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文章速递Role of minimally invasive surgery for rectal cancer 认领
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作者 Kurt A Melstrom Andreas M Kaiser 《世界胃肠病学杂志:英文版》 SCIE CAS CSCD 2020年第30期4394-4414,共21页
Rectal cancer is one of the most common malignancies worldwide.Surgical resection for rectal cancer usually requires a proctectomy with respective lymphadenectomy(total mesorectal excision).This has traditionally been... Rectal cancer is one of the most common malignancies worldwide.Surgical resection for rectal cancer usually requires a proctectomy with respective lymphadenectomy(total mesorectal excision).This has traditionally been performed transabdominally through an open incision.Over the last thirty years,minimally invasive surgery platforms have rapidly evolved with the goal to accomplish the same quality rectal resection through a less invasive approach.There are currently three resective modalities that complement the traditional open operation:(1)Laparoscopic surgery;(2)Robotic surgery;and(3)Transanal total mesorectal excision.In addition,there are several platforms to carry out transluminal local excisions(without lymphadenectomy).Evidence on the various modalities is of mixed to moderate quality.It is unreasonable to expect a randomized comparison of all options in a single trial.This review aims at reviewing in detail the various techniques in regard to intra-/perioperative benchmarks,recovery and complications,oncological and functional outcomes. 展开更多
关键词 Rectal cancer Minimally invasive surgery Laparoscopic surgery Robotic surgery Transanal total mesorectal excision Transanal minimally invasive surgery
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Keystone design perforator island flap in facial defect reconstruction 认领
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作者 Soo Yeon Lim Chi Sun Yoon +1 位作者 Hyun Gun Lee Kyu Nam Kim 《世界临床病例杂志》 SCIE 2020年第10期1832-1847,共16页
Facial defect coverage is a common subject in the field of reconstructive surgery.There are many methods for facial defect reconstruction,and reconstructive surgeons should choose the most appropriate method on a case... Facial defect coverage is a common subject in the field of reconstructive surgery.There are many methods for facial defect reconstruction,and reconstructive surgeons should choose the most appropriate method on a case-by-case basis to achieve both functional and aesthetic improvement.Among various options for facial reconstruction,the local flap technique is considered the best reconstructive modality to provide good tissue matches of color and texture,which is consistent with the ideal goal of reconstruction(replacement of like-with-like).Keystone design perforator island flap(KDPIF),devised by Behan in 2003,has been applied to various fields of reconstructive surgery in the past decade due to its design simplicity,robust vascular supply,and reproducibility.Several studies have reported KDPIF reconstruction of facial defects,such as large parotid defects,small-to-moderate nasal defects,and eyelid defects.However,KDPIF has been used relatively less in facial defects than in other body regions,such as the trunk and extremities.The purpose of this review is to provide an organized overview of facial KDPIF reconstruction including the classification of KDPIF,modifications,physiology,mechanism of flap movement,consideration of facial relaxed skin tension lines and aesthetics,surgical techniques,clinical applications,and precautions for successful execution of KDPIF reconstruction. 展开更多
关键词 Keystone design perforator island flap Reconstructive surgery Facial defects AESTHETICS Plastic surgery Flap surgery
