Left inferior phrenic arterial malformation mimicking gastric varices: A case report and review of literature

BACKGROUND Gastric submucosal arterial dilation resulting from splenic artery occlusion represents an exceedingly rare etiology of acute upper gastrointestinal bleeding(UGIB).Although endoscopy is a widely utilized diagnostic and therapeutic modality for gastrointestinal bleeding,it has limitations in detecting arterial abnormalities.CASE SUMMARY This report presents a rare case of massive UGIB in a 57-year-old male with a tortuous left inferior phrenic artery accompanied by splenic artery occlusion.“Gastric varices”was identified during the patient's endoscopy one year before hemorrhage.Despite initial hemostasis by endoscopic clipping,the patient experienced massive rebleeding after one month,requiring intervention with transcatheter arterial embolization(TAE)to achieve hemostasis.CONCLUSION This is the first case to report UGIB due to a tortuous left inferior phrenic artery.This case highlights the limitations of endoscopy in identifying arterial abnormalities and emphasizes the potential of TAE as a viable alternative for the management of arterial bleeding in the gastrointestinal tract.

Three-dimensional printing for preoperative rehearsal and intraoperative navigation during laparoscopic rectal cancer surgery with left colic artery preservation

BACKGROUND Prior studies have shown that preserving the left colic artery(LCA)during laparo-scopic radical resection for rectal cancer(RC)can reduce the occurrence of anasto-motic leakage(AL),without compromising oncological outcomes.However,anatomical variations in the branches of the inferior mesenteric artery(IMA)and LCA present significant surgical challenges.In this study,we present our novel three dimensional(3D)printed IMA model designed to facilitate preoperative rehearsal and intraoperative navigation to analyze its impact on surgical safety.AIM To investigate the effect of 3D IMA models on preserving the LCA during RC surgery.METHODS We retrospectively collected clinical dates from patients with RC who underwent laparoscopic radical resection from January 2022 to May 2024 at Fuyang People’s Hospital.Patients were divided into the 3D printing and control groups for sta-tistical analysis of perioperative characteristics.RESULTS The 3D printing observation group comprised of 72 patients,while the control group comprised 68 patients.The operation time(174.5±38.2 minutes vs 198.5±49.6 minutes,P=0.002),intraoperative blood loss(43.9±31.3 mL vs 58.2±30.8 mL,P=0.005),duration of hospitalization(13.1±3.1 days vs 15.9±5.6 days,P<0.001),postoperative recovery time(8.6±2.6 days vs 10.5±4.9 days,P=0.007),and the postoperative complication rate(P<0.05)were all significantly lower in the observation group.CONCLUSION Utilization of a 3D-printed IMA model in laparoscopic radical resection of RC can assist surgeons in understanding the LCA anatomy preoperatively,thereby reducing intraoperative bleeding and shortening operating time,demonstrating better clinical application potential.

Left epigastric isolated tumor fed by the inferior phrenic artery diagnosed as ectopic hepatocellular carcinoma:A case report

BACKGROUND Hepatocellular carcinoma(HCC)is one of the most frequent cancers and the main cause of cancer-related death worldwide.Ectopic HCC,an extremely rare type of HCC,exhibits a wide range of clinical signs and radiographic features,making preoperative identification challenging.CASE SUMMARY A 47-year-old man underwent routine abdominal color ultrasonography,which identified an asymptomatic tumor in the left upper abdomen.The patient had no history of hepatitis,did not drink alcohol,and had no family history of cancer.Abdominal contrast-enhanced computed tomography(CT)revealed a heterogeneously enhanced lesion between the spleen and stomach that had invaded the diaphragm,with blood supplied by the left inferior phrenic artery.The patient underwent laparoscopic surgery,and HCC was identified by postoperative pathology.Additionally,specific immunohistochemical staining was performed to assess the molecular biological characteristics of the HCC.The patient underwent two rounds of hepatic arterial interventional chemotherapy after surgery.Abdominal plain and enhanced magnetic resonance imaging and lung CT 3 mo postoperatively revealed no signs of local recurrence or distant metastasis.CONCLUSION This asymptomatic ectopic HCC case described achieved an excellent result due to early detection,radical resection,and systematic surveillance.

