In recent years, with the continuous advancement of hernia surgery techniques, the widespread application of minimally invasive surgery has significantly reduced postoperative recurrence rates and recovery time.However, bleeding complications remain an important factor affecting surgical safety.This article systematically explores the prevention and treatment strategies for bleeding in hernia surgery.Preoperative precise assessment of coagulation function and anatomical characteristics is conducted to identify high-risk patients and develop surgical plans.During the operation, refined hemostatic techniques and precise control of anatomical structures are utilized to reduce the risk of bleeding.Postoperatively, patients' conditions are dynamically monitored to detect early signs of bleeding,and stratified management is implemented based on the extent of bleeding.In the future, intelligent imaging navigation, artificial intelligence-assisted surgery, the application of new hemostatic materials, and the deepening of multidisciplinary collaboration will provide strong support for reducing the risk of bleeding, promoting hernia surgery towards the goal of "precise and bloodless" procedures, and further improving surgical safety and patient prognosis.
The surgical treatments for inguinal hernia, obturator hernia, and stress urinary incontinence in females all inevitably involve the crucial step of protecting the obturator vessels.The author explored the anatomy of the obturator vessels, the relationships between the surgeries for inguinal hernia, obturator hernia, and stress urinary incontinence of females and the obturator vessels, as well as various strategies for protecting the obturator vessels in surgical procedures such as transabdominal preperitoneal approach (TAPP) and totally extraperitoneal approach (TEP) for inguinal hernia, different surgical approaches for obturator hernia, and transobturator tension-free vaginal tape obturator technique(TVT-O) for stress urinary incontinence of females.It is summarized that in TAPP and TEP procedures, due to the dissection of the Retzius space， the “corona mortis” vessels， which are branches of the obturator vessels, are exposed anteriorly and medially to the pubis; The hernial sac of the obturator hernia runs through the obturator canal and thus accompanies the obturator vessel and nerve bundle; In the TVT-O procedure for stress urinary incontinence in females, when puncturing the left and right obturator membranes, it is necessary to keep away from the obturator vessel and nerve bundle.Since the surgical procedures for the above three diseases are different, the surgical sites are also correspondingly different,and the relationships between the surgical methods and the obturator vessels are also different.Therefore,the strategies for protecting the obturator vessels during the surgical operation are different.We need to master the anatomy of the obturator vessels proficiently, clarify the different relationships between the surgical methods of the three diseases and the obturator vessels, and make the correct strategies for protecting the obturator vessels during the surgical procedure.
Hernia is a common and frequently occurring disease in general surgery, which is more common in the elderly population.Due to the frequent comorbidities of cardiovascular and cerebrovascular diseases in elderly patients, long-term oral antithrombotic drug treatment or prevention of pre-existing cardiovascular and cerebrovascular diseases is needed.Venous thromboembolism (VTE) is a rare but highly lethal complication after general surgery.Therefore, balancing perioperative bleeding and thromboembolic events has become one of the focuses of clinical attention in recent years.However, lack of prevention awareness and compliance with guidelines, limitations in assessment tools, and other prevention issues urgently need to be addressed.Specialist physicians have made some preliminary explorations in surgical and anesthesia methods, achieving certain therapeutic effects.The integration and innovation of surgery and prevention technology, the strengthening of multidisciplinary cooperation mode,and the strengthening of basic research and transformation and application will all become the development direction of VTE specialized prevention in the future.Hernia surgery patients will get safer and more efficient perioperative management, and ultimately achieve a double reduction of VTE incidence rate and mortality.
