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31.
输尿管口囊肿的微创手术治疗 总被引:12,自引:0,他引:12
目的评价输尿管口囊肿的微创手术治疗方法及其疗效。方法回顾性分析25例行经尿道电切(TURU)手术治疗输尿管口囊肿患者资料。男9例,女16例;年龄18—61岁,平均38岁;单侧18例,双侧7例;单纯输尿管囊肿22例,异位输尿管囊肿3例。结果25例患者手术一次成功22例,手术平均时间15min,术后平均住院3d。术后定期B超、膀胱造影随诊,随诊时间1—9年,3例异位输尿管囊肿合并重复肾、输尿管畸形患者存在术后膀胱输尿管返流,2例再次行开放手术后痊愈。结论TURU是治疗成人输尿管口囊肿的有效方法;当合并存在重复肾输尿管畸形或术后膀胱输尿管返流时,应采用输尿管膀胱抗返流手术。 相似文献
32.
自1993年1月-2000年12月,诊治腕管综合征96例,其中手术治疗31例,现将有关资料进行分析。1临床资料1.1一般资料本组96例,男25例,女71例;年龄为26~63岁,平均43岁。16例为双侧性,病程最短为1周,最长为10年。病因:腕部外伤史17例,手部关节酸痛史23例,18例女性患者认为发病与妊娠或 相似文献
33.
改良(足母)趾腓侧皮瓣修复拇手指指腹缺损 总被引:8,自引:2,他引:6
目的介绍改良躅趾腓侧皮瓣修复拇、手指指腹缺损的手术方法。方法对15例拇、手指指腹缺损的患者,采用改良的躅趾腓侧皮瓣移植修复。该皮瓣在传统躅趾腓侧皮瓣设计方法基础上,将皮瓣腓侧缘及近端分别向背侧及趾蹼侧移动,从而避开口径细小又紧贴于皮下的躅趾腓侧浅静脉,直接游离第一跖背浅静脉;皮瓣的动脉和神经游离仍以常规方式进行。结果术后15例皮瓣全部成活,未发生动、静脉危象。12例获得4~11个月随访,3例失访。手功能评定:优10例,良2例。皮瓣两点分辨觉为4~8mm,12例对皮瓣外形满意。供区行走无影响,步态正常。10例对供区外观满意,2例欠满意,其中1例蹲趾腓侧偶有触痛。结论应用改良躅趾腓侧皮瓣可显著降低手术难度,提高成功率。 相似文献
34.
To study the effect of vascularized fibulargraft on large defects of long bones and the monitoringmethod for the vascular status of the grafted fibula. 相似文献
35.
完全腹腔镜规则性肝切除的解剖基础与技术问题 总被引:16,自引:2,他引:14
目的探讨腹腔镜规则性肝切除的解剖基础与技术问题。方法 2 0 0 2年 7月至2 0 0 2年 11月 ,治疗原发病灶位于左半肝但未侵及左肝门的原发性肝癌 4例、肝血管瘤 2例、肝囊肿伴感染 1例。肝切除步骤包括显露第 1肝门 ,游离肝周韧带 ,解剖并离断 2、3级肝门 3管 ,解剖第 2肝门并夹闭肝左静脉 ,离断肝实质和切断肝左静脉。结果 7例完全在腹腔镜下完成手术 ,左半肝切除 2例、左外叶切除 4例、肝方叶切除 1例。均成功地在矢状部对 2至 3级肝门的 3管进行解剖和离断。手术时间为 15 0~ 32 0min ,平均 (2 5 3± 5 9)min。出血量 2 0 0~ 10 0 0ml,平均 (4 5 0± 2 6 1)ml。结论腹腔镜规则性左肝切除术是安全可行的 ,对 2级肝门 3管的解剖和离断是行肝段或左半肝切除时控制出血的关键。 相似文献
36.
37.
Five-Year Outcome After Epilepsy Surgery in Nonmonitored and Monitored Surgical Candidates 总被引:9,自引:9,他引:0
Mark D. Holmes† Carl B. Dodrill†‡ Linda M. Ojemann †‡ George A. Ojemann†‡ 《Epilepsia》1996,37(8):748-752
Summary: Purpose : We wished to compare outcome 5 years after temporal lobectomy in 28 patients selected for surgery on the basis of interictal EEG patterns with that in 46 patients who underwent EEG-video monitoring studies as part of their preoperative evaluation during the same era.
Methods : The 28 nonmonitored patients had interictal EEG patterns that demonstrated a consistent, unilateral, anterior-midtemporal epileptiform focus, without discordant findings from other studies. Outcomes were assessed for years 4 and 5 after operation.
