BACKGROUND Renal anastomosing hemangioma(AH)is a rare benign vascular tumor characterized by unique histopathological features.CASE SUMMARY We report a highly unusual case of renal AH.A male patient had undergone part...BACKGROUND Renal anastomosing hemangioma(AH)is a rare benign vascular tumor characterized by unique histopathological features.CASE SUMMARY We report a highly unusual case of renal AH.A male patient had undergone partial nephrectomy for clear cell carcinoma of the kidney four years prior.A follow-up computed tomography scan in the third postoperative year revealed a new mass near the surgical site on the same side of the kidney,raising suspicions of tumor recurrence.However,the characteristics on contrast-enhanced magnetic resonance imaging and ultrasonography were more consistent with those of a benign lesion.The patient strongly insisted on undergoing surgery due to concerns about the possibility of renal cancer recurrence.Postoperative pathology confirmed the diagnosis of renal AH.CONCLUSION This case report presents the imaging features of a patient with rare renal AH and a history of renal clear cell carcinoma,providing broader insights into the differential diagnosis of new lesions after surgery for renal cell carcinoma.展开更多
Since the introduction of stapling instruments in the 1970s various studies have compared the results of sutured and stapled bowel anastomoses. A literature search was performed from 1960 to 2010 and articles relating...Since the introduction of stapling instruments in the 1970s various studies have compared the results of sutured and stapled bowel anastomoses. A literature search was performed from 1960 to 2010 and articles relating to small bowel, colonic and colorectal anastomotic techniques were reviewed. References from these articles were also reviewed, and relevant articles obtained. Either a stapled or sutured gastrointestinal tract anastomosis is acceptable in most situations. The available evidence suggests that in the following situations, however, particular anastomotic techniques may result in fewer complications: A stapled side-to-side ileocolic anastomosis is preferable following a right hemicolectomy for cancer. A stapled side-to-side anastomosis is likely also preferable after an ileocolic resection for Crohn’s disease. Colorectal anastomoses can be sutured or stapled with similar results, although the incidence of strictures is higher following stapled anastomoses. Following reversal of loop ileostomy there is some evidence to suggest that a stapled side-to-side anastomosis or sutured enterotomy closure (rather than spout resection and sutured anastomosis) results in fewer complications. Non-randomised data has indicated that small bowel anastomoses are best sutured in the trauma patient. This article reviews the theory, practice and evidence base behind the various gastrointestinal anastomoses to help the practising general surgeon make evidence based operative decisions.展开更多
BACKGROUND Anastomosing hemangioma(AH)is a rare subtype of benign hemangioma that is most commonly found in the genitourinary tract.Due to the lack of specific clinical and radiologic manifestations,it is easily misdi...BACKGROUND Anastomosing hemangioma(AH)is a rare subtype of benign hemangioma that is most commonly found in the genitourinary tract.Due to the lack of specific clinical and radiologic manifestations,it is easily misdiagnosed preoperatively.Here,we report a case of AH arising from the left renal vein that was discovered incidentally and confirmed pathologically,and then describe its imaging characteristics from a radiologic point of view and review its clinicopathologic features and treatment.CASE SUMMARY A 74-year-old woman was admitted to our department for a left retroperitoneal neoplasm measuring 2.6 cm×2.0 cm.Her laboratory data showed no significant abnormalities.A non-contrast-enhanced computed tomography(CT)scan showed a heterogeneous density in the neoplasm.Non-contrast-enhanced magnetic resonance imaging(MRI)revealed a heterogeneous hypointensity on T1-weighed images and a heterogeneous hyperintensity on T2-weighed images.On contrastenhanced CT and MRI scans,the neoplasm presented marked septal enhancement in the arterial phase and persistent enhancement in the portal phase,and its boundary with the left renal vein was ill-defined.Based on these clinical and radiological manifestations,the neoplasm was initially considered to be a neurogenic neoplasm in the left retroperitoneum.Finally,the neoplasm was completely resected and pathologically diagnosed as AH.CONCLUSION AH is an uncommon benign hemangioma.Preoperative misdiagnoses are common not only because of a lack of specific clinical and radiologic manifestations but also because clinicians lack vigilance and diagnostic experience in identifying AH.AH is not exclusive to the urogenital parenchyma.We report the first case of this neoplasm in the left renal vein.Recognition of this entity in the left renal vein can be helpful in its diagnosis and distinction from other neoplasms.展开更多
Anastomosing hemangioma is a type of tumor lesion of benign behavior scarcely documented, it has been observed in renal parenchyma, testicles, ovaries and adrenal glands, it is usually prone to perirenal and renal med...Anastomosing hemangioma is a type of tumor lesion of benign behavior scarcely documented, it has been observed in renal parenchyma, testicles, ovaries and adrenal glands, it is usually prone to perirenal and renal medullary adipose tissue. In this case report, we present an anastomosed hemangioma in the right kidney of a 33-year-old woman, with previous coexistence of breast cancer, in which an unusual behavior was detected, with characteristics of vascular lesion, in this case we report: The classic conditions, its heterogeneous nature and the vascular alterations that presents in different imaging modalities.展开更多
