Objective.To describe the effects of surgical treatment a nd complications in46patients with carotid body tumor.Method.Retrospe ctive study on surgical treatment and complications was carried out in46case s of CBT whi...Objective.To describe the effects of surgical treatment a nd complications in46patients with carotid body tumor.Method.Retrospe ctive study on surgical treatment and complications was carried out in46case s of CBT which were surgically treated with different kind of procedures.Resul t.All procedures performed successfully except that the CBT was not excised in 4cases.No operative mortality was observed.There were2postoperative hemiple gia,4hypoglossal nerve impairment ,2glossopharyngeal nerve impairment ,1va gus nerve impairment ,and1accessory nerve impairment.One patient presented p ostoperative cranial nerve impairment in glossopharyngeal,vagus and hypoglossa l nerves.Two patients developed local recurrence during the long-term follow-up.Conclusion.Complete surgical excision was possible in each patient if th e diagnosis had been cor-rectly made through selective preoperative angiography ,vessel ultrasound Doppler and other examinations.Reasonable surgical procedur e and Matas training were necessary to the successful surgical treatment and t hus decrease the complicative incidence rate of carotid chemodectomas.展开更多
Objective To evaluate the safety and efficiency of hemi-semi laminectomy approach for the micro- surgical treatment of spinal schwannomas. Methods A total of 22 patients underwent hemi-semi laminectomy for the micros...Objective To evaluate the safety and efficiency of hemi-semi laminectomy approach for the micro- surgical treatment of spinal schwannomas. Methods A total of 22 patients underwent hemi-semi laminectomy for the microsurgical removal of spinal schwannomas during a period of 2009 and 2011 in Affiliated Hospital of Nantong University. We ret- rospectively analyzed the clinical outcomes of these patients. Results Of them, 5 cases were diagnosed with cervical schwannomas, 9 with thoracic schwarmomas, and 8 with lumbar schwannomas. All the tumors including two dumbbell schwannomas were totally removed without major complications. Postoperatively, all patients were followed up from 6 to 36 months. The symp- toms and signs were obviously improved, and no tumor recurrence or spinal deformity occurred. Conclusion Hemi-semi laminectomy is a safe and effective method for resection of spinal schwan- nomas展开更多
AIM: To determine the incidence of colonoscopic perforation (CP), and evaluate clinical findings, management and outcomes of patients with CP from the World Gastroenterology Organization (WGO) Endoscopy Training ...AIM: To determine the incidence of colonoscopic perforation (CP), and evaluate clinical findings, management and outcomes of patients with CP from the World Gastroenterology Organization (WGO) Endoscopy Training Center in Thailand. METHODS: All colonoscopies and sigmoidoscopies performed between 1999 and 2007 in the Endoscopic unit, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok were reviewed. Incidence of CP, patients' characteristics, endoscopic information, intraoperative findings, management and outcomes were analyzed. RESULTS: A total of 17357 endoscopic procedures of the colon (13 699 colonoscopies and 3658 flexible sigmoidoscopies) were performed in Siriraj hospital over a 9-year period. Fifteen patients (0.09%) had CP: 14 from colonoscopy and 1 from sigmoidoscopy. The most common site of perforation was in the sigmoid colon (80%), followed by the transverse colon (13%). Perforations were caused by direct trauma from either the shaft or the tip of the endoscope (n = 12,80%) and endoscopic polypectomy (n = 3, 20%). All patients with CP underwent surgical management: primary repair (27%) and bowel resection (73%). The mortality rate was 13% and postoperative complication rate was 53%. CONCLUSION: CP is a rare but serious complication following colonoscopy and sigmoidoscopy, with high rates of morbidity and mortality. Incidence of CP was 0.09%. Surgery is still the mainstay of CP management.展开更多
Abstract: Objective: To explore the clinical efficacy of different treatment methods of intervention for intractable postpartum hemorrhage. Methods: From the accept and treat patients with intractable postpartum he...Abstract: Objective: To explore the clinical efficacy of different treatment methods of intervention for intractable postpartum hemorrhage. Methods: From the accept and treat patients with intractable postpartum hemorrhage in our hospital from June 2013 to March 2014, 86 cases were chosen to be retrospectively analyzed, randomly divided into observation group and control group with 43 cases in each group. The control group was underwent gauze packing while observation group were packing gauze joint with improved uterine suture Cho, the two groups were observed therapeutic effects and complications. Results: The total efficiency of observation group is 93.02%, and the total efficiency of the control group is 62.79%, there is a significant better treatment effect for observed group than the control group (P 〈0.05), and complication rate of observation group is significantly lower than the control group (P 〈0.05). Conclusions: In refractory postpartum hemorrhage intervention therapy, the use of gauze packing combined with modified suture uterus Cho has better clinical treatment effect with high security, so it is worthy of clinical application.展开更多
