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  • 1.
    Ultrasonographic features of carotid web
    Jie Yang, Yang Hua, Fubo Zhou, Xiaojie Tian, Ran Liu, Lingyun Jia
    Chinese Journal of Medical Ultrasound (Electronic Edition) 2020, 17 (07): 679-683. DOI: 10.3877/cma.j.issn.1672-6448.2020.07.017
    Abstract (603) HTML (3) PDF (716 KB) (336)
    Objective

    To evaluate the features of carotid web (CW) by ultrasonography.

    Methods

    A total of 66 patients with CW were retrospectively enrolled from January 2018 to June 2019 at Xuanwu Hospital, Capital Medical University. All patients were examined by both ultrasonography and CTA, and were divided into either a<50% stenosis group (54 cases) or a ≥50% stenosis group (12 cases). The ultrasonographic characteristics of CW, including the length, thickness, direction (forward or backward to the flow), acute angle between the web and carotid wall, and thrombus between the web and carotid wall were compared between the two groups. The stenosis degrees of carotid artery were compared between patients with and without ischemic stroke.

    Results

    Forty-two (42/66, 63.6%) patients were diagnosed with CW by initial CDFI examination, of whom 21 (21/66, 31.8%) were diagnosed with ulcerative plaque and 3 (3/66, 4.5%) were diagnosed with carotid dissection at first but confirmed by second examination. There were no differences in the web length, thickness, direction, or thrombus detected between the two groups (P>0.05). The angle between the web and carotid wall in the<50% stenosis group was significantly smaller than that of the ≥50% stenosis group (median angel 39o vs 73o, P=0.002), and the percentage of patients with an angle≤ 60o in the<50% stenosis group was significantly higher than that of the ≥50% stenosis group (74.1% vs 41.7%, P=0.042). The diameter of the residual carotid artery at CW location in the<50% stenosis group was significantly larger and peak systolic velocity was significantly higher in the<50% stenosis group than in the≥50% stenosis group (P<0.001). The stenosis degrees of carotid artery were not statistically different between patients with and without ischemic stroke (P=0.321).

    Conclusion

    Ultrasonography can be used to evaluate the characteristics of carotid web in 2D and color mode. When the angle between the CW and carotid wall is large, the carotid artery stenosis ≥ 50% is more likely to happen, but carotid artery stenosis is not the main cause of ischemic stroke.

  • 2.
    Different historical stages of elderly orthopaedic treatments--A retrospect and prospect analysis
    Yingze Zhang
    Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition) 2018, 04 (01): 1-3. DOI: 10.3877/cma.j.issn.2096-0263.2018.01.001
    Abstract (193) HTML (40) PDF (374 KB) (69)
  • 3.
    The effect of combining therapeutic ultrasound and sling exercise for lumbar disc herniation
    Weiwei Wu, Jianye Cao, Liwei Dong, Jing Zhang
    Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition) 2020, 06 (05): 291-296. DOI: 10.3877/cma.j.issn.2096-0263.2020.05.008
    Abstract (397) HTML (2) PDF (657 KB) (15)
    Objective

    The aim of the present study was to evaluate the efficiency of sling exercise, therapeuticultrasound, therapeuticultrasound and sling exercise in patients to alleviate pain and improve lumbar function with lumbar disc herniation.

    Methods

    Individuals were selected from a list of patients being followed at the department of Rehabilitation in the third hospital of Hebei Medical University. 30 patients who were diagnosed with lumbar disc herniation were collected, the diagnoses were established upon medical history, physical examination, and results of imaging studies. The patients were randomly divided into three groups: therapeuticultrasound group received 14 sessions of ultrasonic therapy to the lumbar region, Sling exercise group received 14 sessions of sling exercise, and therapeuticultrasound and sling exercise group received therapeuticultrasound and sling exercise therapy 14 sessions of therapeuticultrasound to the lumbar region,7 sessions per week, 2 weeks. The VAS and ODI were compared with the assessment of the patients before and at the end of the therapy.

    Results

    At the end of treatment, three groups VAS scores (F=3.069, P=0.043) and ODI scores (t=12.676, P<0.001) was lower than that at the beginning of treatment (P<0.05), at the end of treatment the VAS scores (F=59.400, P<0.001) and of the ODI scores (t=12.737, P<0.001) of ultrasonic and sling exercise therapy group was lower than the other group, the difference is significantly.

    Conclusion

    All three groups could reduce pain and improve lumbar function, and the ultrasonic and sling exercise therapy was most effective for lumbar disc herniation treatment in the three groups.

  • 4.
    Diagnosis and treatment of traumatic cerebral infarction in children
    Guiling Zhang, Huaiqiang Zhang, Hongsheng Wang, Yinchen Sun, Peilin Zhao, Zhiming Wang, Wenbo Meng
    Chinese Journal of Neurotraumatic Surgery(Electronic Edition) 2020, 06 (04): 229-232. DOI: 10.3877/cma.j.issn.2095-9141.2020.04.008
    Abstract (323) HTML (4) PDF (589 KB) (27)
    Objective

    To analyze the treatment of different types of traumatic cerebral infarction in children, and explore its pathogenesis in combination with literature so as to improve the cure rate and reduce disability rate.

