| 1 | A totally mini-invasive approach for colorectal laparoscopic surgery显示文摘AIM:To study the short-term outcome of patients treated with laparoscopic right colectomy and how intracorporeal anastomosis has improved the outcome.METHODS:We retrospectively examined all patients affected by colorectal cancer who underwent a laparoscopic right colectomy between January 2006 and December 2010 in our department.Our evaluation criteria were:diagnosis of colorectal carcinoma at presurgical biopsy,elective surgery,and the same surgeon.We excluded:emergency surgery,conversions from laparotomic colectomy,and other surgeons.The endpoints we examined were:surgical time,number of lymph nodes removed,length of stay(removal of nasogastric tube,bowel movements,gas evacuation,solid and liquid feeding,hospitalization),and major complications.Seventy-two patients were divided into two groups:intracorporeal anastomosis(39 patients)and extracorporeal anastomosis(33 patients).RESULTS:Significant differences were observed between intracorporeal vs extracorporeal anastomosis,respectively,for surgical times(186.8 min vs 184.1 min,P < 0.001),time to resumption of gas evacuation(3 d vs 3.5 d,P < 0.001),days until resumption of bowel movements(3.8 d vs 4.9 d,P < 0.001),days until resumption of liquid diet(3.5 d vs 4.5 d,P < 0.001),days until resuming a solid diet(4.6 d vs 5.7 d,P < 0.001),and total hospitalization duration(7.4 d vs 8.5 d,P < 0.001).In the intracorporeal group,on average,19 positive lymph nodes were removed;in the extracorporeal group,on average,14 were removed P < 0.001).Thus,intracorporeal anastomosis for right laparoscopic colectomy improved patient outcome by providing faster recovery of nutrition,faster recovery of intestinal function,and shorter hospitalization than extracorporeal anastomosis.CONCLUSION:Short-term outcomes favor intracorporeal anastomosis,confirming that a less traumatic surgical approach improves patient outcome. | Gabriele Anania Mirco Santini Lucia Scagliarini Alice Marzetti Laura Vedana Serafino Marino Claudio Gregorio Giuseppe Resta Giorgio Cavallesco | 2012 | World Journal of Gastroenterology2012，18，29： | 8 |
| 2 | Cumulative sum analysis score and phacoemulsification competency learning curve显示文摘AIM: To use the cumulative sum analysis score(CUSUM) to construct objectively the learning curve of phacoemulsification competency.METHODS: Three second-year residents and an experienced consultant were monitored for a series of 70 phacoemulsification cases each and had their series analysed by CUSUM regarding posterior capsule rupture(PCR) and best-corrected visual acuity. The acceptable rate for PCR was <5%(lower limit h) and the unacceptable rate was >10%(upper limit h). The acceptable rate for bestcorrected visual acuity worse than 20/40 was <10%(lower limit h) and the unacceptable rate was >20%(upper limit h). The area between lower limit h and upper limit h is called the decision interval. RESULTS: There was no statistically significant difference in the mean age, sex or cataract grades between groups. The first trainee achieved PCR CUSUM competency at his 22 nd case. His best-corrected visual acuity CUSUM was in the decision interval from his third case and stayed there until the end, never reaching competency. The second trainee achieved PCR CUSUM competency at his 39 th case. He could reach best-corrected visual acuity CUSUM competency at his 22 nd case. The third trainee achieved PCR CUSUM competency at his 41 st case. He reached bestcorrected visual acuity CUSUM competency at his 14 th case.CONCLUSION: The learning curve of competency in phacoemulsification is constructed by CUSUM and in average took 38 cases for each trainee to achieve it. | Gustavo Vedana Filipe G.Cardoso Alexandre S.Marcon Licio E.K.Araújo Matheus Zanon Daniella C.Birriel Guilherme Watte Albert S.Jun | 2017 | International Journal of Ophthalmology(English edition)2017，10，7： | 3 |
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