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从妇科肿瘤医生角度看子宫颈癌腹腔镜手术 认领
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作者 王登凤 张国楠 《中国实用妇科与产科杂志》 CAS CSCD 北大核心 2020年第4期313-317,共5页
广泛性子宫切除术+盆腔淋巴结清扫术是早期子宫颈癌的标准治疗方式。由于腹腔镜手术在围手术期结局上的优势,且肿瘤治疗结局与开腹手术相似,逐渐成为早期子宫颈癌的主要手术方式之一。直到2018年11月,《新英格兰医学杂志》发表了2项临... 广泛性子宫切除术+盆腔淋巴结清扫术是早期子宫颈癌的标准治疗方式。由于腹腔镜手术在围手术期结局上的优势,且肿瘤治疗结局与开腹手术相似,逐渐成为早期子宫颈癌的主要手术方式之一。直到2018年11月,《新英格兰医学杂志》发表了2项临床研究结果显示,与开腹手术相比,微创手术的复发率更高、生存期更短。这使得子宫颈癌的微创手术受到了前所未有的打击。而2019年12月《妇科肿瘤学杂志》发表的一项大数据回顾性分析研究结果无疑对于子宫颈癌微创手术是雪上加霜的考验,该研究结果显示,与开腹组相比,腹腔镜组的手术相关并发症发生率更高。文章将从妇科肿瘤医生视角就无瘤原则、无瘤技术及腹腔镜操作细节等方面进行分析及建议。 展开更多
关键词 子宫颈肿瘤 手术 腹腔镜手术 生存率 复发率 并发症
Torsion of Ovarian Tumor in the Elderly: About a Case 认领
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作者 Amadou Bah Ibrahima Diakite +18 位作者 Amadou Maiga Boubacar Yoro Sidibe Madiassa Konaté Zakari Saye Boureima Kelly Tany Koné Siaka Konate Arouna A. Doumbia Bathio Traore Boubacar Karembe Mohamed Lamine Diakite Amadou A. Traoré Abdoulaye Diarra Moustapha Issa Mangane Abdoul Hamidou Almeimoune Bakary T. Dembélé Alhassane Traoré Lassana Kanté Adégné Pierre Togo 《外科学(英文)》 2020年第4期69-73,共5页
We report a case of torsion of an ovarian tumor in a 68-year-old woman with no medical and surgical history. The diagnosis was made in front of an intermittently painful pelvic mass. The treatment consisted of a left ... We report a case of torsion of an ovarian tumor in a 68-year-old woman with no medical and surgical history. The diagnosis was made in front of an intermittently painful pelvic mass. The treatment consisted of a left annexectomy;the anatomopathological examination revealed a fibro-inflammatory and hemorrhagic cyst. Postoperative results were simple with a 12-month follow-up. 展开更多
关键词 TUMOR OVARY CYST SURGERY
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Breast Morphometry in Senegalese Women: Study on a Sample of 118 Subjects 认领
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作者 Ndeye Bigue Mar Assane Ndiaye +8 位作者 A?nina Ndiaye Karim Yacouba Garba Magaye Gaye Sokhna Astou Gawane Thiam Issa Dior Seck Racky Wade Jean Marc Ndiaga Ndoye Mamadou Diop Abdoulaye Ndiaye 《乳腺癌(英文)》 2020年第2期13-20,共8页
Nowadays, women are more and more resorting to breast surgery for the purposes of isolated esthetics or within the framework of a mammectomy for tumor with its cohort of psychological problems post mutilation often re... Nowadays, women are more and more resorting to breast surgery for the purposes of isolated esthetics or within the framework of a mammectomy for tumor with its cohort of psychological problems post mutilation often requiring reconstruction. In context of breast cancer increase in Senegal, we have carried out breast morphology in female subjects of the Sahelian type in order to contribute to the development of a morphological database for reconstruction, reduction or breast augmentation. It was a prospective study on 118 female subjects received at Cancer Institute for screening. They were divided into two groups (age ≤ 40 years and age?> 40 years). Subjects’?morphometric variables were collected in anatomical position and correlated with age, parity, obesity and genital activity using. Fifty six subjects (47.5%) were over 40 years of age. There were 40 multiparous (33.9%). Fifteen subjects (12.7%) and six subjects (5%) were obese and morbidly obese, respectively. Subjects in genital activity were 34 (29%). The overall average size of the areola was 4.3 ± 1.5 cm. The nipple was low located with an average of 7.2 ± 3.5 cm. The diameters mentioned above increased significantly with age and body mass index, for p-values ?0.05, with the exception of the vertical diameter. Breast diameters were greater in postmenopausal women. Morphometry of Sahelian-type women’s breast is strongly influenced by socio-demographic data, hence the need to take it into account during reconstruction, reduction or breast augmentation surgeries in Senegal. 展开更多
关键词 BREASTS MORPHOMETRY Surgery Sahelian WOMAN
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Laparoscopic surgery for early gallbladder carcinoma:A systematic review and meta-analysis 认领