Inguinal hernia is a superficial mass formed by the protrusion of an intra-abdominal organ through a defect in the inguinal region, and can occur in all age groups.In clinical practice, the incidence of inguinal hernia is relatively high, with a higher prevalence in males than in females.Currently,surgery is the only way to cure inguinal hernia, but with the deeper understanding of the anatomy of the inguinal region and the rapid development of material science, effective and individualized surgical procedures are constantly being improved.Therefore, tension-free hernia repair is widely used in clinical practice, among which the Lichtenstein procedure, with its low-tension suture, fewer complications, and conformity to the human anatomical nodes, has gradually become the mainstream procedure, but some patients still face recurrence.Previous studies have found that matrix metalloproteinases (MMPs) and matrix metalloproteinase inhibitors (TIMPs) can be used as biomarkers related to inguinal hernia development, disease progression, and postoperative prognosis.These factors have some potential clinical value in the pathologic process of the disease by participating in the synthesis, secretion, and inhibition of various proteins in the body.The aim of this review is to provide a narrative on the relevance of MMP and TIMP in the mechanism of inguinal hernia and postoperative recurrence.
Abdominal external hernia is a common surgical disease, and mesh implantation is the main treatment.Polypropylene and its modified mesh have excellent mechanical properties and deformation resistance and are the most widely used repair materials.However, due to its inherent chronic inflammatory response, it may lead to abdominal adhesion, mesh infection, mesh erosion and other complications.Once complications such as mesh infection occur, complex secondary operations are often required to remove the mesh, causing a serious burden to patients and society.Therefore, in order to reduce the occurrence of postoperative complications, various new types of mesh based on polypropylene modification have become a research hotspot.The purpose of this paper is to review the advantages and disadvantages of polypropylene and its modified mesh so as to provide some reference for the personalized selection of clinical mesh.
Parastomal hernia is one of the most common complications after ostomy.Surgical repair is the only way to cure parastomal hernia.Laparoscopic parastomal hernia repair is currently the most commonly used repair method.Robot-assisted laparoscopic surgery is a further development of laparoscopic surgery.The high-definition 3D surgical field and flexible joints of the robotic surgical system can perform more accurate operations than the laparoscopic system.It is suitable for parastomal hernia which is symptomatic or has impact on life quality.Common surgical methods include: Modified Sugarbaker repair, Keyhole repair, Extraperitoneal Sugarbaker repair, IPST mesh repair and Hybrid technique.Carrying out robotic parastomal hernia repair has to go through a certain learning curve, and its cost-benefit analysis shows that it has a wide range of application prospects in the treatment of parastomal hernia.This paper reviews the relevant domestic and foreign literature, and the current status and progress of robotic system in the treatment of parastomal hernia.
To investigate the risk factors and management strategies for perioperative bleeding in recurrent inguinal hernia repair.
Methods
A retrospective case-control study was conducted, enrolling 57 patients who underwent surgical repair for recurrent inguinal hernia in The First Affiliated Hospital of Chongqing Medical University between January 2015 and December 2024.Patients were categorized into postoperative bleeding group (n=16) and non-bleeding group (n=41) based on the presence of bleeding-related complications (such as a significant drop in hemoglobin levels,excessive drainage, and hematoma/ecchymosis).Demographic data, previous surgical history, and preoperative and perioperative laboratory data were collected from the electronic medical records.Univariate and multivariate linear regression analyses were performed to identify risk factors associated with intraoperative blood loss, and multivariate logistic regression analysis was conducted to determine independent predictors of postoperative bleeding complications.
Results
The incidence of postoperative hemorrhagic complications (hemoglobin decline, increased drainage volume, hematoma/ecchymosis)following recurrent inguinal hernia repair was 28.1% (16/57).Multivariate linear regression revealed that intraoperative blood loss was significantly associated with body mass index(BMI) (β=5.072, P=0.020), and the consistency of surgical approach between initial and secondary procedures (β=-25.301, P=0.035).Multivariate logistic regression identified perioperative antithrombotic drug use as an independent risk factor for postoperative bleeding (OR=12.120, P=0.005), while intraoperative drainage tube placement served as a protective factor (OR=0.139, P=0.008).
Conclusion
Intraoperative bleeding risk in recurrent inguinal hernia repair is significantly influenced by the secondary surgical approach and BMI.Perioperative antithrombotic drug use and drainage tube placement are critical factors affecting postoperative hematoma complications.