Vascular anatomy of inferior mesenteric artery in laparoscopic radical resection with the preservation of left colic artery for rectal cancer

AIM To investigate the vascular anatomy of inferior mesenteric artery(IMA) in laparoscopic radical resection with the preservation of left colic artery(LCA) for rectal cancer. METHODS A total of 110 patients with rectal cancer who underwent laparoscopic surgical resection with preservation of the LCA were retrospectively reviewed. A 3 D vascular reconstruction was performed before each surgical procedure to assess the branches of the IMA. During surgery, the relationship among the IMA, LCA, sigmoid artery(SA) andsuperior rectal artery(SRA) was evaluated, and the length from the origin of the IMA to the point of branching into the LCA or common trunk of LCA and SA was measured. The relationship between inferior mesenteric vein(IMV) and LCA was also evaluated.RESULTS Three vascular types were identified in this study. In type A, LCA arose independently from IMA(46.4%, n = 51); in type B, LCA and SA branched from a common trunk of the IMA(23.6%, n = 26); and in type C, LCA, SA, and SRA branched at the same location(30.0%, n = 33). The difference in the length from the origin of IMA to LCA was not statistically significant among the three types. LCA was located under the IMV in 61 cases and above the IMV in 49 cases. CONCLUSION The vascular anatomy of the IMA and IMV is essential for laparoscopic radical resection with preservation of the LCA for rectal cancer. To recognize different branches of the IMA is necessary for the resection of lymph nodes and dissection of vessels.

Possible key residues that determine left gastric artery blood flow response to PACAP in dogs

AIM:To determine the effect of pituitary adenylate cy-clase-activating polypeptide (PACAP) on left gastric artery (LGA) flow and to unveil the structural or functional important sites that may be critical for discrimination of different receptor subtypes. METHODS: Peptides, including PACAP-27, PACAP-38, amino acid substituted PACAP-27 and C-terminus truncated analogues PACAP (27-38), were synthesized by a simultaneous multiple solid-phase peptide synthesizer. Flow probes of an ultrasound transit-time blood flowmeter were placed around the LGA of beagle dogs. Whenpeptides were infused intravenously, the blood flow was measured.RESULTS: [Ala4, Val5]-PACAP-27 caused a concentration-dependent vasodepressor action which was similar to that caused by PACAP-27. The LGA blood flow response to [Ala4, Val5]-PACAP-27 was significantly higher than that to PACAP-27, which was similar to that to vasoactive intestinal polypeptide (VIP) at the same dose. [Ala6]-PACAP-27 did not increase the peak LGA ? ow. [Gly8]-PACAP-27 showed a similar activity to VIP. [Asn24, Ser25, Ile26]-PACAP-27 did not change the activity of peptides at all doses. CONCLUSION: NH2 terminus is more important to biological activity of peptides and specifi c receptor recognition than COOH-terminus.

Anomalous origin and vulnerable course of left colic artery in relation to the pancreas—A case report

We report here an anomalous origin and course of left colic artery in relation to pancreas during routine dissection of the abdominal region in a 70-year-old male cadaver in the department of anatomy. The anomalous left colic artery took its origin from the superior mesenteric artery and immediately divided into right and left branches. The right branch passed through the transverse mesocolon to supply the left one third of the transverse colon. The left branch traversed to the left along the inferior border of the body of the pancreas and crossed the left kidney before supplying the left colic flexure of colon and descending colon. This aberrant course of the left branch of the left colic artery can be considered as a “vulnerable” course as it is liable to injury during pancreatic and renal surgeries since the artery is not expected to run along the inferior border of the pancreas. The pancreas, a retroperitoneal organ, is related to major arteries such as abdominal aorta, inferior vena cava, coeliac trunk and its main branches, superior mesenteric vessels, splenic and portal veins. Surgery of the pancreas therefore, not only needs a thorough knowledge of the normal course of branches of these vessels but also demands a good knowledge of possible anomalous vessels arising in this region.

