AIM:To evaluate trans-anal reinforcing sutures in low anterior resection using the double-stapled anastomosis technique for primary rectal cancers performed at a single institution.METHODS:The data of patients who rec...AIM:To evaluate trans-anal reinforcing sutures in low anterior resection using the double-stapled anastomosis technique for primary rectal cancers performed at a single institution.METHODS:The data of patients who received transanal reinforcing sutures were compared with those of patients who did not receive them after low anterior resection.Patients who underwent laparoscopic low anterior resection and the double-stapled anastomosis technique for primary rectal cancer between January2008 and December 2011 were included in this study.Patients with no anastomosis,a hand-sewn anastomosis,high anterior resection,or preoperative chemoradiation were excluded.The primary outcomes measured were the incidence of postoperative anastomotic complications and placement of a diverting ileostomy.RESULTS:Among 110 patients,the rate of placement of a diverting ileostomy was significantly lower in the suture group(SG)compared with the non-suture control group(CG)[SG,n=6(12.8%);CG,n=19(30.2%),P=0.031].No significant difference was observed in the rate of anastomotic leakage[SG,n=3(6.4%);CG,n=5(7.9%)].CONCLUSION:Trans-anal reinforcing sutures may reduce the need for diverting ileostomy.A randomized prospective study with a larger population should be performed in the future to demonstrate the efficacy of trans-anal reinforcing sutures.展开更多
The basement of the South China Sea（SCS）and adjacent areas can be divided into six divisions（regions）-Paleozoic Erathem graben-faulted basement division in Beibu Gulf,Paleozoic Erathem strike-slip pull-apart in Yi...The basement of the South China Sea（SCS）and adjacent areas can be divided into six divisions（regions）-Paleozoic Erathem graben-faulted basement division in Beibu Gulf,Paleozoic Erathem strike-slip pull-apart in Yinggehai waters,Paleozoic Erathem faulted-depression in eastern Hainan,Paleozoic Erathem rifted in northern Xisha（Paracel）,Paleozoic Erathem strike-slip extending in southern Xisha,and Paleozoic-Mesozoic Erathem extending in Nansha Islands（Spratly）waters.The Pre-Cenozoic basement in the SCS and Yunkai continental area are coeval within the Tethyan tectonic domain in the Pre-Cenozoic Period.They are formed on the background of the Paleo-Tethyan tectonic domain,and are important components of the Eastern Tethyan multi-island-ocean system.Three branches of the Eastern Paleo-Tethys tectonic domain,North Yunkai,North Hainan,and South Hainan sea basins,have evolved into the North Yunkai,North Hainan,and South Hainan suture zones, respectively.This shows a distinctive feature of localization for the Pre-Cenozoic basement.The Qiongnan（i.e.South Hainan）Suture Zone on the northern margin of the South China Sea can be considered the vestige of the principal ocean basin of Paleo-Tethys,and connected with the suture zone of the Longmucuo-Shuanghu belt-Bitu belt-Changning-Menglian-Bentong-Raub belt,the south extension of Bitu-Changning-Menglian-Ching Mai belt-Chanthaburi-Raub-Bentong belt on the west of South China Sea,and with the Lianhua-Taidong suture zone（a fault along the east side of Longitudinal Valley in Taiwan）-Hida LP/HT（low pressure-high temperature）metamorphic belt-Hida -marginal HP/LT metamorphic belt in southwestern Honshu of Japan,on the east of the South China Sea.The Qiongbei（North Hainan）suture zone may eastwards extended along the Wangwu-Wenjiao fault zone,and connects with the Lufeng-Dapu-Zhenghe-Shangyu（Lianhuashan）deep fault zone through the Pearl River Mouth Basin.The Meso-Tethys developed on the south of the South China Sea.The Nansha Trough may be considered 展开更多
INTRODUCTIONThe incidence of the morbidly adherent placenta has been increasing due to the increased rate of cesarean section. Life-threatening hemorrhage is the major concern for the morbidly adherent placenta, and e...INTRODUCTIONThe incidence of the morbidly adherent placenta has been increasing due to the increased rate of cesarean section. Life-threatening hemorrhage is the major concern for the morbidly adherent placenta, and efficient bleeding control of lower uterine segment is critical to improve outcomes. When traditional conservative methods do not work, further surgical procedures should be attempted. There are several conservative surgical approaches for lower uterine compression, and peripartum hysterectomy is avoided. In the present study, we aimed to report a rather easy suturing method to compress the lower uterine.展开更多
