough and resting analgesia effect in patients with radical rectal cancer, and significantly improve the early recovery condition.

    The influence of chewing gum for gastrointestinal function after surgery in laparoscopic left hemicolectomy for patiens with colon cancer and its mechanism of action
    HUANG Yongheng, WU Guozhong, PANG Shaochun, PAN Tiansheng, LIN Liangxue
    2021, 9(2):  14. 
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    Objective To investigate the gastrointestinal function of chewing gum after laparoscopic resection of left colon cancer and explore its mechanism of action. Methods 65 patients underwent laparoscopic resection of left colon cancer were selected in the department of general surgery between January 2018 to September 2020 in Nongken Central Hospital. These patients were divided into research group (n=35) and control group (n=30). The patients in the research group chewed 2 pieces of xylitol gum three times daily for 30 minutes after surgery, while control group received traditional managements. The levels of procalcitonin (PCT) and C reactive protein (CRP) were examined with peripheral blood on day 1 and 3 after operation. Postoperative exhaust and defecation time, postoperative

    hospital stays and postoperative inflammatory factor level of the two groups was compared. Results All the 65 patients recovered and were discharged smoothly, and the postoperative exhaust and defecation time and postoperative hospitalization days in the research group were shorter than those in the control group (P<0.05). The levels of inflammatory factors in postoperative day 1 and day 3, PCT and CRP were lower than the control group(P<0.05). Conclusions Chewing gum after laparoscopic resection of the left colon cancer can promote the early recovery of gastrointestinal function, and its mechanism may inhibit the release of inflammatory factors and promote gastrointestinal motility.

    Clinical observation of modified ligation of the sphincteric fistula tract in the treatment of sphincteric perianal fistula
    HE Yaoming, WANG Chengxing, LIANG Weijun, ZHAO Jinglin
    2021, 9(2):  19. 
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    Objective To investigate the clinical effect of modified ligation of the sphincteric fistula tract (LIFT) in the treatment of sphincter anal fistula. Methods According to the random number table, patients with perianal horseshoe abscess were randomly divided into two groups, the experimental group (by modified LIFT ) 50 cases and the control group (by classic operation) 50 cases. The operation

    time, intraoperative blood loss, duration of the postoperative pain, hospital stay, healing time of surgical incision, anal function, anal morphology and recurrence rate of two groups were recorded and analyzed. Results The observation group was better than the control group in operation time, operation blood loss, postoperative pain duration, incision healing time, anal function and anal morphology, the difference wassignificant (P<0.05), but there was no significant difference in hospital stay and anal fistula recurrence

    rate between the two groups (P>0.05). Conclusion Compared with the classic operation, it has good clinical effect to treat sphincteric perianal fistula through modified LIFT.

    Observe the clinical effect of the treatment of horseshoe perianal abscess via the approach between the sphincter internal and the sphincter externus
    WANG Chengxing, LI Xiaoping, ZHAO Jinglin, LI Shangren, TAN Qunying, HE Yaoming
    2021, 9(2):  24. 
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    Objective To investigate the efficacy of treatment of perianal horseshoe abscess via the approach between the sphincter internal and the sphincter externus. Methods From December 2014 to December 2019, 50 cases of horseshoe perianal abscess in gastrointestinal surgery of Jiangmen Central Hospital were selected. According to the random number table, patients with perianal horseshoe abscess were randomly divided into two groups, the experimental group (by the approach between the sphincter

    internal and the sphincter externus) 25 cases and the control group (by classical approach) 25 cases. The operation time, intraoperative blood loss, duration of the postoperative pain, hospital stay, healing time of surgical incision, anal function, anal morphology, recurrence rate, anal fistula rate and complex anal fistula rate of two groups were recorded and analyzed. Results There were statistical differences in the terms of operation time, duration of the postoperative pain, healing time of surgical incision, anal function, anal morphology anal fistula rate and complex anal fistula rate, experiment group is much better

    than that of the control group (P<0.05); However, there were no statistical differences in the terms of intraoperative blood loss, hospital stay and recurrence rate between the two groups (P>0.05). Conclusion Compared with the traditional approach, it has good clinical effect to treat horseshoe perianal abscess through the approach between the sphincter internal and the sphincter externus.

