BACKGROUND Circumferential prolapsed hemorrhoids(CPHs)necessitate surgical intervention.While Milligan-Morgan hemorrhoidectomy(MMH)remains widely used,it compromises functional preservation and associates with signifi...BACKGROUND Circumferential prolapsed hemorrhoids(CPHs)necessitate surgical intervention.While Milligan-Morgan hemorrhoidectomy(MMH)remains widely used,it compromises functional preservation and associates with significant post-operative pain,edema,and delayed healing in severe CPH cases.To address these limitations,our research team innovatively proposed the transverse incision with longitudinal ligation procedure(TILL).This novel technique utilizes targeted transverse incisions and longitudinal pedicle ligation to optimize complete resection while preserving anal anatomy and function.METHODS A total of 180 patients were retrospectively reviewed in China.The patients were divided into two groups of 90 based on the surgical methods.The treatment group underwent the TILL procedure,while the control group underwent MMH.The main observation index was the evaluation of clinical efficacy after wound healing.Secondary outcomes included the recurrence rate and wound healing time.Safety measurements were also evaluated.RESULTS The TILL group showed a significant difference compared to the MMH group(P=0.022),indicating better overall treatment effects.The time for wound healing in the TILL group was shorter than that in the MMH group(P=0.001).Compared to those who underwent MMH,those who underwent TILL experienced significantly reduced postoperative pain,with lower average scores for anal edema and anal stenosis(both P<0.05).CONCLUSION TILL demonstrates superior efficacy to MMH for advanced CPH,reducing recovery times and postoperative pain,edema,and stenosis while preserving anal function.展开更多
In order to do a good job in the treatment of patients with scar uterus undergoing cesarean section, the article mainly compares and analyzes the therapeutic effects of two methods, transverse incision and longitudina...In order to do a good job in the treatment of patients with scar uterus undergoing cesarean section, the article mainly compares and analyzes the therapeutic effects of two methods, transverse incision and longitudinal incision of abdominal wall. This time, a total of 50 patients were selected from January 2018 to January 2021 in a hospital. The medical staff took the lead in conducting a detailed survey on the direction of cesarean section of all patients. The reference results were divided into 10 cases of observation group and 40 cases of control group. The medical staff adopted the method of longitudinal incision of abdominal wall to treat the observation group, while the control group adopted the method of transverse incision of abdominal wall, and then compared the operation indexes and pelvic adhesion of the two groups. After a period of observation, the operation time of parturient women, the delivery time of fetus and the time of anal exhaust in the observation group were significantly better than those in the control group, and the relative bleeding volume was also less, with significant difference between the groups (P<0.05). According to the analysis of the occurrence probability of pelvic adhesion of parturients, the ligation group was significantly higher than the observation group, and the parturients in the observation group also showed a good development trend of incision healing. It can be seen from this that, compared with the abdominal wall transverse incision cesarean section, the application of abdominal wall longitudinal incision treatment is more able to avoid the occurrence of pelvic adhesion and other problems after the operation of the parturient, and the relative operation, delivery of the fetus and other time is also relatively short, thus reducing the risk of severe hemorrhage after the operation of the patients. Because of its many treatment advantages, it is increasingly favored by the industry.展开更多
Objective:To review the published studies reporting various specimen retrieval incisions being used by colorectal surgeons in patients undergoing laparoscopic colorectal resections(LCR).Methods:Standard medical electr...Objective:To review the published studies reporting various specimen retrieval incisions being used by colorectal surgeons in patients undergoing laparoscopic colorectal resections(LCR).Methods:Standard medical electronic databases were searched to find relevant articles and a summary conclusion was generated.Results:There were 43 studies reporting various approaches used for the purpose of specimen retrieval in 2388 patients undergoing LCR.The most common approaches were periumbilical midline incision(1260 reported case in the literature),transverse incision(583 reported cases in the literature)in the right-or left iliac fossa,depending on the side of colonic resection,and Pfannensteil incision(293 reported cases in the literature).Periumbilical midline incision was associated with the higher risk of developing incisional hernia(odds ratio 53.72;95%confidence interval 7.48–386.04;Z=3.96;P=0.0001).In terms of surgical site infection(SSI),there was no difference between the three common approaches to specimen retrieval.Transanal and transvaginal approaches were associated with higher risk of SSI.Conclusions:Midline,transverse and Pfannensteil incisions were the most commonly used approaches for specimen retrieval following LCR.Midline incision was associated with higher risk of incisional hernia.Risk of SSI was similar in all three common approaches.The transanal and transvaginal approaches pose a higher risk of SSI.These conclusions are based on the combined outcome of published case series,case reports and comparative studies.Randomized,controlled trials with longer follow-up are required before recommending the routine use of any approach for specimen retrieval in patients undergoing LCR.展开更多
基金Supported by Scientific Research Fund of China-Japan Friendship Hospital,No.2019-1-QN-53.
