BACKGROUND Hypertensive intracerebral hemorrhage is a common critical disease of the nervous system,comprising one fifth of all acute cerebrovascular diseases and has a high disability and mortality rate.It severely a...BACKGROUND Hypertensive intracerebral hemorrhage is a common critical disease of the nervous system,comprising one fifth of all acute cerebrovascular diseases and has a high disability and mortality rate.It severely affects the patients’quality of life.AIM To analyze the short-term effect and long-term prognosis of neuroendoscopic minimally invasive surgery for hypertensive intracerebral hemorrhage.METHODS From March 2018 to May 2020,118 patients with hypertensive intracerebral hemorrhage were enrolled in our study and divided into a control group and observation group according to the surgical plan.The control group used a hard-channel minimally invasive puncture and drainage procedure.The observation group underwent minimally invasive neuroendoscopic surgery.The changes in the levels of serum P substances(SP),inflammatory factors[tumor necrosis factor-α,interleukin-6(IL-6),IL-10],and the National Hospital Stroke Scale(NIHSS)and Barthel index scores were recorded.Surgery related indicators and prognosis were compared between the two groups.RESULTS The operation time(105.26±28.35)of the observation group was min longer than that of the control group,and the volume of intraoperative bleeding was 45.36±10.17 mL more than that of the control group.The hematoma clearance rates were 88.58%±4.69%and 94.47%±4.02%higher than those of the control group at 48 h and 72 h,respectively.Good prognosis rate(86.44%)was higher in the observation group than in the control group,and complication rate(5.08%)was not significantly different from that of the control group(P>0.05).The SP level and Barthel index score of the two groups increased(P<0.05)and the inflam-matory factors and NIHSS score decreased(P<0.05).The cytokine levels,NIHSS score,and Barthel index score were better in the observation group than in the control group(P<0.05).CONCLUSION Neuroendoscopic minimally invasive surgery is more complicated than hard channel minimally invasive puncture drainage in the treatment of hypertensive intracerebral hemorrhage;however,hematoma clearance is more thorough,and the short-term effect and long-term prognosis are better than hard channel minimally invasive puncture drainage.展开更多
The successful outcome of any minimally invasive procedure is highly dependent on the imaging chain, as the medical team has to rely on indirect visualization of the surgical field during the entire procedure. During ...The successful outcome of any minimally invasive procedure is highly dependent on the imaging chain, as the medical team has to rely on indirect visualization of the surgical field during the entire procedure. During the last decade, the quality of the images obtainable pre- and intraoperatively has evolved significantly. In addition to the introduction of intra-operative image acquisition techniques such as ultrasound, X-ray, CT or MR, optical imaging technology as well as the corresponding processing units have undergone a rapid development. The article will review the activity related to minimally invasive procedures at the Operating Rooms of the Future (FOR) at St. Olavs Hospital, University Hospital of Trondheim, Norway. The imaging related demands of several surgical fields are introduced and the evolution of the imaging and visualization techniques at FOR will be presented. Subsequently, ongoing research projects in a dedicated visualization laboratory will be discussed and the advantages of updating the imaging equipment continuously in order to keep up with the latest developments in the field will be presented. It will be shown that the quality of the image acquisition and display can be significantly improved when compared to today’s standard. In addition to increasing the surgeon’s confidence, better imaging will lead to increased patient safety as well as more efficient interventions.展开更多
