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Application of Pelvic Peritoneum Closure Combined with Extraperitoneal Colostomy in Laparoscopic Surgery for Low Rectal Cancer
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作者 Hongliang Yao Jipan Liu +5 位作者 Caihua Sun Chengjun Wang Yun Li Li Li Bin Zhao Jia Liu 《Proceedings of Anticancer Research》 2023年第3期29-37,共9页
Background:In the treatment of colorectal cancer,laparoscopic surgery has seen a significant amount of success.Reducing the risk of postoperative complications and improving patients’quality of life can be accomplish... Background:In the treatment of colorectal cancer,laparoscopic surgery has seen a significant amount of success.Reducing the risk of postoperative complications and improving patients’quality of life can be accomplished by appropriately employing pelvic peritoneal repair and sigmoid colostomy when appropriate.Objective:To compare fusion closure of pelvic peritoneum combined with extraperitoneal colostomy with non-closure of pelvic peritoneum combined with intraperitoneal colostomy in patients with low rectal cancer who had permanent colostomy.Methods:Low rectal cancer patients admitted to Hengshui People’s Hospital for permanent colostomy were evaluated.The participants were divided into two groups:an observation and a control group.All 30 cases in the observation group underwent pelvic peritoneum closure and extraperitoneal colostomy,while the other 30 cases in the control group underwent intraperitoneal colostomy.The C-reactive protein(CRP)levels of the participants in both groups were evaluated for 6 months to 2 years(24 h before,24 h after,48 h after,96 h after surgery).Results:Comparing the colostomy operative time,time to first passage of flatus postoperatively,time to first defecation postoperatively,length of hospital stay,laboratory indicators,stoma-related complications,colostomy function,etc.,the colostomy operative time significantly differed between the two groups(P<0.05);the observation group did considerably better than the control group in terms of stoma-related complications and bowel movement control 6 months after surgery(P<0.05);and although serum CRP levels increased in both groups 48 h after surgery,the difference was significant(P<0.05).Conclusion:Extraperitoneal colostomy can improve the quality of life of patients with permanent stoma and reduce the occurrence of stoma-related complications.Thus,this technique is worthy of promotion in clinical practice. 展开更多
关键词 Low rectal cancer Closure of pelvic peritoneum Permanent colostomy Extraperitoneal colostomy via rectus abdominis
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Pathophysiology of colorectal peritoneal carcinomatosis: Role of the peritoneum 被引量:12
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作者 Lieselotte Lemoine Paul Sugarbaker Kurt Van der Speeten 《World Journal of Gastroenterology》 SCIE CAS 2016年第34期7692-7707,共16页
Colorectal cancer(CRC) is the third most common cancer and the fourth most common cause of cancerrelated death worldwide. Besides the lymphatic and haematogenous routes of dissemination,CRC frequently gives rise to tr... Colorectal cancer(CRC) is the third most common cancer and the fourth most common cause of cancerrelated death worldwide. Besides the lymphatic and haematogenous routes of dissemination,CRC frequently gives rise to transcoelomic spread of tumor cells in the peritoneal cavity,which ultimately leads to peritoneal carcinomatosis(PC). PC is associated with a poor