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101.
Saeed Shoar Fatemeh Sadat Hosseini Azouba Gulraiz Waleed Ikram Moiz Javed Mohammad Naderan Nasrin Shoar Venkat R. Modukuru 《Surgery for obesity and related diseases》2021,17(3):630-643
Even in the hands of highly experienced bariatric surgeons, perioperative complications are inevitable. Of these, leaks and fistulas are amongst the scariest complications. Intrathoracic gastric fistulas (ITGF) can be associated with serious morbidity, mostly when cases are misdiagnosed or detected with delay. This is a systematic review of the literature to investigate the clinical and surgical outcomes of morbidly obese adult patients with a confirmed diagnosis of ITGF following bariatric surgery. A pooled analysis of 25 articles, encompassing 76 patients with post-bariatric ITGF, showed that the clinical outcome depends on the initial presentation, timing of the diagnosis in relation to symptom onset, and prompt and effective treatment. Any septic or unstable patient must undergo urgent surgical intervention, while stable patients might tolerate a step-up approach and watchful waiting for nonsurgical treatment. Among those who undergo surgery, treatment failure and the mortality rate are substantially high. Contingent upon a prompt management strategy, patients with postbariatric ITGF can generally have a favorable outcome in the long term. 相似文献
102.
CZES型食管支架硬式改软式的临床意义 总被引:1,自引:0,他引:1
目的:改进Z型被膜食管支架的结构,使之具有更好的顺应性,稳定性和耐受性。方法:将被膜Z型食管支架的上下钢丝节段之间的交错连接(硬式支架)改为间隙连接(软式支架),并植入治疗43例食管狭窄或食管瘘患者,观察疗效和并发症,并与46例植入硬式支架者比较。结果:两组均取得显著疗效。软式支架组胸痛,呕吐等症状显著减轻,持续时间缩短,未发生支架移位,穿孔等重大并发症。结论:软式食管支架在顺应性,稳定性和耐受性等方面明显优于硬式支架。 相似文献
103.
《Medical Journal Armed Forces India》2023,79(1):64-71
BackgroundWe have been in constant search of novel innovations to decrease the high morbidity after Pancreaticoduodenectomy (PD). Pancreaticojejunostomy (PJ) and pancreaticogastrostomy (PG) are the two different methods of reconstruction after PD. However, the existing data is ambiguous in supporting either of them as the preferred technique of reconstruction.MethodsThis was a single-center prospective observational study that included 64 patients who underwent PD over two years. We compared PG with PJ as a method of reconstruction after PD. The primary objective was to assess whether PG decreases the rate of postoperative pancreatic fistula (POPF) rates or not. Secondary objectives comprised analysis of perioperative outcomes, 30-day and 90-day mortality.ResultsPancreatic fistula was significantly lower in PG as compared to the PJ group (24% vs. 47%) with a p-value of 0.027. The incidence of clinically pertinent (grade B) fistula was only 3% in the PG group and 32% in the PJ group. PG group had a higher incidence of post pancreatectomy hemorrhage (PPH) and delayed gastric emptying (DGE). No statistically significant difference was seen between either group need for blood transfusion, re-exploration, re-admissions, ICU stay, or length of hospital stay, and 30-day and 90-day mortality. Pancreatic texture and high BMI were independent predictors for pancreatic fistula.ConclusionPG when compared to PJ for reconstruction after PD, decreases the rate of POPF significantly; however, it is associated with an elevated risk of DGE and PPH. There was no difference in 30-day and 90-day mortality between both the treatment groups. 相似文献
104.
Summary We describe a case of a vascular mass arising secondary to a postoperative vertebral arteriovenous fistula mimicking recurrent cervical neurofibroma on CT in a patient with neurofibromatosis. Angiography was required for diagnosis. The recurrent tumor resolved following balloon embolization of the fistula. 相似文献
105.
106.
107.
胰十二指肠切除术的技术改进 总被引:1,自引:0,他引:1
目的 探讨改进胰十二指肠切除术,预防术后并发症,提高手术疗效的方法。方法 采用保留幽门、胰管空肠粘膜吻合+胰肠遮盖套入式吻合、胰管支撑外流充分切除胰钩突的术式,并观察其疗效。结果 全组未发生胰瘘及胰断面出血。保留幽门胰十二批肠切除术(PPPD)者有1例术后发生胃潴留,其余胃排空正常。结论 PPPD只要操作得当,可避免术后胃潴留。胰肠遮盖套入式吻合操作简便,可防止术后胰瘘、胰断面出血等并发症。 相似文献
108.
109.
覆膜自膨式金属支架治疗恶性食管气管瘘 总被引:2,自引:1,他引:1
目的 探讨覆膜金属支架治疗恶性食管气管瘘的效果及并发症。方法 在X线引导下14例食管气管瘘用国产覆膜支架治疗,门诊行食管造影或电话随访。结果 除1例瘘口封堵不全外,其余13例瘘口完全封堵,未发生因操作引起的并发症。8例进普食,6例进半流食,12例肺部感染得到控制。并发症:严重胸痛3例,支架移位致瘘再开放1例,颈动脉及左侧喉返神经受压致头晕及咽麻痹各1例。8例病人死亡,术后生存时间1.4~12个月, 相似文献
110.
Yukito Ichinose Hiroshi Asoh Tokujiro Yano Hideki Yokoyama Takashi Inoue Kohsuke Tayama Takashi Ueda Eiji Takai 《Surgery today》1995,25(9):811-815
An experimental study was conducted to determine whether pericardial fat tissue could induce neovascularization and produce cytokines related to tissue repair. Neovascularization was examined using chick chorioallantoic membranes. Pieces of pericardial fat tissue, omentum, and intercostal muscle were individually placed on a number of chorioallantoic membranes and neovascularization induced by each material was assayed 6 days after the implantation. The intensity of neovascularization was in the order of pericardial fat omentum > muscle. Cytokines, such as interleukin 1 (IL-1) and , tumor necrosis factor- (TNF), interferon- (IFN-), and interleukin 6 (IL-6) were assayed in a culture supernatant of pericardial fat tissue. The latter was obtained 24h after the addition of lipopolysaccharide (LPS) following various incubation times. All cytokines other than IFN are known to play a part in tissue repair, whereas IFN is negatively related to tissue repair because it inhibits fibroblast growth. The pericardial fat tissue incubated with LPS produced a certain amount of IL-1 on day 1, and TNF on days 1 and 8, whereafter these values decreased to an undetectable level. Irrespective of the addition of LPS, a large amount of IL-6 was observed in the supernatant of pericardial fat tissue and it was detectable until day 29. On the contrary, INF was not detected at any assay time. These observations suggest that a pericardial fat pad flap could possibly be beneficial in the prevention of bronchopleural fistula after pulmonary resection. 相似文献