共查询到20条相似文献,搜索用时 31 毫秒
1.
Hand-assisted laparoscopic splenectomy for hydatid cyst 总被引:1,自引:1,他引:0
K. E. W. Ballaux J. M. Himpens G. Leman M. R. P. Van den Bossche 《Surgical endoscopy》1997,11(9):942-943
Splenic hydatidosis is a rare condition. We performed a hand-assisted laparoscopic splenectomy for a large hydatid cyst localized
in the center of the spleen. We discuss the advantages of the ``helping hand.'
Received: 27 September 1996/Accepted: 19 November 1996 相似文献
2.
This paper addresses gastric herniation following laparoscopic fundoplication for reflux esophagitis. Case history: A 46-year-old
woman underwent Nissen fundoplication. Two days postoperatively she developed gastric herniation and perforation with subsequent
pleural effusion and necrotizing fasciitis of the chest wall. A patent crural repair might reduce the occurrence of paraoesophageal
herniation.
Received: 12 April 1996/Accepted: 26 November 1996 相似文献
3.
M. R. P. Van Den Bossche G. Leman K. E. W. Ballaux J. Himpens 《Surgical endoscopy》1999,13(2):166-167
Pulmonary hernias are extremely rare. They are usually treated with open surgical procedures. We describe a case in which
a large, spontaneously acquired intercostal pulmonary hernia was successfully repaired by video-assisted thoracoscopic surgery
(VATS).
Received: 12 August 1996/Accepted: 26 November 1996 相似文献
4.
Conversions and complications in 185 laparoscopic adjustable silicone gastric banding cases 总被引:9,自引:3,他引:6
E. Chelala G. B. Cadiére F. Favretti J. Himpens M. Vertruyen J. Bruyns L. Maroquin M. Lise 《Surgical endoscopy》1997,11(3):268-271
Background: Kuzmak's gastric silicone banding technique is the least invasive operation for morbid obesity. The purpose of this study
was to analyze the complications of this approach.
Methods: Between September 1992 and March 1996, 185 patients underwent laparoscopic gastroplasty by the adjustable silicone band technique.
A minimally invasive procedure using five trocars was performed.
Results: In 11 patients exposure of the hiatus was impeded because of hypertrophy of the left liver lobe which led to conversion in
eight patients and abortion of the procedure in three other patients. Anatomical complications: We observed two gastric perforations
and one band slippage at the early stage, one infection and three rotations of the access port. Functional complications:
There were eight (4%) cases of irreversible total food intolerance resulting in pouch dilation and eight cases (4%) of esophagitis.
One fatality on the 45th day in a patient with a Prader-Willi syndrome.
Conclusion: The most disturbing complications of gastric banding technique are gastric perforation and pouch dilation. Their incidence
may be reduced by improving the technique and by considering pitfalls of the procedure.
Received: 28 May 1996/Accepted: 25 July 1996 相似文献
5.
Familial hypocalciuric hypercalcemia (FHH) is often considered in the differential diagnosis of hyperparathyroidism, but
is rarely diagnosed. So far, FHH has not been documented in Israel. This report presents preliminary evidence for the occurrence
of FHH in Israel.
Received: 11 June 1996 / Accepted: 31 December 1996 相似文献
6.
P. R. Schauer W. H. Schwesinger C. P. Page R. M. Stewart B. A. Levine K. R. Sirinek 《Surgical endoscopy》1997,11(1):8-11
Background: This study examines the notion that gastrointestinal endoscopy performed by supervised surgical residents is safe.
Methods: We reviewed all gastrointestinal endoscopic procedures performed by surgical residents with faculty supervision for complications
and deaths occurring up to 30 days following the procedures.
Results: The overall complication rate for 9,201 upper and lower endoscopy procedures was 1.4% and 0.42%, respectively. Overall mortality
rate was 0.76% for upper endoscopy and 0.6% for lower endoscopy. No mortality was a direct result of a procedure-related complication.
Intestinal perforation, drug overdose, bleeding, and aspiration were the most common procedure-related complications. Each
resident completed an average of 75 upper endoscopies and 79 lower endoscopies during their training period.
Conclusions: Gastrointestinal endoscopy can be performed safely by surgical residents with appropriate supervision. The higher morbidity
and mortality of upper endoscopy are most likely related to the underlying disease rather than the procedure. Awareness of
common complications and application of appropriate precautions and instruction are critical for minimizing complications.
