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Revascularization for Iliac-femoral Artery Pseudoaneurysm with Greater Saphenous Vein

Chinese Medical Sciences Journal 2010年第1期25卷 57-60页

作者： Ji-dong Wu Yue-hong Zheng nim choi Furtado Rui Department of Vascular Surgery Peking Union Medical College Hospital Chinese Academy of Medical Sciences ＆ Peking Union Medical College Beijing 100730 China Department of General Surgery Cir Gen/Vas Central Hospital Centre S. Januario Macao China

Objective To investigate the role of revascularization procedures with autologous greater saphenous vein in surgical management of iliac-femoral artery pseudoaneurysm in parenteral drug abusers. Methods Twenty-one patients with iliac-femoral artery pseudoaneurysm caused by parenteral drug abuse from 2004 to 2007 were enrolled. Among them,15 patients were male and 6 were female; their average age was 31.3 years. The size of pseudoaneurysms ranged from 3.0 cm to 7.5 cm. Common femoral artery and distal external iliac artery were often involved. We performed arterial reconstruction on these patients with autologous greater saphenous vein as a graft after excising iliac-femoral artery pseudoaneurysm through a single curved inguinal incision. All patients were followed up,and the complications were recorded. Results The surgical procedures were finished without intraoperative mortality or perioperative complications. All patients were free of claudication symptoms after the surgery except one case with preoperative popliteal artery stenosis. One case of infection and wound tissue fistula was found later. One case had inguinal incisional hematoma and another complained of numbness in thigh skin. Conclusions The use of autologous greater saphenous venous grafts for arterial reconstruction after pseudoaneurysm excision in drug abusers is safe and effective. This technique offers more advantages than arterial ligation alone without revascularization. An optimal greater saphenous venous graft is a prerequisite for revascularization.

关键词： pseudoaneurysm drug abuser bypass greater saphenous vein

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Hybrid Endovascular Aorta Repair with Simultaneous Supra-aortic Branch or Iliac Branch Revascularization

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Chinese Medical Sciences Journal 2009年第3期24卷 182-185页

作者： Yue-hong Zheng nim choi Hong-ru Deng CU Kouk Kun Yu Furtado Rui Department of Vascular Surgery Peking Union Medical College Hospital Chinese Academy of Medical Sciences ＆ Peking Union Medical College Beijing 100730 China Department of General Surgery Central Hospital Conde S. Januario of Macao Caixa Postal 3002 Macao

Objective To describe a hybrid endovascular procedure for aorta repair with different kinds of bypass followed by concomitant placement of stent graft in the aorta. Methods From June 2007 to May 2008, 5 consecutive patients who presented with aortic aneurysm or dissection were treated with a new hybrid aorta repair technique. Complete surgical rerouting of supra-aortic vessels was simultaneously created by endovascular repair of aortic arch aneurysm with stent graft. Hybrid left carotid-subclavian bypass with stent graft deployment covering the ostium of the left subclavian artery was performed in a Debakey type III aortic dissection case. The supra-aortic branch was revascularized in 2 cases from ascending aorta to bilateral common carotid arteries using a 16-8 mm bifurcated graft, then total aortic arch and descending artery was occluded with stent-graft. The left carotid artery to the left subclavian artery bypass was created in 1 case, followed by stent-graft deployment. Two cases of infrarenal abdominal aortic aneurysm underwent left external iliac artery to left internal iliac artery bypass by a retroperineal route, then hybrid procedure was performed with bifurcated stent-graft. All stent grafts were deployed via a retrograde femoral artery approach in 5 patients. Results Technical success with complete aneurysmal exclusion was achieved in all patients. There was no incidence of encloleak. During a follow-up period of 2 to 10 months, documented perioperative neurologic events did not occur in all patients. One patient suffered from adult respiratory distress syndrome. After received tracheostomy, he recovered later. There was one death resulting from a postoperative myocar- dial infarction. Conclusion Hybrid arch repair provides an alternative therapy to patients otherwise considered prohibitively high risk for traditional open arch and thoracoabdominal aorta repair.

