AIM:To compare the analgesic properties and efficacy of transnasal butorphanol with intramuscular meperidine after anal surgery.METHODS: Sixty patients who underwent fistulectomy were enrolled in the study from Januar...AIM:To compare the analgesic properties and efficacy of transnasal butorphanol with intramuscular meperidine after anal surgery.METHODS: Sixty patients who underwent fistulectomy were enrolled in the study from January 2006 to December 2007. They were randomly divided into transnasal butorphanol (n=30) or intramuscular meperidine (n=30) treatment groups. Assessment of postoperative pain was made using a visual analogue scale (VAS). The VAS score was recorded 6 h after the completion of surgery, before receiving the first dose of analgesic, 60 min after analgesia and the next morning. Any adverse clinical effects such as somnolence, dizziness, nausea or vomiting were recorded. Satisfaction with narcotic efficacy, desire to use the particular analgesic in the future and any complaints were recorded by patients using questionnaires before being discharged.RESULTS: Forty-two men and eighteen women were included in the study. There were no significant differences in VAS scores between the groups within 24 h. Length of hospital stay and the incidence of adverse effects between the groups were similar. In addition, most patients were satisfied with butorphanol nasal spray and wished to receive this analgesic in the future, if needed.CONCLUSION: Butorphanol nasal spray is effective for the relief of pain after fistulectomy. However, it offered patients more convenient usage and would be suitable for outpatients.展开更多
AIM:To study potential predictive factors for early radical resection in two-stage resection for left malignant colonic obstruction.METHODS:Thirty-eight cases of left-sided obstructive colon cancer undergoing two-stag...AIM:To study potential predictive factors for early radical resection in two-stage resection for left malignant colonic obstruction.METHODS:Thirty-eight cases of left-sided obstructive colon cancer undergoing two-stage operations were reviewed between January 1998 and August 2008.Patients were classified into two groups(n = 19 each):early radical resection(interval ≤ 10 d) and late radical resection(interval > 10 d).Baseline demographics,post-diversion outcome,perioperative data,tumor characteristics,outcome and complications were analyzed.RESULTS:The baseline demographics revealed no differences except for less pre-diversion sepsis in the early group(P < 0.001) and more obstruction days in the late group(P = 0.009).The mean intervals of early and late radical resections were 7.9 ± 1.3 d and 17.8 ± 5.5 d,respectively(P < 0.001).After diversion,the presence of bowel sounds,flatus,removal of the nasogastric tube and the resumption of oral feeding occurred earlier in the early group.The operation time and duration of hospital stay were both significant reduced in the early group.Complication rates did not differ between groups.CONCLUSION:The earlier recovery of bowel function seems to be predictive of early radical resection.In contrast,pre-diversion sepsis and more obstruction days were predictive of delayed radical resection.展开更多
AIM:To investigate the comorbid disease could be the predictors for the elective colectomy in colonic diverticulitis.METHODS:A retrospective chart review of 246 patients with colonic diverticulitis admitted between 20...AIM:To investigate the comorbid disease could be the predictors for the elective colectomy in colonic diverticulitis.METHODS:A retrospective chart review of 246 patients with colonic diverticulitis admitted between 2000and 2008 was conducted,and 19 patients received emergent operation were identified and analyzed.Data were collected with regard to age,sex,albumin level on admission,left or right inflammation site,the history of recurrent diverticulitis,preoperative comorbidity,smoking habits,medication,treatment policy,morbidity,and mortality.Preoperative comorbid diseases included cardiovascular disease,diabetes,pulmonary disease,peptic ulcer disease,gouty arthritis,and uremia.Medications in use included non-steroidal anti-inflammatory drugs,acetylsalicylic acid(Aspirin),and corticosteroids.Univariate and multivariate logistic regression analyses were performed to identify the relevant risk factors correlating to colectomy.RESULTS:The mean age of the 246 patients was 69.5years(range,24-94 years).Most diverticulitis could be managed with conservative treatment(n=227,92.3%),and urgent colectomy was performed in 19patients(7.7%).There were three deaths in the surgical group and four deaths in the nonsurgical group.The overall mortality rate in the study was 1.7%among patients with conservative treatment and 15.7%among patients undergoing urgent colectomy.Multiple logistic regression analysis indicated that comorbidities were risk factors for urgent colectomy for diverticulitis.CONCLUSION:To avoid high mortality and morbidity related to urgent colectomy,we suggest that patients with colonic diverticulitis and comorbid diseases may require elective colectomy.展开更多
