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51.
A novel retractor has been designed to achieve atraumatic retraction of the liver and displacement of hollow viscera during endoscopic surgery. The functional section of the instrument, when locked, forms a silicon-covered uniplanar hook which can be deployed for horizontal lift of solid organs such as the liver or be used to engage bowel for displacement from the operative field. Following laboratory testing, the instrument has been evaluated clinically and its ease of deployment and atraumatic nature have been confirmed. It has been found to be particularly effective for elevation of the thick fatty left lobe of the liver during antireflux surgery. 相似文献
52.
Summary A simple technique of stereotactic craniotomy and intraoperative lesion localisation that uses the Brown-Robert-Wells (BRW) stereotactic frame is presented. The method optimises craniotomy placement and facilitates localisation of small intracerebral lesions. Using the system, 16 patients have had resection of intracranial neoplasms from deep and/or eloquent areas of the brain with no neurological morbidity. 相似文献
53.
Franco Rilke M. D. F. R. C. Umberto Veronesi M. D. Alberto Luini M. D. Cristina Brambilla M. D. Viviana Galimberti M. D. Stefano Zurrida M. D. Silvana Pilotti M. D. M. I. A. C. Silvana Di Palma M. D. Roberto Zucali M. D. Laura Lozza M. D. 《The breast journal》1996,2(3):176-180
Abstract: Breast conservation surgery is an effective and safe treatment for many breast carcinomas. It may be possible to further limit the extent of resection (or expand the indication for breast conservation) by the application of preoperative chemotherapy and radiotherapy. We explored the feasibility of this in a pilot study.
Seventy-three patients (mean age 48, 63% premenopausal) with confirmed breast cancer, less than 2.5 cm, received chemotherapy (Group A) or chemotherapy plus radiotherapy (Group B) prior to limited resection (tumorectomy). Axillary dissection was always performed. Results: In 6/31 (19%) Group A and 17/42 (40%) Group B patients the tumor was not palpable after preoperative treatment, with complete pathological remission in 1 and 3 cases respectively. Histologic grading, mitosis, cellular alteration, and cellularity evaluations indicated a consistently greater therapeutic effect with chemoradiotherapy than with chemotherapy alone.
In conclusion, radiotherapy appears useful in the preoperative treatment of breast cancer and its use in association with various drug combinations should be further explored. 相似文献
Seventy-three patients (mean age 48, 63% premenopausal) with confirmed breast cancer, less than 2.5 cm, received chemotherapy (Group A) or chemotherapy plus radiotherapy (Group B) prior to limited resection (tumorectomy). Axillary dissection was always performed. Results: In 6/31 (19%) Group A and 17/42 (40%) Group B patients the tumor was not palpable after preoperative treatment, with complete pathological remission in 1 and 3 cases respectively. Histologic grading, mitosis, cellular alteration, and cellularity evaluations indicated a consistently greater therapeutic effect with chemoradiotherapy than with chemotherapy alone.
In conclusion, radiotherapy appears useful in the preoperative treatment of breast cancer and its use in association with various drug combinations should be further explored. 相似文献
54.
Brian Wm. Davies M.D. Gary A. Pennington M.D. Bahman Guyuron M.D. 《Aesthetic plastic surgery》1993,17(2):125-128
Ambulatory surgery has become routine for many plastic surgery procedures. Anesthesia techniques including general anesthesia by inhalation and intravenous infusion and the dissociative technique have all been used successfully for outpatient anesthesia. Propofol (Diprivan), a relatively new agent, has proven to be a safe and effective general anesthesia agent for outpatient surgery. We report on our experience with propofol as an induction agent and continuous drip for general anesthesia maintenance in 100 consecutive outpatient, plastic surgery procedures performed in an office facility. Assessment factors were recovery-room time, nausea and vomiting in the recovery room and at home, hallucinations, patients' recollection of anesthesia experience, and overall patient satisfaction. 相似文献
55.
目的:为了更完全地切除中颅凹底内外沟通性肿瘤。方法:采用经过改良的Mickey额颞颞下窝入路。其改良主要是将额骨瓣连同其表面附着的颞肌以及游离后的眶颧骨块一并向下翻开,并将手术程序作了相应改变。结果:成功切除了13例肿瘤。术后3例恢复了轻工作,6例能自主生活,3例生活仍需别人照顾,1例复发未再次手术。结论:采用改良的额颞颞下窝入路对中颅凹底内外沟通性肿瘤暴露充分,切除广泛。Mickey入路改良的优点:颞肌血运的保留,有利于骨瓣与正常颅骨的早期融合。同时颞肌附着点的保留,有利于咀嚼功能。 相似文献
56.
联合抗青光眼手术治疗不易控制眼压青光眼的研究 总被引:1,自引:0,他引:1
采用板层下巩膜床双咬切、睫状体剥离合并睛状体上腔植入硅橡胶条的抗青光眼联合手术治疗不易控制眼压的青光眼46例52眼,其中继发性青光眼27眼,原发闭角青光眼10眼,原发开角青光眼6眼,先天、青少年型青光眼7眼,虹膜角膜内皮综合征2眼。手术总有效率达94%。本术式具有小梁切除、睫状体剥离、睫状体扁平部引流的功能。作者认为用硅橡胶条作植入物,比异体或自体组织作植入物更为理想。 相似文献
57.
