ABSTRACT
Objective@#To study the clinical outcomes using laparoscopic complete dissection of cysts, subtotal cystectomy and partial hepatectomy in the treatment of hepatic cystic echinococcosis.@*Methods@#A retrospective study was conducted on 40 patients with hepatic cystic echinococcosis treated by laparoscopic surgery from January 2014 to June 2018 at the First Affiliated Hospital of Xinjiang Medical University. According to the different surgical methods, these patients were divided into three groups: group A (n=14): the laparoscopic complete capsulectomy group, group B (n=14): the laparoscopic subtotal capsulectomy group, group C (n=12): the laparoscopic partial hepatectomy group. The operation time, intraoperative blood loss, time to pass first flatus, duration of drainage tube placement, days of hospitalization after operation, hospitalization expenses, complications of the residual cavity and local recurrence were compared among the 3 groups.@*Results@#In this study, all the 40 patients with hepatic cystic hydatidosis were cured, and no death occurred during the perioperative period. The intraoperative blood loss, postoperative duration of drainage tube placement, and hospitalization cost of the three groups were significantly the highest in group C (all P<0.05). The operative time and the time to pass first flatus in group C were both significantly greater than group B (P<0.05). The length of postoperative hospitalization in group A was significantly less than in group C (P<0.05). Postoperative recurrence and complications in group B were significantly worse than those in group A and group C (all P<0.05).@*Conclusion@#Laparoscopic complete dissection of the external capsule turned out to be the best laparoscopic treatment of hepatic cystic echinococcosis, followed by laparoscopic partial hepatectomy. Open surgery should be considered in patients with lesions which are evaluated preoperatively to have difficulty in carrying out laparoscopic complete dissection of capsule or partial hepatectomy.
ABSTRACT
Objective To study the clinical outcomes using laparoscopic complete dissection of cysts,subtotal cystectomy and partial hepatectomy in the treatment of hepatic cystic echinococcosis.Methods A retrospective study was conducted on 40 patients with hepatic cystic echinococcosis treated by laparoscopic surgery from January 2014 to June 2018 at the First Affiliated Hospital of Xinjiang Medical University.According to the different surgical methods,these patients were divided into three groups:group A (n =14):the laparoscopic complete capsulectomy group,group B (n =14):the laparoscopic subtotal capsulectomy group,group C (n =12):the laparoscopic partial hepatectomy group.The operation time,intraoperative blood loss,time to pass first flatus,duration of drainage tube placement,days of hospitalization after operation,hospitalization expenses,complications of the residual cavity and local recurrence were compared among the 3 groups.Results In this study,all the 40 patients with hepatic cystic hydatidosis were cured,and no death occurred during the perioperative period.The intraoperative blood loss,postoperative duration of drainage tube placement,and hospitalization cost of the three groups were significantly the highest in group C (all P ＜ 0.05).The operative time and the time to pass first flatus in group C were both significantly greater than group B (P ＜ 0.05).The length of postoperative hospitalization in group A was significantly less than in group C (P ＜ 0.05).Postoperative recurrence and complications in group B were significantly worse than those in group A and group C (all P ＜ 0.05).Conclusion Laparoscopic complete dissection of the external capsule turned out to be the best laparoscopic treatment of hepatic cystic echinococcosis,followed by laparoscopic partial hepatectomy.Open surgery should be considered in patients with lesions which are evaluated preoperatively to have difficulty in carrying out laparoscopic complete dissection of capsule or partial hepatectomy.
ABSTRACT
There are few reports in the literature about the colonization of benthic macroinvertebrates on bryophytes. The aim of the present study was to analyzed the oligochaetes established on bryophytes adhered to stones in a first-order stream. The collections were carried out in an Atlantic Forest fragment area during the dry and rainy seasons. We identified 15 taxa from a total of 422 oligochaetes specimens, of which the most abundant were Pristina sp.1, Enchytraeidae and Pristina jenkinae. Unlike other habitats, where the abundance of macroinvertebrates tends to be greater in the dry season, we did not find any significant differences in the abundance, richness, composition and diversity between the two periods. The results of this study indicate that bryophytes are possible areas of refuge for oligochaetes in periods of faster water flow.
