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The emergence and application of surgical robots is a major breakthrough in contemporary minimally invasive surgery. Since Da Vinci surgical system was introduced into China, the number of operations has grown rapidly, especially in the past decade, its efficacy and safety have been widely recognized. In the field of gastrointestinal surgery, robots are the most widely used in gastric cancer surgery. Compared to traditional laparoscopic surgery, robot surgery has made significant progress in terms of technology, with more precise operations, convenient lymph node dissection, and narrow space operations. However, it also faces shortcomings such as long surgical time and high costs. This article aims to review the development of robotic gastrointestinal cancer surgery and systematically summarize its advantages and disadvantages, and propose prospects for future development trends.

Objective·To systematically evaluate the effect of prehabilitation on outcomes in patients undergoing elective gastrointestinal surgery.Methods·PubMed, EMbase, Cochrane Library, Web of Science, CINAHL, Chinese BioMedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), Wanfang and VIP Database were searched systematically from the establishment of each database to January 31, 2022. The literatures were screened, and evaluated according to the preset inclusion and exclusion criteria. The literature quality was evaluated and the data were extracted. Meta-analysis was performed on randomized controlled trials by using RevMan 5.4. The main observation indexes were the postoperative complication rate and the incidence of surgical site infection. The secondary indexes were hospitalization days, 6-minute walk test (6MWT), Hospital Anxiety and Depression Scale (HADS) score, mortality and compliance of prerehabilitation execution.Results·Sixteen articles were included, including 15 articles in English and 1 article in Chinese, with a total of 1 616 patients. The overall quality of the included researches was good. The meta-analysis results showed that compared with the control group, the incidences of postoperative complications and surgical site infection were reduced [(odds ratio, OR)=0.57, 95% (confidence interval, CI) 0.35‒0.94, P=0.030; OR=0.64, 95%CI 0.46‒0.90, P=0.009]; the length of hospital stay was shortened [mean difference (MD)=-2.45, 95%CI -3.17 ‒ -1.73, P=0.000] in the experimental group after the implementation of prehabilitation. There was no significant difference in preoperative 6MWT level between the two groups. Compared with the baseline, the change of 6MWT level before operation of the experimental group was bigger than that of the control group (MD=24.19, 95%CI 3.77‒44.60, P=0.020). There were no significant differences in the preoperative HADS score and the postoperative mortality between the two groups.Conclusion·Prehabilitation can reduce the incidence of postoperative complications, especially surgical site infection, in patients undergoing elective gastrointestinal surgery, thus shortening the length of hospital stay and promoting the recovery of patients.

Objective: To investigate the effects of hyperthermic intraperitoneal chemotherapy (HIPEC) combined with neoadjuvant intraperitoneal-systemic chemotherapy (NIPS) on cellular immune function, tumor markers and tumor invasion metastasis related indicators in patients with peritoneal metastasis of advanced gastric cancer. Methods: 116 patients with peritoneal metastasis of advanced gastric cancer who were hospitalized in the gastrointestinal surgery department of the First Affiliated Hospital of Xinjiang Medical University from June 2019 to January 2022 were selected, and they were divided into the observation group and the control group according to the random number table method, with 58 patients in each group. Patients in the control group received NIPS, and patients in the observation group received HIPEC combined with NIPS. The curative effect, survival rate and adverse reactions in the two groups were observed, and the changes of cellular immune function, tumor markers and tumor invasion metastasis related indicators in the two groups were compared. Results: The total clinical effective rate in the observation group (68.97%) was higher than (50.00%) in the control group (P<0.05). After treatment, the CD3*, CD4*, CD4*/CD8* in the two groups decreased, but the observation group was higher than the control group (P<0.05). CD8+ increased, but the observation group was lower than the control group (P<0.05). Carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA199) and carbohydrate antigen 125 (CA125) in the two groups after treatment decreased, but the observation group was lower than the control group (P<0.05). Endothelial growth factor (VEGF), matrix metalloproteinase-2 (MMP-2) and matrix metalloproteinase-9(MMP-9) decreased in the two groups after treatment decreased, but the observation group was lower than the control group (P<0.05). The 6-month, 9-month and 12-month survival rates in the observation group were higher than those in the control group (P<0.05). There was no difference in the incidence of adverse reactions in the two groups (P>0.05). Conclusion: HIPEC combined with NIPS can improve the cellular immune function of patients with peritoneal metastasis of advanced gastric cancer, regulate the level of tumor markers and tumor invasion and metastasis related indicators, and improve the survival rate. [ABSTRACT FROM AUTHOR]

To investigate the effects of dexmedetomidine combined with percutaneous acupoint electrical stimulation on gastrointestinal function and postoperative pain of patients after mixed hemorrhoid stripping. 60 patients who underwent mixed hemorrhoidectomy in our hospital from March 2022 to July 2022 were selected, and 60 patients were randomly divided into Matched group (30 cases) and observation group (30 cases). The Matched group was given dexmedetomidine analgesia, and the observation group were given preoperative percutaneous acupoint electrical stimulation, 2min before the operation to the end of the operation. The method and dose of dexmedetomidine were the same as Matched group. The pain scores of patients in two groups were compared before and after 0.5 h, 1 h, 2 h and 3 h, the postoperative pain efficacy of patients in two groups were compared, the wound healing time, the time of rotting flesh completely shedding, the length of hospital stay and the recovery of gastrointestinal function of the two groups were compared, and the levels of vasoactive intestinal peptide, motilin and gastrin in the two groups were compared before and after surgery. There were no difference in pain scores in two groups before and 3 h after surgery (P>0.05); after surgery for 0.5 h, 1 h and 2 h, the pain score of the observation group was lower than that of the matched group (P<0.05). The effective rate of postoperative pain in the observation group was higher than the matched group (P<0.05). Compared with Matched group, the wound healing time, carrion shedding time and hospital stay time of the observation group were lower (P<0.05). The recovery time of bowel sounds, incidence of postoperative nausea and vomiting and exhaust time in the observation group were shorter than those in the matched group (P<0.05). Before surgery, there was no difference in the levels of vasoactive intestinal peptide, motilin and gastrin in two groups (P>0.05). After surgery, the levels of vasoactive intestinal peptide and gastrin in both groups increased, while the levels of motilin decreased, and the range of change in observation group was lower than that in matched group (P<0.05). Dexmedetomidine combined with percutaneous acupoint electrical stimulation can improve gastrointestinal function and postoperative pain in patients with mixed hemorrhoid dissection. [ABSTRACT FROM AUTHOR]

