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51.
52.
游离空肠移植重建下咽颈段食管临床观察 总被引:1,自引:0,他引:1
目的:探讨游离空肠移植重建下咽颈段食管的可行性、技术操作方法及疗效。方法:回顾性分析采用游离空肠重建下咽颈段食管11例,其中喉癌术后复发1例,颈段食管癌2例,下咽癌8例。术中切除喉、下咽、颈段食管及部分颈段气管1例,切除喉、下咽及颈段食管8例,保留喉切除颈段食管2例。所有病例均给予颈淋巴清扫。术后放射治疗3例,剂量50~55Gy。结果:术后除1例移植肠管坏死改用前臂游离桡侧皮瓣卷成皮管移植重建外,其余10例均成活,成功率为90.9%。肠管成活病例中无咽瘘、感染等并发症发生,随访3~27个月,喉癌术后复发患者1例术后2个月肿瘤再发,出现吞咽梗阻。结论:游离空肠移植重建下咽颈段食管手术成功率高,恢复消化道的连续性安全可靠,内侧为黏膜的空肠瓣是下咽颈段食管极好的修复材料。 相似文献
53.
M. J. Englesbe S. J. Pelletier S. Kheterpal M. O'Reilly D. A. Campbell Jr. 《American journal of transplantation》2006,6(4):666-670
The severity of illness in transplant patients and the complexity of transplant operations results in significant postoperative morbidity and mortality. Remarkable efforts have been made by transplant physicians to study and improve organ allocation, graft and patient survival, immunosuppression and the long-term management of post-transplant complications. Less effort has been spent studying the actual transplant operation and systems of acute transplant care. The National Surgical Quality Improvement Program (NSQIP) has provided a standardized approach to quality improvement and has demonstrated significant potential for a reduction in postoperative morbidity and mortality in other surgical disciplines. Medical centers are under increasing pressure to measure surgical quality and the nexus of transplant surgical quality improvement should not lie in the hands of CMS or JACHO, but rather it should be created and developed within the transplant community. The time has come for a national transplant surgical quality improvement program based on the NSQIP infrastructure. Such a proactive approach toward quality improvement from the transplant community is an excellent investment for patients, providers and health care payers. 相似文献
54.
C. TASKIRAN K. YUCE P.O. GEYIK† T. KUCUKALI‡ & A. AYHAN 《International journal of gynecological cancer》2006,16(3):1342-1347
The purpose of this study was to predict lymphatic involvement in endometrial cancer using clinicopathologic variables of patients treated with surgical staging. Overall, 461 patients treated with an initial surgical staging procedure including complete pelvic-para-aortic lymphadenectomy were included. The mean number of resected lymph nodes was 27 (median 26; range 15-83), and 54 patients (12%) had lymphatic involvement. Of these patients, 32 had only pelvic, 15 had both pelvic and para-aortic, and 7 had isolated para-aortic metastases. In the multivariate analysis, deep myometrial invasion (P= 0.02), lymphvascular space invasion (P= 0.001), positive peritoneal cytology (P= 0.002), and cervical involvement (P= 0.003) predicted retroperitoneal lymph node metastasis (RLN) significantly. Two hundred seventy-four patients (59.4%) had at least one of these poor prognostic factors identified by multivariate analysis. In this patient population, 53 (19.3%) had lymphatic involvement compared to 1 patient in the group of 187 patients with low-risk criteria. Ninety-eight percent of patients with RLN were predicted by this model, and with the advent of accurate diagnostic techniques, 40% of patients could be saved from undergoing lymphadenectomy. 相似文献
55.
