414例输精管注射粘堵术随访报告

１９９２年４月至１９９３年１２月共施行输精管注射粘堵术４３４例，对其中的４１４例进行了１８个月～４２个月随访。２９例术后再孕，其中孕后检查出精子者２５例。表明手术失败率为６％。术后发生血肿３例、感染２例，并发症率为１．２％。认为输精管注射粘堵术是一种并发症低，效果可靠，且为群众乐于接受的男子节育方法。     

输精管栓堵术节育效果的调查与判定标准评价

采用两阶段抽样的方法，对山东省潍坊地区三个县农村采用输精管栓堵法节育术的受术者１５０５例进行了问卷调查。又从其中随机抽取１６．５％的受术对象２４８例采集精液做精子计数。研究结果表明，并发症总发生率为０．７３％。术后一年，精子消失率为８８．３％，９５％可信限为８４．２～９２．４％。按赵生才制定的标准，节育有效率为９５．９％，９５％可信限为９３４～９８．４％。调查发现，术后精子计数在４００万／ｍｌ以下的１９例受术者中，有６例女方仍然使用宫内节育器，７例正值哺乳期，５例未采用措施，１例不详。因此，作者指出，不能证明栓堵术后精子计数小于４００万／ｍｌ可以作为判定男性节育术有效的评价标准。作者认为，判定男性阻塞性节育术效果应以精液两次离心沉淀中精子消失为标准。     

414例输精管注射粘堵术随访报告

１９９２年４月至１９９３年１２月共施行输精管注射粘堵术４３４例，对其中的４１４例进行了１８个月－４２个月随访２９例术后再孕，其中孕后检查出精子者２５例，表明手术失败率为６％。术后发生血肿３例、感染２例，并发症率为１．２％。认为精客注射射粘堵术是一种并发症低，效果可靠，且为群众乐于接受的男子节育方法。     

庆大霉素精囊灌注预防输精管检堵术后感染的回顾性研究

输精管可复性注射栓堵术是一种安全、有效简单的男性节育术。但作为一种外科手术,不可避免的会有并发症。赵生才报道栓堵术1040例,并发症为15例,其中感染13例,血肿2例,可见感染是栓堵术的主要并发症。本研究目的就是观察用庆大霉素精囊灌注是否能降低输精管可复性注射栓堵术后感染的发生率。资料来源与方法受术者共3775人,手术按“输精管可复性注射栓堵术操作常规”进行。把受术者分为2组,第一组为884人,用1％普鲁卡因6ml每侧3ml精囊灌注,     

三种经皮穿刺输精管绝育术临床应用比较

输精管绝育术是一种安全、有效、简便、经济的永久性节育方法。30年来从阴囊切口、切断、结扎、包埋输精管的传统方法至输精管粘堵术、栓堵术、电凝术等诸多新方法相继出现并试用人体,为控制人口的过快增长,取得了较好的效果。本文报告自1994年4月～1998年11月对经皮穿刺输精管粘堵、栓堵及电凝3种绝育术有效率及术后并发症情况进行的临床比较和分析。1　临床资料11　一般资料　本组对象,年龄27～38岁,平均325岁,已有2个子女,自愿行输精管绝育。12　所用材料　上海产504Ｐ,山西产ＭＰＵ,山东滨洲产ＪＣＤ30型输精管节育电凝仪及6号硅胶绝缘…     

活脉疏痛灵治疗输精管绝育术后附睾淤积症100例临床研究

我站1989年～1998年共行输精管绝育术14384例。经男科门诊复诊及随访,术后并发感染、血肿、附睾淤积、痛性结节等术后并发症共计316例,发生率为2.19％。其中附睾淤积症100例占并发症发生率的31.64％。占绝育总数的0.69％。     

