Indwelling Time Of Drainage Tube Research Articles

Effects of oscillatory positive expiratory pressure therapy in patients undergoing thoracic or upper abdominal surgery: A systematic review and meta-analysis

BackgroundPreventing postoperative complications and accelerating patient recovery are critical issues in clinical treatment and nursing care. This meta-analysis aimed to evaluate the effects of oscillatory positive expiratory pressure therapy (OPEPT) in patients undergoing thoracic or abdominal surgery. MethodsWe searched PubMed, the Cochrane Library, Web of Science, EBSCO, SinoMed, Weipu, WanFang, and China National Knowledge Infrastructure (CNKI) for randomized controlled trials (RCTs) on the role of OPEPT on patients undergoing thoracic and upper abdominal surgeries. Two researchers independently conducted literature screening, quality assessment, and data extraction based on the inclusion and exclusion criteria, and used the RevMan 5.4 software to perform the meta-analysis. ResultsA total of 13 RCTs involving 1166 patients undergoing thoracic or abdominal surgery were included. The meta-analysis results showed that the decreases in FEV1[MD = 0.30, 95%CI (0.22, 0.38), P < 0.001] and FVC levels [MD = 0.38, 95%CI (0.26, 0.49), P < 0.001] were statistically less in the OPEPT group than those in the control group. OPEPT could increase the postoperative drainage volume [MD = 91.53, 95%CI (57.55, 125.50), P < 0.001] and reduce the length of hospital stay [MD = −1.85, 95%CI (−3.42, −0.28), P = 0.02]. no significant effects on the FEV1/FVC [MD = 2.60, 95%CI (−0.46, 5.67), P = 0.10] and the indwelling time of drainage tube [MD = −1.39, 95%CI (−3.18, 0.41), P = 0.13] between patients undergoing OPEPT and routine care. No publication bias was detected amongst the synthesized outcomes (all P > 0.05). ConclusionOPEPT, with its promising therapeutic approach, has shown to positively influence the recovery process for patients undergoing thoracic and upper abdominal surgeries. More high-quality, large-sample studies are needed in the future to explore the efficacy and safety of OPEPT.

An exploration of safety and feasibility of transoral vestibular endoscopy in the treatment of thyroid malignant tumors

Objective:To investigate the safety and feasibility of transoral vestibular endoscopy in the treatment of patients with thyroid malignant tumors. Methods:120 patients with thyroid cancer admitted to Xi 'an Central Hospital from January 2019 to December 2021 were selected and randomly divided into endoscopic surgery group（60 cases） and traditional open surgery group（60 cases）. The general operation conditions, postoperative complications and postoperative quality of life were compared between the two groups. Results:The intraoperative blood loss, indwelling drainage tube time and average length of hospital stay in the endoscopic surgery group were significantly lower than those in the traditional open surgery group （P<0.05）, while the operation time and number of lymph nodes dissected were significantly higher than those in the traditional open surgery group （P<0.05）. There was no significant differences in VAS score at 24h after surgery, white blood cell count, TgAb （+） and temporary hypothyroidism between the two groups at 24 h after operation （P >0.05）. The CRP, total drainage volume, TgAb and serum calcium in the endoscopic surgery group were higher than those in the traditional open surgery group, and the PTH and Tg were lower than those in the traditional open surgery group （P<0.05）.One case of hoarseness,2 cases of extremities numbness, 1 case of subcutaneous effusion and 2 cases of chin nerve injury occurred in the endoscopic surgery group, the total incidence of postoperative complications was 10.00%. Five cases of hoarseness, 11 cases of choking cough limbs numbness, 1 case of drinking water, 1 case of postoperative bleeding and 4 cases of subcutaneous effusion occurred in the traditional open surgery group, the total postoperative incidence of complications was 36.67%, the total incidence of complications in endoscopic surgery group was lower than that in traditional open surgery group （P<0.05）. The total scores of physiological status, social/family status, emotional status, functional status and quality of life in endoscopic surgery group were significantly lower than those in traditional open surgery group （P<0.05）. Conclusion:The application of oral vestibular endoscopy in the treatment of thyroid malignant tumors has the advantages of good surgical status and postoperative recovery, fewer postoperative complications.The patient was well tolerated,with positive safety，this technique has high clinical application value.