关键词： aortic aneurysm dissection surgery hybrid

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Thoraco-abdominal Aorta Revascularization through a Retroperitoneal Approach

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Chinese Medical Sciences Journal 2010年第4期25卷 233-236页

作者： Yue-hong Zheng Kun Yu Jie-feng Zhang nim choi Hong-ru Deng Furtado Rui Department of Vascular Surgery Peking Union Medical College Hospital ChineseAcademy of Medical Sciences ＆ Peking Union Medical College Beijing 100730 China Department of Extracorporeal Circulation Fuwai Hospital Beijing 100037 China Department of Vascular Surgery Weifang People＇s Hospital Shandong 261041 China Department of General Surgery Cir Gen/Vas Central Hospital Centre S. Januario Macao China

Objective To investigate the application of the retroperitoneal approach in aortic surgery. Methods We collected and analyzed data of 7 patients in Macao who presented with aortic diseases from 2007 to 2008 and were treated with aorta repair through retroperitoneal approach. Demographic features as well as intraoperative and postoperative data were analyzed. One case of thoracoabdominal aneurysm and 4 cases of abdominal aneurysm received artificial graft, among which hybrid iliac artery reconstruction with Zenith stent covering the ostium of the left subclavian artery was performed in 2 cases of infrarenal abdominal aneurysm. Aortic-iliac artery bypass was performed in 2 cases of aortoiliac occlusion. Results No operative or early postoperative death was observed. No perioperative intestinal adhesion or ureteral obstruction was found. One case reported delayed paraplegia and graft infection as postoperative complications. The complications were partially removed 3 months later after rehabilitation. Conclusion Retroperitoneal approach is a safe and feasible technique, which associated with a low incidence of postoperative pulmonary complications.

关键词： aorta retroperitoneal approach revascularization

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International expert consensus on laparoscopic pancreaticoduodenectomy

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Hepatobiliary Surgery and Nutrition 2020年第4期9卷 464-483页

作者： Renyi Qin Michael L.Kendrick Christopher L.Wolfgang Barish H.Edil Chinnusamy Palanivelu Rowan WParks Yinmo Yang Jin He Taiping Zhang Yiping Mou Xianjun Yu Bing Peng Palanisamy Senthilnathan Ho-Seong Han Jae Hoon Lee Michiaki Unno Steven WMOlde Damink Virinder Kumar Bansal Pierce Chow Tan To Cheung nim choi Yu-Wen Tien Chengfeng Wang Manson Fok Xiujun Cai Shengquan Zou Shuyou Peng Yupei Zhao Department of Biliary-Pancreatic Surgery Affiliated Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina Mayo Clinic RochesterMNUSA Division of Surgical Oncology Department of SurgeryThe John Hopkins University School of MedicineBaltimoreMDUSA Department of Surgery University of OklahomaOklahoma CityOKUSA Department of Surgical Gastroenterology and Hepatopancreatobiliary Surgery GEM Hospital and Research CentreCoimbatoreTamil NaduIndia Clinical Surgery Royal Infirmary of Edinburgh and University of EdinburghEdinburghUK Department of General Surgery Peking University First HospitalBeijingChina Department of Surgery Johns Hopkins Medical InstitutionsBaltimoreMDUSA Department of General Surgery Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina Department of Gastroenterology and Pancreatic Surgery Zhejiang Provincial People’s HospitalHangzhou Medical CollegeHangzhouChina Department of Pancreatic Surgery Fudan University Shanghai Cancer CenterFudan UniversityShanghaiChina Department of Pancreatic Surgery West China HospitalSichuan UniversityChengduChina Department of Surgery Seoul National University College of MedicineSeoul National University Bundang HospitalSeoulKorea Division of Hepatopancreatobiliary Surgery Department of SurgeryAsan Medical CenterSeoulKorea Department of Surgery Tohoku University Graduate School of MedicineSendaiJapan Department of Surgery NUTRIM School of Nutrition and Translational Research in MetabolismMaastricht University Medical CentreMaastrichtThe Netherlands Department of Surgical Disciplines All India Institute of Medical SciencesNew DelhiIndia Department of Hepatopancreatobiliary and Transplant Surgery Singapore General HospitalSingaporeSingapore Department of Surgery The University of Hong KongQueen Mary HospitalHong KongChina Department of General Surgery Hospital Conde S.JanuárioMacaoChina Department of Surgery National Ta

