下肢开放复杂伤口与创面的修复

目的 探讨多种原因造成的下肢开放复杂伤口与创面的修复.方法 应用皮瓣、肌皮瓣、大网膜移植等方法,对155例下肢复杂伤口与创面进行修复.结果 一次手术愈合率为50%;两次手术愈合率为14.8%;三次手术愈合率为7.7%.结论 皮瓣、肌皮瓣以及大网膜移植,可以有效修复多种原因造成的下肢复杂伤口与创面.     

Case report: Omental lymphangioma mimicking gastric cystic tumor

Omental lymphangioma is a rare pathology presented in the abdomen, and it can mimic several clinical conditions. Owing to its variable signs and symptoms, making a correct diagnosis by clinicians may be difficult. Surgical excision is the gold standard treatment. In this article, we report a case who presented with nonspecific abdominal complaints, and underwent surgery. Final pathologic diagnosis revealed omental cystic lymphangioma.     

Absorption of Insulin in the Peritoneal Cavity in a Diabetic Animal Model

Abstract: This study was conducted to determine if different anatomical sites within the peritoneal cavity have different capacities for portal insulin absorption. Diabetic male Sprague-Dawley rats were studied. They were anesthetized and injected with streptozotocin. Blood glucose was measured before and after insulin (1 U/kg) was applied directly to the omentum, serosal surface of cecum, or parietal peritoneum or injected subcutaneously. In a control group, blood glucose was measured at intervals without administering insulin. In addition, insulin labeled with radioactive iodine (¹²⁵I) was applied to the same three locations in the peritoneal cavity or injected intravenously. Animals were sacrificed at 1, 5, 15, or 30 mins, and radioactivity was measured in excised livers and in blood samples. Blood glucose in the omental group responded to insulin with a greater hypoglycemic effect than in the peritoneal and control groups. The percentage of radioactivity recovered in liver was significantly higher in the omental than in the serosal and peritoneal groups at 1 and 5 mins. The ratio of liver-to-blood radioactivity was also significantly higher in omental than in serosal and peritoneal groups and higher in the serosal than in the peritoneal group at 5 mins. The data suggest that, in this model, the omentum is a better site for insulin absorption than serosa or parietal peritoneum and that significant portal venous absorption of insulin occurs.     

大网膜在外科临床中的应用

目的 探讨大网膜在外科临床中的应用及方法。方法 收集胸腹部外科手术时曾附加大网膜进行治疗的病例共92例,分析其附加治疗的原因及疗效。结果 本组应用大网膜在腹部手术90例,胸部手术2例;术中均采用附加大网膜进行治疗。92例患者全部治愈出院。手术后无大出血、胃肠穿孔,吻合瘘,严重腹腔感染及切口肿瘤种植等并发症。结论 大网膜应用于临床外科,在治疗胸腹腔软组织缺损及预防手术后并发症可以取得良好效果。     

Recanalization of obstructed tenckhoff peritoneal dialysis catheter: Wire/stylet manipulation combined with endoluminal electrocauterization

We report the results of fluoroscopically guided wire/stylet manipulation combined with endoluminal electrocauterization in seven patients with obstructed Tenckhoff peritoneal dialysis catheters. In preparation for clinical application, electrocauterization was performed using a stone basket to recanalize surgically removed Tenckhoff catheters obstructed with omental fat ingrowing through the side holes. All ingrowing omental fat was removed easily by electrocauterization with the rotating movement of a stone basket. The technique was then applied in vivo in seven cases with ingrowing omental fat and malpositioned catheter; six (86%) were successfully recanalized. Among those six cases with initial success, four maintained good catheter function with durable patency (mean 261.3 days). No significant complication was noted.     

An extremely large primary omental hydatid cyst: report of a rare case

Hydatid disease is a parasitic infection caused by Echinococcus granulosus (larval form) in humans with lesionsmost frequently encountered in the liver and lungs. It can rarely involve extra-hepatic organs. It is endemicin some regions of Iran. The omental hydatid cyst is a very rare manifestation of the disease. This report presentsthe interesting case of a very large omental hydatid cyst.     

腔镜技术在腋窝淋巴结清扫及带蒂大网膜一期重建乳房的应用

目的：探讨应用腔镜技术行腋窝淋巴结清扫及带蒂大网膜重建乳房的临床效果。 方法：分析35例行微创根治+微创乳房重建的I、II期乳腺癌患者资料,患者先行腔镜腋窝淋巴结清扫术+腔镜辅助肿瘤所在象限腺体切除,然后采用腹腔镜获取的带蒂大网膜经皮下隧道即时重建乳房。 结果：手术平均总时间为318 min,其中腔镜腋窝淋巴结清扫平均时间为41 min,腹腔镜大网膜获取平均时间为59 min,术中平均出血量为75 mL（主要为腺体部分切除时出血）。1例患者术中损伤胃网膜动脉后改为仅用1条大网膜动脉做为蒂部血管作为供血,术后出现大网膜部分坏死;1例患者出现切口脂肪液化;余患者大网膜成活,无腹部并发症,腋窝形态及上肢功能良好。乳房美学评价,28例优,6例良,1例一般。 结论：腔镜腋窝淋巴结清扫联合腹腔镜带蒂大网膜获取进行一期重建乳房安全可行,手术达到较好的微创效果与美观要求。     

肝硬化患者肠系膜、网膜及腹膜后水肿的CT表现及相关性分析

目的：探讨研究肝硬化患者肠系膜、网膜及腹膜后水肿的CT表现及相关性。方法：回顾分析经手术活检病理证实的62例肝硬化,62例均作腹部CT扫描,从腹部CT表现评估肠系膜、网膜及腹膜后水肿的分布、结构及严重性,对其表现进行相关性分析。结果：48例（77．4％）患者有肠系膜或网膜或腹膜后水肿,其中15例并发胸腔和（或）腹腔积液。46例患者有肠系膜水肿,其中单纯性肠系膜水肿18例,并发网膜或腹膜后水肿28例。1例患者单纯性网膜及腹膜后水肿。肠系膜并发网膜或腹膜后水肿与肠系膜水肿呈中重度改变及弥漫性分布均具有显著性相关（P〈0．01）,中重度肠系膜水肿与肠系膜水肿弥漫性分布及团块状改变均具有显著性相关（P〈0．01）。结论：肠系膜、网膜及腹膜后水肿是肝硬化的常见表现,三种水肿之间具有一定的相关性,CT对其诊断和特征描述有很大的价值。     

Laparotomy for organ evisceration from abdominal stab wounds: A South African experience

Introduction

Organ evisceration following abdominal stab wound (SW) is currently considered as an absolute indication for mandatory laparotomy due to the high incidence of associated intra-abdominal injuries, but literature describing the spectrum of organ injury encountered is limited.