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71.
72.
Fady K. Balaa T. Clark Gamblin Allan Tsung J. Wallis Marsh David A. Geller 《Journal of gastrointestinal surgery》2008,12(2):338-343
Background Application of linear stapling devices for extrahepatic vascular control in liver surgery has been well-established. However,
the technique for use of stapling devices in hepatic parenchymal transection is not well defined.
Purpose To describe the safety and efficacy of our technique for use of vascular stapling devices in hepatic parenchymal transection
during open right hepatic lobectomy is the purpose of this study.
Methodology We reviewed our experience with 101 consecutive open right hepatic lobectomies performed by a single surgeon between January
2003 and July 2006, in which vascular staplers were utilized for the parenchymal transection phase.
Results Of the 101 patients who underwent resection, 53 (52%) were female. The mean age was 58 years. Malignant disease was the indication
for resection in the majority of patients (88%). Of those with cancer, 78% (69 of 89) had metastatic colorectal cancer, 6%
(5 of 89) had metastatic neuroendocrine tumor, 4% (4 of 89) had hepatocellular carcinoma, 4% (4 of 89) had cholangiocarcinoma,
and the remaining 8% were other metastatic cancers. Twelve patients (12%) underwent resection for hepatic adenoma or symptomatic
benign disease (FNH or hemangioma). Forty-eight patients (48%) underwent a major ancillary procedure at the time of hepatic
resection. Thirty-nine patients (39%) had a nonanatomic wedge resection of a left lobe lesion, 27 patients (27%) had one or
more lesions treated with radiofrequency ablation (RFA), and 6 patients (6%) were treated with a synchronous bowel resection.
The median total operative time was 336 min (range 155–620 min). A Pringle maneuver for temporary vascular inflow occlusion
was utilized in all cases, with a median time of 9 min (range 4–17 min). Ten patients (10%) required blood transfusion during
surgery or in the postoperative period. The maximum transfusion was 2 U of packed red blood cells (PRBC) in seven patients
and 1 U of PRBC in three patients. The mean nadir postoperative hematocrit was 28.2. All patients with malignant disease had
tumor-free margins at the completion of the procedure. The average hospital length of stay was 6.0 days. One patient (1%)
developed a clinically significant bile leak requiring a postoperative endoscopic retrograde cholangiography (ERCP). No patient
required reoperation. The 30 and 60-day postoperative survival was 100%.
Conclusion These findings indicate that application of vascular stapling devices for parenchymal transection in major hepatic resection
is a safe technique, with low transfusion requirements and minimal postoperative bile leak. The technique allows for rapid
transection of the entire right hepatic lobe in under 10 min. Short video clips of the technique will be demonstrated.
Presented at the 2007 American Hepato–Pancreato–Biliary Association, Las Vegas, Nevada, April 19–22, 2007 (oral presentation/video
presentation). 相似文献
73.
Yi-Hwa Liu 《Journal of nuclear cardiology》2007,14(4):483-491
Conclusion Quantification of nuclear cardiac images provides a secondary support in reading myocardial perfusion images and improves
the reproducibility in the diagnosis of cardiovascular diseases. The technology for the remote Web reading of nuclear cardiac
images and the quantitative data allows for an easy and secured access to patient studies without the limitations of time
and space. The recent increasing interests and applications in molecular targeted imaging have opened a new field in nuclear
cardiology, and absolute image quantification of the focal tracer uptake in the myocardium is exceedingly critical for the
quantitative analysis of molecular targeted images. 相似文献
74.
CASE REPORT: A 12-year-old boy who had a history of Kawasaki disease 9 years ago experienced a subarachnoid hemorrhage by ruptured right posterior cerebral artery aneurysm. On day 1 operation, as the aneurysm was very fragile and bled easily, two intraoperative ruptures, including a very premature rupture, were encountered. As a result, a left hemiparesis especially severe in the left hand was caused by the right anterior thalamic infarction due to the occlusion of a thalamo-perforating artery arising near the neck of the aneurysm. DISCUSSION: The histopathological examination of the intraoperative excised aneurysmal dome disclosed the thickening of the endothelial inner due to the endothelial hypertrophy and the invasion of inflammatory cells. This finding of the aneurysm was partially mimicking the finding of the coronary artery of the patients with Kawasaki disease. The combination of cerebral aneurysm and Kawasaki disease has never been reported until now, and the etiology of the aneurysm of this patient is unclear. 相似文献
75.
