ABSTRACT
Subphrenic splenic implantation is a rare disease, usually occurred followed the splenic trauma and splenectomy. Surgeries are often necessary for diagnosing and treating it. A 46-year-old male post-splenectomy patient, tolerating abdominal bloating and pain for more than 1 year, was admitted to the Second Xiangya Hospital, Central South University. Fundus bulge suggested a possibility of stromal tumors originating from the muscularispropria layer with endoscopic ultrasound. Slightly stomachic thickness was detected using enhanced computed tomography (CT). Without any improvement for symptoms after medication, the patient strongly requested to undergo an endoscopic therapy. Natural orifice transluminal endoscopic surgery (NOTES) result confirmed it as subphrenic splenic implantation with postoperative pathology. In this case, NOTES helped us to confirm the diagnosis, relieve the symptoms, as well as prevent secondary surgery injury, which would be helpful to other clinicians.
Subject(s)
Humans , Male , Middle Aged , Endoscopy , Gastric Fundus , Intraoperative Complications , Splenectomy/adverse effects , Tomography, X-Ray ComputedABSTRACT
Objective To evaluate the clinical efficacy of submucosal tunnel endoscopic resection (STER) for upper gastrointestinal muscularis propria submucosal tumors (SMTs) with diameter ≥3.5 cm.Methods The clinical data of 14 patients with SMTs≥3.5 cm who were admitted to the Second Xiangya Hospital of Central South University between October 2011 and July 2014 were retrospectively analyzed, including 13 patients with tumor at esophagus and 1 patient with tumor at cardia.All patients underwent STER and the observed indexes included operation tine, tumor location and diameter, results of pathological examination and occurrence of postoperative complications.All patients were followed up regularly at the out-patient department including reexamination of gastroscopy, endoscopic ultrasonography (EUS) and computed tomography (CT) till August 2014.Measurement data with normal distribution were presented as average (range).Results All the 14 patients underwent STER successfully with mean operation time of 83 minutes (range, 60-160 minutes).Fourteen tumors were exited, with 13 located at esophagus and 1 at gastric cardia.En bloc resection was achieved in 13 patients and the tumors were extracted through the tunnel.The tumor in the remaining 1 patient was large with a diameter of 5.3 cm and close to trachea, it was extracted by 2 pieces.The average diameter of 14 tumors extracted was 4.1 cm and postoperative pathological examination confirmed the tumors as leiomyomas.Three patients had postoperative complications, subcutaneous emphysema occurred in 1 patient and retrosternal pain in 1 patient.One patient suffered mucosal laceration and recovered after a metal stent was inserted for 2 weeks.The average duration of postoperative hospital stay was 6.4 days (range, 4.0-8.0 days).All patients were followed up for a median time of 11.5 months (range, 1.0-24.0 months) with no recurrence.Conclusion STER is a safe and effective method for SMTs with diameter≥3.5 cm.
ABSTRACT
OBJECTIVE@#To compare the hemostatic efficacy and safety of endoscopic band ligation(EBL) and endoscopic hemoclip placement(EHP) for bleeding due to Dieulafoy lesions in the upper gastrointestinal tract.@*METHODS@#Between February 2004 and October 2006, 34 patients with Dieulafoy lesions in the upper gastrointestinal tract were prospectively enrolled,including 22 cases of lesions in the stomach,10 in gastrointestinal stoma,and 2 in duodenal, who were randomly assigned to undergo EBL (n=16) or EHP (n=18). The therapeutic results of these 2 groups were compared.@*RESULTS@#The median number of O-ring or hemoclip required in the EBL group and the EHP group was similar. The rate of primary haemostasis,recurrent bleeding,transfer into surgery, complications, and average stay and blood transfusion requirements did not significantly differ in the 2 groups (P>0.05).@*CONCLUSION@#In this study, no significant differences are detected in the efficacy and the safety of EBL vs. EHP for bleeding due to Dieulafoy lesions in the upper gastrointestinal tract.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Endoscopy, Gastrointestinal , Methods , Gastric Mucosa , General Surgery , Gastrointestinal Hemorrhage , General Surgery , Hemostasis, Endoscopic , Methods , Ligation , Methods , Prospective Studies , Surgical InstrumentsABSTRACT
Objective:To study the relation between the costimulating molecules CD40,CD80 on DC and their antigen presentation function in patients with chrnic HBV infection .Methods:The DC from healthy donors and patients were stained with anti human specific mouse monoclonal antibodies conjugated with fluorescein isothiocyanate(FITC) respectively.Mouse McAb used were anti HLA ABC,HLA DR,CD1a,CD14,CD40,CD80.Results:There are no remarkable difference in MHC I?MHC II between two groups;remarkable difference was showed in CD40(P