Background: Ten-millimeter ports are often used in laparoscopic surgery. It could be difficult to close the ports sites, especially in obese patients. We described a new method to close ten-millimeter port-site wounds...Background: Ten-millimeter ports are often used in laparoscopic surgery. It could be difficult to close the ports sites, especially in obese patients. We described a new method to close ten-millimeter port-site wounds, effective and easily to perform. Methods: Forty cases of laparoscopic bariatric surgery were performed from April 2010 to September 2011 at IRCAD Taiwan. Among them, 30 patients received trocar hole closed with SURGICEL® Original Hemostat and the other 10 patients received trocar hole closed with autologous fat. The results were recorded. Results: In group of SURGICEL® Original Hemostat, includes 21 female and 9 male, age range from 18 to 54 with average 39.5 years. Average BMI is 42.4 (range from 32.6 to 55). The operations include 27 cases of laparoscopic sleeve gastrectomy, 2 cases of laparoscopic gastric bypass, and 1 case of laparoscopic mini-bypass. Group of autologous fat includes 3 female and 7 male, age range from 20 to 49 with average 38.6 years. Average BMI is 39 (range from 32.8 to 64.5). The operations include 9 cases of laparoscopic sleeve gastrectomy, and 1 case of laparoscopic mini-bypass. No complications of trocar wound including infection, hematoma, and hernia were found for a mean follow-up of 6 months. Conclusions: For obese patients, closure of port sites can be difficult. We described a method of closing 10-mm port-sites wounds, which are easy, effective, and not required any special instruments.展开更多
【目的】探讨磁共振成像在外侧型腰椎间盘突出症压迫脊神经与多裂肌萎缩和脂肪浸润相关性中的应用价值。【方法】回顾性分析我院经手术证实的60例单侧外侧型腰椎间盘突出症患者的临床和MRI资料,根据病程长短分为A、B、C三组,测量病变层...【目的】探讨磁共振成像在外侧型腰椎间盘突出症压迫脊神经与多裂肌萎缩和脂肪浸润相关性中的应用价值。【方法】回顾性分析我院经手术证实的60例单侧外侧型腰椎间盘突出症患者的临床和MRI资料,根据病程长短分为A、B、C三组,测量病变层面总多裂肌横截面积(total cross-sectional area,TCSA)、无脂肪多裂肌横截面积(fat-free CSA,FCSA)、多裂肌至椎弓板的垂直距离(distance of the multifidus muscle to the lamina,MLD),并计算FCSA/TCSA、MLD比(患侧MLD/健侧MLD)、FCSA/TCSA比[(患侧FCSA/TCSA)/(健侧FCSA/TCSA)]。ROC曲线用于计算诊断阈值和曲线下面积(area under the curve,AUC)。【结果】三组组内MLD患侧大于健侧(P<0.01),C组FCSA/TCSA患侧小于健侧(P<0.05)。三组之间FCSA/TCSA比和MLD比差异有统计学意义(P<0.05),且呈负相关关系(r=-0.34,P<0.05)。ROC曲线上MLD的诊断阈值是6.74 mm,敏感度和特异度分别为73.3%和60.0%,AUC为0.682(P<0.05)。【结论】MRI新指标可以有效评估外侧型腰椎间盘突出症所致的脊神经压迫、多裂肌萎缩及脂肪浸润,对腰椎间盘突出症的诊断和评价有重要的指导作用。展开更多
文摘Background: Ten-millimeter ports are often used in laparoscopic surgery. It could be difficult to close the ports sites, especially in obese patients. We described a new method to close ten-millimeter port-site wounds, effective and easily to perform. Methods: Forty cases of laparoscopic bariatric surgery were performed from April 2010 to September 2011 at IRCAD Taiwan. Among them, 30 patients received trocar hole closed with SURGICEL® Original Hemostat and the other 10 patients received trocar hole closed with autologous fat. The results were recorded. Results: In group of SURGICEL® Original Hemostat, includes 21 female and 9 male, age range from 18 to 54 with average 39.5 years. Average BMI is 42.4 (range from 32.6 to 55). The operations include 27 cases of laparoscopic sleeve gastrectomy, 2 cases of laparoscopic gastric bypass, and 1 case of laparoscopic mini-bypass. Group of autologous fat includes 3 female and 7 male, age range from 20 to 49 with average 38.6 years. Average BMI is 39 (range from 32.8 to 64.5). The operations include 9 cases of laparoscopic sleeve gastrectomy, and 1 case of laparoscopic mini-bypass. No complications of trocar wound including infection, hematoma, and hernia were found for a mean follow-up of 6 months. Conclusions: For obese patients, closure of port sites can be difficult. We described a method of closing 10-mm port-sites wounds, which are easy, effective, and not required any special instruments.
文摘【目的】探讨磁共振成像在外侧型腰椎间盘突出症压迫脊神经与多裂肌萎缩和脂肪浸润相关性中的应用价值。【方法】回顾性分析我院经手术证实的60例单侧外侧型腰椎间盘突出症患者的临床和MRI资料,根据病程长短分为A、B、C三组,测量病变层面总多裂肌横截面积(total cross-sectional area,TCSA)、无脂肪多裂肌横截面积(fat-free CSA,FCSA)、多裂肌至椎弓板的垂直距离(distance of the multifidus muscle to the lamina,MLD),并计算FCSA/TCSA、MLD比(患侧MLD/健侧MLD)、FCSA/TCSA比[(患侧FCSA/TCSA)/(健侧FCSA/TCSA)]。ROC曲线用于计算诊断阈值和曲线下面积(area under the curve,AUC)。【结果】三组组内MLD患侧大于健侧(P<0.01),C组FCSA/TCSA患侧小于健侧(P<0.05)。三组之间FCSA/TCSA比和MLD比差异有统计学意义(P<0.05),且呈负相关关系(r=-0.34,P<0.05)。ROC曲线上MLD的诊断阈值是6.74 mm,敏感度和特异度分别为73.3%和60.0%,AUC为0.682(P<0.05)。【结论】MRI新指标可以有效评估外侧型腰椎间盘突出症所致的脊神经压迫、多裂肌萎缩及脂肪浸润,对腰椎间盘突出症的诊断和评价有重要的指导作用。