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从妇科肿瘤医生角度看子宫颈癌腹腔镜手术 认领
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作者 王登凤 张国楠 《中国实用妇科与产科杂志》 CAS CSCD 北大核心 2020年第4期313-317,共5页
广泛性子宫切除术+盆腔淋巴结清扫术是早期子宫颈癌的标准治疗方式。由于腹腔镜手术在围手术期结局上的优势,且肿瘤治疗结局与开腹手术相似,逐渐成为早期子宫颈癌的主要手术方式之一。直到2018年11月,《新英格兰医学杂志》发表了2项临... 广泛性子宫切除术+盆腔淋巴结清扫术是早期子宫颈癌的标准治疗方式。由于腹腔镜手术在围手术期结局上的优势,且肿瘤治疗结局与开腹手术相似,逐渐成为早期子宫颈癌的主要手术方式之一。直到2018年11月,《新英格兰医学杂志》发表了2项临床研究结果显示,与开腹手术相比,微创手术的复发率更高、生存期更短。这使得子宫颈癌的微创手术受到了前所未有的打击。而2019年12月《妇科肿瘤学杂志》发表的一项大数据回顾性分析研究结果无疑对于子宫颈癌微创手术是雪上加霜的考验,该研究结果显示,与开腹组相比,腹腔镜组的手术相关并发症发生率更高。文章将从妇科肿瘤医生视角就无瘤原则、无瘤技术及腹腔镜操作细节等方面进行分析及建议。 展开更多
关键词 子宫颈肿瘤 手术 腹腔镜手术 生存率 复发率 并发症
Perioperative management of endoscopic transsphenoidal pituitary surgery 认领
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作者 Martin Hanson Hao Li +3 位作者 Eliza Geer Sasan Karimi Viviane Tabar Marc A.Cohen 《世界耳鼻咽喉头颈外科杂志(英文)》 2020年第2期84-93,共10页
The contemporary embrace of endoscopic technology in the approach to the anterior skull base has altered the perioperative landscape for patients requiring pituitary surgery.Utility of a multi-disciplinary unit in man... The contemporary embrace of endoscopic technology in the approach to the anterior skull base has altered the perioperative landscape for patients requiring pituitary surgery.Utility of a multi-disciplinary unit in management decisions facilitates the delivery of optimal care.Evolution of technology and surgical expertise in pituitary surgery mandates ongoing review of all components of the care central to these patients.The many areas of potential variability in the pre,intra and post-operative timeline of pituitary surgery are readily identifiable.Core undertakings and contemporary controversies in the peri-operative management of patients undergoing endoscopic transsphenoidal pituitary surgery are assessed against the available literature with a view to providing guidance for the best evidence-based practice. 展开更多
关键词 PITUITARY Pituitary surgery Endoscopic skull base surgery Perioperative management
Pediatric sinonasal and skull base lesions 认领
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作者 Charles A.Riley Christian P.Soneru +2 位作者 Jonathan B.Overdevest Marc L.Otten David A.Gudis 《世界耳鼻咽喉头颈外科杂志(英文)》 2020年第2期118-124,共7页
Pediatric skull base lesions are complex and challenging disorders.Safe and comprehensive management of this diverse group of disorders requires the expertise of an experienced multidisciplinary skull base team.Adult ... Pediatric skull base lesions are complex and challenging disorders.Safe and comprehensive management of this diverse group of disorders requires the expertise of an experienced multidisciplinary skull base team.Adult endoscopic skull base surgery has evolved due to technologic and surgical advancements,multidisciplinary team approaches,and continued innovation.Similar principles continue to advance the care delivered to the pediatric population.The approach and management of these lesions varies considerably based on tumor anatomy,pathology,and surgical goals.An understanding of the nuances of skull base reconstruction unique to the pediatric population is critical for successful outcomes. 展开更多
关键词 PEDIATRICS Endoscopic sinus surgery Endoscopic skull base surgery Juvenile nasopharyngeal angiofibroma MENINGOENCEPHALOCELE Pituitary adenoma CRANIOPHARYNGIOMA Clival chordoma CHONDROSARCOMA
左布比卡因腰麻用于肛肠外科手术的临床分析 认领
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作者 王苏婷 《世界复合医学》 2020年第6期181-183,共3页
