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Comparison of modified gunsight suture technique and traditional interrupted suture in enterostomy closure

World Journal of Gastroenterology 2023年第29期29卷 4571-4579页

作者： Chang Chen Xiang Zhang Zhi-Qiang Cheng Bin-Bin Zhang Xin Li Ke-Xin Wang Yong Dai Yan-Lei Wang Department of Colorectal Surgery Qilu HospitalShandong UniversityJinan 250012Shandong ProvinceChina Department of Nursing Qilu Hospital of Shandong University De Zhou HospitalDezhou 254300Shandong ProvinceChin Department of General Surgery Huantai Branch of Qilu Hospital of Shandong UniversityZibo 255000Shandong ProvinceChina

BACKGROUND Prophylactic enterostomy surgery is a common surgical approach used to reduce the risk of anastomotic leakage in patients who have undergone partial intestinal resection due to trauma or tumors.However,the traditional interrupted suturing technique used in enterostomy closure surgery has several issues,including longer surgical incisions and higher incision tension,which can increase the risk of postoperative complications.To address these issues,scholars have proposed the use of a“gunsight suture”technique.This technique involves using a gunsight incision instead of a traditional linear incision,leaving a gap in the center for the drainage of blood and fluid to reduce the risk of infection.Building on this technique,we propose an improved gunsight suture technique.A drainage tube is placed at the lowest point of the incision and close the gap in the center of the gunsight suture,which theoretically facilitates early postoperative mobility and reduces the burden of dressing changes,thereby reducing the risk of postoperative complications.AIM To compare the effectiveness of improved gunsight suture technique with traditional interrupted suture in closing intestinal stomas.METHODS In this study,a retrospective,single-center case analysis was conducted on 270 patients who underwent prophylactic ileostomy closure surgery at the Department of Colorectal Surgery of Qilu Hospital from April 2017 to December 2021.The patients were divided into two groups:135 patients received sutures using the improved gunsight method,while the remaining 135 patients were sutured with the traditional interrupted suture method.We collected data on a variety of parameters,such as operation time,postoperative pain score,body temperature,length of hospital stays,laboratory indicators,incidence of incisional complications,number of wound dressing changes,and hospitalization costs.Non-parametric tests and chi-square tests were utilized for data analysis.RESULTS There were no statistically significant differences in general patient i

关键词： Enterostomy Abdominal wound closure technique suture techniques Surgical wound infection Hospital costs Hospital stay

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Application of purse-string suture for management of duodenal stump in radical gastrectomy

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Chinese Medical Journal 2011年第7期124卷 1018-1021页

作者： SHAO Qin-shu WANG Yong-xiang YE Zai-yuan ZHAO Zhong-kuo XU Ji Department of General Surgery Zhejiang Province People'sHospital Hangzhou Zhejiang 310014 China

Background Gastric cancer （GC） is the second leading cause currently the only possible curative approach. Duodenal stump gastrectomy, and optimal treatment is still lacking. of cancer mortality worldwide, and surgical resection is leakage is the most serious complication after radical Methods We retrospectively reviewed 2034 cases of total or subtotal gastrectomy for GC from January 1995 to December 2009, including 465 cases of duodenal stump closure using purse-string suture （group A）, 835 cases of duodenal stump treated with linear cutting stapler and seromuscular layer suture （group B）, and 734 cases of duodenal stump closure using full-thickness and seromuscular layer suture （group C）. We evaluated the surgical cost, operative time for duodenal stump closure, short-term postoperative complications, perioperative blood loss, and postoperative recovery.

关键词： gastrectomy gastric cancer complications suture techniques

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Vocal cord mucosal flap for the treatment of acquired anterior laryngeal web

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Chinese Medical Journal 2014年第7期127卷 1294-1297页

作者： Xiao Yang Wang Jun Han Demin Ma Lijing Ye Jingying Xu Wen Department of Otolaryngology Head and Neck Surgery Beijing Tongren Hospital Capital Medical University Beijing 100730 China

Background Anterior glottic web is one type of laryngeal stenosis.Previous surgical methods had some drawbacks,such as large surgical trauma,long postoperative recovery time,and multiple-stage surgery.This study aimed to explore better treatment to repair anterior glottis web.Methods We performed vocal cord mucosal flap procedure on 32 patients with anterior laryngeal webs.All subjects received vocal cord scar releasing and vocal cord mucosal flap repair and suture under general anesthesia with selfretaining laryngoscope.Results All 32 patients completed surgery in one stage,without postoperative laryngeal edema,difficulty in breathing,or other complications.After the surgery,the anterior commissure of vocal cords recovered to a decent triangle shape in 28 patients; however,in four patients there were 2 to 3 mm adhesion residuals on the anterior ends of the vocal cords,accompanied by scar appearance of bilateral vocal cords.The GRB score,voice handicap index scores,and maximum phonation time score significantly improved in all patients after the surgery.There was no evidence of recurrent laryngeal webbing in the 6-rnonth follow-up.Conclusion Vocal cords mucosal flap repair surgery has the advantages of less trauma,quick recovery,and significant improvement of the voice in the treatment of laryngeal webs.