The Application of Whole-Process Case Management in Patients with Triple-Negative Breast Cancer.

Objective To explore the application of professional whole-process case management during nursing in patients with triple-negative breast cancer. Methods This study recruited 60 patients with triple-negative breast cancer who were diagnosed and treated at Department of Breast Surgery in our hospital assessed for eligibility between June 2018 and June 2020, and we assigned them at a ratio of 1 : 1 via the random number table method to receive either general nursing (control group) or professional whole-process case management plus general nursing (observation group). We analyzed and evaluated the hospitalization, the indwelling time of drainage tube, complications, recovery, quality of life, posttraumatic growth, and nursing satisfaction between these two groups at registration, discharge, and the sixth month after surgery, respectively. Results Professional whole-process case management achieved a shorter duration of drainage tube placement and hospitalization and a lower incidence of postoperative complications versus general nursing (P < 0.05). Moreover, the observation group had got better recovery (P < 0.05) and a better quality of life at discharge and 6 months after surgery (P < 0.05). Professional whole-process case management obtained higher scores of posttraumatic growth and higher nursing satisfaction versus general nursing (P < 0.05). Conclusion Whole-process case management promotes the postoperative recovery of patients with triple-negative breast cancer and shortens the duration of drainage tube indwelling and hospitalization, which lowers the incidence of postoperative complications, improves their quality of life, and enhances nursing satisfaction.

Clinical effects of partially de-epithelized local flaps in repairing tubercular chest wall defects

Objective: To explore the clinical effects of partially de-epithelized local flaps in repairing tubercular chest wall defects. Methods: A retrospective observational study was conducted. From April 2010 to February 2021, twelve patients who met the inclusion criteria were admitted to the Department of Burns and Plastic Surgery of the Eighth Medical Center of PLA General Hospital, including 9 males and 3 females with age of (42±18) years. The sizes of tubercular chest wall defects of patients were ranged from 4 cm×3 cm×2 cm to 16 cm×8 cm×5 cm, which were all repaired with partial de-epithelized local flaps. The widths of flaps were equal to the widths of the defects, and the lengths of flaps were 2 cm longer than those of the defects. In one patient, the local flap was too large to close the donor site directly by suturing, so an autologous back free medium thickness skin graft was used for repair. In other patients, the collection areas of local flaps were small, and the donor areas of flaps were directly closed. The duration of operation, intraoperative bleeding, and postoperative drainage volume and indwelling time of drainage tube were observed and recorded. In two weeks after operation, the survival, color, and texture of flaps, the presence of subcutaneous hydrops and skin ulcer, and donor site healing including wound disruption, local infection, hematoma were observed. Chest X-ray, CT scan, or nuclear magnetic resonance imaging was performed in one month after operation to check whether new local hydrops and bone destruction occurred in the chest wall defects and the concomitant tuberculose focus of patients. All patients were followed up for more than 6 months to record whether the surgical incisions of the chest wall defects of the patients were complicated by hypertrophic scar, redness, swelling, and sinus. Results: In surgery, the patient had (104±18) min of operation duration, (119±53) mL of intraoperative bleeding, (134±49) mL of cumulative drainage of drainage tube, and (5.3±1.7) days of drainage tube indwelling time. In two weeks after operation, all the grafted local flaps survived, and the color and texture of flaps were similar to the surrounding normal skin. One patient had fluid leakage from the incision of chest wall defect area with the incision partially dehisced, which healed well after a phase Ⅱ operation; no wound infection, subcutaneous hydrops, or wound rupture occurred in other patients. The incisions of donor sites in all the patients healed well and no wound disruption, local infection, or hematoma occurred. One month after operation, no new bone destruction was observed in the operative region by chest imaging examination. Patients were followed up for 6 to 96 months, with one patient having wound swelling, ulceration, and sinus in the operative area of the chest wall defect in 12 months after surgery, which healed after phase Ⅱ operation; the incisions of chest wall defect wounds in other patients healed well and had no scar, redness and swelling, or sinus. Conclusions: Partially de-epithelized local flap could be used in repairing tubercular chest wall defect wounds, with the advantages of flexible flap design, minimal donor site injury, and good postoperative wound healing.