prognosis and bad quality of life for these patients in their terminal stages of disease. A loco-regional treatment modality for PC combining cytoreductive surgery and hyperthermic intraperitoneal peroperative chemotherapy has resulted in promising clinical results. However,this novel approach is associated with significant morbidity and mortality. A comprehensive understanding of the molecular events involved in peritoneal disease spread is paramount in avoiding unnecessary toxicity. The emergence of PC is the result of a molecular crosstalk between cancer cells and host elements,involving several well-defined steps,together known as the peritoneal metastatic cascade. Individual or clumps of tumor cells detach from the primary tumor,gain access to the peritoneal cavity and become susceptible to the regular peritoneal transport. They attach to the distant peritoneum,subsequently invade the subperitoneal space,where angiogenesis sustains proliferation and enables further metastatic growth. These molecular events are not isolated events but rather a continuous and interdependent process. In this manuscript,we review current data regarding the molecular mechanisms underlying the development of colorectal PC,with a special focus on the peritoneum and the role of the surgeon in peritoneal disease spread. 展开更多
关键词 PERITONEAL CARCINOMATOSIS PATHOPHYSIOLOGY PERITONEAL METASTATIC cascade Cytoreductive surgery peritoneum Hyperthermic INTRAPERITONEAL peroperative chemotherapy
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Inhibitory effect of genistein on MMP-2 and MMP-9 expression through suppressing NF-κB activity in peritoneum of murine model of endometriosis 被引量:1
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作者 Dwi Yuliawati Karyono Mintaroem Sutrisno Sutrisno 《Asian pacific Journal of Reproduction》 2018年第6期261-265,共5页
Objective:To analyze the inhibitory effect of genistein on matrix metalloproteinase-2 (MMP-2) and matrix metalloproteinase-9 (MMP-9) through inhibition of nuclear factor-kappa B (NF-κB ) activation.Methods: A total o... Objective:To analyze the inhibitory effect of genistein on matrix metalloproteinase-2 (MMP-2) and matrix metalloproteinase-9 (MMP-9) through inhibition of nuclear factor-kappa B (NF-κB ) activation.Methods: A total of 36 female mice were divided into six groups (n=6 in each group): control group (untreated mice), endometriosis mice group, and endometriosis mice groups administered with genistein at different doses (1.30 mg/day;1.95 mg/day;2.60 mg/day;and 3.25 mg/day). The genistein treatment was performed for 14 d. The expressions of NF-κB , MMP-2 and MMP-9 on the endometriosis lesions were analyzed by the immunohistochemical technique.Results: The activity of NF-κB in the endometriosis group increased significantly than that of the control group (P<0.05). The expression of MMP-2 or MMP-9 in the endometriosis group increased significantly than that of the control group (P<0.05). Administration of genistein at different doses was capable of significantly reducing the activity of NF-κB compared to that of the endometriosis group (P<0.05), reaching the level comparable to that of the control group at the third highest dose (P>0.05). The four doses of genistein administration were capable of significantly reducing the expression of MMP-2 compared to that of the endometriosis group (P<0.05), reaching an expression comparable to that of the control group for the highest dose (P>0.05). Administration of genistein at different doses was capable of significantly reducing the expression of MMP-9 compared to that of the endometriosis group (P<0.05), reaching the level comparable to that of the control group at the highest dose (P>0.05). Conclusions:Genistein suppresses the expression of MMP-2 and MMP-9 through suppressing NF-κB activity in the peritoneum of murine model of endometriosis. 展开更多