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作者 Xu Feng Jia-Sheng Cao +9 位作者 Ming-Yu Chen Bin Zhang Sarun Juengpanich Jia-Hao Hu Win Topatana Shi-Jie Li Ji-Liang Shen Guang-Yuan Xiao Xiu-Jun Cai Hong Yu 《世界临床病例杂志》 SCIE 2020年第6期1074-1086,共13页
BACKGROUND There is a controversy as to whether laparoscopic surgery leads to a poor prognosis compared to the open approach for early gallbladder carcinoma (GBC)We hypothesized that the laparoscopic approach is an al... BACKGROUND There is a controversy as to whether laparoscopic surgery leads to a poor prognosis compared to the open approach for early gallbladder carcinoma (GBC)We hypothesized that the laparoscopic approach is an alternative for early GBC.AIM To identify and evaluate the safety and feasibility of laparoscopic surgery in the treatment of early GBC.METHODS A comprehensive search of online databases,including MEDLINE (PubMed),Cochrane libraries,and Web of Science,was performed to identify noncomparative studies reporting the outcomes of laparoscopic surgery and comparative studies involving laparoscopic surgery and open surgery in early GBC from January 2009 to October 2019.A fixed-effects meta-analysis was performed for 1-and 5-year overall survival and postoperative complications,while 3-year overall survival,operation time,blood loss,the number of lymph node dissected,and postoperative hospital stay were analyzed by random-effects models.RESULTS The review identified 7 comparative studies and 8 non-comparative studies.1068 patients (laparoscopic surgery:613;open surgery:455) were included in the meta-analysis of 1-,3-,and 5-year overall survival with no significant differences observed [(HR=0.54;95%CI:0.29-1.00;12=0.0%;P=0.051),(HR=0.75;95%CI:0.34-1.65;I^2=60.7%;P=0.474),(HR=0.71;95%CI:0.47-1.08;I^2=49.6%;P=0.107),respectively].There were no significant differences in operation time[weighted mean difference (WMD)=18.69;95%CI:-19.98-57.36;I^2=81.4%;P=0.343],intraoperative blood loss (WMD=-169.14;95%CI:-377.86-39.57;I2=89.5%;P=0.112),the number of lymph nodes resected (WMD=0.12;95%CI:-2.95-3.18;I^2=73.4%;P=0.940),and the complication rate (OR=0.69;95%CI:0.30-1.58;I2=0.0%;P=0.377) between the two groups,while patients who underwent laparoscopic surgery had a reduced length of hospital stay (WMD=-5.09;95%CI:-8.74--1.45;I2=91.0%;P=0.006).CONCLUSION This systematic review and meta-analysis confirms that laparoscopic surgery is a safe and feasible alternative to open surgery with comparable survival and operation-rela 展开更多
关键词 LAPAROSCOPIC SURGERY Open SURGERY EARLY GALLBLADDER carcinoma SURVIVAL META-ANALYSIS
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Unusual Foreign Bodies of Surgical Discovery on a Traumatic Spine 认领
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作者 Habib Abdoul Karim Ouiminga Julien T. Savadogo +5 位作者 Denléwendé Sylvain Zabsonré Anatole Jean Innocent Ouedraogo Diane Ndzana Mengyou Li Désiré Harouna Sankara Magatte Gaye 《神经科学国际期刊(英文)》 2020年第1期15-21,共7页
Introduction: Para-spinal non-metallic foreign bodies (fabrics or plastics) are rare and poorly documented. They are often unknown and discovered at the stage of infectious complications and present big therapeutic ch... Introduction: Para-spinal non-metallic foreign bodies (fabrics or plastics) are rare and poorly documented. They are often unknown and discovered at the stage of infectious complications and present big therapeutic challenges. We report a rare case of three para-spinal foreign bodies (fabric, plastic and postoperative gauze) discovered during surgery of a traumatic thoracic spine. Case report: A 32-year-old man admitted for a polytrauma (collision motorcycle-cart). The admission examination noted closed trauma of the thoracic spine, an ASIA score of A, dyspnea, a penetrating wound of the left side of the chest. The CT scan showed a compressive left pleural effusion, multiple ribs fractures, pulmonary contusion, unstable fracture of fifth and sixth thoracic vertebrae associated with posterior epidural hematoma responsible for medullar compression. There was a rounded, para-spinal image, dotted with small areas of low density, air bubbles. We lifted the vital emergency by draining the left pleural effusion, debriding the penetrating chest wound, and administering broad-spectrum antibiotic therapy. Fourteen days later, we decided to stabilize the spine. After a posterior approach, we discovered free pus and para-vertebral three foreign bodies. Enterobacter spp.was isolated in pus susceptible to imipenem. The immediate operative follow-up was simple. Conclusion: The best treatment remains preventive by simple measures, exploration of penetrating wounds, repeated count and careful verification of gauze, because the infectious complications that they generate are source of mortality and serious medico-legal implications. 展开更多