目的比较左布比卡因与布比卡因腰麻用于肛肠手术的麻醉效果。方法选取该院自2017年1月—2019年9月收治的58例肛肠外科手术患者作为观察对象,随机分为观察组(29例)与对照组(29例)。分别给予左布比卡因与布比卡因腰麻。观察两组患者麻醉... 目的比较左布比卡因与布比卡因腰麻用于肛肠手术的麻醉效果。方法选取该院自2017年1月—2019年9月收治的58例肛肠外科手术患者作为观察对象,随机分为观察组(29例)与对照组(29例)。分别给予左布比卡因与布比卡因腰麻。观察两组患者麻醉起效时间、肌松达标时间、最高麻醉平面及感觉阻滞时间,对比两组患者术后疼痛程度、麻醉前后血压与心率变化情况。结果观察组麻醉起效时间(4.2±1.4)min、肌松达标时间(9.4±0.9)min,最高麻醉平面(2.2±0.8)L同对照组相比组间差异无统计学意义(t=0.245、0.658、0.647,P>0.05);观察组感觉阻滞时间(4.1±1.2)min优于对照组(t=7.523,P<0.05)。麻醉后,观察组患者的收缩压、舒张压与心率同对照组差异无统计学意义(t=0.658、0.451、0.823,P>0.05)。观察组术后疼痛评分为(2.4±0.9)分,对照组术后疼痛评分为(3.0±1.1)分,组间差异有统计学意义(t=2.273,P<0.05)。结论左布比卡因腰麻行肛肠外科手术相比于布比卡因具有更大优越性,术后镇痛效果佳,感觉阻滞时间长。 展开更多
关键词 外科手术 左布比卡因 肛肠外科手术
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开放性眼外伤玻璃体手术时机的探讨 认领
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作者 曹亚菲 王丽 +1 位作者 王晓霞 邓卫东 《中华眼外伤职业眼病杂志》 2020年第6期434-438,共5页
目的探讨开放性眼外伤玻璃体手术的时机。方法回顾性研究。选取洛阳市第一人民医院2017年1月至2019年1月收治的开放性眼外伤患者100例(100眼),按受伤后至手术的时间分为两组。对照组在伤后10~14天行玻璃体手术,研究组为伤后早期(2~4天)... 目的探讨开放性眼外伤玻璃体手术的时机。方法回顾性研究。选取洛阳市第一人民医院2017年1月至2019年1月收治的开放性眼外伤患者100例(100眼),按受伤后至手术的时间分为两组。对照组在伤后10~14天行玻璃体手术,研究组为伤后早期(2~4天)行玻璃体手术,比较两组手术效果及并发症情况。随访3个月。结果研究组的总治愈率为96.0%,高于对照组的76.0%(χ^2=8.306,P=0.000)。研究组术后继发性青光眼发生率为2.0%、外伤性增生性玻璃体视网膜病变发生率为4.0%,硅油依赖发生率为2.0%,玻璃体再积血率为0,均低于对照组相应的16.0%、22.0%、14.0%及12.0%,各参数两组间差异均有统计学意义(χ^2=5.983,7.162,4.891,6.383,P=0.011,0.010,0.000,0.021)。结论开放性眼外伤伤后早期行玻璃体手术,能够提高治疗效果,减少外伤性增生性玻璃体视网膜病变等并发症发生。 展开更多
关键词 外伤 开放性 手术 玻璃体 效果 治疗 时机 手术 并发症
Breast Morphometry in Senegalese Women: Study on a Sample of 118 Subjects 认领
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作者 Ndeye Bigue Mar Assane Ndiaye +8 位作者 A?nina Ndiaye Karim Yacouba Garba Magaye Gaye Sokhna Astou Gawane Thiam Issa Dior Seck Racky Wade Jean Marc Ndiaga Ndoye Mamadou Diop Abdoulaye Ndiaye 《乳腺癌(英文)》 2020年第2期13-20,共8页
Nowadays, women are more and more resorting to breast surgery for the purposes of isolated esthetics or within the framework of a mammectomy for tumor with its cohort of psychological problems post mutilation often re... Nowadays, women are more and more resorting to breast surgery for the purposes of isolated esthetics or within the framework of a mammectomy for tumor with its cohort of psychological problems post mutilation often requiring reconstruction. In context of breast cancer increase in Senegal, we have carried out breast morphology in female subjects of the Sahelian type in order to contribute to the development of a morphological database for reconstruction, reduction or breast augmentation. It was a prospective study on 118 female subjects received at Cancer Institute for screening. They were divided into two groups (age ≤ 40 years and age?> 40 years). Subjects’?morphometric variables were collected in anatomical position and correlated with age, parity, obesity and genital activity using. Fifty six subjects (47.5%) were over 40 years of age. There were 40 multiparous (33.9%). Fifteen subjects (12.7%) and six subjects (5%) were obese and morbidly obese, respectively. Subjects in genital activity were 34 (29%). The overall average size of the areola was 4.3 ± 1.5 cm. The nipple was low located with an average of 7.2 ± 3.5 cm. The diameters mentioned above increased significantly with age and body mass index, for p-values ?0.05, with the exception of the vertical diameter. Breast diameters were greater in postmenopausal women. Morphometry of Sahelian-type women’s breast is strongly influenced by socio-demographic data, hence the need to take it into account during reconstruction, reduction or breast augmentation surgeries in Senegal. 展开更多
关键词 BREASTS MORPHOMETRY Surgery Sahelian WOMAN
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Laparoscopic surgery for early gallbladder carcinoma:A systematic review and meta-analysis 认领
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作者 Xu Feng Jia-Sheng Cao +9 位作者 Ming-Yu Chen Bin Zhang Sarun Juengpanich Jia-Hao Hu Win Topatana Shi-Jie Li Ji-Liang Shen Guang-Yuan Xiao Xiu-Jun Cai Hong Yu 《世界临床病例杂志》 SCIE 2020年第6期1074-1086,共13页