    Methods

    The clinical data of 42 cases of traumatic cerebral infarction in children were retrospectively analyzed in The Hospital of 81st Group Army PLA from January 2015 to December 2019. The diagnosis of traumatic cerebral infarction in children was made by CT scan and MRI scan. According to different conditions, children with traumatic cerebral infarction were classified, and different treatment strategies were selected. Children with lacunar infarction were treated with calcium antagonists and neurotrophic drugs, supplemented by hyperbaric oxygen and exercise rehabilitation. The children of focal cerebral infarction and complex cerebral infarction treated by junior dehydrant and hormone also included the calcium antagonist and nutritional nerve drugs. The therapeutic regimen perhaps adjusted by the evolution of the disease. The children of extensive cerebral infarction underwent emergency cranial decompression, and was treated by reducing intracranial pressure and preventing complications after operation. The treatment results and recovery were observed.

    Results

    In 42 cases of traumatic cerebral infarction in children, 35 cases (83.3%) were good recovery, 4 cases (9.5%) were moderate disability, 2 cases (4.8%) were severe disability, 1 case (2.4%) died, and no vegetative state. The good recovery rate of lacunar infarction was 100%, that of focal cerebral infarction was 62.5%, that of mixed cerebral infarction was 60%, and that of extensive cerebral infarction was 50%.

    Conclusion

    It is of great significance to improve the therapeutic effect and prognosis of children with traumatic cerebral infarction to adopt different treatment schemes for different types of cerebral infarction.

  • 5.
    Characterization of Patients with Supratentorial Hypertensive Intracerebral Hemorrhage in the Tibetan Plateau over an Altitude of 4000 meters
    Zhongzheng He, Jiankang Ma, Sang Gong, Gongsangmingjiu, Cidanzhaxi, Zhiyong Jin, Caihong Ran, Hong Wang, Yu Wang, Qianfa Long
    Chinese Journal of Cerebrovascular Diseases(Electronic Edition) 2020, 14 (02): 96-99. DOI: 10.11817/j.issn.1673-9248.2020.02.007
    Abstract (567) HTML (2) PDF (555 KB) (25)
    Objective

    To characterize the patients with supratentorial hypertensive intracerebral hemorrhage (ICH) in the Tibetan Plateau over an altitude of 4000 meters.

    Methods

    A total of 68 cases with supratentorial hypertensive ICH were retrospectively included in Ali Regional People’s Hospital from January 2017 to September 2018. The clinical and laboratory data were collected. A simple linear correlation analysis was applied to analyze the correlation between the amount of bleeding and sex, age, nationality, time from onset , systolic blood pressure (SBP), diastolic blood pressure (DBP), hemoglobin (Hb), serum triglyceride (TG), and cholesterol. According to computed tomography (CT) findings, 68 cases were divided into the basal ganglia ICH group (33 cases) and the lobar ICH group (35 cases). The characteristics between two groups were analyzed using t-test or χ2 test.

    Results

    The data of sex, age, nationality, time from onset, SBP, DBP, Hb, TG, and cholesterol of 68 cases on admission did not show any definitive correlation with the hematoma volumes (P>0.05). The SBP and DBP of patients in the basal ganglia ICH group were significantly higher than that in the lobar ICH group, respectively [(184.9±28.5) mmHg vs (164.6±24.4) mmHg; (113.0±18.1) mmHg vs (103.0±18.4) mmHg] (t=0.499, 0.486; P=0.002, 0.033).

    Conclusion

    The relevant factors of hematoma volumes in patients with ICH in plateau area were not yet clear. Diastolic and systolic blood pressure of patients in the basal ganglia ICH group was higher than that in those in lobar ICH group.

  • 6.
    Multi-center study of electrospun composite biomaterial and SIS biological mesh in adult inguinal hernia surgery
    Shaojie Li, Jianxiong Tang, Hongbing Xiao, Lei Hua, Lei Huang, Ding Ping, Xianke Si, Xingchen Hu, Zhao Cai
    Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition) 2020, 14 (04): 336-341. DOI: 10.3877/cma.j.issn.1674-392X.2020.04.004
    Abstract (341) HTML (7) PDF (882 KB) (47)
    Objective

    To compare the efficacy evaluation of electrospun composite biomaterials and a porcine small intestine submucosa mesh for hernia repair.

    Methods

    A randomized, single-blind, controlled multicenter trial was performed in 3 hospitals in Shanghai. Eligible adult patients with primary unilateral reducible groin hernias were randomly assigned (1∶1) to electrospun composite biomaterials (experimental group) or porcine small intestine submucosa (control group) mesh groups. Patients were treated with the tARB technique and assessed at 1,3 and 6 months after the surgery. The primary endpoint was hernia recurrence. The secondary endpoints were postoperative complications including groin pain and operative site infections.