Both interchannel wetlands and multi-channels are crucial geomorphologic units in an anastomosing river system. Planform characteristics and development of interchannel wetlands and multi-channels control the characte...Both interchannel wetlands and multi-channels are crucial geomorphologic units in an anastomosing river system. Planform characteristics and development of interchannel wetlands and multi-channels control the characteristics of anastomosing rivers. To under- stand the role that interchannel wetlands play in the development of anastomosing rivers, a study was conducted on the Maqu Reach of the Upper Yellow River （MRUYR）, a gravel-bed anastomosing river characterized by highly developed interchannel wetlands and ana- branches. Geomorphologic units in the studied reach were extracted from high resolution satellite imagery in Google Earth. The size distributions of interchannel wetlands and inter- channel wetland clusters （IWCs）, a special combination of interchannel wetlands and ana- branches, were investigated. Geomorphologic parameters, including the ratio of interchannel wetland area to IWC area （P）, shoreline density （DL）, and node density （Dn） were used to analyze planform characteristics of IWCs and the development of multi-channels in the stud- ied reach. The results suggest that small or middle sized interchannel wetlands and large or mega sized IWCs are more common at the study site. The area of IWC （Su） is highly cor- related with other geomorphologic parameters. P increases with increasing Su, and the upper limit is about 80%, which indicates that the development of interchannel wetlands and ana- branches in the IWC is in the equilibrium stage. In contrast, D~ and D, show a tendency to decrease with increasing Su due to diverse evolution processes in IWCs with different sizes. There are three main reasons leading to the formation of IWCs： varying stream power due to the meandering principal channel; development of the river corridor due to the weakening of geologic structure control; and high stability of interchannel wetlands due to conservation by shoreline vegetation.展开更多
The anastomosing fluvial system was considered as the same term of the braided fluvial system. Smith and others have recognized the difference between them. They described the anastomosing fluvial system as 'a low...The anastomosing fluvial system was considered as the same term of the braided fluvial system. Smith and others have recognized the difference between them. They described the anastomosing fluvial system as 'a low energy complex of several interconnected channels of variable sinuosity crossing a wetland and forming many elongate vegetated islands', and established a depositional model of anastomosing fluvial system based on their展开更多
The anastomosing river that is present within the First Great Bend of the Yellow River is different from other sand-bedded rivers of this type because it contains gravel-bedded materials. It is therefore important to ...The anastomosing river that is present within the First Great Bend of the Yellow River is different from other sand-bedded rivers of this type because it contains gravel-bedded materials. It is therefore important to determine whether, or not, the specific characteristics of this anastomosing river are similar to those seen in sand-bedded forms, including the characteristics of erosion and deposition, and the stability of channel and interchannel wetlands. Four Landsat images from 1990, 2001, 2013, and 2016 alongside two Google Earth(GE) images from 2011 and 2013 were utilized in this study in tandem with field sampling and observations to select a 12 km main channel length section of the Qihama reach anastomosing river. This section was then used to determine variations in channel planform and sedimentary characteristics over a 26 year period. The results of this study show that this gravel-bedded anastomosing river has exhibited a high degree of stability overall, and that there has been no obvious channel and wetland bank erosion and deposition. Data also show that over the 26 years of this study, anastomosing belt area increased by 2.43%, while the ratio of land to water area remained almost equal. The number of wetlands has also increased along this river section at a rate as high as 62.16% because of the fragmentation of some small interchannel examples, while the talweg has alternately migrated to either the left or right over long periods of time at a relatively stable rate. Indeed, as a result of the migration of this line, there has been significant turnover in the number of islands within the main channel while bank shift has occurred at a rate of about 5 m/yr. The numerous anastomosing channels within this river section remained very stable over the course of this study, characterized by a mean annual migration rate of just 1 m/yr, while the sediments in bank columnar sections are mainly composed of fine sands or silts with a relatively high clay content. The sediment grain-size distribution curve for this river section contains multiple peaks, distinct from the muddy sediments within bank columnar sections from sand-bedded anastomosing rivers. The dense vegetation within riparian and interchannel wetlands alongside this river reach has also protected anastomosing channels from erosion and maintainedtheir stability, a key feature of this gravel-bedded system.展开更多
