Objective To investigate the clinical curative effect of divided excision and plastic combined with procedure for prolapse and hemorrhoids (PPH) in treatment for circular mixed hemorrhoids. Methods Clinical observation on 120 patients with circular mixed hemorrhoids between May 2007 and May 2008 treated by divided excision and plastic combined with PPH was carried out. Results The mean hospital stay after operation was 7.6 d. The wound healing average time was 11.9 d. The incidence rate of postoperative urinary retention was 5.8% (7/120). Average scores of pain in 3 d after operation: 5.3 points (1-8 points) on day 1, 3.6 points （2-9 points） on day 2, 2.2 points （1-8 points） on day 3. All patients were followed up for 12 months, there were 3 cases of hematochezia， 1 case of prolapse, and 1 case of remained abnormal outgrowth skin; the anus function was normal in all cases without anal stricture or tightening feeling. Conclusions Divided excision and plastic combined with PPH can better treat circular mixed hemorrhoids. This operation can not only completely clear the lesions, but also repair and reconstruct the anus and anal canal, protect its size and function. It is an ideal operation for treatment for circular mixed hemorrhoids.
近年来，胆石症的发病谱已发生了根本性的变迁，一些大城市的胆囊结石发病率逐步增加，过去常见的肝内胆管结石已明显减少； 但多数地区肝内胆管结石发病率仍较高，仍是我国的常见病之一，其治疗也仍是胆道外科中的困难问题。运用现代肝脏外科手术技术，处理肝门部和肝内胆管及血管，获得良好的显露，基本上可达到“解除梗阻，去除病灶，通畅引流”的肝胆管结石外科治疗原则。由于肝内胆管结石本身的复杂性，目前尚无一种手术方式可使所有患者获得满意效果，因此，应根据患者的实际情况采用“个体化治疗方案”。常用的手术方法有胆管探查取石、胆肠引流、肝叶切除术等。根据病情、患者的身体素质、技术条件和病变的性质等综合考虑来决定术式。
的讨论先天性巨结肠的手术治疗。方法回顾106例先天性巨结肠的手术治疗方式及疗效。结果采用改良Duhamel术式治疗先天性巨结肠并发症少，远期排便功能良好。结论改良Duhamel术式适于任何年龄和所有类型的巨结肠，疗效满意。
目的探讨胃癌穿孔的手术时机及术式选择。方法对我院1985年1月至2000年12月间急诊收治的64例胃癌穿孔患者的资料进行回顾性分析。结果保守治疗后行择期手术5例； 59例行急诊手术，其中行根治性切除术22例，姑息性切除术10例，穿孔修补后3周内二期行根治性手术6例，行单纯穿孔修补术14例，穿孔修补+短路手术7例。本组手术后30天内死亡6例，死亡率为9.4%，58例中获随访52例，随访5年，失访6例，其中根治性手术、姑息性切除、单纯穿孔修补和穿孔修补+短路手术者平均生存期分别为31个月、18个月、5个月和7个月。结论合理的手术时机及术式选择是延长患者生命和提高患者生存质量的关键所在。
目的 探讨闭合性十二指肠损伤的诊断与术式选择及其效果。 方法对1980～1999年间收治的33例闭合性十二指肠损伤患者临床资料进行回顾性总结分析。结果 合并伤27例，其中胰腺损伤占24.2%(8/33)，术前诊断率为18.2%(6/33)，术中漏诊率为15.2%(5/33)。术式选择：单纯十二指肠损伤以修补为主，十二指肠裂口较大或缺损者，可采用空肠浆膜覆盖术及十二指肠空肠Y型吻合术等其它术式，合并有胰腺损伤者宜行Graham简化术。同时应行充分的十二指肠减压和腹腔引流。术后并发症发生率为39.4%(13/33)，治愈率为84.8%(28/33)，死亡率为15.2%(5/33)。 结论 十二指肠损伤应重视早期诊断，在剖腹探查中应识别其损伤特征，并掌握切开探查方法，防止漏诊；术式选择宁简勿繁，不同患者适时、适当地采用最佳的诊断和治疗方法是十二指肠损伤手术成功的关键。
目的探讨低位直肠息肉恶变的合理的外科手术方式。方法对我院1997年1月至2001年12月收治的32例低位直肠息肉恶变患者的资料进行回顾性分析。 结果32例中经肛门局部切除20例，经腹前切除低位吻合（Dixon术）8例，经腹会阴联合切除（Miles’术）4例，其中27例术后给予放、化疗。28例获随访1~5年，2例死亡，余均无局部复发。 结论低位直肠息肉恶变手术方式的正确选择是达到“根除癌肿”、“改善患者生活质量”目的的关键，术中冰冻病理检查是手术方式选择的重要依据。
Thisstudyisbasedonaretrospectivereviewof48patientswithechinococcosisofliverwithemphasisonthedifferentialdiagnosisandtheselectionofsurgery.Causesofmisdiagnosisandtheevaluationofavariousoperationsonthisdiseasewerediscussed.Results:Thecommonmisdiagnosiswasduetoobscurehistoryandsymptoms,errorsonimmunologicaltests,lackofspecificmanifestationonradiologicalexaminationandtheforemostsymptomsofcomplications.Theoperativewaysmustbechoseninaccordancewitheachindividualdisease.Theimprovementofoperativetechniquessuchas“tumorfree”operation,irrigationwithhypertonicsalinesolution,infillingwithgreateromentum,applicationofbiojellycanincreasethetherapeuticeffectofoperation.Conclusion:Thekeypointofdifferentialdiagnosisistorecognizetheatypicalcases.Rationalselectionofoperationsandimprovementofoperativetechniquesandmethodsarethecrucialtoincreasethetherapeuticeffectofthisdisease.
Objective To summarize the effectiveness of modified surgical repair for severe ingrown toenail. Methods Between January 2005 and December 2010, 13 patients with severe ingrown toenail (16 toes) were treated. There were 12 males (15 toes) and 1 female (1 toe), aged 18-32 years with an average of 20 years. The disease duration was 1-15 years (mean, 2 years and 9 months). All affected toes were great toes. Ingrown toenail occurred bilaterally in 3 cases and unilaterally in 10 cases. Granulation tissue surrounding nail-edge, embedded toenail, and necrotic nail bed were completely removed; tension glue was used to make wound edge close to nail bed. Results At 3-5 days after operation, wound congestion, swelling, and exudation were improved; at 7 days, new nail bed formed; at 2 weeks, all wounds healed, and nail bed was epitheliogenic, wound edge healed well close to nail plate, and patients returned to normal life. At 6 months after nail extraction, new toenail grew and nail groove formed. No recurrent sign was found during 24-month follow-up. Conclusion Modified surgical repair is one of effective methods to treat severe ingrown toenail with the advantages of good appearance and low recurrent rate.
Objective To compare the effect of two different operations on treating severely comminuted intercondylar fracture. Methods From December 2001 to October 2003, 20 cases of severely comminuted intercondylar fracture were operated. Of the 20 cases, 7(group 1) were treated with closed reduction and retrograde intramedullary nailing through arthroscope, 13(group2) were treated with open reduction and retrograde intramedullary nailing without arthroscope. Follow-ups were conducted after operation. Results All cases of fracture were recovered. Swelling in group 1 was alleviated more obviously than that in group 2. In group 1, all knees could flex to 120° during 6th to 9th weeks after the operation. In group 2, only 4 could flex 110°.Conclusion Retrograde intramedullary nailing through arthroscope proves to be less invasive and more effective in treating heavily comminuted intercondylar fracture.