Clinical use of a neuronavigation system in hemangioblastoma resection of posterior cranial fossa

Abstract

The aim of this study was to retrospectively evaluate the effectiveness of the Stryker Leibinger neuronavigation system in surgical resection of hemangioblastomas of the posterior fossa. The study included 16 cases of solid hemangioblastoma of posterior cranial fossa treated since we began using Stryker Leibinger neuronavigation system-assisted microneurosurgery in 2003. These cases were compared on the basis of time, blood loss, and complications to 19 similar cases of solid hemangioblastoma that underwent conventional microneurosurgical resection prior to 2003. All patients in the experimental (neuronavigation-assisted) group underwent surgical resection without complications while the control groups' resections all involved blood loss related to the longer operation time. Neuronavigation also resulted in a clear field of surgical vision and clear lesion boundaries, making it easier to remove lesions and reduce accidental injury of adjacent normal structures. The application of navigation technology is very valuable for solid hemangioblastoma operations not only by shortening operative time, thereby significantly reducing operative blood loss, but also by making surgical excision easier, reducing damage to adjacent normal structures, and decreasing surgical complications and mortality.     

经皮膀胱穿刺造瘘在经尿道前列腺等离子电切术治疗大体积前列腺增生中的前瞻性对照研究

目的探讨经皮膀胱穿刺造瘘在经尿道前列腺等离子电切术（plasma kinetic resection of prostate，PKRP）治疗大体积前列腺增生中的价值。方法2009年1月～2011年12月，将72例进行PKRP的大体积前列腺增生患者随机分为膀胱造瘘组和对照组，分别采用经皮膀胱造瘘＋PKRP或单纯PKRP。记录术前前列腺体积、手术时间、切除的前列腺质量，检测术前、术后即刻和术后1天的血清钠、钾和氯。结果与对照组相比，膀胱造瘘组切除的前列腺组织质量大[（88．66±23．48）gVS．（78．39±16．04）g，t=2．168，P=0．034]，手术时间短[（74．03±30．54）minVS．（92．36±34．36）min，t=-2．393，P=0．019]。2组术后血清钠、钾和氯均正常。结论经皮膀胱穿刺造瘘可以缩短PKRP的手术时间，对血清钠、钾和氯无明显影响。     

经闭孔行闭孔神经阻滞对预防膀胱侧壁肿瘤电切时闭孔神经反射的作用

目的探讨经闭孔行闭孔神经阻滞对预防膀胱侧壁肿瘤电切时闭孔神经反射的作用。方法回顾性分析67例膀胱侧壁浅表性肿瘤行经尿道膀胱肿瘤电切术的患者资料,根据术中是否行闭孔神经阻滞分为闭孔神经阻滞组（35例）和对照组（32例）,其中闭孔神经阻滞组术中辅以经闭孔法闭孔神经阻滞,而对照组未行闭孔神经阻滞。比较两组术中闭孔神经反射发生率、膀胱穿孔率、手术时间、及出血量,并术后随访观察肿瘤的复发情况。结果两组术中电切时间、出血量、术后1年肿瘤复发率均无统计学差异,但闭孔神经阻滞组闭孔神经反射率及膀胱穿孔率较对照组明显降低。结论经闭孔行闭孔神经阻滞能有效预防膀胱侧壁肿瘤电切时闭孔神经反射,可降低膀胱穿孔率,其操作要点是选择准确的穿刺点、掌握好穿刺方向和深度。     

R0 resection in the treatment of gastric cancer: Room for improvement

Gastric carcinoma is one of the most frequent malignancies in the world and its clinical behavior especially depends on the metastatic potential of the tumor.In particular,lymphatic metastasis is one of the main predictors of tumor recurrence and survival,and current pathological staging systems reflect the concept that lymphatic spread is the most relevant prognostic factor in patients undergoing curative resection.This is compounded by the observation that two-thirds of gastric cancer in the Western world...