Minimally invasive surgery started spreading worldwide in 1987,when the first laparoscopic cholecystectomy was performed.Meanwhile,improvement of endoscopic equipment and instruments allowed gastroenterologists to att...Minimally invasive surgery started spreading worldwide in 1987,when the first laparoscopic cholecystectomy was performed.Meanwhile,improvement of endoscopic equipment and instruments allowed gastroenterologists to attempt more aggressive endoluminal interventions,even beyond the wall barrier.The first transgastric peri-toneoscopy,in 2004,brought to light the concept of natural orifice transluminal endoscopic surgery(NOTES).The idea of incisionless surgery is attractive and has become a new goal for both surgeons and other people interested in this field of investigation.The authors present a review of all developments concerning NOTES,including animal studies and human experience.展开更多
Objective To design a technique of esophagus-stomach-abdominal wall drainage for the de-layed intrathoracic esophageal perforation and to improve the therapeutic results. Methods Four patients were treated by this sim...Objective To design a technique of esophagus-stomach-abdominal wall drainage for the de-layed intrathoracic esophageal perforation and to improve the therapeutic results. Methods Four patients were treated by this simplified technique. There were 1 case of lower intrathoracic esophageal perforation to the left thorax , 1 high and 2 middle perforation to the right. This technique used two plastic tubes (chest tube) in a diameter about 1 .2cm . One tube served as an intercostal drainage tube to drain purulent effusion , the other was inserted abdominally through stomach to the esophagus about 10cm above the esophageal perforation. Results The four patients were treated successfully by the esophagus-stomach-abdominal wall drainage. There was no mortality or severe morbidity or complication. Hospitalizations were shortened. Conclusion This technique is simple, safe and effective. It may provide a more promising alternative method of treatment for delayed esophageal perforation, especially in the critically ill patients. The procedure can also be extended to deal with esophagus-stomach anastomotic leak.展开更多
文摘Minimally invasive surgery started spreading worldwide in 1987,when the first laparoscopic cholecystectomy was performed.Meanwhile,improvement of endoscopic equipment and instruments allowed gastroenterologists to attempt more aggressive endoluminal interventions,even beyond the wall barrier.The first transgastric peri-toneoscopy,in 2004,brought to light the concept of natural orifice transluminal endoscopic surgery(NOTES).The idea of incisionless surgery is attractive and has become a new goal for both surgeons and other people interested in this field of investigation.The authors present a review of all developments concerning NOTES,including animal studies and human experience.
文摘Objective To design a technique of esophagus-stomach-abdominal wall drainage for the de-layed intrathoracic esophageal perforation and to improve the therapeutic results. Methods Four patients were treated by this simplified technique. There were 1 case of lower intrathoracic esophageal perforation to the left thorax , 1 high and 2 middle perforation to the right. This technique used two plastic tubes (chest tube) in a diameter about 1 .2cm . One tube served as an intercostal drainage tube to drain purulent effusion , the other was inserted abdominally through stomach to the esophagus about 10cm above the esophageal perforation. Results The four patients were treated successfully by the esophagus-stomach-abdominal wall drainage. There was no mortality or severe morbidity or complication. Hospitalizations were shortened. Conclusion This technique is simple, safe and effective. It may provide a more promising alternative method of treatment for delayed esophageal perforation, especially in the critically ill patients. The procedure can also be extended to deal with esophagus-stomach anastomotic leak.
