ObjectiveTo explore the curative effect and value of laparoscopic operation in the treatment of acute gangrenous and perforated appendicitis. MethodsThe clinical data of 243 patients with acute gangrenous and perforated appendicitis from February 2011 to February 2014 in our hospital were retrospectively analyzed. Laparoscopic appendectomy was performed in 118 cases (LA group), and open appendectomy was performed in 125 cases (OA group). The operative time, hospital stay, hospital costs, incision bleeding, gastrointestinal function recovery, wound infection, pelvic abscess, and postoperative adhesions of two groups were compared. ResultsThere was no significant difference in the operative time, incision bleeding, and the incidence of pelvic abscess after operation between the LA group and OA group (P>0.05). Compared with the OA group, the recovery time of gastrointestinal function was significantly shortened (P<0.01), eating time was earlier (P<0.01), hospitalization time also shortened significantly (P<0.01), and the incidence of postoperative wound infection and intestinal adhesion were significantly decreased (P<0.01) after operation in LA group. But the cost of hospitalization in LA group increased significantly (P<0.05). ConclusionsThe laparoscopic operation in the treatment of gangrenous and perforated appendicitis are light of pain., recover quickly, shorter of hospital stay, and fewer complications. The increase of hospitalization expenses is the only deficiency.
ObjectiveTo investigate effect of laparoscopic radical gastrectomy on gastrointestinal motility and gastrointestinal hormones in patients with gastric cancer. MethodsTwo hundred and eighty-nine patients who underwent laparoscopic radical gastrectomy from December 2013 to December 2015 were selected as observation group, 325 patients underwent laparotomy radical gastrectomy during the same period were selected as control group. The postoperative bowel sounds recovery time, the first anal exhaust time, and gastrin, motilin and vasoactive intestinal peptide levels in blood at 12 h before operation and at 24 h after operation were compared between these two groups. ResultsThe baselines had no significant differences between these two groups (P > 0.05). The postoperative bowel sounds recovery time and the first anal exhaust time in the observation group were significantly shorter than those in the control group (P < 0.05). Compared with the levels at 12 h before operation, the gastrin and motilin levels were significantly decreased and the vasoactive intestinal peptide level was significantly increased at 24 h after operation in these two groups (P < 0.05); Compared with the control group, the gastrin and motilin levels at 24 h after operation were significantly increased (P < 0.05) and the vasoactive intestinal peptide level was significantly decreased in the observation group (P < 0.05). ConclusionsPostoperative gastrointestinal motility recovery time in patients undergoing laparoscopic radical gastrectomy is significantly faster than that of laparotomy radical gastrectomy. There is a certain relation between gastrin, motilin or vasoactive intestinal peptide change and operation mode, it might be one of mechanisms of faster recovery of gastrointestinal motility after laparoscopic radical gastrectomy for gastric cancer.
ObjectiveTo observe the efficiency of endovenous laser therapy combined with planning sucking operation in the treatment of great saphenous varicose veins. MethodsTotally 48 patients (60 limbs) were treated from May 2011 to May 2014 in general surgery department of our hospital. The main trunk of great saphenous vein was ablated by endovenous laser treatment; and the varicose veins in calf were resected by planning sucking operation. ResultsAll 48 patients (60 limbs) were cured without recurrent during 6-36 months followed-up. The operative time of each side was 18-43 min, the average operative time was 22.6 min; with 1-3 skin incisions. Hospital stay was 5-8 d, the average hospitalization time was 6.7 d. After operation, the varicose veins and the felling of swelling were disappeared, the pigmentation was reduced or disappeared. Local skin numbness showed in 6 cases and recovered in 3-7 months after operation. Felling of burns appeared in 2 cases, and was healed after treatment. Ankle swelling presented in 5 cases, and released in 6-13 d with related treatment. Different degree of subcutaneous bruising appeared without any hematoma, and recovered in 2-4 weeks. Two cases were lost during the followed-up. ConclusionsEndovenous laser therapy combined with planning sucking operation is safe and effective in the treatment of great saphenous varicose. It is worthy of promotion with minimum damage, less pain, fast recovery, no scars, shorter operative time, and shorter hospital stay.