关键词 peritoneum METALLOPROTEINASE GENISTEIN ENDOMETRIOSIS ISOFLAVONES
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Caval replacement with parietal peritoneum tube graft for septic thrombophlebitis after hepatectomy: A case report
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作者 Charlotte Maulat Léopoldine Lapierre +3 位作者 Isabelle Migueres Xavier Chaufour Guillaume Martin-Blondel Fabrice Muscari 《World Journal of Hepatology》 CAS 2019年第1期133-137,共5页
BACKGROUND Caval vein thrombosis after hepatectomy is rare, although it increases mortality and morbidity. The evolution of this thrombosis into a septic thrombophlebitis responsible for persistent septicaemia after a... BACKGROUND Caval vein thrombosis after hepatectomy is rare, although it increases mortality and morbidity. The evolution of this thrombosis into a septic thrombophlebitis responsible for persistent septicaemia after a hepatectomy has not been reported to date in the literature. We here report the management of a 54-year-old woman operated for a peripheral cholangiocarcinoma who developed a suppurated thrombophlebitis of the vena cava following a hepatectomy.CASE SUMMARY This patient was operated by left lobectomy extended to segment V with bile duct resection and Roux-en-Y hepaticojejunostomy. After the surgery, she developed Streptococcus anginosus, Escherichia coli, and Enterococcus faecium bacteraemias, as well as Candida albicans fungemia. A computed tomography scan revealed a bilioma which was percutaneously drained. Despite adequate antibiotic therapy,the patient's condition remained septic. A diagnosis of septic thrombophlebitis of the vena cava was made on post-operative day 25. The patient was then operated again for a surgical thrombectomy and complete caval reconstruction with a parietal peritoneum tube graft. Use of the peritoneum as a vascular graft is an inexpensive technique, it is readily and rapidly available, and it allows caval replacement in a septic area. Septic thrombophlebitis of the vena cava after hepatectomy has not been described previously and it warrants being added to the spectrum of potential complications of this procedure.CONCLUSION Septic thrombophlebitis of the vena cava was successfully treated with antibiotic and anticoagulation treatments, prompt surgical thrombectomy and caval reconstruction. 展开更多
关键词 Bilioma Septic THROMBOPHLEBITIS SEPTICAEMIA PARIETAL peritoneum TUBE GRAFT Complete caval reconstruction Case report
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Malignant fibrous histiocytoma presenting as hemoperitoneum mimicking hepatocellular carcinoma rupture 被引量:4
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作者 Hsin-Chi Chen Chi-Jen Chen +1 位作者 Chin-Ming Jeng Chan-Ming Yang 《World Journal of Gastroenterology》 SCIE CAS CSCD 2007年第47期6441-6443,共3页
