Objective To summarize the experience of laparoscopic appendectomy(LA). Methods A retrospective analysis was made on clinical date of 368 cases of appendicitis treated with laparoscopic appendectomy in this hospital from March 1998 to March 2005.There were 35 cases of simple appendicitis,276 cases of suppurative appendicitis,39 cases of appendiceal perforation with peritonitis,and 18 cases of chronic appendicitis. Results The procedure was successfully accomplished in 363 cases,while conversions to open surgery were performed in 5 cases.The operative time was 22~55 min(mean,30.5 min),and the intraoperative blood loss was 2~10 ml.One case of abdominal residual infection and 1 case of adhesive ileus were cured with conservative treatment postoperatively.Pelvic abscess occurred in 1 case and was cured with a re-operation of laparoscopic abscess drainage. Conclusions Laparoscopic appendectomy is safe and effective in skilled hands.

The purpose is to discuss the pattern of teaching,further strengthen the teaching innovation and improve the teaching quality,on the aspects of teaching contents,preparation of multimedia courseware,variety of teaching methods and establishment of teaching feedback system.

Objective To investigate the methods of anesthesia,infusion and the skill of removing urinary calculus for the treatment of uretemlith stones using ureterescope air pressure path lithoclasty.Methods Six hundred and ninety ureterolith stone patients using ureterescope air pressure path lithoclasty,383 patients were anesthetized by single sacro-anesthesia,and the diclofenac sodium suppositories were added in 312 cases to strengthen the anesthesia effeets.Antegrade perfusion with furosemide in the operation was used.Results Broken the stones in orthophoria were successful in 645 patients.the total success rate Was 93.5%and the total rate of removing urinary calculus was 93.8%.Conclusions Ureteroscope air pressure path lithoclasty is high efficiency,safety and easy manipulation.It is a satinfactory method for the treatment of ureterolith stones,and the correct method of anesthesia and infusion perfect skill of removing urinary calculus can improve the rate of removing urinary calculus and decrease the costs.

Objective To evaluate the effect of neoadjuvant chemotherapy on advanced gastric cancer before laparoscopic radical gastrectomy.Methods 46 advanced gastric cancer cases in our hospital from January 2010 to January 2013 were included in experimental group who were given two courses of neoadjuvant chemotherapy with FOLFOX regimen prior to surgery,the responsives (38 cases) received two more courses of neoadjuvant chemotherapy before surgery,and those in whom the chemotherapy was judged as ineffective (8 cases),received radical gastrectomy 21 days later.As a control,36 diseasematched cases went on upfront surgery without neoadjuvant chemotherapy.All these 82 cases underwent successful laparoscopic gastrectomy.Results The overall effective rate of neoadjuvant chemotherapy was 59％.Before the operation,the differences of pathological staging between the two groups were significantly different; The difference in operation time,the intraoperative blood loss and harvested lymph node number between the experimental group and control group was not statistically different (P ＞ 0.05).The R0 resection rate in experimental group (63％) was higher than in the control group (36％),P ＜0.05.The recurrence rate and mortality rate in experimental group was lower than that in the control group,P ＜ 0.05.Conclusions In advanced gastric carcinoma preoperative neoadjuvant chemotherapy significantly improved the resection rate and reduced postoperative recurrence and mortality rate.