Objective To evaluate surgical methods and results of extracardiac conduit total cavopulmonary anastomosis (EC-TCPA) without cardiopulmonary bypass (CPB). Methods From May 2000 to April 2003, 11 patients with function...Objective To evaluate surgical methods and results of extracardiac conduit total cavopulmonary anastomosis (EC-TCPA) without cardiopulmonary bypass (CPB). Methods From May 2000 to April 2003, 11 patients with functional univentricle underwent off-pump EC-TCPA (no-CPB group). Their postoperative outcome was retrospectively compared with a 17-patient group who underwent EC-TCPA with cardiopulmonary bypass (CPB group) over a concurrent time period. Results There was 1 operative death in no-CPB group and 2 in CPB group; early postoperative hemodynamics appe-ared to significantly improve in no-CPB group. Blood and platelet transfusions decreased and blood plasma transfusion significantly lowered in no-CPB group compared with CPB group (P = 0.036). Postoperative courses of patients in no-CPB group were smooth and event free, and extubation time was substantially short. Intensive cares unit stay (P = 0.04) and hospital stay (P = 0.02) postoperation were significantly shorter, hospital costs were significantly reduced (P = 0.004) in no-CPB group compared with CPB group. Conclusions EC-TCPA without use of CPB is not a difficult procedure; the procedure results in improvement in postoperative hemodynamics, and decreased use of blood and blood products. It is a more efficient operation with more short recovery time and reduced hospital stay.展开更多
Objective： To investigate the necessity of modification to the traditional pigtail probe and evaluate its efficiency and therapeutic effect in searching the nasal cut ends and anastomosing the lacerated lacrimal cana...Objective： To investigate the necessity of modification to the traditional pigtail probe and evaluate its efficiency and therapeutic effect in searching the nasal cut ends and anastomosing the lacerated lacrimal canaliculus. Methods： Eighty-seven patients （including 87 eyes） suffering from canalicular laceration were randomized into two groups： 41 patients treated with traditional pigtail probes （Group A） and 46 with modified pigtail probes （Group B）. During the reconstruction of the lacerated canaliculi, the traditional pigtail probe and the modified pigtail probe were used respectively to seek for the nasal cut ends of lacerated lacrimal canaliculi. Peripherally inserted central catheter （PICCTM） silicone tube with diameter of 0.95 mm was intubated as a stent for 4-6 months. The surgical outcomes were retrospectively analyzed after stent removal. Results： In Group B, the primary success rate of searching the nasal cut ends of lacerated lacrimal canaliculi was 93.48% （43/46） and the final success rate was 97.83% （45/46）. No false passage formed in Group B. Statistical sig- nificance was found between Group A and Group B as the primary success rates of searching the nasal cut ends （ x^2 = 10.522, P〈0.01） and the false passage forming rates were concerned （ x^2=4.704, P〈0.05）, whereas no significance was found between the two groups as the final success rates were concerned （ x^2=0.007, P〉0.05）. The mean time of searching the nasal cut ends of lacerated lacrimal canaliculi in Group B was （5.02±2.73） minutes and the mean time of operation was （33.90±4.84） minutes, and both were significantly shorter than those of Group A （t1=9.779, t2=10.700, P〈0.01）. The cure rate of Group B was 95.65%, though higher than that of Group A, no statistical significance was found （Z=-1.007, P〉0.05）. Totally, 2 patients （2.30%） were found to be absent of common canaliculus and underwent bicanalicular nasal intubation in the two groups. Conclusions： Pigtail probes are efficient and convenient apparatus for searching the nasal cut ends of the lacerated lacrimal canaliculi in the reconstruction of canalicular laceration. Necessary or proper modifications to the pigtail probes can minimize the risk of iatrogenic damages or complications and enhance the efficiency and therapeutic effect of canalicular repair.展开更多
文摘Objective To evaluate surgical methods and results of extracardiac conduit total cavopulmonary anastomosis (EC-TCPA) without cardiopulmonary bypass (CPB). Methods From May 2000 to April 2003, 11 patients with functional univentricle underwent off-pump EC-TCPA (no-CPB group). Their postoperative outcome was retrospectively compared with a 17-patient group who underwent EC-TCPA with cardiopulmonary bypass (CPB group) over a concurrent time period. Results There was 1 operative death in no-CPB group and 2 in CPB group; early postoperative hemodynamics appe-ared to significantly improve in no-CPB group. Blood and platelet transfusions decreased and blood plasma transfusion significantly lowered in no-CPB group compared with CPB group (P = 0.036). Postoperative courses of patients in no-CPB group were smooth and event free, and extubation time was substantially short. Intensive cares unit stay (P = 0.04) and hospital stay (P = 0.02) postoperation were significantly shorter, hospital costs were significantly reduced (P = 0.004) in no-CPB group compared with CPB group. Conclusions EC-TCPA without use of CPB is not a difficult procedure; the procedure results in improvement in postoperative hemodynamics, and decreased use of blood and blood products. It is a more efficient operation with more short recovery time and reduced hospital stay.
文摘Objective： To investigate the necessity of modification to the traditional pigtail probe and evaluate its efficiency and therapeutic effect in searching the nasal cut ends and anastomosing the lacerated lacrimal canaliculus. Methods： Eighty-seven patients （including 87 eyes） suffering from canalicular laceration were randomized into two groups： 41 patients treated with traditional pigtail probes （Group A） and 46 with modified pigtail probes （Group B）. During the reconstruction of the lacerated canaliculi, the traditional pigtail probe and the modified pigtail probe were used respectively to seek for the nasal cut ends of lacerated lacrimal canaliculi. Peripherally inserted central catheter （PICCTM） silicone tube with diameter of 0.95 mm was intubated as a stent for 4-6 months. The surgical outcomes were retrospectively analyzed after stent removal. Results： In Group B, the primary success rate of searching the nasal cut ends of lacerated lacrimal canaliculi was 93.48% （43/46） and the final success rate was 97.83% （45/46）. No false passage formed in Group B. Statistical sig- nificance was found between Group A and Group B as the primary success rates of searching the nasal cut ends （ x^2 = 10.522, P〈0.01） and the false passage forming rates were concerned （ x^2=4.704, P〈0.05）, whereas no significance was found between the two groups as the final success rates were concerned （ x^2=0.007, P〉0.05）. The mean time of searching the nasal cut ends of lacerated lacrimal canaliculi in Group B was （5.02±2.73） minutes and the mean time of operation was （33.90±4.84） minutes, and both were significantly shorter than those of Group A （t1=9.779, t2=10.700, P〈0.01）. The cure rate of Group B was 95.65%, though higher than that of Group A, no statistical significance was found （Z=-1.007, P〉0.05）. Totally, 2 patients （2.30%） were found to be absent of common canaliculus and underwent bicanalicular nasal intubation in the two groups. Conclusions： Pigtail probes are efficient and convenient apparatus for searching the nasal cut ends of the lacerated lacrimal canaliculi in the reconstruction of canalicular laceration. Necessary or proper modifications to the pigtail probes can minimize the risk of iatrogenic damages or complications and enhance the efficiency and therapeutic effect of canalicular repair.
