Endoscopic submucosal dissection(ESD) of large gastric lesions often leads to severe gastric strictures, especially in cases of large ESD in the antrum of the stomach. It has recently been reported that balloon dilati...Endoscopic submucosal dissection(ESD) of large gastric lesions often leads to severe gastric strictures, especially in cases of large ESD in the antrum of the stomach. It has recently been reported that balloon dilation, mucosal incision, and local steroid injections can successfully treat gastric strictures. However, there are some complications with existing methods and decreasing the quality of life. We have developed a novel method to prevent severe gastric strictures that does not involve balloon dilation, mucosal incision, or steroid injections after circumferential ESD. Our original method involves the submucosal injection of a mixed solution composed of triamcinolone acetonide and a general solution of glycerol, hyaluronic acid, and a small amount of indigo carmine and epinephrine dur-ing the ESD procedure; this mixture is called a mixed solution of triamcinolone(MST). According to standard ESD procedures, several milliliters of MST are injected into the submucosal layer for the purpose of elevating the submucosa during ESD resulting in prevention of severe strictures. Our method using MST take several advantages such as MST method suppress inflammation in ulcer from initial phase, prevention of stricture without obstructive symptoms, and does not require several ballooning. Therefore, MST method is safe and gentle, shorten the hospitalization duration. Here, we described two cases in which we prevented severe strictures of the gastric antrum after completing a circumferential ESD using MST without any complications.展开更多
目的：总结自制“血管分流栓”在杂交手术治疗复杂型 Stanford B 型主动脉夹层的经验和方法。方法对40例急性复杂型 Stanford B 型主动脉夹层采用杂交手术，采用自制“血管分流栓”保持颈动脉血流重建颈部血管。结果均手术成功，术后无...目的：总结自制“血管分流栓”在杂交手术治疗复杂型 Stanford B 型主动脉夹层的经验和方法。方法对40例急性复杂型 Stanford B 型主动脉夹层采用杂交手术，采用自制“血管分流栓”保持颈动脉血流重建颈部血管。结果均手术成功，术后无脑部急性缺血及左上肢缺血症状；破口封闭良好，无内漏，旁路血管通畅；2例术后死亡，1例术后3 d 发生 A 型夹层；一过性精神症状6例；左侧血胸1例；随访38例，失访2例，1例于出院后1周死亡。术后1个月、1年复查，无脑缺血及左上肢缺血症状；主动脉 CTA 均示支架无移位和内漏，移植的人工血管通畅。结论杂交手术治疗复杂型 Stanford B 型主动脉夹层安全有效，自制“血管分流栓”能保持颈动脉血流通畅，有效减少脑缺血的发生。展开更多
目的:比较混合胸腔镜和全胸腔镜手术在食管癌外科治疗中的安全性、可行性及手术切除效果。方法:回顾性分析2018年1月至2020年1月经右胸食管癌根治术患者的临床病例资料,比较混合胸腔镜手术(混合腔镜组)和全胸腔镜手术(全腔镜组)术前、...目的:比较混合胸腔镜和全胸腔镜手术在食管癌外科治疗中的安全性、可行性及手术切除效果。方法:回顾性分析2018年1月至2020年1月经右胸食管癌根治术患者的临床病例资料,比较混合胸腔镜手术(混合腔镜组)和全胸腔镜手术(全腔镜组)术前、术中和术后等方面的差异。结果:全腔镜组较混合腔镜组在手术时间有所延长[(455±79) min vs (439±76) min,P=0.035)],混合腔镜组在术中出血、术后胸管引流时间、腹腔引流时间、ICU住院及术后住院时间较全腔镜组有所延长;全腔镜组清扫淋巴结站数及枚数多于混合腔镜组[(7.8±2.4) vs (7.3±2.1),P=0.022;(19.6±4.3) vs (18.5±3.2),P=0.003)];全腔镜组术后总体并发症低于混合腔镜组(7.4%vs13.6%,P=0.049)。结论:全腔镜食管癌根治术具有出血少、术后恢复快、术后并发症少,对肺功能影响较小、术后生活质量高等优点,全腔镜食管癌根治术可获得良好的疗效。展开更多
基金Supported by Grant support from Daiichi Sankyo Co.,Ltd.,Astra Zeneca Co.,Ltd.,and Otsuka Pharmaceutical Co.,Ltd(To Yokosuka O)the lecture fees from Daiichi Sankyo,AstraZeneca(To Arai M)
文摘AIM: To investigate the optimum period of treatment for post endoscopic submucosal dissection (ESD) ulcers.