The Huanan (South China) subcontinent was created by amalgamation of the Yangtze, Xianggan, Cathaysia and Zhemin microcontinents by the Guangxi orogeny in the Early Palaeozoic. The closure of the Tethyan Ocean and sub...The Huanan (South China) subcontinent was created by amalgamation of the Yangtze, Xianggan, Cathaysia and Zhemin microcontinents by the Guangxi orogeny in the Early Palaeozoic. The closure of the Tethyan Ocean and subsequent collision event outside the amalgamated continent reactivated fossil sutures and resulted in intracontinental (ensialic) orogenies in the Mesozoic. Based on evidence from deformation, molasse and granitoids, the Sichuan-Guizhou-Hunan—southern Hubei and Hunan-Jiangxi-Fujian Yanshanian fold-thrust systems and the Lower Yangtze-northwestern Fujian Indosinian fold-thrust system are thought to be intracontinental orogens. Their main features are as follows: intracontinental orogenies occurred areally, thrusting propagated towards the interior of the continental, they extend parallelly to the strikes of the fossil sutures, and the details of the temporal-spatial evolution of the orogens depend on subduction-collision events.展开更多
目的:探讨单向倒刺缝线在腹腔镜下肝叶切除联合术中胆道探查中应用的安全性及有效性。方法:回顾性分析2014年12月—2015年8月期间24例行腹腔镜肝切除联合术中胆道探查术的患者资料,其中10例采用传统缝线缝合胆管(传统缝线组),14例术中...目的:探讨单向倒刺缝线在腹腔镜下肝叶切除联合术中胆道探查中应用的安全性及有效性。方法:回顾性分析2014年12月—2015年8月期间24例行腹腔镜肝切除联合术中胆道探查术的患者资料,其中10例采用传统缝线缝合胆管(传统缝线组),14例术中采用倒刺线缝合胆管(倒刺线组),比较两组的相关临床资料。结果:所有患者均手术成功,两组患者术前一般资料、术中出血量、术后并发症发生率(肺部感染)、术后住院时间差异均无统计学意义(均P>0.05);但倒刺线组手术时间(230.50 min vs.354.68 min)、胆总管缝合时间(5.33 min vs.33.82 min)、肝管缝合时间(9.04 min vs.25.14 min)均明显少于传统缝线组(均P<0.05)。所有患者出院1个月返院行T管造影,拔除T管,无结石残留、胆汁漏、胆管狭窄。结论:单向倒刺缝线用于腹腔镜下肝叶切除联合胆道探查术安全、可行,可吸收倒刺缝线的使用可以降低腹腔镜下缝合难度,缩短手术时间和学习曲线,而不增加胆汁渗漏的风险。展开更多
BACKGROUND:After pancreaticoduodenectomy,the incidence of postoperative pancreatic fistula remains high,especially in patients with 'soft' pancreatic tissue remnants.No 'gold standard' surgical techniq...BACKGROUND:After pancreaticoduodenectomy,the incidence of postoperative pancreatic fistula remains high,especially in patients with 'soft' pancreatic tissue remnants.No 'gold standard' surgical technique for pancreaticoenteric anastomosis has been established.This study aimed to compare the postoperative morbidity and mortality of pancreaticogastrostomy and pancreaticojejunostomy for 'soft' pancreatic tissue remnants using modified mattress sutures.METHODS:Seventy-five patients who had undergone pancreaticogastrostomy and 75 who had undergone pancreaticojejunostomy after pancreaticoduodenectomy between 2002 and 2008 were retrospectively compared using matched-pair analysis.A modified mattress suture technique was used for the pancreaticoenteric anastomosis.Patients with an underlying 'hard' pancreatic tissue remnant,as in chronic pancreatitis,were excluded.Both groups were homogeneous for age,gender,and underlying disease.Postoperative morbidity,mortality,and preoperative and operative data were analyzed.RESULTS:There were no significant differences between the groups for the incidence of postoperative pancreatic fistula (10.7% in both).Postoperative morbidity and mortality,median operation time,median length of hospital stay,intraoperative blood loss,and the amount of intraoperatively transfused erythrocyte concentrates also did not significantly differ between the groups.Patient age >65 years (P=0.017),operation time >350minutes (P=0.001),and intraoperative transfusion of erythrocyte concentrates (P=0.038) were identified as risk factors for postoperative morbidity.CONCLUSIONS:Our results showed no significant differences between the groups in the pancreaticogastrostomy and pancreaticojejunostomy anastomosis techniques using mattress sutures for 'soft' pancreatic tissue remnants.In our experience,the mattress sutures are safe and simple to use,and pancreaticogastrostomy in particular is feasible and easy to learn,with good endoscopic accessibility to the anastomosis region.However,the location of the anastomosi展开更多