Background: Traditional treatment of axillary odour is the surgical removal of skin and subcutaneous tissue along the edge of the axillary hair in a fusiform shape, which requires the restriction of upper limb activit...Background: Traditional treatment of axillary odour is the surgical removal of skin and subcutaneous tissue along the edge of the axillary hair in a fusiform shape, which requires the restriction of upper limb activity, has large scars and a high recurrence rate. Minimally invasive methods have developed in recent years. The subcutaneous trimming method with small incision reduces the incision compared to traditional incision, but still requires skin incision, which does not achieve true, minimally invasive treatment. Simple negative pressure suction is difficult to destroy the sweat glands and sebaceous glands in the dermis layer. Thus, we hypothesized that combination of three minimally invasive methods might be more effective. Objective: To explore the clinical effect of combined treatment of axillary osmidrosis by three minimally invasive methods of microwave, scraping & suction and scratching. Methods: From October 2015 to October 2020, 80 patients with underarm odor were enrolled and lacal swelling anesthetic was applied. Microwave was used to treat sweat glands and sebaceous glands in the dermis following the pores. The curettage-aspiration was used to scrape and suck the apocrine sweat glands in the subcutaneous fat layer and the junction between the subcutaneous fat and dermis. To achieve the purpose of minimally invasive and thorough treatment of underarm odor, the spoon scraped the remaining sweat gland tissue. Results: Among 80 patients on 160 sides, all cases (100.00%) were cured on 160 sides at 1 month post-operative follow-up, 75 cases (93.75%) were cured on 150 sides, 5 cases (6.25%) on 5 sides were ineffective at 6-month post-operative follow-up, 74 cases (92.50%) were cured on 148 sides, 6 cases (7.50%) on 5 sides were ineffective at 1-year post-operative follow-up. Complications occurred in 5 cases (6.25%) after operation: 2 cases (2.50%) with skin necrosis on 3 sides, 1 case (1.25%) with uneven skin on 2 sides, 1 case (1.25%) with axillary abscess on 2 sides, and 1 case (1.25%) with keloids on 2 sides. Conclusion: The combination of three minimally invasive methods of microwave, scraping & suction and scratching to treat underarm odor is simple operation, has high cure rate, quick postoperative recovery, and few complications. It is an effective method for minimally invasive and thorough treatment of underarm odor in clinic.展开更多
AIM: To develop and evaluate the endoscopic operation robot (EOR). The EOR is a robot system designed specifically for remote manipulation of the scope during gastrointestinal endoscopy by a seated endoscopist. METHOD...AIM: To develop and evaluate the endoscopic operation robot (EOR). The EOR is a robot system designed specifically for remote manipulation of the scope during gastrointestinal endoscopy by a seated endoscopist. METHODS: Total colonoscopy examinations using a colonoscopy training model were performed compared conventional insertion by manual manipulation and remote-controlled insertion, using the EOR. The author investigated the time taken for each of the 50 examinations. RESULTS: The median insertion time (in minutes) for each 10 examinations (EOR vs manual manipulation) was 73.70 ± 25.37 vs 3.77 ± 1.34 in the first group, 38.40 ± 6.24 vs 3.40 ± 0.97 in the second group, 27.6 ± 4.01 vs 2.70 ± 0.95 in the third group, 23.8 ± 3.65 vs 3.10 ± 0.88 in the fourth group, and 22.9 ± 5.02 vs 2.60 ± 1.08 in the fifth group.CONCLUSION: The study suggested the possibility of the clinical application of the EOR.展开更多
目的探讨日间手术模式下射频消融(RFA)闭合术治疗下肢静脉曲张的临床疗效及安全性。方法收集2021年12月至2022年5月新疆维吾尔自治区人民医院收治的日间手术模式下治疗的101例大隐静脉曲张患者(112条肢体)的临床资料,按照手术方法的不...目的探讨日间手术模式下射频消融(RFA)闭合术治疗下肢静脉曲张的临床疗效及安全性。方法收集2021年12月至2022年5月新疆维吾尔自治区人民医院收治的日间手术模式下治疗的101例大隐静脉曲张患者(112条肢体)的临床资料,按照手术方法的不同将患者分为高位结扎组(n=50)和RFA组(n=51)。比较两组患者围手术期相关指标、围手术期并发症发生率及术后3个月大隐静脉主干闭塞率。结果RFA组患者的术前禁食、禁水时间,手术时间,术后禁食、禁水时间,术后下床时间均短于高位结扎组患者,术中出血量少于高位结扎组患者,术中VAS评分高于高位结扎组患者,术后6 h VAS评分低于高位结扎组患者,差异均有统计学意义(P<0.05)。术后3个月,RFA组患者的大隐静脉主干闭合率为98.2%(56/57),高位结扎组患者的大隐静脉主干闭合率为100%(55/55)。两组患者围手术期并发症的总发生率比较,差异无统计学意义(P>0.05)。结论RFA在日间手术模式下治疗下肢静脉曲张安全、有效,能够缩短术前禁食、禁水时间,手术时间,术后禁食、禁水时间,术后下床时间,减少术中出血量和术后疼痛程度,且不会增加围手术期相关并发症。展开更多
