Objective To investigate the safety and feasibility of electrocoagulation of gallbladder artery in laparoscopic cholecystectomy ( LC) . Methods A total of 376 patients with gallbladder benign diseases underwent LC in our hospital from May 2004 to September 2013.The gallbladder artery was treated by electrocoagulation . Results Because of unclear gallbladder triangle due to abdominal adhesion , conversion to laparotomy was performed in 9 patients.In the remaining 367 patients, three-port LC with electrocoagulation of the gallbladder artery was conducted successfully .Laparoscopic appendectomy was conducted simultaneously in 12 patients.An additional fenestration and drainage of the left renal cyst was performed in 1 patient.Postoperatively, a secondary bile duct exploration was conducted in 1 patient because of bile duct obstruction caused by common bile duct stones . Conclusion The electrocoagulation of gallbladder artery is safe and feasible in LC for the treatment of gallbladder benign diseases .

Objective To explore the value of laparoscopic ovarian-conserving restoration for ovarian cyst torsion . Methods A total of 62 cases of ovarian cyst torsion , 12 of which were combined with pregnancy , between January 2007 and June 2012 were retrospectively analysed .The surgical management involved laparoscopic high ligation of ovary blood vessels , restoration of the ovary, and resection of ovarian cysts . Results All the 62 cases of laparoscopic restoration were successfully performed with ovarian reservation.The cysts twisted for 180°~1080°, including 19 cases of <360°, 21 cases of 360°~720°, and 22 cases of >720°.The cysts were coloured purple black in 26 cases, purple or normal in 36 cases.The operation time was (57 ±23) min, the intraoperative blood loss was 5-130 ml (mean, 50.6 ml), and anal exsufflation time was (24 ±13) hours.No embolism, infection, and abortion occurred during post-operation.The level of estrogen recovered to normal in 1-3 months postoperatively .Ovulation at the procedure side was found in 43 cases in 6-24 months. Conclusions Laparoscopic ovarian-conserving surgery is a safe procedure for ovarian cyst pedicle torsion .High ligation of ovarian blood vessles and resection of ovarian cysts can not only avoid the possibility of thrombosis but also preserve the ovarian functions .The shortage of this operation is complicated to perform .

Objective To evaluate the safety of myomectomy by extrusion in cesarean section , in comparison with routine cesarean delivery. Methods From January 2008 to December 2010, a total of 128 operations of myomectomy by extrusion in cesarean section were performed (Myoma Group), while another group of 128 cases undergoing caesarean section , which respectively followed every cases of the Myoma Group but had no hysteromyoma , was selected as the control group .The amount and rate of postpartum hemorrhage , the level of postpartum fever , and postoperative hospital stay between the two groups were compared , respectively. Results In the two groups:the amount of postpartum hemorrhage was (233.6 ±58.9) ml vs.(228.5 ±90.9) ml (t=0.530, P=0.597); the rate of postpartum hemorrhage was 0% (0/128) vs.0.8% (1/128) (P=1.000); the decrease of haemoglobin was (6.17 ±2.83) g/L vs.(6.89 ±3.09) g/L (t=-1.944, P=0.053); the decrease of hematocrit was 2.22%± 0.98%vs.2.27%±1.02% (t=-0.400, P=0.690); the rate of postpartum fever was 2.3% (3/128) vs.5.5% (7/128) (χ2 =1.665, P=0.197);the length of postoperative hospital stay was (4.2 ±0.8) d vs.(4.1 ±1.2) d (t=0.706, P=0.481). There were no significant differences between the two groups in the abovementioned parameters . Conclusions The myomectomy by extrusion in cesarean section does not increase the level of postpartum hemorrhage and the rate of postpartum infections .It is a simple, minimally invasive , safe and feasible surgical method , being worthy of clinical application .

Objective To investigate two different hysterectomy ( total abdominal hysterectomy and total laparoscopic hysterectomy ) on short-term efficacy and influence on sexual functions . Methods The retrospective records of 100 cases of total laparoscopic hysterectomy ( TLH) and 100 cases of total abdominal hysterectomy ( TAH) from January 2009 to December 2012 were reviewed.The operation time, intraoperative blood loss, postoperative hospital stay, and sexual satisfaction at 12 months postoperatively were compared between the two groups . Results The operation time was longer in the TLH Group than that in the TAH Group [(128 ±11) min vs.(87 ±33) min, t=-11.787, P=0.000].The intraoperative blood loss was less in the TLH Group than that in the TAH Group [(108 ±37) ml vs.(155 ±28) ml, t=-10.129, P=0.000].The hospital stay was shorter in the TLH Group than that in the TAH Group [(5.5 ±1.9) d vs.(8.2 ±1.6) d, t =-10.870, P =0.000].There were no significant differences between the two groups in sexual frequency (Z=-1.300, P=0.193), libido (Z=-0.564, P=0.573), achievement of orgasm (Z =-1.591, P=0.112), sexual intercourse disorder (Z =-0.478, P =0.633), and the overall satisfaction (Z=-0.083, P=0.934).Extent of dyspareunia was worse in the TLH Group than in the TAH Group (Z=-3.752, P=0.000). Conclusions TLH has less blood loss and shorter hospitalization time than TAH .Hysterectomy has a certain influence on sex functions .Differences in the sexual satisfaction are not statistically significant between the two procedures .

