ObjectiveTo standardize the techniques for laparoscopic radical rectal resection and discuss its application prospect. MethodsThe clinical data of 433 patients who underwent laparoscopic radical rectal resections from July 2003 to December 2010 in our hospital were reviewed retrospectively, and the different surgery procedures and the development prospect were explored. ResultsFive cases (1.2%) underwent handassistant laparoscopic procedures, 412 cases (95.2%) were done by laparoscopic-assisted operation, and the specimens were taken out with transanal pull-through technique in 16 cases (3.7%). In all of them, conversion to open procedures occurred in 11 patients (2.5%), and 290 (67.0%) patients were followed-up in 1 to 6 years, average in 2.7 years. Local recurrence occurred in 7 (2.4%) patients, while distant metastasis were diagnosed in 22 （7.6%） cases, and the overall mortality was 15.9% (46/290). There was no port-site metastasis occurred. ConclusionsFour-port laparoscopic rectal resection technique is also the clinical mainstream. Standardized laparoscopic procedure for rectal resections enhances the transformation of laparoscopic skills, and makes the operation predictable. Single incision procedure and natural orifice transluminal endoscopic surgery are future direction to explore.
Objective To study the clinical significance of the microorganism culture result of amniotic fluid in cesarean section in the treatment of anti-infection after operation. Methods From August 2016 to May 2017 in Women’s and Children’s Hospital of Sichuan Province, 502 amniotic fluid samples were collected in cesarean section to carry out bacteria culture. The correlations between the amniotic fluid culture result and the preoperative and intraoperative risk factors and the correlations between postoperative infection and the preoperative and intraoperative risk factors were analyzed. Results In the 502 amniotic fluid samples, there were 131 samples culture-positive. The microbiological culture results of amniotic fluid were statistically different between the puerperae with gestational age<37 weeks and the ones with gestational age≥37 weeks (P=0.001). Postoperative infection occurred in 6 puerperae, in whom the amniotic fluid culture results were positive in 3 puerperae. There was no statistical difference in the occurrence of postoperative infection between the puerperae with amniotic fluid culture-positive results and the ones with negative results (P=0.382). The occurrence of postoperative infection was associated with preoperative infections, gestational age, using time of antimicrobial, and preoperative rupture of membranes (P<0.05). Conclusions The contamination rate of amniotic fluid specimen was high, which was of low reference value to anti-infection treatment after operation. When an extension of anti-infection treatment be carried out after cesarean section, suitable specimens should be selected according to the infection site.
ObjectiveTo evaluate the functional outcomes and quality of life in patients with surgery for slow transit constipation (STC).MethodsFrom March 2013 to July 2017, 29 patients undergoing total or subtotal colectomy for STC in our department were analyzed prospectively. Their preoperative and postoperative 1-year follow-up details were analyzed. Evacuation function of all patients was assessed by bowel movements, abdominal pain, bloating, straining, laxative, enema use and the Wexner constipation scales. Quality of life was evaluated by the Gastrointestinal Quality of Life Index (GIQLI) and the short-form (SF)-36 survey.ResultsA high number of patients (93.1%, 27/29) in STC stated that surgery received benefits to their health. Compared with that before operation, the number of bowel movements per week during a 1-year follow-up increased significantly (31.6±19.9 vs. 1.21±0.6, P<0.05). Significant trends toward improvement of bloating, straining, laxative and enema use were noted 1-year following surgery (P<0.05). The Wexner constipation scales scores during a 1-year follow-up decreased significantly (5.69±3.4 vs. 20.34±0.6, P<0.05). The GIQLI scores during a 1-year follow-up increased significantly (120.7±20.4 vs. 78.6±17.3, P<0.05). Moreover, results of SF-36 showed significant improvements in 7 spheres (role physical, role emotional, physical pain, vitality, mental health, social function and general health) during a 1-year follow-up compared with those before operation (P<0.05).ConclusionTotal or subtotal colectomy for STC did not only alleviate constipation symptoms dramatically, but also received significant improvements in the patients’ quality of life.