Malignant fibrous histiocytoma (MFH) is a pleomorphic mesenchynal sarcoma. It is uncommonly arises primarily from the intra-peritoneal cavity. Primary peritoneal MFH with tumor bleeding and rupture is rare. We describ... Malignant fibrous histiocytoma (MFH) is a pleomorphic mesenchynal sarcoma. It is uncommonly arises primarily from the intra-peritoneal cavity. Primary peritoneal MFH with tumor bleeding and rupture is rare. We describe the imaging features of a 70-year-old patient presenting with ruptured hemorrhagic peritoneal MFH at subhepatic area,accompanied by massive hemoperitoneum,mimicking a ruptured pedunculated hepatocellular carcinoma. Computed tomography (CT) revealed a large heterogeneous enhanced subhepatic mass with adjacent liver,gallbladder and colon invasion. Tumor hemorrhage and rupture complicated with peritoneal seeding and massive bloody ascites were also detected. Angiography showed a hypervascular tumor fed by enlarged right hepatic arteries,cystic artery and omental branches of gastroepiploic artery. The patient underwent laparotomy for tumor resection,but the tumor recurred one month after operation. To our knowledge,the CT appearance of ruptured intraperitoneal MFH complicated by hemoperitoneum has not been previously described. 展开更多
关键词 恶性纤维组织细胞瘤 腹膜 腹腔积血 自然破裂
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Coexistence of tuberculous peritonitis and primary papillary serous carcinoma of the peritoneum:A case report and review of the literature
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作者 Xiang-Qian Hou Hai-Hong Cui Xing Jin 《World Journal of Gastroenterology》 SCIE CAS CSCD 2009年第6期761-763,共3页
A major diagnostic challenge to the evaluation of an incomplete intestinal obstruction is to distinguish between infectious and malignant etiologies.We present a case of an elderly woman complaining of abdominal pain ... A major diagnostic challenge to the evaluation of an incomplete intestinal obstruction is to distinguish between infectious and malignant etiologies.We present a case of an elderly woman complaining of abdominal pain accompanied with nausea and vomiting,and failure to pass gas or stools.Anti-tuberculosis drugs were used to relieve her abdominal pain,and a needle biopsy of the peritoneal cavity showed evidence of primary papillary serous carcinoma of the peritoneum(PSCP). This is a rare description of tuberculosis in the setting of PSCP.This report illustrates the potential complex nature of malignancies,and emphasizes the need to consider coexistence of malignancy and infection in patients, especially in those with risk factors for malignancy who fail with antibiotic therapy. 展开更多
关键词 乳头状突起血浆癌 腹膜 结节状腹膜炎 治疗方法
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The follow up of quality life after in terventional therapy of post-peritoneum metastatic tumors
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作者 史周印 姜祖光 张明智 《中国临床康复》 CSCD 2002年第10期1541-1541,共1页
Objective Increase therapeutic effective rat e of post-perineum malignant carcin oma and decrease side effects.Method Inject chemotherapy drugs such as 5-FU,DDP and /or IL-2into tumors at variant po ints induced by B-... Objective Increase therapeutic effective rat e of post-perineum malignant carcin oma and decrease side effects.Method Inject chemotherapy drugs such as 5-FU,DDP and /or IL-2into tumors at variant po ints induced by B-ultrasound.Result The general effective rate was 72.7%in 11patients,which is hig her than other therapies.Conclusion B-ultrasound interventional thera py is recommended in the treatment of post-peritoneum malig nant tumors. 展开更多
关键词 腹膜后转移瘤 介入治疗 生存质量
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体外丝线牵拉辅助两孔腹腔镜内环缝合在治疗内环口皱褶冗厚斜疝中的应用
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作者 刘雪来 叶茂 +3 位作者 丁柏匀 管考平 张震 魏延栋 《中国微创外科杂志》 CSCD 北大核心 2024年第1期7-12,共6页