The development of intestinal anastomosis techniques,including hand suturing,stapling,and compression anastomoses,has been a significant advancement in surgical practice.These methods aim to prevent leakage and minimi...The development of intestinal anastomosis techniques,including hand suturing,stapling,and compression anastomoses,has been a significant advancement in surgical practice.These methods aim to prevent leakage and minimize tissue fibrosis,which can lead to stricture formation.The healing process involves various phases:hemostasis and inflammation,proliferation,and remodeling.Mechanical staplers and sutures can cause inflammation and fibrosis due to the release of profibrotic chemokines.Compression anastomosis devices,including those made of nickel-titanium alloy,offer a minimally invasive option for various surgical challenges and have shown safety and efficacy.However,despite advancements,anastomotic techniques are evaluated based on leakage risk,with complications being a primary concern.Newer devices like Magnamosis use magnetic rings for compression anastomosis,demonstrating greater strength and patency compared to stapling.Magnetic technology is also being explored for other medical treatments.While there are promising results,particularly in animal models,the realworld application in humans is limited,and further research is needed to assess their safety and practicality.展开更多
In this editorial,we comment on the article by Chen and Cai.We focus on renal anastomotic hemangioma,which is a rare benign hemangiomatous disease.This disease has unique clinical characteristics.Its biological behavi...In this editorial,we comment on the article by Chen and Cai.We focus on renal anastomotic hemangioma,which is a rare benign hemangiomatous disease.This disease has unique clinical characteristics.Its biological behavior is benign,but its imaging results are similar to those of renal cancer.Renal anastomotic hemangioma is easy to misdiagnose and can lead to unnecessary radical nephrectomy.Therefore,urologists need a better understanding of this disease.We believe that patients with renal anastomotic hemangioma should receive individualized diagnosis and treatment to avoid overtreatment.展开更多
BACKGROUND Portal vein arterialization(PVA)has been used in liver transplantation(LT)to maximize oxygen delivery when arterial circulation is compromised or has been used as an alternative reperfusion technique for co...BACKGROUND Portal vein arterialization(PVA)has been used in liver transplantation(LT)to maximize oxygen delivery when arterial circulation is compromised or has been used as an alternative reperfusion technique for complex portal vein thrombosis(PVT).The effect of PVA on portal perfusion and primary graft dysfunction(PGD)has not been assessed.All patients receiving PVA and LT at the Fundacion Santa Fe de Bogota between 2011 and 2022 were analyzed.To account for the time-sensitive effects of graft perfusion,patients were classified into two groups:prereperfusion(pre-PVA),if the arterioportal anastomosis was performed before graft revascularization,and postreperfusion(post-PVA),if PVA was performed afterward.The pre-PVA rationale contemplated poor portal hemodynamics,severe vascular steal,or PVT.Post-PVA was considered if graft hypoperfusion became evident.Conservative interventions were attempted before PVA.展开更多
文摘BACKGROUND Renal anastomosing hemangioma(AH)is a rare benign vascular tumor characterized by unique histopathological features.CASE SUMMARY We report a highly unusual case of renal AH.A male patient had undergone partial nephrectomy for clear cell carcinoma of the kidney four years prior.A follow-up computed tomography scan in the third postoperative year revealed a new mass near the surgical site on the same side of the kidney,raising suspicions of tumor recurrence.However,the characteristics on contrast-enhanced magnetic resonance imaging and ultrasonography were more consistent with those of a benign lesion.The patient strongly insisted on undergoing surgery due to concerns about the possibility of renal cancer recurrence.Postoperative pathology confirmed the diagnosis of renal AH.CONCLUSION This case report presents the imaging features of a patient with rare renal AH and a history of renal clear cell carcinoma,providing broader insights into the differential diagnosis of new lesions after surgery for renal cell carcinoma.
文摘Since the introduction of stapling instruments in the 1970s various studies have compared the results of sutured and stapled bowel anastomoses. A literature search was performed from 1960 to 2010 and articles relating to small bowel, colonic and colorectal anastomotic techniques were reviewed. References from these articles were also reviewed, and relevant articles obtained. Either a stapled or sutured gastrointestinal tract anastomosis is acceptable in most situations. The available evidence suggests that in the following situations, however, particular anastomotic techniques may result in fewer complications: A stapled side-to-side ileocolic anastomosis is preferable following a right hemicolectomy for cancer. A stapled side-to-side anastomosis is likely also preferable after an ileocolic resection for Crohn’s disease. Colorectal anastomoses can be sutured or stapled with similar results, although the incidence of strictures is higher following stapled anastomoses. Following reversal of loop ileostomy there is some evidence to suggest that a stapled side-to-side anastomosis or sutured enterotomy closure (rather than spout resection and sutured anastomosis) results in fewer complications. Non-randomised data has indicated that small bowel anastomoses are best sutured in the trauma patient. This article reviews the theory, practice and evidence base behind the various gastrointestinal anastomoses to help the practising general surgeon make evidence based operative decisions.