关键词 TEXTILOMA Foreign Body SPINE Traumatism Surgery
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Surgical Outcomes of Nontraumatic Pediatric Cataracts 认领
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作者 Aslihan Uzun Huban Atilla 《眼科学期刊(英文)》 2020年第2期115-122,共8页
Purpose: To evaluate post-surgical complications in patients who were operated for nontraumatic pediatric cataracts in our clinic. Methods: Medical records of 62 patients (101 eyes) that underwent cataract surgery you... Purpose: To evaluate post-surgical complications in patients who were operated for nontraumatic pediatric cataracts in our clinic. Methods: Medical records of 62 patients (101 eyes) that underwent cataract surgery younger than 15 years of age, without history of ocular trauma and with a minimum follow-up period of 6 months, were reviewed retrospectively. Results: The most common initial complaint was leukocoria. Thirty-nine patients (62.9%) had bilateral cataracts and 23 patients (37.1%) had unilateral cataracts. The most common type was posterior polar cataract (22%) in patients with unilateral cataracts, and total cataract (33%) in patients with bilateral cataracts. The overall prevalence of postoperative complications was 58%, visual axis opacification (VAO) being the most common one (39%). The incidence of VAO was significantly higher in eyes with intact posterior capsules. Secondary glaucoma occurred in 12 (12%) eyes. Thirty-one (50%) patients were orthophoria, 17 (27%) patients had esotropia, and 14 (23%) patients had exotropia. Additional surgery for all of these complications was performed in 53 (53%) eyes. Conclusions: Despite appropriate surgical treatment of nontraumatic pediatric cataracts, post-surgical complications including VAO, glaucoma, or strabismus remain an important cause of morbidity in these patients. Posterior capsulotomy and anterior vitrectomy must be performed in all children below 6 years to reduce the need for additional surgery for VAO. 展开更多
关键词 CONGENITAL CATARACT PEDIATRIC CATARACT Visual AXIS OPACIFICATION GLAUCOMA Surgery
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微创旋切术与传统外科手术治疗乳腺良性肿瘤的临床效果对比分析 认领
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作者 代广全 《智慧健康》 2020年第3期99-100,102共3页
目的本文主要研究和对比微创旋切术与传统外科手术治疗乳腺良性肿瘤的临床效果。方法随机选取我院在2015年11月至2018年11月收治的乳腺良性肿瘤患者100例作为研究对象,然后随机分为对照组和观察组,对照组采用传统开放性外科手术治疗,观... 目的本文主要研究和对比微创旋切术与传统外科手术治疗乳腺良性肿瘤的临床效果。方法随机选取我院在2015年11月至2018年11月收治的乳腺良性肿瘤患者100例作为研究对象,然后随机分为对照组和观察组,对照组采用传统开放性外科手术治疗,观察组采用当下最先进的微创旋切术治疗,最后分别对比两种治疗方式的临床效果,包括切口长度、术中出血量、手术时间、切口愈合时间、术后乳房满意度,以及术后并发症。结果治疗结束后,观察组的对照组患者的切口长度(5.2±1.5)mm、术中出血量(15.2±2.8)mL、手术时间(16.5±3.2)min、切口愈合时间(4.2±0.3)天,明显优于对照组,差异明显具有统计学意义(P<0.05);对照组的术后对乳房外观满意度为76%明显低于观察组的满意度100%,差异明显具有统计学意义(P<0.05);在术后并发症上,观察组的发病率为2%明显高于对照组的并发率30%,差异明显具有统计学意义(P<0.05)。结论在乳腺良性肿瘤治疗中,采用微创旋切术可大大缩短切口长度、减少术中出血量、缩短手术时间、缩短愈合时间,另外在术后患者对乳房外观非常满意,得到患者的认可,具有较好的临床效果,值得推广使用。 展开更多
关键词 微创旋切术 外科手术 开放性手术 乳腺良性肿瘤
Burgeoning study of sentinel-node analysis on management of early gastric cancer after endoscopic submucosal dissection 认领
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作者 David Friedel Xiaocen Zhang Stavros Nicholas Stavropoulos 《世界胃肠内镜杂志:英文版(电子版)》 2020年第4期119-127,共9页