文摘BACKGROUND Circumferential prolapsed hemorrhoids(CPHs)necessitate surgical intervention.While Milligan-Morgan hemorrhoidectomy(MMH)remains widely used,it compromises functional preservation and associates with significant post-operative pain,edema,and delayed healing in severe CPH cases.To address these limitations,our research team innovatively proposed the transverse incision with longitudinal ligation procedure(TILL).This novel technique utilizes targeted transverse incisions and longitudinal pedicle ligation to optimize complete resection while preserving anal anatomy and function.METHODS A total of 180 patients were retrospectively reviewed in China.The patients were divided into two groups of 90 based on the surgical methods.The treatment group underwent the TILL procedure,while the control group underwent MMH.The main observation index was the evaluation of clinical efficacy after wound healing.Secondary outcomes included the recurrence rate and wound healing time.Safety measurements were also evaluated.RESULTS The TILL group showed a significant difference compared to the MMH group(P=0.022),indicating better overall treatment effects.The time for wound healing in the TILL group was shorter than that in the MMH group(P=0.001).Compared to those who underwent MMH,those who underwent TILL experienced significantly reduced postoperative pain,with lower average scores for anal edema and anal stenosis(both P<0.05).CONCLUSION TILL demonstrates superior efficacy to MMH for advanced CPH,reducing recovery times and postoperative pain,edema,and stenosis while preserving anal function.
文摘In order to do a good job in the treatment of patients with scar uterus undergoing cesarean section, the article mainly compares and analyzes the therapeutic effects of two methods, transverse incision and longitudinal incision of abdominal wall. This time, a total of 50 patients were selected from January 2018 to January 2021 in a hospital. The medical staff took the lead in conducting a detailed survey on the direction of cesarean section of all patients. The reference results were divided into 10 cases of observation group and 40 cases of control group. The medical staff adopted the method of longitudinal incision of abdominal wall to treat the observation group, while the control group adopted the method of transverse incision of abdominal wall, and then compared the operation indexes and pelvic adhesion of the two groups. After a period of observation, the operation time of parturient women, the delivery time of fetus and the time of anal exhaust in the observation group were significantly better than those in the control group, and the relative bleeding volume was also less, with significant difference between the groups (P<0.05). According to the analysis of the occurrence probability of pelvic adhesion of parturients, the ligation group was significantly higher than the observation group, and the parturients in the observation group also showed a good development trend of incision healing. It can be seen from this that, compared with the abdominal wall transverse incision cesarean section, the application of abdominal wall longitudinal incision treatment is more able to avoid the occurrence of pelvic adhesion and other problems after the operation of the parturient, and the relative operation, delivery of the fetus and other time is also relatively short, thus reducing the risk of severe hemorrhage after the operation of the patients. Because of its many treatment advantages, it is increasingly favored by the industry.
文摘Objective:To review the published studies reporting various specimen retrieval incisions being used by colorectal surgeons in patients undergoing laparoscopic colorectal resections(LCR).Methods:Standard medical electronic databases were searched to find relevant articles and a summary conclusion was generated.Results:There were 43 studies reporting various approaches used for the purpose of specimen retrieval in 2388 patients undergoing LCR.The most common approaches were periumbilical midline incision(1260 reported case in the literature),transverse incision(583 reported cases in the literature)in the right-or left iliac fossa,depending on the side of colonic resection,and Pfannensteil incision(293 reported cases in the literature).Periumbilical midline incision was associated with the higher risk of developing incisional hernia(odds ratio 53.72;95%confidence interval 7.48–386.04;Z=3.96;P=0.0001).In terms of surgical site infection(SSI),there was no difference between the three common approaches to specimen retrieval.Transanal and transvaginal approaches were associated with higher risk of SSI.Conclusions:Midline,transverse and Pfannensteil incisions were the most commonly used approaches for specimen retrieval following LCR.Midline incision was associated with higher risk of incisional hernia.Risk of SSI was similar in all three common approaches.The transanal and transvaginal approaches pose a higher risk of SSI.These conclusions are based on the combined outcome of published case series,case reports and comparative studies.Randomized,controlled trials with longer follow-up are required before recommending the routine use of any approach for specimen retrieval in patients undergoing LCR.