BACKGROUND There is a controversy as to whether laparoscopic surgery leads to a poor prognosis compared to the open approach for early gallbladder carcinoma (GBC)We hypothesized that the laparoscopic approach is an al... BACKGROUND There is a controversy as to whether laparoscopic surgery leads to a poor prognosis compared to the open approach for early gallbladder carcinoma (GBC)We hypothesized that the laparoscopic approach is an alternative for early GBC.AIM To identify and evaluate the safety and feasibility of laparoscopic surgery in the treatment of early GBC.METHODS A comprehensive search of online databases,including MEDLINE (PubMed),Cochrane libraries,and Web of Science,was performed to identify noncomparative studies reporting the outcomes of laparoscopic surgery and comparative studies involving laparoscopic surgery and open surgery in early GBC from January 2009 to October 2019.A fixed-effects meta-analysis was performed for 1-and 5-year overall survival and postoperative complications,while 3-year overall survival,operation time,blood loss,the number of lymph node dissected,and postoperative hospital stay were analyzed by random-effects models.RESULTS The review identified 7 comparative studies and 8 non-comparative studies.1068 patients (laparoscopic surgery:613;open surgery:455) were included in the meta-analysis of 1-,3-,and 5-year overall survival with no significant differences observed [(HR=0.54;95%CI:0.29-1.00;12=0.0%;P=0.051),(HR=0.75;95%CI:0.34-1.65;I^2=60.7%;P=0.474),(HR=0.71;95%CI:0.47-1.08;I^2=49.6%;P=0.107),respectively].There were no significant differences in operation time[weighted mean difference (WMD)=18.69;95%CI:-19.98-57.36;I^2=81.4%;P=0.343],intraoperative blood loss (WMD=-169.14;95%CI:-377.86-39.57;I2=89.5%;P=0.112),the number of lymph nodes resected (WMD=0.12;95%CI:-2.95-3.18;I^2=73.4%;P=0.940),and the complication rate (OR=0.69;95%CI:0.30-1.58;I2=0.0%;P=0.377) between the two groups,while patients who underwent laparoscopic surgery had a reduced length of hospital stay (WMD=-5.09;95%CI:-8.74--1.45;I2=91.0%;P=0.006).CONCLUSION This systematic review and meta-analysis confirms that laparoscopic surgery is a safe and feasible alternative to open surgery with comparable survival and operation-rela 展开更多
关键词 LAPAROSCOPIC SURGERY Open SURGERY EARLY GALLBLADDER carcinoma SURVIVAL META-ANALYSIS
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重视临床基本问题,推动乳腺外科学科发展 认领
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作者 辛灵 刘荫华 《中国肿瘤外科杂志》 CAS 2020年第4期281-284,共4页
中华医学会外科学分会乳腺外科学组(CSBrS)成立3年以来,共针对10项乳腺外科临床基本问题撰写了共识意见。其中,强调乳腺病灶空芯针穿刺活检和前哨淋巴结活检的临床价值;推广中心静脉输液港的临床应用范围;重申并规范真空辅助旋切和乳腺... 中华医学会外科学分会乳腺外科学组(CSBrS)成立3年以来,共针对10项乳腺外科临床基本问题撰写了共识意见。其中,强调乳腺病灶空芯针穿刺活检和前哨淋巴结活检的临床价值;推广中心静脉输液港的临床应用范围;重申并规范真空辅助旋切和乳腺标记物植入技术的临床适应证;以及中国妊娠相关性乳腺癌的诊治策略等内容获得临床医生的广泛认同。2019年,CSBrS共完成10项中国乳腺外科领域的多中心真实世界研究。2020年,已经启动包括:《疫情期间乳腺外科临床工作多中心研究》和《多基因检测和BRCA基因检测中国现状》等15项研究课题。作为中国乳腺外科领域的专业学术团体,CSBrS始终关注乳腺外科临床基本问题,并以加强多学科合作,搭建适宜国情的学术研究平台为己任,努力为推动中国乳腺外科临床规范化进程做出贡献。 展开更多
关键词 乳腺癌 外科 专家共识 中华医学会外科学分会乳腺外科学组
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柴芍六君子汤加减联合ERAS对腹腔镜胃癌手术康复的影响 认领
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作者 陈念 刘欢 +2 位作者 倪志强 王永恒 彭书旺 《湖南中医药大学学报》 CAS 2020年第5期626-629,共4页
目的观察柴芍六君子汤加减联合加速康复外科(ERAS)治疗在腹腔镜胃癌手术患者中的安全性和有效性。方法将腹腔镜胃癌D2根治术的患者84例随机分为对照组(ERAS组)44例和观察组(中药配合ERAS组)40例。两组均按ERAS管理,观察组术后加服柴芍... 目的观察柴芍六君子汤加减联合加速康复外科(ERAS)治疗在腹腔镜胃癌手术患者中的安全性和有效性。方法将腹腔镜胃癌D2根治术的患者84例随机分为对照组(ERAS组)44例和观察组(中药配合ERAS组)40例。两组均按ERAS管理,观察组术后加服柴芍六君子汤加减。观察比较两组患者术前及术后第1天、第3天、第5天血清白蛋白(albumin,ALB)、C反应蛋白(Creactive protein, CRP)、白细胞(white blood cell,WBC)水平及术后排气时间、排便时间、住院时间和手术并发症发生率。结果术后第1天两组WBC、CRP均较术前明显上升(P<0.05),ALB明显下降(P<O.05);术后第3天、第5天两组ALB水平较术后第1天升高(P<0.05),WBC、CRP水平较术后第1天下降(P<0.05),且观察组各项指标改善均优于对照组(P<0.05)。术后观察组排气、排便时间均较对照组提前(P<0.05),住院天数短于对照组(P<0.05)。两组术后并发症发生率差异无统计学意义(P>0.05)。结论腹腔镜胃癌手术患者在ERAS管理同时术后加服柴芍六君子汤加减安全有效,可进一步加速术后康复。 展开更多