To investigate the anatomical exposure advantages, safety, and functional prognosis of the right main working port combined with short gastric vessels (SGV) disconnection technique in laparoscopic Nissen fundoplication.
Methods
Retrospective analysis was conducted in 28 patients with gastroesophageal reflux disease (GERD) or hiatal hernia (HH) who underwent laparoscopic Nissen fundoplication at Chengdu Third People's Hospital from April 2020 to June 2023.The surgeon stood on the right side of the patient, using a five-port technique.By retracting the posterior gastric wall and vertically aligning the SGV with the splenic upper pole vessels, precise SGV disconnection was achieved.Perioperative indicators (operative time, blood loss, complications) and postoperative functional recovery (reflux control, dysphagia, GERD-HRQL questionnaire scores) were evaluated.
Results
All 28 patients successfully completed the procedure.The mean total operative time was (123.89±23.48) min,with mean SGV disconnection time of (11.14±3.51) min, and median intraoperative blood loss of 5 (5, 10)ml.No splenic injury, gastric perforation, or conversion to open surgery occurred.No postoperative dysphagia for full liquids occurred 3 day after surgery.GERD-HRQL questionnaire scores at 3 months after surgery significantly decreased compared to preoperative scores [(6.68±0.82) vs.(11.07±2.62),P<0.001].Overweight/obese patients (BMI ≥25 kg/m2) showed no significant differences in operative time or blood loss compared to non-overweight patients [(119.28±4.55) min vs.(132.2±9.11) min,P=0.226; (10.00±5.27) ml vs.(7.78±4.61) ml, P=0.256].
Conclusion
The right main working port combined with SGV disconnection optimizes anatomical exposure, reduces splenic injury risk, and achieves favorable reflux control, particularly in obese patients and complex hiatal hernia cases.However,multicenter randomized controlled trials are warranted to validate its long-term efficacy.
To analyze the factors associated with surgery-related bleeding in day surgery for inguinal hernia patients and evaluate the impact of bleeding on the safety of day surgery.
Methods
A retrospective analysis was conducted on clinical data of 1,328 patients who underwent day surgery for inguinal hernia in The First Affiliated Hospital of Chongqing Medical University between January 2023 and January 2025.The correlations between surgery-related bleeding and factors such as baseline characteristics, surgical approach, chronic medical history, presence of scrotal hernia, history of preperitoneal surgery, recurrent hernia, surgical site, and preoperative use of anticoagulants or antiplatelet medications were analyzed.Chi-square tests were used to screen for bleeding-related risk factors, followed by logistic regression analysis to identify independent risk factors.
Results
Among the 1,328 patients undergoing inguinal hernia day surgery, postoperative bleeding occurred in 40 cases (3.012%).Three patients required conversion from laparoscopy to open surgery to achieve hemostasis, with intraoperative findings revealing bleeding from the distal spermatic artery in scrotal hernia cases.The remaining patients were successfully managed conservatively without blood transfusions or reoperation.Both Chi-square tests and logistic regression analyses indicated that scrotal hernia, history of preperitoneal surgery, recurrent hernia, and preoperative use of antiplatelet medications were significantly associated with surgery-related bleeding(P<0.001).The OR values (95% CI) were 6.20 (2.73-14.08), 19.77 (6.81-57.42), 10.35 (4.13-25.97), and 8.56 (3.63-20.20), respectively.
Conclusion
Scrotal hernia, history of preperitoneal surgery, recurrent hernia, and preoperative use of antiplatelet medications are independent risk factors for bleeding in day surgery for inguinal hernia.These factors may delay patient discharge but rarely lead to severe complications when strict clinical protocols are followed.Preoperative reasonable adjustment of antiplatelet regimens, and selection of appropriate, individualized surgical approaches are critical to ensuring the safety of day surgery for inguinal hernia patients.
To evaluate the clinical efficacy of the component separation technique(CST) combined with complete extraperitoneal bridged mesh repair in the treatment of giant abdominal incisional hernia in adults, and to summarize the surgical procedure and technical details.