To investigate the effect of postoperative acupoint application combined with enhanced recovery after surgery (ERAS) on the rehabilitation effect, gastrointestinal function and quality of life of patients undergoing laparoscopic hepatectomy. According to the two-color ball method, the patients with liver cancer who underwent laparoscopic hepatectomy (n=104) in our hospital from June 2019 to June 2021 were divided into control group (treated with ERAS) and study group (treated with postoperative acupoint application combined with ERAS), with 52 cases each. The postoperative rehabilitation effect, gastrointestinal function and quality of life were compared between the two groups. The hospital stay in the study group was shorter than that in the control group (P<0.05). The levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in the two groups at 7 d after operation increased, but the study group was lower than the control group (P<0.05). The exhaust time, bowel sound recovery time and defecation time in the study group were shorter than those in the control group (P<0.05). The level of Motilin (MTL) in the study group was higher than that in the control group at 3 d and 7 d after operation, and the level of Gastrin (GAS) was lower than that in the control group (P<0.05). The scores of overall health status and functional areas in the study group were higher than those in the control group, the scores of single test items and symptom areas in the study group at 1 month after operation were lower than those in the control group (P<0.05). ERAS combined with postoperative acupoint application for patients undergoing laparoscopic hepatectomy can improve the postoperative rehabilitation effect, promote the recovery of gastrointestinal function, and improve the quality of life of patients. [ABSTRACT FROM AUTHOR]

Objective To study the effect of somatostatin on postoperative gastrointestinal function and stress level in children with acute abdomen. Methods A total of 102 children with acute abdomen who underwent surgery in Xuzhou Children's Hospital from August 2019 to June 2021 were enrolled as subjects and were randomly divided into an observation group and a control group, with 51 children in each group. The children in the control group were given conventional treatment such as hemostasis and anti-infective therapy after surgery, and those in the observation group were given somatostatin in addition to conventional treatment. Peripheral blood samples were collected from both groups before surgery and on days 1 and 5 after surgery. The two groups were compared in terms of the serum levels of endothelin-1 (ET-1), adrenocorticotropic hormone (ACTH), cortisol, gastrin, and motilin, postoperative recovery, and the incidence rate of complications. Results There was no significant difference in the serum levels of ET-1, ACTH, cortisol, gastrin, and motilin between the two groups before surgery (P>0.05). Compared with the control group, the observation group had significantly lower serum levels of ET-1, ACTH, and cortisol on days 1 and 5 after surgery (P<0.05) and significantly higher levels of motilin and gastrin on day 5 after surgery (P<0.05). Compared with the control group, the observation group had significantly shorter time to first passage of flatus, first bowel sounds, and first defecation after surgery, as well as a significantly shorter length of hospital stay (P<0.05). The incidence rate of complications in the observation group was significantly lower than that in the control group (6% vs 24%, P<0.05). Conclusions In children with acute abdomen, somatostatin can significantly reduce postoperative stress response, improve gastrointestinal function, and reduce the incidence rate of complications, thereby helping to achieve a good prognosis. [ABSTRACT FROM AUTHOR]

Objective: To compare the efficacy of endoscopic submucosal dissection (ESD) and laparoscopic surgery (LAP) in the treatment of gastric stromal tumors (GIST) with diameter ≤ 5 cm and the effects on postoperative stress response and gastrointestinal hormones. Methods: The clinical data of 170 patients with GIST with diameter ≤ 5 cm who were treated in Linfen People's Hospital from January 2015 to March 2018 were analyzed retrospectively. According to different surgical methods, 83 patients undergoing LAP were included in group A, and 87 patients undergoing ESD were included in group B. The efficacy, perioperative indexes, postoperative stress response, gastrointestinal hormones levels and the incidence rate of complications were compared between the two groups. Results: Compared with group A, group B had less total hospitalization cost, less intraoperative bleeding, shorter first postoperative fluid intake time, postoperative hospitalization time, postoperative exhaust time and operation time(P<0.05). There was no significant difference in the complete tumor resection rate between the two groups (P>0.05). The levels of serum epinephrine (E) and norepinephrine (NE) at 3d after operation in two groups increased, but group B was lower than group A (P<0.05). The levels of serum gastrin (GAS) and motilin (MTL) at 3 d after operation in two groups decreased, but group B was higher than group A (P<0.05). There was no significant difference in the incidence rate of complications between the two groups (P>0.05). Conclusion: ESD and LAP are equally effective in treating GIST with diameter ≤ 5 cm. ESD has relatively less surgical trauma and faster postoperative recovery, which may be related to reducing stress response and reducing the impact on gastrointestinal hormones. [ABSTRACT FROM AUTHOR]