Background
The telomeric region of mouse chromosome 12 has previously shown frequent allelic loss in murine lymphoma. The Bcl11b gene has been identified and suggested as a candidate tumor suppressor gene within this region. In this study, we aimed to elucidate whether Bcl11b is mutated in lymphomas with allelic loss, and whether the mutations we detected conferred any effect on cell proliferation and apoptosis. 相似文献76.
77.
Daniela Klitscher Lars P. Müller Pol Rommens 《European journal of trauma and emergency surgery》2007,33(1):69-73
Abstract 10 embalmed cadaver forearms and wrists were dissected to determine the anatomical course of the superficial branch of the
radial nerve in the distal forearm. The superficial radial nerve bifurcated in two branches at a mean of 54,7 mm proximal
to the radial styloid. From the styloid process of the radius, the mean distance to the closest dorsal branch of the superficial
radial nerve was 3,5 mm and the mean distance to the closest volar branch was 9,8 mm. The mean distance between the closest
branch of the superficial radial nerve and Lister?s tubercle was 16,4 mm. The crossing point between the nerve and the cephalic
vein was located at a mean of 54,3 mm proximal to the styloid process. At the level of styloid process the mean distance between
the closest dorsal branch of the superficial radial nerve and the first dorsal compartment was 15,2 mm and between the closest
volar branch and the first dorsal compartment 4,4 mm. Detailed knowledge of anatomic characteristics of the superficial branch
of the radial nerve may help prevent injury during operations and treat traumatic lesions of the nerve. Because of great variations
in the course of the superficial radial nerve we could not define an absolute safe zone for surgical procedures on the distal
forearm. Iatrogenic lesions of the superficial radial nerve are described complications of percutaneous procedures. Therefore
open surgical approaches are recommended.
Daniela Klitscher and Lars Peter Müller contributed equally to this work. 相似文献
78.
79.
Benign schwannoma of the pancreas 总被引:2,自引:0,他引:2
Labile Togba Soumaoro Kenichi Teramoto Tohru Kawamura Noriaki Nakamura Takahiro Sanada Kenichi Sugihara Shigeki Arii 《Journal of gastrointestinal surgery》2005,9(2):288-290
Reported cases of intrapancreatic schwannomas have recently increased in the literature. However, none of these cases were
diagnosed clearly as schwannoma preoperatively. We herein describe the clinicopathologic findings of a solitary benign schwannoma
occurring in the head of the pancreas. Additionally, the differential diagnosis versus other cystic- and solid-appearing pancreatic
masses is briefly discussed. 相似文献
80.
Hung J. Kim Torrance Jackson Konrad Noben–Trauth 《Journal of the Association for Research in Otolaryngology》2003,4(1):83-90
Genetic studies on spontaneous mouse mutants with hearing defects have provided important insights into the function of genes
expressed in inner ear hair cells. Here we report on our genetic analyses of the deaf mutants varitint-waddler (Va) and jerker
(Espnje). A high-resolution genetic map localizes VaJ to a 0.14 ± 0.08 cM region between D3Mit85 and D3Mit259 on distal chromosome
3. By comparative mapping, the human ortholog resides at 1p22.3 between markers D1S3449 and D1S2252. To study the effect of
different genetic backgrounds on the hearing phenotype, Espnje and VaJ were crossed to various inbred strains. Auditory-evoked
brainstem response tests on F2 progeny demonstrate that expression, inheritance, and penetrance of the hearing phenotype are
solely controlled by the mutant allele. To test for a genetic interaction between Espnje and Cdh23v, auditory function was
analyzed in double heterozygotes; no significant increases of thresholds of sound pressure levels were observed. The results
establish the framework for cloning the Va gene and provide valuable insights into the genetics of deafness mutations in the
mouse. 相似文献