目的探讨体外丝线牵拉辅助两孔腹腔镜内环缝扎治疗内环皱褶冗厚斜疝的安全性、可行性。方法2019年10月~2023年2月,322例斜疝患儿接受两孔法腹腔镜内环缝扎,其中186例(292侧)内环皱褶冗厚患儿采用体外丝线牵拉法辅助。在腹腔镜监视下,针... 目的探讨体外丝线牵拉辅助两孔腹腔镜内环缝扎治疗内环皱褶冗厚斜疝的安全性、可行性。方法2019年10月~2023年2月,322例斜疝患儿接受两孔法腹腔镜内环缝扎,其中186例(292侧)内环皱褶冗厚患儿采用体外丝线牵拉法辅助。在腹腔镜监视下,针持持针经内环口外下缘入腹膜,于腹膜后间隙走行至精索血管外侧缘出针;于精索血管外侧缘进针,体外轻轻牵拉线尾,腹腔镜下见进针点附近后腹膜间隙增大,缝针顺势在后腹膜间隙跨越精索血管表面。相同方法牵拉和展开折叠在输精管-髂外血管间隙的腹膜皱褶,增大后腹膜间隙,缝针继续在后腹膜间隙贴近髂血管表面跨越Doom三角区冗厚的腹膜组织。相同方法于腹膜外间隙跨越输精管表面。继续直视下缝合内环口内侧壁和上壁腹膜组织,于最初进针处出针和打结,闭合内环口。结果292侧体外丝线牵拉冗厚腹膜后,缝针能顺利跨越精索血管、Doom三角区以及输精管表面。80例单侧手术时间(18.5±3.2)min,106例双侧手术时间(32.6±5.3)min。均无术中并发症发生,均在术后6 h内出院。122例术后随访3~18个月(平均8.5月),未出现切口感染、医源性隐睾或睾丸萎缩等并发症,无复发疝、鞘膜积液。结论对于内环皱褶冗厚的儿童斜疝,体外丝线牵拉法可有效展开冗厚的后腹膜,降低两孔法腹腔镜内环口缝扎时缝针跨越精索血管、Doom三角区以及输精管表面的难度,具有安全性、可行性。 展开更多
关键词 斜疝 腹膜皱褶冗厚 内环缝扎 Doom三角区 精索血管 输精管
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单钩针下压式勾线疝囊高位结扎术治疗儿童腹股沟斜疝的体会
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作者 卞军 施伟栋 +3 位作者 张向宁 丁文泽 姚远 王兴程 《国际医药卫生导报》 2024年第6期994-997,共4页
目的探讨全腹膜外疝囊高位结扎术中采用单钩针下压式勾线治疗儿童腹股沟斜疝的体会。方法回顾性分析2018年5月至2019年5月西安市儿童医院收治的腹股沟斜疝患儿419例。其中男370例,女49例,最小年龄8个月,最大年龄15岁,平均年龄3岁6个月;... 目的探讨全腹膜外疝囊高位结扎术中采用单钩针下压式勾线治疗儿童腹股沟斜疝的体会。方法回顾性分析2018年5月至2019年5月西安市儿童医院收治的腹股沟斜疝患儿419例。其中男370例,女49例,最小年龄8个月,最大年龄15岁,平均年龄3岁6个月;左侧160例,右侧220例,双侧39例。在全腹膜外疝囊高位结扎术中采用单钩针下压式勾线,记录手术时间和后腹膜的完整性。结果女孩单侧手术时间为(4.0±1.0)min,双侧为(6.0±1.2)min;男孩单侧手术时间为(6.0±1.0)min,双侧为(9.0±1.5)min。术中均未出现多次钩挂腹膜的手术过程和后腹膜撕裂等并发症,术后随访均无并发腹膜裂孔疝继发肠坏死情况。结论单钩针全腹膜外疝囊高位结扎术治疗儿童腹股沟斜疝手术中采用下压式勾线,能有效地减少腹膜外勾线时反复勾线和避免钩挂腹膜所引起的后腹膜撕裂等并发症,值得临床借鉴推广。 展开更多
关键词 腹股沟斜疝 单钩针 下压式勾线 完整腹膜
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腹腔镜直肠癌腹会阴联合切除术后盆底腹膜重建技术的研究进展
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作者 蒋自立(综述) 朱勇(审校) 《现代医药卫生》 2024年第3期468-471,共4页
探讨低位直肠癌经腹会阴联合切除术后盆底腹膜重建的方法及意义。通过检索直肠癌术后盆底结构重建技术及盆底腹膜重建相关文献,复习直肠癌盆底重建技术发现,直肠癌腹腔镜腹会阴联合切除术后关闭盆底腹膜是有必要的,虽然增加了外科医师... 探讨低位直肠癌经腹会阴联合切除术后盆底腹膜重建的方法及意义。通过检索直肠癌术后盆底结构重建技术及盆底腹膜重建相关文献,复习直肠癌盆底重建技术发现,直肠癌腹腔镜腹会阴联合切除术后关闭盆底腹膜是有必要的,虽然增加了外科医师的手术难度,但可减少盆腔及会阴区域感染、肠粘连、肠梗阻及放射性肠炎发生率,提高患者生活质量。该文对盆底结构重建方法及盆底腹膜重建的方法及优缺点进行了综述。 展开更多
关键词 重建盆底腹膜 肌皮瓣 腹会阴联合切除术 生物补片 腹腔镜腹会阴联合切除术 综述
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Morphological changes of the peritoneum in peritoneal dialysis patients 被引量:4
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作者 方炜 钱家麒 +1 位作者 余志远 陈诗书 《Chinese Medical Journal》 SCIE CAS CSCD 2004年第6期862-866,共5页
Background Long-term peritoneal dialysis (PD) requires that the peritoneal membrane remain effective for dialysis. Research directed toward human peritoneal morphology and structure is limited. The present study was p... Background Long-term peritoneal dialysis (PD) requires that the peritoneal membrane remain effective for dialysis. Research directed toward human peritoneal morphology and structure is limited. The present study was performed to investigate morphological changes of the human peritoneal membrane during PD and to elucidate the possible mechanisms of its functional deterioration. Methods A total of 32 peritoneal biopsies were performed in normal subjects (n=10),uremic nondialysis patients (n=12) at the time of catheter insertion,and PD patients (n=10) at the time of catheter removal or reinsertion or at the time of renal transplantation. Peritoneal morphology was examined by light microscopy,scanning electron microscopy,and transmission electron microscopy. Results The peritoneal membrane in normal subjects consisted of a monolayer of mesothelial cells on a basement membrane and a layer of connective tissue containing cells,blood vessels,and lymphatic vessels. Mesothelial cells were polygonal,often elongated,and had numerous microvilli on their luminal