关键词 胃癌 腹腔镜 手术 柴芍六君子汤 加速康复外科
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Robotic vs laparoscopic right colectomy—the burden of age and comorbidity in perioperative outcomes: An observational study 认领
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作者 Fulvio Tagliabue Morena Burati +5 位作者 Marco Chiarelli Luca Fumagalli Angelo Guttadauro Elisa Arborio Matilde De Simone Ugo Cioffi 《世界胃肠外科杂志:英文版(电子版)》 SCIE CAS 2020年第6期287-297,共11页
BACKGROUND Several studies have shown the safety,feasibility and oncologic adequacy of robotic right hemicolectomy(RRH).Laparoscopic right hemicolectomy(LRH)is considered technically challenging.Robotic surgery has be... BACKGROUND Several studies have shown the safety,feasibility and oncologic adequacy of robotic right hemicolectomy(RRH).Laparoscopic right hemicolectomy(LRH)is considered technically challenging.Robotic surgery has been introduced to overcome this technical limitation,but it is related to high costs.To maximize the benefits of such surgery,only selected patients are candidates for this technique.In addition,due to progressive aging of the population,an increasing number of minimally invasive procedures are performed on elderly patients with severe comorbidities,who are usually more prone to post-operative complications.AIM To investigate the outcomes of RRH vs LRH with regard to age and comorbidities.METHODS We retrospectively analyzed 123 minimally invasive procedures(68 LRHs vs 55 RRHs)for right colon cancer or endoscopically unresectable adenoma performed in our Center from January 2014 until September 2019.The surgical procedures were performed according to standardized techniques.The primary clinical outcome of the study was the length of hospital stay(LOS)measured in days.Secondary outcomes were time to first flatus(TFF)and time to first stool evacuation.The robotic technique was considered the exposure and the laparoscopic technique was considered the control.Routine demographic variables were obtained,including age at time of surgery and gender.Body mass index and American Society of Anesthesiologists physical status were registered.The age-adjusted Charlson Comorbidity Index(ACCI)was calculated;the tumornode-metastasis system,intra-operative variables and post-operative complications were recorded.Post-operative follow-up was 180 d.RESULTS LOS,TFF,and time to first stool were significantly shorter in the robotic group:Median 6[interquartile range(IQR)5-8]vs 7(IQR 6-10.5)d,P=0.028;median 2(IQR 1-3)vs 3(IQR 2-4)d,P<0.001;median 4(IQR 3-5)vs 5(IQR 4-6.5)d,P=0.005,respectively.Following multivariable analysis,the robotic technique was confirmed to be predictive of significantly shorter hospitalization and fa 展开更多
关键词 Right hemicolectomy Robotic surgery Laparoscopic surgery Elderly patients COMORBIDITY Hospital stay
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Torsion of Ovarian Tumor in the Elderly: About a Case 认领
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作者 Amadou Bah Ibrahima Diakite +18 位作者 Amadou Maiga Boubacar Yoro Sidibe Madiassa Konaté Zakari Saye Boureima Kelly Tany Koné Siaka Konate Arouna A. Doumbia Bathio Traore Boubacar Karembe Mohamed Lamine Diakite Amadou A. Traoré Abdoulaye Diarra Moustapha Issa Mangane Abdoul Hamidou Almeimoune Bakary T. Dembélé Alhassane Traoré Lassana Kanté Adégné Pierre Togo 《外科学(英文)》 2020年第4期69-73,共5页