Objective: To investigate the diagnosis and treatment of acute mesenteric ischemia (AMI). Methods: Clinical data of36 patients with AMI were collected and analyzed retrospectively. All patients were treated with MDT, vascular surgery and gastrointestinal surgery. Surgical exploration was performed in all treated cases. Intraoperative fluorescence endoscopy was used to determineintestinal blood supply in 3 patients. The relevant data of abdominal CT, white blood cell count and D-dimer during the diagnosis andtreatment were counted, and the correlation between them and intestinal necrosis was analyzed by SPSS software. Results: The specificfeatures of abdominal CT and the increase of white blood cell count were correlated with intestinal necrosis. Among the treated patients,11 underwent intestinal resection and 8 underwent postoperative rehabilitation therapy in our hospital after surgical treatment in anotherhospital. Postoperative short bowel syndrome occurred in 8 cases. 1 patient was discharged automatically. One death occurred. Postoper-ative intestinal necrosis and intestinal fistula occurred in 1 patient. 3 months later, the patient underwent intestinal fistula resection, andthe postoperative recovery was good. Five patients underwent ostomy for retraction 6 months after operation. Fluorescent endoscopyshowed good results in determining intestinal blood supply and vitality. Conclusion: AMI is a dangerous disease, improving the under-standing of the disease, early diagnosis, early reconstruction of small intestinal blood circulation is the key to improve the efficacy andprognosis. Precision therapy after multidisciplinary discussion can improve the therapeutic effect. Preoperative abdominal CTA has im-portant significance for the diagnosis of AMI and the judgment of intestinal necrosis. Intraoperative use of indoliclegreen fluorescentimaging agent, coupled with fluorescence navigation endoscopy, to determine the extent of intestinal ischemia, it is worth further discus-sion. Double abdominal wall ostomy is conducive to timely detection of intestinal blood supply recovery, and distal ostomy can be usedfor early enteral nutrition, which is worthy of promotion. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To probe into the effects of different loading doses of dexmedetomidine on postoperative recovery of intestinal function in patients with gastrointestinal tumor. METHODS: Totally 108 patients undergoing gastrointestinal tumor surgery in this hospital from Feb. 2019 to Mar. 2021 were extracted to be divided into the group A, B and C via the random number table, with 36 patients in each group. In group A and B, 0. 5 µ.g/kg and 1. 0 µ.g/kg of dexmedetomidine were pumped intravenously 10 min before anesthesia induction, and 0. 5 µ.g/( kg · h ) of dexmedetomidine was infused continuously until 10 min before the end of skin suture. In group C, the same volume of 0. 9% sodium chloride injection was pumped intravenously. Three groups were given anesthesia induction and maintenance in the same way. The mean arterial pressure ( MAP ) and heart rate ( HR ) were recorded before dexmedetomidine pumping ( T0 ), after endotracheal intubation ( T1 ), at withdrawal of dexmedetomidine ( T2 ), immediately after extubation( T3 ), and 30 min after extubation ( T4 ) in three groups were recorded, the serum levels of cortisol ( Cor) and norepinephrine( NE) were detected after collecting the blood samples at the above time points, the time of exhaust and defecation was recorded, and the incidence of postoperative anesthesia related complications was observed. RESULTS: From T1 to T4, the MAP, HR, serum Cor and NE levels in group A and B were significantly lower than those in group C, and the MAP, HR, serum Cor and NE levels in group B were significantly lower than those in group A, with statistically significant differences( P < 0. 05). The time of exhaust and defecation in group A and B was significantly shorter than that in group C, and the time of exhaust and defecation in group B was significantly shorter than that in group A, with statistically significant differences( P

Objective: To investigate the effects of recombinant human epidermal growth factor (rhEGF) gel combined with Saifurun on pain scores and adverse reactions in patients with chronic wounds. A total of 108 patients with chronic wounds after gastrointestinal surgery, who were diagnosed and treated in Affiliated Hospital of Xiangnan University from March 2017 to September 2019, were chosen and were divided into combination group(n=54) and control group(n=54). The control group was given Saifurun treatment, and the combination group was given rhEGF gel treatment on the basis of the control group's therapy. The two groups were given continuous administration for 14 days, and the pain and adverse reactions were recorded. The pain VAS scores on the 3rd, 7th, and 14th days after treatment of the combination group were lower than those of the control group(P<0.05). The incidence (3.7 %) of skin necrosis, wound infection, fever and other adverse reactions during treatment in the combination group was lower than that (18.5 %) in the control group (P<0.05). The wound healing rates of the combination group on the 3rd, 7th, and 14th days were 83.3 %, 96.3 % and 100.0 %, which were higher than those (59.3 %, 83.3 % and 88.9 %) of the control group (P<0.05). The serum vascular endothelial growth factor (VEGF) levels after treatment in the two groups were higher than those before treatment (P<0.05), and the combination group was higher than the control group (P<0.05). The application of rhEGF gel combined with Saifurun in the patients with chronic wounds can promote pain relief scores, reduce the occurrence of adverse reactions, promote the expression of VEGF, and accelerate wound healing. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effect of ERAS and Dachengqi Granules on surgical stress in patients after gastrointestinal surgery. Methods: Eighty gastrointestinal surgery patients admitted to our hospital in the past 3 years were randomly divided into a research group and a control group, with 40 patients in each group. ERAS and Dachengqi granules were taken in the two groups, Traditional treatment methods and conventional Western medicine treatment combined with placebo, comparing the effects of different treatment methods on patients' surgical stress during the perioperative period. Results: There was no statistically significant difference in pre-operative psychological (HAMA) and physiological (CRP, epinephrine, cortisol) stress indicators between the two groups of patients (P>0.05). Seven days after surgery, all stress indicators of the study group were obvious Lower than the control group (P<0.05). The first exhaustion time, the first postoperative defecation time, the first time after bed activity, and the average hospital stay of the study group were significantly shorter than those of the control group (P<0.05). There was no statistical difference between the nutritional status of the patients in the group before the operation(P>0.05). The comparison index found that each nutrition index gradually recovered after the stress was reduced, and the decrease in the 3 d postoperative period of the study group was significantly lower than that of the control group (P<0.05), and gradually returned to the preoperative level 7 days after the operation. Conclusion: ERAS and Dachengqi granules after gastrointestinal surgery are more conducive to the recovery of gastrointestinal function of patients after surgery, the postoperative stress response was lighter, and the nutritional status of patients is stable, which can shorten the hospitalization time of patients and encourage patients to postoperatively. Rehabilitation is worthy of clinical application. [ABSTRACT FROM AUTHOR]

