ObjectiveTo compare the safety, effectiveness, and stability of 3D Max lightweight patch and standard patch in laparoscopic transabdominal preperitoneal (TAPP) herniorrhaphy. MethodsThe clinical data of 147 patients who underwent laparoscopic TAPP herniorrhaphy with 3D Max from May 2013 to May 2014 in this hospital were collected. Of all the patients, the lightweight patches were used in 75 patients (observation group), the standard patches were used in 72 patients (control group). The mean operative time, mean early postoperative ambulation time, mean bleeding volume, postoperative pain, postoperative foreign body sensation, complications, average hospital stay, and average costs were compared between these two groups. The postoperative pain point was determined by using visual analogue scale (VAS). The foreign body sensation of postoperative groin area was determined basing on the pain point. ResultsThere were no significant differences in the terms of the mean operation time, the mean early postoperative ambulation time, the mean bleeding volume, the average costs, and the average hospital stay between the observation group and the control group (P > 0.05). On postoperative 2 d, the pain point of the observation group was slightly lower than that of the control group, but there was no statistically significant difference between these two groups (P=0.132); On postoperative 1 month and 6 months, the postoperative pain points of the observation group were significantly lower than those of the control group, the differences were statistically significant (P=0.031, P=0.018). There was no recurrence of hernia and complications in the two groups. ConclusionsThe cost of 3D Max lightweight patch in laparoscopic TAPP herniorrhaphy application is slightly higher than that in standard patch, but it could alleviate postoperative pain, reduce postoperative foreign body sensation, and make patients feel more comfortable. It is safe, effective, and stable in clinical application of laparoscopic TAPP herniorrhaphy.
ObjectiveTo investigate effect of sealing one-layer anastomosis in pancreaticojejunostomy in patients underwent pancreaticoduodenectomy. MethodsThe clinical data of 85 patients underwent pancreaticoduodenectomy in this hospital from January 2014 to May 2015 were collected. Of all the patients, 28 patients were underwent sealing onelayer anastomosis in pancreaticojejunostomy (sealing one-layer anastomosis group), 27 patients were underwent ductto-mucosa pancreaticojejunostomy (duct-to-mucosa anastomosis group), and 30 patients were underwent end-to-side invaginated pancreaticojejunostomy (end-to-side invagination group). The anastomosis time, time to pull out drainage tube, postoperative hospital stay, and incidence rate of postoperative pancreatic fistula were compared among these three groups. Results①The anastomosis time (min) of the sealing one-layer anastomosis group was significantly shorter than that of the duct-to-mucosa anastomosis group or end-to-side invagination group (12.51±2.96 versus 25.65±3.35, P < 0.05; 12.51±2.96 versus 23.73±5.27, P < 0.05).②The time to pull out drainage tube of the sealing one-layer anastomosis group was significantly shorter than that of the end-to-side invagination group (7.65±1.30 versus 11.15±3.47, P < 0.05).③The postoperative hospital stay had no statistical significances among these three groups (P > 0.05).④The incidence of pancreatic fistula was 3.57% (1/28), 7.41% (2/27), and 10.00% (3/30) among the sealing one-layer anastomosis group, duct-to-mucosa anastomosis group, and end-to-side invagination group respectively, which had no statistical differences among these three groups (P > 0.05). ConclusionSealing one-layer anastomosis in pancreaticojejunostomy might be a safe anastomosis, and it has advantages of simple operation and short operation time.