Endoscopic submucosal dissection(ESD)represents an organ-preserving alternative to surgical resection of early gastric cancer.However,even with ESD yielding en-bloc resection specimens,there are concerns regarding tum... Endoscopic submucosal dissection(ESD)represents an organ-preserving alternative to surgical resection of early gastric cancer.However,even with ESD yielding en-bloc resection specimens,there are concerns regarding tumor spread such as with larger lesions,ulcerated lesions,undifferentiated pathology and submucosal invasion.Sentinel node navigational surgery(SNNS)when combined with ESD offers a minimally invasive alternative to the traditional extended gastrectomy and lymphadenectomy if lack of lymph node spread can be confirmed.This would have a clear advantage in terms of potential complications and quality of life.However,SNNS,though useful in other malignancies such as breast cancer and melanoma,may not have a sufficient sensitivity for malignancy and negative predictive value in EGC to justify this as standard practice after ESD.The results of SNNS may improve with greater standardization and more involved dissection,technological innovations and more experience and validation such that the paradigm for post-ESD resection of EGC may change and include SNNS. 展开更多
关键词 Early gastric cancer SENTINEL NODE SENTINEL NODE navigation SURGERY Expanded criteria Endoscopic submucosal dissection Function-preserving GASTRECTOMY Organ PRESERVING SURGERY LYMPHADENECTOMY
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Feasibility of robotic assisted bladder sparing pelvic exenteration for locally advanced rectal cancer:A single institution case series 认领
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作者 Nathaniel H Heah Kar Yong Wong 《世界胃肠外科杂志:英文版(电子版)》 2020年第4期190-196,共7页
BACKGROUND Pelvic exenteration for locally advanced rectal cancer involving prostate has been performed via open surgery.Robotic pelvic exenteration offers benefits of better pelvic visualisation and dissection for bl... BACKGROUND Pelvic exenteration for locally advanced rectal cancer involving prostate has been performed via open surgery.Robotic pelvic exenteration offers benefits of better pelvic visualisation and dissection for bladder preserving prostatectomy with vesicourethral anastomosis,while achieving clear margins.AIM To determine the feasibility of robotic assisted bladder sparing pelvic exenteration.METHODS We describe robotic assisted pelvic exenteration in three cases of locally advanced rectal cancer involving prostate and seminal vesicles(SV).The da Vinci S robotic system was used.Robotic console was docked at left oblique position for abdominal phase and redocked to between the patient’s legs for pelvic phase.All three cases were performed fully robotically at Tan Tock Seng Hospital by colorectal and urological teams.RESULTS Case 1:67-year-old with low rectal tumour 3 cm from anal verge involving the prostate.He underwent neo-adjuvant chemoradiotherapy and robotic abdominoperineal resection with en-bloc prostatectomy.Case 2:66-year-old with low rectal tumour 3 cm from anal verge involving prostate and bilateral SV.He underwent neo-adjuvant chemoradiotherapy and robot assisted ultra-low anterior resection with coloanal anastomosis and en-bloc prostatectomy.Case 3:57-year-old with metachronous rectal tumour in the rectovesical pouch inseparable from the anterior mid rectum,prostate and bilateral SV.He underwent robot assisted ultra-low anterior resection with en-bloc prostatectomy.Bladder neck margin revealed cauterized tumour cells,and he underwent total cystectomy and ileal conduit creation.Histology revealed no residual tumour.All patients are currently disease free CONCLUSION Robot assisted bladder sparing pelvic exenteration can be safely performed in locally advanced rectal cancer with acceptable surgical outcome while preserving benefits of minimally invasive surgery. 展开更多
关键词 Rectal cancer Robot surgery Pelvic exenteration Anterior resection Prostatectomy Minimal invasive surgery
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快速康复外科护理在结直肠癌患者中的应用 认领
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作者 孙云 段艳霞 +2 位作者 白小龙 白育花 薛云珠 《中国继续医学教育》 2020年第7期181-183,共3页
目的探讨快速康复外科护理(FTS)理念在结直肠癌患者中的应用价值。方法本研究选取2016年1月—2017年12月在医院进行手术治疗的100例结直肠癌患者作为研究对象,按照随机分配的原则将所有患者分为对照组(50例)和FTS组(50例);对照组采用常... 目的探讨快速康复外科护理(FTS)理念在结直肠癌患者中的应用价值。方法本研究选取2016年1月—2017年12月在医院进行手术治疗的100例结直肠癌患者作为研究对象,按照随机分配的原则将所有患者分为对照组(50例)和FTS组(50例);对照组采用常规护理,FTS组在对照组基础上采用FTS;对两组术后恢复情况及并发症发生情况进行对比分析。结果FTS组进食时间、下床时间、排气时间、排便时间、胃管留置时间、尿管留置时间、住院时间均显著短于对照组(P<0.05),FTS组并发症总发生率显著低于对照组(P<0.05)。结论快速康复外科护理理念应用于结直肠癌手术患者中可促进恢复,缩短住院时间,降低并发症发生率。 展开更多