Existem poucos registros na literatura sobre a colonização de macroinvertebrados bentônicos em briófitas. O presente estudo teve como objetivo analisar a fauna de oligoquetas em briófitas aderidas a pedras em um córrego de primeira ordem. As coletas foram realizadas em um fragmento de Mata Atlântica durante os períodos seco e chuvoso. Foram identificados 15 taxa de um total de 422 espécimes de oligoquetas, sendo os mais abundantes Pristina sp.1, Enchytraeidae e Pristina jenkinae. Ao contrário de outros habitats, onde a abundância de macroinvertebrados tende a ser maior no período de estiagem, diferenças significativas na abundância, riqueza, composição e diversidade não foram observadas em relação aos dois períodos. Os resultados do presente estudo indicam que as briófitas são possíveis áreas de refúgio para os oligoquetas em período de maior corrente.
ABSTRACT
La promoción del conocimiento de la distribución vascular hepática, tanto clásica como de sus variaciones, es fundamental para planear y realizar todos los procedimientos quirúrgicos y radiológicos en el abdomen superior. Se disecaron 64 cadáveres, formolizados al 10%, entre 1980 y 2005. Primero se abrió la cavidad abdominal con incisión en boca de horno, luego se investigaron fundamentalmente el omento menor y el pedículo hepático y se procedió a la disección del compartimiento supramesocólico. Los resultados de las disecciones fueron agrupados en 5 clases: Clase 1 (73,44%): Disposición arterial clásica. Clase 2A (9,37%): Arterias hepáticas izquierdas aberrantes accesorias con origen en la arteria gástrica izquierda. Clase 2B (4,69%): Arterias hepáticas izquierdas aberrantes reemplazantes con origen en la arteria gástrica izquierda. Clase 3A (3,12%): Arterias hepáticas derechas aberrantes accesorias naciendo con origen en la arteria mesentérica superior. Clase 3B (3,12%): Arterias hepáticas derechas aberrantes reemplazantes con origen en la arteria mesentérica superior. Clase 4 (3,12%): Disposición combinada de arterias hepáticas izquierda y derecha aberrantes. Clase 5 (3,12%): Arteria hepática común aberrante reemplazante con origen en la arteria mesentérica superior. Concluimos que la disposición normal de la anatomía hepática fue hallada en el 73,44% y que existe una significativa frecuencia de aparición de arterias hepáticas aberrantes (26,56%). De esta manera, definimos dos sitios fundamentales de origen de arterias hepáticas aberrantes: la arteria gástrica izquierda de la que se originan las arterias hepáticas izquierdas aberrantes (Clase 2 (A-B) 14,06%), recorriendo el omento menor y la arteria mesentérica superior de la que se originan las arterias hepáticas derechas aberrantes (Clase 3 (A-B) 6,24%), realizando un peligroso trayecto retroduodenoportal. Es fundamental la investigación precisa del omento menor y de la cara posterior ...
The promotion of the knowledge of the classic hepatic vascular distribution and its variations is fundamental to plan and to make all the surgical and radiological procedures in the superior abdomen. 64 corpses preserved with formol to 40% were dissected, between 1980 and 2005. First the abdominal cavity with incision in furnace mouth was opened, soon the gastrohepatic epiplon and the hepatic pedicle were investigated, and finally it was dissected all the supramesocolic sector. The results of the dissection were grouped in 5 classes: Class 1 (73,44%): Classic arterial disposition. Class 2A (9,37%): Accessory aberrant left hepatic artery being born of the left gastric artery. Class 2B (4,69%): Replacing aberrant left hepatic artery being born of the left gastric artery. Class 3A (3,12%): Accessory aberrant right hepatic artery being born of the superior mesenteric artery. Class 3B (3,12%): Replacing aberrant right hepatic artery being born of the superior mesenteric artery. Class 4 (3,12%): Combined disposition of aberrants hepatics arteries, right and left. Class 5 (3,12%): Replacing aberrant common hepatic artery being born of the superior mesenteric artery. We concluded that the normal disposition of the hepatic anatomy was found in 73,44%. The aberrants hepatics arteries were found with significant, 26,56%. This way, we defined two fundamental sites of birth of aberrant hepatics arteries: the left gastric artery is the site of birth of the aberrants lefts hepatics arteries (Class 2 (A-B) 14.06%), crossing gastrohepatic epiplon, and the superior mesenteric artery site of birth of the aberrant rights hepatics arteries (Class 3 (A-B) 6.24%), making a dangerous retroduodenoportal passage. For that reason the precise investigation of gastrohepatic epiplon and the back of the hepatic pedicle by the possibility of finding of these aberrant hepáticas arteries is fundamental.