Copyright of Progress in Modern Biomedicine is the property of Publishing House of Progress in Modern Biomedicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective. To explore the effect of intraoperative continuous remifentanil infusion at the 0.05 - 0.15 μg/(kg•min) dosage on postoperative analgesia after gastrointestinal surgery. Methods. The patients received patient-controlled intravenous analgesia (PCIA) after elective gastrointestinal surgery from April to December 2019 in Ruijin Hospital, Shanghai Jiao Tong University School of Medicine were included in this retrospective analysis. They were divided into remifentanil group (n=360) and control group (n=335) according to whether the patients were treated with intraoperative continuous pumping of remifentanil at the 0.05 - 0.15 μg/(kg•min) dosage. Propensity score matching (PSM) was used to compare the difference of postoperative analgesic remedy and the pressing of patient-controlled analgesia (PCA) between the two groups. Results. By using a 1:1 PSM analysis, 286 couples of patients were matched successfully. In the remifentanil group, the proportion of patients receiving postoperative analgesic remedies was significantly less than that in the control group (32.5% vs 40.9%, P=0.037). Compared with the control group, the remifentanil group had a lower risk of poor analgesic effect and necessity of postoperative analgesic remedies (RR=0.696, 95%CI 0.495-0.980). There was no significant difference in the total PCA pressing times between the remifentanil group and control group [5 (1, 12) vs 5 (1, 13), P=0.568], but in the remifentanil group, the proportion of patients with PCA pressing times > 13 was less than that of the control group (21.3% vs 24.5%). Conclusion. Continuous pumping of remifentanil at the 0.05 - 0.15 μg/(kg•min) dosage in elective gastrointestinal surgery is helpful to decrease postoperative analgesic demand. The patients receiving intraoperative remifentanil infusion at a low dosage has a lower risk in requiring postoperative analgesic remedies, compared with patients who do not receive intraoperative remifentanil infusion. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Tranexamic acid as a synthetic antifibrinolytic agent has been used in hip replacement, gastrointestinal surgery, neurosurgery, obstetrics and gynecology, cardiac surgery, and various nasal operations to reduce bleeding. In recent years, tranexamic acid has also been used in spinal surgery. Metaanalysis was used to evaluate whether intraoperative intravenous tranexamic acid reduced the incidence of perioperative bleeding and transfusion events in multilevel posterior spinal surgery compared with placebo. METHODS: The randomized controlled trials of tranexamic acid in the use of PubMed, Cochrane Library and EMBASE in multi-segment posterior spinal surgery were searched by computer. Tranexamic acid was used intravenously in the experimental group and placebo was used in the control group. Two reviewers screened all the retrieved literature according to the inclusion and exclusion criteria. The literature quality was evaluated with the modified Jadad scale and meta-analysis was performed with the Review Manager 5.3 software. RESULTS: (1) A total of nine randomized controlled trials were included in this study. The score of the modified Jadad scale showed 7 points in 6 articles, 6 points in 1 article, 4 points in 1 article and 3 points in 1 article. (2) Meta-analysis showed that the amount of postoperative drainage, intraoperative blood loss, intraoperative erythrocyte recovery, incidence of transfusion events, and total perioperative blood loss in the tranexamic acid group were all lower than those in the placebo group [MD=-102.70, 95%CI(-141.25, -64.15), Z=5.22, P < 0.000 01; MD=-23.23, 95%CI(-44.00, -2.47), Z=2.19, P=0.03; MD=-139.36, 95%CI(-275.23, -3.49), Z=2.01, P=0.04; OR=0.52, 95%CI(0.33, 0.84), Z=2.71, P=0.007; MD=-228.98, 95%CI[-399.75, -58.22], Z=2.63, P=0.009]. Preoperative hemoglobin, hematocrit, immediate postoperative hemoglobin, hospital stay, and operation time had no significant difference between the two groups (P > 0.05). CONCLUSION: Intravenous tranexamic acid can reduce the total perioperative blood loss, intraoperative blood loss, postoperative drainage, intraoperative erythrocyte recovery and the incidence of transfusion events in posterior spinal multilevel surgery. However, due to the limited quantity and quality of the included studies, the above conclusions still need to be verified by more high-quality large-sample studies. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Modern Laboratory Medicine is the property of Journal of Modern Laboratory Medicine Editorial Department and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To explore the feasibility of magnetic compression technique (MCT) in establishing a gastrointestinal anastomosis model in rats. Methods: Magnetic rings (parent and daughter) suitable for gastrointestinal anastomosis in rats were designed and processed. Ten SD rats underwent gastrointestinal anastomosis using magnetic compression technique. The parent and daughter magnetic rings were inserted into the stomach and jejunurn respectively through the mouth. The parent and daughter magnetic rings were attracted to compress the stomach and intestinal wall. The magnets with ischeruia and necrosis of the compressed tissue between them dropped from the anastomotic stoma to the intestrnal tract Then the gastrointestinal anastomosis was established. The magnets were eventually expelled through the digestive tract Rats were killed two weeks after the operation. The blasting pressure was evaluated. The healing of anastomotic stoma was observed by naked eye and light microscope. Results: Except one SD rat died accidentally due to anesthesia, the other nine SD rats successfully completed the operation and survived two weeks after operation. The average operation time was (15.89 ± 3.25) ruin, and the expulsion time of magnetic rings was (8.56 ± 1.26) days (range 7-11 days). The bursting pressure of anastomotic stoma was more than 200 mmHg. The continuity of the mucosal layer was evaluated by HE staining and Masson staining, and the healing was good. Conclusion: The magnetic compression technique is a simple method of anastomosis that is feasible, fast and has !ugh success rate for gastrointestinal anastomosis model in rats [ABSTRACT FROM AUTHOR]