    Results

    172 patients were assigned to experimental (n=86) and control (n=86) groups. At 6 months follow-up, postoperative complications occurred in 5 patients (5/86, 5.95%) and 2 (2/86, 2.35%) patients in the control and experimental groups, respectively (P>0.05). There was no significant difference in VAS or SVS score between the two groups.

    Conclusion

    We demonstrate that electrospun composite biomaterial mesh can be used as a ideal choice for inguinal hernia repair. Electrospun composite biomaterial has the characteristics of low recurrence rate, absorbability and long-term comfort.It can be further applied in clinical practice in the future.

  • 7.
    Key surgical techniques and notes of laparoscopic pancreaticoduodenectomy by using robotic surgery system
    Rong Liu, Jizhe Li
    Chinese Journal of Operative Procedures of General Surgery(Electronic Edition) 2019, 13 (04): 336-339. DOI: 10.3877/cma.j.issn.1674-3946.2019.04.004
    Abstract (122) HTML (1) PDF (872 KB) (38)

    Pancreaticoduodenectomy(PD)remains one of the most complicated hepatobiliary operations. The development of minimally invasive surgery for PD has always been an hot spot. Laparoscopic pancreaticoduodenectomy(LPD) has not been widespread carried out due to its difficulty and long learning curve. LPD accounts for 9% of all PD, according to the National Cancer Data base. Compared with laparoscopic surgery, robotic surgery system has significant advantages in the field of minimally invasive PD, including stereotactic amplified vision, filtering hand tremor and simulating the wrist. The article would review the surgical techniques and notes, which could provide clinical reference for other surgeons.

  • 8.
    Refined management of COVID-19 prevention and control in medical ultrasound department during COVID-19 epidemic
    Zhang Zhang, Lü Lü, Meng Meng
    Chinese Journal of Medical Ultrasound (Electronic Edition) 2020, 17 (08): 787-790. DOI: 10.3877/cma.j.issn.1672-6448.2020.08.014
  • 9.
    Clinical application and efficacy analysis of robot-assisted versus laparoscopic sleeve gastrectomy combined with fundoplication and hiatal hernia repair
    Zheqi Zhou, Aili Aikebaier, Yiliang Li, Maimaitiming Maimaitiaili, Tusuntuoheti Yusujiang, Abudureyimu Kelimu
    Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition) 2026, 20 (03): 259-264. DOI: 10.3877/cma.j.issn.1674-392X.2026.03.004
    Abstract (3) HTML (0) PDF (7513 KB) (0)
    Objective

    To assess the intraoperative and postoperative safety and efficacy of robotic-assisted sleeve gastrectomy combined with fundoplication and hiatal hernia repair (SGFD+HHR).

    Methods

    This single-center retrospective cohort study included 76 patients with obesity and hiatal hernia who underwent either robotic-assisted or laparoscopic SGFD+HHR at the People's Hospital of Xinjiang Uygur Autonomous Region between January 2020 and July 2024. The patients were divided into a laparoscopic group (n=51) and a robotic group (n=25) based on the surgical approach. Perioperative parameters, postoperative weight loss efficacy, complication rates, Gastroesophageal Reflux Disease Questionnaire (GerdQ) scores, and reflux improvement were compared between the two groups.

    Results

    There were no statistically significant differences between the two groups in baseline characteristics, operative duration, time to meeting discharge criteria, body weight and body mass index at baseline and 6 and 12 months postoperatively, percentage of excess weight loss (%EWL), percentage of total weight loss (%TWL) at 6 and 12 months postoperatively, the incidence of early and long-term postoperative complications, GerdQ score, or reflux improvement at 12 months postoperatively (all P>0.05). However, the robotic group had less intraoperative blood loss than the laparoscopic group (Z=-3.913, P<0.001). In both groups, GerdQ scores at 12 months postoperatively were significantly lower than baseline scores (Z=-3.650 and -3.611, respectively; both P<0.001).

    Conclusion

    For patients with obesity and hiatal hernia, both robotic-assisted and laparoscopic SGFD+HHR achieved satisfactory weight loss and anti-reflux outcomes. No significant differences were observed between the two approaches in postoperative weight loss efficacy or complication rates, whereas robotic-assisted surgery was associated with reduced intraoperative blood loss.

  • 10.
    Clinical application of the 3+2+1 anatomical dissection and suturing strategy in totally robotic hiatal hernia repair combined with fundoplication
    Dingwei Lu, Hongrui Guo, Di Liu, Xianlong Mao, Honglin Yi, Rujuan Wang, Chunli Zou, Peng Li
    Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition) 2026, 20 (03): 265-271. DOI: 10.3877/cma.j.issn.1674-392X.2026.03.005
    Abstract (3) HTML (0) PDF (8280 KB) (1)
    Objective

    To evaluate the clinical value and significance of the "3+2+1" anatomical dissection and suturing strategy in totally robotic hiatal hernia repair combined with fundoplication.

    Methods

    This is a single-center retrospective observational study. A total of 52 patients with gastroesophageal reflux disease (GERD) who underwent totally robotic hiatal hernia repair combined with fundoplication at the Department of General SurgeryⅡ, Yan'an Hospital Affiliated to Kunming Medical University, from January to December 2025 were enrolled. All procedures were performed using the "3+2+1" anatomical dissection and suturing strategy. Perioperative indicators, postoperative symptom improvement, and patient satisfaction were analyzed.

