Ojective To investigate the application of mini-laparoscopic herniotomy to the treatment of inguinal hernia in infants and children. Methods With the help of mini-laparoscope 600 children with indirect inguinal hernia were treated by purse-string ligature using lift-insert suture method from August 1998 to December 2000. Results There were 5 recurrences out of 600 cases, the recurrence rate being 0.83%, which was lower than that by the traditional method. Conclusions The principle of mini-laparoscopic herniotomy is sound and it is simple and convenient to handle. Small incision and minimal injuzy thought of as its additional advantages.

Objective To evaluate mid-term clinical effects of laparoscopic intraperitoneal onlay mesh herniorrhaphy (IPOM) for adult inguinal hernia. Methods A retrospective analysis was made on 546 cases of inguinal hernia treated by IPOM (603 sides) between June 2002 to December 2004. We closed the hernia sac by the lift-insert method following with the implantation of the Prolene mesh with the help of a stapler. Results The operation was successfully completed in all the cases, except for 2 cases of conversions to open surgery because of difficulties in covering the defects. There were no intraoperative complications, and 5 cases of postoperative seroma which subsided after physical therapy. The operative time was 25~40 min (mean, 31 min), and the hospital stay was 36~72 h (mean, 46 h). Follow-up observations for 18~48 months (mean, 28 months) found 6 cases of recurrence, with the recurrence time at 30~45 months (mean,38.2 months). The racurrence rate was 0.995%. Conclusions Laparoscopic intraperitoneal onlay mesh herniorrhaphy a minimally invasive method with reliable outcomes, low recurrence rate, and rapid recovery.

Objective To investigate the retroperitoneal ganglioneuroma ( GN) imaging findings ,and analyze its enhanced features .Methods 37 patients with retroperitoneal GN confirmed by pathology were chosen as subjects , the imaging features were analyzed and were compared with the pathologic results .All 37 cases underwent CT scan ,22 patients underwent CT enhance scan .Results 37 cases of retroperitoneal GN ,the lesions were located in the right side in 23 cases,14 cases located on the left.All lesions were demarcated,round or oval in 19 cases,18 cases of irreg-ular shape.CT scan 26 cases of 34 lesions of uniform density ,and density close to cystic lesions ,11 cases of 17 une-ven density,showed a little patchy,small strips calcification.Enhanced arterial phase lesions no enhancement ,venous phase and delayed phase showed progressive enhancement .Conclusion Retroperitoneal GN has certain characteristic imaging findings and strengthen the characteristics contribute to its diagnosis and differential diagnosis .

Objective To explore the effect of transabdominal preperitoneal prosthetic(TAPP) repair combined with intraperitoneal onlay mesh(IPOM) on laparoscopic repair of inguinal hernia.Methods From January to December 2006,laparoscopic hernioplasty was performed on 30 adult patients with inguinal hernia.The hernia area was divided into two parts by the subperitoneal vessel across the area.The medial part was repaired by TAPP using polypropylene patch,and the lateral part was repaired by IPOM with Proceed patch.During to operation,an incision was made on the peritoneum along the subperitoneal vessel,and then the peritoneum was separated medially to expose an operative area(7.5 cm?6.5 cm),which was an avascular area with loose connective tissues and few vital nerves.Results All the operations were accomplished under epidural anesthesia.The operative time was 30-40 min(mean 35 min) for unilateral hernia,and 50-60 min(mean 55 min) for bilateral ones.The amount of blood loss during the operation was 1-5 ml.The patients could walk on the second day after the operation.They were discharged from the hospital 3-4 days after the operation,and were back to work in 2 weeks.During a 2-12-month follow-up(mean,9 months),no adhesive intestinal obstruction and local or systemic complications was observed.Conclusions The combined technique of IPOM and TAPP is a minimal invasive method with confirmed efficacy.By using this easily mastered method,the operative time is reduced,and the patients can recover quickly.

Objective To explore the clinical value of laparoscopy combined with radionuclide imaging in the diagnosis and treatment of pediatric gastrointestinal hemorrhage, especially for Meckel’s diverticulum and double intestine. Methods ~ 99m Tc~-pertechnetate abdominal scintigraphy was performed in 22 children with a history of recurrent hemafecia or melena in this hospital from December 1998 to December 2005. All the children were given a laparoscopic exploration. Results Among the 22 patients, scintigraphy showed positive findings in 18 patients and negative, 4 patients. The positive patients were all confirmatively diagnosed by laparoscopic surgery and pathological examinations, including Meckel’s diverticulum in 14 patients and duplications of alimentary tract in 4 patients. In the other 4 patients with negative results, no organic pathologic changes was identified by laparoscopy in 3 patients and Meckel’s diverticulum was found after laparoscopic exploration in 1 patient. Conclusions Radionuclide imaging is an important method in the diagnosis of gastrointestinal tract hemorrhage in children and provides scientific basis for surgical intervention. The combination of laparoscopy and radionuclide imaging not only has values in the diagnosis and treatment of pediatric gastrointestinal hemorrhage, but also minimizes the blindness and trauma of exploratory laparotomy.

