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31.
目的探讨囊肿切除、胆道重建治疗婴儿胆总管囊肿的疗效.方法1984年6月~1999年6月共有15例婴儿先天性胆总管囊肿患儿在我科接受了囊肿切除、胆道重建手术治疗,并对这些患儿进行了随访,随访资料包括症状、体征、B超.钡餐及肝功能检查.结果随访资料完整者12例,除1例术后3个月死于肝功能衰竭外,其余11例成活的患儿生长发育均正常;2例未行套叠瓣的患儿偶有上腹疼痛,但腹痛可自行缓解,钡餐检查见钡剂返流;全组病例肝功均正常,未见胆道结石、消化道溃疡、食道下端静脉曲张.结论囊肿切除、胆道重建治疗婴儿先天性胆总管囊肿可取得满意的疗效. 相似文献
32.
目的 探讨原发性腹膜后恶性肿瘤的临床特点、诊断及治疗措施。方法 分析57例原发性胜利膜后恶性肿瘤的病程、病理类型及手术治疗方式。结果 57例中完整手术切除31例,占54.4%,部分切除9例,占15.8%.单纯活检17例,占29.8%。结论原发性腹膜后恶性肿瘤发病隐蔽,症状不典型,治疗以抹切除为主,强调完整切除提高生存率。 相似文献
33.
Constricting band penile injuries in children may be caused by inadvertent entrapment by a variety of agents including hair, thread, and circumcision dressings. Alternatively, the offending band may have been self-applied or applied by an attendant. Unrelieved, the band causes serious vascular occlusion, progressive tissue necrosis, and injury to the urethra and erectile tissue. We report a case of CBPI in a 12-year-old circumcised boy. The glans was attached to the penile shaft by a tenuous segment of tissue dorsally with complete transection of the urethra. A three-stage reconstruction using a delayed groin flap was successful. 相似文献
34.
目的:探讨先天性胆管囊肿的病因、分型、诊断和治疗方法。方法:回顾1986至1996年10年间收治的先天性胆管囊肿28例进行分析。结果:28例中Ⅰ型19例(6785%),IVA型8例(286%),IVB型1例(36%)。B超检查26例,24例手术证实;CT9例7例手术证实。手术治疗为最佳手段,以囊肿切除为首选。本组25例手术治疗,囊肿切除13例(占52%)。结论:B超为主要诊断手段。先天性胆管囊肿癌变率随病程延长而逐渐上升,故切除囊肿为首选治疗手段 相似文献
35.
First experience with gamma probe guided sentinel lymph node surgery in penile cancer 总被引:3,自引:0,他引:3
Wawroschek F Vogt H Bachter D Weckermann D Hamm M Harzmann R 《Urological research》2000,28(4):246-249
Because of the curative approach, the detection of lymph node metastases in squamous cell carcinoma (SCC) of the penis is
of significant clinical relevance. Sentinel lymph node (SLN) identification by means of lymphangiography has been proven to
be insufficiently safe. However, the high morbidity of inguinal lymphadenectomy and the considerable individual variability
regarding the location of lymph node metastases justify the necessity of a technique that enables the identification of SLNs.
Since 1998, SLNs have been intraoperatively identified and selectively dissected, after peritumoral injection of technetium-99m
nanocolloid and using lymphoscintigraphy, in three patients (one with malignant melanoma and two with SCC). At least one SLN
could be detected in each patient. The maximum surgical time was 30 min. There were no severe complications. Lymph node metastases
did not occur in any patient. Upon a mean follow-up of 10 months, all patients are currently free of tumor. Owing to the long-term
results of sentinel lymphadenectomy in malignant melanoma of other locations and our preliminary results with respect to penile
carcinoma, we consider the current method appropriate as the only primary operation for lymph node staging in early stages
and, in combination with modified inguinal lymphadenectomy, in locally advanced stages.
Received: 24 November 1999 / Accepted: 21 April 2000 相似文献
36.
目的 :观察大黄、水蛭等对肾大部切除所致大鼠慢性肾衰保护作用的影响。方法 :采用 5 6肾大部切除模型 ,并随机分成假手术组 ,肾大部分切除组 ,包醛氧淀粉组 ,肾衰宁组及大黄、水蛭等高、中、低剂量组。采用ELISA法观察各组动物肿瘤坏死因子 (TNF α)水平 ,同时观察大鼠 2 4h尿蛋白、尿素氮 (BUN)、血肌酐 (Scr)的变化。结果 :大黄、水蛭等能减少尿蛋白 ,降低TNF α、BUN、Scr,以低剂量组效果最佳 ,与模型组比较有显著性差异。结论 :大黄、水蛭等对肾大部切除大鼠的肾脏具有保护作用 ,可减轻肾脏的损害。 相似文献
37.
