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Viable cryopreserved umbilical tissue (vCUT) reduces post-operative adhesions in a rabbit abdominal adhesion model

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Bioactive Materials 2019年第1期4卷 97-106页

作者： Sandeep Dhall Turhan Coksaygan Tyler Hoffman Matthew Moorman Anne Lerch Jin-Qiang Kuang Malathi Sathyamoorthy Alla Danilkovitch Osiris Therapeutics Inc.7015 Albert Einstein DrColumbiaMD21046USA University of Maryland 655 W.Baltimore StreetBaltimoreMD21201USA

Post-operative adhesions,a common complication of surgery,cause pain,impair organ functionality,and often require additional surgical *** of inflammation,protection of injured tissue,and rapid tissue repair are critical for adhesion *** barriers are biomaterials used to prevent adhesions by physical separation of opposing injured *** adhesion barriers have poor anti-inflammatory and tissue regenerative *** cord tissue(UT),a part of the placenta,is inherently soft,conforming,biocompatible,and biodegradable,with antimicrobial,anti-inflammatory,and antifibrotic properties,making it an attractive alternative to currently available adhesion *** use of fresh tissue is preferable,availability and short storage time limit its clinical use.A viable cryopreserved UT(vCUT)“point of care”allograft has recently become *** retains the extracellular matrix,growth factors,and native viable cells with the added advantage of a long shelf life at−80℃.In this study,vCUT's anti-adhesion property was evaluated in a rabbit abdominal adhesion *** cecum was abraded on two opposing sides,and vCUT was sutured to the abdominal wall on the treatment side;whereas the contralateral side of the abdomen served as an internal untreated *** and histological evaluation was performed at 7,28,and 67 days *** adhesions were detectable on the vCUT treated side at all time *** scores for adhesion,inflammation,and fibrosis were lower on the vCUT treated side as compared to the control *** conclusion,the data supports the use of vCUT as an adhesion barrier in surgical procedures.

关键词： Placental Cryopreserved Post-surgical adhesiolysis Inflammation Fibrosis

Disturbed passage of jejunal limb near esophageal hiatus after overlapped esophagojejunostomy following laparoscopic total gastrectomy

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World Journal of Gastrointestinal Surgery 2022年第11期14卷 1285-1296页

作者： Hirokazu Noshiro Keiichiro Okuyama Yukie Yoda Department of Surgery Saga University Faculty of MedicineSaga 849-8501Japan Department of Surgery Saga UniversitySaga 849-8501Japan

BACKGROUND Overlapped esophagojejunostomy(OEJ) is a secure purely laparoscopic reconstruction after laparoscopic total gastrectomy(LTG). However, long-term surgical results have not been documented *** In this paper, we report unusual patients who manifested jejunal limb stricture near the esophageal hiatus without anastomotic stenosis during long-term observation after *** From April 2009 until May 2020, we retrospectively reviewed 211 patients underwent LTG following by OEJ for gastric carcinoma and took a standard surveillance program. We aimed to characterize a novel complicated disorder observed in these patients to assist treatment and *** Five patients(2.4%) had unusual jejunal limb stricture after LTG and OEJ,occurring at a mean of 10 mo after initial radical LTG. All five patients had disturbed oral intake and marked weight loss, and two had aspiration *** diagnostic modalities and intraoperative findings in each patient revealed an intact anastomosis, bent or tortuous jejunal limb resulting from loose fibrous adhesions on the left crus at the esophageal hiatus and no cancer recurrence. All five patients were successfully treated by reoperation for adhesiolysis, division of the left crus and rearrangement of the jejunal *** Disturbed passage through the jejunal limb near the hiatus can occur after some types of OEJ following LTG. We speculate that it may result from a short remnant esophagus, excessive mobilization of the jejunal limb that permits bending or tortuosity and adhesions on the left crus at the hiatus. Prevention for this complication is possible during the original LTG procedure.