Methods
From January 2016 to June 2021, the clinical data of 36 patients with huge incisional hernia who were treated with CST combined with complete extraperitoneal bridging repair surgery in the Department of Hernia and Abdominal Wall Surgery, Wuhan Central Hospital, Tongji Medical College, Huazhong University of Science and Technology were retrospectively analyzed.The patients were followed up postoperatively.
Results
There were 36 patients in the research group, including 15 males and 21 females, aged 43-78 years, 8 cases of incisional hernia in the upper abdominal wall and 28 cases of incisional hernia in the lower abdominal wall; the average diameter of the hernia ring was (15.28±2.04) cm.All patients'operations were successfully completed.They resumed a liquid diet 12 hours after the operation, and got out of bed 24 hours after the operation.The postoperative defecation time of patients was 2-8 days, with an average of (3.8±1.7) days.3 patients had obvious abdominal distension symptoms in the early postoperative period, and symptomatic treatment was required with relief after 2 to 4 days.All patients complained of pain in the abdominal wall in the operation area within 48 hours after the operation.The visual analogue scale of pain (1-5 points) at 3 days after operation, with an average score of 2.6 points, 11 patients needed analgesics for adjuvant treatment for 2 to 10 days, with an average of (4.6±1.3) days.The postoperative hospital stay was 5 to 11 days, with an average of (6.8±1.6) days.The abdominal CT was reviewed 3 days after the operation and the abdominal cavity and wound drainage tube were removed.There was no obvious local hematoma that occurred, and the drainage volume in 72 hours was 200-710 ml,with an average of (260±30) ml.No local wound infection occurred in all patients at 7 d after operation,and 4 cases of fat liquefaction occurred.The postoperative follow-up period was 12 to 48 months.All patients were followed up, and there were no complications such as intestinal obstruction, delayed mesh infection, chronic pain, mesh bulge and recurrence of incisional hernia.
Conclusion
The CST combined with complete extraperitoneal bridged repair is a safe and effective surgical approach for treating giant abdominal incisional hernia in adults, and offers distinct advantages.
To explore the clinical efficacy of self-gripping mesh in laparoscopic transabdominal preperitoneal hernia repair (TAPP) versus Lichtenstein hernia repair.
Methods
This study used a prospective randomized controlled clinical trial, a total of 130 male patients with unilateral primary inguinal hernia who were admitted to the Department of Gastrointestinal Surgery of the Second Hospital of Jilin University from March 2022 to June 2023 were selected as the research objects, and they were divided into the TAPP group and the Lichtenstein group by random number table method.The TAPP group underwent laparoscopic TAPP repair, and the Lichtenstein group underwent Lichtenstein hernia repair.Both groups used self-gripping meshes.The operation time, postoperative time out of bed, postoperative hospital stay, hospital costs and postoperative complications were compared between the two groups.
Results
Of the 130 patients, 126 patients (63 each in the TAPP and Lichtenstein groups) completed follow-up.The average postoperative time out of bed for the TAPP group was earlier than that in the Lichtenstein group (P<0.001), and the early postoperative pain in patients in the TAPP group was less than that in the Lichtenstein group on postoperative 1 day (P<0.001), 1 week (P<0.001) and 1 month (z=-2.320,P=0.02).However, the average operation time for the TAPP group was longer than that in the Lichtenstein group, and the average hospital costs was more than that in the Lichtenstein group (P<0.001).There was no significant difference in postoperative complications such as seroma, incision infection, local foreign body sensation, chronic pain and recurrence between the two groups (P>0.05).
Conclusion
Self-gripping mesh is safe and reliable in both TAPP and Lichtenstein hernia repair.Each procedure has its own indications,advantages and disadvantages, so we should choose the appropriate surgical method for individualized treatment according to the specific conditions of the patient.
To evaluate the safety and efficacy of a composite chemical medical adhesive for mesh fixation in transabdominal preperitoneal herniorrhaphy (TAPP).
