Objective To explore the feasibility and safety of single-port laparoscopic surgery in the treatment of incarcerated inguinal hernia in children. Methods The clinical efficacy of single-port laparoscopic and epidural anesthesia needle treatment for incarcerated inguinal hernia in children of 32 cases were analyzed retrospectively. Results Thirty-two children were operated successfully. The operation time was (16.24 ± 4.67) min for unilateral hernia (in 25 cases) and (21.69 ± 5.85) min for bilateral hernia (in 7 cases). The blood loss was (2.50 ± 0.56) ml. The recovery time of intestinal peristalsis was (16.42 ± 4.86) h after surgery, and the postoperative hospital stay was (3.25 ± 0.82) d. Intraoperative exploration found 7 cases had concealed contralateral hernia;incarcerated hernia contents included bowel in 27 cases, ovaries in 3 cases, and greater omentum in 2 cases. All the incarcerations were successfully restored by hand and no-damage clamp assistance. The incarcerated organ had good blood flow in all the 32 cases. The follow-up time was (15.62 ± 5.34) months, and there was no recurrence and atrophy of testis or ovaries. Conclusions The single-port laparoscopic surgery for incarcerated inguinal hernia in children has advantages of preservation of anatomy of the inguinal canal easily to perform high ligation of hernial sac, and reduction under direct visual control. Meanwhile, occult inguinal hernia in the opposite side can be cured. It was a safe, effective, and minimally invasive procedure, being worthy of further clinical application.

Objective To investigate the feasibility and safety of umbilical single- port laparoscopic surgery in the treatment of children ovarian cysts. Methods The clinical efficacy of umbilical single-port laparoscopic surgery in the treatment of children ovarian cysts of 36 cases was analyzed retrospectively. Results Thirty-six children successfully completed surgery. The operative time was (27.8 ± 8.6) min, the diameter of ovarian cysts was (7.2 ± 2.4) cm, and the blood loss was (6. 5 ± 1.6) ml. All the children were confirmed to have benign ovarian cysts by pathological examination. Thirty-four children retained ovarian tissue after removal of the cyst, and 2 children underwent oophorectomy because of ovarian necrosis. The anus exhaust was recovered (18.4 ± 4.6) h after surgery, and the postoperative hospital stay was (4.2 ± 1.3) d. The children began to diet after anesthesia conscious. All the children recovered well, and no surgical complications occurred. The followed-up time was (24.6 ± 6.3) months, and no recurrence occurred. Conclusions Umbilical single-port laparoscopic surgery in the treatment of children ovarian cysts is easy, minimally invasive, no scar formation, quickly recovered and reliable. It is worth of further clinical application.

Objective To validate the gross tumor volume (GTV) delineation in head and neck cancer based on magnetic resonance imaging (MRI) or computed tomography (CT) by cross-sectional autopsy,and to provide a basis for clinical evaluation of the two imaging methods.Methods Ten New Zealand rabbits were selected for transplantation of VX2 carcinoma cells,and a head and neck cancer model was successfully established in six rabbits.Each rabbit was fixed and received MRI scan and CT scan in the same body position.Then,they were sacrificed and fixed in gelatin solution (-70℃) for 72 h; all cryopreserved rabbits underwent cross-sectional autopsy using a jig saw,with the same position and sectional thickness as in MRI scan and CT scan,and cross-sectional autopsy images were obtained using a digital single-lens reflex camera.GTVs were separately delineated based on CT,MRI,and cross-sectional autopsy images.The GTVMRI,GTVCT,GTVSA,and volume difference ratios (VDRs) were calculated;two-way classification ANOVA and paired t-test were used for difference analyses.Results The mean values of GTVMRI,GTVCT,and GTVSA were 8.20 ± 2.56,8.40 ± 2.20,and 8.11 ± 2.88 cm3,respectively,without significant differences among them (F =0.06,P =0.943).The mean values of VDRMRI-SA and VDRCT-SA were 0.180 ± 0.060 and 0.309 ± 0.091,respectively,with a significant difference between them (t =7.49,P =0.001).Conclusion The GTV delineation based on MRI is more accurate than that based on CT in head and neck cancer.