    Results

    All surgeries were completed successfully without conversion to open surgery or complications, with 100% patient satisfaction. The mean robotic operating time was (82.03±32.91) minutes, intraoperative blood loss was 5 (5,5) ml, and postoperative hospital stay was (3.80±1.70) days. Gastroesophageal reflux disease questionnaire and gastroesophageal reflux disease-health related quality of life scores at 1, 3, 6, and 12 months postoperatively were significantly lower than preoperative values (all P<0.001).

    Conclusion

    Totally robotic hiatal hernia repair combined with fundoplication utilizing the "3+2+1" anatomical dissection and suturing strategy is safe and reliable, effectively alleviating reflux symptoms in patients with GERD, promoting rapid recovery, and achieving high patient satisfaction.

  • 11.
    Application experience of the robotic 3+1 mode in hiatal hernia repair
    Zanlin Li, Yushan Zumunaiti, Aili Aikebaier, Abudureyimu Kelimu, Yiliang Li
    Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition) 2026, 20 (03): 272-276. DOI: 10.3877/cma.j.issn.1674-392X.2026.03.006
    Abstract (2) HTML (0) PDF (6178 KB) (0)
    Objective

    To share and discuss the surgical safety and clinical experience of the robotic "3+1" mode in hiatal hernia repair.

    Methods

    This study was a single-center retrospective case series. A total of 145 patients who underwent da Vinci robot-assisted laparoscopic hiatal hernia repair in the Department of Minimally Invasive, Hernia and Abdominal Wall Surgery, People's Hospital of Xinjiang Uygur Autonomous Region, from January 2022 to January 2025 were included. All patients underwent trocar placement using the "3+1" mode, and the operations were completed accordingly. Postoperative improvement, hernia recurrence, and complications were followed up through outpatient appointments, online consultations, and telephone calls. The follow-up deadline was December 2025.

    Results

    All 145 patients successfully underwent robot-assisted laparoscopic hiatal hernia repair combined with fundoplication, without conversion to open abdominal or thoracic surgery. Among them, 137 patients underwent Nissen fundoplication, 2 underwent Dor fundoplication, and 6 underwent Toupet fundoplication. The mean hernia defect area was (47.5±17.3) cm2, the mean operative time was (67.5±18.8) min, the mean intraoperative blood loss was (15.0±5.0) ml, the mean postoperative hospital stay was (6.5±2.5) days, and the mean surgical cost was RMB (6.8±1.0)×104 yuan. The mean postoperative follow-up duration was (30.5±7.5) months. Postoperative symptoms such as acid reflux, heartburn, and chest pain were markedly improved compared with those before surgery. During follow-up, no pleural effusion, pulmonary infection, wound infection, or recurrence was observed.

    Conclusion

    Robot-assisted hiatal hernia repair using the robotic "3+1" mode has high surgical safety. The trocar placement method is simple, standardized, highly reproducible, and highly operable.

  • 12.
    Feasibility and safety of preserving the hepatic branch of the vagus nerve during laparoscopic hiatal hernia repair
    Liquan Cai, Jinlong Zhang, Xunfeng Gao, Dan Yu, Jinhui Zhang, Heng Zhang
    Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition) 2026, 20 (03): 277-283. DOI: 10.3877/cma.j.issn.1674-392X.2026.03.007
    Abstract (2) HTML (0) PDF (8126 KB) (0)
    Objective

    To investigate the feasibility of preserving the hepatic branch of the vagus nerve during laparoscopic hiatal hernia repair combined with fundoplication and its effect on postoperative gallbladder function.

    Methods

    This retrospective cohort study included 73 patients with gastroesophageal reflux disease complicated by hiatal hernia who underwent laparoscopic hiatal hernia repair in the Department of General Surgery, Shenzhen Hospital, Southern Medical University, from January 2019 to December 2023. Seventeen patients who underwent other concomitant procedures and two patients with recurrent hernia or type IV hernia were excluded. The remaining 54 patients were divided into the hepatic branch of the vagus nerve preservation group (n=17) and the hepatic branch of the vagus nerve resection group (n=37) according to whether the hepatic branch of the vagus nerve was preserved during surgery. Operative time, intraoperative blood loss, length of hospital stay, postoperative complications, and other indicators were compared between the two groups. All patients underwent routine outpatient follow-up at 1, 6, 12, and 36 months after surgery, and abdominal ultrasonography or computed tomography (CT) was performed to monitor gallbladder status. The incidence of gallstones was recorded.

    Results

    There were no statistically significant differences between the hepatic branch of the vagus nerve preservation group and the resection group in operative time, intraoperative blood loss, length of hospital stay, or complications (P>0.05). In the hepatic branch of the vagus nerve resection group, two cases of asymptomatic gallstones were detected at the 6-month postoperative follow-up. With prolonged follow-up, the number of patients with gallstones increased. At the 3-year follow-up, gallstones were detected in nine patients (24.30%). No imaging evidence of gallstones or other gallbladder lesions was observed in the remaining patients. At 3 years after surgery, the incidence of gallstones in the hepatic branch of the vagus nerve resection group was significantly higher than that in the hepatic branch of the vagus nerve preservation group (24.30% vs. 0.0%), and the difference was statistically significant (P<0.05).