下腰痛患者后路手术并发症的防治 总被引:30,自引:0,他引:30
目的:分析下腰痛患者后路手术并发症出现的原因,探讨防治办法。方法:回顾分析我科自1988~1998年6月间采用后路手术治疗下腰痛,即腰椎间盘突出症和/或腰椎管狭窄症患者570例的临床资料。结果:33例发生术后并发症,发生率5.79%,早期(术后2周以内)并发症18例,晚期并发症15例,但无一例并发神经根损伤。结论:除了术中操作技能外,术前严格掌握手术适应证,术后及时观察、早期功能锻炼,都有利于并发症的防治。 相似文献
58.
Summary It has been widely observed that the outcome after repeat lumbar surgery is rarely comparable to that of primary surgery. In particular, the results of repeat surgery for lumbar spinal stenosis (LSS) have not been favourable. We used a matched-pair format in an attempt to decrease the confounding factors so as to determine as exactly as possible the effect of prior back surgery on the LSS patients surgical outcome. The matching criteria were sex, age, myelographic findings, major symptom, and duration of symptoms. From one group of 251 patients without prior back surgery (SO patients) and another of fifty-three patients with one preceding back operation (RS patients), forty-one similar matched patients pairs (one SO and one RS-patient) were formed.There were 8 female and 33 male pairs. The mean age of the SO patients was 51.6 and of the RS patient 51.4 years, and the mean follow-up time was 4.6 and 4.4 years. The assessment of outcome was based on a subjective disability questionnaire. The SO patients fared significantly better than the RS patients (32.1 versus 41.3, P = 0.026). A short time interval between operations in the RS patients had a worsening effect on outcome, but this trend was not significant.We concluded that one preceding back operation had a worsening effect on the outcome of patients operated on for LSS. As a whole, the results of RS patients were unfavourable. The proper time for achieving good surgical results in LSS patients is the initial operation. 相似文献
59.
William V. Giannobile Rafaél A Hernandez Richard D. Finkelman Susan Ryarr Christopher P. Kiritsy Mark D'Andrea Samuel E. Lynch 《Journal of periodontal research》1996,31(5):301-312
Platelet-derived growth factor (PDGF) and insulin-like growth factor I (IGF-I) in combination have previously been shown to enhance periodontal regeneration. The objective of this study was to further characterize the biological effects of this combination of growth factors in non-human primates and compare the effects to those of each growth factor individually. Ligature-induced periodontitis was initiated in 10 cynomolgus monkeys. After periodontal lesions were established, surgery was performed, and either a methylcellulose gel vehicle or vehicle containing 10 μg each of either PDGF-BB, IGF-I or both PDGF-BB and IGF-I was applied to exposed root surfaces. Biopsies were taken 4 and 12 wk after treatment and the extent of periodontal regeneration was assessed by histomorphometry. At both 4 and 12 wk vehicle-treated lesions generally revealed minimal osseous defect fill (ODF) (8.5±2.1% and 14.5±5.7%, respectively) and new attachment (NA) (34.1±5.2% and 26.6±10.5%, respectively). IGF-I treatment did not significantly alter healing compared to vehicle in any parameter at both 4 and 12 wk. PDGFBB-treated sites exhibited significant (p<0.05) regeneration of NA (69.6±12.0%) at 12 wk; trends for PDGF-BB treatment effect were also observed in other parameters at 4 and 12 wk. although these increases were not statistically significant. Treatment with PDGF-BB/IGF-I resulted in 21.6±5.1 % and 42.5±8.3% ODF at 4 and 12 wk, respectively, and 64.1±7.7% and 74.6±7.4% NA at 4 and 12 wk, respectively (all significantly greater than vehicle, p<0.05). The results from this study demonstrated that: 1) IGF-1 alone at the dose tested did not significantly alter periodontal wound healing; 2) PDGF-BB alone significantly stimulated NA, with trends of effect on other parameters; and 3) the PDGF-BB/IGF-I combination resulted in significant increases in NA and ODF above vehicle at both 4 and 12 wk. 相似文献
60.
Bojan Pajic Grigoris Pallas Gerding Heinrich Matthias Böhnke 《Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie》2006,244(1):22-27
Purpose It was the aim of this study to investigate the efficacy, longevity, and safety of a new ab interno intervention for the treatment
of primary open-angle glaucoma (POAG).
Methods The previously described method of radiofrequency-mediated “sclerothalamotomy ab interno” was applied in 53 eyes of consecutive
patients with POAG between April 2002 and July 2002. Average preoperative intraocular pressure (IOP) was 25.6±2.3 mmHg (range
18–48 mmHg). Sclerothalamotomies were carried out with a custom-made high-frequency dissection 19 G probe (tip 0.3×1 mm) applying
bipolar current with a frequency of 500 kHz (tip temperature 130°C).
Results After a follow-up period of 24 months, the average IOP was 15.0±1.6 mmHg (range 11–20 mmHg) (p<0.005). The average number of topical agents was 2.6±1.0 (range 1–5) preoperatively. Twenty-four months after surgery such
agents were used in only five (9.6%) eyes and the average was 0.21±0.53 (range 0–2). Transient IOP elevation was observed
in 12 of 53 eyes (22.6%) postoperatively. In all cases elevated IOP could efficiently be controlled with topical medication.
In general, IOP dropped continuously over the course of the 6 months following surgery and then remained constant.
Conclusions This study indicates that sclerothalamotomy ab interno is a safe and efficient surgical method for the treatment of POAG.
Long-term results clearly demonstrate the longevity of IOP reduction. 相似文献