Methods
This study was a prospective, equivalent, randomized controlled trial, which included a total of 108 patients with inguinal hernia who received TAPP between January 2023 and July 2023 in the Department of Hernia and Abdominal Wall Surgery, Beijing Chaoyang Hospital, Capital Medical University.There were 52 cases in the experimental group and 56 cases in the control group.During the mesh fixation session, a domestic composite chemical medical adhesive was used in the experimental group, while another domestic single component chemical medical adhesive was used in the control group.The general clinical data, pre- and post-operative clinical parameters, the number of cases of postoperative complications, and hospitalization costs of the two groups were recorded and statistically analyzed.
Results
All 108 cases of TAPP were successfully completed.During 12-18 months postoperative follow-up, there was no recurrence, no wound healing disorder, no mesh infection, no fever, no allergy, and no chronic postoperative pain in both groups.There were 8 cases of postoperative seroma in the inguinal area in the experimental group and 4 cases in the control group, all of which were type I seromas, and the difference between the two groups was not statistically significant (P=0.173).There were 3 cases in the experimental group who still felt discomfort in the inguinal area more than 6 months after surgery and 2 cases in the control group, with no statistical significant difference between the two groups (P=0.587).There was no scrotal hematoma in the experimental group, and one scrotal hematoma in the control group, and the difference between the two groups was not statistically significant (P=0.333).The median hospitalization cost was ¥10,937.1 in the experimental group and ¥11,443.2 in the control group, with no statistical significant difference between the two groups (P=0.127).
Conclusion
The application of the domestic composite chemical medical adhesive in TAPP operation for mesh fixation is safe and effective.
This research aims to evaluate the safety and effectiveness of totally endoscopic sublay repair (TES) in comparison to laparoscopic intraperitoneal onlay mesh repair (IPOM)for individuals with small to medium ventral hernias, while also investigating the socio-economic benefits,enhancements in postoperative quality of life, and patient satisfaction associated with TES.
Methods
A retrospective cohort study was conducted on 88 patients who underwent ventral hernia repair at Shaoxing Central Hospital between May 2019 and November 2023, including 39 patients treated with IPOM and 49 with TES.Patients were divided into an IPOM group and a TES group based on the type of surgery they underwent.The general baseline characteristics, such as age, gender, body mass index, surgical time,postoperative pain, hospitalization costs, and discharge satisfaction scores were compared between the two groups.Postoperative quality of life was assessed through outpatient or telephone follow-ups.
Results
There were no significant disparities in the baseline characteristics between the groups (P>0.05).The The surgery time for the TES group (207.17±40.13 minutes) was significantly longer than that for the IPOM group(165.74±36.98 minutes, P<0.05), but the visual analog scores for pain on the first day (3.26±1.13 vs 4.38±1.25, P<0.001) and the second day (2.78±0.86 vs 3.67±0.96, P<0.001) post-operation were lower.Additionally, the hospitalization costs were significantly reduced (14,300±3,600 yuan vs 36,600±9,400 yuan, P<0.001), and the total postoperative drainage volume was less (126.57±65.84 ml vs 234.98±125.68 ml, P<0.001).The incidence of complications was lower in the TES group compared to the IPOM group,with a statistically significant difference (6/49 vs 12/39, P=0.032).Six-month postoperative follow-up showed that patients in the TES group had better overall quality of life (2.51±0.41 vs 2.69±0.43, P<0.05)and overall satisfaction at 15 days (4.17±0.58 vs 3.85±0.75, P<0.05) compared to the IPOM group, with statistically significant differences.The average follow-up time was 18 months, with 1 case of delayed intestinal fistula and 2 cases of chronic pain in the TES group; There were 5 cases of chronic pain and no delayed intestinal fistula in the IPOM group.
Conclusion
TES and IPOM have comparable safety and efficacy.Although TES has a longer surgical time, it shows advantages in postoperative quality of life,patient satisfaction, and economic benefits.