Objective: To investigate the effects of sufentanil combined with ropivacaine for epidural controlled analgesia on the stress hormones and gastrointestinal motility after cesarean section. Methods: 114 cases of pregnant women who underwent cesarean section in our hospital from October 2017 to October 2018 were selected as research objects, all pregnant women were divided into control group (n=51) and research group (n=63) according to the random number table, the control group was treated with sufentanil combined with levobupivacaine PCEA, research group was postoperatively treated with sufentanil combined with ropivacaine PCEA, the changes of postoperative stress hormones, gastrointestinal hormones, electrogastric parameters, prolactin (PRL) levels and adverse reactions were compared between the two groups. Results: The number of postoperative pressure of 24 h PCA, dosage of analgesic solution and VAS in the research group were significantly lower than that in the control group, and the difference was statistically significant (P<0.05). Preoperatively, there were no statistically significant differences in stress hormones, gastrointestinal hormones, electrogastric parameters and PRL in both group(P>0.05). 24 h after surgery, angiotensinⅡ (AngⅡ), norepinephrine (NE), cortisol (Cor), the gallbladder contraction (CCK), vascular active peptide (VIP) in both group were significantly higher than those before operation, motilin (MTL), gastric power, gastric electrical frequency, and normal slow wave rhythm ratio in both groups were obviously decreased compared with preoperative, the changes of the above indexes in the study group were significantly smaller than those in the control group (P<0.05). PRL level in the research grou was significant higher than that in the control group (P<0.05). There was no statistically significant difference in the total adverse reaction rate in both group (P>0.05). Conclusion: Sufentanil combined with ropivacaine for epidural analgesia can effectively reduce the postoperative pain after cesarean section, inhibit the secretion of stress hormones, and improve the gastrointestinal dynamics. [ABSTRACT FROM AUTHOR]

Objective: To explore the mode of pharmaceutical care by clinical pharmacists in nutritional support of the pa - tients with gastric cancer in the department of gastrointestinal surgery. Methods: Being a member of surgical treatment team, clinical pharmacists actively rendered nutritional support and pharmaceutical care in accordance with the nutritional status of gastric carcinoma patients. Results and Conclusion: With active involvement of clinical pharmacists, gastric carcinoma patients during perioperative period were provided with treatment profiles with more optimal nutritional support. Clinical pharmacists could play an active role in the development of nutritional and pharmaceutical care mode in gastrointestinal surgery. [ABSTRACT FROM AUTHOR]

Objective: To analyze the efficacy and safety of endoscopic retrograde cholangiopancreatography(ERCP) in the treatment of choledocholithiasis. Methods: 164 cases of choledocholithiasis patients who were treated by elective ERCP in our hospital from January 2017 to August 2018 were selected as the research objects, the operation condition, stone effect, gastrointestinal disease quality of life index(GIQLI) scale before and after surgery, and the incidence of complications were ananlyed. Results: The operation time of patients with choledocholithiasis was(37.90±4.21) min, the intraoperative blood loss was(10.86±1.29) m L, the postoperative ventilation time was(4.38±0.65) d, the incision pain time was(1.02±0.12) d, the length of hospital stay was(8.62 0.96) d, the success rate of surgery was 97.56%(160/164), the stone removal rate was 95.73%(157/164), and the stone removal rate was 1.82%(3/164). Before surgery, the GIQLI scores of patients with common bile duct stones were all higher than those before surgery(P<0.05). There were 5 cases of pancreatitis, 1 case of cholangitis, 6 cases of bleeding and 4 cases of hyperamylase in the patients with choledocholithiasis. Conclusion: ERCP is an effective treatment for choledocholithiasis, but the related complications should be actively prevented and managed. [ABSTRACT FROM AUTHOR]

Copyright of Nursing of Integrated Traditional Chinese & Western Medicine is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: To explore the effects of somatostatin on the levels of gastrointestinal hormones and clinical outcomes in critically ill infants after gastrointestinal surgery., Methods: Using a random number table method, critically ill infants after gastrointestinal surgery who were admitted to the Intensive Care Unit of Xuzhou Children's Hospital from June 2019 to June 2021 were randomly divided into an observation group (29 cases) and a control group (30 cases). The control group received routine treatment such as anti-infection and hemostasis after surgery, while the observation group received somatostatin in addition to the routine treatment [3.5 μg/(kg·h) infusion for 7 days]. The levels of serum gastrin (GAS), motilin (MTL), insulin, and glucagon-like peptide-1 (GLP-1) before surgery, on the 3rd day after surgery, and on the 7th day after surgery were compared between the two groups. The recovery progress and incidence of complications after surgery were also compared between the two groups., Results: There was no significant difference in the levels of serum GAS, MTL, insulin, and GLP-1 between the two groups before surgery ( P >0.05). On the 3rd and 7th day after surgery, the levels of serum GAS, MTL, insulin, and GLP-1 in the observation group were higher than those in the control group ( P <0.05). In the observation group, the levels of GAS, MTL, insulin, and GLP-1 on the 7th day after surgery were higher than those before surgery and on the 3rd day after surgery ( P <0.05), and the levels on the 3rd day after surgery were higher than those before surgery ( P <0.05). There was no significant difference in the levels of serum GAS, MTL, and insulin before surgery, on the 3rd day after surgery, and on the 7th day after surgery in the control group ( P >0.05). The level of GLP-1 on the 7th day after surgery was higher than that before surgery and on the 3rd day after surgery ( P <0.05), and the level on the 3rd day after surgery was higher than that before surgery ( P <0.05) in the control group. The observation group had shorter first time of anal exhaust, recovery time of bowel sounds, and first time of defecation after surgery compared to the control group ( P <0.05). The incidence of complications after surgery in the observation group was lower than that in the control group (10% vs 33%, P <0.05)., Conclusions: Somatostatin can increase the levels of serum GAS, MTL, insulin, and GLP-1 in critically ill infants after gastrointestinal surgery, promote the recovery of gastrointestinal function, and reduce the incidence of postoperative complications.

