Objective： To evaluate the clinical application of superselective transcatheter arterial embolization （TAE） in nasopharyngeal angiofibroma before operation. Methods： Superselective angiography was done via femoral...Objective： To evaluate the clinical application of superselective transcatheter arterial embolization （TAE） in nasopharyngeal angiofibroma before operation. Methods： Superselective angiography was done via femoral. TAE with polyvinyl alcohol particles and/or gelfoam （GF） was performed in 12 patients with nasopharyngeal angiofibroma. All patients underwent surgical removal of devascularized tumors in 3 to 7 days after TAE. Results： During digital subtraction angiography, tumor staining was seen in 12 patients. Embolization of maxillary artery was performed in 12 cases and additional embolization of ascending pharyngeal artery in 8 cases. Conclusion： Superselective angiographic diagnosis, embolization and appropriate embolic particle size are important for successful treatment of nasopharyngeal angiofibroma. TAE is safe and effective in decreasing haemorrhage during surgical operation for nasopharyngeal angiofibroma.展开更多
We report a rare case of postoperative pseudoaneurysm of the gastroduodenal artery following radical gastrectomy.Surgical trauma to the gastroduodenal artery during regional lymphadenectomy was considered as the cause...We report a rare case of postoperative pseudoaneurysm of the gastroduodenal artery following radical gastrectomy.Surgical trauma to the gastroduodenal artery during regional lymphadenectomy was considered as the cause of the postoperative pseudoaneurysm. The pseudoaneurysm was successfully managed by ligating the bleeding vessel. We should consider the possibility of pseudoaneurysm formation in a patient with gastrointestinal bleeding in the postoperative period following radical gastrectomy with regional lymph node and perivascular lymphatic dissection.展开更多
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
AIM： To investigate distal small bowel motility and lipid absorption in patients following elective abdominal aortic aneurysm （AAA） repair surgery, METHODS： Nine patients （aged 35-78 years; body mass index （BMI...AIM： To investigate distal small bowel motility and lipid absorption in patients following elective abdominal aortic aneurysm （AAA） repair surgery, METHODS： Nine patients （aged 35-78 years; body mass index （BMI） range： 23-36 kg/m2） post-surgery for AAA repair, and seven healthy control subjects （20-50 years; BMI range： 21-29 kg/m^2） were studied, Continuous distal small bowel manometry was performed for up to 72 h, during periods of fasting and enteral feeding （Nutrison）. Recordings were analyzed for the frequency, odgin, length of migration, and direction of small intestinal burst activity. Lipid absorption was assessed on the first day and the third day post surgery in a subset of patients using the ^13C-triolein-breath test, and compared with healthy controls. Subjects received a 20-min intraduodenal infusion of 50 mL liquid feed mixed with 200μL ^13C-triolein. End-expiratory breath samples were collected for 6 h and analyzed for ^13CO2 concentration. RESULTS： The frequency of burst activity in the proximal and distal small intestine was higher in patients than in healthy subjects, under both fasting and fed conditions （P〈 0.005）. In patients there was a higher proportion of abnormally propagated bursts （71% abnormal）, which began to normalize by d 3 （25% abnormal） post-surgery.Lipid absorption data was available for seven patients on d 1 and four patients on d 3 post surgery. In patients, absorption on d 1 post-surgery was half that of healthy control subjects （AUC ^13CO2 1323±244 vs 2646±365; P〈0.05, respectively）, and was reduced to the one-fitch that of healthy controls by d 3 （AUC ^13CO2 470±832 vs 2646±365; P〈 0.05, respectively）. CONCLUSION： Both proximal and distal small intestinal motor activity are transiently disrupted in critically ill patients immediately after major surgery, with abnormal motility patterns extending as far as the ileum. These motor disturbances may contribute to impaired absorption of enteral nutrition, especially when intraluminal processing is necessary for efficient digestion.展开更多
Objective To investigate the role of revascularization procedures with autologous greater saphenous vein in surgical management of iliac-femoral artery pseudoaneurysm in parenteral drug abusers. Methods Twenty-one pat...Objective To investigate the role of revascularization procedures with autologous greater saphenous vein in surgical management of iliac-femoral artery pseudoaneurysm in parenteral drug abusers. Methods Twenty-one patients with iliac-femoral artery pseudoaneurysm caused by parenteral drug abuse from 2004 to 2007 were enrolled. Among them,15 patients were male and 6 were female; their average age was 31.3 years. The size of pseudoaneurysms ranged from 3.0 cm to 7.5 cm. Common femoral artery and distal external iliac artery were often involved. We