Clinical significance of aberrant left hepatic artery during gastrectomy:A systematic review

BACKGROUND Vascular variations are frequently encountered during surgery.Approximately thirty percent of these variations are aberrant left hepatic arteries originating from the left gastric artery.AIM To summarize the safety and feasibility of aberrant left hepatic arteries(ALHA)ligation in gastric cancer patients who underwent laparoscopic-assisted gastrectomy(LAG).METHODS The literature search was systematically performed on databases including Pub Med,Embase,and Cochrane Library.The publishing date of eligible studies was from inception to June 2021.RESULTS A total of nine studies were included according to the inclusion and exclusion criteria in this review.The variation rate of ALHA ranged from 7.00%to 20.70%,and four studies compared the differences between the ALHA ligation group and the preservation group.Only one study showed worse postoperative outcomes in the ALHA ligation group.In all the included studies,a significant difference was found between the ALHA ligation group and the preservation group in terms of postoperative liver enzymes after LAG.However,there was no significant difference in the number of retrieved lymph nodes between the two groups.CONCLUSION In conclusion,it is not always safe and feasible for surgeons to ligate the ALHA during LAG surgery,and it is necessary for gastric cancer patients to undergo preoperative examination to clarify the ALHA subtypes,measure the diameter of the ALHA,and determine whether the patients have chronic liver disease.

Retrograde embolization technique of the right gastric artery during the implantation of port-catheter system for hepatic arterial infusion chemotherapy

Objective:This study aimed to introduce and evaluate a new embolization technique for the right gastric artery(RGA) during percutaneous implantation of a port-catheter system for hepatic arterial infusion chemotherapy(HAIC).Methods:From January 2013 to January 2017,159 patients with unresectable advanced liver cancer underwent percutaneous implantation of a port-catheter system.In 86 of these patients(56 men;aged 28-88 years;mean:60.6±12.0 years),in whom the RGA was obvious on arteriography,embolization of RGA was attempted using microcoils to protect the gastric mucosa during HAIC.In the first phase(first three years),antegrade embolization of the RGA using a 2.7 Fr microcatheter was performed in 55 patients.In the second phase(next two years),embolization of the RGA was attempted by combining antegrade embolization and retrograde embolization through the left gastric artery(LGA) in 31 patients.The success rates and the incidence of acute gastroduodenal mucosal toxicity(AGMT) in these two groups were compared.Results:The total success rate of the RGA embolization was 70.9%.The success rate was 83.9% in 31 patients who underwent combined antegrade and retrograde embolization,which was significantly higher than that of antegrade embolization alone(63.6%) performed in 55 patients(p=0.047).No complications related to embolization of RGA were documented.The incidence of AGMT was 29.1%(16/55) in patients in the first phase,which was significantly higher than that in the patients in the second phase(9.7%,3/31)(p=0.037).Conclusion: A combination of retrograde embolization via LGA could increase the success rates of RGA embolization and reduce the incidence of AGMT after HAIC.

Angiographic Findings of Extrahepatic Branches Originating from Hepatic Artery and Its Clinical Significance

Objective： To observe the presentation and variation of extrahepatic branches originating from hepatic artery by hepatic arteriography. Methods： Hepatic arteriogram of 200 cases with unresectable hepatic primary or metastatic tumors before interventional therapy were retrospectively analyzed. Two interventional radiologists independently reviewed the type, originating artery, distribution and variation of extrahepatic artery. Results： Five types of extrahepatic artery were found, with the most common type of the right gastric artery （n=156, 78%）, followed by the cystic artery （n=126, 63%）, accessory left gastric artery （n=19, 9.5%）, hepatic falciform artery （n=5, 2.5%）, and accessory left inferior phrenic artery （n=4, 2%）. In 188 cases, there were extrahepatic arteries derived from hepatic proper artery or its branches, and the most frequent originating site was the right hepatic artery （130 extrahepatic branches）, followed by the proper hepatic artery （103 branches）, left hepatic artery （56 branches） and middle hepatic artery （3 branches）. The left hepatic artery was the arising site with the multiple types of extrahepatic branches including all above branches except the cystic artery. Conclusion： Many types of extrahepatic branches usually derive from the hepatic artery or its distal branches, and its originating sites are not constant. It is important to avoid damage of extrahepatic tissue during interventional therapy for liver tumors.

Acute pancreatitis associated left-sided portal hypertension with severe gastrointestinal bleeding treated by transcatheter splenic artery embolization:a case report and literature review

Left-sided portal hypertension(LSPH)followed by acute pancreatitis is a rare condition with most patients being asymptomatic.In cases where gastrointestinal(GI)bleeding is present,however,the condition is more complicated and the mortality is very high because of the difficulty in diagnosing and selecting optimal treatment.A successfully treated case with severe GI bleeding by transcatheter splenic artery embolization is reported in this article.The patient exhibited severe uncontrollable GI bleeding and was confirmed as gastric varices secondary to LSPH by enhanced computed tomography(CT)scan and CT-angiography.After embolization,the bleeding stopped and stabilized for the entire follow-up period without any severe complications.In conclusion,embolization of the splenic artery is a simple,safe,and effective method of controlling gastric variceal bleeding caused by LSPH in acute pancreatitis.