基金the People’s Livelihood Science and Technology Innovation Project of the Bureau of Science and Technology of Jiaxing City,No.2019AD32201。
文摘BACKGROUND Anastomosing hemangioma(AH)is a rare subtype of benign hemangioma that is most commonly found in the genitourinary tract.Due to the lack of specific clinical and radiologic manifestations,it is easily misdiagnosed preoperatively.Here,we report a case of AH arising from the left renal vein that was discovered incidentally and confirmed pathologically,and then describe its imaging characteristics from a radiologic point of view and review its clinicopathologic features and treatment.CASE SUMMARY A 74-year-old woman was admitted to our department for a left retroperitoneal neoplasm measuring 2.6 cm×2.0 cm.Her laboratory data showed no significant abnormalities.A non-contrast-enhanced computed tomography(CT)scan showed a heterogeneous density in the neoplasm.Non-contrast-enhanced magnetic resonance imaging(MRI)revealed a heterogeneous hypointensity on T1-weighed images and a heterogeneous hyperintensity on T2-weighed images.On contrastenhanced CT and MRI scans,the neoplasm presented marked septal enhancement in the arterial phase and persistent enhancement in the portal phase,and its boundary with the left renal vein was ill-defined.Based on these clinical and radiological manifestations,the neoplasm was initially considered to be a neurogenic neoplasm in the left retroperitoneum.Finally,the neoplasm was completely resected and pathologically diagnosed as AH.CONCLUSION AH is an uncommon benign hemangioma.Preoperative misdiagnoses are common not only because of a lack of specific clinical and radiologic manifestations but also because clinicians lack vigilance and diagnostic experience in identifying AH.AH is not exclusive to the urogenital parenchyma.We report the first case of this neoplasm in the left renal vein.Recognition of this entity in the left renal vein can be helpful in its diagnosis and distinction from other neoplasms.
文摘Anastomosing hemangioma is a type of tumor lesion of benign behavior scarcely documented, it has been observed in renal parenchyma, testicles, ovaries and adrenal glands, it is usually prone to perirenal and renal medullary adipose tissue. In this case report, we present an anastomosed hemangioma in the right kidney of a 33-year-old woman, with previous coexistence of breast cancer, in which an unusual behavior was detected, with characteristics of vascular lesion, in this case we report: The classic conditions, its heterogeneous nature and the vascular alterations that presents in different imaging modalities.
基金Foundation： National Natural Science Foundation of China, No.41571005, No.4 1271027
文摘Both interchannel wetlands and multi-channels are crucial geomorphologic units in an anastomosing river system. Planform characteristics and development of interchannel wetlands and multi-channels control the characteristics of anastomosing rivers. To under- stand the role that interchannel wetlands play in the development of anastomosing rivers, a study was conducted on the Maqu Reach of the Upper Yellow River （MRUYR）, a gravel-bed anastomosing river characterized by highly developed interchannel wetlands and ana- branches. Geomorphologic units in the studied reach were extracted from high resolution satellite imagery in Google Earth. The size distributions of interchannel wetlands and inter- channel wetland clusters （IWCs）, a special combination of interchannel wetlands and ana- branches, were investigated. Geomorphologic parameters, including the ratio of interchannel wetland area to IWC area （P）, shoreline density （DL）, and node density （Dn） were used to analyze planform characteristics of IWCs and the development of multi-channels in the stud- ied reach. The results suggest that small or middle sized interchannel wetlands and large or mega sized IWCs are more common at the study site. The area of IWC （Su） is highly cor- related with other geomorphologic parameters. P increases with increasing Su, and the upper limit is about 80%, which indicates that the development of interchannel wetlands and ana- branches in the IWC is in the equilibrium stage. In contrast, D~ and D, show a tendency to decrease with increasing Su due to diverse evolution processes in IWCs with different sizes. There are three main reasons leading to the formation of IWCs： varying stream power due to the meandering principal channel; development of the river corridor due to the weakening of geologic structure control; and high stability of interchannel wetlands due to conservation by shoreline vegetation.