The correlation between intraoperative saline irrigation volume and postoperative drainage volume and short-term efficacy in single-level posterior lumbar interbody fusion.

This study aimed to explore: (I) the effect of different intraoperative saline irrigation volumes on postoperative drainage volume, drainage tube removal time, and short-term efficacy in single-level posterior lumbar interbody fusion (PLIF); and (II) the recommended intraoperative saline irrigation volume. A total of 120 patients with lumbar degenerative diseases who underwent single-level PLIF between January 2013 and December 2019 were enrolled. Based on the average total postoperative drainage volume, the patients were divided into 2 groups: group A (total postoperative drainage ≤103.86 mL) and group B (total postoperative drainage >103.86 mL). The recommended intraoperative saline irrigation volume (825 mL) was calculated from the receiver operating characteristic (ROC) curve and critical value. Using the recommended intraoperative saline irrigation volume (825 mL), patients were divided into 2 groups: group C (greater group, intraoperative irrigation volume >825 mL) and group D (lower group, intraoperative irrigation volume ≤825 mL) to evaluate the effect of different intraoperative saline irrigation volumes on postoperative drainage volume, extubation time, and short-term efficacy. A greater intraoperative saline irrigation volume was associated with lower postoperative drainage volume, shorter indwelling drainage tube time, shorter hospitalization time, lower hospital charges, and better recovery from postoperative pain (P<0.05). According to the ROC curve and critical value calculation, we found that when the intraoperative saline irrigation volume was greater than 825 mL, the total postoperative drainage volume was more likely to decrease [P<0.001, area under the curve (AUC) =0.852, sensitivity =88.1%, specificity =73.8%]. Patients with more than 825 mL intraoperative saline irrigation had lower postoperative drainage volume, shorter indwelling drainage tube time, shorter hospitalization time, lower hospital charges, and better postoperative pain recovery. There was a significant correlation between the intraoperative saline irrigation volume and patient outcomes. At least 825 mL intraoperative saline irrigation is recommended during single-level PLIF.

Application of three-dimensional image reconstruction technology based on high-resolution CT in pyeloplasty.

BackgroundThree-dimensional (3D) image reconstruction technology is widely used in surgical operations for its intuitive visualization. Pyeloplasty requiresprecise cutting and suturing. The reconstruction technology can accurately determine the location and scope of the stenosis at the junction of the renal pelvis and ureter and the relationship with the surrounding vasculature. The purpose of this article is to retrospective evaluate the application value of image reconstruction technology in pyeloplasty based on high-resolution 3D CT images.MethodsA total of 20 patients with renal pelvic ureteral junction obstruction admitted to our hospital from August 2019 to August 2020 were selected. In this group, left pyeloplasty was performed in 8 patients and right pyeloplasty in 12 patients. In terms of conditions, there was 1 case with secondary pyeloplasty, 6 cases of patients with kidney stones, 2 cases with renal ectopic blood vessels, 1 case with renal prolapse, 1 case with horseshoe kidney, and 1 case with ureteral polyps. There were 12 males and 8 females, with an average age of 34.65±10.67 years and an average body mass index (BMI) of 22.48±3.03 kg/m2. In all patients, 3D CT reconstruction technology was used to guide the formulation of robot-assisted laparoscopic pyeloplasty plans; verify the consistency between the actual operation and the preoperative planning; and observe the operation time, blood loss, postoperative exhaust time, indwelling drainage tube time, and follow-up for comorbidities.ResultsThe operation was successful in all 20 patients. The actual operation was 100% consistent with the preoperative planning, the operative time was 160.80±63.26 min, the intraoperative blood loss was 47±30.45 mL, the postoperative exhaust time was 1.15±0.37 days, the drainage tube indwelling time was 4.35±1.50 days, and the average follow-up time was 7.95±3.41 months. There were no complications.ConclusionsThree-dimensional image reconstruction technology based on high-resolution CT has high clinical application value in the treatment of ureteropelvic junction obstruction (UPJO), which simplifies the operation process and shortens the operation time, and is a valuable tool for auxiliary surgeons in devising the operation plan.