performed arterial reconstruction on these patients with autologous greater saphenous vein as a graft after excising iliac-femoral artery pseudoaneurysm through a single curved inguinal incision. All patients were followed up,and the complications were recorded. Results The surgical procedures were finished without intraoperative mortality or perioperative complications. All patients were free of claudication symptoms after the surgery except one case with preoperative popliteal artery stenosis. One case of infection and wound tissue fistula was found later. One case had inguinal incisional hematoma and another complained of numbness in thigh skin. Conclusions The use of autologous greater saphenous venous grafts for arterial reconstruction after pseudoaneurysm excision in drug abusers is safe and effective. This technique offers more advantages than arterial ligation alone without revascularization. An optimal greater saphenous venous graft is a prerequisite for revascularization.展开更多
Objective To report surgical experience in pseudoaneurysm (PA) repair of arteriovenous fistula (AVF) for renal hemodialysis. Methods Twenty patients undergoing PA repair of AVF for renal hemodialysis were treated in C...Objective To report surgical experience in pseudoaneurysm (PA) repair of arteriovenous fistula (AVF) for renal hemodialysis. Methods Twenty patients undergoing PA repair of AVF for renal hemodialysis were treated in Central Hospital Conde S. Januario of Macao. Sixteen patients had PAs of AVF in upper extremities, 4 in lower extremities. All patients were treated with surgical therapy. Results All operations were finished without death. One patient suffered from acute thrombosis, recovered without any complication through instant thrombectomy. One patient with postoperative incision bleeding recovered after low molecular weight heparin was ceased. And one AVF could not be mature six weeks later, was recovered after ligation of branch vein. And one patient died due to recurrent cerebral infarction. Conclusion Surgical repair is the best choice for PA of AVF for renal hemodialysis.展开更多
Objective.To summarize the experience of minim ally invasive treatment in 520patie nts with intracranial aneurysms on a retrospective study.Methods.The measures used in the treatment of520patients were reviewed in ter...Objective.To summarize the experience of minim ally invasive treatment in 520patie nts with intracranial aneurysms on a retrospective study.Methods.The measures used in the treatment of520patients were reviewed in terms o f timing of surgery,induced-hypotensive anesthesia,b rain protection combined with temporal occlusion of the feeding artery,exter-nal drainage of CSF,dynamic monitoring of intracranial pressure,blood flow velocity,serum osmolality and CT scanning,anti-vasospasm therapy a s well as selected interventional en dovascular embolization of aneurysms.Results.Of the 520patients,485were treated with either direct clipping or endov ascular embolization and35patients were treated non-surgic ally.In 449patients undergoing dir ect clipping and 36undergoing endov ascu-lar embolization,intraoperative r upture of aneurysm occurred in 27(6.0%)and 0%,respectively.Death oc-curred in 13(2.6%),hemiplegia in 8(1.6%),and vegetative state in 2(0.4%).The operative mortality of direct clipping was 3.8%in 210patie nts before 1990and 1.8%in 275patien ts after 1990(36patients undergo-ing endovascular embolization,the operative mortality was 0%).Conclusion.The outcome of patients with intracranial aneurysms can be markedly impr oved and the opera-tive mortality can be lowered by mini mally invasive treatment.展开更多
Objective: To study surgical management for pati ents with femoral pseudoaneurysm resulting from addictive drug injection. Methods: Clinical data of 34 patients with femoral pseudoaneury sm resulting from addictive dr...Objective: To study surgical management for pati ents with femoral pseudoaneurysm resulting from addictive drug injection. Methods: Clinical data of 34 patients with femoral pseudoaneury sm resulting from addictive drug injection were retrospectively reviewed. Results: Thirteen patients underwent bypass graft (end to side) of external iliac artery and superficial femoral artery using expanded polytetr afluoroethylene (ePTFE). Three patients who had an autogenous saphenous vein gra ft in situs,one of whom was then performed an ePTFE graft when rupture and blee ding occurred at the anastomotic site. Color Doppler image showed patent grafted blood vessels in all the patients after operation. Eighteen patients had their femoral arteries ligated. Limbs of all the 34 patients were saved. Conclusions: Ligating femoral artery is an effective way to tre at femoral artery pseudoaneurysm if autogenous saphenous vein graft or artificia l vessel graft is not applicable.展开更多