    Conclusion

    Preserving the hepatic branch of the vagus nerve during laparoscopic hiatal hernia repair combined with fundoplication is feasible. In the short term, it may reduce the impact on gastrointestinal function and facilitate postoperative recovery. In the long term, it may help reduce the formation of gallstones; however, whether this effect is attributable to preservation of the hepatic branch of the vagus nerve requires further investigation.

  • 13.
    Mid-term efficacy analysis of laparoscopic repair with synthetic mesh for type Ⅲ hiatal hernia: A single-center retrospective study
    Xiaojian Fu, Xianjue Huang, Yuxiao Chu, Zhiyuan Zhu, Qiyuan Yao, Rong Hua
    Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition) 2026, 20 (03): 284-288. DOI: 10.3877/cma.j.issn.1674-392X.2026.03.008
    Abstract (2) HTML (0) PDF (6297 KB) (0)
    Objective

    To explore the mid-term efficacy of laparoscopic repair with synthetic mesh for type Ⅲ hiatal hernia.

    Methods

    This study is a retrospective case series study. A total of 62 patients with typeⅢ hiatal hernia who underwent laparoscopic hiatal hernia repair with synthetic mesh in the Center for Obesity and Hernia Surgery , Department of General Surgery, Huashan Hospital, Fudan University from January 2017 to December 2023 were included. The perioperative conditions, postoperative complications, and follow-up results of the patients were analyzed.

    Results

    All 62 patients successfully completed laparoscopic surgery without conversion to open surgery. The average operation time was (114.5±35.7) minutes, and the average postoperative hospital stay was 5.0(4.0, 6.0) days. The average follow-up period was (72±24.6) months. The GerdQ score after surgery was significantly lower than that before surgery [(6.4±1.0) points vs (8.6±2.1) points, P<0.05], and the number of patients requiring proton pump inhibitor treatment significantly decreased (7 vs 41). The postoperative anatomical recurrence rate was 8.2% (5/61), the symptom recurrence rate was 8.2% (5/61), and the incidence of dysphagia was 16.4% (10/61). Patient-related factors were not significantly correlated with recurrence or dysphagia.

    Conclusion

    Laparoscopic repair with synthetic mesh for type Ⅲ hiatal hernia is safe and feasible. It can effectively improve clinical symptoms, and reduce the risk of recurrence.

  • 14.
    Effect of intervention model based on Orem's self-care theory in postoperative patients with hiatal hernia
    Jianhui Ma, Jie Bai, Ye Zhao, Li Zhang
    Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition) 2026, 20 (03): 289-295. DOI: 10.3877/cma.j.issn.1674-392X.2026.03.009
    Abstract (2) HTML (0) PDF (8532 KB) (0)
    Objective

    To investigate the influence of an intervention model based on Orem's self-care theory on postoperative self-efficacy, pain, and psychological status in patients with hiatal hernia (HH).

    Methods

    This study adopted a retrospective cohort design to select 96 HH patients who were admitted to Bainiaohu Hospital and Xinjiang Uygur Autonomous Region People's Hospital from July 2024 to June 2025 as the research subjects. These patients were divided into the control group and the experimental group, with 48 cases in each group, based on the different intervention methods. The control group received routine nursing care, while the experimental group was given an intervention model based on Orem's self-care theory for 1 week. Paired-sample and independent-sample t-tests were used to compare self-efficacy, pain intensity, psychological status, and self-care ability within and between the two groups before and after the intervention.

    Results

    After 1 week of intervention, the experimental group had significantly higher general self-efficacy scale (GSES) score (28.48±4.14) points and exercise of self-care agency (ESCA) score (102.54±13.07) points than the control group GSES score (25.38±3.87) points, ESCA score (95.21±11.36) points (t=3.790, 2.933, both P<0.05). The changes in GSES and ESCA scores from baseline to post-intervention were compared between the two groups. The corresponding values were (5.02±3.02) vs (9.06±4.42) points and (7.67±5.78) vs (16.04±13.85) points, with statistically significant differences (t=5.229, 3.864; all P<0.001; Cohen's d≈1.07, 0.80). The scores of depression (8.98±0.67) points, anxiety (9.85±0.95) points, and stress (10.75±1.39) points in the depression-anxiety-stress scale (DASS-21) in the experimental group were significantly lower than those in the control group depression (9.44±0.77) points, anxiety (11.85±1.38) points, stress (12.58±1.47) points (t=3.082, 8.229, 6.233, all P<0.05). The visual analog scale (VAS) scores at 12 h (4.96±0.68) points, 24 h (3.92±0.58) points, and 48 h (2.73±0.45) points after operation in the experimental group were significantly lower than those in the control group at 12 h (5.38±0.76) points, 24 h (4.54±0.62) points, and 48 h (3.63±0.53) points after operation (t=2.853、5.059、8.968, P<0.05). Repeated-measures ANOVA revealed significant main effects of time, group, and time-group interaction on VAS scores (Ftime=254.171, Ptime<0.001; Fgroup=80.352, Pgroup=0.026; Finteraction=3.702, Pinteraction= 0.026). In addition, the duration of pain in the experimental group was significantly shorter than that in the control group (t=7.093, P<0.001).