Comparison of the Clinical Effect of Uniportal Video-assisted Thoracoscopic Lobectomy and Biportal Video-assisted Thoracoscopic Lobectomy in the Treatment of Lung Cancer

背景与目的近年来单孔胸腔镜肺癌根治术逐渐兴起，作为一种新的手术方式，其可行性及安全性尚未得到普遍认可。本研究拟探讨单孔胸腔镜肺癌根治术在治疗Ⅰ期至部分Ⅲa期肺癌病例中的可行性及安全性。方法回顾性分析苏州大学附属第一医院胸外科同一治疗组在2018年5月-2019年3月连续进行的胸腔镜肺癌根治术患者的临床资料。排除部分不符合要求的病例后，根据手术方式分为单孔组（55例）和单操作孔组（87例），共142例。分析两组患者的临床数据，进行统计学分析。结果142例患者均行肺叶切除+淋巴结清扫术，术后顺利出院，未有围手术期死亡。单孔组和单操作孔组比较，年龄、肿瘤位置、术后病理类型、肿瘤大小、肿瘤的病理性原发灶-淋巴结-转移（pathological tumor-node-metastasis, pTNM）分期的差异均无统计学意义（P > 0.05）。单孔组手术时间更短[(167.65±43.85) min vs (181.71±51.28) min]，术中出血量更少[(57.45±50.19) mL vs (87.47±132.54) mL]，术后引流管留置时间[(4.82±2.82) d vs (5.84±3.43) d]及术后住院天数[(6.91±3.88) d vs (7.74±3.87) d]更短，但差异无统计学意义（P > 0.05）。单孔组的术后总引流量显著低于单操作孔组[(1, 064.82±776.38) mL vs (1, 658.71±1, 722.38) mL]，术后24 h及72 h视觉疼痛评分明显更低[（4.73±0.73）分vs（5.25±0.74）分；（2.16±0.71）分vs（2.55±0.86）分]，差异有统计学意义（P < 0.05）。结论在Ⅰ期至部分Ⅲa期肺癌病例中，单孔胸腔镜肺癌根治术安全可行。

Surgical treatment of renal angiomyolipoma with inferior vena cava tumor thrombus: case report and literature review

Objective To explore the clinical characteristics of renal angiomyolipoma (AML) with inferior vena cava (IVC) tumor thrombus and to improve the diagnosis and treatment of the disease. Methods The clinical data of 3 patients with renal AML and inferior vena cava tumor thrombus was retrospectively reviewed. The patients were all female, aged 19 to 70 years. Among them, 2 patients presented with lumbago on the right side, and the other one was diagnosed by physical examination. The body mass index ranged from 18.4 to 24.6 kg/m2, with a median value of 20.4 kg/m2. According to the American Society of Anesthesiologists (ASA), they were classified as grade Ⅱ. Color doppler ultrasound examination of the kidney and IVC was performed in all the 3 patients, all of which showed hyperechoic solid mass in the right kidney. Color doppler ultrasound of IVC showed hyperechoic band in the IVC, indicating blood flow signals and the tumor thrombus. All the 3 cases showed irregular fat density or mixed density in the right kidney and multiple irregular fat density were observed in the right renal vein and inferior vena cava on CT. Two of them received MRI examination of IVC, which showed irregular lesions in the right kidney, short T1 and long T2 signals, low lipids, and no definite limited diffusion on DWI. Irregular fat signal were seen in the right renal vein and inferior vena cava. All 3 patients were diagnosed with right renal mass with IVC tumor thrombus, with 1 patient of Mayo grade Ⅲ tumor thrombus and the other 2 of Mayo gradeⅡtumor thrombus. One underwent laparoscopic radical nephrectomy and inferior vena cava tumor thrombectomy, another one underwent open right partial nephrectomy and tumor thrombectomy, and the third one suffered preoperative AML rupture, undergoing open radical nephrectomy and tumor thrombectomy. Results The operation time was 168 to 659 min, with median of 220 min. Intraoperative blood loss ranged from 50 to 300 ml, with the median of 50 ml. Postoperative indwelling time of drainage tube was 5 to 11 days, with the median of 6 days. Postoperative hospital stay ranged from 7 to 14 days, with a median of 8 days. Postoperative follow-up ranged from 12 to 16 months, with a median follow-up of 13 months. All the three patients underwent operation without postoperative complications. Postoperative pathology proved to be right renal angiomyolipoma. After 3 months of follow-up, the patients showed no tumor recurrence or metastasis. Conclusions Renal AML is a benign lesion, which is rarely concurrent with inferior vena cava cancer thrombus. Enhanced CT examination is the main diagnostic method, surgical resection of the lesion is the preferred treatment, partial nephrectomy combined with thrombectomy can be performed in patients with AML, if permitted, and postoperative prognosis turns out to be propitious. Key words: Inferior vena cava; Renal angiomyolipoma; Tumor thrombus