输精管结扎术残端处理方式与再通关系的研究

用７种残端处理技术完成的２３７３例输精管结扎术的一项前瞻性研究表明，术后２年随访时共有７８例查见精子，其中２７例配偶受孕，精子阳性率为３．２９％，再孕率１．１４％。各种术式的精子阳性率：附睾端开放加包埋０．５５％，两端单纯结扎１．４１％，结扎加筋膜包埋２．６３％，石碳酸烧灼３．１７％，精囊端折叠３．７１％，结扎加电灼４．７５％和不作包埋的附睾端开放７．５３％。经统计学处理各种术式的精子阳性率之间差异有非常显著意义（Ｐ＜０．０００１）。由不同手术者完成的相同术式结果分析表明，除石碳酸烧灼组以外，其余各组皆无组内差异。７个残端处理组的并发症发生率有显著差异（Ｇ＝２０．９６，Ｐ＜０．０１）、其中不作包埋的附睾端开放组并发症发生率达２．１７％，折叠组的出血和感染等发生虽少，但术后近期局部结节反应发生率达４．７７％。本研究表明，输精管残端处理方式的不同可能影响术后节育效果和安全性，但手术者经验和技术水平也起很大作用。     

恒河猴两种节育术后睾丸附睾的组织学及超微结构观察

本文介绍了12只恒河猴输精管结扎术及输精管内过滤装置节育术术后睾丸、附睾和输精管的组织学及超微结构观察结果。术后两年内,两组动物睾丸的组织学及超微结构均无异常改变。术后9月,结扎猴的尾部附睾管及近睾端输精管管腔显著扩张、上皮变薄、腔内充满大量变性、坏死精子,出现附睾郁积。附睾主细胞出现微绒毛疏短、排列紊乱等超微结构变化;而行过滤装置节育的动物附睾管及输精管的组织学及超微结构均未见异常改变。提示两种节育术对睾丸形态结构均无影响;但输精管结扎木可导致附睾郁积及其上皮的萎缩性变化,而过滤装置节育术后无此改变,值得进一步探讨。     

输精管滤过装置节育术的临床研究

本文报告51例输精管腔植入由作者研制的输精管滤过装置与40例钳穿法输精管结扎术经过1至3年的临床比较研究。其结果:两组不同术式的节育有效率均为100％,滤过装置组术后1～3年仍有51.6％(16/31)测出中性α-糖苷酶活性,至今仅有12例附睾轻度肿胀和近附睾段输精管轻度增粗;而结扎组一年后均有不同程度的附睾肿胀和近附睾段输精管增粗,并有1例并发附睾淤积症。两组间有非常显著的统计学差异(P<0.005)。结果提示:输精管滤过装置不仅能限制精子通过而达到节育的目的,又不完全影响附睾液的排出,较好地避免或减少了附睾淤积的发生。因此,有可能作为一种新型的、非阻塞性的男性节育方法用于临床。     

应用显微外科技术治疗梗阻性无精症42例疗效分析

目的 探讨应用显微外科技术治疗梗阻性无精子症的临床治疗效果.方法 自2000年12月至2011年12月,应用显微外科技术对梗阻性无精子症患者施行输精管吻合和输精管附睾吻合术42例并进行回顾性分析.结果 42例中,36例术后精液可见精子,术后复通率85.7％;配偶已怀孕27例,致孕率64.3％.结论 应用显微外科技术行输精管吻合和输精管附睾吻合术治疗梗阻性无精子症临床效果良好.     

Objective comparison of complications resulting from laparoscopic bariatric procedures

BACKGROUND: Several surgical treatment options for morbid obesity exist. Currently, there are no studies that objectively compare complication rates after laparoscopic bariatric operations performed at a single institution. We objectively classify and compare complications resulting from laparoscopic adjustable gastric banding (LABG), Roux-en-Y gastric bypass (RYGB), and biliopancreatic diversion (BPD) with duodenal switch (DS). STUDY DESIGN: A retrospective review of a prospective database of all patients undergoing laparoscopic bariatric operation was performed. Complications were categorized according to severity score using a well-described classification system and compared between procedures. RESULTS: From September 2000 to July 2003, 780 laparoscopic bariatric operations were performed: 480 LAGB, 235 RYGB, and 65 BPD+/-DS. There was one late death. Total complication rates were: 9% for LAGB, 23% for RYGB, and 25% for BPD+/-DS. Complications resulting in organ resection, irreversible deficits, and death (grades III and IV) occurred at rates of 0.2% for LAGB, 2% for RYGB, and 5% for BPD+/-DS. LAGB group had a statistically significant lower overall complication rate, both by incidence and severity, as compared with other groups (p < 0.001). After controlling for differences of admission body mass index, gender, and race, the LAGB group had an almost three and a half times lower likelihood of a complication compared with the RYGB group (odds ratio, 3.4; 95% CI, 2.2-5.3, p < 0.001) and had an over three and a half times lower likelihood of a complication compared with the BPD with DS group (odds ratio, 3.6; 95% CI, 1.8-7.1, p < 0.001). There was no statistically significant difference between complication rates of RYGB and BPD+/-DS. CONCLUSIONS: Bariatric operation complication rates range from 9% to 25%; very few complications are serious. Laparoscopic adjustable gastric banding is the safest operation in terms of complication rate and severity when compared with laparoscopic Roux-en-Y gastric bypass or laparoscopic malabsorptive operations.     

