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中国医疗器械信息 2009年第4期15卷 79-80页

作者：方华

西班牙巴塞罗纳Hospital Clínic以Antoni Alcaraz医生为首的医疗小组成功地通过在肚脐上开一个口进入腹部,摘除了被诊断患有肾癌的妇女身上的肾。这样做手术在西班牙是第一次，在全世界也是少见的。手术后病人的恢复时间比用常规的通... 详细信息

西班牙巴塞罗纳Hospital Clínic以Antoni Alcaraz医生为首的医疗小组成功地通过在肚脐上开一个口进入腹部,摘除了被诊断患有肾癌的妇女身上的肾。这样做手术在西班牙是第一次，在全世界也是少见的。手术后病人的恢复时间比用常规的通过腹腔镜来做缩短了一半，效果远比预料的好。手术使用了特别设计的工具。

关键词：手术入口肚脐肾脏摘除安全手术后病人恢复时间西班牙

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Clinical analysis of surgical treatment of portal hypertension

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World Journal of Gastroenterology 2005年第29期11卷 4552-4559页

作者： Xin-Bao Xu Jing-Xiu Cai Xi-Sheng Leng Jia-Hong Dong Ji-Ye Zhu Zhen-Ping He Fu-Shun Wang Ji-Run Peng Ben-Li Han Ru-Yu Du Department of Hepatobiliary Surgery People's Hospital Peking University Beijing 100044 China Department of Hepatobiliary Surgery Airforce General Hospital Beijing 100036 China Center of Hepatobiliary Surgery Southwest Hospital The Third Military Medical University Chongqing 400038 China

AIM: To review the experience in surgery for 508 patients with portal hypertension and to explore the selection of reasonable operation under different ***: The data of 508 patients with portal hypertension treated surgically in 1991-2001 in our centers were analyzed. Of the 508 patients, 256 were treated with portaazygous devascularization (PAD),167 with portasystemic shunt (PSS), 62 with selective shunt (SS), 11 with combined portasystemic shunt and portaazygous devascularization (PSS+PAD), 9 with liver transplantation (LT), 3 with union operation for hepatic carcinoma and portal hypertension (HCC+PH).RESULTS: In the 167 patients treated with PSS, free portal pressure (FPP) was significantly higher in the patients with a longer diameter of the anastomotic stoma than in those with a shorter diameter before the operation (P＜0.01). After the operation, FPP in the former patients markedly decreased compared to the latter ones (P＜0.01).The incidence rate of hemorrhage in patients treated with PAD, PSS, SS, PSS+PAD, and HCC+PH was 21.09% (54/256), 13.77 (23/167), 11.29 (7/62), 36.36% (4/11),and 100% (3/3), respectively. The incidence rate of hepatic encephalopathy was 3.91% (10/256), 9.58% (16/167),4.84% (3/62), 9.09% (1/11), and 100% (3/3), respectively while the operative mortality was 5.49% (15/256), 4.22% (7/167), 4.84% (3/62), 9.09% (1/11), and 66.67% (2/3) respectively. The operative mortality of liver transplantation was 22.22% (2/9).CONCLUSION: Five kinds of operation in surgical treatment of portal hypertension have their advantages and disadvantages. Therefore, the selection of operation should be based on the actual needs of the patients.

关键词：临床分析手术治疗高血压手术入口门静脉

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Rectosigmoid findings are not associated with proximal colon cancer: Analysis of 6 196 consecutive cases undergoing total colonoscopy

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World Journal of Gastroenterology 2005年第15期11卷 2249-2254页

作者： Makoto Okamoto Takao Kawabe Yutaka Yamaji Jun Kato Tsuneo Ikenoue Goichi Togo Haruhiko Yoshida Yasushi Shiratori Masao Omata Department of Gastroenterology

AIM: To review the risk of proximal colon cancer in patients undergoing ***: We estimated the risk of advanced proximal adenomas and cancers in 6 196 consecutive patients that underwent colonoscopy (mean age 60 years, 65% males,without prior history of colorectal examination). Neoplasms were classified as diminutive adenoma (5 mm or less),small adenoma (6-9 mm), advanced adenoma (10 mm or more, with villous component or high-grade dysplasia)and cancer (invasive adenocarcinoma). The sites of neoplasms were defined as rectosigmoid (rectum and sigmoid colon) and proximal colon (from cecum to descending colon).RESULTS: The trend of the prevalence of advanced proximal adenoma was to increase with severe rectosigmoid findings, while the prevalence of proximal colon cancer did not increase with severe rectosigmoid findings. Among the 157 patients with proximal colon cancer, 74% had no neoplasm in the rectosigmoid colon. Multivariate logisticregression analysis revealed that age was the main predictor of proximal colon cancer and existence of rectosigmoid adenoma was not a predictor of proximal colon ***: Sigmoidoscopy is inadequate for colorectal cancer screening, especially in older populations.

关键词：结肠肿瘤结肠镜检查手术入口耐受性

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Portal hypertensive colopathy in patients with liver cirrhosis

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World Journal of Gastroenterology 2005年第20期11卷 3127-3130页

作者： Keiichi Ito Katsuya Shiraki Takahisa Sakai Hitoshi Yoshimura Takeshi Nakano First Department of Internal Medicine Mie University School of Medicine 2-174 Edobashi Tsu Mie 514-8507Japan

AIM: In patients with liver cirrhosis and porlal hypertension, portal hypertensive colopathy is thought to be an important cause of lower gastrointestinal hemorrhage. In this study, we evaluated the prevalence of colonic mucosal changes in patients with liver cirrhosis and its clinical significance. METHODS: We evaluated the colonoscopic findings and liver function of 47 patients with liver cirrhosis over a 6-year period. The main cause of liver cirrhosis was post-viral hepatitis (68%) related to hepatitis B (6%) or C (62%)infection. All patients underwent upper gastrointestinal endoscopy to examine the presence of esophageal varices, cardiac varices, and congestive gastropathy, as well as a full colonoscopy to observe changes in colonic mucosa. Portal hypertensive colopathy was defined endoscopically in patients with vascular ectasia, redness, and blue vein. Vascular ectasia was classified into two types: type 1, solitary vascular ectasia; and type 2, diffuse vascular ***: Overall portal hypertensive colopathy was present in 31 patients (66%), including solitary vascular ectasia in 17 patients (36%), diffuse vascular ectasia in 20 patients (42%), redness in 10 patients (21%) and blue vein in 6 patients (12%). As the Child-Pugh class increased in severity, the prevalence of portal hypertensive colopathy rose. Child-Pugh class B and C were significantly associated with portal hypertensive colopathy. Portal hypertensive gastropathy, esophageal varices, ascites and hepatocellular carcinoma were not related to occurrence of portal hypertensive colopathy. Platelet count was significantly associated with portal hypertensive colopathy, but prothrombin time, serum albumin level, total bilirubin level and serum ALT level were not related to occurrence of portal hypertensive colopathy. CONCLUSION: As the Child-Pugh class worsens and platelet count decreases, the prevalence of portal hypertensive colopathy increases in patients with liver cirrhosis. A colonoscopic

关键词：高血压手术入口肝硬化病理机制血小板

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