Objective: To explore the clinical efficacy of different treatment methods of intervention for intractable postpartum hemorrhage. Methods: From the accept and treat patients with intractable postpartum hemorrhage in...Objective: To explore the clinical efficacy of different treatment methods of intervention for intractable postpartum hemorrhage. Methods: From the accept and treat patients with intractable postpartum hemorrhage in our hospital from June 2013 to March 2014, 86 cases were chosen to be retrospectively analyzed, randomly divided into observation group and control group with 43 cases in each group. The control group was underwent gauze packing while observation group were packing gauze joint with improved uterine suture Cho, the two groups were observed therapeutic effects and complications. Results: The total efficiency of observation group is 93.02%, and the total efficiency of the control group is 62.79%, there is a significant better treatment effect for observed group than the control group (P 〈0.05), and complication rate of observation group is significantly lower than the control group (P 〈0.05). Conclusions: In refractory postpartum hemorrhage intervention therapy, the use of gauze packing combined with modified suture uterus Cho has better clinical treatment effect with high security, so it is worthy of clinical application.展开更多
Objective:The aim of our study was to evaluate the clinical effect and the prospect of the three-incision (right thoracotomy, midline laparotomy and left cervical incisions) esophagectomy for the treatment of esophage...Objective:The aim of our study was to evaluate the clinical effect and the prospect of the three-incision (right thoracotomy, midline laparotomy and left cervical incisions) esophagectomy for the treatment of esophageal carcinoma.Meth-ods:We reviewed our experience with 1226 patients undergoing three-incision esophagectomy for middle and upper esopha-geal carcinoma.Results:Anastomotic leak rates were determined for the entire group.The overall leak rate was 8.5% (104 patients).Overall hospital mortality was 0.24% (3 patients).No patient died as a result of anastomotic leakage.Conclusion:The three-incision technique can radically remove carcinoma and perform a complete lymphadenectomy.Although the cervical anastomotic leak rate is slightly high, the management of this complication is relatively easy and the satisfactory results can be achieved.展开更多
Purpose: The optimal surgical treatment of displaced type B and C fractures of the proximal humerus in the elderly remains controversial. Good clinical results have been reported by plating these fractures as well as...Purpose: The optimal surgical treatment of displaced type B and C fractures of the proximal humerus in the elderly remains controversial. Good clinical results have been reported by plating these fractures as well as a high rate of complications. Our retrospective study aims to evaluate clinical recovery and complications using the S3 locking plate in elderly patients. Methods: Fifty-one patients older than 65 years of age, with a complex proximal humeral fracture type B or C (AO classification system), were included. Patients have been followed up for a minimum of 12 months. We assessed callus formation, radiological results, clinical outcome (according to the Constant Shoulder Score System) and complications. Any difference in the clinical recovery among the 2 types of fracture pattern (B and C) was investigated. Results: The mean time of fracture healing was 12.4 weeks. The mean Constant score at 3, 6 and 12 months was 68, 73 and 75 respectively. No statistically significant difference in the clinical outcome was observed between the 13 and C fracture patterns (p 〉 0.05). We noticed an overall of 5 complications (9.8%). There was no need to revision any of the implants. Conclusion: Anatomic reduction and proper plate positioning are essential for minimizing implant- related complications. In our experience the S3 angular stability system offers a proper osteosyntesis and a ~ood clinical recovery with a low rate of complications.展开更多
Objective: To evaluate the clinical effects of onepassage, double-passage and circular canalicular intubations in repairing lacerations of canaliculus. Methods: Atotal of 109 eyes in 109 cases ofcanalicular lacerat...Objective: To evaluate the clinical effects of onepassage, double-passage and circular canalicular intubations in repairing lacerations of canaliculus. Methods: Atotal of 109 eyes in 109 cases ofcanalicular laceration were repaired with three types of silicone intubations, among which 23 with one-passage canalicular intubation, 51 with double-passage canalicular intubation, and 35 with circular canalicular intubation. The average follow-up period was 12-15 months. Results: The wound/junction of the lacrimal canaliculi was ruptured in 5 cases (9.80%) of the double-passage group, 3 cases (8.57%) of the circular group, and 8 cases (34.78%) of the one-passage group. The rupture incidence of the one-passage group was significantly higher than that of the other two groups ( χ^2=9.416, P〈0.01). During the inmbation, canaliculitis was observed in 12 cases (23.53%) of the double-passage group, while only 3 cases (8.57%) in the circular group and 8 cases (34.78%) in the one-passage group. The circular group had significantly lower incidence of canaliculitis than the other two groups ( χ^2=6.095, P〈0.05). After extubation 6 months after laceration repair, the lacrimal passage remained patent with canalicular irrigation in 46 cases (90.20%) in the double-passage group, 30 cases (85.71%) in the circular group and 15 cases (65.22%) in the one-passage group. Six months after surgery, the canalicular patency in the one-passage group was significantly lower than that of the other two groups ( χ^2=7.390, P〈0.05). Conclusions: Circular canalicular intubation is more stable and has less surgical complications than the doublepassage and one-passage canalicular intubations. It is also more effective clinically 12-15 months after laceration surgery.展开更多
