23G玻璃体切割手术系统治疗婴幼儿先天性白内障

目的探讨23G经结膜无缝合玻璃体切割系统行晶状体切除联合前段玻璃体切割术治疗婴幼儿先天性白内障的疗效。方法对26例（43只眼）先天性白内障施行23GTVS晶状体切除并前段玻璃体切割术,随访观察术后眼部情况。结果采用该手术方式治疗婴儿先天性白内障,术后患儿眼部反应轻微,无纤维素性渗出,并发症少,减轻了术后护理的难度。结论应用23GTVS行晶状体切除联合前段玻璃体切割术治疗婴幼儿先天性白内障,操作简单,术后视觉通路保持良好,具有较好的临床应用效果。     

Passive removal of silicone oil with a 25-gauge sutureless system

Purpose To report the outcome of a new sutureless technique for passive removal of silicone oil with a 25-gauge system. Methods Between January 2005 and February 2006, 32 patients (32 eyes) underwent passive silicone oil removal with a 25-gauge system in a prospective, interventional case series in our hospital. Main data recorded were visual acuity, intraocular pressure (IOP), silicone oil removal time, complications, and number of sutured sites. Results Mean follow-up was 11.46 ± 3.98 months. Mean silicone oil removal time was 8.93 ± 0.85 (range, 7.0–11.5) min. A suture was placed in only one eye because of leakage. Visual acuity improved in 27 eyes (86.4%), and stabilized in five eyes (15.6%). IOP decreased significantly at all visits during follow-up. On day one, four eyes (12.5%) were hypotonous. Choroidal folds were observed in two eyes (6.25%). No other complications were noted. Conclusions Passive removal of silicone oil with a 25-gauge sutureless technique was effective for 1000 centistokes of oil. Transient hypotony in the early postoperative period did not adversely affect the visual outcomes. Presented as a paper at the Cannes Retina Festival, 24th Annual ASRS and 6th Annual EVRS Meeting, 12 September 2006     

Perceval sutureless aortic valve replacement after ascending aortic replacement

In patients with a narrow sinotubular junction, small sinus of Valsalva, or extensibility loss in the aortic root, aortic valve replacement (AVR) with a standard valve is challenging due to limited surgical field. Detailed preoperative measurements of the aortic root render performing AVR using the Perceval valve easy.     

心下型完全性肺静脉异位引流外科治疗的回顾性队列研究

目的比较无内膜接触缝合(Sutureless)手术和传统手术纠治心下型完全性肺静脉异位引流(total anomalous pulmonary venous connection,TAPVC)的效果。方法回顾性分析2014年6月至2019年4月于我院行手术纠治的46例心下型TAVPC患者的临床资料,排除合并单心室、法洛四联症等患者。根据手术方式将患者分为传统手术组和Sutureless手术组。传统手术组35例,男28例(80.0%)、女7例(20.0%),中位年龄21(8,42)d,中位体重3.6(3.0,4.0)kg。Sutureless手术组11例,男8例(72.7%)、女3例(27.3%),中位年龄14(6,22)d,中位体重3.5(2.9,3.6)kg。比较两组手术疗效。结果传统手术组死亡5例(10.9%),其中院内死亡4例(8.7%),晚期死亡1例(2.2%)。传统手术组死亡率(14.3%,5/35)高于Sutureless手术组(0.0%,0/11),但差异无统计学意义(P=0.317)。Cox回归模型分析发现性别(P=0.042)、年龄(P=0.028)、体外循环时间(P=0.007)、主动脉阻断时间(P=0.018)、气管插管时间(P=0.042)是术后死亡的危险因素。中位随访时间为18.00(5.00,37.75)个月。术后发生肺静脉梗阻22例,均为传统手术组患者,两组差异有统计学意义(P=0.000)。结论对于心下型TAPVC,与传统手术相比,Sutureless手术可以降低术后肺静脉梗阻发生率。     

23G经结膜无缝线玻璃体手术患者的围手术期护理

目的：探讨23G经结膜无缝线玻璃体手术围手术期患者的护理方法,以提高临床治疗效果。方法：回顾性分析山西省眼科医院2010年1月至2012年1月间49例23G经结膜无缝线玻璃体手术患者的临床资料,总结临床护理方法。结果：本组49例手术均获成功,患者对护理满意度高。结论：围手术期护理对于降低该类手术术后并发症的发生率,提高治疗效果,促进患者康复具有重要作用。     

单孔腹腔镜肾癌保肾手术68例经验总结

目的:总结单孔腹腔镜肾癌保肾手术临床应用经验,分析其适应证、安全性、手术方式的选择及治疗效果.方法:回顾性分析2010年12月-2021年6月笔者分别在上海长海医院(22例)、上海第九人民医院(46例)主刀完成的单孔腹腔镜肾部分切除术(13例)、单孔腹腔镜肾癌冷冻消融术(33例)和单孔腹腔镜免缝合肾部分切除术(22例)...     