Received 25 March 1996/Accepted: 24 April 1996 相似文献
7.
R. M. M. Seibel 《Surgical endoscopy》1997,11(2):154-162
From its beginning surgical tomography developed rapidly. The possibility to identify every structure inside the body and
to guide instruments with monitoring of tissue changes increase safety. Different therapies have been performed under CT and
MRI guidance and evaluated in studies, like biopsies, tumor pain therapy and treatments of tumors as well as treatments of
the spine. The results show that surgical tomography is an accurate guiding technique. Especially in combination with micro
endoscopy offers a new way of surgery. The complication rate as well as the frequency of side effects is very low.
Received: 9 September 1996/Accepted: 15 November 1996 相似文献
8.
K. Nakajima M. Fukuzawa M. Minami Y. Fujii Y. Fukui N. Usui Y. Komoto M. Takashina A. Okada 《Surgical endoscopy》1998,12(1):54-56
This report describes a case of anterior mediastinal teratoma in a 10-year-old girl, which was successfully resected thoracoscopically.
Received: 4 October 1996/Accepted: 23 January 1997 相似文献
9.
Lobectomy with extended lymph node dissection by video-assisted thoracic surgery for lung cancer 总被引:5,自引:0,他引:5
Background: Between September 1992 and September 1996, we performed 88 VATS (video-assisted thoracic surgery) lobectomies and two VATS
pneumonectomies.
Methods: The indications for surgery were 68 cases of lung cancer, nine cases of bronchiectasis, six cases of tuberculosis, and seven
cases of benign lesions. Of the 68 cases of lung cancer, 36 were treated by VATS lobectomy with extended lymph node dissection
for clinical stage I lung cancer, making full use of recently developed devices for thoracoscopic surgery, such as roticulating
endoscissors, miniretractors, endoclips, and harmonic scalpels.
Results: Twenty-four lymph nodes were resected on average (range, 10 to 51) by VATS. This number was comparable to lymph nodes resected
in open thoracotomy during the same period. Among the 36 patients who underwent extended lymph node dissection, 20 showed
no lymph node metastasis postoperatively (stage I), while 16 had N1 or N2 cancer. All patients with stage I cancer have survived
4 to 36 months (median: 17 months) with no signs of recurrence.
Conclusions: This survival of stage I lung cancer after VATS is comparable to that of open thoracotomy. We thus believe that VATS lobectomy
with extended lymph node dissection can be an alternative to standard posterolateral thoracotomy for stage I lung cancer.
Received: 10 May 1996/Accepted: 19 November 1996 相似文献
10.
First trimester of pregnancy laparoscopic procedures 总被引:3,自引:3,他引:0
Laparoscopic procedures are being performed during pregnancy with increasing frequency; however, few first-trimester operations
have been published. Two first-trimester procedures are here reported, both performed with uneventful recoveries.
Received: 25 March 1996/Accepted: 24 January 1997 相似文献
11.
As the immunocompromised patient population grows, the gastrointestinal surgeon is increasingly called upon to make complex
diagnostic and therapeutic decisions. The surgeon should first identify the patient as immunocompromised and then categorize
the probable degree of immunocompromise as mild, moderate, or severe. Mildly immunocompromised patients tend to present late
and with minimal symptoms, but the disease entities are the same ones seen in the general population. Moderately and severely
immunocompromised patients may also develop the usual surgical problems, but the differential diagnosis is expanded to include
complications of the immunocompromised state or complications of the underlying problem which caused the immune compromise.
The expanded differential diagnosis includes infections with atypical organisms, opportunistic neoplasms, neutropenic enterocolitis,
complications of medications, and forms of biliary tract disease not seen in the general population. Advances in oncology,
transplantation, and the treatment of AIDS, have extended the life expectancy of these patients and increased the immunocompromised
population. Prompt appropriate operative therapy may be lifesaving when surgical complications develop.
Received: 11 April 1996/Accepted: 1 May 1996 相似文献
12.
Laparoscopic fundoplication in infants and children 总被引:2,自引:0,他引:2
Background: Laparoscopic fundoplication is a new method for treating gastroesophageal reflux in children. We present 160 children with
gastroesophageal reflux treated by laparoscopic fundoplication.
Methods: Patients underwent either a laparoscopic Nissen or Toupet fundoplication. Many patients also required gastrostomies and gastric
outlet procedures.