文摘Endoscopic submucosal dissection(ESD) of large gastric lesions often leads to severe gastric strictures, especially in cases of large ESD in the antrum of the stomach. It has recently been reported that balloon dilation, mucosal incision, and local steroid injections can successfully treat gastric strictures. However, there are some complications with existing methods and decreasing the quality of life. We have developed a novel method to prevent severe gastric strictures that does not involve balloon dilation, mucosal incision, or steroid injections after circumferential ESD. Our original method involves the submucosal injection of a mixed solution composed of triamcinolone acetonide and a general solution of glycerol, hyaluronic acid, and a small amount of indigo carmine and epinephrine dur-ing the ESD procedure; this mixture is called a mixed solution of triamcinolone(MST). According to standard ESD procedures, several milliliters of MST are injected into the submucosal layer for the purpose of elevating the submucosa during ESD resulting in prevention of severe strictures. Our method using MST take several advantages such as MST method suppress inflammation in ulcer from initial phase, prevention of stricture without obstructive symptoms, and does not require several ballooning. Therefore, MST method is safe and gentle, shorten the hospitalization duration. Here, we described two cases in which we prevented severe strictures of the gastric antrum after completing a circumferential ESD using MST without any complications.
文摘目的：总结自制“血管分流栓”在杂交手术治疗复杂型 Stanford B 型主动脉夹层的经验和方法。方法对40例急性复杂型 Stanford B 型主动脉夹层采用杂交手术，采用自制“血管分流栓”保持颈动脉血流重建颈部血管。结果均手术成功，术后无脑部急性缺血及左上肢缺血症状；破口封闭良好，无内漏，旁路血管通畅；2例术后死亡，1例术后3 d 发生 A 型夹层；一过性精神症状6例；左侧血胸1例；随访38例，失访2例，1例于出院后1周死亡。术后1个月、1年复查，无脑缺血及左上肢缺血症状；主动脉 CTA 均示支架无移位和内漏，移植的人工血管通畅。结论杂交手术治疗复杂型 Stanford B 型主动脉夹层安全有效，自制“血管分流栓”能保持颈动脉血流通畅，有效减少脑缺血的发生。
文摘目的:比较混合胸腔镜和全胸腔镜手术在食管癌外科治疗中的安全性、可行性及手术切除效果。方法:回顾性分析2018年1月至2020年1月经右胸食管癌根治术患者的临床病例资料,比较混合胸腔镜手术(混合腔镜组)和全胸腔镜手术(全腔镜组)术前、术中和术后等方面的差异。结果:全腔镜组较混合腔镜组在手术时间有所延长[(455±79) min vs (439±76) min,P=0.035)],混合腔镜组在术中出血、术后胸管引流时间、腹腔引流时间、ICU住院及术后住院时间较全腔镜组有所延长;全腔镜组清扫淋巴结站数及枚数多于混合腔镜组[(7.8±2.4) vs (7.3±2.1),P=0.022;(19.6±4.3) vs (18.5±3.2),P=0.003)];全腔镜组术后总体并发症低于混合腔镜组(7.4%vs13.6%,P=0.049)。结论:全腔镜食管癌根治术具有出血少、术后恢复快、术后并发症少,对肺功能影响较小、术后生活质量高等优点,全腔镜食管癌根治术可获得良好的疗效。