Importance:While laparoscopic pancreaticoduodenectomy(LPD)is being adopted with increasing enthusiasm worldwide,it is still challenging for both technical and anatomical ***,there is no consensus on the technical standards for ***:The aim of this consensus statement is to guide the continued safe progression and adoption of *** Review:An international panel of experts was selected based on their clinical and scientific expertise in laparoscopic and open *** were produced upon reviewing the literature and assessed by the members of the expert *** literature search and its critical appraisal were limited to articles published in English during the period from 1994 to *** Web of Science,Medline,and Cochrane Library and Clinical Trials databases were searched,The search strategy included,but was not limited to,the terms'laparoscopic','pancreaticoduodenectomy,'pancreatoduodenectomy','Whipple's operation',and'minimally invasive surgery'.Reference lists from the included articles were manually checked for any additional studies,which were included when *** method was used to establish expert consensus and the AGREE II-GRS Instrument was applied to assess the methodological quality and externally validate the final *** statements were further discussed during a one-day face-to-face meeting at the 1st Summit on Minimally Invasive Pancreatico-Biliary Surgery in Wuhan,***:Twenty-eight international experts from 8 countries constructed the expert *** statements were produced by the members of the expert *** least 80%of responders agreed with the majority(80%)of *** than three randomized controlled trials published to date,most evidences were based on level 3 or 4 studies according to the AGREE II-GRS *** and Relevance:The Wuhan international expert consensus meeting on LPD has produced a set of clinical practice statement

关键词： Consensus pancreaticoduodenectomy laparoscopy Delphi technique

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澳门住院截肢患者的临床特点及预后分析

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中华老年多器官疾病杂志 2017年第10期16卷 721-724页

作者：梁刚柱蔡念张杨彭蓬光梁展云房锋俊仁伯爵综合医院普通外科澳门999078 首都医科大学附属北京世纪坛医院血管外科北京100038 首都医科大学附属北京朝阳医院血管外科北京100020 仁伯爵综合医院整形外科澳门999078 即墨市人民医院整形外科青岛266200

目的调查分析澳门仁伯爵综合医院近5年截肢患者的临床特点、预后及危险因素。方法回顾性分析2011年1月至2016年12月澳门仁伯爵综合医院截肢患者,记录截肢患者的人口学资料、截肢原因、截肢危险因素、截肢平面以及伴随疾病等进行分析。... 详细信息

目的调查分析澳门仁伯爵综合医院近5年截肢患者的临床特点、预后及危险因素。方法回顾性分析2011年1月至2016年12月澳门仁伯爵综合医院截肢患者,记录截肢患者的人口学资料、截肢原因、截肢危险因素、截肢平面以及伴随疾病等进行分析。多因素logistic回归分析疾病危险因素对截肢平面的影响。采用Kaplan-Meier法对截肢后患者生存时间做生存分析。结果共有175例住院患者进行了208次截肢手术,年龄(70.3±14.1)岁。其中膝上截肢71例,膝下截肢51例,足部截肢或截趾86例。130例因糖尿病足截肢,41例因糖尿病足合并下肢血管病变截肢,19例因下肢血管病变截肢,18例因其他原因截肢。多因素logistic回归分析结果表明高血压和下肢血管病患者更易发生膝上截肢(RR值分别为2.012,1.914,P值分别为0·215,0.107),糖尿病患者更易发生足部截肢(RR=0.315,=0.019)。Kaplan-Meier生存分析结果表明截肢平面对于患者生存期有一定影响,膝上截肢患者术后生存期最短。结论澳门仁伯爵综合医院截肢患者最常见的原因是糖尿病足,其次为下肢血管病变,其他原因包括创伤、肿瘤等。截肢平面与患者的心血管病危险因素与伴随疾病有关。截肢患者术后生存期较短,截肢平面是影响术后生存期的一个因素。

关键词：截肢术糖尿病足危险因素预后周围血管病

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中国门静脉高压症外科治疗现状多中心调研分析

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中华器官移植杂志 2023年第3期44卷 152-159页