腹腔镜下直肠癌根治术中淋巴结清扫的争议与进展

腹腔镜下直肠癌根治术是目前直肠恶性肿瘤的主要治疗方式。淋巴结的清扫是决定手术根治性的重要因素。淋巴结清扫范围以及淋巴结的清扫方式是手术的关键。本文结合国内外指南、文献以及刁德昌教授团队的实践经验,对腹腔镜下直肠癌根治术中淋巴结清扫的争议与进展进行论述。为临床直肠癌淋巴结清扫选择提供参考,以更好地平衡肿瘤治疗效果和患者功能保护。

保留左结肠动脉腹腔镜直肠癌根治术对患者胃功能、并发症的影响

目的探析保留左结肠动脉(leftcolicartery,LCA)腹腔镜直肠癌根治术对患者胃功能、并发症的影响。方法选取2020年12月至2023年11月敦化市医院收治的57例行腹腔镜直肠癌根治术患者,按随机数字分组法分为对照组(28例)与观察组(29例)。对照组患者术中不保留LCA,观察组术中保留LCA。对比两组并发症发生率、胃功能、排尿功能、肛肠动力学。结果与术前比,术后30d两组患者的胃泌素、胃动素、胃蛋白酶原Ⅰ、降钙素基因相关肽(calcitonin gene-related peptide,CGRP)水平均升高,且观察组患者的胃泌素、胃动素、胃蛋白酶原Ⅰ、CGRP水平高于对照组;与术前相比,术后30d两组患者的肛管静息压、肛管最大收缩压均降低,且观察组患者的肛管静息压、肛管最大收缩压均高于对照组,差异均有显著性(P<0.05)。术后7d两组患者的膀胱过度活动症状评分(overactive bladder symptom scale,OABSS)各项评分较术前均降低,且术后7d观察组患者的OABSS各项评分低于对照组,差异均有显著性(P<0.05)。观察组患者术后并发症总发生率低于对照组,差异有显著性(P<0.05)。结论腹腔镜根治术中保留LCA可改善直肠癌患者的肛肠动力学指标,快速恢复其胃功能与排尿功能,并降低并发症发生风险。

左结肠动脉保留在腹腔镜下直肠癌根治术中的临床价值

目的 探讨腹腔镜下直肠癌根治术中保留左结肠动脉的临床价值。方法 回顾性分析我院行腹腔镜下直肠癌根治术的93例直肠癌患者的临床资料,将术中保留左结肠动脉的48例患者纳入保留组,术中未保留左结肠动脉的45例患者纳入未保留组。比较2组患者围术期相关指标、并发症发生情况及术后1、2、3年生存率。结果 与未保留组比较,保留组患者首次肛门排气时间、肠鸣音恢复时间及首次进食时间缩短,术中失血量减少,手术时间延长,差异均有统计学意义(P<0.05);2组患者淋巴结清扫数比较差异无统计学意义(P>0.05)。2组术后并发症发生率及术后1、2、3年生存率比较,差异均无统计学意义(P>0.05)。结论腹腔镜下直肠癌根治术中保留左结肠动脉可减少术中出血量,促进患者术后胃肠功能恢复,且不会增加并发症,更符合人体解剖学结构理念。