文摘The anastomosing fluvial system was considered as the same term of the braided fluvial system. Smith and others have recognized the difference between them. They described the anastomosing fluvial system as 'a low energy complex of several interconnected channels of variable sinuosity crossing a wetland and forming many elongate vegetated islands', and established a depositional model of anastomosing fluvial system based on their
基金National Natural Science Foundation of China,No.41571005,No.41271027
文摘The anastomosing river that is present within the First Great Bend of the Yellow River is different from other sand-bedded rivers of this type because it contains gravel-bedded materials. It is therefore important to determine whether, or not, the specific characteristics of this anastomosing river are similar to those seen in sand-bedded forms, including the characteristics of erosion and deposition, and the stability of channel and interchannel wetlands. Four Landsat images from 1990, 2001, 2013, and 2016 alongside two Google Earth(GE) images from 2011 and 2013 were utilized in this study in tandem with field sampling and observations to select a 12 km main channel length section of the Qihama reach anastomosing river. This section was then used to determine variations in channel planform and sedimentary characteristics over a 26 year period. The results of this study show that this gravel-bedded anastomosing river has exhibited a high degree of stability overall, and that there has been no obvious channel and wetland bank erosion and deposition. Data also show that over the 26 years of this study, anastomosing belt area increased by 2.43%, while the ratio of land to water area remained almost equal. The number of wetlands has also increased along this river section at a rate as high as 62.16% because of the fragmentation of some small interchannel examples, while the talweg has alternately migrated to either the left or right over long periods of time at a relatively stable rate. Indeed, as a result of the migration of this line, there has been significant turnover in the number of islands within the main channel while bank shift has occurred at a rate of about 5 m/yr. The numerous anastomosing channels within this river section remained very stable over the course of this study, characterized by a mean annual migration rate of just 1 m/yr, while the sediments in bank columnar sections are mainly composed of fine sands or silts with a relatively high clay content. The sediment grain-size distribution curve for this river section contains multiple peaks, distinct from the muddy sediments within bank columnar sections from sand-bedded anastomosing rivers. The dense vegetation within riparian and interchannel wetlands alongside this river reach has also protected anastomosing channels from erosion and maintainedtheir stability, a key feature of this gravel-bedded system.
文摘The development of intestinal anastomosis techniques,including hand suturing,stapling,and compression anastomoses,has been a significant advancement in surgical practice.These methods aim to prevent leakage and minimize tissue fibrosis,which can lead to stricture formation.The healing process involves various phases:hemostasis and inflammation,proliferation,and remodeling.Mechanical staplers and sutures can cause inflammation and fibrosis due to the release of profibrotic chemokines.Compression anastomosis devices,including those made of nickel-titanium alloy,offer a minimally invasive option for various surgical challenges and have shown safety and efficacy.However,despite advancements,anastomotic techniques are evaluated based on leakage risk,with complications being a primary concern.Newer devices like Magnamosis use magnetic rings for compression anastomosis,demonstrating greater strength and patency compared to stapling.Magnetic technology is also being explored for other medical treatments.While there are promising results,particularly in animal models,the realworld application in humans is limited,and further research is needed to assess their safety and practicality.
文摘In this editorial,we comment on the article by Chen and Cai.We focus on renal anastomotic hemangioma,which is a rare benign hemangiomatous disease.This disease has unique clinical characteristics.Its biological behavior is benign,but its imaging results are similar to those of renal cancer.Renal anastomotic hemangioma is easy to misdiagnose and can lead to unnecessary radical nephrectomy.Therefore,urologists need a better understanding of this disease.We believe that patients with renal anastomotic hemangioma should receive individualized diagnosis and treatment to avoid overtreatment.
文摘BACKGROUND Portal vein arterialization(PVA)has been used in liver transplantation(LT)to maximize oxygen delivery when arterial circulation is compromised or has been used as an alternative reperfusion technique for complex portal vein thrombosis(PVT).The effect of PVA on portal perfusion and primary graft dysfunction(PGD)has not been assessed.All patients receiving PVA and LT at the Fundacion Santa Fe de Bogota between 2011 and 2022 were analyzed.To account for the time-sensitive effects of graft perfusion,patients were classified into two groups:prereperfusion(pre-PVA),if the arterioportal anastomosis was performed before graft revascularization,and postreperfusion(post-PVA),if PVA was performed afterward.The pre-PVA rationale contemplated poor portal hemodynamics,severe vascular steal,or PVT.Post-PVA was considered if graft hypoperfusion became evident.Conservative interventions were attempted before PVA.
