Table of Content

20 October 2011, Volume 11 Issue 05

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Clinical study of hydroxyethyl starch treatment for patients after laparoscopic resection for colorectal carcinoma

2011, 11(05):  329-332. 

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Objective To investigate the impacts of hydroxyethyl starch (130/ 0.4, 6%) (HS) therapy for patients after laparoscopic surgery for colorectal carcinoma. Methods Between January 2011 and July 2011, 45 patients of colorectal carcinoma after laparoscopic surgery were enrolled in this study. 23 postoperative patients in the HS group received hydroxyethyl starch (130/0.4, 6%) daily for the first three postoperative days; the other 22 postoperative patients in the albumin (ALB) group were given intravenous albumin therapy. Preoperative and postoperative heart rate, mean arterial pressure, CVP, PT, APTT, HCT, creatinine, albumin, postoperative length of stay, and postoperative anus exhaust time were compared. Results Preoperative clinical data, tumor stage, and pathological type of the two groups were comparable. There were no significant differences in heart rate, mean arterial pressure, PT, APTT, creatinine, albumin, postoperative length of stay, and postoperative anus exhaust time between the two groups (P>0.05). Compared with the ALB group and preoperation HS group, the CVP levels on the day 1, and day 3 after surgery were significantly higher in HS group (P<0.05); and the HCT levels on day 1, day 3 and day 5 after surgery were significantly lower in the HS group (P<0.05). Conclusion Hydroxyethyl starch (130/ 0.4, 6%) treatment in the early period after laparoscopic resection for colorectal carcinoma can effectively maintain hemodynamics stationary, improve colloid osmotic pressure of blood, and save the use of albumin.

Diagnosis Values of Multislice spiral CT in Rare Small-bowel Obstruction

2011, 11(05):  333-335. 

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Objective To evaluate the value of multislice spiral CT (MSCT) in diagnosing rare small-bowel obstruction (SBO). Materials and Methods The MSCT imaging features of 18 patients with rare cause of SBOs were reviewed retrospectively. Results The presence of SBOs could be diagnosed in all patients on MSCT. The underlying etiology of SBOs were diagnosed correctly in 77.22% of patients. Among the 18 patients, congenital intestinal atresia were found 1 case, foreign body in 3 cases, bezoar in 2 cases, abdominal cocoons in 1 cases, internal abdominal hernia in 2 cases, obturator hernia in 4 cases, small intestinal volvulus in 5 cases. Associated complications were arised in 5 patients with ischemia in 2 patients and perforations in 3 patients. Conclusion MSCT are not only useful for diagnosis and evaluation the severity of rare SBOs, but also useful for identifing the cause and associated complications of rare SBOs.

The cause and management measure of recurrent laryngeal nerve injuries in thyroid surgery in malignant thyroid neoplasms

2011, 11(05):  348-349. 

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Objective To investigate the cause and preventive measures of recurrent laryngeal nerve (RLN) injuries in thyroid surgery in malignant thyroid neoplasms. Methods One hundred and eighty-seven patients with malignant thyroid neoplasms were treated by surgery from January 1996 to January 2006.The relationship to RLN injuries of operative ways and RLN exposed or not during operation were the analysed major point of this paper. Results There were 18 cases RLN in all these 187 patients, the injury incidence of RLN was almost 1%(18/187)in all surgery patients in malignant thyroid neoplasms. The temproary RLN injuries incidence in malignant thyroid neoplasms was 83.3%(15 cases), and the permanent damage RLN incidence in malignant thyroid neoplasms was 16.7%(3 cases). Conclusion The incidence of injury of RLN is related with the patterns of thyroidectomy.Most of RLN was temparary injury, and permanent damage RLN was rare.The anatomy of RLN and indentification in the procedure of thyroidectomy could not be ovoid to the paralyisis of RLN. A good command of the neck anatomy and the variation of RLN as well as careful operation will provide the key to the prevention the RLN injury in thyroid surgery in malignant thyroid neoplasms.

Ultrasonic scalpel in radical mastectomy in the clinical application of

2011, 11(05):  357-358. 

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Objective To study the ultrasonic scalpel in the modified radical mastectomy in the application of results. Methods Retrospective analysis of 54 cases of modified radical mastectomy for breast cancer clinical data, of which 31 cases using the ultrasonic scalpel, 23 electric knife, knife present study by ultrasound and electric knife in the modified radical mastectomy compared two groups of operative time, intraoperative in blood loss, intraoperative injuries, vice rate, the number of detected lymph nodes, postoperative drainage, axillary drainage tube indwelling time, hospital stay, time of suture removal. Results of surgery in the two groups side injury, the number of lymph nodes detected no significant difference in operative time, blood loss, postoperative drainage, axillary drainage tube indwelling time, hospital stay, time of suture removal, ultrasonic scalpel group were superior to Electric knife. Conclusion In the modified radical mastectomy in the effective application of ultrasonic scalpel, surgical procedures can improve the efficiency of possible axillary dissection without axillary vascular injuries, postoperative recovery time is short, there are good prospects.

The analysis of the reasons caused locking compression plate breakage in treating fractures

2011, 11(05):  375-377. 

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【Abstract】objective To analyse the reasons caused locking compression plate brekage in fracture treatment. Method A retrospective analysis was done to study the causes of the 8 cases with locking compression plate breakage following fractural treatment．Result 0f the 8 cases，1 was caused by short length of plate,5 by oversized srew density,1 by noncompression to the bone fracture, 5 by no bone plant,1 by postoperative infection,2 by operative mistakes,4 were open fractures with severe primary injury.Conclusion The successful application of locking compression plate in fracture treatment does not lie in a correct understanding and skillful mastery of the principle of locked internal fixators,but also lies in the correct application of the principles of AO internal fixation.

Analysis of perioperative risks for elderly patients in cardiac surgery

2011, 11(05):  378-382. 

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【Abstract】Objective To analyze the perioperative characteristics and risk of elderly patients underwent cardiac surgery. Method From January 2007 to June 2011, 255 patients underwent different cardiac surgery were included in this study. The patients were divided by age into two groups : 55 patients with age ≥70 years in group A and 200 patients with age <70 years in group B. Preoperative risk factors, surgical strategy, perioperative management, postoperative complications and prognosis were compared between the two groups. Result Hypertension, acute coronary syndrome and renal insufficiency were found significantly higher in group A than in group B(P<0.05), and so was EuroSCORE (5.56±2.26 vs 2.14±2.21, P<0.05); Time of cardiopulmonary bypass in group A (102.61±38.36min) was significantly shorter than in Group B (119.66±47.57min , P<0.05), and so was time of aorta cross clamping (63.57±27.08min vs 79.46±35.29min , P<0.05 ). Frequency of postoperative lung infection and acute kidney injury in group A were significantly higher than in Group B( P<0.05). Ventilation time and length of ICU stay were significantly longer in group A than in group B. There was no significant difference in stroke, severe ventricular arrhythmia, total drainage, use of inotropic drugs between the two groups. No significantly difference in hospital mortality was shown between the two groups. Conclusion: Careful discrimination of perioperative risks, individualized surgical strategy, shorter cardiopulmonary bypass time ,active and correct management of postoperative complications may reduce operative risk and mortality for elderly patients in cardiac surgery.