目的:对采用头皮冠状切口所引发的并发症进行分析,探讨防治策略。方法:对我科2003-01~2006—07应用头皮冠状切口行颅颌面骨折修复重建、颌面部肿瘤切除与缺损修复、先天性颅颌面畸形矫正的221例中发生并发症的40例进行分析总结。结果:18例出现头皮麻木及感觉异常,9例有较宽切口瘢痕,6例出现脱发,4例发生颞窝凹陷,2例发生头皮下血肿,2例出现单侧面神经颞支损伤,1例发生鼻眶区肥厚。结论:头皮冠状切口具有切口隐蔽、面部疤痕不明显,显露充分的优点,但对其并发症也不容忽视。应根据具体情况选择合适的切口类型,术中精细的解剖、神经血管的良好保护以及正确的缝合方法可减少并发症的发生。 相似文献
56.
57.
陈春民 《山西医科大学学报》2002,33(Z1):37-38
目的探讨胆道梗阻性重症胰腺炎合理治疗方案.方法分析29例胆道梗阻性重症胰腺炎的临床治疗.结果治疗效果满意.结论对胆道梗阻性重症胰腺炎宜早期手术.手术方法应简单易行,确保充分引流及解除胆道梗阻.如何避免坏死的胰腺组织继发感染是问题关键,保护胰腺被膜完整性是避免胰腺继发感染的重要措施之一. 相似文献
58.
本文报告113例脑前循环系统动脉管其中包括颈内动脉后交通动脉瘤75例.前交通动脉瘤17例,大脑中动脉瘤10例,人脑前动脉-胼周动脉瘤3例,颈内动脉-眼动脉瘤2例,颈内动脉海绵窦段动脉瘤1例.多发动脉瘤5例.共118个动脉瘤在显微镜下直视手术,动脉瘤直接夹闭术108例.孤立或包裹术5例:5例多发动脉瘤行同期手术3例,分期手术2例.术中发生动脉瘤破裂18次.Hunt和HessⅠ~Ⅱ级病人中有例行早期手术.全组术后死亡率为7.9%.着重讨论手术时机.术中动脉瘤破裂处理及多发动脉瘤的治疗. 相似文献
59.
J. Carleson P. Kogner I. Bileviciute E. Theodorsson A. Appelgren B. Appelgren S. Kopp N. Yousef T. Lundeberg 《Archives of oral biology》1997,42(12):869-876
Temporomandibular joint (TMJ) arthritis was induced in female Lewis rats by unilateral injection of a suspension of heat-killed Mycobacterium butyricum in paraffin oil into the TMJ. Control rats received paraffin oil by the same route. Arthritic and control rats were pretreated either with capsaicin or denervation of the mandibular branch of the trigeminal nerve. Tissues were collected for neuropeptide extraction and analysed by radioimmunoassay and reverse-phase high-performance liquid chromatography. In all groups, the levels of substance P- (SP), calcitonin gene-related peptide- (CGRP) and neuropeptide Y- (NPY) like immunoreactivity (LI) were higher in the trigeminal ganglia than in the TMJs. In control rats, capsaicin significantly lowered the levels of SP-LI in the trigeminal ganglia and TMJ, but not CGRP-LI and NPY-LI. In the arthritic rats, capsaicin pretreatment significantly lowered the SP-LI and CGRP-LI in the trigeminal ganglia and TMJ, but not the NPY-LI. In the trigeminal ganglia the unilateral denervation significantly lowered SP-LI in control rats, and in arthritic rats SP-LI and CGRP-LI. On the denervated side of the arthritic TMJ, NPY-LI, SP-LI and CGRP- LI were significantly lowered as compared to the arthritic control rats and to the contralateral side. In this rat model, pretreatment with capsaicin and surgical denervation decreased the neuropeptide content in the trigeminal ganglia and the TMJ. The results clearly demonstrate a close interaction between increased neuropeptide release from sensory and sympathetic neurones after induction of arthritis in the rat. 相似文献
60.
分析原发性腹膜后恶性肿瘤12例。83%以腹块和腹痛为主要症状,体征中腹块占91.5%,以恶性淋巴瘤居首位占61%。全组完全切除率为58%,行脏器联合切除占25%。完全切除加放疗、化疗3年存活率为28.5%,部分切除及活检未给其它治疗者5例预后差,均1年内死亡,差别显著。 相似文献