    Conclusion

    The nursing intervention based on Orem's self-care theory significantly enhances self-efficacy, strengthens self-care ability, alleviates negative emotional states, and improves pain control in postoperative HH patients, thereby providing scientific and high-quality psychological nursing support.

  • 15.
    Risk factors and preventive measures for hematoma formation after laparoscopic inguinal hernia repair surgery
    Wenting Li, Huan Huang
    Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition) 2026, 20 (03): 296-300. DOI: 10.3877/cma.j.issn.1674-392X.2026.03.010
    Abstract (2) HTML (0) PDF (5843 KB) (0)
    Objective

    To explore the risk factors for hematoma formation after laparoscopic inguinal hernia repair (LIHR) and its preventive measures.

    Methods

    This study is a retrospective case-control study. The clinical data of 275 patients who received LIHR and were admitted to Tangdu Hospital, Air Force Medical University from January to December 2025, they were divided into the hematoma group (n=32) and the non-hematoma group (n=243) based on whether a hematoma formed after the operation. The clinical data of both groups were collected and a multivariate logistic regression analysis was performed to analyze the risk factors for hematoma formation after LIHR surgery, and corresponding preventive measures were proposed based on the identified risk factors.

    Results

    There were statistically significant differences in age, body mass index, location of the hernia, diaphragm diameter, surgical type, and mesh type between the two groups (P<0.05). Multivariate Logistic regression analysis showed that age≥65 years (OR 4.735, 95% CI 1.510-14.845), body mass index≥24 kg/m2 (OR 3.445, 95% CI 1.363-8.707), bilateral hernia (OR 4.375, 95% CI 1.887-10.144), diaphragm diameter≥4 cm (OR 5.436, 95% CI 1.422-20.773), surgical type (total extraperitoneal hernia repair) (OR 3.105, 95% CI 1.158-8.322), and conventional mesh type (OR 4.088, 95% CI 1.266-13.198) were all independent risk factors for hematoma formation after LIHR (P<0.05).

    Conclusion

    The hematoma formation following LIHR are closely associated with age, body mass index, hernia location, diaphragm diameter, surgical type, and mesh type. The incidence of hematoma can be actively reduced through measures such as appropriate weight loss training, strict adherence to surgical operating standards, meticulous dissection using ultrasonic scalpel, preferential use of lightweight mesh, and compression care.

  • 16.
    The impact of laparoscopic preperitoneal mesh repair on early postoperative pain and quality of life in adult patients with umbilical hernia
    Jing Dai, Jun Zhang, Xingxing Wei
    Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition) 2026, 20 (03): 301-306. DOI: 10.3877/cma.j.issn.1674-392X.2026.03.011
    Abstract (2) HTML (0) PDF (7973 KB) (0)
    Objective

    To evaluate the impact of laparoscopic preperitoneal mesh repair (LPPMR) on early postoperative pain and quality of life in adult patients undergoing umbilical hernia repair.

    Methods

    This is a retrospective cohort study. A retrospective analysis of the medical records of patients who underwent umbilical hernia repair at the First Affiliated Hospital of Xi 'an Jiaotong University between June 2023 and June 2025 was conducted. Patients were categorized into two groups based on surgical approach preference at admission and surgeon expertise: the LPPMR group (n=48), receiving laparoscopic preperitoneal mesh repair, and the IPOM group (n=48), receiving laparoscopic intraperitoneal onlay mesh repair. Comparative analyses were performed between the two groups on operative parameters, early postoperative pain levels, recovery of abdominal wall muscle function, postoperative quality of life, and follow-up outcomes.

    Results

    Operative duration was significantly longer in the LPPMR group compared to the IPOM group. However, the LPPMR group demonstrated significantly shorter time to first flatus and lower overall surgical costs (P<0.05). Visual analog scale (VAS) pain scores assessed at 24, 48, 72 h, and 1 week postoperatively were lower in the LPPMR group than those in the IPOM group. Repeated- measures analysis of variance (ANOVA) indicated significant main effects for both time (F=334.600, P<0.001) and surgical group (F=16.932, P<0.001) on early postoperative pain, with no significant interaction (P>0.05). At 1 and 3 months after surgery, the LPPMR group exhibited superior performance in plank hold times, supine static crunch times, and number of bridge exercises than those in the IPOM group. The repeated measures ANOVA showed that the effects of time and group were significant for all the above three indicators (all P values<0.001), while the interaction effects were not significant (all P values>0.05). Furthermore, quality of life assessments at 1, 3, and 6 months after the surgery revealed significantly higher scores in both the physical and psychological domains for the LPPMR group than those of the IPOM group. Repeated-measures ANOVA showed significant time effects across all domains (P<0.001), with group effects significant only for the physical (F=17.948, P<0.001) and psychological (F=25.134, P<0.001) domains. The interaction effect had no significant effect on any of these four domains (all P>0.05). No hernia recurrences were reported in either group during follow-up. One month after the operation, the incidence of incision site pain (6.25% vs 20.83%) and foreign body sensation (4.17% vs 16.67%) was significantly lower in the LPPMR group than that in the IPOM group (P<0.05). The overall complication rates did not differ significantly between the two groups (P>0.05).