文摘Objective.To describe the effects of surgical treatment a nd complications in46patients with carotid body tumor.Method.Retrospe ctive study on surgical treatment and complications was carried out in46case s of CBT which were surgically treated with different kind of procedures.Resul t.All procedures performed successfully except that the CBT was not excised in 4cases.No operative mortality was observed.There were2postoperative hemiple gia,4hypoglossal nerve impairment ,2glossopharyngeal nerve impairment ,1va gus nerve impairment ,and1accessory nerve impairment.One patient presented p ostoperative cranial nerve impairment in glossopharyngeal,vagus and hypoglossa l nerves.Two patients developed local recurrence during the long-term follow-up.Conclusion.Complete surgical excision was possible in each patient if th e diagnosis had been cor-rectly made through selective preoperative angiography ,vessel ultrasound Doppler and other examinations.Reasonable surgical procedur e and Matas training were necessary to the successful surgical treatment and t hus decrease the complicative incidence rate of carotid chemodectomas.
文摘Objective To evaluate the safety and efficiency of hemi-semi laminectomy approach for the micro- surgical treatment of spinal schwannomas. Methods A total of 22 patients underwent hemi-semi laminectomy for the microsurgical removal of spinal schwannomas during a period of 2009 and 2011 in Affiliated Hospital of Nantong University. We ret- rospectively analyzed the clinical outcomes of these patients. Results Of them, 5 cases were diagnosed with cervical schwannomas, 9 with thoracic schwarmomas, and 8 with lumbar schwannomas. All the tumors including two dumbbell schwannomas were totally removed without major complications. Postoperatively, all patients were followed up from 6 to 36 months. The symp- toms and signs were obviously improved, and no tumor recurrence or spinal deformity occurred. Conclusion Hemi-semi laminectomy is a safe and effective method for resection of spinal schwan- nomas
文摘AIM: To determine the incidence of colonoscopic perforation (CP), and evaluate clinical findings, management and outcomes of patients with CP from the World Gastroenterology Organization (WGO) Endoscopy Training Center in Thailand. METHODS: All colonoscopies and sigmoidoscopies performed between 1999 and 2007 in the Endoscopic unit, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok were reviewed. Incidence of CP, patients' characteristics, endoscopic information, intraoperative findings, management and outcomes were analyzed. RESULTS: A total of 17357 endoscopic procedures of the colon (13 699 colonoscopies and 3658 flexible sigmoidoscopies) were performed in Siriraj hospital over a 9-year period. Fifteen patients (0.09%) had CP: 14 from colonoscopy and 1 from sigmoidoscopy. The most common site of perforation was in the sigmoid colon (80%), followed by the transverse colon (13%). Perforations were caused by direct trauma from either the shaft or the tip of the endoscope (n = 12,80%) and endoscopic polypectomy (n = 3, 20%). All patients with CP underwent surgical management: primary repair (27%) and bowel resection (73%). The mortality rate was 13% and postoperative complication rate was 53%. CONCLUSION: CP is a rare but serious complication following colonoscopy and sigmoidoscopy, with high rates of morbidity and mortality. Incidence of CP was 0.09%. Surgery is still the mainstay of CP management.
文摘Abstract: Objective: To explore the clinical efficacy of different treatment methods of intervention for intractable postpartum hemorrhage. Methods: From the accept and treat patients with intractable postpartum hemorrhage in our hospital from June 2013 to March 2014, 86 cases were chosen to be retrospectively analyzed, randomly divided into observation group and control group with 43 cases in each group. The control group was underwent gauze packing while observation group were packing gauze joint with improved uterine suture Cho, the two groups were observed therapeutic effects and complications. Results: The total efficiency of observation group is 93.02%, and the total efficiency of the control group is 62.79%, there is a significant better treatment effect for observed group than the control group (P 〈0.05), and complication rate of observation group is significantly lower than the control group (P 〈0.05). Conclusions: In refractory postpartum hemorrhage intervention therapy, the use of gauze packing combined with modified suture uterus Cho has better clinical treatment effect with high security, so it is worthy of clinical application.