Background Funnel chest has a negative effect on adolescents and it has a strong effect on adolescents＇ psychological and behavior. This study aimed to investigate the psychological characteristics and factors that a...Background Funnel chest has a negative effect on adolescents and it has a strong effect on adolescents＇ psychological and behavior. This study aimed to investigate the psychological characteristics and factors that affect adolescents with funnel chest and to evaluate the relationship between the patients＇ age and their physiological and psychological health. We aimed to establish an age model for maximum surgery benefits for funnel chest patients to provide an objective basis for choosing surgery. Methods The study adopted a general evaluation approach to assess the risk and benefits of minimally invasive surgery for funnel chest. The funnel chest index, the Symptom Checklist-90, and the Eysenck Personality Questionnaire were used as assessment tools to observe physiological and psychological features in funnel chest patients. A sample of 234 adolescents with funnel chest was selected from a third-grade class-A hospital in Beijing. Age groups were adopted as an independent variable, and other factors in funnel chest patients were dependent variables. Results There was a significant difference in the relapse rate for funnel chest in the different age groups （X2=11.883, P=-O.008）. There was a higher relapse rate in patients of 〈10 or 〉-19 years old than in patients of 11-18 years old. There was a significant difference in the SCL-90 total score in the different age groups （F=12.538, P=-0.0001）, the patients older than 13 years had a higher score than those younger than 13 years in the SCL-90. There was a significant difference in the standard score of E （introversion/extraversion） in the different age groups （F=10.06, P=0.0001）. There was also a significance in the funnel chest index before surgery in the different psychological scales （P〈0.01）, with a higher funnel chest index score associated with more obvious psychological trauma. Age and the number of variables, including the relapse rate, SCL-90 score, standard score of E, and standard score of N in the EPQ were significantly correlated （correlation indices were 0.402, 0.623, -0.505, and 0.473, respectively, P〈0.01）. Conclusions There are higher complication rates after surgery and relapse rates when funne{ chest patients are too young or too old. There is more obvious psychological trauma in patients with a high funnel chest index. Our results indicate that the best age for surgery for funnel chest is 14-16 years.展开更多
文摘BACKGROUND Hypertensive intracerebral hemorrhage is a common critical disease of the nervous system,comprising one fifth of all acute cerebrovascular diseases and has a high disability and mortality rate.It severely affects the patients’quality of life.AIM To analyze the short-term effect and long-term prognosis of neuroendoscopic minimally invasive surgery for hypertensive intracerebral hemorrhage.METHODS From March 2018 to May 2020,118 patients with hypertensive intracerebral hemorrhage were enrolled in our study and divided into a control group and observation group according to the surgical plan.The control group used a hard-channel minimally invasive puncture and drainage procedure.The observation group underwent minimally invasive neuroendoscopic surgery.The changes in the levels of serum P substances(SP),inflammatory factors[tumor necrosis factor-α,interleukin-6(IL-6),IL-10],and the National Hospital Stroke Scale(NIHSS)and Barthel index scores were recorded.Surgery related indicators and prognosis were compared between the two groups.RESULTS The operation time(105.26±28.35)of the observation group was min longer than that of the control group,and the volume of intraoperative bleeding was 45.36±10.17 mL more than that of the control group.The hematoma clearance rates were 88.58%±4.69%and 94.47%±4.02%higher than those of the control group at 48 h and 72 h,respectively.Good prognosis rate(86.44%)was higher in the observation group than in the control group,and complication rate(5.08%)was not significantly different from that of the control group(P>0.05).The SP level and Barthel index score of the two groups increased(P<0.05)and the inflam-matory factors and NIHSS score decreased(P<0.05).The cytokine levels,NIHSS score,and Barthel index score were better in the observation group than in the control group(P<0.05).CONCLUSION Neuroendoscopic minimally invasive surgery is more complicated than hard channel minimally invasive puncture drainage in the treatment of hypertensive intracerebral hemorrhage;however,hematoma clearance is more thorough,and the short-term effect and long-term prognosis are better than hard channel minimally invasive puncture drainage.