作者：郑磊李海洋王继洲梁霄窦剑王继涛樊强丁雄翟文龙晋云李波何松青李涛刘军王葵李志伟曾永毅邵英梅卜阳尚东麻勇娄诚尹新民贺杰峰朱海宏武金才徐志丹巴桑顿珠鲁建国张立婷赵建国吕凌吕国悦蔡念张丹图罗蒙张万广祁小龙陈孝平上海交通大学医学院附属第九人民医院普外科上海200011 贵州医科大学附属医院肝胆外科贵阳550001 中国科学技术大学附属第一医院(安徽省立医院)肝胆外科合肥230036 浙江大学医学院附属邵逸夫医院普外科杭州310000 河北医科大学第三医院肝胆外科石家庄050051 河北医科大学附属邢台市人民医院肝胆外科邢台054001 重庆医科大学附属第二医院肝胆外科重庆400010 郑州大学第一附属医院肝胆胰外科郑州450052 云南省第一人民医院肝胆胰外科昆明650030 西南医科大学附属医院肝胆外科泸州646000 广西医科大学第一附属医院肝胆外科南宁530021 应急总医院普外科北京100028 山东第一医科大学附属省立医院器官移植肝胆外二科济南250021 上海东方肝胆外科医院肝外二科上海200438 南方科技大学附属第二医院(深圳市第三人民医院)肝胆外科深圳518112 福建医科大学孟超肝胆医院肝胆外科福州350005 新疆医科大学第一附属医院消化血管外科中心肝胆包虫病外科乌鲁木齐830054 宁夏回族自治区人民医院肝胆外科银川750002 大连医科大学附属第一医院普外三科大连116011 哈尔滨医科大学附属第一医院肝脏微创外科哈尔滨150001 天津市第三中心医院肝胆外科天津300170 湖南省人民医院微创外科长沙410000 山西白求恩医院(山西医科大学第三医院)肝胆外科太原030032 青海省人民医院肝胆外科西宁810000 海南省人民医院肝胆外科海口570031 江西省人民医院器官移植中心南昌330006 西藏自治区人民医院普通外科拉萨850000 空军军医大学第二附属医院普通外科西安710038 兰州大学第一医院传染科兰州730000 内蒙古医科大学附属医院肝胆胰脾外科呼和浩特010050 南京医科大学第一附属医院肝胆中心南京210029 吉林大学第一医院肝胆胰外科吉林大学肝移植中心长春130021 澳门仁伯爵综合医院普通外科中国澳门999078 香港玛丽医院肝胆胰及肝移植外科中国香港999077 华中科技大学同济医学院附属同济医院肝脏外科中心武汉430030 东南大学附属中大医院门静脉高压中心南京210009

目的调查研究门静脉高压症外科治疗现状以了解我国当前外科治疗的真实情况及未来发展。方法本研究由中国肝胆胰专科联盟、中国门静脉高压联盟(CHESS)联合发起,调查对象为2021年国内开展门静脉高压症外科治疗的378家医疗机构及其团队,全... 详细信息

目的调查研究门静脉高压症外科治疗现状以了解我国当前外科治疗的真实情况及未来发展。方法本研究由中国肝胆胰专科联盟、中国门静脉高压联盟(CHESS)联合发起,调查对象为2021年国内开展门静脉高压症外科治疗的378家医疗机构及其团队,全面调查2021年国内开展门静脉高压症外科治疗的医院及其团队开展门静脉高压症外科手术的基本情况,包括手术例数、手术方式、术后并发症的处理、首要作用、存在的困惑和阻碍,肝移植以及内镜和经颈静脉肝内门腔静脉分流术(transjugular intrahepatic portosystemic shunt,TIPS)开展的情况等。结果经调查,2021年全国378家医疗机构共计开展8512例门静脉高压症外科手术,以脾切除术联合断流术为主(53.0%),腹腔镜手术占比76.1%,预防再出血(67.0%)是首要作用,72.8%的团队外科术后常规应用预防性抗凝药物,80.7%的团队认为术后门静脉血栓的形成是开展手术的主要难点,内镜治疗和介入TIPS治疗均已熟练开展的医疗机构达到65.3%,门静脉高压症患者未行肝移植治疗的原因以医院无肝移植的资质(69.3%)和患者经济因素(69.0%)为主。结论本次调研充分显示外科治疗是我国门静脉高压症治疗的重要组成部分,未来仍需进一步规范化手术适应证的把握、手术操作的流程以及术后并发症的处理,需进一步开展更多高质量的前瞻性、多中心临床随机对照研究。

关键词：肝移植门静脉高压症问卷调查研究

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