Complications of open and laparoscopic antireflux surgery: 32-year audit at a teaching hospital

Background:Open or laparoscopic surgery for gastroesophageal reflux disease gives longterm freedom from symptoms in 83–100% of cases but has a certain percentage of complications. This study was undertaken to evaluate the early and late complication rates after primary or repeat antireflux operations.Study Design:The records of all patients who underwent surgery for gastroesophageal reflux disease during a 32-year period at a university teaching hospital were reviewed retrospectively. Records for 793 adults (448 men and 345 women) aged 16–85 years (mean, 51) were retrieved for calculation of complication rates and statistical analysis.Results:A total of 827 operations were performed: 793 primary and 41 for recurrent disease (2 patients were each reoperated on twice). There were 49 laparoscopic operations. Only two patients died (mortality, 0.3%), both after open operation. Morbidity was 24% after open surgery and 14% after laparoscopic operation. The total (early and late) complication rate was higher after reoperations than that after open or laparoscopic procedures. The overall complication rate in the open operations was similar in the first and the third decade of the study, namely, 24.6% and 26.1%, respectively.Conclusions:Surgical treatment of gastroesophageal reflux disease carries very low mortality when performed in a specialized unit. The main causes of morbidity after open operation are infectious complications. The incidence of complications is substantially lower after laparoscopic surgery than after open operation. Reoperation is seldom required, but it carries higher morbidity than the primary operations.     

Complications and demographic characteristics of patients undergoing lumbar discectomy in community hospitals

We determined the incidence of acute, major complications in a population of 28,395 patients who underwent lumbar laminectomy for discogenic radiculopathy in the United States in 1980. This population was drawn from a broad cross-section of community hospitals and represented 31% of all patients who underwent laminectomy that year for this condition. Our cohort excluded patients with a) operations exceeding two disc levels, b) fusion, c) previous lumbar laminectomy, or d) coexistent discitis, spondylosis, spinal stenosis, myelopathy, or arachnoiditis. The incidence of death was 5.9 per 10,000. The causes of death were septicemia, myocardial infarction, and pulmonary emobolus. The incidence of at least one major complication was 157 per 10,000. The incidences of specific complications were as follows: infection requiring intravenously administered antibiotics, 30.7; major neurological deficit, 29.8; pulmonary embolus, 10.7; and myocardial infarction, 5.6. We studied four additional categories of complication. Patients were counted only when a second operation was required to treat the complication. The categories and incidence per 10,000 were as follows: incisional hematoma, 8.7; cerebrospinal fluid fistula, 10.5; ventral perforation, 1.6; and retention of a foreign body, 0.7. Among the patients whose hospitalizations were otherwise normal, 6.7% received a blood transfusion; of the patients whose hospitalizations were complicated, 24% required transfusion. The demographic characteristics of transfusion. The demographic characteristics of patients with a normal hospitalization were tabulated separately from those whose hospitalizations were complicated. Neurosurgeons performed 60% of the operations, and orthopedic surgeons performed 40%. The speciality of the surgeon was not a factor in determining the risk involved in surgery. Spinal anesthesia was used in 7% of the cases, and no pattern of complications emerged that was uniquely related to that technique.     

