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Unexpected right-sided sigmoid colon in laparoscopy: A case report and review of literature
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作者 Shi-Fu Hu Xiang-Yu Liu +1 位作者 Han-Bo Liu Yuan-Yuan Hao 《World Journal of Gastrointestinal Surgery》 SCIE 2024年第11期3606-3613,共8页
BACKGROUND The presence of a right-sided sigmoid colon is a rare anatomical variation usually discovered incidentally during surgical interventions.This case report details an unexpected right-sided sigmoid colon iden... BACKGROUND The presence of a right-sided sigmoid colon is a rare anatomical variation usually discovered incidentally during surgical interventions.This case report details an unexpected right-sided sigmoid colon identified during a laparoscopic appendectomy and examines the pertinent literature to explore its clinical importance.CASE SUMMARY A 71-year-old woman presented with acute appendicitis.A preoperative computed tomography(CT)scan showed peri-appendiceal inflammation but no significant anatomical abnormalities.During laparoscopic surgery,an unexpected finding was encountered:The sigmoid colon was situated on the right side and exhibited an abnormal relationship with the cecum and ascending colon.Postoperative pathological examination confirmed appendicitis with no additional pathological findings.The right-sided sigmoid colon anomaly was verified through intraoperative assessment and later re-evaluation with CT and colonographic imaging.The patient underwent a laparoscopic appendectomy and experienced a smooth postoperative recovery.CONCLUSION This case highlights the necessity of being attentive to anatomical variations during laparoscopic surgery,particularly when managing appendicitis.A review of the literature indicated that the occurrence of a right-sided sigmoid colon is infrequent and may be associated with anomalies in midgut rotation during embryonic development.Awareness of this variation can help prevent surgical complications and inform future clinical practice. 展开更多
关键词 Right-sided sigmoid colon laparoscopy Anatomical variation Literature review surgical implications Case report
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Model for end-stage liver disease score versus Child score in predicting the outcome of surgical procedures in patients with cirrhosis 被引量:16
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作者 Maarouf A Hoteit Amaar H Ghazale +4 位作者 Andrew J Bain Eli S Rosenberg Kirk A Easley Frank A Anania Robin E Rutherford 《World Journal of Gastroenterology》 SCIE CAS CSCD 2008年第11期1774-1780,共7页
AIM: To determine factors affecting the outcome of patients with cirrhosis undergoing surgery and to compare the capacities of the Child-Turcotte-Pugh (CTP) and model for end-stage liver disease (MELD) score to p... AIM: To determine factors affecting the outcome of patients with cirrhosis undergoing surgery and to compare the capacities of the Child-Turcotte-Pugh (CTP) and model for end-stage liver disease (MELD) score to predict that outcome. METHODS: We reviewed the charts of 195 patients with cirrhosis who underwent surgery at two teaching hospitals over a five-year period. The combined endpoint of death or hepatic decompensation was considered to be the primary endpoint. RESULTS: Patients who reached the endpoint had a higher MELD score, a higher CTP score and were more likely to have undergone an urgent procedure. Among patients undergoing elective surgical procedures, no statistically significant difference was noted in the mean MELD (12.8 + 3.9 vs 12.6 + 4.7, P = 0.9) or in the mean CTP (7.6 ± 1.2 vs 7.7 ± 1.7, P = 0.8) between patients who reached the endpoint and those who did not. Both mean scores were higher in the patients reaching the endpoint in the case of urgent procedures (MELD: 22.4 ± 8.7 vs 15.2 ± 6.4, P = 0.0007; CTP: 9.9 ± 1.8 vs 8.5 ± 1.8, P = 0.008). The performances of the MELD and CTP scores in predicting the outcome of urgent surgery were only fair, without a significant difference between them (AUC = 0.755 ± 0.066 for MELD vs AUC = 0.696 ± 0.070 for CTP, P = 0.3). CONCLUSION: The CTP and MELD scores performed equally, but only fairly in predicting the outcome of urgent surgical procedures. Larger studies are needed to better define the factors capable of predicting the outcome of elective surgical procedures in patients with cirrhosis.equally, but only fairly in predicting the outcome of urgent surgical procedures. Larger studies are needed to better define the factors capable of predicting the outcome of elective surgical procedures in patients with cirrhosis. 展开更多
关键词 Liver cirrhosis Prognosis Severity of illness index surgical procedures OPERATIVE Postoperative complications
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Cancellation Causes of Elective Surgical Procedures in a Major Pediatric Surgery Department 被引量:1
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作者 Salsabil Mohamed Sabounji Mbaye Fall +2 位作者 Cheikh Seye Mouhamadou Mansour Diene Gabriel Ngom 《Open Journal of Pediatrics》 2022年第1期131-136,共6页