Objective To compare the clinical effect of single-port laparoscopic appendectomy and traditional mult-port laparoscopic appendectomy in children with appendicitis. Methods The clinical data of 96 appendicitis children who had underwent laparoscopic appendectomy were retrospectively analyzed. Among the children, 48 children received single- port laparoscopic appendectomy (observation group), and 48 children received mult-port laparoscopic appendectomy (control group). The operation time, blood loss, postoperative exhaust time, postoperative hospital stay, incision length and surgery-related complications between 2 groups were compared. Results All children were operated successfully. There were no statistical differences in blood loss and postoperative hospital stay between 2 groups (P>0.05). The operation time, postoperative exhaust time and incision lengths in observation group were significantly lower than those in control group: (19.8 ± 5.3) min vs. (30.2 ± 8.1) min, (15.6 ± 4.7) h vs. (22.7 ± 6.5) h and (1.1 ± 0.2) cm vs. (2.3 ± 0.4) cm, and there were statistical differences (P<0.01). There was 1 case with incision infection in observation group, and the child was cured after symptomatic treatment. There was no other surgery-related complication in 2 groups, and all children recovered smoothly. Conclusions The single-port laparoscopic appendectomy is safe and feasible in children with appendicitis. It has short operation time, fast recovery of gastrointestinal function, and better cosmetic effect.

OBJECTIVETo analyze the risk factors for level Ib lymph node enlargement on CT in patients with nasopharyngeal carcinoma (NPC) and provide clinical evidence for defining the indications of prophylactic level Ib irradiation.

METHODSA total of 435 newly diagnosed NPC patients receiving radiotherapy in Nanfang Hospital in the past 2 years were enrolled in this analysis. The correlations were analyzed with Logistic regression between level Ib lymphadenopathy and the clinical risk factors including T stage, N stage, diameter of level II lymph nodes, submandibular gland involvement, nasal cavity involvement, oropharyngeal involvement, and involvement of 4 or more lymphatic drainage regions.

RESULTSUnivariate analysis showed that level Ib lymphadenopathy were positively correlated with N stage (P=0.023), submandibular gland involvement (P=0.045), and level II lymph node diameter (P<0.001). Multivariate Logistic regression analysis suggested a significant correlation only between the diameter of the level II lymph nodes and level Ib lymphadenopathy (P=0.013).

CONCLUSIONLevel Ib lymphadenopathy is positively correlated with the size of ipsilateral level II lymph nodes in NPC patients.

Carcinoma ; Humans ; Lymph Nodes ; pathology ; Lymphatic Diseases ; epidemiology ; Lymphatic Metastasis ; Nasopharyngeal Neoplasms ; epidemiology ; Neck ; Paranasal Sinuses ; Risk Factors ; Submandibular Gland

Objective To investigate the safety and efficiency of laparoscopic gallbladder - preserving chole-lithotomy in the treatment of cholecystolithiasis in children. Methods The clinical data obtained from 18 children with gallstones undergoing laparoscopic gallbladder - preserving cholelithotomy at Dalian Children′s Hospital of Dalian Medi-cal University during July 2010 and December 2016 were retrospectively analyzed. Eight boys and 10 girls of 5 - 14 years old [mean (9. 2 ± 3. 1)years old]were included in the study,of whom 11 cases had a single stone,7 cases with multiple stones. All patients were followed up for 3 - 72 months. Results All of 18 patients without pancreaticobiliary maljunction were diagnosed by Color Doppler ultrasound and magnetic resonance cholangiopancreatography(MRCP). Gallbladder functions were assessed preoperatively and they were all in good condition. Laparoscopic gallbladder - pre-serving cholelithotomy was successfully performed in all patients without conversion to cholecystectomy. Operation time was 28 - 66 min,with mean value of (40. 2 ± 14. 3)min;intraoperative blood loss was 4 - 12 mL,with mean value of (8. 3 ± 2. 8)mL;postoperative hospital stay lasted 3 - 5 d,with mean value of (3. 8 ± 1. 2)d. There were no complica-tions such as bile leakage,postoperative bleeding,biliary duct damage,biliary pancreatitis during therapy. The patients were followed up for 3 - 72 months,and the Color Doppler ultrasound showed no gallstone recurrence after surgery. Conclusions For children with good gallbladder function,laparoscopic gallbladder - preserving cholelithotomy can preserve gallbladder function and the integrity of biliary tract. The operation is easy and reliable,with minimal invasion, quick recovery,and low recurrence rate. It is a feasible method for the treatment of gallstones in children.