Objective:: To explore the role of tentorium cerebelli hiatus incision in treating severe and most severe brain injuries complicated by tentorial herniation. Methods: From July 1994 to July 1999 tentorium cerebelli hi...Objective:: To explore the role of tentorium cerebelli hiatus incision in treating severe and most severe brain injuries complicated by tentorial herniation. Methods: From July 1994 to July 1999 tentorium cerebelli hiatus incision was done based on intracranial hematoma evacuation and bone flap craniectomy decompression in 70 cases of severe and most severe brain injuries complicated by tentorial herniation. Results: Of the 70 cases, GCS 3-5 was in 23 and GCS 6-8 in 47; satisfactory recovery in 39 cases ( 55.7 %), moderate disability in 12 ( 17.1 %), severe deficit in 6 ( 8.6 %), vegetative survival in 4 ( 5.7 %) and 8 ( 11.4 %) died. Conclusions: Tentoriun cerebelli incision is helpful in alleviating secondary brain stem injury from tentorial herniation and in reducing the disability and death rate of the patients.展开更多
Objective： Mitral valve disease tends to be treated with anterolateral minithoracotomy （ALMT） rather than median stemotomy （MS）, as ALMT uses progressively smaller incisions to promote better cosmetic outcomes. T...Objective： Mitral valve disease tends to be treated with anterolateral minithoracotomy （ALMT） rather than median stemotomy （MS）, as ALMT uses progressively smaller incisions to promote better cosmetic outcomes. This meta-analysis quantifies the effects of ALMT on surgical parameters and post-operative outcomes compared with MS. Methods： One randomized controlled study and four case-control studies, published in English from January 1996 to January 2013, were identified and evaluated. Results： ALMT showed a significantly longer cardiopulmonary bypass time （P=0.001） and aortic cross-clamp time （P=0.05） compared with MS. However, the benefits of ALMT were evident as demonstrated by a shorter length of hospital stay （P〈0.00001）. According to operative complications, the onset of new arrhythmias following ALMT decreased significantly as compared with MS （P=0.05）; however, the incidence of peri-operative mortality （P=0.62）, re-operation for bleeding （P=0.37）, neurologic events （P=0.77）, myocardial infarction （P=0.84）, gastrointestinal complications （P=0.89）, and renal insufficiency （P=0.67） were similar to these of MS. Long-term follow-up data were also examined, and revealed equivalent survival and freedom from mitral valve events. Conclusions： Current clinical data suggest that ALMT is a safe and effective alternative to the conventional approach and is associated with better short-term outcomes and a trend towards longer survival.展开更多
文摘Objective:: To explore the role of tentorium cerebelli hiatus incision in treating severe and most severe brain injuries complicated by tentorial herniation. Methods: From July 1994 to July 1999 tentorium cerebelli hiatus incision was done based on intracranial hematoma evacuation and bone flap craniectomy decompression in 70 cases of severe and most severe brain injuries complicated by tentorial herniation. Results: Of the 70 cases, GCS 3-5 was in 23 and GCS 6-8 in 47; satisfactory recovery in 39 cases ( 55.7 %), moderate disability in 12 ( 17.1 %), severe deficit in 6 ( 8.6 %), vegetative survival in 4 ( 5.7 %) and 8 ( 11.4 %) died. Conclusions: Tentoriun cerebelli incision is helpful in alleviating secondary brain stem injury from tentorial herniation and in reducing the disability and death rate of the patients.
文摘Objective： Mitral valve disease tends to be treated with anterolateral minithoracotomy （ALMT） rather than median stemotomy （MS）, as ALMT uses progressively smaller incisions to promote better cosmetic outcomes. This meta-analysis quantifies the effects of ALMT on surgical parameters and post-operative outcomes compared with MS. Methods： One randomized controlled study and four case-control studies, published in English from January 1996 to January 2013, were identified and evaluated. Results： ALMT showed a significantly longer cardiopulmonary bypass time （P=0.001） and aortic cross-clamp time （P=0.05） compared with MS. However, the benefits of ALMT were evident as demonstrated by a shorter length of hospital stay （P〈0.00001）. According to operative complications, the onset of new arrhythmias following ALMT decreased significantly as compared with MS （P=0.05）; however, the incidence of peri-operative mortality （P=0.62）, re-operation for bleeding （P=0.37）, neurologic events （P=0.77）, myocardial infarction （P=0.84）, gastrointestinal complications （P=0.89）, and renal insufficiency （P=0.67） were similar to these of MS. Long-term follow-up data were also examined, and revealed equivalent survival and freedom from mitral valve events. Conclusions： Current clinical data suggest that ALMT is a safe and effective alternative to the conventional approach and is associated with better short-term outcomes and a trend towards longer survival.