文摘The successful outcome of any minimally invasive procedure is highly dependent on the imaging chain, as the medical team has to rely on indirect visualization of the surgical field during the entire procedure. During the last decade, the quality of the images obtainable pre- and intraoperatively has evolved significantly. In addition to the introduction of intra-operative image acquisition techniques such as ultrasound, X-ray, CT or MR, optical imaging technology as well as the corresponding processing units have undergone a rapid development. The article will review the activity related to minimally invasive procedures at the Operating Rooms of the Future (FOR) at St. Olavs Hospital, University Hospital of Trondheim, Norway. The imaging related demands of several surgical fields are introduced and the evolution of the imaging and visualization techniques at FOR will be presented. Subsequently, ongoing research projects in a dedicated visualization laboratory will be discussed and the advantages of updating the imaging equipment continuously in order to keep up with the latest developments in the field will be presented. It will be shown that the quality of the image acquisition and display can be significantly improved when compared to today’s standard. In addition to increasing the surgeon’s confidence, better imaging will lead to increased patient safety as well as more efficient interventions.
文摘Background: Traditional treatment of axillary odour is the surgical removal of skin and subcutaneous tissue along the edge of the axillary hair in a fusiform shape, which requires the restriction of upper limb activity, has large scars and a high recurrence rate. Minimally invasive methods have developed in recent years. The subcutaneous trimming method with small incision reduces the incision compared to traditional incision, but still requires skin incision, which does not achieve true, minimally invasive treatment. Simple negative pressure suction is difficult to destroy the sweat glands and sebaceous glands in the dermis layer. Thus, we hypothesized that combination of three minimally invasive methods might be more effective. Objective: To explore the clinical effect of combined treatment of axillary osmidrosis by three minimally invasive methods of microwave, scraping & suction and scratching. Methods: From October 2015 to October 2020, 80 patients with underarm odor were enrolled and lacal swelling anesthetic was applied. Microwave was used to treat sweat glands and sebaceous glands in the dermis following the pores. The curettage-aspiration was used to scrape and suck the apocrine sweat glands in the subcutaneous fat layer and the junction between the subcutaneous fat and dermis. To achieve the purpose of minimally invasive and thorough treatment of underarm odor, the spoon scraped the remaining sweat gland tissue. Results: Among 80 patients on 160 sides, all cases (100.00%) were cured on 160 sides at 1 month post-operative follow-up, 75 cases (93.75%) were cured on 150 sides, 5 cases (6.25%) on 5 sides were ineffective at 6-month post-operative follow-up, 74 cases (92.50%) were cured on 148 sides, 6 cases (7.50%) on 5 sides were ineffective at 1-year post-operative follow-up. Complications occurred in 5 cases (6.25%) after operation: 2 cases (2.50%) with skin necrosis on 3 sides, 1 case (1.25%) with uneven skin on 2 sides, 1 case (1.25%) with axillary abscess on 2 sides, and 1 case (1.25%) with keloids on 2 sides. Conclusion: The combination of three minimally invasive methods of microwave, scraping & suction and scratching to treat underarm odor is simple operation, has high cure rate, quick postoperative recovery, and few complications. It is an effective method for minimally invasive and thorough treatment of underarm odor in clinic.
