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21.
Mesh fixation with human fibrin glue (Tissucol) in open tension-free inguinal hernia repair: a preliminary report 总被引:2,自引:0,他引:2
S. Canonico A. Santoriello F. Campitiello A. Fattopace A. Della Corte I. Sordelli R. Benevento 《Hernia》2005,9(4):330-333
Background: The Lichtenstein technique for inguinal hernia repair is easy to learn and associated with few complications. However, recent
studies have suggested that this technique is inferior to some ‘sutureless’ repair systems in terms of perceived difficulty,
operating time, surgeon satisfaction, etc. Methods: We employed a sutureless Lichtenstein technique in 80 consecutive patients with primary unilateral inguinal hernia, to assess
patient and trainee surgeon outcomes. Human fibrin glue was used in place of conventional sutures. Results: The mean operating time was 36 min and all patients were discharged 5–6 h after the operation. On a 100-point visual analogue
scale, the surgeons rated the difficulty of the operation as low (mean score, 31), and perceived satisfaction as high (mean
score, 84). No complications were observed at 12-month follow-up. Conclusion: This study confirms the efficacy of mesh fixation with human fibrin glue, and supports the viability of a sutureless Lichtenstein
procedure. 相似文献
22.
Teruyuki Usuba Yutaka Suzuki Akira Kuramochi Hisao Tajiri Katsuhiko Yanaga 《Digestive endoscopy》2007,19(1):18-21
Background: Buried bumper syndrome (BBS) is a rare complication of percutaneous endoscopic gastrostomy (PEG). Along with the widespread use of the button‐type kit, BBS is encountered frequently. Methods: In the present study, we examined causes and treatments for BBS among 1400 patients who had undergone PEG. Results: The causes of BBS after PEG were classified into two categories: early causes consisted of wound infection, inappropriate size of kit and severe lordosis, while late causes were inappropriate exchange of kit, rough management or weight gain. The treatments for BBS could be determined by the degree of wound infection, fistula and burial of the bumper. Conclusion: We prepared a flowchart for replacement, by which BBS can be managed safely and quickly without surgical or endoscopic intervention. 相似文献
23.
Pratipal Singh Vivek Vijjan Manu Gupta Deepak Dubey Aneesh Srivastava 《International journal of urology》2007,14(6):558-560
Congenital thoracic ectopic kidney is a very rare developmental anomaly and the rarest form of all ectopic kidneys. It is usually asymptomatic and discovered incidentally on routine chest radiography. Herein we reported the first case of staghorn stone in a thoracic kidney managed successfully by percutaneous nephrolithotomy. 相似文献
24.
T. Scholz Ø. Mathisen A. Bergan S. Osnes R. Innes T. Pedersen A. O. Aasen O. Søreide 《Transplant international》1997,10(3):180-184
We have introduced and evaluated several modifications of the conventional venovenous bypass (VVBP) in 29 adult patients
undergoing liver transplantation (OLT). A percutaneous technique for insertion of a jugular venous return cannula and a femoral
vein cannula was applied. The inferior mesenteric vein (IMV) was used for splanchnic decompression, which facilitated dissection
of the recipient liver and allowed portal anastomosis to be performed without disconnecting the portal bypass. A heat exchanger
was introduced into the bypass circuit to prevent heat loss. The percutaneous technique prevented complications related to
dissection in the axilla and groin. Hemodynamic characteristics corresponded to those found using the traditional technique.
Complications related to the VVBP were seen in only one patient in whom the femoral catheter was accidentally introduced into
the femoral artery. We conclude that percutaneous cannulas, use of the IMV for splanchnic decompression and the introduction
of a heat exchanger offer significant benefits and that they are safe and reliable.
Received: 23 August 1996 Received after revision: 14 January 1997 Accepted: 27 January 1997 相似文献
25.
Sixteen patients receiving percutaneous endoscopic gastrostomy (PEG) feeding following a period of nasogastric (NG) feeding were investigated to assess acceptance and identify problems by means of a questionnaire. PEG was considered to be superior to NG feeding in terms of tolerance and cosmetic acceptance by 81% and 88% of participants respectively ( P < 0.001). Pain was an infrequent problem. Interruptions to feeding were consideed to be more common with NG feeding by 50% of participants; 38% considered interruptions equally common with both PEG and NG, and 12% considered interruptions more common with PEG feeding ( P = NS). The time for care was equivalent for both methods. Seventy-five percent considered PEG to have made a valuable contribution to enteral feeding. Leakage was however considered to be more frequent in PEG feeding by 81% of participants (compared to 12% who considered leakage to be more common with NG feeding; P < 0.001) and leakage was more frequent at die junctions in the catheter rather than from the stoma. Thirty-one percent of patients with PEG had needed systemic antibiotics for stomal infections. All patients with both PEG and NG feeding needed professional help. Sixty-two percent needed professional help more frequently with PEG than with NG feeding (compared to 19% who considered that the NG tube needed professional help more frequently; P <0.05). We conclude that leakage and infections are major problems in PEG enteral feeding. 相似文献
26.