Introduction: Cancellation of surgical operation is a surgical operation registered in the official schedule the day before or added to the list after and not carried out on the operating day. The purpose of this work... Introduction: Cancellation of surgical operation is a surgical operation registered in the official schedule the day before or added to the list after and not carried out on the operating day. The purpose of this work was to determine the causes of cancellation of elective surgical operations in a major pediatric surgery department in Senegal. Patients and methods: It was a prospective and descriptive study of 278 patients scheduled during a period of 13 weeks. The study took place between April 3<sup>rd</sup>, 2017, and January 31<sup>st</sup>, 2018. Mean age was 2.9 years with extremes of 3 days and 15 years. The age group of 29 days to 30 months was the most represented (62.2%). Sex ratio was 1.41. Causes of cancellation were categorized into administrative and organizational causes, patient-related causes and staff-related causes. Results: Cancellation rate was 29.4%. Patient-related causes were most common (51.2%). Upper Respiratory tract infection (URTI) was commonest reason within this category (57.5%). Organizational causes (28.1%) came second and were mainly represented by the unavailability of the operating room (60.8%) related to breakdowns of anesthesia equipment. Finally, staff-related causes (20.7%) were due for most to the unavailability of the anesthesiologist (12 cases/17). Conclusion: Majority of causes that led to cancellation of elective surgical operations in our Pediatric surgery department are related to intercurrent illnesses affecting the patient, in particular URTI. 展开更多
关键词 CANCELLATION Elective Surgery URTI Pediatric Surgery surgical procedures
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The Use of 3D laparoscopy in Surgical Operation
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作者 Lanadrid Vinual Yuan Dalkia Lee 《International English Education Research》 2016年第12期26-27,共2页
Purpose: studying and analyzing the application effect of three dimensional (3D) laparoscopy m surgical operation. Method: We select 126 patients who were diagnosed celiac disease in our hospital between May 2015... Purpose: studying and analyzing the application effect of three dimensional (3D) laparoscopy m surgical operation. Method: We select 126 patients who were diagnosed celiac disease in our hospital between May 2015 and April 2016 as our research subjects. All of these patients have indications for laparoscopic surgery, and we divide them into two groups randomly (observation and control group). While the observation group is treated by 3D laparoscopic operation system, and the control group is treated by 2D laparoscopic system. During the treatment ,we observe the operation time, intra-operative bleeding and hospitalization time between the two different methods. Result: During the operation, the operation time of observation is (135.5±23.84) minutes and intra-operative bleeding time is (130.2±20. 11) milliliters, which both them are significantly lower than control group (163.8±25.22)min, (146.3±27.42)ml. This difference is statistically significant (P 〈0.05). On the other hand, there is no obvious difference between observation and conlrol about indwelling catheter time, postoperative hospitalization time and postoperative exhaust time. For the observation, the datum were (2.3±0.31) d, (8.1±1. 32) d, (3.2±0.58) d and they were no statistical significance. Conclusion: Compared with traditional laparoscopic surgery, the image of 3D laparoscopic surgery is more clear and stereoscopic. What's more, operators can have a good command of it easily to shorten operation time, which avoid surgery vascular damage and reduce bleeding amounts to some extent. It is a good assistant for clinical use. 展开更多
关键词 three dimensional laparoscopy surgical operation
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Surgical procedures of thoracic ossification of the ligamentum flavum
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作者 李方财 《外科研究与新技术》 2011年第2期102-103,共2页
Objective To investigate different surgical procedures for treatment of thoracic ossification of ligamentum flavum.Methods From January 1994 to June 2008,56 cases of thoracic ossification of ligamentum flavum underwent
关键词 surgical procedures of thoracic ossification of the ligamentum flavum
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CHANGES OF INTERLEUKIN-6 AND RELATED FACTORS AS WELL AS GASTRIC INTRAMUCOSAL pH DURING COLORECTAL AND ORTHOPAEDIC SURGICAL PROCEDURES 被引量:2
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作者 Xi Hong Tie-hu Ye +3 位作者 Xiu-hua Zhang Hong-zhi Ren Yu-guang Huang Yu-fen Bu 《Chinese Medical Sciences Journal》 CAS CSCD 2006年第1期57-61,共5页
Objective To investigate the changes of perioperative serum levels of interleukin-6(IL-6), C-reactive protein (CRP), and cortisol, as well as gastric intramucosal pH (pHi) and plasma lactate, aiming to compare systemi... Objective To investigate the changes of perioperative serum levels of interleukin-6(IL-6), C-reactive protein (CRP), and cortisol, as well as gastric intramucosal pH (pHi) and plasma lactate, aiming to compare systemic changes and tissue perfusion during colorectal and orthopaedic surgical procedures. Methods Twenty patients were randomly assigned to two groups, 10 cases of operation on vertebral canal, 10 cases of colorectal radical operation.Venous blood was drawn at 1 day before operation, 2, 4, and 6 hours following skin incision, and 1 day after operation, in order to measure serum IL-6, CRP, and cortisol.pHi and plasma lactate were also measured at the same time points.Results Serum concentrations of IL-6 and cortisol increased gradually following operation, reaching the peak value at 6 hours from the beginning of operation.CRP was not detectable until the first day after operation.Peak concentration of IL-6 had positive relationship with CRP.These variables changed more significantly in colorectal group than that in orthopaedic group (P<0.05).pHi decreased gradually, reaching the lowest level at 4 hours from the beginning of operation, and to more extent in colorectal group than that in orthopaedic group (P<0.05).Conclusion IL-6 may reflect tissue damage more sensitively than CRP.Colorectal surgery might induce systemic disorder to more extent, in terms of immuno-endocrinal aspect as well as tissue perfusion, reflected with pHi. 展开更多