Incidence of thromboembolic complications in lumbar spinal surgery in 1,111 patients

Deep venous thrombosis (DVT) and pulmonary embolism (PE) cause significant morbidity and mortality in orthopaedic surgical practice, although the incidence following surgery to the lumbosacral spine is less than following lower limb surgery. Our objective was to compare our rate of thromboembolic complications with those published elsewhere and investigate whether the adoption of additional pharmacological measures reduced the incidence of clinically evident DVT and PE. This retrospective study was undertaken to investigate the incidence of DVT/PE during the 10 years from 1 January 1985 to 31 December 1994, and then to assess the effectiveness of an anticoagulant policy introduced during 1995 using low dose aspirin or LMH in high risk cases. All records for spinal operations were reviewed for thrombo-embolic complications by reference to the Scottish Morbidity Record form SMR1. To ensure that all patients were compliant with the policy, data for the whole of 1995 was omitted and the period 1 January 1996 to 31 December 2003 was taken to assess its effectiveness. Surgery was done with the patient in the kneeling, seated prone position which leaves the abdomen free and avoids venous kinking in the legs. Records of a total of 1,111 lumbar spine operations were performed from 1 January 1985 to 31 December 2004 were reviewed. The overall incidence of thrombo-embolic complications was 0.29%. A total of 697 operations were performed from 1 January 1985 to 31 December 1994 with two cases of DVT and no cases of PE giving thromboembolic complication rate of 0.29%. During the period 1 January 1996 to 31 December 2003, 414 operations resulted in one case of DVT and no cases of PE, a rate of 0.24%. The incidence of symptomatic thrombo-embolic complications in lumbar spinal surgery is low in the kneeling, seated prone operating position, whether or not anticoagulation is used.     

胃癌术后的早期并发症分析

本文报告该院１９８３～１９９４年间１４５４例胃癌患者中有１２１例（８．３２％）在术后早期共发生各种并发症１６８例次（１１．５５％），其中一般性并发症占８．２５％；与胃肠道切除重建有关的特殊并发症占３．３０％。发生较多的并发症有切口感染、肺部感染、吻合口梗阻及吻合口瘘等。作者认为在当今手术治疗胃癌逐渐增多的情况下，应对其手术并发症进行比较全面系统地了解和认识，以便有针对性地加以预防，从整体上提高手术治疗胃癌的效果。     

Arthrodesis of the shoulder after septic arthritis. Long-term results

We analysed the long-term results of arthrodesis of the shoulder after infection in 15 patients. At the time of operation, 14 cultures were positive for Staphylococcus aureus. The mean follow-up was 8.3 years (3 to 14) and 90% of the patients were satisfied with the outcome. There were complications in five patients (33%); in three there was nonunion with loosening of the implant. One patient had a sound bony union but with a persistent sinus six years after arthrodesis and another had a sinus which healed after the metal was removed. Four of these five patients (80%) were heavy smokers (> 20 cigarettes/day). Cancellous bone grafting did not affect the incidence of complications. The mean age of the patients with complications was 58.6 v 48.6 years for those without (p = 0.2808; not significant). Those with complications had had more previous operations (6.4 v 2.5, p < 0.05). Antibiotics, as determined by the bacteriological cultures, were administered for six weeks. The complication rate was higher in patients with active sepsis but the younger the patient and the fewer number of previous operations (< 50 years, < four previous operations), the better was the outcome. Considering the rate of complications, we recommend early surgery in these patients.     

Perioperative complications related to minimally invasive transforaminal lumbar fusion: evaluation of 204 operations on lumbar instability at single center