27.
Albert B. Zajko M.D. Klaus M. Bron William L. Campbell 《Cardiovascular and interventional radiology》1987,10(1):28-31
Biliary obstruction and multiple hepatic abscesses occurred in a patient after ligation of a segmental branch of the right
hepatic duct. The patient was successfully managed by transhepatic biliary drainage and balloon dilatation of an internal
fistula that developed between the ligated duct and a Roux limb of jejunum. Internal biliary fistulas may be dilated using
interventioanl radiologic techniques to permit nonobstructed bile flow. Implications for the nonsurgical treatment' of biliary
strictures are discussed. 相似文献
28.
目的分析单侧听耳患者的鼓室成形术,了解手术方法和手术疗效。方法对9耳慢性化脓性中耳炎胆脂瘤型进行了乳突根治术加鼓室成形术,对37耳慢性化脓性中耳炎单纯型和中耳炎后遗症进行鼓室成形术,并比较术后效果。手术后3个月~1年之间进行术后听力评价。结果46耳单侧听力耳术前言语频率气导平均听阈为60.2±23.1dB HL,骨导听阈35.7±17.0dB HL;手术后的平均气导听阈为51.3±22.6dB HL,骨导听阈为36.3±10.6dB HL。鼓室成形术后疗效评定:37耳外耳道宽敞,人工鼓膜完整,血运好,近正常鼓膜色泽;纯音测听500~2000Hz平均气导听力改善23例(62.16%,23/37),听力不变13例(35.14%,13/37),听力恶化(下降10dB以上)1例(2.70%,1/37)。乳突根治术加鼓室成形术后疗效评定:9耳术腔干洁,人工鼓膜完整,血运好,近正常鼓膜色;纯音测听500~2000Hz平均气导听力改善5例(56.56%,5/9),听力不变4例(44.44%,4/9)。结论各型慢性化脓性中耳炎都可作为单侧听力耳的手术适应症。手术时只要注意手术技巧,认真仔细,一般不会造成手术后骨导听力的下降。术后干耳和保持原有听力是手术的最终目的。 相似文献
29.
In our recent review of action control deficits in hemispatial neglect we concluded that many patients with the disorder have deficits in visuomotor control [Coulthard, E., Parton, A., & Husain, M. (2006). Action control in visual neglect. Neuropsychologia, 44(13), 2717-2733]. This conclusion has been questioned and it has been argued instead that there are no action deficits in neglect [Himmelbach, M., Karnath, H.-O., & Perenin, M.-T. (2007). Action control is not affected by spatial neglect: A comment on Coulthard et al. Neuropsychologia, 45(8), 1979-1981]. We proposed that rather than being specific to the neglect syndrome, action control deficits are more likely to relate to lesion location. Although many of these impairments may contribute to the manifestation of neglect, they may also occur in brain-damaged patients without the condition. In this article, we explore this framework further, discussing how neglect behaviour may emerge from damage to a set of visuomotor or cognitive modules, or their connections. Central to our view is the idea that the critical combination of deficits leading to neglect varies considerably between cases, and that visuomotor or cognitive modules disrupted in the syndrome may not, in fact, be specific to neglect. 相似文献
30.
超声引导下经皮经肝胆管穿刺置管引流在梗阻性黄疸病人中的应用 总被引:1,自引:0,他引:1
目的 评价超声引导下经皮经肝穿刺胆管置管引流 (UPTBD)对梗阻性黄疸病人的治疗价值。方法 对 1995年 1月至 2 0 0 2年 7月期间的 4 17例梗阻性黄疸病人进行 4 97次UPTBD治疗 ,并回顾总结他们的临床资料。结果 接受PTBD治疗共有 4 17例 (5 1例病人进行了两个胆管枝的PTBD) ,穿刺成功率达 93.2 % (4 36 / 4 6 8) ,32例首次穿刺失败的病人有 2 9例进行了第二次穿刺置管 ,全部成功。发生胆汁漏 /胆汁性腹膜炎 9例 ,胆道出血 8例 ,感染性休克 1例 ,无腹腔出血、后腹膜血肿、气胸等其他并发症。对 6 4例置管引流患者进行肝功能检测 ,与穿刺前相比 ,引流后 1周和 3周检测病人血清胆红素、转氨酶均显著下降。结论 UPTBD是一项姑息性治疗梗阻性黄疸的快捷、安全、有效的方法 相似文献