Objective To investigate the effect of goal-directed fluid therapy （GDFT） on elderly patients after gastrointestinal surgery. Methods Sixty patients undergoing gastrointestinal tumor radical operation （age was no less than 60 years old， ASA Ⅱ OR Ⅲ） were included and randomly divided into two groups based on fluid therapy: conventional fluid therapy （group C） and goal-directed fluid therapy （group G） . Group C received conventional fluid therapy according to the change of blood pressure during operation，maintaining average arterial pressure at 60~110 mmHg. Whereas group G received goal-directed fluid therapy，we could get the stroke volume variation， cardiac index， and stroke volume index et al through the Flotrac/Vigileo. The goals of group G were maintaining stroke volume variation 2% ~13% ， cardiac index 2.5 ～4.0 L/(min.m)， stroke volume index 35~47 ml/m2，MAP 65~110 mmHg. Record the total volume of liquid， the crystal volume，and colloid volume. The first time of exhaust time after operation， total hospital stay， postoperative hospital stay and the total medical expenses were recorded. Results Compared with group C， patients in group G received less crystal solution and colloid solution. The incidence of postoperative pulmonary complications was lower. The first time of exhaust time after operation was earlier，postoperative hospital stay and total hospital stay was shorter， and the total medical expenses was less than group C. Conclusion GDFT can improve the prognosis in elderly patients after gastrointestinal surgery， reduce postoperative complications and save medical resources. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To probe into the effects of Simo decoction on the postoperative recovery of gastrointestinal function in patients undergoing gastrointestinal surgery. METHODS: 84 patients undergoing gastrointestinal surgery admitted into People’s Hospital of Guangzhou Huadu District in 2017 were selected and divided into observation group and control group via random number, with 42 cases in each. The control group was given conventional therapy after surgery, while the observation group was given Simo decoction based on the control group. The recovery of gastrointestinal function and incidences of gastrointestinal reaction of both groups were observed. RESULTS: The recovery time of borborygmus, evacuation time of anus and defecation time of observation group were significantly shorter than those of the control group, with statistically significant difference (P <0.05); there were no statistical significance in differences of incidences of abdominal distention, nausea, stomachache and emesis between two groups (P > 0.05). CONCLUSIONS: Simo decoction can promote the recovery of gastrointestinal function in patients undergoing gastrointestinal surgery and improve patients’ prognoses. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effects of dexmedetomidine (Dex) on the hemodynamics and agitation of patients with gastrointestinal suxgery. Methods: 93 cases who had taken the gastrointestinal surgery in our hospital from May 2013 to May 2015 were selected as the research sublets. According to the different anesthesia methods, the selected patients were divided into the study group (52 cases) and the control group (41 cases). The patients in the study group were treated with the general anesthesia combined with dexmedetomidine continuous infusion, while the patients in the control group were treated with general anesthesia. Then the mean arterial pressure (MAP), heart rate (HR), pulse oxygen saturation (SpO2), respiratory rate (RR) and Ramsay score of patients at the beginning (T1), the process (T2) and the end of the operation were observed and compared. Results: At T1, T2 and T3, the HR, RR and MAP in the study group were lower than those of the control group, and the differences were statistically significant (P<0.05); There was no statistically significant difference about the SpO2 in the two groups at different time points (P>0.05); There was no significant difference in the hemodynamic parameters of the study group at each time point (P>0.05). The Ramsay score of the study group was (2.81± 0.28), which was higher than (1.51 ± 0.41) in the control group, and the difference was statistically significant (P<0.05); The incidence of complications in the study group was 5.77%, which was lower than 29.27% in the control group, and the difference was statistically significant (P<0.05). Conclusion: DEX of general anesthesia in patients undergoing gastrointestinal surgery has good sedative, analgesic effect, which can keep the hemodynamics stable and less affect the agitation, and it is worthy of clinical application. [ABSTRACT FROM AUTHOR]

Objective To explore the prevention and treatment of acute kidney injury (AKI) after gastrointestinal surgical procedures. Method We retrospectively analyzed the data of patients underwent gastrointestinal surgery in recent 2 years in the First Affiliated Hospital of Kunming Medical University and the First People's Hospital of Yunnan Province. Result The incidence of AK1 was 2.1 %. Elderly patients with basic diseases had poorer prognosis than non-elderly patients. Conclusion In the patients after gastrointestinal Surgery, early rehydration, diuresis, ant-infection and preventive hemodialysis can achieve the goal of prevention and treatment of acute kidney injury in early stage. [ABSTRACT FROM AUTHOR]

Objective: To observe the effect of transcutaneous electrical acupoint stimulation (TEAS) on the recovery of patients undergoing gastrointestinal surgery under general anesthesia., Methods: Sixty patients (ASA Ⅱ-Ⅲ) selected for scheduled gastrointestinal surgery were randomly divided into control group and TEAS group ( n =30 cases per group). Patients in the two groups received general anesthesia, and those of the TEAS group also received TEAS for 30 min (8-12 mA) immediately after surgery. The changes of systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR) before anesthesia, before acupoint stimulation, before extubation, immediately after extubation, 10 and 30 min after extubation were recorded. The recovery time of spontaneous breathing, extubation time, VAS scores and Bruggman comfort scale (BCS) scores at the time of discharging from postanesthesia care unit (PACU) were recorded., Results: Compared with the control group, the recovery time of spontaneous breathing and extubation time were significantly shorter （ P <0.05）, the VAS score was significantly lower ( P <0.05), and the BCS score significantly increased in the TEAS group ( P <0.05). There were no significant differences between two groups in the levels of SBP, DBP and HR at each time point ( P >0.05)., Conclusion: TEAS can accelerate the gastrointestinal surgery patients' recovery from general anesthesia, enhance the postoperative analgesic effect, improve patients' discomfort, has less adverse reactions, and is thus conducive to promote the postoperative rehabilitation.

