ObjectiveTo assess the outcomes of laparoscopy-assisted surgery for treatment of advanced gastric cancer.MethodsA total of 115 patients with advanced gastric cancer were included between January 2014 and December 2018 were analyzed retroprospectively, the patients were divided into two groups: open surgery group (OS group, n=63) and laparoscopy-assisted surgery group (LAS group, n=52). Baseline characteristics, intraoperative parameters and postoperative items, and long-term efficacy were compared between the two groups.ResultsThere was no significant difference in preoperative baseline data including gender, age and preoperative serum parameters between the two groups (P>0.05). Intraoperative blood loss in the LAS group was significantly less than that in the OS group (P<0.05). In addition, the first feeding time after operation and postoperative hospital stay in the LAS group were significantly shorter than the OS group (P<0.05). Furthermore, numbers of white blood cells and neutrophils in the LAS group were fewer than that in the OS group at postoperative 2 days (P<0.05); the level of serum albumin in the LAS group was higher than that OS group (P<0.05). The number of lymph nodes detected during operation in the LAS group was more than that in the OS group (P<0.05). Operative time and occurrence of postoperative complications were not statistically significant between the two groups (P>0.05). One hundred and ten of 115 patients were followed- up, the follow-up rate was 95.7%. The follow-up time ranged from 6 to 48 months, with a median follow-up time of 12.4 months. The disease-free survival time of the OS group was 12.2±6.5 months, while that of the LAS group was 13.5±7.4 months. There was no significant difference between the two groups (P>0.05).ConclusionsLaparoscopic technique in treatment of advanced gastric cancer has the minimally invasive advantage, less intraoperative blood loss, less surgical trauma, and faster postoperative recovery in comparing to the traditional open surgery. Also the lymph node dissection is superior to open surgery. The curative effect is comparable to that of open surgery.
ObjectiveTo explore the model of sharing appointments between medical inspection resources in medical alliance hospitals in the medical profession, in order to improve the utilization efficiency of medical inspection resources and patient satisfaction, and to promote the effective implementation of intelligent services in medical alliance hospitals. MethodsBy analyzing the medical process of medical inspection appointments, and organizing the inspection appointment resources of each hospital according to the actual business characteristics of each hospital of the medical alliance by the unified medical inspection appointment platform. Through the unified big data platform, the business collaboration between the medical alliance hospitals and the sharing and scheduling of medical inspection resources among the hospitals of the medical alliance are realized. ResultsThe construction and use of the medical alliance unified inspection platform has realized the sharing and utilization of inspection resources between hospitals in the medical alliance, which is convenient for patients to choose their own inspection resources across hospitals when making an appointment for inspection, and further improves patient satisfaction. ConclusionThe unified medical appointment platform unifies the management of the medical alliance's appointment examination resources, which can not only effectively improve the utilization efficiency of medical inspection appointment resources, but also expand the effective scope of patients' choice of medical inspection appointments, and at the same time improve patient satisfaction and promote the construction of hospital intelligent services.
目的 探讨腹腔镜下乙状结肠癌根治术保留盆腔自主神经的可行性及对术后泌尿、生殖功能的影响。 方法 选取2007年8月－2009年7月60例行腹腔镜下乙状结肠癌根治术患者，手术按标准腹腔镜下乙状结肠癌前切除手术方式操作。术后采用问卷调查方式对患者术后泌尿功能、男性勃起功能、女性性功能进行效果评价。生殖泌尿功能评估包含国际前列腺增生评分（IPSS）、国际勃起功能评分量表（IIEF）、女性性功能评估量表（FSFI）。 结果 58例患者成功保留自主神经，56例接受术后泌尿、生殖功能测定，置放尿管时间为1～7 d，平均3 d，拔除尿管后排尿功能良好（IPSS 0～7分）57例（95.0%），一般（IPSS 8～14分）2例（3.3%），差（IPSS 15～35分）1例（1.7%），术前、术后IPSS评分差异无统计学意义（P=0.075）。30例男性患者术后，射精良好27例（90.0%），一般2例（6.7%），差1例（3.3%）；但是勃起功能测定良好（IIEF 60～75分）28例（93.4%），一般（IIEF 44～59分）1例（3.3%），差（IIEF 5～43分）1例（3.3%），术前、术后IIEF差异无统计学意义。26例女性患者术后性功能评分，良好（FSFI 76～95分） 23例（88.5%），一般（FSFI 58～75分） 2例（7.7%），差（FSFI 4～57分）1例（3.8%）。盆腔神经保留成功的患者术前、术后差异无统计学意义（P=0.122）。 结论 多数腹腔镜下乙状结肠癌根治术患者能有效保留盆腔自主神经，且术后能保留泌尿、生殖功能。