关键词 结直肠癌 手术 护理 快速康复外科 手术效果 并发症
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Penile prosthesis implant in the special populations:diabetics,neurogenic conditions,fibrotic cases,concurrent urinary continence surgery,and salvage implants 认领
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作者 Eric Chung 《亚洲男性学杂志:英文版》 SCIE CAS CSCD 2020年第1期39-44,共6页
Penile prosthesis implant(PPI)remains an effective and safe treatment option for men with erectile dysfunction(ED).However,PPI surgery can be associated with a higher risk of complications in certain populations.This ... Penile prosthesis implant(PPI)remains an effective and safe treatment option for men with erectile dysfunction(ED).However,PPI surgery can be associated with a higher risk of complications in certain populations.This article provides a critical review of relevant publications pertaining to PPI in men with diabetes,significant corporal fibrosis,spinal cord injury,concurrent continence surgery,and complex salvage cases.The discussion of each category of special populations includes a brief review of the surgical challenges and a practical action-based set of recommendations.While specific patient populations posed considerable challenges in PPI surgery,strict pre-and postoperative management coupled with safe surgical practice is a prerequisite to achieving excellent clinical outcomes and high patient satisfaction rate. 展开更多
关键词 CONTINENCE SURGERY diabetes erectile dysfunction penile prosthesis IMPLANT Peyronie’s disease PRIAPISM SALVAGE SURGERY spinal cord injury
Long-term clinical performance of flapless implant surgery compared to the conventional approach with flap elevation:A systematic review and meta-analysis 认领
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作者 He Cai Xing Liang +1 位作者 Dong-Yuan Sun Jun-Yu Chen 《世界临床病例杂志》 SCIE 2020年第6期1087-1103,共17页
BACKGROUND The conventional implant approach involves flap elevation,which may result in increased soft tissue and bone loss and postoperative morbidity.The flapless surgical technique,aided by three-dimensional medic... BACKGROUND The conventional implant approach involves flap elevation,which may result in increased soft tissue and bone loss and postoperative morbidity.The flapless surgical technique,aided by three-dimensional medical imaging equipment,is regarded as a possible alternative to the conventional approach to alleviate the above issues.Several studies have been performed regarding the role of flapless implant surgery.However,the results are inconsistent and there is no robust synthesis of long-term evidence to better inform surgeons regarding which type of surgical technique is more beneficial to the long-term prognosis of patients in need of implant insertion.AIM To compare the long-term clinical performance after flapless implant surgery to that after the conventional approach with flap elevation.METHODS PubMed,EMBASE,Cochrane Central Register of Controlled Trials,and grey literature databases were searched from inception to 23 September 2019.Randomised controlled trials(RCTs)and cohort studies comparing the long-term clinical performance after flapless implant surgery to that after the conventional approach over a follow-up of three years or more were included.Meta-analyses were conducted to estimate the odds ratios(ORs)or mean differences(MDs)and their 95%confidence intervals(CIs)between the long-term implant survival rate,marginal bone loss,and complication rate of the flapless and conventional groups.Subgroup analyses were carried out to account for the possible effects of the guided or free-hand method during flapless surgery.RESULTS Ten articles,including four RCTs and six cohort studies,satisfied the eligibility criteria and nine of them were included in the meta-analysis.There was no significant difference between the long-term implant survival rate[OR=1.30,95%CI(0.37,4.54),P=0.68],marginal bone loss[MD=0.01,95%CI(-0.42,0.44),P=0.97],and complication rate[OR=1.44,95%CI(0.77,2.68),P=0.25]after flapless implant surgery and the conventional approach.Moreover,subgroup analyses revealed that there was no statis 展开更多
