To our knowledge this is the first report to provide a detailed description of surgical procedure for adhesiolysis and hepatectomy in patients who have undergone esophagectomy and reconstruction. We performed a hepati...To our knowledge this is the first report to provide a detailed description of surgical procedure for adhesiolysis and hepatectomy in patients who have undergone esophagectomy and reconstruction. We performed a hepatic resection of the left medial segment in a patient with a reconstructed stomach tube after esophagectomy for the esophageal carcinoma. The reconstructed stomach tube overlapped with the left medial segment of the liver and the hepatoduodenal ligament and was extensively and strongly adhered to them. It is important for clinicians to know how to perform the detachment procedure successfully in order to secure a surgical field for liver resection without damaging the fragile reconstructed gastric</span><span style="font-family:Verdana;"> tube. In order to avoid vascular injury of the stomach tube, it was decided that detachment around the hepatoduodenal ligament preceded detachment of the stomach tube from the liver. After complete separation of the hepatoduodenal ligament from the stomach tube, the hepatoduodenal ligament was encircled with tape. Subsequently, adhesiolysis was performed between the stomach tube </span><span style="font-family:Verdana;">and the liver. Finally, parenchymal transection was performed using the intermittent hepatic inflow occlusion and crush clamping techniques to dissect the parenchyma. The patient was discharged two weeks after surgery without complication.展开更多
近年来，我国早产儿的出生率呈逐年上升趋势，由5％上升为8．1％［1］。极低出生体重儿由于贲门括约肌松弛［2］，胃容量小，消化功能弱，易发生呕吐、腹胀，新生儿坏死性小肠结肠炎（N EC ）发病率高。持续胃肠减压是新生儿重症监护室...近年来，我国早产儿的出生率呈逐年上升趋势，由5％上升为8．1％［1］。极低出生体重儿由于贲门括约肌松弛［2］，胃容量小，消化功能弱，易发生呕吐、腹胀，新生儿坏死性小肠结肠炎（N EC ）发病率高。持续胃肠减压是新生儿重症监护室（N IC U ）针对极低出生体重儿采用的一项常用的护理操作技术，减压效果直接影响其病情进展、住院时间、甚至预后。由于极低出生体重儿体表发育不成熟，前额发际模糊不清，采用前额发际到剑突的体表测量不能准确判断胃管置入深度；故本研究采用鼻尖和外耳廓的体表测量标志置入胃管，以探讨适合其胃肠减压时留置胃管的深度，为临床护理提供理论依据。展开更多
重症监护病房多数病人因病情以及治疗需要，常常需要气管插管，不能经口进食，为保证营养供给、保护胃黏膜，常需行早期胃肠内营养支持［1］，同时为防止误吸，往往需要留置胃管。采用常规方法置胃管失败率很高［2］。为减轻患者痛苦，...重症监护病房多数病人因病情以及治疗需要，常常需要气管插管，不能经口进食，为保证营养供给、保护胃黏膜，常需行早期胃肠内营养支持［1］，同时为防止误吸，往往需要留置胃管。采用常规方法置胃管失败率很高［2］。为减轻患者痛苦，提高插管成功率，2013年3月—2014年3月，我们对IC U 70例气管插管患者采用可视喉镜直视引导下胃管置入法与传统胃管置入法进行比较，经临床观察，效果满意。现报告如下。展开更多
文摘To our knowledge this is the first report to provide a detailed description of surgical procedure for adhesiolysis and hepatectomy in patients who have undergone esophagectomy and reconstruction. We performed a hepatic resection of the left medial segment in a patient with a reconstructed stomach tube after esophagectomy for the esophageal carcinoma. The reconstructed stomach tube overlapped with the left medial segment of the liver and the hepatoduodenal ligament and was extensively and strongly adhered to them. It is important for clinicians to know how to perform the detachment procedure successfully in order to secure a surgical field for liver resection without damaging the fragile reconstructed gastric</span><span style="font-family:Verdana;"> tube. In order to avoid vascular injury of the stomach tube, it was decided that detachment around the hepatoduodenal ligament preceded detachment of the stomach tube from the liver. After complete separation of the hepatoduodenal ligament from the stomach tube, the hepatoduodenal ligament was encircled with tape. Subsequently, adhesiolysis was performed between the stomach tube </span><span style="font-family:Verdana;">and the liver. Finally, parenchymal transection was performed using the intermittent hepatic inflow occlusion and crush clamping techniques to dissect the parenchyma. The patient was discharged two weeks after surgery without complication.
文摘近年来，我国早产儿的出生率呈逐年上升趋势，由5％上升为8．1％［1］。极低出生体重儿由于贲门括约肌松弛［2］，胃容量小，消化功能弱，易发生呕吐、腹胀，新生儿坏死性小肠结肠炎（N EC ）发病率高。持续胃肠减压是新生儿重症监护室（N IC U ）针对极低出生体重儿采用的一项常用的护理操作技术，减压效果直接影响其病情进展、住院时间、甚至预后。由于极低出生体重儿体表发育不成熟，前额发际模糊不清，采用前额发际到剑突的体表测量不能准确判断胃管置入深度；故本研究采用鼻尖和外耳廓的体表测量标志置入胃管，以探讨适合其胃肠减压时留置胃管的深度，为临床护理提供理论依据。
文摘重症监护病房多数病人因病情以及治疗需要，常常需要气管插管，不能经口进食，为保证营养供给、保护胃黏膜，常需行早期胃肠内营养支持［1］，同时为防止误吸，往往需要留置胃管。采用常规方法置胃管失败率很高［2］。为减轻患者痛苦，提高插管成功率，2013年3月—2014年3月，我们对IC U 70例气管插管患者采用可视喉镜直视引导下胃管置入法与传统胃管置入法进行比较，经临床观察，效果满意。现报告如下。
