Plasma cortisols in 18 abdominal emergency patients and 20 planned-operation patients were examined. The result showed that cortisols in planned-operation patients were increased after their operations. On the other hand, plasma cortisols in emergency patients were higher in preoperative period than that in the postoperative period. There were no furher increase after operations. The changes of plasma cortisols between two kinds of patients were very different. This means that stress reactions in the patient with acute abdomen can be reduced by early operations.
ObjectiveTo systematically review the effect of perioperative supplemental oxygen administration on surgical site infection (SSI) in patients underwent abdominal surgery with general anesthesia.
MethodsDatabases including PubMed, EMbase, The Cochrane Library (Issue 2,2015), CBM, VIP, WanFang Data and CNKI were searched to collect randomized controlled trials (RCTs) about perioperative supplemental oxygen administration versus normal FiO2 in patients underwent abdominal surgery with general anesthesia from inception to March, 2015. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was conducted using RevMan 5.3 software.
ResultsA total of 13 RCTs involving 3 532 patients were included. The results of meta-analysis indicated that: the incidence of SSI in the perioperative supplemental oxygen administration group was lower than that in the control group (OR=0.68, 95%CI 0.47 to 0.99, P=0.04). There were no significiant differences between both groups in incidence of atelectasis, incidence of infection requiring reoperation and 30-day mortality after surgery (all P values >0.05).
ConclusionPerioperative supplemental oxygen administration could further decrease the risk of SSI in patients underwent abdominal surgery with general anesthesia, and does not increase the risk of other adverse events. Due to the limitations of quality of included studies, more high quality studies are needed to verify the above conclusions.
ObjectiveTo investigate the feasibility and security of laparoscopic Whipple pancreaticoduodenectomy(LPD)or laparoscopic pylorus preserving pancreaticoduodenectomy(LPPPD)for the patients with periampullary diseases, estimate the ratio of postoperative complications between LPD and LPPPD.
MethodsFourty-five patients who underwent the LPD or LPPPD from January 2010 to March 2014 were reviewed retrospectively. These patients were divided into LPD group and LPPPD group basing on the Whipple or polyrus preservation.
ResultsAmong these 45 patients, 25 patients were performed the LPD, the other 20 patients were performed the LPPPD. There were 25(55.56%)complications after operation, including 10 cases of pancreatic fistula, 1 case of bile leakage, 6 cases of delayed gastric emptying, 3 cases of infection, 2 cases of stomach intestine stomatorrhagia, 1 case of mesenteric venous thrombosis, 1 case of ascites, 1 case of chylous fistula. The complication rate had no significant difference between two groups. One patient died after operation in the LPPPD group.
ConclusionLaparoscopic pancreaticoduodenectomy is safe and feasible in the treatment of periampullary diseases, the LPPPD could partly prevent the occurrence of reflux of the digestive juice following the resection of pylorus and improve the quality of life.
Objective To analyze the outcome of patients with Blunt Abdominal Injury (BAI) in the Deyang People’s Hospital after the Wenchuan Earthquake, in order to provide evidence for future improvement in emergency response after earthquakes and in the treatment of BAI patients. Methods Data on the BAI patients within 1 week after the earthquake were collected from the Information Department of the Hospital. Microsoft EXCEL was used for data input. Results A total of 23 BAI inpatients were treated, of whom 15 were from Mianzhu City and sent to hospital within 12 hours of the earthquake. This was 1.9% of the total inpatients. The BAI inpatients suffered severe and complex injuries, and 5 of them died (mortality rate: 22%). Linenectomy was conducted for patients with spleen injuries and two inpatients developed incision infection due to lack of antibiotics during the perioperative period. Conclusions It is important to establish an emergency response mechanism for medical rescue for patients with the viscera injury, including BAI, after an earthquake. This would help to guarantee rational allocation of the rescue workers, triage of the wounded, optimization of operation, as well as a reduction in mortality from BAI.
Abstract From March, 1987 through May, 1996, a total of 13 cases of severe deep burn and bone defect of hand and wrist were treated by groin skin and iliac bone composite graft with vascular pedicle and had resulted in satisfactory result. The operation was relatively simple. Because thecomposite graft carried its own blood supply in the pedicle, it was not necessary to revascularize the composite graft by anastomosis of blood vessel during operation. Owing to the presence of abundant vascular supply of the iliac bone, the antiinfection potency was high, so its application was suitable for those conditions such as fresh severe deep burn with infection and bone defect. As a result, this technique gave the best chance to save the limb from amputation, and the duration required for treatment could be markedly shortened. This method provided the possibility to solve effectively the difficult problem dealing with the treatment of severe deep burn with infection and bone defect of the hand and wrist.