Laparoscopic gastrointestinal surgery has experienced 30 years of development in China, and has now entered a high plateau stage at the technical level. Laparoscopic surgery, once an emerging technology, is gradually becoming a "traditional surgery". Meanwhile, laparoscopic gastrointestinal surgery is gradually moving towards a new situation of multi-disciplinary and multi-technical integration. High-quality clinical studies are constantly being reported, and new tools and techniques are emerging. In the next era, the development of laparoscopic gastrointestinal surgery will focus more on international research, digital surgery, high-tech operating rooms, etc. An urging requirement is to understand and face the current intensified involution and other practical problems, and to create another glorious innovation for Chinese laparoscopic gastrointestinal surgery in the next 30 years.

Anatomical plane and fascia have been described in medical behaviors for hundreds of years since the appearance of anatomy and operation. Generally, these descriptions can be sorted into three theories, i.e. plane surgery, fascia theory and mesentery anatomy. However, these theories are difficult to satisfy the scientific paradigm that includes consistency in description, independence in validation, potential to solve practical problems, and the interaction of the above-mentioned theries. Recently, membrane anatomy was proposed as the anatomy of mesentery and its beds in broad sense. Behind it lies fascia membrane/serous membrane structure, as well as inherent life events and general order. Mesentery in broad sense is described as the fascia membrane/serous membrane in serous cavity, which envelops and suspends the organ/tissue and its feeding structures to the posterior wall of the body. Anatomy is the setting/structure, in which life events/functions occur. In the research and discussion of membrane anatomy, abiding by the scientific paradigm and upholding the scientific spirit are the only way to obtain reliable knowledge and the criterion for in-depth scientific research.

In radical gastrectomy, D2 systemic lymphadenectomy, which includes complete resection of the bursa sac and omentum, and D2 extended lymphadenectomy outside the bursa sac, is a standard procedure accepted by gastrointestinal surgeons generally. However, a series of clinical trials showed that both D2 extended lymphadenectomy and bursectomy could not improve oncologic benefit, but increase surgical risk. These findings showed a lot of conflicts in gastric cancer surgery, gastrointestinal surgery, even in oncological surgery. It was demonstrated that bursa sac and greater omentum were neither mesogastrium nor the proximal segment of dorsal mesogastrium (PSDM), which has been identified recently. Local physiological structures (such as blood vessels and lymphatic nodes) and pathological events (such as lymph nodes metastasis and metastasis V) only occur in mesentery in broad sense (i.e. PSDM). Broken PSDM during radical gastrectomy can result in cancer cell leakage into the operational field. Therefore, complete PSDM excision in the D2 field (D2+CME) is suggested as a better procedure for local advanced gastric cancer, which can get benefits not only in surgical hazard, but also in oncologic result. The results of PSDM research could lead to three changes: (1) resolving some long standing problems in gastric cancer surgery, gastrointestinal surgery, and even oncologic surgery; (2) opening an new era for finding and utilizing extra-intestinal mesentery in broad sense; (3) formulating the theory of membrane anatomy which may update, iterate and upgrade related information of classical anatomy, pathology, surgery and oncology.

Membrane anatomy is the anatomy of mesentery in broad sense and its beds, which was merged from clinical results of surgical practice, optic observation and traditional theories contradiction or omission. Membrane anatomy is not only a plane, but also a body or bloc which is surrounded by fascia and serous membrane. It is not only fascia, but also a channel or pathway, in which the life event occurred. It is not only mesentery anatomy, but included mesentery beds, on which the mesentery was lied, even buried in. Following the new version of this anatomy map, surgical hazard during operation and postoperative oncological recurrence will be decreased simultaneously. And, following the definition of the mesentery in broad sense, new mesenteries will be discovered under macro surgery, which will optimize surgical operation and get better surgical and oncological results.

The intestinal flora of patients after gastrointestinal surgery is in a state of disorder, which may affect the surgical efficacy and prognosis. Timely and effective reconstruction of microbiota balance is very important for reducing postoperative complications, ensuring the recovery of gastrointestinal function and improving quality of life. The purpose of this article is to explore the effect of gastrointestinal surgery on intestinal flora and the clinical significance of microbiota balance reconstruction.

Medical artificial intelligence is a deeply integrated field of production-university-research. The collaborative innovation system of "industry, education and research" has broken down the barriers between various disciplines and has shown great impetus in scientific and technological innovation and achievement transformation. The Affiliated Hospital of Qingdao University where the authors work, relying on Shandong Key Laboratory of Digital Medicine and Computer-Assisted Surgery and Institute of Digital Medicine and Computer-Assisted Surgery of Qingdao University, has jointly established a close "industry-university-research" cooperation mechanism with the State Key Laboratory of Virtual Reality Technology and Systems of Beijing University of Aeronautics and Astronautics and Qingdao Hisense Medical Equipment Co., Ltd., which lasted for 10 years and carried out a series of useful explorations in scientific and technological innovation and achievement transformation in the field of gastrointestinal surgery of artificial intelligence with fruitful results. It mainly comprises of the following: (1) The research and development (R&D) of Hisense computer-assisted surgery (CAS) system has important clinical significance for laparoscopic gastrointestinal surgery guided by surrounding blood vessels that grasps globally the movement and variation of blood vessels in order to accurately select surgical strategies. (2) R&D of an automatic identification system for gastrointestinal diseases (namely image-assisted diagnosis system of artificial intelligence) initially applies deep neural network of artificial intelligence to the identification of lymph node metastases in rectal cancer, which has achieved accurate clinical diagnosis. (3) The virtual endoscopy platform for the gastrointestinal tract developed can successfully provide a new virtual endoscopy view of the intestinal wall eversion and realize the one-way navigation of the intestinal wall. (4) A localized platform of laparoscopic surgery simulation training is established with completely independent intellectual property rights. We realize that clinical requirement is the source of research and development, clinical practice is the source of innovation, and clinicians are practitioners of transformation of achievements. The establishment of artificial intelligence models often requires the support of massive and high-quality clinical data. Therefore, the effectiveness of its promotion and application can only be ensured by adopting a multi-center research approach. In the whole process of scientific and technological innovation and achievement transformation, the issues of medical ethics and intellectual property rights cannot be ignored.