Objective：To summarize our experience in surgical treatment of traumatic lower limb pseudoaneurysm.Methods：Twenty patients with traumatic lower limb pseudoaneurysm were surgically treated in our department from Janu...Objective：To summarize our experience in surgical treatment of traumatic lower limb pseudoaneurysm.Methods：Twenty patients with traumatic lower limb pseudoaneurysm were surgically treated in our department from January 2007 to January 2012.The treatment protocols included interventional covered-stent placement （10 cases）,spring coil embolization （2 cases）,and surgical operation （8 cases）.Surgical operations included pseudoaneurysm repair （2 cases）,autologousvein transplantation （1 case）,and artificial-vessel bypass graft （5 cases）.Results：All the patients were successfully treated without aggravating lower limb ischemia.Pseudoaneurysm disappeared after treatment.A surgical operation is suitable to most pseudoaneurysms,but its damage is relatively obvious and usually leads to more bleeding.It also requires a longer operating time.Compared to a surgical operation,interventional therapy is less traumatic and patients usually have a quicker recovery （P＜0.05）.All patients were followed up once per month for 12-36 months by color Doppler ultrasound examination.There were no cases of pseudoaneurysm recurrence.Conclusion：Both surgical operation and interventional therapy are safe and effective in the treatment of pseudoaneurysm.展开更多
文摘Objective： To evaluate the clinical application of superselective transcatheter arterial embolization （TAE） in nasopharyngeal angiofibroma before operation. Methods： Superselective angiography was done via femoral. TAE with polyvinyl alcohol particles and/or gelfoam （GF） was performed in 12 patients with nasopharyngeal angiofibroma. All patients underwent surgical removal of devascularized tumors in 3 to 7 days after TAE. Results： During digital subtraction angiography, tumor staining was seen in 12 patients. Embolization of maxillary artery was performed in 12 cases and additional embolization of ascending pharyngeal artery in 8 cases. Conclusion： Superselective angiographic diagnosis, embolization and appropriate embolic particle size are important for successful treatment of nasopharyngeal angiofibroma. TAE is safe and effective in decreasing haemorrhage during surgical operation for nasopharyngeal angiofibroma.
文摘We report a rare case of postoperative pseudoaneurysm of the gastroduodenal artery following radical gastrectomy.Surgical trauma to the gastroduodenal artery during regional lymphadenectomy was considered as the cause of the postoperative pseudoaneurysm. The pseudoaneurysm was successfully managed by ligating the bleeding vessel. We should consider the possibility of pseudoaneurysm formation in a patient with gastrointestinal bleeding in the postoperative period following radical gastrectomy with regional lymph node and perivascular lymphatic dissection.
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.
基金Supported by National Health and Medical Research Council of AustraliaMargarete and Walther Lichenstein-Stiftung(Basel,Switzerland)
文摘AIM： To investigate distal small bowel motility and lipid absorption in patients following elective abdominal aortic aneurysm （AAA） repair surgery, METHODS： Nine patients （aged 35-78 years; body mass index （BMI） range： 23-36 kg/m2） post-surgery for AAA repair, and seven healthy control subjects （20-50 years; BMI range： 21-29 kg/m^2） were studied, Continuous distal small bowel manometry was performed for up to 72 h, during periods of fasting and enteral feeding （Nutrison）. Recordings were analyzed for the frequency, odgin, length of migration, and direction of small intestinal burst activity. Lipid absorption was assessed on the first day and the third day post surgery in a subset of patients using the ^13C-triolein-breath test, and compared with healthy controls. Subjects received a 20-min intraduodenal infusion of 50 mL liquid feed mixed with 200μL ^13C-triolein. End-expiratory breath samples were collected for 6 h and analyzed for ^13CO2 concentration. RESULTS： The frequency of burst activity in the proximal and distal small intestine was higher in patients than in healthy subjects, under both fasting and fed conditions （P〈 0.005）. In patients there was a higher proportion of abnormally propagated bursts （71% abnormal）, which began to normalize by d 3 （25% abnormal） post-surgery.Lipid absorption data was available for seven patients on d 1 and four patients on d 3 post surgery. In patients, absorption on d 1 post-surgery was half that of healthy control subjects （AUC ^13CO2 1323±244 vs 2646±365; P〈0.05, respectively）, and was reduced to the one-fitch that of healthy controls by d 3 （AUC ^13CO2 470±832 vs 2646±365; P〈 0.05, respectively）. CONCLUSION： Both proximal and distal small intestinal motor activity are transiently disrupted in critically ill patients immediately after major surgery, with abnormal motility patterns extending as far as the ileum. These motor disturbances may contribute to impaired absorption of enteral nutrition, especially when intraluminal processing is necessary for efficient digestion.
