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排序方式: 共有10000条查询结果,搜索用时 531 毫秒
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Yutaka Senga Seiichiro Ozono Hayakazu Nakazawa Satoshi Nagamori Ken Marumo Shigeo Horie Tetsuro Onishi Noriomi Miyao Masahiro Nakao Tatsuo Igarashi Tomoyasu Tsushima Michihiko Hasegawa Masaru Murai the Japanese Society of Renal Cancer 《International journal of urology》2007,14(4):284-288
OBJECTIVE: A joint study was undertaken by the Japanese Society of Renal Cancer to investigate the present status of partial nephrectomy in Japan and to speculate about what may be the indications for partial nephrectomy in patients with renal cell carcinoma. METHODS: Data were tabulated for 469 patients from participating medical institutions and various clinical factors were investigated with regard to disease progression (local recurrence and distant metastasis). RESULTS: Disease progression was observed in 21 patients (4.5%). No significant relation to disease progression was observed for sex, laterality, tumor histology, grade and tumor size. Although patients with solitary tumors displayed excellent prognosis irrespective of tumor diameter, patients with multiple tumors displayed a high likelihood of disease progression. Patients older than 77 years old and patients with imperative indication were found to have a poorer prognosis. CONCLUSION: In patients with solitary tumors, partial nephrectomy can be actively performed, even if the patient displays elective indications and the tumor is >4 cm in diameter. In patients displaying multiple tumors with imperative indications, the decision whether to perform partial nephrectomy should be made by the patients and their physicians after considering the impact on curability and the quality of life. 相似文献
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The authors present the case of a 43-year-old women who underwent a laparoscopic gastric bypass in 2003 for morbid obesity.
They report that 2 years later, she had maintained significant weight loss, but had developed acute abdominal pain, followed
by nausea and emesis. In the emergency room, she had diffuse tenderness, tachycardia, and leukocytosis. After initial resuscitation,
a computed tomography was performed, which showed free air above the liver and thickened small bowel loops. She was brought
emergently to the operating room for laparoscopy. At surgery, turbid fluid and inflamed small bowel loops were seen. A perforated
marginal ulcer was discovered in the Roux limb, approximately 2 cm distal to the gastrojejunal anastomosis. The perforation
was oversewn primarily and patched with omentum. The repair was tested by intraoperative endoscopy. A gastrostomy tube also
was placed within the gastric remnant for enteral access. The patient did extremely well postoperatively, and had an uneventful
postoperative course. She was discharged on postoperative day 4. The gastrostomy tube was removed at 1 month, and at this
writing, she remains well since surgery. An upper endoscopy at 2 months was completely normal, and the Helicobacter pylori test results were negative. The gastric pouch had not significantly enlarged since initial surgery, as indicated by both
endoscopy and barium study. Marginal ulcer is reported to be 0.6% to 16% after laparoscopic gastric bypass [1]. Etiologies include gastrogastric fistula, excessively large gastric pouch containing antral mucosa, H. pylori infection, nonsteroidal antiinflammatory use, and smoking [2]. Unfortunately, none of these applied to the reported patient. Because her exact etiology remains unknown, she at this writing
continues to receive proton pump inhibitor therapy.
Electronic supplementary material The online version of this article (doi: ) contains supplementary material, which is available to authorized users. 相似文献
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Pawan Kumar Dhruva Rao Deborah Clements Michael M. Davies Jared Torkington 《Surgical endoscopy》2007,21(6):1036
We present our comments on the above article. 相似文献
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