关键词 FLAPLESS IMPLANT SURGERY Dental implantation Minimally invasive surgical procedures COMPUTER-ASSISTED SURGERY CONE-BEAM computed tomography IMPLANT survival RATE Marginal bone loss Complication RATE
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Unilateral Frontal Sinus Aspergillosis: A Case Report and Review Literature 认领
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作者 Yannick Canton Kessely Felicien G. Toudjingar +6 位作者 Loobé Regis Mwabanyol Mahamat Ali Bolti Aboubakar Aouami Kader Ndiaye Olivier Ouambi Yusra Aboulbachar Ali Momar Code Ba 《神经科学国际期刊(英文)》 2020年第2期101-106,共6页
Frontal sinus aspergillosis is a rare infection that can be usually associated with immunocompromised states and life-threatening with high mortality rate. The authors report in a developing country a case of immunoco... Frontal sinus aspergillosis is a rare infection that can be usually associated with immunocompromised states and life-threatening with high mortality rate. The authors report in a developing country a case of immunocompetent patient with left unilateral frontal headache, associated with left eye ptosis. The Brain CT Scan revealed frontal sinus aspergillosis. She underwent surgery followed by itraconazole cure. The outcome is successful after a period of 14 months with resolution of symptomatology. Anatomopathological examination confirmed aspergillosis. They share their experience of management of this disease in a country where neurosurgery is very young specialty and where molecules against aspergillosis are not available. 展开更多
关键词 ASPERGILLOSIS FUNGAL INFECTION SINUS Surgery
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Gastro Intestinal Stromal Tumor: State of the Art through Our Experience of 64 Cases and a Literature Review 认领
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作者 Saad Slaiki Hicham El Bouhaddouti +2 位作者 Abdelmalek Ousadden Khalid Ait Taleb El Bachir Benjelloun 《癌症治疗(英文)》 2020年第5期265-275,共11页
Gastrointestinal stromal tumors are rare. They are a subject of controversy. We have reported 64 cases of gastrointestinal stromal tumor diagnosed in the surgery department of CHU Hassan II of FES between January 2014... Gastrointestinal stromal tumors are rare. They are a subject of controversy. We have reported 64 cases of gastrointestinal stromal tumor diagnosed in the surgery department of CHU Hassan II of FES between January 2014 and December 2018. The study involved 64 patients (34 men and 30 women) with an average age of 56. The circumstances of findings were dominated by abdominal pain (48 cases), vomiting 16 case followed by transit disorder with 9 cases. The tumor locations were mainly the stomach (n = 31), the small intestine (n = 28), the duodenum (n = 3), and the colon (n = 2). Ultrasound, endoscopy and CT were the main additional tests to detect tumor syndrome. 55 patients were treated by complete surgical excision. Tumor size ranged from 4cm to 18cm. Histologically, the spindle cell type was predominant in 88.91% of cases;epithelioid type was present in 7.81% of cases, while the mixed type was found in 3.6%. The analysis of the expression of CD 117 marker was present in 95.31%, while immunostaining with this marker returned negative in 3 cases;i.e. 5% whose c-kit was positive. Imatinib was indicated in 44 patients (63.60%), with 9 indications for metastatic tumor. As a neoadjuvant, imatinib was indicated in 5 patients, with remission in 28 patients (50.9%), stabilization in 4 patients (7.2%), 2 cases of tumor recurrence and 7 cases of death. 展开更多
关键词 STROMAL Tumor IMATINIB Surgery GIST
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退变性脊柱侧凸手术加速康复外科围手术期管理策略专家共识 认领
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作者 白玉树 翟骁 +29 位作者 陈自强 魏显招 杨明园 杨操 周许辉 李危石 李利 吴继功 许建中 赵建华 王达义 钱邦平 朱泽章 胡勇 孙武权 房敏 郑召民 王征 李淳德 丁文元 夏磊 沈建雄 仉建国 孙天胜 罗卓荆 海涌 吕国华 郝定均 邱勇 李明 《第二军医大学学报》 CAS CSCD 北大核心 2020年第3期233-242,共10页
退变性脊柱侧凸常见于老年患者,通常合并高血压病、冠心病、糖尿病和骨质疏松等基础疾病,手术风险高、并发症多。加速康复外科(ERAS)要求综合考量患者的年龄、症状、体征、身体状况和骨质量等因素,以制定个体化的手术方案和围手术期干... 退变性脊柱侧凸常见于老年患者,通常合并高血压病、冠心病、糖尿病和骨质疏松等基础疾病,手术风险高、并发症多。加速康复外科(ERAS)要求综合考量患者的年龄、症状、体征、身体状况和骨质量等因素,以制定个体化的手术方案和围手术期干预措施,这对改善患者预后和康复十分重要。经全国多位脊柱外科专家多次讨论,在循证医学证据支持下,针对退变性脊柱侧凸手术ERAS围手术期管理策略制定本共识意见,供临床工作参考和应用。 展开更多
关键词 退变性脊柱侧凸 外科学 加速康复外科 围手术期 专家共识
Prof. Henrik Petrowsky: complex hepatobiliary and pancreatic surgery 认领