关键词 INTERLEUKIN-6 C-reactive protein gastric intramucosal pH surgical procedure
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Surgical Procedures,Pathological Features and Prognosis in Young Women with Breast Cancer in China--a Single Institute Experience
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作者 Hai-li Lu Tatsiana Paliyenka Jing Han 《Advances in Modern Oncology Research》 2018年第5期5-10,共6页
Objective:To compare the differences in surgical procedures,pathological features and prognosis between young and elderly women with breast cancer in China.Methods:A retrospective study compared the data of surgical p... Objective:To compare the differences in surgical procedures,pathological features and prognosis between young and elderly women with breast cancer in China.Methods:A retrospective study compared the data of surgical procedures,pathological features and prognosis of 61 cases of young females(≤40 years)and 507 cases of elderly females(>40 years),treated in our department from August 2011 to July 2018.This data was analyzed using SPSS 23.0 program.Results:10.74% of total cases,in this period of time,involve young females.In terms of surgical procedures,24.59%of young patients underwent breast conserving surgery(8.48% elderly,respectively),and 13.11%underwent reconstruction surgery(1.18% elderly,respectively),with statistically significant differences existing between the two groups(P<0.05).Progesterone receptor(PR)expression in young women was significantly higher than in elderly females(P<0.05).There were no significant differences between the two groups in the proportion of invasive ductal carcinoma(IDC),axillary lymph node metastasis(ALNM),expression of estrogen receptor(ER),human epidermal growth factor receptor-2(HER-2)and Ki-67,but the lymphatic metastasis stage showed an increasing rate with younger age.No significant difference was found in 3-year disease-free survival(DFS)and overall survival(OS).Conclusion:The selection rate of breast conserving and reconstructive surgery in young women with breast cancer is significantly higher than that in elderly women.The younger the patient,the more frequently the PR positive expression,and the more likely ALNM to occur.The 3-year prognosis of the young and elderly patients is similar. 展开更多
关键词 BREAST NEOPLASM YOUNG women surgical procedures PATHOLOGICAL features PROGNOSIS
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State of Play of Anesthesia for Outpatient Medical and Surgical Procedures in the City of Kinshasa
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作者 Joseph Tsangu Phuati Justin Mboloko Esimo +10 位作者 Antoine Tshimpi Wola Benjamin Longo-Mbenza Medard Bulabula Isokuma Luc Mokassa Bakumobatane Eric Amisi Bibonge Wilfrid Mbombo Dibwe Patrick Mukuna Miteo Patrick Kobo Utumpu Heritier Mawalala Malengele Gibency Mfulani Berthe Barhayiga Nsimire 《Open Journal of Anesthesiology》 2022年第2期77-90,共14页
Context and Objective: The practice of outpatient anaesthesia has many advantages over anesthesia with conventional hospitalisation, particularly in the reduction of post-operative complications and the faster resumpt... Context and Objective: The practice of outpatient anaesthesia has many advantages over anesthesia with conventional hospitalisation, particularly in the reduction of post-operative complications and the faster resumption of activity, etc. No study has been carried out on this subject in our community;this study was carried out in order to come up with a concrete state of play when it comes to outpatient anesthesia for medical and surgical procedures in the city of Kinshasa. Methodology: This was a cross-sectional study, which took place in seven hospitals in the city of Kinshasa from 1 November 2020 to 31 January 2021. The population consisted of all patients who received outpatient anesthesia and the included patients had signed an informed consent. The variables of the study were the general profile of patients, surgical procedures and indications, anesthetic data and patient evolution. Statistical analyses were performed with SPPS 21.0 with p Results: We collected data from 971 patients who had undergone anesthesia in the seven medical facilities in the city of Kinshasa. Among these patients, 394 had benefited from outpatient anesthesia, i.e. a frequency of outpatient anesthesia estimated at 40.5%. Three hundred and ninety-four (394) patients were selected. They were 58.6% women and 41.4% men i.e. a sex ratio M/F of 0.7. The mean age was 39.3 ± 18.7 years with the extremes of 1 and 82 years. Gastroscopy was the most performed (operative) procedure (21.6%). Patients were classified as ASA 1 in 75.1%, narcosis (80.7%) using propofol (80.2%) was the most used anesthetic technique and performed by a specialist doctor in Anesthesia in 65.5%. Suxamethonium was the most used curare in 13.2%. Fentanyl was the most used opioid in 14.5%. Bupivacaine (10.9%) was the most widely used local anesthetic. Eleven patients or 3.2% had complications and, i.e. (0.8%) were hospitalized, class ASA II appeared to be a factor associated with complications. Conclusion: Ambulatory anesthesia is a reality in the city of Kinshasa;however, it is still underdeveloped and mainly concerns explorations (gastroscopy, colonoscopy, laparoscopy…) and some minor procedures. This anesthesia mainly uses propofol and is done by the specialist doctor. A high-powered study and an evaluation of this practice in the light of international recommendations would be useful. 展开更多
关键词 ANESTHESIA Medical and surgical Outpatient procedures