To evaluate the efficacy and feasibility of laparoscopic surgery for the repair of incisional hernias following liver transplantation.
Methods
The clinical data of 30 patients with incisional hernia following liver transplantation who underwent laparoscopic incisional hernia repair in Beijing Chaoyang Hospital, Capital Medical University from January 2020 to January 2022 were retrospectively analyzed.The general condition, operation condition and hospitalization time of the patients were analyzed, and the postoperative recurrence, postoperative pain, intestinal obstruction, intestinal fistula, wound infection, mesh infection, hematoma and seroma, postoperative satisfaction rate were followed up and recorded.
Results
The 30 patients, aged between 43 and 70 years, had a hospital stay ranging from 6 to 10 days.All surgeries were performed using laparoscopic techniques, with operation times between 50 and 80 minutes.Follow-up was conducted at 3 days, 7 days, 1 month, 3 months, 6 months, 1 year, and 2 years, with no cases lost to follow-up.During the follow-up period, there were no incidences of hernia recurrence, chronic pain, bowel obstruction, intestinal fistula, wound infection, mesh infection, hematoma, or seroma.The postoperative satisfaction rate was 100%.
Conclusion
Laparoscopic surgery is a reliable and feasible approach for the repair of incisional hernias following liver transplantation,with promising results that support its further clinical application.
To compare the clinical efficacy and safety of laparoscopic transabdominal preperitoneal hernia repair (TAPP) and open Lichtenstein tension-free hernioplasty in elderly patients with inguinal hernia.
Methods
A retrospective analysis was conducted on the clinical data of 234 elderly patients with inguinal hernia who underwent surgical treatment at Shijingshan Hospital in Beijing between September 2020 and September 2023.Patients were divided into two groups based on the surgical approach 120 patients received TAPP (TAPP group), and 114 patients underwent Lichtenstein repair (Lichtenstein group).The two groups were compared in terms of operative time, intraoperative blood loss, and postoperative pain assessed by the visual analog scale (VAS) at 1 week and 1 month after surgery.Postoperative complications and recurrence rates within a 12-month follow-up period were also recorded and analyzed.
Results
There were no statistically significant differences between the two groups in operative time or 12-month recurrence rates (P>0.05).However, the TAPP group showed significantly lower postoperative pain scores and a lower incidence of surgical complications compared to the Lichtenstein group (P<0.05).
Conclusion
Compared with the Lichtenstein technique, TAPP offers comparable outcomes in terms of operative time and recurrence rate, while providing significant advantages in reducing postoperative pain and complications.When selecting the surgical approach, factors such as the surgeon's proficiency in laparoscopic techniques, clinical experience, and patient preference should be comprehensively considered to determine the most appropriate method.
To evaluate the effects of intravenous versus intranasal administration of dexmedetomidine on postoperative cognitive function and agitation in elderly patients undergoing elective laparoscopic tension-free inguinal hernia repair under general anesthesia, and to compare the clinical outcomes of the two administration methods.
Methods
This prospective study included 440 elderly patients scheduled for elective laparoscopic inguinal hernia repair under general anesthesia at Beijing Chaoyang Hospital from February to December 2024.Patients were randomly assigned, using a computer-generated randomization method, to either the intravenous group (IV group, n=220) or the intranasal group (NA group, n=220).The IV group received 0.5 μg/kg dexmedetomidine via intravenous injection before anesthesia, while the NA group received 2 μg/kg intranasal dexmedetomidine.Postoperative cognitive function, agitation, adverse events, and anesthesia recovery time were compared between the two groups.
Results
At 5, 15, and 30 minutes after awakening, Ramsay sedation scores were significantly lower in the IV group compared to the NA group (P<0.01).No significant difference in preoperative cognitive impairment rates was observed between the groups (P>0.05).However, the incidence of cognitive dysfunction on postoperative day 1 and day 3 was significantly lower in the IV group than in the NA group (P<0.001).There was no significant difference in anesthesia recovery time between the IV and NA groups [(15.2±3.6) min vs (16.2±4.1) min, P>0.05].Additionally, no significant differences were observed between the groups in the incidence of adverse events such as hypotension,bradycardia, or nausea and vomiting (P>0.05).