基金Supported by Kitakyushu Foundation for the Advancement of Industry Science and Technology
文摘AIM: To develop and evaluate the endoscopic operation robot (EOR). The EOR is a robot system designed specifically for remote manipulation of the scope during gastrointestinal endoscopy by a seated endoscopist. METHODS: Total colonoscopy examinations using a colonoscopy training model were performed compared conventional insertion by manual manipulation and remote-controlled insertion, using the EOR. The author investigated the time taken for each of the 50 examinations. RESULTS: The median insertion time (in minutes) for each 10 examinations (EOR vs manual manipulation) was 73.70 ± 25.37 vs 3.77 ± 1.34 in the first group, 38.40 ± 6.24 vs 3.40 ± 0.97 in the second group, 27.6 ± 4.01 vs 2.70 ± 0.95 in the third group, 23.8 ± 3.65 vs 3.10 ± 0.88 in the fourth group, and 22.9 ± 5.02 vs 2.60 ± 1.08 in the fifth group.CONCLUSION: The study suggested the possibility of the clinical application of the EOR.
文摘目的探讨日间手术模式下射频消融(RFA)闭合术治疗下肢静脉曲张的临床疗效及安全性。方法收集2021年12月至2022年5月新疆维吾尔自治区人民医院收治的日间手术模式下治疗的101例大隐静脉曲张患者(112条肢体)的临床资料,按照手术方法的不同将患者分为高位结扎组(n=50)和RFA组(n=51)。比较两组患者围手术期相关指标、围手术期并发症发生率及术后3个月大隐静脉主干闭塞率。结果RFA组患者的术前禁食、禁水时间,手术时间,术后禁食、禁水时间,术后下床时间均短于高位结扎组患者,术中出血量少于高位结扎组患者,术中VAS评分高于高位结扎组患者,术后6 h VAS评分低于高位结扎组患者,差异均有统计学意义(P<0.05)。术后3个月,RFA组患者的大隐静脉主干闭合率为98.2%(56/57),高位结扎组患者的大隐静脉主干闭合率为100%(55/55)。两组患者围手术期并发症的总发生率比较,差异无统计学意义(P>0.05)。结论RFA在日间手术模式下治疗下肢静脉曲张安全、有效,能够缩短术前禁食、禁水时间,手术时间,术后禁食、禁水时间,术后下床时间,减少术中出血量和术后疼痛程度,且不会增加围手术期相关并发症。
文摘Background Funnel chest has a negative effect on adolescents and it has a strong effect on adolescents＇ psychological and behavior. This study aimed to investigate the psychological characteristics and factors that affect adolescents with funnel chest and to evaluate the relationship between the patients＇ age and their physiological and psychological health. We aimed to establish an age model for maximum surgery benefits for funnel chest patients to provide an objective basis for choosing surgery. Methods The study adopted a general evaluation approach to assess the risk and benefits of minimally invasive surgery for funnel chest. The funnel chest index, the Symptom Checklist-90, and the Eysenck Personality Questionnaire were used as assessment tools to observe physiological and psychological features in funnel chest patients. A sample of 234 adolescents with funnel chest was selected from a third-grade class-A hospital in Beijing. Age groups were adopted as an independent variable, and other factors in funnel chest patients were dependent variables. Results There was a significant difference in the relapse rate for funnel chest in the different age groups （X2=11.883, P=-O.008）. There was a higher relapse rate in patients of 〈10 or 〉-19 years old than in patients of 11-18 years old. There was a significant difference in the SCL-90 total score in the different age groups （F=12.538, P=-0.0001）, the patients older than 13 years had a higher score than those younger than 13 years in the SCL-90. There was a significant difference in the standard score of E （introversion/extraversion） in the different age groups （F=10.06, P=0.0001）. There was also a significance in the funnel chest index before surgery in the different psychological scales （P〈0.01）, with a higher funnel chest index score associated with more obvious psychological trauma. Age and the number of variables, including the relapse rate, SCL-90 score, standard score of E, and standard score of N in the EPQ were significantly correlated （correlation indices were 0.402, 0.623, -0.505, and 0.473, respectively, P〈0.01）. Conclusions There are higher complication rates after surgery and relapse rates when funne{ chest patients are too young or too old. There is more obvious psychological trauma in patients with a high funnel chest index. Our results indicate that the best age for surgery for funnel chest is 14-16 years.
