腹腔镜辅助小切口甲状腺结节手术的临床应用

Objective To study the feasibility, superiority and experience of minimally invasive laparoscopic-assisted surgery of the thyroid using ultrosonic scalpel. Methods In a period from January, 2006-August, 2008, 56 patients of the department of general surgery, the hospital of Heilongjiang Province were diagnosed as thyroid node. The size of the nodes ranged from 5.0 cm×4.2 cm to 3.5 cm×2.0 cm in uhrosonography. An incision of about 1.5-2.0 cm was made 1.0 cm above the suprasternal notch and the operation was performed with ultrosonic scalpel assisted with laparoscope. Partial thyroideetomy of lateral thyroid was performed in 20 cases, subtotal thyroidectomy in 25 cases, subtotal thyroidectomy of unilateral thyroid and partial thyroidectomy of contralateral thyroid respectively in 1 case, partial thyroidectomy of bilateral thyroid in 10 cases. Results All 56 cases have undergone minimally invasive laparoscopic-assisted surgery successfully in 50-146 min and no complications occurred. Fifty five cases were confirmed to be benign lesion pathologically. Conclusion Laparoscopic-assisted surgery of the thyroid is an effective with a good cosmetic result.     

胰腺实性假乳头状瘤的诊治进展

目的 总结胰腺实性假乳头状瘤的诊治进展.方法 分析近年来有关胰腺实性假乳头状瘤诊治进展的文献报道. 结果 胰腺实性假乳头状瘤是一种少见的胰腺低度恶性肿瘤,有其特殊的临床、影像学及病理特征.手术切除是其主要的治疗方法 且预后良好.结论 熟悉并掌握胰腺实性假乳头状瘤的特征有助于临床准确诊断与治疗,但对其深入认识尚需更多的病例积累与基础研究.     

全腹腔镜下脾切除贲门周围血管离断术的临床应用

全腹腔镜脾切除及贲门周围血管离断术(Total laparo-scopic splenectomy,TLS)因其难度大、风险高而报告较少。于2005年4月至2008年4月期间共完成完全腹腔镜下脾切除、贲门周围血管离断术7例,效果满意。报告如下。1资料与方法1·1临床资料男4例,女3例。年龄33~58岁,平均47·4岁。肝炎后肝硬化5例,酒精性肝硬化2例。6例有上消化道出血,其中有4例出血次数在2次以上;1例无出血史的患者其胃镜及食管钡餐透视均提示有重度静脉曲张,RC征阳性。7例患者均存在有脾功能亢进,CT和超声提示脾脏明显增大,其中巨脾3例,最大者脾脏长径在超声下达到25·3 cm,查体丁戊线3 cm。肝功能ChildA级5例,B级2例。有3例患者同时患有胆囊结石。1·2手术方法1·2·1麻醉、体位、套管位置采用全身麻醉,患者取右倾30°~45°体位(同时取大小腰垫2个垫于左季肋区),头侧抬高30°。取脐与左肋缘中点联线中点10 mm戳孔(A点)为腹腔镜观察孔,剑突左侧肋缘下2 cm处5 mm戳孔(B点)及左腋前线肋缘下2 cm处12 mm戳孔(C点)为主操作孔,左腋前线与左腋中线间中点肋缘下约4 cm处5 ...     

经皮穿刺导管取栓术治疗急性髂股静脉血栓形成一例

患者,男性,56岁。因左下肢突然肿胀3天于2011年11月28日急诊入院。查体:左下肢高度肿胀,皮肤发绀,左大腿较右大腿增粗6cm,左小腿较右小腿增粗4cm。入院诊断:急性左髂股静脉血栓形成。下肢静脉顺行造影检查,发现左髂股静脉未见显影。下肢静脉彩超检查显示左髂股静脉内充满低回声血栓(见图1)。     

腹腔镜辅助小切口甲状腺结节手术的临床应用

Objective To study the feasibility, superiority and experience of minimally invasive laparoscopic-assisted surgery of the thyroid using ultrosonic scalpel. Methods In a period from January, 2006-August, 2008, 56 patients of the department of general surgery, the hospital of Heilongjiang Province were diagnosed as thyroid node. The size of the nodes ranged from 5.0 cm×4.2 cm to 3.5 cm×2.0 cm in uhrosonography. An incision of about 1.5-2.0 cm was made 1.0 cm above the suprasternal notch and the operation was performed with ultrosonic scalpel assisted with laparoscope. Partial thyroideetomy of lateral thyroid was performed in 20 cases, subtotal thyroidectomy in 25 cases, subtotal thyroidectomy of unilateral thyroid and partial thyroidectomy of contralateral thyroid respectively in 1 case, partial thyroidectomy of bilateral thyroid in 10 cases. Results All 56 cases have undergone minimally invasive laparoscopic-assisted surgery successfully in 50-146 min and no complications occurred. Fifty five cases were confirmed to be benign lesion pathologically. Conclusion Laparoscopic-assisted surgery of the thyroid is an effective with a good cosmetic result.     