文摘Objective To investigate the role of revascularization procedures with autologous greater saphenous vein in surgical management of iliac-femoral artery pseudoaneurysm in parenteral drug abusers. Methods Twenty-one patients with iliac-femoral artery pseudoaneurysm caused by parenteral drug abuse from 2004 to 2007 were enrolled. Among them,15 patients were male and 6 were female; their average age was 31.3 years. The size of pseudoaneurysms ranged from 3.0 cm to 7.5 cm. Common femoral artery and distal external iliac artery were often involved. We performed arterial reconstruction on these patients with autologous greater saphenous vein as a graft after excising iliac-femoral artery pseudoaneurysm through a single curved inguinal incision. All patients were followed up,and the complications were recorded. Results The surgical procedures were finished without intraoperative mortality or perioperative complications. All patients were free of claudication symptoms after the surgery except one case with preoperative popliteal artery stenosis. One case of infection and wound tissue fistula was found later. One case had inguinal incisional hematoma and another complained of numbness in thigh skin. Conclusions The use of autologous greater saphenous venous grafts for arterial reconstruction after pseudoaneurysm excision in drug abusers is safe and effective. This technique offers more advantages than arterial ligation alone without revascularization. An optimal greater saphenous venous graft is a prerequisite for revascularization.
文摘Objective To report surgical experience in pseudoaneurysm (PA) repair of arteriovenous fistula (AVF) for renal hemodialysis. Methods Twenty patients undergoing PA repair of AVF for renal hemodialysis were treated in Central Hospital Conde S. Januario of Macao. Sixteen patients had PAs of AVF in upper extremities, 4 in lower extremities. All patients were treated with surgical therapy. Results All operations were finished without death. One patient suffered from acute thrombosis, recovered without any complication through instant thrombectomy. One patient with postoperative incision bleeding recovered after low molecular weight heparin was ceased. And one AVF could not be mature six weeks later, was recovered after ligation of branch vein. And one patient died due to recurrent cerebral infarction. Conclusion Surgical repair is the best choice for PA of AVF for renal hemodialysis.
文摘Objective.To summarize the experience of minim ally invasive treatment in 520patie nts with intracranial aneurysms on a retrospective study.Methods.The measures used in the treatment of520patients were reviewed in terms o f timing of surgery,induced-hypotensive anesthesia,b rain protection combined with temporal occlusion of the feeding artery,exter-nal drainage of CSF,dynamic monitoring of intracranial pressure,blood flow velocity,serum osmolality and CT scanning,anti-vasospasm therapy a s well as selected interventional en dovascular embolization of aneurysms.Results.Of the 520patients,485were treated with either direct clipping or endov ascular embolization and35patients were treated non-surgic ally.In 449patients undergoing dir ect clipping and 36undergoing endov ascu-lar embolization,intraoperative r upture of aneurysm occurred in 27(6.0%)and 0%,respectively.Death oc-curred in 13(2.6%),hemiplegia in 8(1.6%),and vegetative state in 2(0.4%).The operative mortality of direct clipping was 3.8%in 210patie nts before 1990and 1.8%in 275patien ts after 1990(36patients undergo-ing endovascular embolization,the operative mortality was 0%).Conclusion.The outcome of patients with intracranial aneurysms can be markedly impr oved and the opera-tive mortality can be lowered by mini mally invasive treatment.
文摘Objective: To study surgical management for pati ents with femoral pseudoaneurysm resulting from addictive drug injection. Methods: Clinical data of 34 patients with femoral pseudoaneury sm resulting from addictive drug injection were retrospectively reviewed. Results: Thirteen patients underwent bypass graft (end to side) of external iliac artery and superficial femoral artery using expanded polytetr afluoroethylene (ePTFE). Three patients who had an autogenous saphenous vein gra ft in situs,one of whom was then performed an ePTFE graft when rupture and blee ding occurred at the anastomotic site. Color Doppler image showed patent grafted blood vessels in all the patients after operation. Eighteen patients had their femoral arteries ligated. Limbs of all the 34 patients were saved. Conclusions: Ligating femoral artery is an effective way to tre at femoral artery pseudoaneurysm if autogenous saphenous vein graft or artificia l vessel graft is not applicable.
文摘Objective：To summarize our experience in surgical treatment of traumatic lower limb pseudoaneurysm.Methods：Twenty patients with traumatic lower limb pseudoaneurysm were surgically treated in our department from January 2007 to January 2012.The treatment protocols included interventional covered-stent placement （10 cases）,spring coil embolization （2 cases）,and surgical operation （8 cases）.Surgical operations included pseudoaneurysm repair （2 cases）,autologousvein transplantation （1 case）,and artificial-vessel bypass graft （5 cases）.Results：All the patients were successfully treated without aggravating lower limb ischemia.Pseudoaneurysm disappeared after treatment.A surgical operation is suitable to most pseudoaneurysms,but its damage is relatively obvious and usually leads to more bleeding.It also requires a longer operating time.Compared to a surgical operation,interventional therapy is less traumatic and patients usually have a quicker recovery （P＜0.05）.All patients were followed up once per month for 12-36 months by color Doppler ultrasound examination.There were no cases of pseudoaneurysm recurrence.Conclusion：Both surgical operation and interventional therapy are safe and effective in the treatment of pseudoaneurysm.