腹腔镜左半结肠癌根治术中采用IMA-CMA技术对淋巴结清扫的影响分析

目的 探讨腹腔镜左半结肠癌根治术中采用肠系膜下动脉优先解剖联合完全内侧入路(Priority Anatomy of the Inferior Mesenteric Artery Combined with Complete Medial Approach,IMA-CMA)技术对淋巴结清扫的影响。方法 回顾性选取2019年5月-2023年5月南平第一医院治疗的81例腹腔镜左半结肠癌根治术患者的临床资料,根据手术方法不同分为IMA-CMA组和对照组,其中IMA-CMA组44例,对照组37例。对照组采用传统入路技术,IMA-CMA组采用IMA-CMA技术,比较两组患者的手术相关指标、淋巴结清扫情况、术后肠功能恢复情况、并发症发生情况及复发率和转移率。结果 同对照组相比较,IMA-CMA组手术时间较短,术中出血量较低,253组淋巴结清扫数目较多,差异有统计学意义(P均<0.05)。同对照组相比较,IMA-CMA组腹痛腹胀持续时间、术后排便时间及术后排气时间均较短,差异有统计学意义(P均<0.05)。IMA-CMA组并发症发生率为4.55%,低于对照组的18.92%,差异有统计学意义(χ^(2)=4.204,P<0.05)。术后1年,IMA-CMA组和对照组复发率、转移率比较,差异无统计学意义(P均>0.05)。结论 腹腔镜左半结肠癌根治术中采用IMA-CMA技术能够缩短手术时间,减少术中出血量,对淋巴结的清扫情况更佳,且可以改善术后肠功能恢复情况及并发症发生情况,不增加复发和转移风险。

Clinical Implication of ST Segment Depression in aVR &aVL in Patients with Acute Inferior Wall Myocardial Infarction

Objectives: The aim of the study was to assess the role of ST segment depression in the limb leads aVR and aVL for the diagnosis of acute posterior wall infarction and the identification of infarct related artery (IRA) in patients with acute inferior wall MI. Methods: In 159 patients with I-STEMI, 127 (80%) had RCA occlusion and 32 (20%) had LCX occlusion. In the ECG algorithms, RCA occlusion was indicated by ST depression in lead aVL higher than lead aVR and no ST depression in lead aVL and aVR. LCX occlusion was indicated by ST depression in lead aVR higher than or equal to lead aVL and no ST depression in aVL and aVR. Results: The sensitivity, specificity, positive and negative predictive values of these algorithms were high (98%, 82%, 92% and 95% for RCA occlusion and 83%, 98%, 95% and 92% for LCX occlusion). Conclusion: The ECG algorithms can reliably identify the culprit artery in I-STEMI. ST segment depression in limb leads aVR and aVL with avR ≥ aVL helps to diagnose left circumflex artery as a culprit IRA in an acute inferior wall MI.

保留左结肠-乙状结肠动脉弓在中低位直肠癌根治术中的应用体会

目的:探讨在中低位直肠癌根治术中,保留左结肠-乙状结肠动脉弓对吻合口血供和张力的影响及应用价值。方法:回顾性分析安徽医科大学第二附属医院2019年1月-2021年5月行腹腔镜中低位直肠癌根治术60例患者的临床资料,保留(研究组)和不保留左结肠-乙状结肠动脉弓(对照组)患者各30例。记录术中肠管断端血供、肠系膜根部淋巴结数目、保留乙状结肠肠管长度、淋巴结清扫时间、手术时间和出血量,以及术后并发症情况。结果:60例患者均顺利完成手术,无围手术期死亡病例。研究组结肠断端血供良好率高于对照组(P<0.05),对照组有4例患者肠管预切线处血供不佳,需进一步游离结肠脾区。研究组乙状结肠剩余长度明显长于对照组(P<0.05)。研究组淋巴结清扫时间长于对照组,差异有统计学意义(P<0.05)。肠系膜下动静脉根部淋巴结清扫数目、手术时间和术中出血量,两组差异均无统计学意义(P>0.05)。术后并发症研究组5例,对照组6例,两组差异无统计学意义(P>0.05)。研究组无吻合口漏,对照组吻合口漏1例。结论:中低位直肠癌根治术中保留左结肠-乙状结肠动脉弓,未明显增加手术时间和术后并发症的发生,肿瘤根治效果与传统手术相似。该术式通过增加吻合口近端肠管的长度可以减少吻合口张力,同时改善吻合口血供,可能有利于降低吻合口漏的发生,近期疗效较好。