In hospitals and medical schools as densely populated sites with high risk of coronavirus disease 2019 (COVID-19), it is vital to adjust the teaching and training strategy for medical students to ensure curriculum completion with safety. This article aims to introduce the experience of teaching and training for medical students under the epidemic situation at Department of Surgery, Shanghai Medical College, Fudan University and Zhongshan Hospital. The content includes exploring diversified online teaching models for undergraduate surgery courses and clinical practice, carrying out online graduate education and dissertation plans, and strengthening comprehensive education of medical humanity combined with knowledge of COVID-19 prevention. Through implementation of the above teaching strategies, scheduled learning plans of medical students can be well completed in an orderly, safe and quality-ensured manner. Our experience provides practical solution of medical teaching and could be advisable for other medical colleges and teaching hospitals.

Since its introduction in China, the rapid development of robotic surgical system has brought a new trend in gastrointestinal surgery. Although clinical trials have proven its safety and effectiveness compared with traditional laparoscopic surgery, robotic gastrointestinal surgery has no obvious advantages in either short-term efficacy or long-term survival after surgery. Significantly increased costs have not brought corresponding clinical benefits, and that has limited robotic surgery to become the mainstream option for gastrointestinal surgery. In this paper, the clinical findings of robotic gastrointestinal surgery were reviewed, and the application of robotic surgical system in gastrointestinal surgery should be viewed rationally. The majority of gastrointestinal surgeons should not take the so-called "advanced equipment" as a monopolized asset, but choose surgery methods that the patients can benefit from, doctors are satisfied with, and can reflect the best socioeconomic benefits for the patients. With the development of a new generation of robotic surgical system and the support of more high-quality evidence-based medicine, it is believed that robotic gastrointestinal surgery will go towards a better future along a rational and objective track.

Acute abdomen, abdominal trauma, gastrointestinal bleeding and gastrointestinal tumors are the main conditions that are routinely treated in gastrointestinal surgery department with high incidence and critical condition. These conditions need emergency or selective operations. During the outbreak of the coronavirus disease 2019 (COVID-19), it's a great challenge for us to meet the patients' requirement under the situation. As the COVID-19 was brought under control in China, the Department of General Surgery in Nanfang Hospital resumed regular medical services gradually. Based on our clinical practice, the four major measures of strengthening pre-hospital screening, perioperative prevention and control, medical staff protection, and ward management were adopted. These main measures include the strict implementation of the appointment system and triage system before admission; the conduction of epidemiological and preliminary screening of viral nucleic acids; the chest CT examination during the perioperative period to re-screen COVID-19; the reduction of the risk of droplets and aerosol transmission; the minimally invasive surgery combined with enhanced recovery program in order to reduce patient's susceptibility and shorten the length of postoperative hospital stay; the reinforcement of specific infection control training for medical staff; the strict implementation of hierarchical protection; the establishment of gastrointestinal surgery prevention and control system; the rehearsal of emergency exercise; the installation of quarantine wards; the screening and management of family care-givers; the strict disinfection of environment and materials. Our preliminary practice shows that following the work guidelines issued by the Guangdong Province COVID-19 Prevention and Control Office and adopting precise management strategies in combination with the specific clinical features of gastrointestinal surgery, it is possible to safely resume regular care for the patients and comply to epidemic control at the same time.

Since the China Gastrointestinal Cancer Surgery Union was established, it has continuously collected the annual reports of 95 gastrointestinal surgery centers nationwide from 2014 to 2017, and collected data on more than 130 000 cases of gastric cancer. This article combines the experience of associated databases at home and abroad to analyze the construction of the China Gastrointestinal Cancer Surgery Union Database, and explore the role of multi-center cooperation and big data analysis in the promotion of gastrointestinal surgery. For a complete database to successfully achieve its ultimate goal, it needs clear goals, continuous funding, a qualified management team, consensus on data content, a high completion rate, and the support and cooperation of an advanced processing system. As a high-quality database with clear construction goals and database project construction based on the goals, while promoting the level of clinical diagnosis and treatment, it is also widely used in risk prediction model development, audit supervision, epidemiological research, health service research, and clinical hypothesis testing, etc. How to build a high-quality database to give a full promotion in clinical diagnosis and treatment is a huge challenge. Although the construction of medical databases in China has just started, we believe that with the further improvement in understanding, management and analysis capabilities for surgical databases, more databases including the China Gastrointestinal Cancer Surgery Union Database will make greater contributions in promoting the development of diagnosis and treatment of gastrointestinal cancer in China and the world.

Objective: To observe the therapeutic effect of electroacupuncture (EA) at Zusanli (ST 36) and Neiguan (PC 6) on stress responses of patients undergoing gastrointestinal surgery., Methods: A total of 40 patients undergoing gastrointestinal surgery were randomized into conventional treatment group (control) and EA group ( n ＝20 in each group). Patients of the EA group received conventional treatment (pre- and post-surgical fasting, measures for gastrointestinal decompression, parenteral nutrition support, and patient controlled analgesia pump, etc.) and EA stimulation (2 Hz, 30 min) of bilateral ST 36 and PC 6 (twice after surgery, at an interval of 6 h), and patients of the control group received conventional treatment only. The visual analogue scale (VAS) score was used to assess the patients' pain severity and the blood glucose levels were detected once every 4－6 h within 24 h after operation. Serum cortisol (Cort) and adrenocorticotropic hormone (ACTH) levels were detected by chemiluminescence method, and serum D-lactic acid level (for assessing gastrointestinal mucosal injury) was assayed by ELISA., Results: After the treatment, the levels of serum Cort, ACTH, D-lactate acid and the highest blood glucose were significantly lower in the EA group than those in the control group ( P <0.05, P <0.01), suggesting a reduction of stress reactions after EA. But no significant difference was found between the control and EA groups in the VAS score ( P >0.05)., Conclusion: EA at ST 36 and PC 6 can alleviate stress responses and reduce intestinal mucosal damage in patients undergoing gastrointestinal surgery.