We report a case of torsion of an ovarian tumor in a 68-year-old woman with no medical and surgical history. The diagnosis was made in front of an intermittently painful pelvic mass. The treatment consisted of a left ... We report a case of torsion of an ovarian tumor in a 68-year-old woman with no medical and surgical history. The diagnosis was made in front of an intermittently painful pelvic mass. The treatment consisted of a left annexectomy;the anatomopathological examination revealed a fibro-inflammatory and hemorrhagic cyst. Postoperative results were simple with a 12-month follow-up. 展开更多
关键词 TUMOR OVARY CYST SURGERY
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Unusual Foreign Bodies of Surgical Discovery on a Traumatic Spine 认领
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作者 Habib Abdoul Karim Ouiminga Julien T. Savadogo +5 位作者 Denléwendé Sylvain Zabsonré Anatole Jean Innocent Ouedraogo Diane Ndzana Mengyou Li Désiré Harouna Sankara Magatte Gaye 《神经科学国际期刊(英文)》 2020年第1期15-21,共7页
Introduction: Para-spinal non-metallic foreign bodies (fabrics or plastics) are rare and poorly documented. They are often unknown and discovered at the stage of infectious complications and present big therapeutic ch... Introduction: Para-spinal non-metallic foreign bodies (fabrics or plastics) are rare and poorly documented. They are often unknown and discovered at the stage of infectious complications and present big therapeutic challenges. We report a rare case of three para-spinal foreign bodies (fabric, plastic and postoperative gauze) discovered during surgery of a traumatic thoracic spine. Case report: A 32-year-old man admitted for a polytrauma (collision motorcycle-cart). The admission examination noted closed trauma of the thoracic spine, an ASIA score of A, dyspnea, a penetrating wound of the left side of the chest. The CT scan showed a compressive left pleural effusion, multiple ribs fractures, pulmonary contusion, unstable fracture of fifth and sixth thoracic vertebrae associated with posterior epidural hematoma responsible for medullar compression. There was a rounded, para-spinal image, dotted with small areas of low density, air bubbles. We lifted the vital emergency by draining the left pleural effusion, debriding the penetrating chest wound, and administering broad-spectrum antibiotic therapy. Fourteen days later, we decided to stabilize the spine. After a posterior approach, we discovered free pus and para-vertebral three foreign bodies. Enterobacter spp.was isolated in pus susceptible to imipenem. The immediate operative follow-up was simple. Conclusion: The best treatment remains preventive by simple measures, exploration of penetrating wounds, repeated count and careful verification of gauze, because the infectious complications that they generate are source of mortality and serious medico-legal implications. 展开更多
关键词 TEXTILOMA Foreign Body SPINE Traumatism Surgery
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网络在外科无菌术教学改革中的应用 认领
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作者 许新才 孙学斌 《科教文汇》 2020年第16期93-94,共2页
目的:探讨网络在外科无菌术教学中的应用;方法:将网络引入教学,以网络为纽带,将课前、课堂及课后融为一个整体;结果:通过以网络为纽带,将课前、课堂及课后协同作用后,学生对无菌术理论及应用的掌握程度有了明显的提高;结论:促进学生的... 目的:探讨网络在外科无菌术教学中的应用;方法:将网络引入教学,以网络为纽带,将课前、课堂及课后融为一个整体;结果:通过以网络为纽带,将课前、课堂及课后协同作用后,学生对无菌术理论及应用的掌握程度有了明显的提高;结论:促进学生的学习积极性,提升无菌术教学质量及教学效果。 展开更多
关键词 外科 无菌术 教学 网络 改革 应用
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Surgical Outcomes of Nontraumatic Pediatric Cataracts 认领
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作者 Aslihan Uzun Huban Atilla 《眼科学期刊(英文)》 2020年第2期115-122,共8页