Conclusion
Intravenous administration of dexmedetomidine is superior to intranasal administration in protecting postoperative cognitive function and reducing agitation in elderly patients undergoing hernia repair, with comparable effects on anesthesia recovery time and adverse event profiles.Intravenous dexmedetomidine may thus be a more effective option in postoperative management, particularly for cognitive protection in elderly patients.
To study the effect of general anesthesia with S(+)-ketamine and sufentanil on intraoperative hemodynamics and postoperative spontaneous recovery in children undergoing laparoscopic high ligation of hernia sac.
Methods
A total of 88 children who underwent laparoscopic high ligation of hernia sac in Linquan County People's Hospital from February 2022 to May 2023 were selected and divided into observation group and control group with 44 cases in each group by the random number table method.Both groups underwent laparoscopic high ligation of hernia sac under intravenous-inhalation general anesthesia.The anesthesia induction regimen in the observation group was cis-atracurium (0.05 mg/kg),propofol (3 mg/kg), S(+)-ketamine (0.5 mg/kg) and anisodamine (0.1 mg/kg) intravenous drip, while the control group was changed from S(+)-ketamine to sufentanil (0.2 μg/kg) intravenous drip, and sevoflurane was used to maintain anesthesia in both groups.Perioperative indicators, hemodynamics, the Chinese version face, legs, activity, cry, consolability behavioral tool scale score, postoperative recovery quality and adverse reactions were compared between the two groups.
Results
The heart rate (HR) immediately after tracheal intubation (T2) was significantly increased in both groups (P<0.05), and the mean arterial pressure (MAP)from T2 to immediately after the end of surgery (T5) was significantly increased (P<0.05).HR at T2 in observation group was lower than that in control group, and MAP at T2-T5 was lower than that in control group, the difference was statistically significant (P<0.05).The proportion of remedial analgesia at 24 hours after surgery was lower in observation group than that in control group, the difference was statistically significant (P<0.05).The postoperative spontaneous breathing recovery time, anesthesia recovery time and incidence rate of recovery agitation in observation group were lower compared with those in control group,the differences were statistically significant (P<0.05).There were no statistically significant differences in the incidence rates of adverse reactions such as bradycardia, hypotension and nausea and vomiting between the two groups (P>0.05).
Conclusion
The application of S(+)-ketamine for general anesthesia in children undergoing laparoscopic high ligation of hernia sac is beneficial to maintaining perioperative hemodynamic stability, enhancing postoperative analgesia effect, shortening anesthesia recovery time and reducing the risk of recovery agitation.
To analyze the reasons for same-day cancellations of day surgeries and explore the optimized management plans and intervention measures to reduce the day surgery cancellation rate.
Methods
A retrospective study was conducted on cases of same-day cancellations of day surgery in the Day Surgery Center of Taiyuan Central Hospital from January 2022 to December 2024.The cancellation rates and reasons before and after the implementation of refined preoperative management were analyzed.
Results
After the implementation of refined preoperative management, the same-day cancellation rate decreased from 5.34% to 2.87%, with statistically significant difference (P=0.002).Notably, the cancellation rate for hernia surgeries significantly improved, dropping to 2.04%, with statistically significant difference (P<0.05).Analysis of the reasons for cancellations revealed that, prior to refined management, patient-related factors accounted for 42.09%, followed by disease-related factors for 31.58%,and medical team-related factors for 26.32%.After the implementation of refined management, diseaserelated factors became the primary reason for cancellations for 37.50%, followed by patient-related factors for 37.50%, and medical team-related factors for 25.00%, with statistically significant differences (P<0.05).