The Effect of Prostate Volume on Robotic-assisted Radical Prostatectomy

Objective: To investigate the effect ofprostate volume on robot-assisted radical prostatectomy.Methods: Clinical data of 75 patients underwent RARPin the Affiliated Hospital of Qingdao University wereretrospectively analyzed. The patients were dividedinto 3 groups according to size of prostate. A total of35 cases with prostate volume less than 30ml wererecorded as group 1, 27 cases with volume of 30 to50 ml were recorded as group 2, and 13 cases withvolume greater than 50ml were recorded as group3. Age, BMI, preoperative PSA, operation time,intraoperative bleeding volume, postoperative drainagevolume, indwelling time of catheter, indwelling time ofdrainage tube, total hospitalization time, pathologicalstage, surgical margin, urine control and biochemicalrecurrence were observed. Results: All operationswere performed under Da Vinci robot assistance, andno patient was transferred to open surgery. There wasno significant difference in age, preoperative PSA,BMI, operation time, intraoperative bleeding volume,postoperative drainage volume, indwelling time ofcatheter, total hospitalization time, pathological stage,rate of positive surgical margin and recovery of urinarycontinence between the groups. Indwelling time ofdrainage tube was longer in group with larger prostate,6.4 (±4.5) days in group 1, 6.3 (±2.9) days in group 2and 7.1 (±2.5) days in group 3. Gleason score was lowerin group with larger prostate, with statistical difference.Conclusion: Prostate volume had no significant effecton urinary control, rate of positive surgical margin andrecurrence after RARP. Gleason score of pathologicaltissue was lower and indwelling time of drainage tubewas longer in patients with larger prostate after RARP.Operation time and intraoperative bleeding volumeof large prostate patients underwent RARP need tobe further studied. RARP has certain advantages forpatients with large prostate.

Randomized study of percutaneous ureteroscopic plasma column electrode decortication and laparoscopic decortication in managing simple renal cyst.

BackgroundTo assess the safety and efficacy of a novel technology referred to as percutaneous ureteroscopic plasma column electrode (PCE) by comparing laparoscopic decortication in the management of simple renal cyst (SRC).MethodsBetween March 2016 and June 2017, 53 patients with SRCs were randomized to divided into two groups, the PCE group (24 patients), or laparoscope group (29 patients). The operative time, blood loss, days of drainage, catheter, and hospital stay and complications were compared with the two groups. All patients were followed- up to 6 months after treatment.ResultsNo patients had intraoperative complications such as hemopneumothorax, adjacent organ injury, infection or hemorrhage shock. In the PCE group and laparoscope group: the mean operation time was 34.1±8.2 vs. 58.4±16.7 min (P<0.05). The mean blood loss was 2.0±1.16 vs. 9.7±4.09 mL (P<0.05). The mean postoperative indwelling drainage tube time was 2.5±1.5 vs. 2.9±1.09 d (P>0.05). The mean intra-urethral indwelling catheter time was 2.1±0.88 vs. 2.0±1.15 d (P>0.05). The mean postoperative hospital stay was 3.0±1.7 vs. 3.7±1.53 (P>0.05). One patient in electrode group was suffered from rupture of the collecting system during the operation, and was treated by indwelling D-J stent. During follow up, no cysts recurrence was found.ConclusionsPercutaneous ureteroscopic PCE decortication is a safe, minimally invasive and effective therapy to treat SRCs, with equal efficacy and advantages in shortening the operation time and reducing the amount of intraoperative bleeding compared with laparoscopic decortication.