Purpose: To evaluate post-surgical complications in patients who were operated for nontraumatic pediatric cataracts in our clinic. Methods: Medical records of 62 patients (101 eyes) that underwent cataract surgery you... Purpose: To evaluate post-surgical complications in patients who were operated for nontraumatic pediatric cataracts in our clinic. Methods: Medical records of 62 patients (101 eyes) that underwent cataract surgery younger than 15 years of age, without history of ocular trauma and with a minimum follow-up period of 6 months, were reviewed retrospectively. Results: The most common initial complaint was leukocoria. Thirty-nine patients (62.9%) had bilateral cataracts and 23 patients (37.1%) had unilateral cataracts. The most common type was posterior polar cataract (22%) in patients with unilateral cataracts, and total cataract (33%) in patients with bilateral cataracts. The overall prevalence of postoperative complications was 58%, visual axis opacification (VAO) being the most common one (39%). The incidence of VAO was significantly higher in eyes with intact posterior capsules. Secondary glaucoma occurred in 12 (12%) eyes. Thirty-one (50%) patients were orthophoria, 17 (27%) patients had esotropia, and 14 (23%) patients had exotropia. Additional surgery for all of these complications was performed in 53 (53%) eyes. Conclusions: Despite appropriate surgical treatment of nontraumatic pediatric cataracts, post-surgical complications including VAO, glaucoma, or strabismus remain an important cause of morbidity in these patients. Posterior capsulotomy and anterior vitrectomy must be performed in all children below 6 years to reduce the need for additional surgery for VAO. 展开更多
关键词 CONGENITAL CATARACT PEDIATRIC CATARACT Visual AXIS OPACIFICATION GLAUCOMA Surgery
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微创旋切术与传统外科手术治疗乳腺良性肿瘤的临床效果对比分析 认领
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作者 代广全 《智慧健康》 2020年第3期99-100,102共3页
目的本文主要研究和对比微创旋切术与传统外科手术治疗乳腺良性肿瘤的临床效果。方法随机选取我院在2015年11月至2018年11月收治的乳腺良性肿瘤患者100例作为研究对象,然后随机分为对照组和观察组,对照组采用传统开放性外科手术治疗,观... 目的本文主要研究和对比微创旋切术与传统外科手术治疗乳腺良性肿瘤的临床效果。方法随机选取我院在2015年11月至2018年11月收治的乳腺良性肿瘤患者100例作为研究对象,然后随机分为对照组和观察组,对照组采用传统开放性外科手术治疗,观察组采用当下最先进的微创旋切术治疗,最后分别对比两种治疗方式的临床效果,包括切口长度、术中出血量、手术时间、切口愈合时间、术后乳房满意度,以及术后并发症。结果治疗结束后,观察组的对照组患者的切口长度(5.2±1.5)mm、术中出血量(15.2±2.8)mL、手术时间(16.5±3.2)min、切口愈合时间(4.2±0.3)天,明显优于对照组,差异明显具有统计学意义(P<0.05);对照组的术后对乳房外观满意度为76%明显低于观察组的满意度100%,差异明显具有统计学意义(P<0.05);在术后并发症上,观察组的发病率为2%明显高于对照组的并发率30%,差异明显具有统计学意义(P<0.05)。结论在乳腺良性肿瘤治疗中,采用微创旋切术可大大缩短切口长度、减少术中出血量、缩短手术时间、缩短愈合时间,另外在术后患者对乳房外观非常满意,得到患者的认可,具有较好的临床效果,值得推广使用。 展开更多
关键词 微创旋切术 外科手术 开放性手术 乳腺良性肿瘤
Burgeoning study of sentinel-node analysis on management of early gastric cancer after endoscopic submucosal dissection 认领
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作者 David Friedel Xiaocen Zhang Stavros Nicholas Stavropoulos 《世界胃肠内镜杂志:英文版(电子版)》 2020年第4期119-127,共9页
Endoscopic submucosal dissection(ESD)represents an organ-preserving alternative to surgical resection of early gastric cancer.However,even with ESD yielding en-bloc resection specimens,there are concerns regarding tum... Endoscopic submucosal dissection(ESD)represents an organ-preserving alternative to surgical resection of early gastric cancer.However,even with ESD yielding en-bloc resection specimens,there are concerns regarding tumor spread such as with larger lesions,ulcerated lesions,undifferentiated pathology and submucosal invasion.Sentinel node navigational surgery(SNNS)when combined with ESD offers a minimally invasive alternative to the traditional extended gastrectomy and lymphadenectomy if lack of lymph node spread can be confirmed.This would have a clear advantage in terms of potential complications and quality of life.However,SNNS,though useful in other malignancies such as breast cancer and melanoma,may not have a sufficient sensitivity for malignancy and negative predictive value in EGC to justify this as standard practice after ESD.The results of SNNS may improve with greater standardization and more involved dissection,technological innovations and more experience and validation such that the paradigm for post-ESD resection of EGC may change and include SNNS. 展开更多