目的 研究保留盆腔自主神经的直肠系膜全切除术后患者的排尿和性功能。方法 将 63例DukesA、B期直肠癌患者随机分为对照组 (2 9例 )和研究组 (3 4例 )。对照组行Miles手术 (13例 ) ,Dixon手术 (16例 ) ;研究组行保留盆腔自主神经的直肠系膜全切除术 ,保留肛门 2 5例 ,未保留肛门 9例。观察比较 2组患者术后自主排尿的情况 ,膀胱残余尿量及性功能。结果 研究组患者术后轻、中、重度排尿障碍的发生率分别为 11.8%、5 .9%和 0 ,明显低于对照组 (2 4.1%、2 0 .7%和 3 .5 % )。研究组中 17例男性患者术后 2例 (11.8% )阴茎不能勃起 ,4例 (2 3 .5 % )不能完成性交及射精 ;17例女性患者术后 1例 (5 .9% )性交时阴道湿润性差 ;7例男、女患者 (2 0 .6% )术后不能体会性高潮。对照组中 15例男性患者术后 11例 (73 .3 % )阴茎不能勃起 ,13例 (86.7% )不能完成性交及射精 ;14例女性患者术后 6例 (4 2 .9% )阴道湿润性差 ;2 5例男、女患者 (86.2 % )术后不能体会性高潮。研究组男、女患者术后性功能障碍发生率显著低于对照组。结论 保留盆腔自主神经的直肠系膜全切除术能较好保留直肠癌患者术后的排尿和性功能。 相似文献
38.
Shigemi Onoue Takehito Katoh Yoshihisa Shibata Yasushi Mokuno Katsushi Yoshida Satoshi Kamiya Tetsuya Abe Kiyoshi Hiramatsu Minoru Esaki Haruhiko Chigira 《International journal of clinical oncology / Japan Society of Clinical Oncology》1997,2(2):121-124
We report a case of a long-term survivor with malignant melanoma of the anus who did not undergo radical surgery. A 71-year-old
woman who presented with anal bleeding and anal tumor underwent an excisional biopsy in September 1985. The biopsy specimen
was a lobulated, polypoid, pigmented mass 2 cm in diameter, that had been located on the anterior wall of the anus. A satellite
nodule 7 mm in diameter was found on the left wall of the anus at the level of the dentate line. Both tumors were histologically
diagnosed as malignant melanoma. The primary tumor was 6 mm thick. Melanoma cells were present microscopically at the cut
end of the rectum. Because of her history of ischemic heart disease, the patient rejected our recommendation that she undergo
radical surgery, and received 10 courses of carboplatin 20 mg intramuscularly and OK-432 10 K.E. (Klinische Einheit) intradermally
every week. A single, pigmented metastatic inguinal lymph node developed and was excised in June 1987. A recurrent tumor was
detected in the rectum in October 1992, so again we recommended radical surgery. The patient rejected radical surgery again,
and received 12 courses of carboplatin 10 mg intramuscularly every 2 weeks. She died of disease at home in July 1993 after
surviving for 7 years and 10 months. An autopsy was not performed. This case shows that local excision of the primary lesion
may be appropriate to preserve the quality of life of patients with early-stage malignant melanoma of the anus. 相似文献
39.
Objective: To study the pattern of lymphnode metastasis in carcinoma of esophagus. Methods: 200 cases of resected esophageal
cancer specimens were carefully examined pathologically. Lymphnode metastasis, its pathway and extent in relation to pathological
changes were analyzed. Results: Lymphnode metastasis was mainly regional and extended vertically in both directions. Leaping-over
metastasis was another feature. The deeper invasion by the tumor, the higher frequencies of metastasis development, and vice
versa. However, leaping-over metastasis was more likely to occur where tumor invasion was less severe. Conclusion: Owing to
the high frequency of lymphnode metastasis in the superior mediastinum and the widely spanned leaping-over metastasis, an
operative approach by three incisions through right thoracotomy with excision of the whole segment of esophagus and anastomosis
at cervical region was recommended, in order to dissect lymphnodes in the cervical, thoracic and abdominal regions and to
leave less or no metastatic lymphnodes behind. 相似文献
40.
目的:探讨微粒子炭在指导直肠癌手术中淋巴结清除的临床意义。方法:采用前瞻性病例对照研究,患者随机分组:40 例直肠癌患者术前经肠镜局部注射微粒子炭后行直肠癌根治术,40例仅行常规直肠癌根治术作为对照组。所有病例记录清除的淋巴结数并做病理检查。结果:术中被黑染的淋巴结清晰可辨;注墨组平均每例清除淋巴结数为(24. 6±4. 2)个,对照组为(15. 1±2. 6)个,P=0. 003 7;淋巴结转移病例中,注墨组平均每例清除转移淋巴结(7 .8±1 .7)个,对照组(4. 2±2. 0)个,P=0. 004 5;注墨组总的淋巴结黑染率62 .0%, 转移淋巴结黑染率66. 4%。结论:局部应用微粒子炭对指导直肠癌手术中的淋巴结清除具有统计学意义。 相似文献