在各种原因(外伤、术中后囊膜破裂、晶状体脱位等)导致的无充足囊袋支撑的情况下,常规的人工晶状体(Intraocular lens, IOL)植入方案实施困难。房角支撑型IOL和虹膜夹持型IOL因其较多的并发症现已不作为常规选择,因此,IOL巩膜固定术成...在各种原因(外伤、术中后囊膜破裂、晶状体脱位等)导致的无充足囊袋支撑的情况下,常规的人工晶状体(Intraocular lens, IOL)植入方案实施困难。房角支撑型IOL和虹膜夹持型IOL因其较多的并发症现已不作为常规选择,因此,IOL巩膜固定术成为目前无充足囊膜支撑时的主流术式。从有缝线的IOL巩膜悬吊到无缝线的IOL巩膜层间固定,再到新型巩膜固定IOL的研发,术者们致力于提高手术效果的同时简化手术操作和减少术后并发症的发生,IOL巩膜固定手术技术得以不断改进,本文就IOL巩膜固定术的进展进行综述。Conventional intraocular lens (IOL) implantation is challenging in cases where sufficient capsular support is compromised due to various factors, such as trauma, intraoperative capsular rupture or lens dislocation. Angle-supported anterior chamber IOL and iris-clamp IOL are not standard options due to their associated complications. As a result, scleral fixation of the IOL has become the predominant choice in scenarios without sufficient capsular support. The evolution from sutured scleral suspension techniques for IOL to sutureless interscleral fixation methods and the introduction of novel scleral fixation IOL designs reflects surgeons’ efforts to improve surgical outcomes, streamline procedures and minimize postoperative complications. As a result, surgical techniques for scleral fixation of IOL continue to evolve. This article provides an overview of recent developments in scleral fixation of IOL.展开更多
目的探讨胸腹腔镜联合下食管癌根治术治疗食管癌的临床疗效。方法回顾性分析2012年10月至2014年6月在本科因食管癌行食管癌根治术患者108例。51例患者行胸腹腔镜食管癌根治术(minimally invasive esophagectomy,MIE),57例患者行传统开...目的探讨胸腹腔镜联合下食管癌根治术治疗食管癌的临床疗效。方法回顾性分析2012年10月至2014年6月在本科因食管癌行食管癌根治术患者108例。51例患者行胸腹腔镜食管癌根治术(minimally invasive esophagectomy,MIE),57例患者行传统开放食管癌根治术(open esophagectomy,OE)。从手术结局、肿瘤学结局、围术期并发症三方面评估两种手术的临床疗效。结果两组患者一般资料比较无显著性差异(P>0.05)。MIE组与OE组手术时间,术中输血患者比例无明显差异(P>0.05)。MIE组和OE组比较,术中出血量[(150.5±30.4)vs(215.5±40.4)mL],术中平均输液量(2.2 vs 3.1 L),术后ICU监护时间(1 vs 2 d),禁食时间(6 vs 8 d),术后住院时间(8 vs 10 d)有显著性差异(P<0.05)。两组患者平均淋巴结切除数目、切缘阳性率无显著性差异(P>0.05),肺部并发症发生率MIE组2例(3.9%),明显少于OE组25(43.8%)。结论胸腹腔镜联合下食管癌根治术不仅可以达到与开放手术相同的肿瘤切除效果,且在减少术后住院时间、术中出血量及减少术后肺部并发症方面较开放手术更有优势。展开更多
文摘在各种原因(外伤、术中后囊膜破裂、晶状体脱位等)导致的无充足囊袋支撑的情况下,常规的人工晶状体(Intraocular lens, IOL)植入方案实施困难。房角支撑型IOL和虹膜夹持型IOL因其较多的并发症现已不作为常规选择,因此,IOL巩膜固定术成为目前无充足囊膜支撑时的主流术式。从有缝线的IOL巩膜悬吊到无缝线的IOL巩膜层间固定,再到新型巩膜固定IOL的研发,术者们致力于提高手术效果的同时简化手术操作和减少术后并发症的发生,IOL巩膜固定手术技术得以不断改进,本文就IOL巩膜固定术的进展进行综述。Conventional intraocular lens (IOL) implantation is challenging in cases where sufficient capsular support is compromised due to various factors, such as trauma, intraoperative capsular rupture or lens dislocation. Angle-supported anterior chamber IOL and iris-clamp IOL are not standard options due to their associated complications. As a result, scleral fixation of the IOL has become the predominant choice in scenarios without sufficient capsular support. The evolution from sutured scleral suspension techniques for IOL to sutureless interscleral fixation methods and the introduction of novel scleral fixation IOL designs reflects surgeons’ efforts to improve surgical outcomes, streamline procedures and minimize postoperative complications. As a result, surgical techniques for scleral fixation of IOL continue to evolve. This article provides an overview of recent developments in scleral fixation of IOL.
文摘目的探讨胸腹腔镜联合下食管癌根治术治疗食管癌的临床疗效。方法回顾性分析2012年10月至2014年6月在本科因食管癌行食管癌根治术患者108例。51例患者行胸腹腔镜食管癌根治术(minimally invasive esophagectomy,MIE),57例患者行传统开放食管癌根治术(open esophagectomy,OE)。从手术结局、肿瘤学结局、围术期并发症三方面评估两种手术的临床疗效。结果两组患者一般资料比较无显著性差异(P>0.05)。MIE组与OE组手术时间,术中输血患者比例无明显差异(P>0.05)。MIE组和OE组比较,术中出血量[(150.5±30.4)vs(215.5±40.4)mL],术中平均输液量(2.2 vs 3.1 L),术后ICU监护时间(1 vs 2 d),禁食时间(6 vs 8 d),术后住院时间(8 vs 10 d)有显著性差异(P<0.05)。两组患者平均淋巴结切除数目、切缘阳性率无显著性差异(P>0.05),肺部并发症发生率MIE组2例(3.9%),明显少于OE组25(43.8%)。结论胸腹腔镜联合下食管癌根治术不仅可以达到与开放手术相同的肿瘤切除效果,且在减少术后住院时间、术中出血量及减少术后肺部并发症方面较开放手术更有优势。