surface. There were lots of oval or roundish pinocytotic vesicles in the cytoplasm of the mesothelial cells. The peritoneal morphology of uremic nondialysis patients was similar to that of normal subjects. However,significant abnormalities of the peritoneal membrane were observed in PD patients,and the changes were found to be progressive. Microvilli were the first site of damage which involved microvilli shortening,a gradual reduction in their number,and,eventually,the total disappearance of microvilli. Mesothelial cells then detached from the basement membrane, disappearing completely in some cases. In the end,the peritoneal membrane consisted only of submesothelial connective tissue without any cells.Conclusions PD can modify peritoneal morphology and structure. The morphological change is progressive and may be one of the important causes of peritoneal failure. Peritoneal biopsies can provide lots of valuable information about the effects of PD. Studying the relationship between peritoneal structure and its function proved very useful for understanding the physiopathology of the peritoneum during PD. 展开更多
关键词 peritoneal dialysis·peritoneal biopsy·peritoneum·mesothelial cell
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Expression of aquaporin-1 in the human peritoneum and the effect of peritoneal dialysis on its expression 被引量:1
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作者 方炜 钱家麒 +1 位作者 余志远 陈诗书 《Chinese Medical Journal》 SCIE CAS CSCD 2003年第9期1370-1373,共4页
Objective To investigate the expression of aquaporin-1 (AQP1) in the human peritoneum and to evaluate the effect of peritoneal dialysis (PD) on its expression.Methods Peritoneal biopsies were obtained from normal subj... Objective To investigate the expression of aquaporin-1 (AQP1) in the human peritoneum and to evaluate the effect of peritoneal dialysis (PD) on its expression.Methods Peritoneal biopsies were obtained from normal subjects (n =10), uremic nondialysis patients (n = 12) at catheter insertion and PD patients ( n = 10) at the time of catheter removal, reinsertion or renal transplantation. Western blot, immuno-histochemical staining and reverse transcript-polymerase chain reaction ( RT-PCR) techniques were used to investigate AQP1 expression.Results All peritoneal samples expressed AQP1 at both mRNA and protein levels. Western blot revealed a major band at 28 kD as well as more diffuse bands between 35 and 50 kD. The 28 kD band represents the nonglycosylated form of the protein while the 35 - 50 kD bands correspond to glycosylated AQP1. Immunohistochemical staining found the positive deposits were distributed in the mesothelial cells, endothelial cells of capillaries, venules and small veins, whereas no signal was detected in the arterioles. Semi-quantitative analysis showed that AQP1 expression was remarkably stable in all samples, whatever their origin (P>0. 05).Conclusions Our findings suggested that AQP1 is the molecular counterpart of an ultra small pore during PD. Secondly, the peritoneal mesothelial cell might also be involved in peritoneal transcellular water transport. As regards whether or not the structural or distributional alterations of AQP1 in the peritoneum may be more obviously expressed during PD, further study is needed. 展开更多
关键词 aquaporins·gene expression·peritoneum·peritoneal dialysis
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腹膜外途径腹腔镜修补膀胱直肠瘘5例报道
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作者 闫学川 赵凯 +4 位作者 张宗亮 尹心宝 朱冠群 杨瀚 王科 《微创泌尿外科杂志》 2024年第1期57-61,共5页
