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991.
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993.
Constantine T. Frantzides Mark A. Carlson Ali Keshavarzian Jacob E. Roberts 《American journal of surgery》2010,200(2):305-307
Background
The management of high-grade esophageal dysplasia has included surveillance, endoscopic ablative techniques, and esophagectomy. Herein we describe an alternative treatment, laparoscopic transgastric esophageal mucosal resection.Methods
Laparoscopic transgastric esophageal mucosal resection was accomplished through an anterior gastrotomy. The mucosa was stripped from the Z-line to the proximal extent of the abnormal epithelium. The gastrotomy then was closed with a linear stapler, and a Nissen fundoplication was performed.Results
Six patients with high-grade dysplasia of the distal esophagus underwent mucosal resection. After 4 to 7 years of endoscopic surveillance, all patients have regenerated squamous epithelium. One patient developed nondysplastic Barrett's esophagus after 2 years and was treated medically. Two strictures were treated successfully with dilatation.Conclusions
Laparoscopic transgastric esophageal mucosal resection was a reasonable treatment for high-grade dysplasia in this small sample of patients. This technique is a potential alternative treatment for high-grade dysplasia of the esophagus. 相似文献994.
Nicolas C. Buchs Pietro Addeo Francesco M. Bianco Antonio Gangemi Subhashini M. Ayloo Pier C. Giulianotti 《World journal of surgery》2010,34(9):2109-2114
Background
Minimally invasive pancreaticoduodenectomy (PD) remains one of the most challenging abdominal procedures and its application in the elderly population is poorly reported in the literature so far. The goal of this study was to demonstrate that robot-assisted PD can be safely performed in patients aged 70 years and older.Methods
Forty-one consecutive robot-assisted PD performed between April 2007 and January 2010 were prospectively entered in a dedicated database. Patients were stratified into two groups: group 1, aged ≥70 years (n = 15, 36.6%); and group 2, aged <70 years (n = 26, 63.4%). The data were reviewed retrospectively.Results
Indications for surgery and patient characteristics were the same in both groups, with the exception of age. There was no statistical difference in terms of operative time (P = 0.376), blood loss (P = 0.989), conversion rate (P = 0.52), mortality (P = 0.36), or overall morbidity rate (P = 0.74). The mean hospital stay was 14.3 days in group 1 and 11.2 days in group 2. This was not statistically significant (P = 0.136).Conclusions
Robot-assisted pancreaticoduodenectomy can be performed safely in elderly patients with comparable mortality, morbidity, and outcomes compared with a younger population. Age alone should not be a contraindication for robotic pancreatic resection. 相似文献995.
Introduction
The purpose of this study was to evaluate the acute fixation strength of fibrin sealant as an alternative fixation method for laparoscopic ventral hernia repair (LVHR) when utilized with absorbable and nonabsorbable barrier meshes. 相似文献996.
Martina de Zwaan Anja Hilbert Lorraine Swan-Kremeier Heather Simonich Kathy Lancaster L. Michael Howell Tim Monson Ross D. Crosby James E. Mitchell 《Surgery for obesity and related diseases》2010,6(1):79-85
BackgroundWeight loss surgery induces a marked change in eating behavior. However, not much work has been done characterizing the eating behavior after weight loss surgery. We conducted a detailed analysis of patients' eating behavior 18–35 months after Roux-en-Y gastric bypass surgery, determined whether preoperative eating disorders might be associated with non-normative postoperative eating, and examined the association of such eating behaviors with weight loss and psychopathology.MethodsA sample of 59 patients who had undergone Roux-en-Y gastric bypass was interviewed in person after surgery about a range of eating behaviors, including binge eating, chewing and spitting out food, picking at and nibbling food, and nocturnal eating and compensatory behaviors such as vomiting and laxative and diuretic misuse. An established semistructured interview was used. The prevalence of preoperative eating disorders was assessed retrospectively. The eating-related and general psychopathology and quality of life were assessed using self-report questionnaires before and after surgery.ResultsSubjective bulimic episodes were reported by 25% and vomiting for weight and shape reasons by 12% of the participants, on average, 2 years after surgery. Subjective bulimic episodes were significantly associated with a preoperative binge eating disorder, with more eating-related and general psychopathology after surgery, and with less weight loss.ConclusionA substantial subgroup of patients with a preoperative eating disorder will develop binge eating after surgery that might be associated with less weight loss. A subsample will start vomiting for weight and shape reasons after bariatric surgery. Clinicians must probe carefully for these behaviors postoperatively to identify patients in need of treatment of pathological eating behaviors. 相似文献
997.
目的:探讨显微内窥镜下椎管减压、椎间植骨融合治疗腰椎失稳症的临床疗效。方法:2006年7月~2008年12月共收治退变性腰椎失稳症患者48例,患者均有持续性腰痛,伴有双侧臀部、双侧或一侧下肢疼痛、麻木,均有间歇性跛行、腰部屈伸活动受限。腰椎动力位X线片示均为单节段失稳,椎间水平移位≥4mm或椎间角度变化≥11°,但滑移不超过Ⅰ度。均采用显微内窥镜下经椎板间隙入路椎管减压、经椎间孔入路椎体间自体骨粒、椎间融合器置入椎体间融合术。术后2周(出院时)拍腰椎正侧位X线片,术后每3个月复查X线片。按照Macnab标准评价疗效,随访观察近期治疗效果。结果:手术时间70~150min,平均95min;出血量110~210ml,平均150ml。随访6~18个月,平均12个月。术后症状及体征均有不同程度缓解,术中、术后均无任何并发症发生。末次随访时按照Macnab标准,优24例,良20例,可4例。X线检查未见cage移位、下沉,37例随访超过9个月的患者均见椎间隙变模糊,过伸过屈侧位X线片示椎体间无移位,但所有患者均未观察到椎间隙消失和骨小梁完全通过椎体间上下终板。结论:显微内窥镜下椎管减压及椎间融合术治疗退变性椎间失稳症具有创伤小、早期疗效满意等优点,长期疗效及融合情况需进一步随访观察。 相似文献
998.
Mahdavi A Shamshirsaz AA Peiretti M Zakashansky K Idrees MT Nezhat F 《Journal of minimally invasive gynecology》2006,13(3):237-241
Vaginal clear cell adenocarcinoma arising from pelvic endometriosis has not been reported in the literature. We report a case of a 50-year-old woman with stage I clear cell adenocarcinoma of the vagina who was found to have endometriosis adjacent to the vaginal tumor. She was treated with neoadjuvant chemoradiation, laparoscopically assisted radical vaginal hysterectomy, radical upper vaginectomy, and pelvic lymphadenectomy followed by combination chemotherapy. 相似文献
999.
Mara M Fucikova Z Maskova J Kuzel D Haakova L 《European journal of obstetrics, gynecology, and reproductive biology》2006,126(2):226-233
Objective: To compare the clinical results of surgical and endovascular treatment of uterine myomas in young women. 相似文献
1000.