AIM To investigate the anesthetic management of peroral endoscopic myotomy(POEM) and its associated complications.METHODS This study was a single-center,retrospective,observational study comprising a case series of al...AIM To investigate the anesthetic management of peroral endoscopic myotomy(POEM) and its associated complications.METHODS This study was a single-center,retrospective,observational study comprising a case series of all patients who underwent POEM in our hospital from April 2015 to November 2016.We collected data regarding patient characteristics,anesthetic methods,surgical factors,and complications using an electronic chart.RESULTS There were 86 patients who underwent POEM in our hospital during the study period.Preoperatively,patients were maintained on a low residue diet for 48 h prior to the procedure.They were fasted of solids for 24 h before surgery.There was one case of aspiration(1.2%).During POEM,patients were positioned supine with the upper abdomen covered by a clear drape so that pneumoperitoneum could be timeously identified.In three cases,the peak airway pressure exceeded 35 cm H2 O during volume controlled ventilation with tidal volumes of 6-8 m L/kg and subsequent impairment of ventilation.These cases had been diagnosed with spastic esophageal disorders(SEDs) and the length of the muscular incision on the esophageal side was longer than normal.CONCLUSION In the anesthetic management of POEM,it is important to prevent aspiration during induction of anesthesia and to identify and treat complications associated with CO_2 insufflation.展开更多
Embryologically, chromaffin cells of the pheo-chromocytoma and ganglion cells of the ganglioneuroma are both derived from neural crest cells. Composite pheochromocytoma-ganglioneuroma (Pheo-GN) in a single adrenal gla...Embryologically, chromaffin cells of the pheo-chromocytoma and ganglion cells of the ganglioneuroma are both derived from neural crest cells. Composite pheochromocytoma-ganglioneuroma (Pheo-GN) in a single adrenal gland is very rare. A case report of a patient with composite Pheo-GN of the adrenal gland and renal pelvic cancer is presented. Laparoscopic left adrenalectomy, nephroureterectomy and para-aortic lymphadenectomy were performed. This represents the first report of simultaneous surgical treatment for composite Pheo-GN and renal pelvic cancer.展开更多
文摘AIM To investigate the anesthetic management of peroral endoscopic myotomy(POEM) and its associated complications.METHODS This study was a single-center,retrospective,observational study comprising a case series of all patients who underwent POEM in our hospital from April 2015 to November 2016.We collected data regarding patient characteristics,anesthetic methods,surgical factors,and complications using an electronic chart.RESULTS There were 86 patients who underwent POEM in our hospital during the study period.Preoperatively,patients were maintained on a low residue diet for 48 h prior to the procedure.They were fasted of solids for 24 h before surgery.There was one case of aspiration(1.2%).During POEM,patients were positioned supine with the upper abdomen covered by a clear drape so that pneumoperitoneum could be timeously identified.In three cases,the peak airway pressure exceeded 35 cm H2 O during volume controlled ventilation with tidal volumes of 6-8 m L/kg and subsequent impairment of ventilation.These cases had been diagnosed with spastic esophageal disorders(SEDs) and the length of the muscular incision on the esophageal side was longer than normal.CONCLUSION In the anesthetic management of POEM,it is important to prevent aspiration during induction of anesthesia and to identify and treat complications associated with CO_2 insufflation.
文摘Embryologically, chromaffin cells of the pheo-chromocytoma and ganglion cells of the ganglioneuroma are both derived from neural crest cells. Composite pheochromocytoma-ganglioneuroma (Pheo-GN) in a single adrenal gland is very rare. A case report of a patient with composite Pheo-GN of the adrenal gland and renal pelvic cancer is presented. Laparoscopic left adrenalectomy, nephroureterectomy and para-aortic lymphadenectomy were performed. This represents the first report of simultaneous surgical treatment for composite Pheo-GN and renal pelvic cancer.
