Objective We searched and reviewed medical evidence to find the guide of bowel preparation we should choose before large bowel preparation. Method Firstly, we put forward clinical questions. Secondly, we searched medical evidence from PubMed, MEDLINE, EMbase, Cochrane Library, Science and ACP in recent 10 years. And then we reviewed the results. Results We finally identified 17 literatures including 2 system reviews, 6 meta-analyses and 9 randomized control trials which included 4 multicentre randomized clinical trials. Most of literature suggested that there was no evidence showing the benefit of mechanical bowel preparation (MBP). No MBP before large bowel surgery would not increase rate of anastomotic leakage. On the contrary, MBP may increase the percentage of anastomotic leakage and wound infection. Considering the research with the clinical situation, we produced a new method of simplified MBP to treat the patient. It reached the predictive effect. Conclusion No evidence of systematic review and meta-analysis supports the benefit of BMP. The new simplified bowel preparation before surgery in West China Hospital was worthy to test.
ObjectiveTo analyze and explore the thyroid defunctionalization method for preoperative preparation of hyperthyroidism patients in endoscopic thyroid surgery. MethodsThe clinical data of 45 cases of hyperthyroidism treated with endoscopic surgery in this hospital from June 2009 to June 2014 were analyzed retrospectively. These patients were divided into study group (n=20) and control group (n=25) according to the preoperative preparation method, the study group was prepared with thyroid defunctionalization method, the control group was prepared with antithyroid drugs and iodine. The intraoperative blood loss, conversion to open surgery, and postoperative complications were compared in these two groups. ResultsThe intraoperative blood loss and the operation time of the study group were significantly less than those of the control group﹝intraoperative blood loss: (120.32±50.26) mL versus (200.63±60.95) mL, P < 0.05; operation time: (120.43±40.56) min versus (180.76±50.92) min, P < 0.05﹞. There was no case of conversion to open surgery in the study group, there were three cases of conversion to open surgery in the control group. The incidence of postoperative complications of the study group was significantly lower than that of the control group﹝10% (2/20) versus 24% (6/25), P < 0.05﹞. ConclusionThyroid defunctionalization method is more suitable as compared with the traditional method for the preoperative preparation of hyperthyroidism in endoscopic thyroid surgery.
ObjectivesTo systematically review the efficacy of dyclonine and lidocaine for preparation before gastroscopy.MethodsPubMed, CNKI, CBM, VIP and WanFang Data databases were electronically searched to collect randomized controlled trials (RCTs) of dyclonine vs. lidocaine for preparation before gastroscopy from inception to December 31st, 2017. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was then performed by using RevMan 5.3 software.ResultsA total of 11 RCTs were included. The results of meta-analysis showed that: dyclonine could improve anesthetic effect (RR=1.38, 95%CI 1.31 to 1.47, P<0.000 01), and was more capable to remove bubble (RR=1.40, 95%CI 1.28 to 1.52,P<0.000 01), and had superior textures (RR=1.43, 95%CI 1.18 to 1.74,P=0.000 3).ConclusionsOral dyclonine can improve the visual definition of gastric mucosa and anesthetic effect, and has superior textures. Thus, dyclonine can be regarded as a recommended option prior to gastroscopy. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.