胃切除术后近期并发症

本文总结了１９８４－１９９５年间我科治疗的胃切除术后近期并发症２８全我，主要并发症为各种胃肠道瘘、胃肠道出血及梗阻。其中胃肠道瘘是致死的主要原因。对各并发症发生的原因及防治措施进行了讨论。     

脂肪抽吸术并发症

脂肪抽吸术是消除局部脂肪堆积改善体形的一项技术 ,通过抽吸管吸引或超声辅助下抽吸脂肪从而实现体形重塑。这种形体的改善往往是永久性的 ,因此脂肪抽吸术 (ＳｕｃｔｉｏｎＬｉｐｅｃｔｏｍｙ)问世十几年来很快受到整形外科医师和患者的欢迎 ,并被认为是治疗局部脂肪沉积的首选方法。最早应用脂肪抽吸的是西德医生ＪｏｓｅｆＳｃｈｒａｄｄｅ ,早在 2 0世纪 60年代他用妇科刮宫用的刮匙在皮下 1ｃｍ深处形成隧道 ,刮除两旁的脂肪组织 ,并用抽吸的方法去除脂肪组织碎片。到 70年代中期 ,瑞士的Ｋｏｓｓｅｌｒｉｎｇ发明了一种有别于子宫刮…     

LOCAL COMPLICATIONS OF THIOPENTONE INJECTION

Cases of local complications following injection of thiopentonethat had been reported to the Medical Defence Union over a recentseven-year period were investigated. There were three casesof gangrene distal to the site of injection; five cases of isolateddamage to nerves and muscles; ten cases of local tissue necrosisat the site of injection. It is estimated that the incidenceof gangrene is probably less than one case in a million injections.Brief case reports are presented.     

下颌骨牵引成骨的并发症

牵引成骨（distraction osteogenesis, DO）技术已经成为颅面外科及口腔颌面外科医生的一项常规手段，这是因为对于一些传统截骨术和骨移植术效果不佳的下颌骨及中面部发育不良综合征患者，DO技术有着明显的优势［1］.     

THE VASCULAR COMPLICATIONS OF CERVICAL RIB

The consequences of cervical rib do not appear to be widely understood. Whilst most cervical ribs cause little or no trouble, and, at the most, require shoulder raising exercises, some are the cause of serious nerve compression and sometimes arterial compression. Much confusion has existed in the understanding of the vascular manifestations of cervical rib, and this confusion has often led to incorrect treatment with serious consequences, in this regard it is particularly important for the surgeon to deal with the diseased artery at the same time as the cervical rib is excised. Nine cases of cervical rib with arterial compression are reported. The importance of recognition of arterial compression, before surgery is undertaken, is stressed.     

COMPLICATIONS OF RETROGRADE BALLOON CAUTERY ENDOPYELOTOMY

PURPOSE: Adult ureteropelvic junction obstruction is increasingly managed with endoscopic techniques. Retrograde balloon cautery endopyelotomy is quick, requires minimal hospital stay and allows most patients a rapid return to work. The complication rate of retrograde balloon cautery endopyelotomy ranges from 13 to 34%, with vascular injury in 0 to 16% of patients. We report 5 uncommon complications, including 4 vascular injuries, that clinicians should be familiar with when using this technique. MATERIALS AND METHODS: We reviewed 52 retrograde endoscopic endopyelotomy procedures performed during a 5-year period. There were 5 uncommon complications. RESULTS: Accessory lower pole renal artery injuries occurred in 3 patients, 1 of whom presented 12 days after endopyelotomy. Embolization was successfully performed in all 3 cases and none had subsequent hypertension. In 1 case a right ovarian vein laceration was not evident on preoperative or postoperative angiography. Emergency post-embolization abdominal exploration revealed a 2 mm. injury to the right ovarian vein before entering the right renal vein close to the ureteropelvic junction incision. Nephrectomy and ovarian vein ligature were curative. In 1 case the electrocautery wire broke intracorporeally after firing, resulting in a bobby pin-like configuration. Successful removal was accomplished by twisting the catheter and wrapping the wire around the tip, enabling atraumatic removal. CONCLUSIONS: Retrograde balloon cautery endopyelotomy is an emerging technology with potential adverse outcomes. The complications we noted are complex and potentially life threatening. Awareness of these complications may help avoid poor outcomes and expedite appropriate treatment.     

腹腔镜胆囊切除术的胆道并发症

胆道并发症是腹腔镜胆囊切除术（ＬＣ）常见而严重的并发症。为减少此并发症,对３６０例ＬＣ进行了性分析。其中４例发生胆道工发症（１．１％）。包括３例胆管损伤（１例胆总管横断伤、１例胆总管穿孔、例肝总管部分夹１例胆囊管胆漏。胆总管横断伤的病人因诊断延迟死亡。对胆道并发症的发生原因、诊断和预防措施进行了分析并根据有关文献进行了讨论。     

THE VASCULAR COMPLICATIONS OF DIGITAL REPLANTATION

A report on a series of 18 digital replantations is presented. The overall survival of digits was 13 (72%). All but one of the crush and avulsion amputations developed vascular complications. Venous insufficiency was much more commonly seen than arterial. Substantial blood loss was the rule in all digits which developed further vascular problems. A conservative approach is advocated for the majority of these complications.