    Conclusion

    Both LPPMR and IPOM are safe and effective procedures for umbilical hernia repair. Although associated with a longer operative time, LPPMR offers distinct advantages, including reduced early postoperative pain, enhanced recovery of abdominal wall function, and improved short-term quality of life. LPPMR may serve as a preferred option for patients prioritizing rapid recovery and quality of life, though surgeon learning curve and operative time should be considered.

  • 17.
    Efficacy of different laparoscopic surgeries for recurrent inguinal hernia in elderly male patients
    Yu Zheng, Shaofan Qiu, Chunyi Song, Xiangyu Zhang, Jia Wang, Shaowei Ma
    Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition) 2026, 20 (03): 307-312. DOI: 10.3877/cma.j.issn.1674-392X.2026.03.012
    Abstract (2) HTML (0) PDF (7457 KB) (0)
    Objective

    To investigate the clinical efficacy of transabdominal preperitoneal laparoscopic hernia repair (TAPP) versus totally extraperitoneal laparoscopic hernia repair (TEP) in elderly male patients with recurrent inguinal hernia, and their influences on respiratory function and testicular hemodynamic parameters.

    Methods

    A total of 104 elderly male patients with recurrent inguinal hernia admitted to the Second Hospital of Hebei Medical University from June 2021 to March 2024 were enrolled, and randomly divided into TAPP group and TEP group by the random number table method, with 52 cases in each group. The perioperative indicators, respiratory function indicators [airway pressure (Paw), end-tidal carbon dioxide partial pressure (PETCO2)], trauma response indicators [tumor necrosis factor-α (TNF-α), interleukin (IL)-1β, and IL-6], testicular hemodynamic parameters [resistance index (RI), end-diastolic velocity (EDV), peak systolic velocity (PSV)], complication rates and postoperative recurrences of patients were compared between the two groups.

    Results

    The operation duration and postoperative pain duration were shorter, and hospitalization costs were lower in the TEP group compared with the TAPP group, with statistically significant differences (all P<0.05). At 10 min and 30 min after pneumoperitoneum establishment, Paw and PETCO2 values in the TEP group were significantly lower than those in the TAPP group (all P<0.001). Serum levels of TNF-α, IL-1β and IL-6 on postoperative day 1 and day 3 were markedly lower in the TEP group (all P<0.001). The TEP group had higher EDV and lower RI than the TAPP group (all P<0.001). No significant intergroup differences were found in the incidence of complications and 1year postoperative recurrence rate between the two groups (P>0.05).

    Conclusion

    TAPP and TEP are safe and effective treatment options for recurrent inguinal hernia in elderly males. However, TEP has a smaller impact on perioperative respiratory function, can alleviate pain and trauma stress, and reduces the economic burden on patients.

  • 18.
    Application of biological mesh in laparoscopic trans-abdominal preperitoneal hernia repair
    Kang Chen, Guangyuan Wang, Tianxiang Gou, Yong Liu, Tao Qu
    Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition) 2026, 20 (03): 313-317. DOI: 10.3877/cma.j.issn.1674-392X.2026.03.013
    Abstract (2) HTML (0) PDF (6386 KB) (0)
    Objective

    To evaluate the efficacy of biological mesh in laparoscopic trans- abdominal preperitoneal hernia repair (TAPP).

    Methods

    A retrospective analysis was conducted on clinical data of 185 patients who underwent TAPP hernia repair at Liupanshui People's Hospital between January 2018 and December 2023. Based on the type of mesh used during surgery, patients were divided into two groups: 90 cases receiving lightweight large-pole polypropylene mesh were assigned to the control group, while 95 cases receiving biological mesh were assigned to the observation group. Surgical indicators and postoperative complications were recorded; serum inflammatory markers were measured before and after surgery; postoperative pain was assessed; all patients were followed for 6 to 18 months, and post-discharge outcomes were documented.

    Results

    No statistically significant differences were observed between the two groups in terms of operative time, intraoperative blood loss, or time to ambulation (P>0.05). The total incidence of postoperative complications was significantly lower in the observation group compared to the control group (P=0.025). Three days after surgery, levels of C-reactive protein (CRP) and white blood cell count (WBC) were significantly elevated in both groups compared to preoperative values (P<0.01). Postoperative pain scores were significantly lower in the observation group compared to the control group (P<0.001). No significant difference was found in the incidence of foreign body sensation at the surgical site between the two groups (P>0.05). The incidence of chronic postoperative pain in the surgical area was significantly lower in the observation group (P=0.003), and overall postoperative satisfaction was significantly higher compared to the control group (P<0.001).

