ABSTRACT
OBJECTIVE: To investigate the feasibility of abdominal surgical resection of intracardiac leiomyomatosis.METHODS: The clinical data of 4 cases of intracardiac leiomyomatosis performed in zhongshan Hospital,Fudan University from December 2015 to August 2017 were analyzed retrospectively. RESULTS: Four patients underwent onestage surgery through an abdominal approach,without death. The operative time was 185-420(315.3 ± 86.4) min.Extracorporeal circulation time was 22-175(71.8±60.4)min and blood loss was 600-3000(1475.0±941.7)mL. Acute renal failure occurred in one of the patients after operation,the rest had no surgical complications. After 8-26 months of follow-up,there was no sign of recurrence and metastasis. CONCLUSION: One-stage surgery of intracardiac leiomyomatosis through an abdominal approach is feasible. But,how to determine the indications of surgery remains to be further explored and studied.
ABSTRACT
Objective To explore the clinical application of one-stage surgery combined posterior inter-fix-ation and anterior debridement for thoracolumbar tuberculosis in children. Methods The clinical data of thoraco-lumbar tuberculosis in children treated by combined surgery of posterior and anterior approach from January 2006 to December 2014 was reviewed retrospectively. The enrolled patients were divided into group A(25 patients under-went one-stage surgery)and group B(16 patients underwent two-stage surgery). Operation time,blood loss and complications were compared. The clinical effectiveness was evaluated by using visual analogue scale(VAS), kyphotic angle,neurological function(ASIA)and bone fusion. Results All operations completed successfully. There was statistically significance between two groups regarding to operation time [(202 ± 50)min vs. (254 ± 46)min]and blood loss[(332 ± 162)mL vs.(432 ± 106)mL]. The follow-up of 12 ~ 60 months indicated that bone grafts were fused without instrumentation failure. For patients with spinal cord injury ,there was 1 or 2 grades improvement by ASIA grading. VAS and the kyphotic angle were improved after operation ,but there was no statisti-cally significance between two groups regarding to the efficiency. Conclusions One-stage surgery combined pos-terior and anterior approach is a safe and effective method for thoracolumbar tuberculosis in children for immediate stability of spine,less blood loss and shorter operation time.
ABSTRACT
Objective To explore the clinical application of one-stage surgery combined posterior inter-fix-ation and anterior debridement for thoracolumbar tuberculosis in children. Methods The clinical data of thoraco-lumbar tuberculosis in children treated by combined surgery of posterior and anterior approach from January 2006 to December 2014 was reviewed retrospectively. The enrolled patients were divided into group A(25 patients under-went one-stage surgery)and group B(16 patients underwent two-stage surgery). Operation time,blood loss and complications were compared. The clinical effectiveness was evaluated by using visual analogue scale(VAS), kyphotic angle,neurological function(ASIA)and bone fusion. Results All operations completed successfully. There was statistically significance between two groups regarding to operation time [(202 ± 50)min vs. (254 ± 46)min]and blood loss[(332 ± 162)mL vs.(432 ± 106)mL]. The follow-up of 12 ~ 60 months indicated that bone grafts were fused without instrumentation failure. For patients with spinal cord injury ,there was 1 or 2 grades improvement by ASIA grading. VAS and the kyphotic angle were improved after operation ,but there was no statisti-cally significance between two groups regarding to the efficiency. Conclusions One-stage surgery combined pos-terior and anterior approach is a safe and effective method for thoracolumbar tuberculosis in children for immediate stability of spine,less blood loss and shorter operation time.
ABSTRACT
Obstructing colorectal cancer is one of the acute abdominal diseases which are common in clinical practice.The initial symptoms of 8.0％-33.9％ patients with obstructing colorectal cancer are complete or incomplete acute colonic obstruction.Seventy percent of obstructing colorectal cancer located at the left colon.There are no standard treatment methods for obstructed left colonic carcinoma (OLCC).Previously,a staged procedure was recommended.With the improvement of the intestinal surgical techniques,one-stage resection and anastomosis including intraoperative colonic irrigation,subtotal colectomy,metal stents placement and transanal drainage tube placement were preferred by most of the surgeons.In addition,metal stents placement and transanal drainage tube placement can reduce bowel pressure,which creates the possibility for the treatment of malignant colorectal obstruction by laparoscopes.
