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Article in Chinese | WPRIM | ID: wpr-908430


Abdominal rectus diastasis is common in postpartum women and obese people, with clinical manifestations of midline abdominal bulge and lower back pain. Severe cases may affect the function of abdominal wall muscle groups, which cause a series of physiological dysfunction. There are few studies on the diagnosis and optimal management of abdominal rectus diastasis, especially on its surgical indications, and no uniform conclusion is achieved. The authors comprehensively analyze the research progress at home and abroad, exploring the etiology, diagnosis, treatment options and surgical indications of abdominal rectus diastasis, in order to provide references for clinical practice.

Article in Chinese | WPRIM | ID: wpr-816286


OBJECTIVE: To retrospectively analyze and compare the clinical effects of transvaginal cervical cerclage during pregnancy with different surgical indications.METHODS: A total of 39 patients who underwent transvaginal cervical cerclage during pregnancy in the Gynaecology and Obstetrics Department of the First Affiliated Hospital of Gannan Medical University from July 2012 to June 2018 were enrolled.The patients were grouped according to the indications of surgery:those with the history of late abortion or preterm labor being the indication of surgery were the indication of the history of the cerclage group(group H,20),and those with the length of the cervix being shortened or the shape of the cervix being changed in vaginal ultrasound indication cerclage group(group U,20).The patients whose hysical examination revealed dilated cervix with or without amniocentesis were included as emergency cerclage group(group E,7).The clinical effects of vaginal cervical cerclage during pregnancy were compared among the 3 groups.RESULTS: The gestational week of cerclage in the H group[(15.64 ± 2.96)w] was shorter than that in the U group[(22.04±5.01)w]and the E group[(22.08±2.96)w],and the difference was statistically significant(P0.05).The extended days[(29.43±47.24)d],gestational age of delivery[(26.39±6.52)w],full-term birth rate(14.29%)and live birth rate(28.57%)in group E were all lower than those in group H[(136.45±53.70)d,(35.60±7.07)w,69.57%,86.36%]and group U[(103.40±36.15)d,(36.81±3.45)w,70.00%,100.00% ],with statistically significant differences(P0.05).The abortion rate(71.42%)in group E was higher than that in group H(13.04%)and group U(00.00%)(P0.05).There was no significant difference in preterm birth rate among the three groups(P>0.05).CONCLUSION: Cervical cerclage with three different surgical indications can effectively improve the pregnancy outcome of patients with cervical insufficiency.The pregnancy outcomes are similar between the indication of the history of the cerclage and the vaginal ultrasound indication cerclage,but better than the emergency cerclage.

Article in Chinese | WPRIM | ID: wpr-608210


Gallbladder carcinoma is the most common malignancy in biliary tract.Early dissemination,rapid and silent progression and delayed diagnose could portend a dismal prognosis.The 5-year survival rate is less than 10%.Clarifying the etiological feature can improve the early diagnosis.Comprehending surgical indications of benign lesions can provide the methods for rational prophylactic resections.Standardized treatment of accident gallbladder carcinoma could improve the patients' prognosis.Efficient serologic markers could be used for early diagnosis and screening.

Rev. cuba. cir ; 55(4): 312-324, oct.-dic. 2016. ilus
Article in Spanish | LILACS | ID: biblio-844831


Introducción: la cirugía es el tratamiento de elección para los divertículos de Zenker, pero existen diferencias en relación con el acceso a utilizar: abierto o endoscópico. Objetivo: comparar los resultados del tratamiento quirúrico del divertículo de Zenker de acuerdo con el acceso utilizado. Métodos: se realizó una revisión bibliográfica en PubMed/Medline con las palabras: divertículo, Zenker, faringoesofágico, cricofaríngeo, diverticulectomía, diverticulopexia, diverticulotomía, diverticulostomía publicados entre 2006 y 2016. Se incluyeron estudios con más de 40 casos, comparativos o no, en los idiomas inglés, español, portugués, francés e italiano. Las variables estudiadas fueron: indicaciones quirúrgicas, recidiva del divertículo, tiempo quirúrgico, tiempo para la alimentación oral, estadía hospitalaria, reoperaciones, complicaciones, mejoría de los síntomas y mortalidad. Resultados: no se encontraron ensayos aleatrorizados. Se incluyeron cuatro revisiones sistemáticas y un metanálisis, además de un grupo de estudios que comparan los accesos peroral y transcervical y otros que comparan los resultados entre diferentes técnicas de los accesos endoscópico y convencional. La mayoría de los estudios son de carácter retrospectivo.Para evaluar los resultados a largo plazo se tomaron los artículos con seguimiento mayor de 12 meses. Conclusiones: con el acceso abierto se logran mejores resultados a largo plazo, pero tiene más complicaciones inmediatas. Es preferible usarlo en pacientes jóvenes y cuando existen condiciones anatómicas desfavorables para la endoscopia. El tratamiento endoscópico constituye una opción adecuada para pacientes de alto riesgo quirúrgico y anestésico(AU)