文摘AIM:To evaluate trans-anal reinforcing sutures in low anterior resection using the double-stapled anastomosis technique for primary rectal cancers performed at a single institution.METHODS:The data of patients who received transanal reinforcing sutures were compared with those of patients who did not receive them after low anterior resection.Patients who underwent laparoscopic low anterior resection and the double-stapled anastomosis technique for primary rectal cancer between January2008 and December 2011 were included in this study.Patients with no anastomosis,a hand-sewn anastomosis,high anterior resection,or preoperative chemoradiation were excluded.The primary outcomes measured were the incidence of postoperative anastomotic complications and placement of a diverting ileostomy.RESULTS:Among 110 patients,the rate of placement of a diverting ileostomy was significantly lower in the suture group(SG)compared with the non-suture control group(CG)[SG,n=6(12.8%);CG,n=19(30.2%),P=0.031].No significant difference was observed in the rate of anastomotic leakage[SG,n=3(6.4%);CG,n=5(7.9%)].CONCLUSION:Trans-anal reinforcing sutures may reduce the need for diverting ileostomy.A randomized prospective study with a larger population should be performed in the future to demonstrate the efficacy of trans-anal reinforcing sutures.
基金funded by the State Fund for Natural Science of China(No40976029)the National Basic Research Program of China("973")(2007CB411700 and 2009CB2194)+2 种基金the Major Knowledge Innovation Programs of the Chinese Academy of Sciences(kzcx2-yw- 203-01)the National Program of Sustaining Science and Technology(2006BABl 9B02)the Program of the Ministry of Land and Resources,China(GT-YQ-QQ-2008-1-02 and 2009GYXQ06)
文摘The basement of the South China Sea（SCS）and adjacent areas can be divided into six divisions（regions）-Paleozoic Erathem graben-faulted basement division in Beibu Gulf,Paleozoic Erathem strike-slip pull-apart in Yinggehai waters,Paleozoic Erathem faulted-depression in eastern Hainan,Paleozoic Erathem rifted in northern Xisha（Paracel）,Paleozoic Erathem strike-slip extending in southern Xisha,and Paleozoic-Mesozoic Erathem extending in Nansha Islands（Spratly）waters.The Pre-Cenozoic basement in the SCS and Yunkai continental area are coeval within the Tethyan tectonic domain in the Pre-Cenozoic Period.They are formed on the background of the Paleo-Tethyan tectonic domain,and are important components of the Eastern Tethyan multi-island-ocean system.Three branches of the Eastern Paleo-Tethys tectonic domain,North Yunkai,North Hainan,and South Hainan sea basins,have evolved into the North Yunkai,North Hainan,and South Hainan suture zones, respectively.This shows a distinctive feature of localization for the Pre-Cenozoic basement.The Qiongnan（i.e.South Hainan）Suture Zone on the northern margin of the South China Sea can be considered the vestige of the principal ocean basin of Paleo-Tethys,and connected with the suture zone of the Longmucuo-Shuanghu belt-Bitu belt-Changning-Menglian-Bentong-Raub belt,the south extension of Bitu-Changning-Menglian-Ching Mai belt-Chanthaburi-Raub-Bentong belt on the west of South China Sea,and with the Lianhua-Taidong suture zone（a fault along the east side of Longitudinal Valley in Taiwan）-Hida LP/HT（low pressure-high temperature）metamorphic belt-Hida -marginal HP/LT metamorphic belt in southwestern Honshu of Japan,on the east of the South China Sea.The Qiongbei（North Hainan）suture zone may eastwards extended along the Wangwu-Wenjiao fault zone,and connects with the Lufeng-Dapu-Zhenghe-Shangyu（Lianhuashan）deep fault zone through the Pearl River Mouth Basin.The Meso-Tethys developed on the south of the South China Sea.The Nansha Trough may be considered
文摘INTRODUCTIONThe incidence of the morbidly adherent placenta has been increasing due to the increased rate of cesarean section. Life-threatening hemorrhage is the major concern for the morbidly adherent placenta, and efficient bleeding control of lower uterine segment is critical to improve outcomes. When traditional conservative methods do not work, further surgical procedures should be attempted. There are several conservative surgical approaches for lower uterine compression, and peripartum hysterectomy is avoided. In the present study, we aimed to report a rather easy suturing method to compress the lower uterine.