负压引流在预防乳腺癌术后皮瓣下积液中的应用

乳癌术后病人发生皮瓣下积液是常见的并发症，因其影响皮瓣的愈合，致使病人术后恢复过程延长，延误了患者综合治疗的时机，影响病人生活质量，后果严重，作者于1995年以来，对参加术后治疗的27例病人，术后皮瓣下采用“负压引流法”，取得良好了效果，实践证明此法行之有效，故加以总结如下。1．临床资料本组27例，年龄26岁～67岁。女性26例，男性1例，其中25例行改良根治术，2例行根治术，术前选用外径1．ocm硅胶管二根，质地较硬，能承受5－10kpa的负压而不会使内壁相贴，长约30－40cm，引流湍剪成鱼口状，向上约每隔Zcm左右剪倒孔一个…     

腹腔镜辅助小切口甲状腺结节手术的临床应用

Objective To study the feasibility, superiority and experience of minimally invasive laparoscopic-assisted surgery of the thyroid using ultrosonic scalpel. Methods In a period from January, 2006-August, 2008, 56 patients of the department of general surgery, the hospital of Heilongjiang Province were diagnosed as thyroid node. The size of the nodes ranged from 5.0 cm×4.2 cm to 3.5 cm×2.0 cm in uhrosonography. An incision of about 1.5-2.0 cm was made 1.0 cm above the suprasternal notch and the operation was performed with ultrosonic scalpel assisted with laparoscope. Partial thyroideetomy of lateral thyroid was performed in 20 cases, subtotal thyroidectomy in 25 cases, subtotal thyroidectomy of unilateral thyroid and partial thyroidectomy of contralateral thyroid respectively in 1 case, partial thyroidectomy of bilateral thyroid in 10 cases. Results All 56 cases have undergone minimally invasive laparoscopic-assisted surgery successfully in 50-146 min and no complications occurred. Fifty five cases were confirmed to be benign lesion pathologically. Conclusion Laparoscopic-assisted surgery of the thyroid is an effective with a good cosmetic result.     

腹腔镜辅助小切口甲状腺结节手术的临床应用

Objective To study the feasibility, superiority and experience of minimally invasive laparoscopic-assisted surgery of the thyroid using ultrosonic scalpel. Methods In a period from January, 2006-August, 2008, 56 patients of the department of general surgery, the hospital of Heilongjiang Province were diagnosed as thyroid node. The size of the nodes ranged from 5.0 cm×4.2 cm to 3.5 cm×2.0 cm in uhrosonography. An incision of about 1.5-2.0 cm was made 1.0 cm above the suprasternal notch and the operation was performed with ultrosonic scalpel assisted with laparoscope. Partial thyroideetomy of lateral thyroid was performed in 20 cases, subtotal thyroidectomy in 25 cases, subtotal thyroidectomy of unilateral thyroid and partial thyroidectomy of contralateral thyroid respectively in 1 case, partial thyroidectomy of bilateral thyroid in 10 cases. Results All 56 cases have undergone minimally invasive laparoscopic-assisted surgery successfully in 50-146 min and no complications occurred. Fifty five cases were confirmed to be benign lesion pathologically. Conclusion Laparoscopic-assisted surgery of the thyroid is an effective with a good cosmetic result.     

术中疑似甲状腺癌的手术体会

目的　总结 8例在术中疑似甲状腺癌病例的术式选择及治疗体会。方法　术前均行临床检查未能确诊为甲状腺癌 ,术中根据甲状腺肿物的大体生物学特性而疑似甲状腺癌的病例行患侧甲状腺全叶、峡部及对侧甲状腺大部切除术治疗。结果　术后病理为甲状腺乳头状癌 6例 ,滤泡状癌 1例 ,结节性甲状腺肿 1例。术后转他院再手术 1例 ,术后 3例出现甲减而口服甲状腺素片治疗 ,术后 2例接受碘内照射治疗。结论　细针穿刺活检和术中冰冻检查有时很难区分良性甲状腺肿和分化良好的甲状腺癌。因此 ,对于术前难以确诊而术中高度疑似甲状腺癌的病例 ,采取针对性、恰当的术式治疗 ,是影响疗效的关键。本组资料显示 :该术式具有较强的可行性