Results: Twelve patients (7.5%) were converted to open fundoplication. Laparoscopic gastrostomies were placed in 112 patients (75.7%)
and laparoscopic gastric outlet procedures in 62 patients (41.9%). Feedings were initiated by postoperative day 2 in 126 children
(85.7%). Sixty-four percent were discharged by postoperative day 3. Complications occurred in 11 of 148 fundoplications (7.4%),
in nine of 112 gastrostomies (8.0%), and in three of 62 gastric outlet procedures (4.8%). One patient died as a result of
a surgical error in placing a gastrostomy (0.7%).
Conclusion: Laparoscopic fundoplication appears to foster a more rapid recovery and decreased hospital stay while maintaining complication
rates similar to or better than open fundoplication.
Received: 22 March 1996/Accepted: 12 June 1996 相似文献
13.
Prosthetic reinforcement of posterior cruroplasty during laparoscopic hiatal herniorrhaphy 总被引:3,自引:2,他引:1
Symptomatic gastroesophageal reflux after Nissen fundoplication may occur if the wrap herniates into the thorax. In an attempt
to prevent recurrent hiatal hernia we employed polytetrafluoroethylene (PTFE) mesh reinforcement of posterior cruroplasty
during laparoscopic Nissen fundoplication and hiatal herniorrhaphy. Three patients with symptomatic gastroesophageal reflux
and a large (≥8 cm) hiatal defect underwent laparoscopic posterior cruroplasty and Nissen fundoplication. The cruroplasty
was reinforced with a PTFE onlay. No perioperative complications occurred, and in follow-up (≤11 months) the patients are
doing well. When repairing a large defect of the esophageal hiatus during fundoplication, the surgeon may consider reinforcement
of the repair with PTFE mesh.
Received: 5 March 1996/Accepted: 3 June 1996 相似文献
14.
The tich mutation leads to the abnormal development of bones in mice such that a `V-shaped' tongue of noncalcified cartilage
appears in the central portion of the proximal tibial growth plate. In this study, alcian green staining of cartilage glycosaminoglycans
was used to demonstrate the pattern of limb development in embryos of stage-matched tich and normal, co-isogenic, A.TL mice
from the earliest stages in skeletogenesis. The growth plates of normal A.TL siblings were symmetrical across the limb rudiment
whereas the growth plate in tich siblings show the beginnings of a V-shaped tongue of cartilage reaching towards the diaphysis.
This showed first at E16.5. It was apparent that the crown rump distance, tibia, ulna, and the length of calcified cartilage
in tich were significantly shorter than A.TL. These results confirmed that calcification was not the primary defect in tich
but point to a temporal dysfunction in growth factor expression (possibly bone morphogenetic proteins) that stems from early
limb bud formation and translates through later stages in development.
Received: 30 May 1996 / Accepted: 24 September 1996 相似文献
15.
G. R. Soybir F. Köksoy C. Polat A. Özşeker O. Yalçln Y. Aker C. Topuzlu 《Surgical endoscopy》1997,11(7):711-713
Background: The effects of gallstones and sterile or infected bile on postoperative adhesions and abscess formation were investigated
in Sprague Dawley rats.
Methods: The first three groups were injected intraperitoneally with serum saline, sterile bile, or infected bile, respectively. Laparotomy
was adjusted to the next seven groups. Serum saline, sterile bile, and infected bile were injected in the fourth through sixth
groups intraperitoneally, respectively. Gallstones were placed intraabdominally to the seventh through ninth groups. The injections
of sterile bile in group 7 and of infected bile in group 8 were added to laparotomies. Only laparotomy was carried out in
group 10.
Results: Abscess formations were seen only in infected-bile-injected groups. Significant adhesion formations were seen in infected-bile
groups. Sterile bile and/or gallstones had no significant effect in abscess or adhesion formation.
Conclusions: Results suggest that noninfected gallstones and sterile bile, even in combination, do not increase postoperative intraabdominal
complications in rats.
Received: 29 March 1996/Accepted: 26 August 1996 相似文献
16.
We have developed a new device which enables rapid sealing of a minilaparotomy during laparoscopic assisted surgery to recreate
an airtight condition. This device consists of a center rod and two discs (7 cm in diameter) which form an airtight condition
by compressing the inner and outer surfaces of the abdominal wall. Advanced laparoscopic procedures requiring both pneumoperitoneum
and minilaparotomy are facilitated with the use of this device. This new device is called the Sandwich-disc: Takasago Medical
Industry Co., Ltd.
