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排序方式: 共有109条查询结果,搜索用时 46 毫秒
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A. Shiozaki H. Fujiwara Y. Murayama S. Komatsu Y. Kuriu H. Ikoma M. Nakanishi D. Ichikawa K. Okamoto T. Ochiai Y. Kokuba E. Otsuji 《Diseases of the esophagus》2014,27(5):470-478
This study was designed to determine the efficacy of esophagectomy preceded by the laparoscopic transhiatal approach (LTHA) with regard to the perioperative outcomes of esophageal cancer. The esophageal hiatus was opened by hand‐assisted laparoscopic surgery, and carbon dioxide was introduced into the mediastinum. Dissection of the distal esophagus was performed up to the level of the tracheal bifurcation. En bloc dissection of the posterior mediastinal lymph nodes was performed using LTHA. Next, cervical lymphadenectomy, reconstruction via a retrosternal route with a gastric tube and anastomosis from a cervical approach were performed. Finally, a small thoracotomy (around 10 cm in size) was made to extract the thoracic esophagus and allow upper mediastinal lymphadenectomy to be performed. The treatment outcomes of 27 esophageal cancer patients who underwent LTHA‐preceding esophagectomy were compared with those of 33 patients who underwent the transthoracic approach preceding esophagectomy without LTHA (thoracotomy; around 20 cm in size). The intrathoracic operative time and operative bleeding were significantly decreased by LTHA. The total operative time did not differ between the two groups, suggesting that the abdominal procedure was longer in the LTHA group. The number of resected lymph nodes did not differ between the two groups. Postoperative respiratory complications occurred in 18.5% of patients treated with LTHA and 30.3% of those treated without it. The increase in the number of peripheral white blood cells and the duration of thoracic drainage were significantly decreased by this method. Our surgical procedure provides a good surgical view of the posterior mediastinum, markedly shortens the intrathoracic operative time, and decreases the operative bleeding without increasing major postoperative complications. 相似文献
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The degradation kinetics of L-glutamine (Gln) in aqueous solution was studied as a function of buffer concentration, pH and temperature. Stability tests were performed using a stability-indicating high-performance liquid chromatographic assay. The degradation product of Gln was 5-pyrrolidone-2-carboxylic acid. The reaction order for Gln in aqueous solution followed pseudo-first-order kinetics under all experimental conditions. The maximum stability of Gln was observed in the pH range from 5.0 to 7. 5. The pH-rate profile described by specific acid-base catalysis and hydrolysis by water molecules agreed with the experimental results. Arrhenius plots showed the temperature dependence of Gln degradation, and the apparent activation energy at pH 6.41 was determined to be 9.87 x 10(4) J mol(-1). 相似文献
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The preventive and therapeutic effects of 2-(10,11-dihydro-10-oxodibenzo [b,f]thiepin-2-yl)propionic acid (CN-100) on local and systemic changes of rats with adjuvant arthritis being used frequently as experimental model of rheumatoid arthritis were investigated in comparison with those of reference drugs, indometacin and pranoprofen. Preventively and therapeutically CN-100 showed potent inhibitory effects on adjuvant primary inflammation and secondary lesion. CN-100 also exerted an evident preventive effect on destruction of foot bone, improved the changes in organ weight, and stimulated weight gain. These effects were dose-dependent, and the effects at 5.0 mg/kg were almost the same as those of indometacin and pranoprofen at 1.25 and 2.5 mg/kg, respectively. The mode of action of CN-100 resembled that of reference compounds. Although CN-100 improved the change in albumin/globulin ratio, which was a parameter of systemic inflammatory reactions, the effect was more remarkable in therapeutic administration than in preventive one. This suggests that CN-100 is suitable for clinical application. 相似文献
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Reconstruction technique for umbilical endometriosis. 总被引:2,自引:0,他引:2
E M Kokuba N M Sabino H Sato A Y Aihara E Schor L M Ferreira 《International journal of gynaecology and obstetrics》2006,94(1):37-40
OBJECTIVE: To present a technique for immediate umbilical reconstruction in women undergoing resection of umbilical endometriosis. METHODS: Umbilical reconstruction using 2 semicircular defatted skin flaps was performed in 7 patients surgically treated for umbilical endometriosis from October 2000 to June 2004. The patients were followed up for at least 6 months. RESULTS: Anatomical aspect, depression, and abdominal wall scar were considered satisfactory, although hypertrophic umbilical scars developed in 2 patients. CONCLUSION: This technique using 2 semicircular defatted flaps is efficient in creating a new umbilicus with a natural appearance while leaving a minimal scar. Moreover, it allows for laparoscopic inspection of the abdominal cavity. 相似文献
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Nakamura T Kokuba Y Mitomi H Sato T Ozawa H Ihara A Watanabe M 《Surgical endoscopy》2006,20(9):1501-1503
Purpose We devised a new method for the safe introduction of the first trocar and induction of pneumoperitoneum for laparoscopic excision
of the large intestine.
Methods With this method, a small laparotomy is first conducted according to the size of the exposed affected intestinal tract or
tumor size, prior to the application of a LAP DISC (LD) to the wound and introduction of a 12-mm trocar for the establishment
of pneumoperitoneum. The method is advantageous in that organ injury and vessel injury are avoided when the small laparotomy
is conducted first, and prompt transition to a conventional laparotomy is possible. The diaphragm of the iris bulb can be
controlled in a non-stepwise manner. In addition, trocars, the stapler, and other instruments, can be inserted under the pneumoperitoneum.
Furthermore, the use of a 5-mm flexible scope allows surgical maneuvers, except for application of LD, to be conducted via
5-mm trocars. In addition, the 5-mm scope can be inserted through any trocar, allowing multidirectional avoidance of dead
space and intraperitoneal observation. When only 5-mm trocars are used, it is not necessary for the sites of trocar puncture
to be closed by sutures, and this minimizes the risk of adhesions and port-site herniation. The method is also considered
to be excellent from the point of view of esthetics.
Results We employed this surgical approach in 50 patients with colorectal cancer at our hospital. None of the patients developed any
traumatic complications associated with the insertion of trocars, and none of the patients, even those with a past history
of abdominal operation, required conversion to conventional laparotomy.
Conclusions Based on these results, this method involving a small laparotomy prior to the application of an LD and introduction of a 12-mm
trocar for establishing pneumoperitoneum, with the efficient use of a 5-mm flexible camera, is considered to be safe and useful
for laparoscopic excision of the large intestine. 相似文献
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