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作者 Henrik Petrowsky 《肝胆外科与营养》 SCIE 2020年第1期124-125,共2页
Expert’s introduction Prof.Henrik Petrowsky(Figure 1)is a Professor of Surgery and Vice-Chair of the Department of Surgery and Transplantation at the University of Zürich,Switzerland.He serves as Program Directo... Expert’s introduction Prof.Henrik Petrowsky(Figure 1)is a Professor of Surgery and Vice-Chair of the Department of Surgery and Transplantation at the University of Zürich,Switzerland.He serves as Program Director of the HPB Surgery and Liver Transplant Fellowship at the Swiss HPB and Transplant Center Zurich.Prof.Petrowsky is heading the Liver and Pancreas Tumor Center,which is embedded in the Comprehensive Cancer Center Zurich at the University Hospital Zurich.His current practice consists of liver transplantation and HPB surgery.His research interests have mirrored his clinical work mainly focusing on translational and outcome research in liver transplantation and hepatobiliary surgery. 展开更多
关键词 SURGERY SURGERY hepato
急性坏死性胰腺炎的外科干预:时机比技术更重要 认领
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作者 王春友 《中华消化外科杂志》 CAS CSCD 北大核心 2020年第4期366-369,共4页
目前,围绕急性坏死性胰腺炎的手术和非手术治疗、早期手术还是后期手术、微创干预还是开放手术等问题,仍在探索中不断取得进步并逐步形成共识。进一步探索清除胰腺坏死组织最佳手术时机及手术技术、实施微创与开放相结合的外科干预策略... 目前,围绕急性坏死性胰腺炎的手术和非手术治疗、早期手术还是后期手术、微创干预还是开放手术等问题,仍在探索中不断取得进步并逐步形成共识。进一步探索清除胰腺坏死组织最佳手术时机及手术技术、实施微创与开放相结合的外科干预策略、提高针对胰腺坏死组织延期一次性手术清除的成功率,是降低急性坏死性胰腺炎后期病死率的关键。近20年来,对急性坏死性胰腺炎局部并发症病理转归多样性认识的深化,划时代改变了急性坏死性胰腺炎后期的治疗模式。从20世纪末的早期开腹手术引流减压到计划性多次手术清创,再到延期一次性手术,以及近年来探索实施的创伤递进式手术策略,随着治疗理念的变革,逐步实现了疗效的突破。相较于坏死组织的清除技术,手术时机的选择对治疗成功更具重要意义。根据现有针对急性坏死性胰腺炎循证医学研究结果,鉴于急性坏死性胰腺炎病情的复杂性、个体间的差异性、以及有限的多中心研究结果,目前尚不能确定外科技术对改善预后的优势;而手术时机的正确把握,对提高急性坏死性胰腺炎手术治疗效果的地位不容置疑。笔者回顾性分析其团队收治的1000余例外科治疗急性坏死性胰腺炎患者的临床资料,探讨针对急性坏死性胰腺炎后期局部并发症外科干预时机及技术对改善预后的临床意义。 展开更多
关键词 胰腺炎 急性坏死性 外科 手术时机 手术技术 预后
Endoscopic ear surgery 认领
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作者 Ismet Emrah Emre Cemal Cingi +1 位作者 Nuray Bayar Muluk Joao Flavio Nogueira 《中华耳科学杂志:英文版》 CSCD 2020年第1期27-32,共6页
Objectives:This article reviews the advantages and disadvantages of endoscopic ear surgery(EES).Method:Pubmed,Google and the Proquest Central Database at Kirikkale University were queried using the keywords"endos... Objectives:This article reviews the advantages and disadvantages of endoscopic ear surgery(EES).Method:Pubmed,Google and the Proquest Central Database at Kirikkale University were queried using the keywords"endoscopic ear surgery","ear surgery"and"endoscopy"to identify the literature needed for the review.Results:Endoscopes allow for enhanced surgical visualisation.The distal part of the apparatus is illuminated and contains lenses angled to allow a wider view of the operative area.Transcanal endoscopic techniques have transformed the external ear canal(EAC)into an operative gateway.The benefits EES can offer include wider views,enhanced imaging capabilities and increased magnification,and ways to see otherwise poorly visualisable portions of the middle ear.EES permits surgeons to operate using minimally invasive otological techniques.When compared with microscope-assisted surgery,endoscopic tympanoplasty has been shown to require a shorter operating time in some instances.There are a number of drawbacks to EES,however,which include the fact that it is a single-handed technique,that the light source may produce thermal injury and that visualisation using the endoscope is severely curtailed if bleeding is profuse.Conclusion:EES is a safe and effective technique.The current literature supports the idea that the results achieved by endoscopic methods are usually comparably beneficial to results obtained using conventional microscopic methods. 展开更多
关键词 ENDOSCOPIC EAR SURGERY EAR SURGERY ENDOSCOPY BENEFIT
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Use of omental patch and endoscopic closure technique as an alternative to surgery after endoscopic full thickness resection of gastric intestinal stromal tumors: A series of cases 认领
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作者 Amit H Sachdev Shahzad Iqbal +1 位作者 Igor Braga Ribeiro Diogo Turiani Hourneaux de Moura 《世界临床病例杂志》 SCIE 2020年第1期120-125,共6页