Objective To explore the feasibility and safety of breast conserving surgery ( BCS) in patients with early breast cancer after local lumpectomy . Methods Clinical data of 26 patients who previously had received local lumpectomy from January 2009 to December 2011 were retrospectively analyzed .All the patients were diagnosed as solitary invasive ductal carcinoma with preoperative staging of T1N0M0.The interval from lumpectomy to BCS was 6-24 days (mean, 10 days) and the maximum diameter of tumors before first operation was 1-2 cm (mean, 1.6 cm).The shortest distance between nipple and operative incision was 2-6 cm (mean, 4.5 cm). Results The operations were successfully completed in all 26 patients, 15 of which received sentinel lymph node biopsy and 11 of which received axillary lymph node dissection .The hospital stay was 3-5 days with stage-Ⅰhealing of incision .All patients received whole breast radiation therapy after BCS .There was no local recurrence or distant metastasis during 2 -5 year ’ s follow-up (median, 32 months).All the patients were satisfied with the shape of breast and the quality of life . Conclusion For those patients with early breast cancer who have received local lumpectomy , meet the requirement of CBS , and have the willing of breast conserving , BCS is an ideal choice after rigid application of surgical indications .

Objective-To-investigate-surgical-skills-and-safety-of-laparoscopic-hysterectomy-procedure-for-enlarged-uterus-in-woman-with-adenomyosis-.-Methods-Fourteen-cases-of-adenomyosis-with-uterus-larger-than-twelve-week-pregnancy-accepted-laparoscopic-hysterectomy-form-December-2012-to-December-2013-in-our-hospital-.-Some-operating-techniques-,-including-the-management-of-uterine-vessels-and-separation-of-cardinal-ligament-and-uterosacral-ligament-,-were-modified-.-Results-The-operation-was-performed-successfully-under-laparoscopy-in-all-the-cases-.No-conversion-to-open-surgery-was-required-.No-operating-complication-happened.The-operating-time-was-(160.7-±66.1)-min,-and-the-intraoperative-blood-loss-was-(184.3-±50.5)-ml.-Conclusion-Modified-laparoscopic-techniques-should-be-considered-as-an-acceptable-alternative-in-hysterectomy-for-the-management-of-large-uterus-in-woman-with-adenomyosis-.

Objective-To-explore-the-feasibility-and-safety-of-endoscopic-total-thyroidectomy-via-chest-wall-approach-.-Methods-Endoscopic-total-thyroidectomy-via-chest-wall-approach-was-performed-in-20-patients-with-nodular-goiter-from-January-2008-to-December-2012.Subcutaneous-operative-space-was-created-through-an-unilateral-areola-incision-,-through-which-laparoscope-and-surgical-instruments-were-introduced-.The-neck-suture-suspension-technique-was-used-to-reveal-the-thyroid-gland-.By-using-an-ultrasonic-scalpel-,-the-thyroid-was-separated-and-removed-completely-.-Results-All-the-operations-were-successfully-completed-without-conversions-to-open-surgery-.The-operation-time-was-90-180-min-(mean,-120-min).The-blood-loss-was-15-40-ml-(mean,-20-ml).The-postoperative-hospital-stay-ranged-from-4-to-7-days-(mean,-5.8-days).There-was-1-case-of-temporary-hoarseness.No-severe-hemorrhage-,-wound-infection-,-or-subcutaneous-effusion-was-found-.-Conclusion-Endoscopic-total-thyroidectomy-via-chest-wall-approach-is-a-safe-and-feasible-procedure-.