本文回顾性分析了我院采用经腹膜外途径腹腔镜治疗的5例膀胱直肠瘘患者,采用了经腹膜外途径切除膀胱和直肠瘘口,并分开缝合,两瘘口间填塞带血管蒂大网膜,同期行乙状结肠造口。5例患者手术时间100~130 min(平均115 min),术中出血20~50 ml... 本文回顾性分析了我院采用经腹膜外途径腹腔镜治疗的5例膀胱直肠瘘患者,采用了经腹膜外途径切除膀胱和直肠瘘口,并分开缝合,两瘘口间填塞带血管蒂大网膜,同期行乙状结肠造口。5例患者手术时间100~130 min(平均115 min),术中出血20~50 ml(平均32 ml)。术后6个月将乙状结肠还纳。随访1年无尿瘘复发,无其他并发症。 展开更多
关键词 腹腔镜 腹膜 膀胱直肠瘘
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基于腹膜退缩理论的腹部筋膜与层面一Toldt筋膜
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作者 陈仕才 《消化肿瘤杂志(电子版)》 2024年第2期153-159,共7页
Toldt筋膜一直以来被认为是在肠系膜发育旋转过程中结肠系膜与后腹壁发生黏附时两者表面的内脏腹膜相互附着形成的融合筋膜。尽管关于胃肠道膜解剖的各种理念逐渐被越来越多的临床医生所熟知并应用于胃肠道手术中,但对于Toldt筋膜能否... Toldt筋膜一直以来被认为是在肠系膜发育旋转过程中结肠系膜与后腹壁发生黏附时两者表面的内脏腹膜相互附着形成的融合筋膜。尽管关于胃肠道膜解剖的各种理念逐渐被越来越多的临床医生所熟知并应用于胃肠道手术中,但对于Toldt筋膜能否被打开以及手术层面的选择仍有争议。我们在前期研究中提出了腹膜退缩理论,根据此理论我们认为腹膜外筋膜始终包绕着肠系膜,Toldt筋膜并非腹膜融合筋膜,而是胚胎发育过程中、腹膜退缩后保留的腹膜外筋膜,并将上皮下结缔组织层、浆膜下层(肿瘤TNM分期中的T_(3)层)、Toldt筋膜层及分隔肠系膜脂肪细胞小叶的纤维间隔统一归为腹膜外筋膜层。本文将以Toldt筋膜为例,说明肠系膜黏附区域的典型结构,同时指出全结肠系膜切除术的正确层面为系膜筋膜平面与筋膜后平面之间的Toldt筋膜层。腹膜退缩理论大大简化了对腹部筋膜与层面的认识,有助于推动胃肠道膜解剖手术的开展。 展开更多
关键词 腹膜退缩理论 肠系膜 腹膜外筋膜 Toldt筋膜
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Non-closure of the peritoneum and subcutaneous tissue at radical hysterectomy: A randomized controlled trial
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作者 Zhou-Fang XIONG Wei-Hong DONG Ze-Hua WANG 《Frontiers of Medicine》 SCIE CSCD 2010年第1期112-116,共5页
We conducted a trial to assess the influence of closure or nonclosure of the peritoneum and subcutaneous tissue on the clinical outcomes of cervical cancer patients who underwent radical hysterectomy with lower abdom-i... We conducted a trial to assess the influence of closure or nonclosure of the peritoneum and subcutaneous tissue on the clinical outcomes of cervical cancer patients who underwent radical hysterectomy with lower abdom-inal cross incision.This randomized controlled trial was performed on 158 cervical cancer patients in our hospital between January 2002 and June 2004.Eighty-two patients were allocated to the“closure”group and 76 patients to the“nonclosure”group.Results showed that non-closure of the peritoneum and subcutaneous tissue could shorten operation time and febrile duration,reduce antibiotics requirement,increase the volume of drainage and decrease the incidence of liquefaction of subcutaneous fat(P<0.05).There was no difference in blood loss,postoperative complications,bowel function restoration and post-operative stay between the two groups(P>0.05).Our study revealed that closure of the peritoneum and subcutaneous tissue provides no immedi-ate postoperative benefits while unnecessarily lengthening surgical time and anesthesia exposure.The practice of closure of the peritoneum and subcutaneous tissue at radical hysterectomy should be questioned. 展开更多
关键词 cervical cancer radical surgery peritoneum subcutaneous tissue
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腹部增强CT诊断及经导管动脉栓塞治疗自发性腹膜后血肿
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作者 陈尘 高健 +1 位作者 郅新 洪楠 《中国介入影像与治疗学》 北大核心 2023年第12期718-721,共4页
目的评估腹部增强CT诊断及经导管动脉栓塞治疗自发性腹膜后血肿(SRH)的价值。方法回顾性分析7例SRH患者,4例经腹部增强CT、1例经平扫CT、2例经超声诊断;均通过造影明确责任动脉后予以经导管动脉栓塞治疗;记录总造影用时,即首次造影与末... 目的评估腹部增强CT诊断及经导管动脉栓塞治疗自发性腹膜后血肿(SRH)的价值。方法回顾性分析7例SRH患者,4例经腹部增强CT、1例经平扫CT、2例经超声诊断;均通过造影明确责任动脉后予以经导管动脉栓塞治疗;记录总造影用时,即首次造影与末次造影之间的时间间隔,以及治疗效果。结果7例SRH中,6例造影可见明确责任动脉,均成功予以栓塞,随访至术后30天,病情均稳定;1例未见明确责任动脉,经内科保守治疗后病情稳定。4例经增强CT诊断SRH总造影用时32~60 min、中位用时47.5 min,其余3例总造影用时36~80 min、中位用时63.0 min。结论腹部增强CT有助于诊断SRH及显示责任动脉、提高治疗效果;经导管动脉栓塞可有效治疗SRH。 展开更多
关键词 腹膜 血肿 栓塞 治疗性 血管造影术 体层摄影术 X线计算机