Introduction: Surgery is the treatment of choice in Zenker´s diverticula, but there are different opinions about the access to be used, that is, open or endoscopic. Objective: To compare the results of the surgical treatment results of Zenker´s diverticulum according to the access employed. Methods: A literature review was made in PubMed/Medline using the keywords: diverticulum, Zenker, pharyngoesophageal, crycopharyngeal, diverticulectomy, diverticulopexy, diverticulotomy, diverticulostomy in articles published from 2006 to 2016. There were included several studies of more than 40 cases, either comparative or not in English, Spanish, French, Italian and Portuguese languages. The studied variables were surgical indications, recurrence, surgical time, length of time for oral feeding, hospital stay, reoperations, complications, symptoms improvement and mortality. Results: Randomized studies were not found. Four systematic reviews, one meta-analysis, comparative studies on perioral and transcervical access and others which compare the results of the endoscopic and of the conventional access were all included. Most of them were retrospective. For evaluation of long-term results, those articles with follow-up periods over 12 months were taken. Conclusions: The open access provides better long-term results, but it has more immediate complications. It is advisable to use it in young patients and when anatomic conditions are unfavorable for the endoscopic treatment. Finally, the endoscopic treatment is an adequate choice for patients with high surgical and anesthetic risk(AU)

Humans , Female , Aged, 80 and over , Endoscopes, Gastrointestinal/adverse effects , Review Literature as Topic , Zenker Diverticulum/surgery
Clinical Medicine of China ; (12): 478-480, 2016.
Article in Chinese | WPRIM | ID: wpr-497868


Objective Due to the anatomy of the scapula itself is exceptional,fracture is often associated with other damage.So it is particularly important to evaluate the patients,physical examination,as well as the choice of surgical approach during perioperative period.By studing of the relevant literatures,this article reviewed the anatomy and classification of the shoulder blades,patient assessment,surgical indications and approaches,as well as the functional exercise.

Article in Chinese | WPRIM | ID: wpr-489797


Liver metastasis is the leading cause of death from colorectal cancer (CRC).Multidisciplinary team model has become standard strategy for the diagnosis and treatment of colorectal liver metastases (CRLM),making individualized treatment through precise staging and molecular typing.Preoperative hepatic and regional arterial infusion chemotherapy and portal vein chemotherapy during surgery can reduce the incidence of liver metastases for stage Ⅲ CRC.Surgical resection of CRLM has been accepted by all scholars,and can be performed by minimally invasive surgery.The criteria for hepatic resection of CRLM have been extended including complete tumor resection,negative resection margin and adequate remnant liver volume.Simultaneous resections of primary tumor and liver metastases are safe and feasible.However,neoadjuvant chemotherapy is still controversial.For unresectable liver metastases,conversion therapy should be implemented to make the liver metastases become resectable.For unconvertible and unresectable CRLM,aggressive and comprehensive treatment is required to control the disease progression.

Article in Japanese | WPRIM | ID: wpr-376109


A 75-year old woman in whom a left ventricular tumor had been detected by echocardiography 2 years before referral to our hospital, presented with blurry vison for one month. Acute cerebral infarction was diagnosed. We suspected that the infarction was occurred by an embolus from the intraventricular tumor, and resected it through left atrial incision. The resected tumor was 10 mm in size and it resembled a sea anemone. The tumor was pathologically diagnosed as papillary fibroelastoma. The postoperative course was good, with no recurrence for the last 18 months.

Article in Chinese | WPRIM | ID: wpr-429792


Severe acute biliary pancreatitis can be treated by nonsurgical and surgical approaches,and choice of the surgical techniques as well as its timing are the keys points to the whole therapy.Early enteral nutrition via placing nasointestinal feeding tube plays an important role in the nutritional support for patients with severe acute pancreatitis.This paper intends to explore the experience in standardizing the therapy for all similar cases via reviewing and summarizing the treating process of a typical patient with severe acute biliary pancreatitis.