The aim is to report a case of poor wound healing secondary to enterocutaneous fistula wound management after oesophageal hiatal hernia repair and described our treatment experience.Using the stoma chassis decompression tugging to reduce the tension of the abdominal wall,combined with simplified negative pressure wound technology and saline flushing,and applying the negative pressure wound technology combined with the stoma bag to collect the digestive fluid of enterocutaneous fistulas.The negative pressure wound technique and stoma bag could collect the digestive fluid of the fistula,avoid the contamination of the skin around the fistula,reduce the symptoms caused by the dermatitis,alleviate the pain,and eventually promote the wound healing.
Acute pancreatitis,casuing systemic inflammatory response,can lead to intestinal flora disturbance,gut barrier dysfunction and intestinal immune function impairment.The underlying patho-genesis is closely associated with gut microorganisms,which significantly increases the mortality of sever acute pancreatitis(SAP).Recently the imbalance of intestinal flora is being regarded as an critical poten-tial therapeutic target of AP via traditional Chinese medicine,in with Euphorbia kansui has played a im-portant role in the treatment of SAP.This review aims to provide more basic research and clinical applica-tion evidence of Kansui in the cure of AP from the perspective of gut microorganisms,through summariz-ing and analyzing the existed pertinent literature.
Objective To explore the short-term efficacy of Shenling Baizhu San granules combined with training of lifting the anus for anal dysfunction after Dixon operation for middle and low rectal cancer.Methods Forty-fivepatients with rectal cancer undergoing Dixon'soperation were divided into a control group(treated with Montmorillonite powder combined with levator ani muscle training)of 21 cases,and a study group(treated with oral Shenling Baizhu San granules beside of the same as control group)of 24 cases.The recovery of anal function was evaluated using Williams criteria,Wexner scoring system,and defecography at 1,3,6 months after surgery.Results Williams Anal Function Assessment:The fine anal function rate of in the study group was higher than that in the control group at 3 months after surgery,with a statistically significant difference(P=0.042),but there was no statistically significant difference at 1 and 6 months after surgery(P>0.05).Wexner score of anal incontinence:The Wexner score of anal incontinence in the study group was significantly lower than that in the control group at 1,3,6 months after surgery,with a statistically significant difference(P<0.05).Six months after surgery,defecography in ZD patients at the study group patients(20/24)and 15 patients(15/21)at the control group showed fine rectal filling without significant stenosis and no leakage of contrast media.Conclusion Shenling Baizhu San granules combined with training of lifting the anuscan accelerate the recovery of anal dys-function after Dixon's operation for middle and low rectal cancer,and reduce the incidence of postopera-tive anal incontinence.
Pancreatic cancer is a relatively common malignant tumor in hepatobiliary and pancreatic surgery,with insidious onset,atypical early symptoms,easy to metastasize,and a five-year survival rate of less than 6%.Pancreaticoduodenectomy is the standard procedure for pancreatic and peripelvic tumors,and laparoscopic pancreaticoduodenectomy has higher requirements for the operator's luminal technique,and more precise requirements for the assessment of tumor invasion of adjacent organs and vascular varia-tions.Three-dimensional visualization technology integrates digital medicine,computer and artificial intelligence technologies,and the three-dimensional visualization platform can reorganize and integrate two-dimensional image data to construct three-dimensional abdominal anatomical structure images,and the three-dimensional display of the anatomical structure around the pancreas is conducive to improving the accuracy of preoperative assessment,increasing the safety of the operation,accelerating the patient's recovery after the operation,and achieving the purpose of precise treatment,which is in line with the accelerated recovery surgery concept.The concept is in line with the accelerated rehabilitation surgery.
Objective To investigate the clinical effect of unilateral percutaneous kyphoplasty(PKP)in the treatment of vertebral compression fracture in the elderly from the perspective of the injected volume and distribution of bone cement.Methods The clinical data of 60 elderly patients with vertebral compression fracture who were treated in the hospital from September 2019 to September 2022 were retro-spectively analyzed.According to the position of bone cement in vertebral body displayed on postoperative thoracolumbar orthotopic X-ray film,the patients were divided into control group(eccentric distribution,31 cases)and observation group(centric distribution,29 cases).Perioperative parameters of the two groups were compared.Changes in pain scores and imaging data before operation,1 week,6 months and 12 months after operation,activities of daily living and the incidence rates of complications in the two groups were recorded.Results There was no statistically significant difference between the two groups in terms of surgical time,blood loss,length of hospital stay,injected volume of bone cement and the incidence of complications(P>0.05).The Visual Analog Scale(VAS)scores,Oswestry disability index(ODI)scores and kyphosis angles(Cobb angle)of the two groups decreased at 1 week,6 months and 12 months after operation.The VAS score,ODI score and Cobb angle of the observation group were lower than those of the control group at each time point(P<0.05).Conclusion The distribution of bone cement in elderly patients with vertebral compression fracture after unilateral PKP can affect the curative effect.Eccentric distribution can delay pain relief and affect quality of life of the patients.Therefore,centric distribution of bone cement should be maintained as much as possible.