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Application of Plan-Do-Check-Action cycle and fishbone diagram analysis in optimizing surgical procedures to improve satisfaction degree of doctor-nurse-patient
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作者 Jierong Lin Xiaoqun Fang +1 位作者 Yu Zhang Yu Lian 《Annals of Eye Science》 2020年第1期4-8,共5页
Background:To study the application of management tools such as Plan-Do-Check-Action(PDCA)cycle and fishbone diagram in optimizing surgical procedures to improve the satisfaction of doctor-nurse-patient.Methods:The fu... Background:To study the application of management tools such as Plan-Do-Check-Action(PDCA)cycle and fishbone diagram in optimizing surgical procedures to improve the satisfaction of doctor-nurse-patient.Methods:The fundus surgery nursing team of our hospital began to implement the PDCA cycle management mode to optimize the surgical procedure from July 2017,set up a project activity improvement team,unified the surgical labeling processing plan,and made the fundus surgery procedure,and established the preoperative health education for surgical patients,and standardized the training content of post-rotating doctors and interns.Results:The satisfaction degree to surgical procedure after implementation of doctors and nurses was higher than that before implementation.Conclusions:Using PDCA cycle and fishbone diagram analysis tools to manage the surgical procedure optimization can better integrate doctor-nurse medical care,improve the efficiency and accuracy of the surgical procedure delivery and operation,and optimize the satisfaction of the three parties of doctor-nurse-patient. 展开更多
关键词 Plan-Do-Check-Action(PDCA)cycle fishbone diagram doctor-nurse-patient surgical procedure satisfaction degree
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Comparison of the Efficacy of Ultrasound-Guided Microwave Ablation of Parathyroid Adenoma with Surgical Procedures
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作者 Jiehao Huang Wei Xu Can Liu 《Yangtze Medicine》 2021年第3期171-178,共8页
<strong>Objective:</strong> To compare the clinical efficacy and safety of ultrasound-guided microwave ablation with surgery for the treatment of primary parathyroid adenoma. <strong>Methods:</str... <strong>Objective:</strong> To compare the clinical efficacy and safety of ultrasound-guided microwave ablation with surgery for the treatment of primary parathyroid adenoma. <strong>Methods:</strong> The clinical data of patients with primary parathyroid adenoma admitted to the First Hospital of Yangtze University from January 2010 to May 2020 were retrospectively analyzed, and they were divided into 43 cases in the microwave ablation group (MWA) and 39 cases in the surgical procedure group (SR) according to the different treatment methods. The surgical condition, postoperative complications, and changes in serum parathyroid hormone (PTH) and serum calcium and phosphorus levels were analyzed in both groups. <strong>Results:</strong> The hospital stay and operation time of patients in the microwave ablation group were shorter than those in the surgical group, and the intraoperative bleeding was significantly less than that in the surgical group (P < 0.05);the serum parathyroid hormone (PTH), blood calcium and blood phosphorus levels of patients in both groups were significantly lower than those before treatment (P < 0.05) after surgery of 1, 3 and 6 months respectively, and the differences between groups were not statistically significant (P > 0.05). There was no statistically significant difference in the incidence of postoperative complications between the two groups (P > 0.05). <strong>Conclusion: </strong>Microwave ablation can achieve the same therapeutic effect as surgery. It is a safe and feasible clinical technique worthy of clinical promotion with its short hospitalization time, less bleeding and less trauma. 展开更多
关键词 Primary Parathyroid Adenoma Microwave Ablation surgical Procedure Parathyroid Hormone
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A Systematic Review on Efficacy and Safety of Gasless Laparoscopy in the Management of Uterine Leiomyoma 被引量:8
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作者 刘麒薇 韩桐 +2 位作者 杨敏 童晓文 王建军 《Journal of Huazhong University of Science and Technology(Medical Sciences)》 SCIE CAS 2016年第1期142-149,共8页
Uterine leiomyoma causes considerable morbidity in women. This study systematically reviewed the efficacy and safety of gasless laparoscopic myomectomy(GLM) in the management of uterine leiomyoma by comparing GLM wi... Uterine leiomyoma causes considerable morbidity in women. This study systematically reviewed the efficacy and safety of gasless laparoscopic myomectomy(GLM) in the management of uterine leiomyoma by comparing GLM with other minimally invasive procedures. Cochrane Library, PubMed, EMBASE, Web of Science, WANFANG database and China National Knowledge Infrastructure(CNKI) were searched for studies published in English or Chinese between January 1995 and May 2015, and related references were traced. Study outcomes from randomized controlled trials and retrospective cohort studies were presented as mean difference(MD) or odds ratio(OR) with a 95% confidence interval(CI). Seventeen studies(including 1862 patients) meeting the inclusion criteria, including 934 treated with GLM and 928 treated with other minimally invasive procedures were reviewed. The results of meta-analysis revealed that GLM resulted in significantly shorter operating time [MD=–10.34, 95% CI(–18.12, –2.56), P〈0.00001], shorter hospital stay [MD=–0.47, 95% CI(–0.88, –0.06)], less time to flatus [MD=–2.04, 95% CI(–2.59, –1.48)], less postoperative complications [OR=0.20, 95% CI(0.06, 0.62)] and less blood loss [MD =–30.74, 95% CI(–47.50, –13.98)]. On the other hand, there were no significant differences in duration of post-operative fever [MD=–0.52, 95% CI(–1.46, 0.42)] between the two groups. Additionally, GLM was associated with lower febrile morbidity, lower postoperative abdominal pain, and higher postoperative hemoglobin than other minimally invasive procedures for the treatment of uterine leiomyoma. In conclusion, GLM and other minimally invasive procedures are feasible, safe, and reliable for uterine leiomyoma treatment. However, available studies show that GLM is more effective and safer than other minimally invasive approaches. 展开更多