直肠癌手术中低位结扎肠系膜下动脉的争议

肠系膜下动脉(inferior mesenteric artery, IMA)的结扎是直肠癌手术中至关重要的一步,但其结扎水平却一直难以达成统一的认识。主要争议点是,关于术中左结肠动脉(left colic artery, LCA)是否保留,其吻合口漏发生率、IMA根部淋巴结(253站淋巴结)清扫、术中神经损伤及术后排便、排尿及性功能的影响等在各研究中心不能达成一致,这就造成了在手术时术者对于手术术式的选择难以形成统一的规范,因此不论对术者或是患者都会产生不同程度的影响。随着腹腔镜辅助下手术技术及高清镜、3D腹腔镜、4K高清镜、显微外科、三维CT血管造影技术的发展,之前术中的一些解剖难题及难以实施的精细手术操作也得到了很大程度的解决和改进,这些都为术者选择更加安全合理可行的术式提供了支撑。

保留左结肠动脉在腹腔镜直肠癌根治术中的临床疗效观察

目的:探讨保留左结肠动脉(LCA)在腹腔镜直肠癌根治术中的临床效果。方法:回顾性分析接受腹腔镜直肠癌根治术的中低位直肠癌患者98例,根据术中LCA保留与否分为保留组(45例)和不保留组(53例),比较2组患者术中情况(手术时间、出血量、标本切除长度)、术后病理及术后恢复情况(术后排气时间、术后排便时间、住院时间)和并发症等临床指标。结果:2组手术时间、术中出血量比较,差异无统计学意义(P>0.05);2组淋巴结清扫总数[(16.67±4.45)vs(18.02±6.84)枚]、253组淋巴结清扫总数[(2.87±1.77)vs(3.13±1.43)枚]比较差异均无统计学意义(P>0.05);保留组术后排气时间[(2.02±0.72)vs(2.79±0.77)d]及排便时间[(3.04±1.87)vs(3.92±1.16)d]均优于不保留组,差异有统计学意义(P<0.05);保留组术后并发症总发生率(13.33%)低于不保留组(22.64%),但差异无统计学意义(P>0.05)。结论:腹腔镜直肠癌根治术中保留LCA,不影响淋巴结清扫,可改善患者术后胃肠道功能,手术方式安全可行。

腹腔镜下左半结肠切除术中切除肠系膜下动脉主干的近期疗效观察

目的:观察腹腔镜辅助左半结肠切除术中切除肠系膜下动脉(inferior mesenteric artery,IMA)主干的近期疗效。方法:选取2018年2月—2021年2月南阳市第二人民医院就诊的94例行腹腔镜下左半结肠切除术的结肠癌患者作为研究对象,按随机数表法分为观察组(47例)与对照组(47例)。观察组在行腹腔镜左半结肠切除术时,保留左结肠动脉(left colic artery,LCA)以及两支左右的乙状结肠动脉(sigmoid artery,SA),于远端离断肠系膜下动脉主干;对照组则解剖IMA主干,并清扫其周围淋巴结,分离出LCA与一支SA之后,于根部闭合离断LCA以及该SA。比较两组患者的手术情况、术后恢复情况及并发症发生率。结果:观察组患者手术时间短于对照组,术中出血量少于对照组,切除肠管长度大于对照组,差异有统计学意义(t=5.065、7.174、2.436,P<0.05),淋巴结清扫数目无明显差异,差异无统计学意义(t=0.443,P>0.05);观察组术后首次排气时间短于对照组,胃肠道功能恢复时间、引流管拔除时间早于对照组,住院时间短于对照组,差异有统计学意义(t=3.548、2.674、2.763、3.571,P<0.05);术后30 d两组患者的并发症发生情况无明显差异,差异无统计学意义(χ^(2)=0.123,P>0.05)。结论:腔镜辅助下左半结肠切除术中切除IMA主干的近期疗效优于保留IMA主干,术中出血量较少,手术时间较短,切除可疑肠管的长度增加,术后恢复较快。

术前影像学诊断肝总动脉起源于胃左动脉1例及手术安全性探讨

目的报道1例通过术前影像学检查发现的肝总动脉起源于胃左动脉的肝动脉变异并复习相关文献。方法通过术前增强计算机断层扫描(CT)及磁共振成像(MRI)检查发现肝总动脉起源于胃左动脉的动脉变异,在腹腔镜手术中进行查证,并于术后补充CT血管造影再验证。结果术中证实患者存在肝总动脉起源于胃左动脉的动脉变异,术后CT血管造影再次证实存在该变异。结论肝总动脉起源于胃左动脉的肝动脉变异在临床或尸体解剖中极少被发现,而掌握这种解剖变异可以让术者在术前做好充足准备,并指导手术施行以确保患者有良好的短期及长期预后。