关键词 Early gastric cancer SENTINEL NODE SENTINEL NODE navigation SURGERY Expanded criteria Endoscopic submucosal dissection Function-preserving GASTRECTOMY Organ PRESERVING SURGERY LYMPHADENECTOMY
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Feasibility of robotic assisted bladder sparing pelvic exenteration for locally advanced rectal cancer:A single institution case series 认领
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作者 Nathaniel H Heah Kar Yong Wong 《世界胃肠外科杂志:英文版(电子版)》 SCIE CAS 2020年第4期190-196,共7页
BACKGROUND Pelvic exenteration for locally advanced rectal cancer involving prostate has been performed via open surgery.Robotic pelvic exenteration offers benefits of better pelvic visualisation and dissection for bl... BACKGROUND Pelvic exenteration for locally advanced rectal cancer involving prostate has been performed via open surgery.Robotic pelvic exenteration offers benefits of better pelvic visualisation and dissection for bladder preserving prostatectomy with vesicourethral anastomosis,while achieving clear margins.AIM To determine the feasibility of robotic assisted bladder sparing pelvic exenteration.METHODS We describe robotic assisted pelvic exenteration in three cases of locally advanced rectal cancer involving prostate and seminal vesicles(SV).The da Vinci S robotic system was used.Robotic console was docked at left oblique position for abdominal phase and redocked to between the patient’s legs for pelvic phase.All three cases were performed fully robotically at Tan Tock Seng Hospital by colorectal and urological teams.RESULTS Case 1:67-year-old with low rectal tumour 3 cm from anal verge involving the prostate.He underwent neo-adjuvant chemoradiotherapy and robotic abdominoperineal resection with en-bloc prostatectomy.Case 2:66-year-old with low rectal tumour 3 cm from anal verge involving prostate and bilateral SV.He underwent neo-adjuvant chemoradiotherapy and robot assisted ultra-low anterior resection with coloanal anastomosis and en-bloc prostatectomy.Case 3:57-year-old with metachronous rectal tumour in the rectovesical pouch inseparable from the anterior mid rectum,prostate and bilateral SV.He underwent robot assisted ultra-low anterior resection with en-bloc prostatectomy.Bladder neck margin revealed cauterized tumour cells,and he underwent total cystectomy and ileal conduit creation.Histology revealed no residual tumour.All patients are currently disease free CONCLUSION Robot assisted bladder sparing pelvic exenteration can be safely performed in locally advanced rectal cancer with acceptable surgical outcome while preserving benefits of minimally invasive surgery. 展开更多
关键词 RECTAL cancer Robot SURGERY PELVIC EXENTERATION ANTERIOR resection Prostatectomy Minimal invasive SURGERY
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快速康复外科护理在结直肠癌患者中的应用 认领
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作者 孙云 段艳霞 +2 位作者 白小龙 白育花 薛云珠 《中国继续医学教育》 2020年第7期181-183,共3页
目的探讨快速康复外科护理(FTS)理念在结直肠癌患者中的应用价值。方法本研究选取2016年1月—2017年12月在医院进行手术治疗的100例结直肠癌患者作为研究对象,按照随机分配的原则将所有患者分为对照组(50例)和FTS组(50例);对照组采用常... 目的探讨快速康复外科护理(FTS)理念在结直肠癌患者中的应用价值。方法本研究选取2016年1月—2017年12月在医院进行手术治疗的100例结直肠癌患者作为研究对象,按照随机分配的原则将所有患者分为对照组(50例)和FTS组(50例);对照组采用常规护理,FTS组在对照组基础上采用FTS;对两组术后恢复情况及并发症发生情况进行对比分析。结果FTS组进食时间、下床时间、排气时间、排便时间、胃管留置时间、尿管留置时间、住院时间均显著短于对照组(P<0.05),FTS组并发症总发生率显著低于对照组(P<0.05)。结论快速康复外科护理理念应用于结直肠癌手术患者中可促进恢复,缩短住院时间,降低并发症发生率。 展开更多
关键词 结直肠癌 手术 护理 快速康复外科 手术效果 并发症
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