关键词 uterine leiomyoma gasless laparoscopy minimally invasive procedures systematic review meta-analysis
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The Requirements for Laparoscopy-Assisted Distal Gastrectomy to Become Standard Procedure for Gastric Cancer: Based on Qualitative Study of Surgeons’ Experiences 被引量:1
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作者 Nozomu Murakami Kouichi Tanabe +7 位作者 Shinichi Kadoya Masanari Shimada Katsuo Shimada Masahide Kaji Mitsuaki Sakatoku Koichiro Sawada Hatsuna Yasuda Tatsuhiko Kashii 《Surgical Science》 2014年第4期176-182,共7页
Laparoscopy-assisted distal gastrectomy (LADG) has become one of the standard surgical procedures for gastric cancer in Japan and Korea. However, LADG is currently listed as being in the clinical research phase under ... Laparoscopy-assisted distal gastrectomy (LADG) has become one of the standard surgical procedures for gastric cancer in Japan and Korea. However, LADG is currently listed as being in the clinical research phase under the Gastric Cancer Treatment Guidelines. The aim of this study is to report surgeons’ opinions of what is needed if LADG is to become a standard procedure. We conducted questionnaire survey with open questions in hospitals that either applied or did not apply LADG and compared the answers. We labeled and categorized the collected data using content analysis. The number of hospitals which applied LADG more than doubled from 5 to 12 hospitals over 3 years. Overall, hospitals reported that the necessary elements for LADG to become a standard procedure are: clinical trials of LADG (n = 5, 22.7%), surgeons’ practical experience in performing LADG (n = 4, 18.2%), stability of radical treatment (n = 4, 18.2%), and a shorter operative duration (n = 3, 13.6%) for the procedure. Surgeons’ practical experience was chosen as the most important requirement in the hospitals which applied LADG while clinical trials (n = 2, 40.0%) and stability of radical treatment (n = 2, 40.0%) were the most common answers in the hospitals which did not apply LADG. Hospitals and surgeons’ practical experience, stabilizing radical cure, and the large scale of clinical trials are for LADG to become a standard procedure and to gain equivalent importance as open distal gastrectomy in treating gastric cancer. 展开更多
关键词 laparoscopy QUESTIONNAIRE Survey Content Analysis Open DISTAL GASTRECTOMY surgical Procedure
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Application of retroperitoneal laparoscopy and robotic surgery in complex adrenal tumors
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作者 Kai Huang Ye-Hua Wang 《Artificial Intelligence in Cancer》 2021年第3期42-48,共7页
As a surgical method for the treatment of adrenal surgical diseases,laparoscopy has the advantages of small trauma,short operation time,less bleeding,and fast postoperative recovery.It is considered as the gold standa... As a surgical method for the treatment of adrenal surgical diseases,laparoscopy has the advantages of small trauma,short operation time,less bleeding,and fast postoperative recovery.It is considered as the gold standard for the treatment of adrenal surgical diseases.Retroperitoneal laparoscopy is widely used because it does not pass through the abdominal cavity,does not interfere with internal organs,and has little effect on gastrointestinal function.However,complex adrenal tumors have the characteristics of large volume,compression of adjacent tissues,and invasion of surrounding tissues,so they are rarely treated by retroperitoneal laparoscopy.In recent years,with the development of laparoscopic technology and the progress of surgical technology,robotic surgery has been gradually applied to the surgical treatment of complex adrenal tumors.This paper reviews the clinical application of retroperitoneal laparoscopic surgery and robotic surgery in the treatment of complex adrenal tumors. 展开更多
关键词 Retroperitoneal laparoscopic Robotic surgical procedures Complex adrenal tumors Clinical application ROBOTIC
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Endoscopic treatment of biliopancreatic pathology in patients with Whipple's pancreaticoduodenectomy surgical variants: Lessons learned from single-balloon enteroscopy-assisted ERCP
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作者 Rodrigo Garcés-Durán Laurent Monino +2 位作者 Pierre H Deprez Hubert Piessevaux Tom G Moreels 《Hepatobiliary & Pancreatic Diseases International》 SCIE CAS CSCD 2024年第5期509-514,共6页