    Advances in surgical treatment of intraductal papillary mucinous neoplasm of the pancreas
    YUAN Jiaqi, CHEN Xiaobin, HOU Lichao
    2021, 9(2):  28. 
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    Intraductal papillary mucinous neoplasm (IPMN) of the pancreas is a kind of mucinous tumor involving the main pancreatic duct or branch pancreatic duct, and lacks the characteristics of mucinous cystadenoma. IPMN may progress to pancreatic ductal adenocarcinoma. At present, many studies are exploring the pathogenesis and diagnosis of IPMN, and have made progress. However, there is no complete unification of its surgical indications and surgical methods. In this paper, the progress of IPMN treatment was discussed from the aspects of epidemiology, classification, malignancy evaluation, surgical treatment and prognosis.

    Application progress of endoscope technology in general surgery
    JIANG Lan
    2021, 9(2):  32. 
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    With the rapid integration of industrial technology and interdisciplinary disciplines, endoscopic technology continuously improves the advantages of shortening surgical duration and reducing patient intraoperative injury, and endoscopic technology has been more widely used in clinical practice in recent years. This paper focuses on the development history and progress of endoscopic

    technology, introduces the technical requirements of different types, the clinical application and development prospects of general surgery, and analyzes the problems and future development trend of endoscopic technology.

    Meta analysis of the application effect of clinical nursing pathway in patients with thyroid tumor surgery
    GONG Lili, CHEN Chen
    2021, 9(2):  37. 
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    Objective To explore the application effect of clinical nursing pathway in patients with thyroid tumor surgery. Methods CNKI, VIP database,Wanfang database, CBMdisc and other databases were searched to search the clinical randomized controlled trials or clinical controlled trials of clinical nursing pathway in patients with thyroid surgery from when building the library to June 2019.

    The literature was screened and extracted. RevMan 5.0 software was used to evaluate the quality of literature. Finally, RevMan 5.3 was used for analysis. Results A total of 19 clinical controlled studies were included, including 2371 patients with thyroid surgery, including 1193 patients with the clinical nursing pathway (experimental group) and 1178 patients with the traditional clinical nursing (control group). The average hospitalization time of the experimental group was significantly less than that of the

    control group, the satisfaction and knowledge mastery of the experimental group was significantly higher than that of the control group, the bed rest time of the experimental group was significantly lower than that of the control group, and the incidence of complications of the experimental group was significantly lower than that of the control group. Conclusion The implementation of clinical nursing pathway for patients with thyroid surgery can significantly shorten the average length of hospital stay, improve patient satisfaction and mastery of knowledge, and reduce the occurrence of complications.

    Effect of rational emotional behavior therapy on psychological and stress response after radical mastectomy
    CHEN Zejie
    2021, 9(2):  44. 
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    Objective To explore the effect of rational emotional behavior therapy on psychological and stress response after radical mastectomy. Methods Patients who underwent radical mastectomy for breast cancer in Shantou Central Hospital from January 2019 to January 2020 were selected. The random number table was divided into a control group and an observation group, each with 40 cases. Patients in the control group received conventional nursing care, and patients in the observation group received

    reasonable emotional behavior therapy on the basis of conventional treatment, including cognitive education, guidance and understanding, psychological intervention and reasonable behavior intervention. After all, the stress level and nursing satisfaction of the two groups of patients, to determine the impact of reasonable emotional therapy on the surgical stress response of patients undergoing radical breast cancer surgery. Results Compared with the control group, after receiving reasonable emotional intervention, the total score of self-rating depression scale (SDS), quality of life scale(QLQ)-C30 and automatic thinking

    questionnaire(ATQ) of patients in the observation group increased significantly, and the difference was statistically significant (P<0.05); The stress level of the observation group was significantly lower than that of the control Group (P<0.05); And the nursing satisfaction score of the observation group was significantly higher than that of the control group (P<0.05). Conclusion The application of rational emotional behavior intervention in the surgical process of breast cancer patients can effectively

    alleviate the adverse psychology of patients, reduce post-operative stress response, and improve nursing satisfaction, which can be further studied and applied in clinical practice.