ABSTRACT
A 78-year-old woman had been undergoing medical treatment for hypertension since she delivered a son in her early twenties. Three months previously, she was admitted with heart failure. She had felt leg fatigue for a long time, and the pressure gradient between the upper and lower limbs was about 60 mmHg. On further examinations, she was found to have an atrial septal defect (ASD), tricuspid valve regurgitation, atrial fibrillation, and severe coarctation of the aorta (CoA) with well-developed collateral arteries. We performed ASD closure, tricuspid annuloplasty with a flexible ring, left atrial maze operation and extra-anatomic bypass from the ascending to the abdominal aorta through a median sternotomy and upper median laparotomy. She had no postoperative complications and the pressure gradient between the upper and lower limbs improved remarkably postoperatively. It is rare for a patient over 70 years old who for the first time was given a diagnosis of CoA and ASD with other heart disease and who underwent surgical correction. We think one stage surgery with extra-anatomic bypass from the ascending to the abdominal aorta is a safe and effective technique for patients suffering CoA with heart disease.
ABSTRACT
Objective To investigate the feasibility of application of anterograde tubular ileal fistula in Ⅰ stage anastomosis of colon cancer with acute obstruction. Method Eighty patients of colon cancer with acute obstruction who treated with anterograde tubular ileal fistula in Ⅰ stage anastomosis were analyzed restropectively. Result Clinical observation showed that 80 patients were cured and discharged,no one did occur anastomotic leakage, abdominal abscess,and other serious complications. Conclusion If correctly graspe the timing of operation for colon cancer with acute obstruction,irrigation methods,good perioperative management,select the anterograde tubular ileal fistula, Ⅰ stage resection and anastomosis is safe and feasible.
ABSTRACT
Objective To evaluate the safety and efficacy of self-expanding metallic stents (SEMS) in one-stage surgery for patients with left-sided malignant colorectal obstruction. Methods The clinical data of 97 patients with left-sided colorectal cancer who had been admitted to the First Affiliated Hospital of Zhejiang Chinese Medical University from May 2005 to September 2008 were retrospectively analyzed. Forty-six patients with left-sided malignant colorectal obstruction were in the test group, after the placement of SEMS, they received one-stage resection and anastomosis; 51 patients with left-sided colorectal cancer (without obstruction) were in the control group, and they received one-stage surgery. The defecation and anal exhaust time, hospital stay and incidence of postoperative complications between the 2 groups were analyzed. All data were analyzed via t test or chi-square test. Results One patient in test group had acute diffuse peritonitis which was induced by intestinal perforation at postoperative day 4, and was treated with radical resection for sigmoid cancer. One-stage surgery was successfully performed on 45 patients, and they were discharged at postoperative day 11-16. One patient died of respiratory infection and heart failure at postoperative day 10. All patients were followed up for 4-48 months. There was no significant difference in defecation and anal exhaust time, hospital stay, incidence of perioperative complications, recurrence, metastasis and survival within follow-up interval between the 2 groups (t=0.164, 1.358, χ~2 = 0.252, 1.200, 0.580, P >0.05). Conclusion SEMS is effective and safe in the treatment of left-sided malignant colorectal obstruction.
ABSTRACT
STATEMENT OF PROBLEM: Resonance frequency analysis (RFA) has been increasingly served as a non-invasive and objective method for clinical monitoring of implant stability. Many clinical studies must be required for standardized baseline data using RFA. PURPOSE: This study was performed to evaluate RFA value changes in two stage surgery group and one stage surgery group in patients. MATERIAL AND METHOD: Forty-seven mandibles in consecutively implant installed patients were selected for this study and 141 fixtures were installed. Ninety-three fixtures were double threaded, machined surface design (Bra.nemark. MK III, Nobel Biocare AB, Go teborg, Sweden) and 48 fixtures were root form, threaded, HA-coated surface one (Replace(TM), Steri-Oss/Nobel Biocare AB, USA). Among those, each 10 fixture was installed in one stage group patients. ISQ values were measured using Osstell(TM) (Integration Diagnostics Ltd. Sweden) during fixture installation, at healing abutment connection and in the loading period for two stage surgery group patients and during at each 4, 6, 8, 10, 12 week and in the loading phase for one stage surgery group patients and evaluated the changes according to the time and fixture type. RESULTS: In two stage surgery group, mean and SD of ISQ values of machined surface implants were 76.85 +/- 3.74, 75.76 +/- 5.04, 75.73 +/- 4.41 and those of HA-coated surface implant were 75.05 +/- 6.23, 77.58 +/- 5.23, 78.32 +/- 4.29 during fixtures installation, at healing abutment connection and in the loading period, respectively. In one-stage surgery group, the ISQ values of machined surface and HA-coated surface implants decreased until 4 or 6 week and maintained at plateau for 1-3 week and increased to the loading period. CONCLUSIONS: Machined and HA-coated surface implants showed minimal ISQ changes with time if they were installed at the sites showing at least intact cortical plate and good bone qualities. And HA-coated implants had a tendency to show somewhat increased ISQ values with time.