文摘The Huanan (South China) subcontinent was created by amalgamation of the Yangtze, Xianggan, Cathaysia and Zhemin microcontinents by the Guangxi orogeny in the Early Palaeozoic. The closure of the Tethyan Ocean and subsequent collision event outside the amalgamated continent reactivated fossil sutures and resulted in intracontinental (ensialic) orogenies in the Mesozoic. Based on evidence from deformation, molasse and granitoids, the Sichuan-Guizhou-Hunan—southern Hubei and Hunan-Jiangxi-Fujian Yanshanian fold-thrust systems and the Lower Yangtze-northwestern Fujian Indosinian fold-thrust system are thought to be intracontinental orogens. Their main features are as follows: intracontinental orogenies occurred areally, thrusting propagated towards the interior of the continental, they extend parallelly to the strikes of the fossil sutures, and the details of the temporal-spatial evolution of the orogens depend on subduction-collision events.
文摘目的:探讨单向倒刺缝线在腹腔镜下肝叶切除联合术中胆道探查中应用的安全性及有效性。方法:回顾性分析2014年12月—2015年8月期间24例行腹腔镜肝切除联合术中胆道探查术的患者资料,其中10例采用传统缝线缝合胆管(传统缝线组),14例术中采用倒刺线缝合胆管(倒刺线组),比较两组的相关临床资料。结果:所有患者均手术成功,两组患者术前一般资料、术中出血量、术后并发症发生率(肺部感染)、术后住院时间差异均无统计学意义(均P>0.05);但倒刺线组手术时间(230.50 min vs.354.68 min)、胆总管缝合时间(5.33 min vs.33.82 min)、肝管缝合时间(9.04 min vs.25.14 min)均明显少于传统缝线组(均P<0.05)。所有患者出院1个月返院行T管造影,拔除T管,无结石残留、胆汁漏、胆管狭窄。结论:单向倒刺缝线用于腹腔镜下肝叶切除联合胆道探查术安全、可行,可吸收倒刺缝线的使用可以降低腹腔镜下缝合难度,缩短手术时间和学习曲线,而不增加胆汁渗漏的风险。
文摘BACKGROUND:After pancreaticoduodenectomy,the incidence of postoperative pancreatic fistula remains high,especially in patients with 'soft' pancreatic tissue remnants.No 'gold standard' surgical technique for pancreaticoenteric anastomosis has been established.This study aimed to compare the postoperative morbidity and mortality of pancreaticogastrostomy and pancreaticojejunostomy for 'soft' pancreatic tissue remnants using modified mattress sutures.METHODS:Seventy-five patients who had undergone pancreaticogastrostomy and 75 who had undergone pancreaticojejunostomy after pancreaticoduodenectomy between 2002 and 2008 were retrospectively compared using matched-pair analysis.A modified mattress suture technique was used for the pancreaticoenteric anastomosis.Patients with an underlying 'hard' pancreatic tissue remnant,as in chronic pancreatitis,were excluded.Both groups were homogeneous for age,gender,and underlying disease.Postoperative morbidity,mortality,and preoperative and operative data were analyzed.RESULTS:There were no significant differences between the groups for the incidence of postoperative pancreatic fistula (10.7% in both).Postoperative morbidity and mortality,median operation time,median length of hospital stay,intraoperative blood loss,and the amount of intraoperatively transfused erythrocyte concentrates also did not significantly differ between the groups.Patient age >65 years (P=0.017),operation time >350minutes (P=0.001),and intraoperative transfusion of erythrocyte concentrates (P=0.038) were identified as risk factors for postoperative morbidity.CONCLUSIONS:Our results showed no significant differences between the groups in the pancreaticogastrostomy and pancreaticojejunostomy anastomosis techniques using mattress sutures for 'soft' pancreatic tissue remnants.In our experience,the mattress sutures are safe and simple to use,and pancreaticogastrostomy in particular is feasible and easy to learn,with good endoscopic accessibility to the anastomosis region.However,the location of the anastomosi