    Conclusion

    The use of biological mesh in TAPP hernia repair in the treatment of adolescent inguinal hernia reduces the risk of postoperative complications and inflammatory responses, alleviates postoperative pain, decreases recurrence rates, and improves prognosis compared to conventional polypropylene mesh.

  • 19.
    The impact of laparoscopic trans-abdominal preperitoneal hernia repair and transinguinal preperitoneal repair on the postoperative recovery of gastrointestinal function in patients with unilateral inguinal hernia
    Fei Duan, Shang Yang, Xudong Bi, Yongming Dong, Qin Zhao, Jinzhu Zhang
    Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition) 2026, 20 (03): 318-323. DOI: 10.3877/cma.j.issn.1674-392X.2026.03.014
    Abstract (2) HTML (0) PDF (7691 KB) (0)
    Objective

    To compare the impacts of laparoscopic trans-abdominal preperitoneal hernia repair (TAPP) and transinguinal preperitoneal hernia repair (TIPP) on postoperative gastrointestinal function recovery and early rehabilitation in patients with unilateral inguinal hernia.

    Methods

    Data were collected from 120 patients with inguinal hernias who were admitted to Bayannur City Hospital and underwent surgical treatment from January 2023 to December 2024. Based on surgical technique, they were divided into a control group (TIPP procedure, 58 cases) and an observation group (TAPP procedure, 62 cases). The surgical-related indicators, recovery time of gastrointestinal function (resumption of bowel sounds, first flatus/ defecation), postoperative pain visual analogue scale (VAS), quality of life index for digestive diseases (GLQI), and complication rates were compared between the two groups of patients.

    Results

    All patients completed follow-up with no dropouts. The operative times in the control group and observation group were (50.16±9.46) min and (46.33±8.02) min, respectively. The first ambulation time postoperatively was (7.86±1.15) h and (7.44±0.96) h, respectively. Postoperative hospitalization durations were (2.59±0.30) d and (1.94±0.22) d, respectively. The first passage of flatus time was (9.16±1.42) h and (8.58±1.25) h, respectively. The first defecation time was (25.21±3.23) h and (23.94±3.07) h, respectively. Bowel sound recovery time was (7.82±1.33) h and (7.25±1.24) h, respectively. Recovery time for oral intake was (8.34±1.21) h and (7.89±1.17) h, respectively. Postoperative VAS scores at day 1 were (3.89±0.92) points and (3.56±0.85) points, respectively. VAS scores at 1 week postoperatively were (1.97±0.43) points and (1.51±0.41) points, respectively. Postoperative GLQI scores at day 1 were (50.36±6.85) points and (53.17±6.94) points, respectively. GLQI scores at 1 week postoperatively were (58.31±8.27) points and (67.39±8.52) points, respectively. All these indicators showed significant differences between the two groups (P<0.05). The comparison of complication rates between the two groups showed no statistically significant difference (P>0.05). There was no incomplete intestinal obstruction nor recurrence of hernia in the two groups.

    Conclusion

    TAPP treatment for unilateral inguinal hernia demonstrates superior efficacy to TIPP repair in alleviating early postoperative pain and promoting gastrointestinal function recovery, without increasing the risk of complications. It represents a surgical approach that facilitates faster patient recovery.

  • 20.
    Application of arcuate line approach in single incision laparoscopic totally extraperitoneal inguinal hernia repair
    Zhipeng Hua, He Huang, Wei Zhang, Chenglin Luo, Ning Su, Qiong Hong, Hongwen Zhang
    Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition) 2026, 20 (03): 324-328. DOI: 10.3877/cma.j.issn.1674-392X.2026.03.015
    Abstract (1) HTML (0) PDF (5706 KB) (0)
    Objective

    To investigate the application of arcuate line approach in single incision laparoscopic totally extraperitoneal inguinal hernia repair (SIL-TEP).

    Methods

    A retrospective analysis was conducted on the clinical data of 90 adult patients with unilateral or bilateral inguinal hernias who underwent SIL-TEP at Qichun Peoples' Hospital from March 2020 to February 2024. Among them, 52 patients underwent SIL-TEP by arcuate line approach (arcuate line approach group) and 38 patients underwent SIL-TEP by umbilicus approach (umbilicus approach group). Compare the surgical duration, chopstick effect duration, bleeding volume, pain score, bed rest time, and intraoperative and postoperative complications between the two groups.

    Results

    All patients completed the surgery successfully, and there was no case of incision infection or recurrence. There was no statistical difference between the two groups in complications such as intraoperative blood loss, postoperative bed rest time, postoperative serum swelling (P>0.05); There were statistically significant differences between the two groups in terms of surgical time, the duration of chopstick effect (interference between instruments), the number of cases of peritoneal damage during surgery, and postoperative pain scores (P<0.05).

    Conclusion

    The SIL-TEP hernia repair surgery via the arcuate line approach is more convenient than the umbilicus approach, reducing surgical difficulty and making the operation approach safe and feasible.

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