Background: Endoscopic treatment of biliopancreatic pathology is challenging due to surgically altered anatomy after Whipple's pancreaticoduodenectomy. This study aimed to evaluate the feasibility and safety of si... Background: Endoscopic treatment of biliopancreatic pathology is challenging due to surgically altered anatomy after Whipple's pancreaticoduodenectomy. This study aimed to evaluate the feasibility and safety of single-balloon enteroscopy-assisted endoscopic retrograde cholangiopancreatography(SBE-ERCP) to treat biliopancreatic pathology in patients with Whipple's pancreaticoduodenectomy surgical variants. Methods: We retrospectively analyzed 106 SBE-ERCP procedures in 46 patients with Whipple's variants. Technical and clinical success rates and adverse events were evaluated. Results: Biliary SBE-ERCP was performed in 34 patients and pancreatic SBE-ERCP in 17, including 5 with both indications. From a total of 106 SBE-ERCP procedures, 76 were biliary indication with technical success rate of 68/76(90%) procedures and clinical success rate of 30/34(88%) patients. Mild adverse event rate was 8/76(11%), without serious adverse events. From a total of 106 SBE-ERCP procedures, 30 were pancreatic indication with technical success rate of 24/30(80%) procedures( P = 0.194 vs. biliary SBEERCP) and clinical success rate of 11/17(65%) patients( P = 0.016 vs. biliary SBE-ERCP). Mild adverse event rate was 6/30(20%)( P = 0.194 vs. biliary SBE-ERCP), without serious adverse events. After SBE-ERCP failure, endoscopic ultrasound-guided drainage, percutaneous drainage and redo surgery were alternative therapeutic options. Conclusions: Biliopancreatic pathology after Whipple's pancreaticoduodenectomy variants can be treated using SBE-ERCP without serious adverse events. Technical and clinical success rates are high for biliary indications, whereas clinical success rate of pancreatic indications is significantly lower. SBE-ERCP can be considered as first-line treatment option in this patient group with surgically altered anatomy. 展开更多
关键词 ENTEROSCOPY Endoscopic retrograde CHOLANGIOPANCREATOGRAPHY PANCREATICODUODENECTOMY surgically altered anatomy Whipple’s procedure
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Comparison of Surgical Techniques Used in Treating Acromioclavicular Dislocation in Patients Participating in Sports: A Systematic Review
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作者 Walter Hugo Brandão Nascimento Paulo Renan Matos Sucupira Cunha +3 位作者 João Pedro Pimentel Abreu Lethycia Pereira Rosa Kamilly Iêda Silva Veigas Rodrigo Martins Silva Caetano 《Open Journal of Orthopedics》 2024年第1期41-52,共12页
Introduction: The acromioclavicular joint is a superficial diarthrodial joint that surrounds the medial articular facet of the acromion and the distal portion of the clavicle. Due to its anatomy and biomechanics, it i... Introduction: The acromioclavicular joint is a superficial diarthrodial joint that surrounds the medial articular facet of the acromion and the distal portion of the clavicle. Due to its anatomy and biomechanics, it is highly susceptible to trauma and in young men who play contact sports, acromioclavicular dislocation is common. This article aimed to systematically review the literature and compare the surgical techniques used in the treatment of acromioclavicular dislocation in patients who practice sports. Methods: This systematic review was conducted according to the International Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. Eligible studies for this systematic review included articles in English or Spanish published between 2013 and 2023, which mention the occurrence of acromioclavicular dislocation during sports practices. Additionally, only studies that addressed the surgical treatment of acromion-clavicular dislocation and contained original data on the topic were included. Results: We found 144 eligible studies after searching the LILACS and PubMed databases. Based on the inclusion and exclusion criteria and the reviewers’ consensus, we selected four studies for the systematic review. 133 patients with AC joint displacement were evaluated. Mean Age: approximately 31.90 years. 81.92 of these injuries occurred during sports practice. Surgical Procedures Used: titanium plates fixation (49 patients), arthroscopy (24), single tunnel technique (30) and coracoid sling technique (30). The results of the visual analog scale and Constant-Murley scores varied between the techniques used. Twenty-two complications after surgical treatment were identified. Conclusion: A significant variability of operative techniques can be used in the surgical approach of acromioclavicular dislocation, such as arthroscopy, single tunnel, coracoid sling and titanium plates. Although it presented excellent functional results compared to the other three techniques evaluated by this review, using titanium plates is not the gold standard since other techniques not assessed by this work may be more effective. 展开更多
关键词 Acromioclavicular Joint Shoulder Dislocation surgical Procedure Postoperative Complications Postoperative Care
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Feasibility and safety of minimally invasive multivisceral resection for T4b rectal cancer:A 9-year review 被引量:2
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作者 Kai Siang Chan Biquan Liu +2 位作者 Ming Ngan Aloysius Tan Kwang Yeong How Kar Yong Wong 《World Journal of Gastrointestinal Surgery》 SCIE 2024年第3期777-789,共13页
BACKGROUND Colorectal cancer is the third most common cancer and the second highest cause of cancer-related mortality worldwide.About 5%-10%of patients are diagnosed with locally advanced rectal cancer(LARC)on present... BACKGROUND Colorectal cancer is the third most common cancer and the second highest cause of cancer-related mortality worldwide.About 5%-10%of patients are diagnosed with locally advanced rectal cancer(LARC)on presentation.For LARC invading into other structures(i.e.T4b),multivisceral resection(MVR)and/or pelvic ex-enteration(PE)remains the only potential curative surgical treatment.MVR and/or PE is a major and complex surgery with high post-operative morbidity.Minimally invasive surgery(MIS)has been shown to improve short-term post-operative outcomes in other gastrointestinal malignancies,but there is little evi-dence on its use in MVR,especially so for robotic MVR.This is a single-center retrospective cohort