文摘Objective: To explore the clinical efficacy of different treatment methods of intervention for intractable postpartum hemorrhage. Methods: From the accept and treat patients with intractable postpartum hemorrhage in our hospital from June 2013 to March 2014, 86 cases were chosen to be retrospectively analyzed, randomly divided into observation group and control group with 43 cases in each group. The control group was underwent gauze packing while observation group were packing gauze joint with improved uterine suture Cho, the two groups were observed therapeutic effects and complications. Results: The total efficiency of observation group is 93.02%, and the total efficiency of the control group is 62.79%, there is a significant better treatment effect for observed group than the control group (P 〈0.05), and complication rate of observation group is significantly lower than the control group (P 〈0.05). Conclusions: In refractory postpartum hemorrhage intervention therapy, the use of gauze packing combined with modified suture uterus Cho has better clinical treatment effect with high security, so it is worthy of clinical application.
文摘Objective:The aim of our study was to evaluate the clinical effect and the prospect of the three-incision (right thoracotomy, midline laparotomy and left cervical incisions) esophagectomy for the treatment of esophageal carcinoma.Meth-ods:We reviewed our experience with 1226 patients undergoing three-incision esophagectomy for middle and upper esopha-geal carcinoma.Results:Anastomotic leak rates were determined for the entire group.The overall leak rate was 8.5% (104 patients).Overall hospital mortality was 0.24% (3 patients).No patient died as a result of anastomotic leakage.Conclusion:The three-incision technique can radically remove carcinoma and perform a complete lymphadenectomy.Although the cervical anastomotic leak rate is slightly high, the management of this complication is relatively easy and the satisfactory results can be achieved.
文摘Purpose: The optimal surgical treatment of displaced type B and C fractures of the proximal humerus in the elderly remains controversial. Good clinical results have been reported by plating these fractures as well as a high rate of complications. Our retrospective study aims to evaluate clinical recovery and complications using the S3 locking plate in elderly patients. Methods: Fifty-one patients older than 65 years of age, with a complex proximal humeral fracture type B or C (AO classification system), were included. Patients have been followed up for a minimum of 12 months. We assessed callus formation, radiological results, clinical outcome (according to the Constant Shoulder Score System) and complications. Any difference in the clinical recovery among the 2 types of fracture pattern (B and C) was investigated. Results: The mean time of fracture healing was 12.4 weeks. The mean Constant score at 3, 6 and 12 months was 68, 73 and 75 respectively. No statistically significant difference in the clinical outcome was observed between the 13 and C fracture patterns (p 〉 0.05). We noticed an overall of 5 complications (9.8%). There was no need to revision any of the implants. Conclusion: Anatomic reduction and proper plate positioning are essential for minimizing implant- related complications. In our experience the S3 angular stability system offers a proper osteosyntesis and a ~ood clinical recovery with a low rate of complications.
文摘Objective: To evaluate the clinical effects of onepassage, double-passage and circular canalicular intubations in repairing lacerations of canaliculus. Methods: Atotal of 109 eyes in 109 cases ofcanalicular laceration were repaired with three types of silicone intubations, among which 23 with one-passage canalicular intubation, 51 with double-passage canalicular intubation, and 35 with circular canalicular intubation. The average follow-up period was 12-15 months. Results: The wound/junction of the lacrimal canaliculi was ruptured in 5 cases (9.80%) of the double-passage group, 3 cases (8.57%) of the circular group, and 8 cases (34.78%) of the one-passage group. The rupture incidence of the one-passage group was significantly higher than that of the other two groups ( χ^2=9.416, P〈0.01). During the inmbation, canaliculitis was observed in 12 cases (23.53%) of the double-passage group, while only 3 cases (8.57%) in the circular group and 8 cases (34.78%) in the one-passage group. The circular group had significantly lower incidence of canaliculitis than the other two groups ( χ^2=6.095, P〈0.05). After extubation 6 months after laceration repair, the lacrimal passage remained patent with canalicular irrigation in 46 cases (90.20%) in the double-passage group, 30 cases (85.71%) in the circular group and 15 cases (65.22%) in the one-passage group. Six months after surgery, the canalicular patency in the one-passage group was significantly lower than that of the other two groups ( χ^2=7.390, P〈0.05). Conclusions: Circular canalicular intubation is more stable and has less surgical complications than the doublepassage and one-passage canalicular intubations. It is also more effective clinically 12-15 months after laceration surgery.