关键词： vocal cords microsurgery suture techniques glottic web

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A novel method of defective vascular reconstruction using 2-octyl-cyanoacrylate and homemade prosthetic component

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Chinese Medical Journal 2014年第5期127卷 882-886页

作者： Liang Xiangdang Cai Hongfei Sun Geng Liu Zihao Chen Wen Tang Peifu Department of Orthopedics Chinese People&#39 s Liberation Army General Hospital Beijing 100853 China

Background Currently,adhesive technique is popular in vascular repair but not widely used for defective vessels.This study aimed to determine the feasibility and effectiveness of repairing defective vessels with 2-octyl-cyanoacrylate and a homemade prosthetic component.Methods Homemade prosthetic component consisting of expanded polytetrofluoroethylene （ePTFE）,terylene film,and homemade soluble hollow stent mixed with adhesive can replace autologous graft and suture in repairing defective vessels,can fix vessels better using the stent without occlusive bleeding.Forty male mongrel dogs were used,20 for biomechanical tests and 20 for animal experiments.In the biomechanical test,dogs were randomly divided into two groups （n=10 each）,one group repaired on the two sides of the carotid arteries with 2-octyl-cyanoacrylate and homemade component and another group repaired with suture and ePTFE.Of the 40 specimens,10 were used for adhesive and 10 for suture specimens for tension strength test,whereas the remaining specimens were used for bursting pressure test.In animal experiments,dogs were also divided into adhesive and suture groups （n=10）,only of the left carotid artery.Recording the operational time,bleeding or not.Vessels were tested using color Doppler ultrasound,the inner diameter was measured,and the degree of stenosis at 8 weeks was evaluated digital subtraction angiography （DSA） were also performed.Specimens were then analyzed histologically.Results In the adhesive and suture groups,the specimens could afford atension strength of （23.80±1.51） N versus （24.60±1.08） N （P ＞0.05）,the bursting pressure was （52.03±.2.43） kPa versus （50.04±3.51） kPa （P ＞0.05）,and the mean time of anastomosis was （15.20±0.55） minutes versus （25.97±0.58） minutes （P ＜0.05）.One dog in the adhesive group was bleeding from the suture.One dog from each group presented with thrombosis at 1 week.After measuring using ultrasound,the stenosis degree of all dogs were no more than 30％ except the two thromboses.DSA and histological observation show

关键词： arteries injury cyanoacrylate prosthetic component suture techniques

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Rhinoplasty in Chinese： management of lower dorsum and bulbous nasal tip

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Chinese Medical Journal 2009年第3期122卷 296-300页

作者： WANG Tai-ling XUE Zhi-qiang YU Da-shan ZHANG Hai-ming TANG Xiao-jun WANG Jia-qi YANG Xin LUO Jia-lin MA Ji-guang Department 6 Plastic Surgery Hospital of Chinese Academy of Medical Sciences & Peking Union Medical College Beijing 100144 China Department 7 Plastic Surgery Hospital of Chinese Academy of Medical Sciences & Peking Union Medical College Beijing 100144 China Department 3 Plastic Surgery Hospital of Chinese Academy of Medical Sciences & Peking Union Medical College Beijing 100144 China Ping An Clinic Plastic Surgery Hospital of Chinese Academy of Medical Sciences & Peking Union Medical College Beijing 100144 China Laser Department Plastic Surgery Hospital of Chinese Academy of Medical Sciences & Peking Union Medical College Beijing 100144 China Department of Plastic Surgery China-Japan Friendship HospitalBeijing 100029 China Ever Care Xingfu Hospital Beijing 100027 China

Background Bulbous nasal tips and lower dorsa are common facial features in Chinese people, and surgery to reshape these is frequently requested. The use of silicone implants in rhinoplasty has been widely used in China for many years, but is not suitable for patients seeking Caucasian tip shapes. The creation of an excessively high tip supported only by a silicone implant inevitably leads to implant extrusion. Although many rhinoplasty techniques have been used in Caucasian patients, there is currently no suitable method for Chinese patients, whose anatomy differs from that of Caucasians. The present study was aimed to investigate the clinical outcome of a novel method of rhinoplasty in Chinese people. Methods Eighty patients underwent rhinoplasty using our method between 2002 and 2006. We classified the patients into three types, according to the distance between tip defining points, and used different techniques accordingly. Furthermore, an innovative cartilage carving method and a tip fibro-fatty tissue flap were designed and combined with traditional techniques, such as insertion of silicone implant, cartilage grafts, suture techniques and cephalic trimming to reshape the nasal contours. The followup period was 10-60 months （average, 21 months）. Results Remarkable modifications in nasal contours were achieved. No complications developed in any of the 80 patients. Seventy-eight patients were satisfied with the results. The outcomes remained unchanged over time. Conclusion Our method is effective and suitable for the treatment of Chinese patients with lower dorsa and bulbous nasal tips.

关键词： rhinoplasty suture techniques grafts

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