study from 1st January 2015 to 31st March 2023.Inclusion criteria were patients diagnosed with cT4b rectal cancer and underwent MVR,or stage 4 disease with resectable systemic metastases.Pa-tients who underwent curative MVR for locally recurrent rectal cancer,or me-tachronous rectal cancer were also included.Exclusion criteria were patients with systemic metastases with non-resectable disease.All patients planned for elective surgery were enrolled into the standard enhanced recovery after surgery pathway with standard peri-operative management for colorectal surgery.Complex sur-gery was defined based on technical difficulty of surgery(i.e.total PE,bladder-sparing prostatectomy,pelvic lymph node dissection or need for flap creation).Our primary outcomes were the margin status,and complication rates.Cate-gorical values were described as percentages and analysed by the chi-square test.Continuous variables were expressed as median(range)and analysed by Mann-Whitney U test.Cumulative overall survival(OS)and recurrence-free survival(RFS)were analysed using Kaplan-Meier estimates with life table analysis.Log-rank test was performed to determine statistical significance between cumulative estimates.Statistical significance was defined as P<0.05.Meier estimates with life table analysis.Log-rank test was performed to determine statistical significance between cumulative estimates.Statistical significance was defined as P<0.05.RESULTS A total of 46 patients were included in this study[open MVR(oMVR):12(26.1%),miMVR:36(73.9%)].Patients’American Society of Anesthesiologists score,body mass index and co-morbidities were comparable between oMVR and miMVR.There is an increasing trend towards robotic MVR from 2015 to 2023.MiMVR was associated with lower estimated blood loss(EBL)(median 450 vs 1200 mL,P=0.008),major morbidity(14.7%vs 50.0%,P=0.014),post-operative intra-abdominal collections(11.8%vs 50.0%,P=0.006),post-operative ileus(32.4%vs 66.7%,P=0.04)and surgical site infection(11.8%vs 50.0%,P=0.006)compared with oMVR.Length of stay was also shorter for miMVR compared with oMVR(median 10 vs 30 d,P=0.001).Oncological outcomes-R0 resection,recurrence,OS and RFS were comparable between miMVR and oMVR.There was no 30-d mortality.More patients underwent robotic compared with laparoscopic MVR for complex cases(robotic 57.1%vs laparoscopic 7.7%,P=0.004).The operating time was longer for robotic compared with laparoscopic MVR[robotic:602(400-900)min,laparoscopic:Median 455(275-675)min,P<0.001].Incidence of R0 resection was similar(laparoscopic:84.6%vs robotic:76.2%,P=0.555).Overall complication rates,major morbidity rates and 30-d readmission rates were similar between la-paroscopic and robotic MVR.Interestingly,3-year OS(robotic 83.1%vs 58.6%,P=0.008)and RFS(robotic 72.9%vs 34.3%,P=0.002)was superior for robotic compared with laparoscopic MVR.CONCLUSION MiMVR had lower post-operative complications compared to oMVR.Robotic MVR was also safe,with acceptable post-operative complication rates.Prospective studies should be conducted to compare short-term and long-term outcomes between robotic vs laparoscopic MVR. 展开更多
关键词 laparoscopy Minimally invasive surgical procedures Multivisceral resection Pelvic Exenteration Rectal neoplasms Robotic surgical procedures
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Precision at scale:Machine learning revolutionizing laparoscopic surgery
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作者 Carlos M Ardila Daniel González-Arroyave 《World Journal of Clinical Oncology》 2024年第10期1256-1263,共8页
In their recent study published in the World Journal of Clinical Cases,the article found that minimally invasive laparoscopic surgery under general anesthesia demonstrates superior efficacy and safety compared to trad... In their recent study published in the World Journal of Clinical Cases,the article found that minimally invasive laparoscopic surgery under general anesthesia demonstrates superior efficacy and safety compared to traditional open surgery for early ovarian cancer patients.This editorial discusses the integration of machine learning in laparoscopic surgery,emphasizing its transformative po-tential in improving patient outcomes and surgical precision.Machine learning algorithms analyze extensive datasets to optimize procedural techniques,enhance decision-making,and personalize treatment plans.Advanced imaging modalities like augmented reality and real-time tissue classification,alongside robotic surgical systems and virtual reality simulations driven by machine learning,enhance imaging and training techniques,offering surgeons clearer visualization and precise tissue manipulation.Despite promising advancements,challenges such as data privacy,algorithm bias,and regulatory hurdles need addressing for the responsible deployment of machine learning technologies.Interdisciplinary collaborations and ongoing technological innovations promise further enha-ncement in laparoscopic surgery,fostering a future where personalized medicine and precision surgery redefine patient care. 展开更多
关键词 Machine learning Computer neural network Minimally invasive surgical procedures Hand-assisted laparoscopy laparoscopy
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低温等离子治疗儿童鼻咽部第二鳃裂囊肿分析
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作者 温鑫 黄爱萍 +5 位作者 张爱英 许敏 宋英鸾 崔莉 耿江桥 史静 《中国耳鼻咽喉头颈外科》 CSCD 2024年第1期54-56,共3页
目的探讨儿童鼻咽部第二鳃裂囊肿的临床特征和治疗方式,提高诊治能力。方法回顾性分析河北省儿童医院收治的4例儿童鼻咽部第二鳃裂囊肿的临床资料,包括年龄、性别、症状、影像学资料和治疗过程。总结分析病变部位特点,B超、CT或MRI特征... 目的探讨儿童鼻咽部第二鳃裂囊肿的临床特征和治疗方式,提高诊治能力。方法回顾性分析河北省儿童医院收治的4例儿童鼻咽部第二鳃裂囊肿的临床资料,包括年龄、性别、症状、影像学资料和治疗过程。总结分析病变部位特点,B超、CT或MRI特征,术后病理结果及治疗方式。结果4例鼻咽部第二鳃裂囊肿患儿均表现为鼻咽侧壁咽鼓管咽口与腭咽弓后上方连线上的囊性肿物,囊壁较厚,影像学检查结果均为囊性病变。4例患儿选择内镜下低温等离子病变切除术,其中2例为内侧囊壁大部分切除术,将囊腔充分敞开,2例为囊肿全部切除术。术后病理提示衬覆纤毛柱状上皮或复层上皮,周围淋巴组织增生。术后随访1.5~3年无复发。结论儿童鼻咽部第二鳃裂囊肿临床罕见,诊断主要依靠病变部位及术后病理结果,内镜下低温等离子切除病变组织是微创、安全、有效的治疗方式。 展开更多