Hyperbaric Oxygen Therapy as an Adjuvant Therapy for Comprehensive Treatment of Fournier's Gangrene

Objectives: To compare simple conventional treatment with the addition of hyperbaric oxygen therapy (HBOT) to conventional therapies in the treatment of Fournier's gangrene (FG). Methods: A retrospective study of clinical data was performed by reviewing 28 cases of FG from January 2004 to December 2013 at Xiangya Hospital, Central South University. Among them, 12 patients were treated with the conventional therapy (non-HBOT group) and the other 16 cases were combined with hyperbaric oxygen therapy besides conventional therapy (HBOT group). All patients were followed up for 2 months to assess the therapeutic effect. The analyzed data included age, Fournier gangrene severity index (FGSI) score, number of surgical debridement, indwelling drainage tube time, length of stay (LOS), effective time, and curative time. Results: The mortality rate was lower in the HBOT group at 12.5% (2/16) compared to the non-HBOT group, which was 33.3% (4/12). The difference in the number of surgical debridement, indwelling drainage tube time, and curative time between were significantly lower in the HBOT group compared to the non-HBOT group. Conclusions: Our preliminary research suggests that the effect of combining hyperbaric oxygen therapy with conventional therapy offers considerable advantage in the management of Fournier's gangrene. Multicenter studies with a larger sample size are required to confirm these observations.

Problems in application of portable disposable low pressure vacuum drainage system for modified radical mastectomy and the solutions

Objective To put forward the problems in applying portable disposable low pressure vacuum drainage system for modified radical mastectomy and to propose the solutions.Methods We retrospectively analyzed the clinical data of 268breast cancer patients who were treated with portable disposable low pressure vacuum drainage system after receiving modified radical mastectomy in Changhai Hospital from January 2013to September 2013.Based on the use of ordinary vacuum ball,the patients were divided into dual-chamber group and single-chamber group.The incidence of bleeding at the puncture sites,volume of post-operation drainage,indwelling time of drainage tube,and hospitalization stay were recorded for the two groups.Results A total of 23cases had puncture site bleeding,including 22early bleeding and one delayed bleeding.For the dual-chamber group,the indwelling time of parasternal drainage tube was significantly shorter than that of axillary drainage tube median:5.0dvs 9.0d,Z=-10.713,P=0.000).The drainage time(median:9.0dvs 10.0d)and hospitalization stays(median:9.0dvs 9.0d)of the two groups were not significantly different.It was found that 97.8%(262/268)of the patients in this study were discharged early with a drain,but with lack of discharge guidance.Conclusion Disadvantages of portable disposable low pressure vacuum drainage system include puncture site bleeding,drainage tube cannot be extubated independently and measurement cannot be done independently,and insufficient discharge guidance.Improvement of puncture device,use of double-lumen tube independent drainage,and improvement of discharge guidance should be made to improve the system.

Different limited resection of pulmonary lobe methods under the thoracoscopy in the treatment of early nonsmall cell lung cancer occurred in the old age.

The objective was to explore clinical effect of limited resection of lung lobe under the thoracoscopy in the treatment of early nonsmall cell lung cancer occurred in the old age. A total of 150 patients with nonsmall cell lung cancer in the old age is treated by limited resection of lung lobe under thoracoscope. It can be divided into segmental resection group and wedge resection group by surgical methods, to make a comparative analysis of operation time, intraoperative blood loss, hospital stays, and complications during the perioperative period. And there will be postoperation follow-up on survival, relapse and death situation etc., 10 cases are changed to make other operation because of maladaptation to limited resection, and a total of 140 patients have undergone limited resection. Operation time and hospital stays of wedge resection group are shorter than those of segmental resection group (P < 0.05); compared with the bleeding and indwelling drainage tube time in two groups, differences have no statistical significance (P > 0.05). Compared with cases of complications, recurrence and death for groups of segmental resection and wedge resection group, the differences have no statistical significance (P > 0.05). Limited resection of lung lobe in the early treatment of nonsmall cell lung cancer occurred in the old age under the thoracoscopy is safe and feasible.

