1.The feasibility and effectiveness of the interspincterotomy combined with PPH in the treatment of severe mixed hemorrhoids and anal fissure
Chinese Journal of Primary Medicine and Pharmacy 2015;(19):2990-2992
Objective To explore the feasibility and effectiveness of the interspincterotomy combined with PPH in the treatment of severe mixed hemorrhoids and anal fissure.Methods 116 cases of glioma patients with post-operative residual lesions were treated.The observation group of 58 patients were treated with internal sphincterotomy combined with PPH resection,while 58 cases in the control group were treated by traditional external dissection and internal ligation plus resection of anal fissure.The efficacy and safety of treatment of the two groups of patients were evaluated.Results The operation time,hospitalization time,healing time,postoperative curative effect evaluation score of the observation group were (22.5 ±5.3)min,(2.1 ±0.9)d,(9.6 ±2.1)d and (9.8 ±1.6)points,respec-tively,which of the control group were (35.2 ±6.7)min,(9.1 ±2.5)d,(18.4 ±3.7)d and (5.3 ±1.2)points, there were significant differences between the two groups(t =5.68,4.95,6.33,1.35,all P <0.05).Third days after the operation,there were no significant differences in the pain,edema,hemorrhage scores between the two groups(all P >0.05),but seventh days after the operation,the pain,edema,hemorrhage control scores of the observation group were significantly better those of the control group(all P <0.05).The complication rate of the observation group was 5.17%,which of the control group was 17.24%,there was significant difference between the two groups(χ2 =4.25, P <0.05).Conclusion The interspincterotomy combined with PPH is an operation that meeting the requirements of modern hemorrhoid treatment.It is a safe and effective treatment.It is worthy of further promotion in the treatment of severe mixed hemorrhoid and anal fissure.
2.Application of washing fluid in preventing postoperative incisional infection of colorectal cancer
Lianming PENG ; Jingjing CAI ; Yaguang HE ; Tianlei HUANG
China Journal of Endoscopy 2017;23(8):18-22
Objective To explore the application of washing fluid in the prevention of postoperative incision infection of colorectal cancer. Methods 350 patients with colorectal cancer underwent colorectal surgery from Jan. 2012 to Dec. 2015 were randomly divided into three groups: sterile saline, 0.50% metronidazole, 0.50% Povidone-iodine solution group, while part of the rinse liquid heated to 37 ~38℃ before use, then record the operation time, surgical site, postoperative incision infection, incision infection, timely delivery statistical analysis was performed by using single factor analysis and logistic multivariate regression analysis. Age, operation time, surgical site, type of irrigating fluid and temperature of flushing fluid were analyzed statistically. Results The incision infection rate of the patients ≥60 years old and the operation time ≥2 h was higher than the age <60 years, and the operation time was less than 2 h, P < 0.05, the difference was statistically significant; 0.50% metronidazole, 0.50% Povidone-iodine solution group, the infection rates of 0.50% metronidazole and 0.50% povidone-iodine group were 7.69% and 8.55%, respectively, which were significantly lower than those of the saline group 16.38% The infection rate of the rinsing fluid after heating was 7.22% and 14.71%, respectively, lower than that of the normal temperature rinsing solution (P < 0.05), the difference was statistically significant. Conclusions The risk factors of incisional infection in colorectal cancer patients with colorectal cancer were : ≥60 years of age and ≥2 h of operation, while 0.50%metronidazole, 0.50% povidone-iodine solution and heated washing fluid were protective factors. It can be applied to prevent incision infection after laparoscopic surgery.
3.Recurrent factors and diagnosis analysis of rectal cancer after radical surgery treatment
China Modern Doctor 2015;(21):1-3,7
Objective To explore the influencing factors and treatment and prevention methods of the postoperative re-currence after rectal cancer surgery. Methods A total of 330 patients were selected as the study subjects and the num-ber of recurrent patients, location, influencing factors, treatment methods and prognosis were analyzed. Results After (2.98±1.22) years of follow-up visit after surgery, the disease recurred in 50 patients. The age, incisal edge to tumor distance, non-implementation of peritoneal chemotherapy, peritoneal reflex of anatomic site, infiltration of submucosa, severer pathological degree, stage C-D of Dukes staging and CES-D≥16 scores had significant differences between the recurrence group and the non-recurrence group(P<0.05). Thirty-six patients received resurgery, of which 19 patients reached clinically radical treatment requirements, 34 patients survived 1 year and 20 patients survived 3 years. Con-clusion There exists recurrence after rectal cancer surgery, of which the influencing factors are complicated. Corre-sponding measures aiming at the recurrence factors should be taken to reduce the recurrence.