Results : Twenty-six of 28 (92.9%) nonmonitored patients were seizure-free or had at least 75% reduction in seizures. Twenty-nine of 46 (63.0%) monitored patients were seizure-free or had at least 75% reduction in seizures. Preoperative interictal EEGs of 29 of these patients showed independently localized bitemporal, ex-tratemporal, midposterior temporal, or diffuse epileptiform patterns. The remaining 17 monitored patients had preoperative strictly unilateral anterior-midtemporal interictal discharges, and their outcome was comparable to the nonmonitored group, with 15 (88.8%) seizure-free or with at least 75% reduction in seizures.
Conclusions : A proportion of candidates for epilepsy surgery can be selected without ictal recordings provided that interictal EEGs demonstrate consistent unilateral anterior-midtemporal epileptiform discharges and that other data are not discordant. 相似文献
Methods : The 28 nonmonitored patients had interictal EEG patterns that demonstrated a consistent, unilateral, anterior-midtemporal epileptiform focus, without discordant findings from other studies. Outcomes were assessed for years 4 and 5 after operation.
Results : Twenty-six of 28 (92.9%) nonmonitored patients were seizure-free or had at least 75% reduction in seizures. Twenty-nine of 46 (63.0%) monitored patients were seizure-free or had at least 75% reduction in seizures. Preoperative interictal EEGs of 29 of these patients showed independently localized bitemporal, ex-tratemporal, midposterior temporal, or diffuse epileptiform patterns. The remaining 17 monitored patients had preoperative strictly unilateral anterior-midtemporal interictal discharges, and their outcome was comparable to the nonmonitored group, with 15 (88.8%) seizure-free or with at least 75% reduction in seizures.
Conclusions : A proportion of candidates for epilepsy surgery can be selected without ictal recordings provided that interictal EEGs demonstrate consistent unilateral anterior-midtemporal epileptiform discharges and that other data are not discordant. 相似文献
38.
H. Anderl G. Wechselberger M. Ninkovic A. Schwabegger P. Scougall 《European journal of plastic surgery》1996,19(6):327-329
Thoracic duct fistula is a rare but potentially serious complication of head and neck surgery. Such fistulae may be difficult to treat, and several techniques, both operative and non-operative, have been advocated. A case of successful surgical treatment of a chronic thoracic duct fistula is presented. The fistula occurred in a 51-year-old female following treatment of a solitary supraclavicular breast metastasis by local excision and radiotherapy. The divided duct was ligated and the area was covered with the clavicular head of the sternocleidomastoid muscle. 相似文献
39.
Mentosternal contractures still represent a surgical challenge due to their prominent position. They require early operative treatment for both function and aesthetic reasons. Careful clinical examination of scar position and traction forces, both at rest and when functioning, in addition to proper evaluation of the surrounding soft tissue are mandatory for precise preoperative planning of the required reconstruction. In general, the technically most feasible operation is favored if the functional and aesthetic results are good and postoperative risk for recurrence is low. Between 1987 and 1994, 21 patients with cervical, mentosternal, and mentothoracic contractures were operated upon. Eight patients were reconstructed with local flaps and 13 with microvascular free flaps. 相似文献
40.
Background: Laparoscopic surgery has been successfully applied to several gastrointestinal procedures. Although the totally laparoscopic
gastrectomy is feasible, tactile sensation and manipulation of the organ as well as the lesion are decreased when compared
to open surgery. The Dexterity Pneumo Sleeve is a new device which allows the surgeon to insert a hand into the abdominal
cavity while preserving the pneumoperitoneum. This device was used for patients who underwent laparoscopic gastric surgery.
Methods: The first patient presented with a non-Hodgkin's lymphoma of the stomach. A laparoscopically assisted distal gastrectomy
was performed with Roux-en-Y reconstruction. The second patient had a 5-cm leiomyoma involving the greater curve of the stomach,
and this device was used for manipulation of the tumor. The last patient suffered from morbid obesity with its associated
medical complications and a ventral hernia. The Sleeve was applied at the hernia site and a laparoscopically assisted gastric
bypass was performed.
Results: The Pneumo Sleeve was useful in these cases for tactile localization of the tumor and for retraction and manipulation of
the stomach and surrounding upper abdominal organs.
Conclusions: The utilization of this device resulted in a more easily performed dissection, resection, and anastomosis and was felt to
decrease operation time.
Received: 18 September 1996/Accepted: 26 December 1996 相似文献