BACKGROUND Gastrointestinal stromal tumors(GISTs)originate from interstitial cells of Cajal.GISTs can occur anywhere along the gastrointestinal tract.Large lesions have traditionally been removed surgically.However,wi... BACKGROUND Gastrointestinal stromal tumors(GISTs)originate from interstitial cells of Cajal.GISTs can occur anywhere along the gastrointestinal tract.Large lesions have traditionally been removed surgically.However,with recent innovations in advanced endoscopy,GISTs located within the stomach are now removed endoscopically.We describe a new innovative endoscopic technique to close large and hard to access defects after endoscopic full-thickness resection of gastric GISTs.CASE SUMMARY We present a series of three patients who were diagnosed with a gastric GIST.All patients underwent full-thickness endoscopic resection.In all cases,for closure of the surgical bed,conventional endoscopic techniques including hemoclips,endoloop and suturing were unsuccessful.We performed a new technique in which we pulled omental fat into the gastric lumen and completely closed the defect using endoscopic devices.All patients performed well post-procedure and computed tomography was carried out one day after the procedures which showed no extravasation of contrast.CONCLUSION The omental plug technique may be used as an alternative to surgery in selected cases of gastric perforation. 展开更多
关键词 GASTRIC perforation Gastrointestinal STROMAL tumors GASTRIC tumor SURGERY Endoscopy SUTURING
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Analysis of orthopedic surgical procedures in children with cerebral palsy 认领
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作者 Ignacio Rehbein Viviana Teske +3 位作者 Ignacio Pagano Alejandro Cúneo María Elena Pérez Johan von Heideken 《世界骨科杂志:英文版》 2020年第4期222-231,共10页
BACKGROUND Orthopedic surgery in children with cerebral palsy(CP)aims to improve function and prevent deformities.Each child’s condition in CP is unique and many covariables influence surgical decision-making includi... BACKGROUND Orthopedic surgery in children with cerebral palsy(CP)aims to improve function and prevent deformities.Each child’s condition in CP is unique and many covariables influence surgical decision-making including a patient's age and their functional level.Little is known about the frequency of different types of orthopedic surgery in children with CP who have varied functional levels,particularly in countries from Latin America.AIM To assess the type of orthopedic surgical procedures in relation to age and gross motor function in children with CP.METHODS This retrospective study included all children with CP(n=245)treated with elective orthopedic surgery at a Uruguayan university hospital between October 2010 and May 2016 identified from a surgical database.Eighteen children(7%)were lost to follow-up due to missing medical charts.Demographics,gross motor function classification(GMFCS),and orthopedic surgeries were obtained from the medical records of 227 children.Chi-squared tests and analysis of variance were used to assess the frequency of surgery,accounting for GMFCS levels.Mean age for soft tissue vs bone surgery was compared with the independent samples t-test.RESULTS A total of 711 surgical procedures were performed between 1998 and 2016.On average,children had 3.1 surgical procedures and the mean age at first surgery was 8.0 years.There were no significant differences in age at first surgery among GMFCS levels(P=0.47).The most common procedures were lower leg soft tissue surgery(n=189,27%),hip tenotomy(n=135,19%),and hamstring tenotomy(n=104,14%).For children with GMFCS level Ⅰ,the mean number of surgeries per child[1.8(range 1-9)]differed significantly at P<0.05 in children with GMFCS levels Ⅱ[3.2(1-12)],Ⅲ[3.2(1-8)],Ⅳ[3.3(1-13)],and Ⅴ[3.6(1-11)].Within Ⅱ,Ⅲ,Ⅳ,and Ⅴ,there was no significant difference in mean number of surgeries per child when comparing across the groups.The proportion of soft tissue surgery vs bone surgery was higher in GMFCS levels Ⅰ-Ⅲ(80%-85%)compared to lev 展开更多
关键词 Children CEREBRAL PALSY GROSS MOTOR Function Classification System Surgery EPIDEMIOLOGY
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