传统20G与微创23G玻璃体切除手术治疗玻璃体视网膜疾病疗效比较

目的 比较传统20G与微创23G玻璃体切除术式对玻璃体视网膜疾病患者视力情况的改善作用.方法 选取2015年7月至2016年8月榆林市第一医院收治的玻璃体视网膜病变患者82例.根据随机数字表法分为观察组及对照组各41例.对照组患者行传统20G玻璃体手术治疗,观察组患者则行微创23G玻璃体手术治疗.分别比较两组患者术前术后的眼压、视力变化情况,手术时间以及术后并发症发生情况.结果 治疗后1d、3d、7d观察组眼压分别为(10.7±4.2)mmHg、(11.4±4.7)mmHg、(11.7±4.8)mmHg,均显著低于对照组的(19.2±7.3)mmHg、(15.6±5.4)mmHg、(14.9±5.5)mmHg,差异均有统计学意义(均P<0.05).治疗后观察组视力上升率为53.66%(22/41),明显高于对照组的29.27%(12/41),而视力下降率为4.88%(2/41),显著低于对照组的19.51%(8/41),差异均有统计学意义(均P<0.05).观察组手术时间为(37.3±7.5)min,显著低于对照组的(48.3±8.0)min,差异有统计学意义(P<0.05).术后观察组低眼压发生率为14.63%(6/41),显著高于对照组的2.44%(1/41),差异有统计学意义(P<0.05).结论 微创23G玻璃体切除术式治疗玻璃体视网膜疾病可有效改善患者视力,降低了术后眼压上升的风险,但术后早期低眼压是该治疗术式的主要并发症,应给予重视.     

改良两切口23G经结膜免缝合玻璃体切割系统硅油取出术的观察

目的：：评价一次性输血器和自制抽吸头用于23 G经结膜免缝合玻璃体切割系统硅油取出术的有效性和安全性。方法：将23 G灌注管在距离末端5 mm处剪断,制成抽吸头,用于连接一次性输血器和23 G穿刺套管。将输血器的莫菲氏管及以上部分剪除,连接玻璃体切割器的积液盒,利用玻璃体切割器的吸引系统通过睫状体平坦部的两切口主动抽吸清除眼内硅油。结果：患者132例手术中仅有13例(9.8%)需要缝合穿刺口,手术时间为7~28(平均15.1±6.2)min。术后早期107例(81.1%)患者眼压低于11mmHg,并有2例出现周边脉络膜隆起,术后1 wk 眼压基本恢复正常,但有2例(1.5%)高度近视合并黄斑裂孔性视网膜脱离患者出现视网膜再脱离。大部分患者硅油清除干净,仅有4例(3.0%)有少许硅油残留。结论：利用一次性输血器和自制抽吸头连接玻璃体切割器的吸引系统行两切口23 G经结膜免缝合硅油取出术具有安全、有效、快捷、经济等优点,值得推广应用。     

Outcome of different techniques of pterygium excision with conjunctival autografting in pediatric population: Our experience in central India

Aim:

To analyze surgical outcome of pterygium excision with conjunctival autografting in pediatric population ≤16 years.

Settings and Design:

Retrospective case series.

Materials and Methods:

A case sheet review of 145 patients (167 eyes) aged ≤16 years consecutively presented with pterygium from April 2008 to August 2014 in the single center was done. Twenty-six eyes of 25 children who underwent pterygium excision with conjunctival autograft were analyzed. Different techniques used to secure conjunctival autograft in a position were multiple interrupted 8-0 vicryl sutures, single 8-0 vicryl suture in the center of graft and sutureless glue free. Outcome measures were a failure of surgery and recurrence.

Results:

Of the total 167 eyes, 26 eyes of 25 children, mean age 13.07 ± 3.08 years (range 7–16 years) were managed surgically with pterygium excision and conjunctival autograft. The rest of the patients were managed conservatively. In 18 eyes, the graft was secured with multiple sutures, in 6 eyes with a single suture, whereas in 2 eyes, sutureless glue-free graft opposition was done. Mean follow-up was 8.03 months. No case of graft retraction, graft dehiscence or graft displacement was found. Recurrence occurred in 6 eyes and managed surgically.

Conclusions:

Occurrence of pterygium is not uncommon in the pediatric population. A single suture or sutureless glue-free technique may be good alternative for securing conjunctival autograft after pterygium excision in children.