[Clinical Features and Surgical Outcomes of 15 Cases of Intracranial Alveolar Echinococcosis]. / 15ä¾‹é¢ å† æ³¡åž‹æ£˜çƒèš´ç— çš„ä¸´åºŠç‰¹ç‚¹åŠæ‰‹æœ¯ç–—æ•ˆåˆ†æž.

Objective: To investigate the surgical treatment strategy of intracranial alveolar echinococcosis (AE) and the clinical outcomes. Methods: The clinical and follow-up data of 15 intracranial AE patients who underwent surgical treatment in the Departments of Neurosurgery of Sichuan Provincial People's Hospital (SPPH) and People's Hospital of Aba Tibetan and Qiang Autonomous Prefecture (a branch hospital of SPPH) between March 2017 and January 2021 were retrospectively analyzed. Full follow-up data were available for each of the 15 cases. The clinical and imaging characteristics, general surgical information, and surgical outcomes were analyzed. Results: In the 15 patients, there were a total of 50 intracranial lesions, with an average of (3.3±3.1)/case. Four cases had solitary intracranial lesions, while 11 cases had multiple lesions, with the number of intracranial lesions per case ranging from 2 to 13. All patients with solitary intracranial lesions received total resection. In 6 patients with multiple intracranial lesions, only the largest lesion was surgically removed, and in 5 patients, 2 to 3 adjacent lesions were surgically removed. All but one patient had extracranial lesions in their liver, lungs, kidneys, adrenal glands, and thoracic vertebrae. The patients were followed up for 12 to 58 months after surgery, with the mean follow-up time being (28.1±13.4) months. Among the 15 cases, 13 showed stable intracranial condition during postoperative follow-up. Intracranial lesions recurred in 2 patients who had deep lesions accompanied by dissemination to the subarachnoid space. Two patients died during follow-up. Conclusion: Microsurgical treatment of intracranial AE is effective, but total surgical resection is difficult to accomplish when patients have echinococcosis lesions located at a depth, especially when the lesions are spreading to the subarachnoid space. The prognosis of patients is closely associated with the extent of lesion invasion and the control of systemic hydatid lesions, especially those in the liver.

Totally laparoscopic Billroth II gastrectomy with a novel, safe, simple, and time-saving anastomosis by only stapling devices.

BACKGROUND: Totally laparoscopic gastrectomy represents the evolution of laparoscopy-assisted gastrectomy. Most surgeons prefer laparoscopy-assisted gastrectomy rather than totally laparoscopic procedures because of technical difficulties of intracorporeal anastomosis. We created one novel stapling anastomosis without hand-sewn technique in totally laparoscopic Billroth II gastrectomy. The feasibility and early surgical outcomes of totally laparoscopic Billroth II gastrectomy with stapling anastomosis and with hand-sewn anastomosis were introduced in this study. METHODS: We retrospectively analyzed early surgical outcomes in 70 patients who underwent totally laparoscopic Billroth II distal gastrectomy for gastric cancer between January 2010 and July 2011. The patients were divided into hand-sewn and device groups according to whether intracorporeal anastomosis was performed by only hand-sewn technique (n = 36) or only stapling devices (n = 34). In the device group, the gastrojejunostomy was performed using a circular stapler, and an additional side-to-side jejunojejunostomy was made at the site of jejunal enterotomy. RESULTS: There was no difference in the mean number of lymph nodes retrieved in both groups. The blood loss (hand-sewn group 205.8 ± 37.4 vs. device group 201.2 ± 51.2 ml, p > 0.05) and hospital stay (hand-sewn group 6.5 ± 3.7 vs. device group 5.9 ± 4.1 days, p > 0.05) were similar in both groups. We found that intracorporeal anastomosis by totally stapling devices was associated with decreased operative time (hand-sewn group 239.0 ± 40.1 vs. device group 203.6 ± 27.9 min, p < 0.05). CONCLUSION: We suggest that intracorporeal anastomosis using only stapling devices in the described method was as safe and feasible as by hand-sewn technique. Moreover, it is a simple and time-saving method without any difficult hand-sewn procedures.