Objective To compare the anesthesia and analgesic effect of ropivacaine to lidocaine during and after inguinal hernia repair field.Methods The study was designed as a single-centre,double blind,controlled trial,randomized with two parallel groups.One hundred males scheduled for inguinal hernia repair as day surgery under field block would be eligible to participate and then be randomized to receive field block using 0.75% ropivacaine 30 mL or 1%lidoeaine 40 mL.During the first 24 hours after the start of infiltration,assessments of the time from study drus administration to the first request of additional analgesics,wound pain at rest and on mobilization using NRS,as well as an evaluation of patients'ability to perform day-to-day activities were made.Wound healing would be judged by the assessor as normal or abnormal on day 7 after surgery.Results Median time from study drug administration to the first request of additional analgesics waft,22.4 hours in ropivaeaine group and 15.1 hours in lidocaine group respectively.Although there was no statistically significant treatment difference between groups(P>0.05),clinically relevant differences could be seen in favour of ropivacaine.The HRs(hazard rato) for this variable using Cox regression model showed a tendency favoring ropivacaine in increasing the time from study drug administration to the first request of additional analgesics when comparing ropivacaine group and lidocaine group,with an HR of 0.888(95%CI:0.521-1.514;P>0.05),corresponding to a risk reduction of 11.2%.Postoperative wound pain scores at rest at 2nd hour was lower in ropivacaine group than lidocaine group(P<0.05).Pestoperative wound pain scores upon mobilization in 4th hour and the total scores of day-to-day activity questionnaire in 4th hour were lower in ropivacaine group than that of lidocaine group(P<0.05).No any adverse effects were found in the two groups,and wound healing was normal in all patients in the two groups 7 days after surgery.Conclusion Ropivacaine provides effective peroperative anesthesia and postoperative pain relief for inguinal hernia repair in Chjnese patients.

Objective:To compare the long term and short term outcomes between robotic and open surgery for hilar cholangiocarcinoma radical resection.Methods:This is a single-center and retrospective case-control study. Patients underwent hilar cholangiocarcinoma radical resection between January 2016 and December 2016 at Department of Hepatobiliary Surgery of the General Hospital of the Chinese People′s Liberation Army were included. Safety, effectiveness and long-term prognosis of tumors were evaluated. Patients were divided into robotic hilar cholangiocarcinoma radical surgery group (robotic group, n=16) and open hepatic hilar cholangiocarcinoma radical surgery group (open group, n=31) . All cases were confirmed by pathology histological. Age, gender, histology, resection margin status, extent of surgical resection, disease-free survival (DFS) , and overall survival (OS) were retrospectively collected and analyzed.In the follow-up cohort, the primary outcome was patient death and the secondary outcome was tumor recurrence. Continuous variables were expressed as means and medians and were compared using the Student t test if normally distributed or Wilcoxon-Mann-Whitney test for nonparametric variables. Discrete variables were expressed as frequency and percentages and χ 2 or Fisher exact test, when appropriate, were used for comparisons. Kaplan-Meier curves were used to calculate the probability of survival and comparisons were performed using log-rank test. Results:In this study, compared with the open group, the robotic group had a longer operation time ( (338±71) minutes vs. (256±56) minutes, t=4.251, P=0.001) , but the intraoperative blood loss was less (100 ml vs. 200 ml, Z=121.50, P=0.040) , the gastric tube removal time was earlier (3 days vs. 4 days, Z=136.0, P=0.011) , and the postoperative hospital stay was shorter (9 days vs. 12 days, Z=144.50, P=0.040) , and the difference was statistically significant.There was no significant difference in the blood transfusion rate, R0 resection rate, and tumor size between the two groups.The recurrence rates in the robotic group and open surgery were 53.3% and 67.0%, respectively (χ 2=1.04, P=0.307) .The median survival time of the robotic group and the open group was 22.0 months and 25.0 months. There was no significant difference in the overall survival rate between the two groups ( P>0.05) . Conclusion:Compared with laparotomy, robotic HCC radical resection could have an equivalence or non-inferiority approach with acceptable long-term outcome.

Objective:To compare the long term and short term outcomes between robotic and open surgery for hilar cholangiocarcinoma radical resection.Methods:This is a single-center and retrospective case-control study. Patients underwent hilar cholangiocarcinoma radical resection between January 2016 and December 2016 at Department of Hepatobiliary Surgery of the General Hospital of the Chinese People′s Liberation Army were included. Safety, effectiveness and long-term prognosis of tumors were evaluated. Patients were divided into robotic hilar cholangiocarcinoma radical surgery group (robotic group, n=16) and open hepatic hilar cholangiocarcinoma radical surgery group (open group, n=31) . All cases were confirmed by pathology histological. Age, gender, histology, resection margin status, extent of surgical resection, disease-free survival (DFS) , and overall survival (OS) were retrospectively collected and analyzed.In the follow-up cohort, the primary outcome was patient death and the secondary outcome was tumor recurrence. Continuous variables were expressed as means and medians and were compared using the Student t test if normally distributed or Wilcoxon-Mann-Whitney test for nonparametric variables. Discrete variables were expressed as frequency and percentages and χ 2 or Fisher exact test, when appropriate, were used for comparisons. Kaplan-Meier curves were used to calculate the probability of survival and comparisons were performed using log-rank test. Results:In this study, compared with the open group, the robotic group had a longer operation time ( (338±71) minutes vs. (256±56) minutes, t=4.251, P=0.001) , but the intraoperative blood loss was less (100 ml vs. 200 ml, Z=121.50, P=0.040) , the gastric tube removal time was earlier (3 days vs. 4 days, Z=136.0, P=0.011) , and the postoperative hospital stay was shorter (9 days vs. 12 days, Z=144.50, P=0.040) , and the difference was statistically significant.There was no significant difference in the blood transfusion rate, R0 resection rate, and tumor size between the two groups.The recurrence rates in the robotic group and open surgery were 53.3% and 67.0%, respectively (χ 2=1.04, P=0.307) .The median survival time of the robotic group and the open group was 22.0 months and 25.0 months. There was no significant difference in the overall survival rate between the two groups ( P>0.05) . Conclusion:Compared with laparotomy, robotic HCC radical resection could have an equivalence or non-inferiority approach with acceptable long-term outcome.