Clinical research of retroperitoneal laparoscopic intervention ultrasound aided positioning in the treatment of adult renal cyst

Objective To explore the clinical value of retropentoneal laparoscopic interventon ultrasound aided positioning in the treatment of adult renal cyst.Methods The operating information of 327 patients with adult renal cyst was analyzed retrospectively,in which 239 cases applied the retroperitoneal laparoscopic intervention ultrasound aided positioning treatment( interventional ultrasound group),88 cases applied retroperitoneal laparoscopic intervention without ultrasound assisted positioning operation treatment ( non interventional ultrasound group).Results The operation time of the interventional ultrasound group was (3.61 ± 0.49) h,and was longer than that of the non interventionul ultrasound group[ ( 3.27 ± 0.71 ) h ] ( t =4.89,P ＜ 0.05 ).The postoperative indwelling drainage tube time,postoperative renal length of the interventional ultrasound group was (2.24 ± 0.58 ) d,( 12.01 ± 4.25 ) cm respectively,and was shorter than that of the non interventional ultrasound group[ (3.59 ±2.27 ) d、( 13.39 ±5.21 )cm ] ( t =8.49,2.45,all P ＜ 0.05 ).A postoperative ＞ 1 cm cyst residual amount of ultrasound in the intervention group was significantly less than the non-ultrasound in the intervention group (x2 =10.36,P ＜ 0.05 ).Conclusion The ultrasound assisted positioning operation could determine deep cysts position better,so the retroperitoneal laparoscopic intervention ultrasound aided positioning in the treatment of adult renal cyst could reduce cyst of residual risk,and also prevent serious vascular and renal collecting system injury and improve the operation safety. Key words: Polycystic kidney; Posterior approach; Laparoscopic

Direct access to the renal artery for transperitoneal laparoscopic radical nephrectomy: the safety and feasibility

Objective To compare different methods for blockage of renal artery in transperitoneal laparoscopic radical nephrectomy,and evaluate the safety and feasibility of direct access to the renal artery.Methods From May 2008 to December 2010,64 patients with T1N0M0-T2N0M0 stage renal carcinoma underwent transperitoneal laparoscopic radical nephrectomy using a standard procedure to isolate and block renal artery(group A,33 patients) or a direct access to the renal artery via ligament of Treitz(left side) or aorta-inferior vena cava(right side;group B,31 patients).The age,gender,body mass index(BMI),history of previous abdominal surgery,tumor side,tumor maximum diameter,and preoperative TNM stages were all matchable between the two groups.Results One patient in group A was conversed to open surgery due to extensive perirenal adhesion and the others successfully received transperitoneal laparoscopic radical nephrectomy.The operation time,estimated blood loss,intraoperative and postoperative complications,postoperative TNM stage,postoperative fasting time,postoperative indwelling time of drainage tube,postoperative hospital stay and pathological types were similar between the two groups.Patients with T2 stage tumors in Group B had less intraoperation blood loss than those in Group A(P0.05).Conclusion Direct access to the renal artery is feasible and safe of transperitoneal laparoscopic radical nephrectomy.The method not only fulfils the tumor-free principles and reduces intraoperative blood loss,but also broadens the indications of laparoscopic operations for renal cell carcinoma.

Relationship between indwelling time of drainage tube of mediastinum and pericardium and pain of patients with coronary arteries bypass grafting surgery

Objective To know the relationship between indwelling time of drainage tube of medi-astinum and pericardium and pain of patients with coronary arteries bypass grafting surgery. Methods Divid-ed 125 patients with CABG into the early drop group(61 cases) and the later drop group(64 cases)randomly. Different indicator of drop tube was used in the different group. Compared the infection condition of medi-astinum and the postoperative pains between the two groups. Results There was no re-indwelling cases in both groups after drop the drainage tube. The degree of postoperative pain in the early drop group was better than that in the later drop group. The difference of indicence rate of pain at the 2rid and the 3rd day after the operation between the two groups was significantly. Conclusions Drop the drainage tube after the CABG as early as possible can avoid part of postoperative pain, which should be carried out at proper time points. Key words: Coronary arteries bypass grafting surgery; Pain; Indwelling