Zhonghua wei chang wai ke za zhi = Chinese journal of gastrointestinal surgery
-
Zhonghua Wei Chang Wai Ke Za Zhi · Nov 2020
Randomized Controlled Trial[Effect of open-lung ventilation strategy on oxygenation-impairment during laparoscopic colorectal cancer resection].
Objective: After general anesthesia and mechanical ventilation for laparoscopic colorectal cancer resection, about 90% of patients would have different degrees of atelectasis. Authors speculated that an open-lung strategy (OLS) comprising moderate positive end-expiratory pressure (PEEP) and intermittent recruitment maneuvers (RM) can reduce atelectrauma and thus reduce the incidence of oxygenation-impairment during low-tidal-volume ventilation for laparoscopic colorectal cancer resection. The purpose of this study was to verify this hypothesis and provide a better intraoperative ventilation scheme for laparoscopic colorectal cancer resection. ⋯ During ventilation, the patients in the OLS group had higher PaO(2)/FiO(2) [T(1): (427±103) mmHg vs. (366±109) mmHg, t=-2.826, P=0.006; T(2): (453±103) mmHg vs. (388±122) mmHg, t=-2.739, P=0.007], lower Q(S)/Q(T) [ T(1): (9.2±6.5) % vs. (12.6±7.7) %, t=2.322, P=0.022; T(2): (7.0±5.8)% vs.(10.9±9.2)%, t=2.408, P=0.019], and lower driving pressure [T(0): (6±3) cm H(2)O vs. (10±2) cm H(2)O, t=7.421, P<0.001; T(2): (13±3) cm H(2)O vs. (17±4) cm H(2)O, t=5.417, P<0.001] than those in the NOLS group, with stratistical differences in all comparisons. In recovery room, though PaO(2)/FiO(2) [(70.3±9.4) mmHg vs. (66.8±9.4) mmHg, P=0.082] was still higher and Q(S)/Q(T) [(18.6±8.3)% vs. (21.8±8.4)%, P=0.070] was still lower in the OLS group as compared to the NOLS group, the differences were not statistically significant (both P>0.05). Conclusion: The application of such an OLS during low-tidal-volume ventilation can greatly reduce the incidence of oxygenation-impairment in laparoscopic colorectal cancer resection, and such effect may last to the period of emergence from anesthesia.
-
Zhonghua Wei Chang Wai Ke Za Zhi · Apr 2020
Randomized Controlled Trial Comparative Study[Efficacy comparison between robot-assisted and laparoscopic surgery for mid-low rectal cancer: a prospective randomized controlled trial].
Objective: To compare the short- and long-term outcomes of robot-assisted and laparoscopic radical resection for mid-low rectal cancer. Methods: A prospective randomized controlled trial was conducted. A total of 130 patients with mid-low rectal cancer (inclusion criteria: age > 18 or ≤80 years old; pathological diagnosis of rectal adenocarcinoma by colonoscopy; distance from tumor to the anal verge ≤12 cm; no distant metastasis; cT1-3N0-1 or ycT1-3 after neoadjuvant radiotherapy and chemotherapy; suitable for laparoscopic and robotic surgery) at the Department of Colorectal Surgery of the First Affiliated Hospital of Nanchang University from October 2016 to September 2018 were prospectively enrolled. ⋯ The median follow up was 24 (9 to 31) months. In the robot group and the laparoscopy group, the 2-year overall survival rate was 95.4% and 90.6% respectively; the 2-year disease-free survival rate was 90.8% and 85.9% respectively, whose differences were not significant (both P>0.05). Conclusion: Robot-assisted radical resection for mid-low rectal cancer can achieve similar short-term and long-term outcomes of laparoscopic resection, while robot-assisted surgery can decrease blood loss during operation, leading to more precise practice in minimally invasive surgery.
-
Zhonghua Wei Chang Wai Ke Za Zhi · Apr 2012
Randomized Controlled Trial[Impact of hemocoagulase on coagulatory function and deep venous thrombosis after abdominal surgery].
To investigate the impact of hemocoagulase on coagulatory function and deep venous thrombosis after abdominal surgery. ⋯ Hypercoagulable state usually appears after abdominal surgery and use of hemocoagulase may aggravate hypercoagulability and increase the incidence of deep venous thrombosis in lower limbs after abdominal surgery. Preventative use of hemocoagulase must be administered with caution.
-
Zhonghua Wei Chang Wai Ke Za Zhi · Jun 2011
Randomized Controlled Trial[Effect of early enteral nutrition supplemented with glutamine on postoperative intestinal mucosal barrier function in patients with gastric carcinoma].
To investigate the effect of early enteral nutrition (EEN) supplemented with glutamine on postoperative intestinal mucosal barrier function of patients with gastric carcinoma. ⋯ The immunologic tolerance of enteral nutrition supplemented with glutamine is favorable, which provides protective effect on intestinal mucosal barrier in patients with gastric carcinoma undergoing IPHC.
-
Zhonghua Wei Chang Wai Ke Za Zhi · Jul 2010
Randomized Controlled Trial[Effect of bowel preparation with probiotics on intestinal barrier after surgery for colorectal cancer].
To study the effect of bowel preparation with probiotics on intestinal barrier function after surgery for colorectal cancer. ⋯ One-day bowel preparation with probiotics can maintain the intestinal barrier function after surgery of colorectal cancer,which is suitable for elective colorectal surgery.