Long-term Results of Living Donors in Simultaneous Kidney and Liver Transplantations

Introduction

Because of the shortage of organs available for transplantation, living related sequential transplantation with the use of liver and a kidney from the same donor has emerged as a reasonable therapeutic alternative. However, there is insufficient literature about the complications that living donors experience after simultaneous kidney and liver transplantations.

Atrial fibrillation after surgery of the lung: clinical analysis of risk factors

Objective: The aim of this study was to determine which of the clinical parameters are the most valuable in predicting postoperative atrial fibrillation after lung surgery. Materials and methods: Retrospective analysis was carried out on 298 patients after pulmonary resection necessitated mainly by lung cancer. The following parameters were investigated: age and sex, disturbances of cardiac rhythm, history of ischemic heart disease, diabetes and atherosclerosis, NYHA classification and type of surgical procedure. In addition, the duration of surgery, variations in oxygen saturation, changes in systemic blood pressure and heart-rate were noted intraoperatively. Statistical analysis was performed using Fisher's exact test. Results and conclusions: Atrial fibrillation occurred in 25 cases (8.4%) and more frequently after pneumonectomy (24%). Other factors contributing to atrial fibrillation after lung surgery were: history of ischemic heart disease, congestive heart failure, intraoperative cardiac arrest and the need for rethoracotomy.     

移位髋臼骨折的手术治疗

髋臼骨折是一种暴力强，机制复杂，移位多样，常伴有股骨头骨折脱位，且治疗困难的关节内骨折。往往因处理不当而并发创伤性关节炎。我院自1996年以来收治移位髋臼骨折61例。经手术治疗获得明显的治疗效果。     

肱骨近端粉碎性骨折的外科治疗

我院骨科自1994年6月~1999年6月共收治肱骨近端粉碎骨折56例,其中有完整随访资料48例,现报告如下。     

Anesthetic considerations in spine surgery: What orthopaedic surgeon should know!

With clinical innovation and technological advancement, the paradigm of surgical procedures on the spine and spinal cord along with the perioperative management are rapidly evolving. Irrespective of different modes the anesthetic management of spine surgery is challenging in view of significant blood loss, prolong procedure, position-related complications, and complex pain management. The enhanced recovery after surgery (ERAS) for this kind of surgery is yet to be finalized. The aim of this article is to highlight the current evidence-based major perioperative considerations for patients undergoing spine surgery.     

Pre-emptive nonselective perigraft aortic sac embolization with coils to prevent type II endoleak after endovascular aneurysm repair

ObjectivePre-emptive selective embolization of inferior mesenteric artery (IMA), lumbar arteries (LAs), and perigraft sac for prevention of type II endoleak (T2EL) has not been widely adopted. We perform pre-emptive nonselective perigraft aortic sac embolization with coils (PNPASEC) in patients at high risk for development of T2EL (four or more patent LAs, patent IMA ≥3 mm, and ≥30-mm aortic flow lumen). The goal of this study was to see whether PNPASEC decreases T2ELs requiring reinterventions.MethodsAll 266 patients undergoing elective endovascular aneurysm repair between September 1, 2007, and October 31, 2015, were retrospectively evaluated from a prospectively maintained database. Patients (N = 212; 211 men) with preoperative and postoperative contrast-enhanced computed tomography scans were included. Our PNPASEC technique involves leaving a wire in the sac after cannulation of the contralateral gate and inserting large (0.035-inch) coils into the sac after bifurcated graft deployment. T2EL and reintervention rates were compared between patients who underwent PNPASEC (group I) and those who met the criteria but did not have PNPASEC (group II) and those who did not meet the criteria (Group III).ResultsForty-seven (22.2%) patients were PNPASEC candidates and 165 (77.8%) patients (group III) were not. Among PNPASEC candidates, 16 (7.5%) underwent PNPASEC (group I) and 31 (14.6%) did not (group II). There were no significant differences between groups in terms of comorbidities, aneurysm size, and anatomic and neck characteristics. Mean number of patent LAs was similar between group I (4.5 ± 0.8) and group II (4.5 ± 0.9), which was significantly greater than in group III (1.9 ± 1.3; P < .001); 43.6% of group III patients had patent IMA. Mean follow-up was 44 ± 25 months. T2EL at 6 months was observed in 48.4% in group II, 3.0% in group III, and 6.3% in group I (P < .001). Sac diameter increase was seen in 38.7% in group II vs 6.1% in group III and 6.3% in group I (P < .001), with complete sac shrinkage in 23.3% in group II vs 23.8% in group III and 50.0% in group I (P = .09). T2EL-related interventions were performed in 29.0% in group II vs 1.2% in group III and 6.3% in group I (P < .001). Any endoleak at last follow-up was seen in 25.8% in group II vs 2.4% in group III and none in group I (P < .001).ConclusionsNonselective perigraft sac coil embolization in patients at high risk for T2EL (20% of patients undergoing endovascular aneurysm repair) is effective in preventing development of T2EL and is associated with decrease in sac size and reintervention rates.     

胸椎黄韧带骨化症的手术治疗

黄韧带骨化是导致胸椎管狭窄症的主要原因之一。我院自 1985 - 1999年 12月手术治疗 38例胸椎黄韧带骨化症 ,报道如下。1　临床资料1 1　一般资料　本组 38例中男 2 3例 ,女 15例 ;年龄 2 1～ 68岁 ,平均 5 0岁。病史 2个月～ 7年 ,平均 2年 3个月 ;有明确外伤史 1例 ;合并脊髓     

肘部内外侧联合切口切开复位内固定治疗小儿肱骨髁上骨折

我们于1996年5月—2000年6月间共收治小儿肱骨髁上骨折38例，均采用肘内外侧联合切口手术治疗，复位后行克氏针内固定，疗效满意，报告如下。