Received: 11 January 1996/Accepted: 22 March 1996 相似文献
17.
D. Collet 《Surgical endoscopy》1997,11(1):56-63
Background: In 1996, laparoscopic cholecystectomy is the gold standard for symptomatic cholelithiasis. The results of this operation
as published so far include data on the learning curve of the method. The aim of this study is to evaluate the results of
laparoscopic cholecystectomy when performed by a large number of surgeons during the year 1994, not taking into account the
beginning years in which the technique was being used.
Methods: This study has been carried out prospectively and anonymously among members of SFCERO. All the patients who underwent a cholecystectomy
started laparoscopically during 1994 have been included.
Results: Some 4,624 cholecystectomies were performed by 150 surgeons. There were 3,310 females (42.5 ± 19.8 years old) and 1,314 males
(56.3 ± 1.61 years old). The conversion rate was 6.9%: 320 operations had to be converted into laparotomy (group II) while
4,261 were performed entirely by laparoscopy (group I). Morbidity was 5% (N= 230)—4.7% in group I (N= 203) and 8.4% in group II (N= 27). Mortality was 0.2% (N= 9)—namely four intraabdominal complications (three cases of peritonitis and one biliary reoperation), two cardiac failures,
and one brain infarction. The causes of death were not specified in two patients.
Conclusions: These results show that morbidity and mortality have not changed dramatically since the beginnings of this technique, whereas
the frequency of common bile duct (CBD) injuries has decreased. However, the conversion rate has increased slightly. These
results make it possible to calculate the risk of conversion and postoperative complication according to the age of the patient
and the biliary symptoms.
Received: 25 January 1996/Accepted: 10 April 1996 相似文献
18.
T. Otani T. Kaji T. Fukasawa T. Osawa F. Seki T. Yokoyama Y. Kawamura M. Makuuchi 《Surgical endoscopy》1998,12(2):179-180
A simple flower-shaped cannula, in which up to three laparoscopic instruments can be inserted and manipulated freely, is
described. Using this cannula, a three-incision gasless laparoscopic cholecystectomy can be performed easily.
Received: 5 July 1996/Accepted: 12 September 1996 相似文献
19.
Preemptive analgesia in the laparoscopic patient 总被引:1,自引:0,他引:1
Background: One hundred consecutive laparoscopic patients were prospectively followed in the Post-anesthesia Recovery Unit (PAR) in a
community hospital.
Methods: Data was collected regarding (1) intraoperative administration of ketorolac, (2) instillation of local anesthesia into the
wound, and (3) requirements for analgesic administration in the PAR. Those patients receiving both forms of preemptive analgesia
required less narcotic administration in the PAR. The results were highly significant.
Results: Based on these data and the observance of markedly reduced pain in patients during the early postoperative period, an institutional
plan of care was developed which has resulted in the virtual elimination of the need to administer narcotics to patients undergoing
routine laparoscopic surgical procedures.
Conclusions: The resultant plan of care, which includes preemptive analgesia, rapid ambulation, early feeding, and routine timed administration
of non-narcotic pain medications, is presented. Data is also presented which demonstrates a more rapid discharge of patients
from the hospital.
Received: 5 April 1996/Accepted 2 November 1996 相似文献
20.
Laparoscopic liver surgery 总被引:7,自引:0,他引:7
Background: An effort was made to evaluate the indications, safety, and therapeutic efficacy of laparoscopic liver surgery.
Methods: Between 1989 and 1996, 28 patients, 23 to 88 years old were operated upon laparoscopically. Pathology consisted of simple
cyst (ten), polycystic liver disease (seven), hydatid cyst (three, two of them calcified), abscess (one), focal nodular hyperplasia
(six), and metastatic breast cancer (one).
Results: Operations included 17 fenestrations, three pericystectomies, and eight resections (two lateral lobes). Operative time was
45 to 525 min with only four cases longer than 4 h. There was a 21% morbidity rate. There were no mortalities. Follow-up was
1–67 months with one asymptomatic recurrence.
Conclusions: Laparoscopic hepatic surgery can be performed safely with good results by surgeons with hepatic and laparoscopic experience
when careful selection criteria are followed. We advocate the ``four-hands technique' for simultaneous dissection and control
of bleeding and bile ducts during resections.
Received: 10 May 1996/Accepted: 26 July 1996 相似文献