文摘AIM:To compare the analgesic properties and efficacy of transnasal butorphanol with intramuscular meperidine after anal surgery.METHODS: Sixty patients who underwent fistulectomy were enrolled in the study from January 2006 to December 2007. They were randomly divided into transnasal butorphanol (n=30) or intramuscular meperidine (n=30) treatment groups. Assessment of postoperative pain was made using a visual analogue scale (VAS). The VAS score was recorded 6 h after the completion of surgery, before receiving the first dose of analgesic, 60 min after analgesia and the next morning. Any adverse clinical effects such as somnolence, dizziness, nausea or vomiting were recorded. Satisfaction with narcotic efficacy, desire to use the particular analgesic in the future and any complaints were recorded by patients using questionnaires before being discharged.RESULTS: Forty-two men and eighteen women were included in the study. There were no significant differences in VAS scores between the groups within 24 h. Length of hospital stay and the incidence of adverse effects between the groups were similar. In addition, most patients were satisfied with butorphanol nasal spray and wished to receive this analgesic in the future, if needed.CONCLUSION: Butorphanol nasal spray is effective for the relief of pain after fistulectomy. However, it offered patients more convenient usage and would be suitable for outpatients.
文摘AIM:To study potential predictive factors for early radical resection in two-stage resection for left malignant colonic obstruction.METHODS:Thirty-eight cases of left-sided obstructive colon cancer undergoing two-stage operations were reviewed between January 1998 and August 2008.Patients were classified into two groups(n = 19 each):early radical resection(interval ≤ 10 d) and late radical resection(interval > 10 d).Baseline demographics,post-diversion outcome,perioperative data,tumor characteristics,outcome and complications were analyzed.RESULTS:The baseline demographics revealed no differences except for less pre-diversion sepsis in the early group(P < 0.001) and more obstruction days in the late group(P = 0.009).The mean intervals of early and late radical resections were 7.9 ± 1.3 d and 17.8 ± 5.5 d,respectively(P < 0.001).After diversion,the presence of bowel sounds,flatus,removal of the nasogastric tube and the resumption of oral feeding occurred earlier in the early group.The operation time and duration of hospital stay were both significant reduced in the early group.Complication rates did not differ between groups.CONCLUSION:The earlier recovery of bowel function seems to be predictive of early radical resection.In contrast,pre-diversion sepsis and more obstruction days were predictive of delayed radical resection.
文摘AIM:To investigate the comorbid disease could be the predictors for the elective colectomy in colonic diverticulitis.METHODS:A retrospective chart review of 246 patients with colonic diverticulitis admitted between 2000and 2008 was conducted,and 19 patients received emergent operation were identified and analyzed.Data were collected with regard to age,sex,albumin level on admission,left or right inflammation site,the history of recurrent diverticulitis,preoperative comorbidity,smoking habits,medication,treatment policy,morbidity,and mortality.Preoperative comorbid diseases included cardiovascular disease,diabetes,pulmonary disease,peptic ulcer disease,gouty arthritis,and uremia.Medications in use included non-steroidal anti-inflammatory drugs,acetylsalicylic acid(Aspirin),and corticosteroids.Univariate and multivariate logistic regression analyses were performed to identify the relevant risk factors correlating to colectomy.RESULTS:The mean age of the 246 patients was 69.5years(range,24-94 years).Most diverticulitis could be managed with conservative treatment(n=227,92.3%),and urgent colectomy was performed in 19patients(7.7%).There were three deaths in the surgical group and four deaths in the nonsurgical group.The overall mortality rate in the study was 1.7%among patients with conservative treatment and 15.7%among patients undergoing urgent colectomy.Multiple logistic regression analysis indicated that comorbidities were risk factors for urgent colectomy for diverticulitis.CONCLUSION:To avoid high mortality and morbidity related to urgent colectomy,we suggest that patients with colonic diverticulitis and comorbid diseases may require elective colectomy.