关键词 儿童(Child) 外科手术(surgical procedures Operative) 鼻咽部第二鳃裂囊肿(nasopharyngeal cyst of second branchial cleft) 低温等离子(low temperature plasma)
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Robotic versus laparoscopic surgery for sporadic benign insulinoma:Short-and long-term outcomes
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作者 Zhu-Zeng Yin Yuan-Xing Gao +3 位作者 Zhi-Ming Zhao Ming-Gen Hu Wen-Bo Tang Rong Liu 《Hepatobiliary & Pancreatic Diseases International》 SCIE CAS CSCD 2024年第4期399-405,共7页
Background:Minimally invasive surgery is the optimal treatment for insulinoma.The present study aimed to compare short-and long-term outcomes of laparoscopic and robotic surgery for sporadic benign insulinoma.Methods:... Background:Minimally invasive surgery is the optimal treatment for insulinoma.The present study aimed to compare short-and long-term outcomes of laparoscopic and robotic surgery for sporadic benign insulinoma.Methods:A retrospective analysis of patients who underwent laparoscopic or robotic surgery for insulinoma at our center between September 2007 and December 2019 was conducted.The demographic,perioperative and postoperative follow-up results were compared between the laparoscopic and robotic groups.Results:A total of 85 patients were enrolled,including 36 with laparoscopic approach and 49 with robotic approach.Enucleation was the preferred surgical procedure.Fifty-nine patients(69.4%)underwent enucleation;among them,26 and 33 patients underwent laparoscopic and robotic surgery,respectively.Robotic enucleation had a lower conversion rate to laparotomy(0 vs.19.2%,P=0.013),shorter operative time(102.0 vs.145.5 min,P=0.008)and shorter postoperative hospital stay(6.0 vs.8.5 d,P=0.002)than laparoscopic enucleation.There were no differences between the groups in terms of intraoperative blood loss,the rates of postoperative pancreatic fistula and complications.After a median follow-up of 65 months,two patients in the laparoscopic group developed a functional recurrence and none of the patients in the robotic group had a recurrence.Conclusions:Robotic enucleation can reduce the conversion rate to laparotomy and shorten operative time,which might lead to a reduction in postoperative hospital stay. 展开更多
关键词 Robotic surgical procedures laparoscopy INSULINOMA ENUCLEATION PANCREATECTOMY
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Robotic-assisted low anterior resection for rectal cancer shows similar clinical efficacy to laparoscopic surgery: A propensity score matched study
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作者 Shen-Xiang Long Xin-Ning Wang +4 位作者 Shu-Bo Tian Yu-Fang Bi Shen-Shuo Gao Yu Wang Xiao-Bo Guo 《World Journal of Gastrointestinal Surgery》 SCIE 2024年第6期1558-1570,共13页
BACKGROUND Rectal cancer ranks as the second leading cause of cancer-related mortality worldwide,necessitating surgical resection as the sole treatment option.Over the years,there has been a growing adoption of minima... BACKGROUND Rectal cancer ranks as the second leading cause of cancer-related mortality worldwide,necessitating surgical resection as the sole treatment option.Over the years,there has been a growing adoption of minimally invasive surgical techni-ques such as robotic and laparoscopic approaches.Robotic surgery represents an innovative modality that effectively addresses the limitations associated with traditional laparoscopic techniques.While previous studies have reported favo-rable perioperative outcomes for robot-assisted radical resection in rectal cancer patients,further evidence regarding its oncological safety is still warranted.AIM To conduct a comparative analysis of perioperative and oncological outcomes between robot-assisted and laparoscopic-assisted low anterior resection(LALAR)procedures.METHODS The clinical data of 125 patients who underwent robot-assisted low anterior resection(RALAR)and 279 patients who underwent LALAR resection at Shandong Provincial Hospital Affiliated to Shandong First Medical University from December 2019 to November 2022 were retrospectively analyzed.After performing a 1:1 propensity score matching,the patients were divided into two groups:The RALAR group and the LALAR group(111 cases in each group).Subsequently,a comparison was made between the short-term outcomes within 30 d after surgery and the 3-year survival outcomes of these two groups.RESULTS Compared to the LALAR group,the RALAR group exhibited a significantly earlier time to first flatus[2(2-2)d vs 3(3-3)d,P=0.000],as well as a shorter time to first fluid diet[4(3-4)d vs 5(4-6)d,P=0.001].Additionally,the RALAR group demonstrated reduced postoperative indwelling catheter time[2(1-3)d vs 4(3-5)d,P=0.000]and decreased length of hospital stay after surgery[5(5-7)d vs 7(6-8)d,P=0.009].Moreover,there was an observed increase in total cost of hospitalization for the RALAR group compared to the LALAR group[10777(10780-11850)dollars vs 10550(8766-11715)dollars,P=0.012].No significant differences were found in terms of conversion rate to laparotomy or incidence of postoperative complications between both groups.Furthermore,no significant disparities were noted regarding the 3-year overall survival rate and 3-year disease-free survival rate between both groups.CONCLUSION Robotic surgery offers potential advantages in terms of accelerated recovery of gastrointestinal and urologic function compared to LALAR resection,while maintaining similar perioperative and 3-year oncological outcomes. 展开更多
关键词 Rectal cancer Robotic surgical procedures laparoscopy Low anterior resection Clinical efficacy
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