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Objective To investigate the clinical application effect of independently designed subcutaneous tunnel in endo‐scopic thyroid operation .Methods A total of 480 cases of endoscopic thyroid operation were completed in our department from February 2005 to December 2014 ,in which 315 cases adopted the independently designed subcutaneous tunnel for separating the subcutaneous tissues in anterior thoracic region and the other 165 cases used the puncture stick for separating and constructing the subcutaneous tunnel .Results Using independently designed subcutaneous tunnel for constructing the subcutaneous tunnel in the anterior thoracic region had statistical difference in the operative time and intraoperative bleeding amount compared with the punc‐ture stick(P<0 .05) ,and the difference of postoperative complications between the two groups was statistically signifficant (P<0 .05) .Conclusion Adopting the independently designed subcutaneous tunnel for constructing subcutaneous tunnel has the advan‐tages of short time consuming ,less bleeding and fewer complications .The level and size of the constructed subcutaneous tunnel are easy to grasp ,so which is more convenient for endoscopic thyroid operation .
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Objective To explore the clinical experience of endovascular treatment for arteriosclerosis obliterans (ASO) of lower extremities.Methods Endovascular treatment were performed on 22 patients (26 limbs) suffering from ASO which were diagnosed by magnetic resonance angiography (MRA).The clinical efficacy after operation was analyzed.Results Twenty-two lower extremities of 18 patients successfully accepted endovascular treatment with 12 stents planted without major complications.Four cases failed to endovascular treatment and 2 of them converted to bypass surgery.The clinical symptoms of limb ischemia vanished or significantly improved after treatment.The ankle brachial index (ABI) of affected extremities increased from 0.35?0.13 (before operation) to 0.70?0.15 (after operation),P
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Objective To evaluate the clinical efficacy of transplantation of autologous peripheral blood stem cells(PBSC) for the treatment of toe or heel ulcer and of rest pain in patients with lower limb arterial ischemic diseases.Methods To mobilize patients' own stem cells with G-CSF for 5 days.At the sixth day,PBSC are collected with a blood-cells separator.The PBSC were then intramuscularly injected into ischemic areas of the lower limbs.Results After transplantation,all patients are followed up from 3 to 24 months.The rest pain disappeares in 12 patients,while toe or heel ulcers are cicatrized in 11 cases.However,4 patients lost in following up.ConclusionTransplantation of autologous peripheral blood stem cells is an effective method for the treatment of arterial ischemic disease.
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Objective To explore the methods of the endovascular repair of aortic disease(aortic dissection and aortic aneurysm).Methods We retrospectively analysed 64cases of aortic diseases treated with endovascular repair,including 42cases of aortic dissection(38 were Stanford B,4 were Stanford A) and 22 cases of aortic aneurysms.The stent-grafts were set into the aorta cavity to cover the damaged aortic intima through the femoral artery under local or general anesthesia;4 cases also underwent by-pass vascular operations.In 6 cases the left subclavian artery(LSA) was covered by stent-graft at the endovascular therapy without by-pass operation.Results Eighteen cases of immediate inner-leak were found after the stent placement,a rate of 28.13 %(18/64).No other severe complications occurred,such as stent-graft shift or error placement,aortic rupture,conversion to open-operation or paraplegia.The blood flow of all the vital branches of aorta were obviously improved.The mortality in the perioperative period was 6.25 %(4/64),the time of follow-up was 1-78 months(mean 32 months).Reoperation was done in 2 cases of aortic aneurysm group and 2 cases of aortic dissection group.Conclusions The endovascular repair is a good method for aortic disease.The short and middle term result is satistactory,and the long term follow-up needs to be studied.
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Objective To evaluate the effect of endovascular graft exclusion (EVGE) for aorta aneurysm(AA). Methods From October,2000 to August 2002,5 cases of AA were treated by EVGE, 4 of which were thoracic and abdominal aortic dissecting aneurysm and the another one was abdominal AA. Results All the operations were successfully performed. The pseudo cavity in the 4 cases of aortic dissection disappeared after the operation,and the another aortic aneurysm was successfully isolated. Conclusions EVGE is an effective ,less trauma and safe, when the indications are carefully selected.
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Objective To study the management of femoral artery pseudoaneurysm caused by heroin (injection).Methods 11 cases of femoral artery pseudoaneurysm were treated. 4 cases presented with ruptured aneurysm and were treated emergently by direct ligation of the aneurysmal artery through a femoral incision. 2 cases (underwent) elective operation in which the iliac artery was initially exposed through an extraperitoneal (lower) (abdominal) incision to control bleeding, and then the aneurysmal artery was ligated through a femoral (incision).Results All of the operations were successful, and no gangrene of the affected limb occurred.(Conclusions) Arterial ligation for femoral artery pseudoaneurysm caused by heroin injection is simple and (effective). (Intraoperative) observation of distal arterial backflow,measurement of (arterial) pressure and (intraoperative) (arteriography) can improve the safety of the operation.