Objective
To explore the feasibility and safety of non-gastrointestinal decompression after esophagectomy and the necessity of gastric tube or the time to remove gastric tube.
Methods
Thirty patients with esophageal cancer who underwent surgical treatment in the Department of Thoracic and Cardiovascular Surgery, Nanjing Drum Tower Hospital, were included in the trial from June to October 2017. The patients were randomly and equally assigned to a trial group (non-gastrointestinal decompression) or a control group (gastrointestinal decompression). There was no significant difference in age (P=1.000), sex (P=1.000), tumor location (P=0.732), pathological type (P=1.000), pathological stage (P=0.507), and operation time (P=0.674) between the two groups. The clinical effect between the two groups were compared.
Results
There was no statistical difference in incidences of anastomotic leakage (P=1.000), anastomotic bleeding (P=1.000), gastroesophageal reflux (P=1.000) between the two groups. And there was no statistical difference in time of the first flatus (P=0.629) and the first bowel movement (P=0.599) after operation between the two groups.
Conclusion
Without gastrointestinal decompression after Ivor Lewis esophagectomy does not increase the incidences of anastomotic leakage, anastomotic bleeding and gastroesophageal reflux, and has no significant effect on the recovery of gastrointestinal function. Without gastrointestinal decompression after Ivor Lewis esophagectomy is safe and feasible. Removing gastric tube on the second day after operation is reasonable and feasible.
Esophageal cancer is one of the most common malignant tumors in China. The comprehensive treatment of esophageal cancer based on operation is important. In recent ten years, with the development of surgical techniques and medical instruments, tubular stomach has been widely used. Although the advantages of tubular stomach are becoming more and more obvious, there are still many details and problems for the function and application of tubular stomach worthy of further discussion and study. In this paper, the technical progress, advantages, functions and applications of tubular stomach are reviewed and discussed, and the future prospect is predicted.
ObjectiveTo explore the application value of CT-guided microcoil localization in pulmonary nodule (diameter≤15 mm) surgery.MethodsThe clinical data of 175 patients with pulmonary nodules who underwent single utility port video-assisted thoracoscopic surgery at Nanjing Drum Tower Hospital from August 2018 to December 2019 were retrospectively analyzed. According to whether CT-guided coil localization was performed before operation, they were divided into a locating group and a non-locating group. There were 84 patients (34 males, 50 females, aged 57.8±8.8 years) in the locating group and 91 patients (46 males, 45 females, aged 57.6±10.8 years) in the non-locating group. The localization success rate, localization time, incidence of complications, surgical and postoperative conditions were analyzed between the two groups.ResultsAll 84 patients in the locating group were successfully located, and localization time was 19.0±3.6 minutes. Among them, 19 (22.6%) patients had a small pneumothorax, 4 (4.8%) pulmonary hemorrhage and 2 (2.4%) coil shift; 6 (7.1%) patients had mild pain, 3 (3.6%) moderate pain and 1 (1.2%) severe pain. Sex (P=0.181), age (P=0.673), nodule location (P=0.167), nature of lesion (P=0.244), rate of conversion to thoracotomy (P=0.414), rate of disposable resection of nodules (P=0.251) and postoperative hospital stay (P=0.207) were similar between the two groups. There were significant differences in nodule size (P<0.001), nature of nodule (P<0.001), the shortest distance from nodule to pleura (P<0.001), operation time (P<0.001), lung volume by wedge resection (P=0.031), number of staplers (P<0.001) and total hospitalization costs (P<0.001) between the two groups.ConclusionCT-guided microcoil localization has the characteristics of high success rate, and is simple, practicable, effective, safe and minimally invasive. Preoperative CT-guided microcoil localization has important clinical application value for small pulmonary nodules, especially those with small size, deep location and less solid components. It can effectively shorten the operation time, reduce surgical trauma and lower hospitalization costs, which is a preoperative localization technique worthy of popularization.
【摘要】 目的 優化牙釉質電子順磁共振（EPR）譜擬合程序。 方法 將牙釉質EPR譜擬合程序中的RIS-BGS偏移量設置為定參，取優化值；增加手動擬合功能，可以將參數初始值直接代入高斯模型得到擬合譜。 結果 將牙釉質EPR譜擬合程序中RIS-BGS偏移量設置為定參后，其優化值為0.529，減少了變參數量；采用手動擬合功能有助于調整參數初始值；在自動擬合程序對于個別樣品譜不能給出正確結果情況時，仍然可以通過手動擬合來得到一個近似的擬合結果。 結論 優化了EPR譜擬合程序的應用過程。【Abstract】 Objective To optimize the enamel electron paramagnetic resonance (EPR) spectrum fitting procedure. Methods RIS-BGS offset was set as a determined parameter in enamel EPR spectrum fitting program, and an optimized value was given for RIS-BGS offset. A manual fitting function was designed that can substite the initutial value into the Gaussian model function directly. Results RIS-BGS offset was set as a determined parameter, the optimized value of which was 0.529. The number of parameters decreased; the manual fitting function maked it easier to select initial values for parameters. When the auto fitting program failed to give a correct result for some EPR spectrum, a fitting result could still be obtained with the manual fitting method. Conclusion The application of the spectrum fitting procedure can be optimized.