Objective-To-discuss-the-clinical-efficacy-of-limited-decompression-and-pedicle-screw-fixation-for-thoracolumbar-burst-fractures.-Methods-From-October-2005-to-October-2011,-38-patients-with-thoracolumbar-burst-fractures-were-treated-by-lumbar-pedicle-screw-fixation-combined-with-limited-decompression-.The-X-ray-measurements-and-evaluations-of-neurological-functions-before-and-after-surgery-were-reviewed-.-Results-All-the-38-cases-were-followed-up-for-36-months.The-bone-fusion-was-obtained-in-all-the-cases-,-without-pedicle-screw-breakage-,-bending-,-or-prolapse-.Evaluation-of-the-efficacy-at-36-months-after-surgery:excellent-in-36-cases,-good-in-1-case,-and-poor-in-1,-with-a-good-or-excellent-rate-of-97.4%-(37/38).The-preoperative-anterior-height-of-fractured-vertebrae-was-(14.23-±2.51)-mm,-which-was-significantly-lower-than-that-6-months-postoperatively-[(25.68-±3.95)-mm,-q=22.319,-P<0.05],-24-months-postoperatively-[(26.23-±3.15)-mm,-q=23.391,-P<0.05],-and-36-months-postoperatively-[(25.64-±2.86)-mm,-q=22.241,-P<0.05].The-preoperative-Cobb-angle-was-(24.39°±2.54°),-which-was-significantly-more-than-that-36-months-after-surgery[(15.54°±1.05°),-q=27.448,-P<0.05].The-preoperative-VAS-scores-were-(6.1-±1.1)-points,-which-were-significantly-higher-than-that-36-months-after-operation-[(1.2-±0.6)-points,-q=33.930,-P<0.05].There-were-significant-differences-in-the-Frankel-grades-before-and-after-the-operation-(Z-=-2.190,-P-=0.029).-Conclusion-Limited-decompression-and-pedicle-screw-fixation-for-thoracolumbar-burst-fractures-can-not-only-provide-instant-stability-,-but-also-have-advantages-of-high-satisfaction-rate-,-minimal-invasion-,-and-long-term-prevention-of-kyphosis-and-fixation-failure-.

Objective-To-study-the-clinical-characteristics-of-laparoscopic-oviduct-anastomosis-for-the-treatment-of-fallopian-tube-sterilization-or-tubal-infertility-.-Methods-A-total-of-48-cases-of-fallopian-tube-sterilization-or-tubal-infertility-patients-underwent-oviduct-anastomosis-between-January-2006-and-August-2013-in-our-hospital-.The-patients-were-divided-equally-into-laparoscopic-surgery-group-(laparoscopic-group,-24-cases)-or-open-surgery-group-(open-group,-24-cases)-in-chronological-order.The-ratio-of-infertility-patient-was-equal-in-both-laparoscopic-surgery-group-and-open-surgery-group-.Repatency-rate-and-pregnancy-rate-of-different-surgical-procedures-were-analyzed-,-respectively-.-Results-All-the-operations-were-successfully-completed-.Bilateral-tubal-repatency-rate-was-100%in-all-the-patients-during-the-operation-.The-pregnancy-rate-of-laparoscopic-surgery-group-(87.5%,21/24)-was-higher-than-that-in-the-open-surgery-group-(62.5%,15/24)-within-24-months-after-surgery,-with-significant-difference-(χ2-=4.000,-P=0.046).-Conclusions-The-success-rate-of-laparoscopic-oviduct-anastomosis-is-comparable-to-open-surgery-.However-,-the-pregnancy-rate-after-laparoscopic-oviduct-anastomosis-is-higher-than-open-surgery-.Laparoscopic-oviduct-anastomosis-has-a-broad-prospect-of-application-.

Objective-To-discuss-the-value-of-fast-track-surgery-(-FTS-)-in-perioperative-period-of-laparoscopic-cholecystectomy-.-Methods-We-selected-200-cases-of-laparoscopic-cholecystectomy-in-our-hospital-from-January-2012-to-December-2012.The-cases-were-randomly-divided-into-either-traditional-group-(control-group)-or-fast-track-surgery-group-(FTS-group),-with-100-cases-in-each-group-.The-operation-time-,-intraoperative-blood-loss-,-time-to-get-out-of-bed-after-operation-,-time-to-intake-semi-liquid-diet,-time-to-flatus,-time-to-defecation,-and-length-of-hospital-stay-were-compared-.-Results-Compared-with-the-control-group-,-the-FTS-group-had-shorter-time-to-semi-liquid-diet-[(11.3-±2.0)-h-vs.(50.2-±8.7)-h,-t=-43.976,-P=0.000],-shorter-ambulation-time-[(6.2-±1.5)-h-vs.(14.3-±1.7)-h,-t=-35.728,-P=0.000],-shorter-flatus-time-[(12.0-±4.4)-h-vs.(24.9-±5.4)-h,-t=-18.519,-P=0.000],-shorter-defecation-time-[(15.8-±5.3)-h-vs.(25.2-±4.3)-h,-t=-13.773,-P=0.000],-and-shorter-postoperative-hospital-stay-[(3.2-±1.3)-d-vs.(4.2-±2.1)-d,-t-=-4.048,-P=0.000].-Conclusion-Fast-track-surgery-is-feasible-and-safe-,being-helpful-for-patient-’-s-postoperative-recovery-.