Conclusion
Emphasizing preoperative management, improving surgical management systems, optimizing implementation processes, enhancing the professional skills of medical staff, strengthening doctor-patient communication, and improving patient health education can effectively reduce the same-day cancellation rate of day surgeries.These measures are highly beneficial for improving overall medical quality.
To investigate the effects of personalized nursing interventions on patients with post-cholecystectomy incisional hernia.
Methods
80 patients who underwent cholecystectomy and required hernia repair surgery for postoperative incisional hernia from the Third Hospital of Hebei Medical University, Dachang Hui Autonomous County People's Hospital of Hebei Province from 2019 to 2022,According to different nursing methods, they were divided into a control group and an observation group,with 40 cases in each group.The control group received routine nursing care, while the observation group received personalized nursing care.The time to hospital stay, first anal exhaust time, postoperative pain intensity, incidence of postoperative complications, quality of life, and nursing satisfaction were compared and analyzed between the two groups.
Results
The time to hospital stay, first anal exhaust time,postoperative pain scores, and incidence of postoperative complications in the observation group were significantly lower than those in the control group, and the differences were statistically significant(P<0.05).The quality of life and nursing satisfaction in the observation group were higher than those in the control group, and the differences were statistically significant (P<0.05).
Conclusion
Personalized rehabilitation nursing methods can effectively improve the rehabilitation process and quality of life of patients who undergo hernia repair for post-cholecystectomy incisional hernia.The application of personalized rehabilitation nursing strategies allows for individualized interventions based on the specific conditions of patients, thereby improving rehabilitation outcomes and patient satisfaction.Moreover, the results of this study provide experience and guidance for related clinical practice and serve as a reference for the rehabilitation nursing of similar patients.
This paper reports the nursing experience of a patient with congenital scoliosis and incisional hernia with abdominal wall defect.The patient had abdominal hypertension, cardiopulmonary compression, and difficulty in extubation of ventilators.The key points of nursing included predictive nursing care based on the concept of risk warning (respiratory function management, tracheal intubation nursing, prevention of abdominal compartment syndrome, prevention of deep venous thrombosis,prevention of pressure injury, implementation of progressive enteral nutrition, psychological nursing).After 46 days of careful treatment and nursing, the patient recovered well and was discharged from the hospital.Predictive nursing based on the concept of risk warning is beneficial to reducing the occurrence of postoperative complications and promoting the recovery of patients.
To evaluate the clinical efficacy of minimally invasive laparoscopy and traditional open component separation technique (CST) in the treatment of adult (≥18 years of age)abdominal wall hernia.
Methods
PubMed, Medline, Embase, Cochrane Library, Web of Science, VIP information Chinese periodical database, CBM, CNKI and Wanfang Med Online were searched from the establishment of the database to August 1, 2023, and the language of literature was not limited.All controlled clinical trials comparing minimally invasive laparoscopic with traditional open CST for abdominal wall hernia in adults were collected.The data were extracted and cross-checked by two reviewers independently according to the pre-established inclusion criteria.The statistical analysis was performed using RevMan5.4 software provided by the Cochrane website.
Results
A total of 12 articles involving 754 patients were included in this study.Meta-analysis results showed that the minimally invasive laparoscopic CST group was better than the traditional open CST group in terms of postoperative recurrence rate (OR=0.59, 95% CI 0.38-0.92, P=0.02), postoperative complication rate (OR=0.19, 95% CI 0.10-0.34, P<0.000 01), intraoperative blood loss (MD=-45.81, 95% CI -61.56--30.06, P<0.000 01) and postoperative hospital stay (MD=-2.15, 95% CI -3.63--0.67, P=0.004), the differences were statistically significant.However, the operation time of the minimally invasive laparoscopic CST group was longer than that of the traditional open CST group (MD=16.13, 95% CI 2.77-29.48, P=0.02), the difference was statistically significant.
Conclusion
Compared with traditional open CST, minimally invasive laparoscopic CST has advantages in postoperative recurrence rate, postoperative complications, intraoperative blood loss and postoperative hospital stay, but its operation time is slightly longer.