Objective To analyze the causes and preventions of the perioperative complications of micro-laparoscopic hernioplasty in infants and children with indirect inguinal hernia.Methods From January 1997 to January 2007,4500 infants or children with indirect inguinal hernia,including 702 cases who were complicated with hydrocele testis,were treated by micro-laparoscopic hernioplasty in our hospital.By laparoscopy,the endocycle was sutured circularly under the peritoneum using a self-designed needle.Then,only the peritoneum was ligated.Results No organ injury or complication occurred during the operation.The mean operation time was 9 min(5-13 min).Among the patients,4250 received a follow-up of 7-36 months(mean,25 months).Postoperative complications were found in 132 patients(3.1%),included scrotal gas in 10(0.24%),scrotal hydrocele in 16(0.38%),umbilical hernia in 27(0.64%),extraperitoneal emphysema in 20(0.47%),abdominal wall hematoma at the burr hole in 15(0.35%),foreign body sensation at the suture sites in 30(0.71%),scrotal hematoma in 8(0.19%),and iatrogenic cryptorchism in 6(0.14%).Thirty-five patients had recurrence(0.82%).Conclusions Micro-laparoscopic hernioplasty is a safe and reliable method for indirect inguinal hernia in infants and children.It is important to be familiar with the anatomy of the hernia under a laparoscope and to perform the operation carefully so that to avoid or decrease the perioperative complications.

Objective To evaluate the efficacy of mini-laparoscopic hernioplasty with Mesh strengthening in the treatment of hernia in adults. Methods We used mini-laparoscopic and self-decided needle-like instruments to perform 106 cases of Mesh replacement in addition to hernioplasty in treatment ot hernia in adults from January,1999 to Junuary,2001. Results Operation time ranged from 20min to 25min.Food-intake began in the operative day.No Complications occurred.The patient discharged 3d～4d after the operation.Following-up period lasting 5months to 2.5years showed no relapse occurred. Conclusions Mini-laparoscopic hernioplasty combined with Mesh strengthening is feasible in the treatment of hernia in adults.The method have the advantages ot mini-invasion,simple proccedures,shorter operation time and quicker recovery.

Objective To study a new operative procedure for hydrocele in children under mini-lapascope.Methods 103 children with hydrocele aged from 1 to 9 years old were performed by suture around internal rings under mini-laparoscope from November 2000 to March 2002. Results The operative time was (5～8) minutes and hospital stay (4～5) days. The incision didn't need suture and there was no obvious scar after operation. All cases were followed up at 1st month, 6th month and 1st year postoperatively. All cases recovered except for 2 cases recurred at 1st month postoperatively. Conclusions Suture around internal rings under mini-laparoscope is a minimally invasive and simple method for the treatment of hydrocele in children. It can find and deal with hidden patent internal rings.

Objective To explore the clinical effects of laparoscopic hernioplasty in patient over 70 years old. Methods We utilized the modified laparoscopic intraperitoneal onlay mesh (IPOM) to treat the inguinal hernia in 69 elderly patients. Results The laparoscopic operations were completed in all the 69 patients. The operative time was 20～30 min (mean, 25 min). No operative complications took place and the intraoperative blood loss was hardly seen. The duration of hospitalization was 5～7 days. The patients recovered smoothly, without wound infection or scrotum hematoma. Follow-up observations for 6～24 months in the 69 patients found no recurrence. Conclusions Modified laparoscopic IPOM treating inguinal hernia in elderly patients is feasible, on the premise of proper perioperative management.

Objective To explore the genetic impact of three newly discovered single nueleotide polymorphism (SNP) sites of the transforming growth factor (TGF)-β1 gene on the susceptibility of the chronic hepatitis B virus (HBV) infection. Methods Genome DNA was extracted from the peripheral blood samples of 115 cases suffering from the chronic HBV infection (74 chronic hepatitis B, 41 cirrhosis) as well as 41 healthy volunteers. Thereafter, genotyping of rs2241715, rs2241716 and rs4803455 sites of the TGF-β1 gene was performed by genotype-specific polymerase chain reaction (PCR) analysis. The data were analyzed by the ehi square test and Fisher exact test. Results There was a significant difference of rs2241715 genotypes and allele frequencies between healthy volunteers and patients with chronic hepatitis B and cirrhosis (χ2 = 11.419, P＜0.01 and χ2 = 6.218, χ2 = 5.961,P＜0.05,respectively). Interestingly, the risk relative of subjects with T/T genotype suffered from chronic hepatitis B (OR = 2. 974, 95% CI = 1.209 - 7. 314, P = 0.018) and cirrhosis (OR = 3.228, 95%CI=1.201-8.675, P=0.020) was dramatically higher than that in patients with T/G or G/G genotypes. Conclusion The TGF-β1 rs2241715 T/T genotype appears to be associated with the chronic HBV infection.