关键词： Laparoscopic total gastrectomy Overlapped esophagojejunostomy Anastomotic stenosis adhesiolysis Gastric carcinoma

Contribution of Laparoscopy in the Management of Female Infertility in Low Resource Countries: A Review of 208 Cases at the YaoundéGeneral Hospital, Cameroon

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International Journal of Clinical Medicine 2015年第12期6卷 934-939页

作者： Jean Dupont Kemfang Ngowa Jean Marie Kasia Victorine Nkongo Anny Ngassam Jovanny Fouogue Tsuala Philemon Nsem Alexis Medou Department of Obstetrics and Gynaecology Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon Gynecological Endoscopic Surgery and Human Reproductive Teaching Hospital Yaoundé Cameroon Anesthesia Unit Yaoundé General Hospital Yaoundé Cameroon

Background: Infertility is a global problem, but the highest prevalence is in low resource countries, particularly in sub-Saharan Africa where tubal damage following pelvic infection is the commonest cause. Objectives: This study aimed to assess contribution of laparoscopy as a diagnostic and therapeutic tool in infertile women in our setting. Methods: A descriptive review of complete medical records of 208 women who underwent laparoscopy at the Gynaecology Unit of Yaoundé General Hospital from December 2007 to December 2012. Results: Two hundred and eight women were enrolled in this study. Mean age was 32.6 ± 11.25 years. Infertility was secondary in 71.6% of cases;125 (60.1%) women were married and 116 (55.8%) had a positive serology of Chlamydia trachomatis infection. The most frequent findings during diagnostic laparoscopy were: pelvic adhesions (83.7%), hydrosalpinx (21.6%), pyosalpinx (4.8%), perihepatic adhesions (25.5%), uterine fibromas (22.6%), pelvic endometriosis (13%) and ovarian abnormalities (10.1%). The surgical procedures during laparoscopy were: adhesiolysis (79.7%), tuboplasty (35.0%), salpingectomy (8.2%), ovarian cystectomy (5.8%) and myomectomy (1.9%). Three (1.4%) cases of uterine perforation and 1 (0.5%) case of laparoscopy conversion to laparotomy were observed. Conclusion: Diagnostic laparoscopy revealed that tubal lesions and pelvic adhesions were still the major causes of female infertility in developing countries. adhesiolysis and tuboplasty were the most frequently performed surgical procedures during laparoscopy. Therefore, training in endoscopic surgery should be regarded as an important issue in developing countries.

关键词： Laparoscopy Infertility Pelvic Adhesions adhesiolysis Tuboplasty Myomectomy

Theco-thecal bypass technique elucidating a novel procedure and perspective on treatment of post-arachnoiditis syringomyelia:A case report

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World Journal of Surgical Procedures 2021年第1期11卷 1-9页

作者： Mrudul Bhatjiwale Mohinish Bhatjiwale Department of Neurosurgery Narayana Health CityBangalore 560099KarnatakaIndia Neurological Science Neuro Health FoundationMumbai 400091India Department of Neurosurgery Rotary Medical CenterMumbai 400068India Department of Neurosurgery Manav Kalyan Kendra&Navneet Hitech HospitalsMumbai 400068India Department of Neurosurgery Neuro Health FoundationMumbai 400091India

BACKGROUND Post-arachnoiditis syringomyelia is a condition in which there is an intraspinal cerebrospinal fluid(CSF)blockade due to arachnoidal adhesions and *** many of the techniques currently in use,namely,the theco-peritoneal,syringo-pleural,syringo-peritoneal,and syringo-subarachnoid shunts,are effective,the results are often *** SUMMARY A 36-year-old man with a past history of pulmonary tuberculosis,presented with progressive paraesthesia in the feet and progressive paraparesis along with constipation,difficulty in micturition,and decreased *** was bedridden a month before *** resonance imaging revealed a dorsal multiloculated syrinx from D3-D10 vertebral *** underwent a D1-2 to D11 theco-thecal shunt bilaterally to abolish the CSF gradient across the level of the *** was no direct surgical handling of the spinal cord *** the 15-mo follow up,the patient had significant improvement in his symptoms and *** We present a novel technique aimed at correcting the primary cause of a postarachnoiditis syrinx,the subarachnoid cerebrospinal flow obstruction or block,which we believe is simple and effective,involves minimal handling of the normal neural structures,and attempts to restore the physiology of CSF flow across the obstruction,with favorable clinical results.

关键词： Syringomyelia Tubercular Arachnoiditis adhesiolysis Minimally invasive Cerebrospinal fluid Case report

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联合腹腔镜和开放技术修补大和复杂的切口疝

联合腹腔镜和开放技术修补大和复杂的切口疝