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益肾清利活络方治疗腹膜透析患者的效果及对残余肾功能、腹膜功能的影响
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作者 周丽霞 蒋春波 +2 位作者 倪道磊 宋欢 任燕 《中国医学创新》 CAS 2023年第21期93-98,共6页
目的:观察益肾清利活络方治疗腹膜透析(peritoneal dialysis,PD)患者的效果及对残余肾功能、腹膜功能的影响,并探讨其可能作用机制。方法:选择2018年12月—2022年8月在南京中医药大学附属苏州市中医医院肾病科腹透门诊就诊及住院的PD患... 目的:观察益肾清利活络方治疗腹膜透析(peritoneal dialysis,PD)患者的效果及对残余肾功能、腹膜功能的影响,并探讨其可能作用机制。方法:选择2018年12月—2022年8月在南京中医药大学附属苏州市中医医院肾病科腹透门诊就诊及住院的PD患者共80例,采用随机数字表法分为治疗组与对照组,各40例,两组均进行常规治疗,治疗组在常规治疗的基础上服用益肾清利活络方3个月。对两组患者的治疗结果进行观察对比。结果:治疗组患者治疗总有效率相较于对照组显著提升(P<0.05)。与治疗前比较,治疗组治疗后前白蛋白(PAB)、血白蛋白(ALB)、血红蛋白(Hb)水平均升高,超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)水平均下降(P<0.05),且与对照组治疗后相比,差异均有统计学意义(P<0.05)。治疗组治疗后血肌酐(Scr)、血尿素氮(BUN)、β_(2)-微球蛋白(β_(2)-MG)水平均下降,残余肾小球滤过率(rGFR)提高(P<0.05),同对照组治疗后比较,差异均有统计学意义(P<0.05)。治疗组患者治疗后腹膜功能指标均显著提升,且治疗组同对照组比较提升程度明显(P<0.05)。结论:益肾清利活络方可以改善PD患者临床症状,改善营养状态,减轻炎症状况,保护残余肾功能,改善腹膜超滤功能,提高腹透充分性,延缓腹膜纤维化进程。 展开更多
关键词 吴门医派络病理论 益肾清利活络方 腹膜透析 残余肾功能 腹膜功能
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腹腔镜IPOM七步法修补术在创伤性腹壁疝中的应用
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作者 黄恩民 马宁 +10 位作者 马涛 刘创雄 黄浩男 汤福鑫 曾兵 李英儒 江志鹏 侯泽辉 甘文昌 陈双 周太成 《创伤外科杂志》 2023年第4期261-266,共6页
目的探讨腹腔镜内网片(intraperitoneal onlay mesh,IPOM)七步法修补术在创伤性腹壁疝(traumatic abdominal wall hernias,TAWH)中的应用价值。方法回顾性分析2018年1月—2022年10月中山大学附属第六医院胃肠、疝和腹壁外科收治的12例T... 目的探讨腹腔镜内网片(intraperitoneal onlay mesh,IPOM)七步法修补术在创伤性腹壁疝(traumatic abdominal wall hernias,TAWH)中的应用价值。方法回顾性分析2018年1月—2022年10月中山大学附属第六医院胃肠、疝和腹壁外科收治的12例TAWH患者的临床资料和手术录像,其中男性9例,女性3例;年龄44~66岁,平均56.5岁;体质量指数(body mass index,BMI)平均(25.1±3.2)kg/m^(2),最大缺损长轴57~150mm,平均105.5mm,短轴45~105mm,平均68.5mm。致伤原因:道路交通伤10例,机器挤压伤2例。评价腹腔镜IPOM七步法(即腹腔内松解腹壁粘连后,关闭筋膜缺损并置入补片加强腹壁)修补TAWH的可行性,观察术后复发情况,并结合手术录像分析TAWH的特点、术中和术后并发症、术后恢复情况等。结果12例患者均顺利完成腹腔镜IPOM七步法修补术。术前行肉毒素腹横肌注射及渐进性气腹,未发现明显合并疾病。术中无结肠及小肠损伤病例,术后无肠瘘病例。术后恢复排气时间1~5d,平均2.3d,未出现手术部位感染。患者均在门诊进行体格检查,随访3~60个月,平均35.3个月,无复发病例。结论腹腔镜IPOM七步法修补术治疗TAWH是安全可行的。 展开更多
关键词 创伤性腹壁疝 IPOM修补术 七步法 渐进性气腹
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儿童结核性腹膜炎的MSCT诊断价值
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作者 王春祥 张雪宁 闫喆 《国际医学放射学杂志》 北大核心 2023年第5期610-614,共5页
目的分析儿童结核性腹膜炎的多层螺旋CT(MSCT)表现,探讨CT诊断及鉴别诊断价值。方法回顾性分析经临床和/或病理证实的18例儿童结核性腹膜炎(TBP)的MSCT影像表现特点。观察腹膜结构(壁腹膜、大网膜、肠系膜)增厚情况、有无腹腔积液、有... 目的分析儿童结核性腹膜炎的多层螺旋CT(MSCT)表现,探讨CT诊断及鉴别诊断价值。方法回顾性分析经临床和/或病理证实的18例儿童结核性腹膜炎(TBP)的MSCT影像表现特点。观察腹膜结构(壁腹膜、大网膜、肠系膜)增厚情况、有无腹腔积液、有无其他系统(腹腔淋巴结、实质脏器或腹外系统)的异常改变。应用宝石能谱成像(GSI)综合分析平台将能谱CT检查获得的影像数据重建出相应的动、静脉期碘(水)基图,进一步分析其能谱曲线特点。结果CT对TBP的检出率为94.4%(17/18)。TBP的CT影像主要表现为壁腹膜光滑均匀增厚(13例)、大网膜污垢样改变(12例)、肠系膜污垢样改变(16例)、腹腔积液(18例)及腹腔淋巴结肿大(15例),且以上多种表现常同时出现。18例TBP均未累及腹部实质脏器;14例伴有肺部改变,5例合并结核性脑膜炎。网膜、淋巴结及肠系膜组织的能谱曲线随着不同能量的衰减趋势基本趋于一致,以增厚网膜的强化程度最高。结论儿童TBP的MSCT表现具有一定特征性,结合临床资料有助于提高病变的诊断准确性。CT能谱曲线可以提供有价值的半定量信息,可作为传统CT检查的补充,为其诊断提供新的方法。 展开更多
关键词 儿童 腹膜 结核 体层摄影术 X线计算机 能谱曲线
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盲肠/子宫填充盆底缺损在腹腔镜Miles术中临床应用研究
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作者 袁海波 白真真 +1 位作者 包伟 胡孔旺 《皖南医学院学报》 CAS 2023年第3期258-261,共4页
目的:探讨腹腔镜下低位中晚期直肠癌手术后行盆底盲肠/子宫填充与术后盆底不关闭比较对于患者术后早期恢复的优势。方法:在安徽医科大学第一附属医院东城院区外科三病区实施腹腔镜下直肠癌Miles术患者中,随机选择2019年3月~2020年6月的... 目的:探讨腹腔镜下低位中晚期直肠癌手术后行盆底盲肠/子宫填充与术后盆底不关闭比较对于患者术后早期恢复的优势。方法:在安徽医科大学第一附属医院东城院区外科三病区实施腹腔镜下直肠癌Miles术患者中,随机选择2019年3月~2020年6月的盆底不关闭患者20例作为传统组;随机选择2020年6月~2021年9月行盆底盲肠/子宫填充术患者20例作为优化组,通过统计资料对两组术后早期并发症及相关术后指标进行回顾性分析。结果:优化组手术后会阴疝、餐后(半流质)腹胀情况低于传统组(P<0.05);手术时间较传统组长(P<0.05);两组患者术中失血量、术后引流量、术后肛门排气时间、半流质开始时间、术后腹壁切口感染、盆腔感染及造口旁疝发生率比较差异无统计学意义(P>0.05)。结论:盆底盲肠/子宫填充术对于中晚期低位直肠癌Miles术后恢复有积极有效的作用。 展开更多
关键词 直肠癌 腹腔镜 盆底腹膜 盲肠/子宫填充术
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