Background contextMinimally invasive transforaminal lumbar fusion (MIS-TLIF) has demonstrated efficacy in the treatment of lumbar degenerative diseases. The reported incidence of perioperative complications associated with MIS-TLIF surgery is highly variable. Studies concerning perioperative complications in broad patient populations are quite rare. This study analyzes a retrospectively collected database of patients who underwent an MIS-TLIF surgery at a single center.PurposeTo determine the incidence of perioperaive complications with MIS-TLIF procedure based on our definition of Type I and II perioperative complications.Study designRetrospective cohort study; a review of complications.Patient sampleThe sample comprises 204 patients who underwent MIS-TLIF for the treatment of lumbar degenerative diseases.Outcome measuresType I complication including all medical adverse events without direct connection to the specific surgical procedure performed. Type II complication including adverse events with direct connection to the surgical procedure performed.MethodsA total of 204 MIS-TLIF surgeries on lumbar instability or spondylolisthesis, performed between June 2007 and July 2012, were examined in a retrospective study. A complication classification based on the relation to the surgical procedure and the effect duration was used. Perioperative complications until 1 month postoperatively were reviewed for the patients.ResultsThe study group comprised 204 patients (106 women, 98 men; mean age at surgery, 52.4 years; age range, 39–84 years). Overall, there were 75 perioperative complications in 204 patients (36.76%). Only one complication occurred in 54 patients. Nine patients had two complications. One patient had three complications. The incidence of perioperative complication was 31.37% (64/204 patients) in the MIS-TLIF operations. Of all complications, seven (9.33%) were classified as persistent complications and 68 (90.67%) were classified as transient complications. The incidence of Type I and II complications were 13.73% and 23.04%, respectively.ConclusionsMinimally invasive transforaminal lumbar fusion has gained popularity as a procedure for the treatment of lumbar instability or spondylolisthesis, with similar complications as in the open surgery. Transient sensory disturbance was the most common complication in this series.     

Heterotopic bone formation following total hip arthroplasty in ankylosing spondylitis

Heterotopic ossification is a well-recognized complication of total hip arthroplasty. In a retrospective survey of 98 total hip arthroplasties in ankylosing spondylitis performed between 1970 and 1977, 39.8% showed some evidences of heterotopic ossification. Restriction of hip movements was noted in only two. Heterotopic ossification occurred within one year and was higher (64.6%) in patients with bilateral hip replacements if there was evidence of heterotopic bone formation in one hip. The complications were relatively high in hips with previous operations (55%); trochanteric bursitis (50%); and trochanteric detachment (63.3%). No correlation was found between high erythrocyte sedimentation rate and the incidence or extent of heterotopic bone formation.     

Efficacy and Safety of External Volume Expansion (EVE) on Fat Grafting: A Systematic Review and Single-Arm Meta-Analysis

BackgroundThe autologous fat grafting is commonly used for reconstructive or aesthetic purposes. However, due to the huge variation in methods, its retention rate varies a lot. External volume expansion (EVE) has been used to treat recipient sites of fat grafting. Concerns have been raised regarding its efficacy and safety.MethodsWe have searched PubMed, EMBASE, and the Cochrane Library for studies on EVE-assisted fat grafting published from 2000 to 2020. A meta-analysis was conducted to pool the retention rate. The incidence of complications was assessed for reconstructive or aesthetic purposes.ResultsThe 11 included studies involved 1152 patients with operations on 1794 breasts. Four studies were included in the meta-analysis. The pooled retention rate was 65% [95%CI 49, 79]. Eight studies reported the complications. The total complication incidence was 34%, which is 35% for the aesthetic group and 33% for the reconstructive group. The complication rate was not obviously different between the two groups.ConclusionsThe study shows that the EVE-assisted fat grafting has better retention rate than traditional fat grafting. However, the data showed that the complication rate was much higher in the EVE-assisted group.     

Complications of short term multilumen central venous cannulation in children—a prospective study

A prospective study of the incidence of complications, when using multiple lumen central venous catheters in a paediatric intensive care unit, undertook to survey the normal practice of central venous cannulation at the Birmingham Children's Hospital, using a variety of devices and approaches over a period of a year from May 1991. Ninety five percent of the total of 252 devices used were triple lumen, the rest being double lumen catheters. There were 19 failures to secure access at the initial site chosen, but central venous access was secured in all cases. The complication rate during insertion was 18.5%. There were three major and 20 minor non-infective complications with a total incidence of 7.9%. Twenty seven cases (10.8%) suffered infective complications. The incidence of all complications were comparable to those obtained in studies involving the use of single lumen devices. This fact, coupled with the high success rate in catheter placement by operators of varying experience, suggests that multiple lumen central venous devices can be considered as a safe alternative to single lumen catheters for short term use in children.