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intraoperative ultrasonography in hepatobiliary surgery

Hepatobiliary & Pancreatic Diseases International 2002年第3期1卷 425-428页

作者： Li-Wu Lin Zhen Ye En-Sheng Xue Shang-Da Gao Yi-Mi He the Fujian Provincial Institute of Ultrasonic Medicine, Union Hospital, Fujian Medical University, Fuzhou 350001, China Fujian Prov. Inst. Ultrasonic Med. Union Hospital Fujian Medical University Fuzhou 350001 China

Objective: To assess the value of intraoperative ultra- sonography in hepatobiliary surgery. Methods: Aloka-650 and Aloka-500 with a 3.5 MHz probe were used in preoperative uitrasonography and those with 5 MHz or 7.5 MHz probes in intraopera- tive ultrasonography. All patients with carcinoma were confirmed pathologically. Results: In 44 patients with liver cancer (76 tumors), the diagnostic rate of intraoperative ultra- sonography was 97% (74/76), which was markedly higher than 84% (64/76) of preoperative ultra- sonography (Pintraoperative ultrasonography for tumors ≤2 cm in diameter was markedly higher than that (54%; 13/24) of preoperative ultrasonography (Pultrasonography for tumor embulus of the vein was also markedly higher than that (53%; 9/ 17) of preoperative ultrasonography (Pintraoperative and preoperative ultrasonography for cholelithiasis were 99% (108/ 109) and 97% (106/109) respectively (P>0.05). Yet the diagnostic rate (100%; 12/12) of intraopera- tive ultrasonography for gallbladder carcinoma was markedly higher than that (66.7%; 8/12) of pre- operative ultrasonography (Pintraoperative ultrasonography for chole- docholith and biliary tract cancer were all 100%, markedly higher than those (83%; 20/24 and 75%; 12/16) of preoperative ultrasonography (Pintraoperative ultrasonography can raise the detective rate of the liver occupying lesions comparing with that of preoperative untrasonogra- phy. It is of valuable in selecting operative scheme and locating small lesions.

关键词： intraoperative ultrasonography preoperative ultrasonography hepatobiliary Surgery

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Application of contrast-enhanced intraoperative ultrasonography in the decision-making about hepatocellular carcinoma operation

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World Journal of Gastroenterology 2010年第4期16卷 508-512页

作者： Wu, Hong Lu, Qiang Luo, Yan He, Xian-Lu Zeng, Yong Sichuan Univ W China Hosp Dept Hepatobiliary Pancreat Surg Chengdu 610041 Sichuan Prov Peoples R China Sichuan Univ W China Hosp Dept Sonog Chengdu 610041 Sichuan Prov Peoples R China

AIM:To evaluate the detection and differentiation ability of contrast-enhanced intraoperative ultrasonography(CE-IOUS) in hepatocellular carcinoma(HCC) ***:Clinical data of 50 HCC patients were retrospective *** sensitivity,specificity,false negative and false positive rates of contrast enhanced magnetic resonance imaging(CE-MRI),IOUS and CEIOUS were calculated and *** strategy changes due to CE-IOUS were ***:Lesions detected by CE-MRI,IOUS and CEIOUS were 60,97 and 85 *** sensitivity,specificity,false negative rate,false positive rate of CEMRI were 98.2%,98.6%,98.6%,60.0%,respectively;for IOUS were 50.0%,90.9%,1.8%,1.4%,respectively;and for CE-IOUS were 1.4%,40.0%,50.0%,9.1%,*** operation strategy of 9(9/50,18.0%) cases was changed according to the results of ***:Compared with CE-MRI,CE-IOUS performs better in detection and differentiation of small metastasis and regenerative *** plays an important role in the decision-making of HCC operation.

关键词： Hepatocellular carcinoma Liver resection Contrast enhanced magnetic resonance imaging intraoperative ultrasonography Contrast-enhanced intraoperative ultrasonography

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intraoperative ultrasound assistance in resection of intracranial meningiomas

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Chinese Journal of Cancer Research 2013年第3期25卷 339-345页

作者： Hailiang Tang Huaping Sun Liqian Xie Qisheng Tang Ye Gong Ying Mao Qing Xie Mingzhe Zheng Daijun Wang Hongda Zhu Jianhong Zhu Xiaoyuan Feng Zhenwei Yao Xiancheng Chen Liangfu Zhou Neurosurgery Department of Huashan Hospital Radiology Department of Huashan Hospital

Objective： Intracranial meningiomas, especially those located at anterior and middle skull base, are difficult to be completely resected due to their complicated anatomy structures and adjacent vessels. It＇s essential to locate the tumor and its vessels precisely during operation to reduce the risk of neurological deficits. The purpose of this study was to evaluate intraoperative ultrasonography in displaying intracranial meningioma and its surrounding arteries, and evaluate its potential to improve surgical precision and minimize surgical trauma. Methods： Between December 2011 and January 2013, 20 patients with anterior and middle skull base meningioma underwent surgery with the assistance of intraoperative ultrasonography in the Neurosurgery Department of Shanghai Huashan Hospital. There were 7 male and 13 female patients, aged from 31 to 66 years old. Their sonographic features were analyzed and the advantages of intraoperative ultrasonography were discussed. Results： The border of the rneningioma and its adjacent vessels could be exhibited on intraoperative ultrasonography. The sonographic visualization allowed the neurosurgeon to choose an appropriate approach before the operation. In addition, intraoperative ultrasonography could inform neurosurgeons about the location of the tumor, its relation to the surrounding arteries during the operation, thus these essential arteries could be protected carefully. Conclusions： intraoperative ultrasonography is a useful intraoperative technique. When appropriately applied to assist surgical procedures for intracranial meningioma, it could offer very important intraoperative information （such as the tumor supplying vessels） that helps to improve surgical resection and therefore might reduce the postoperative morbidity.

关键词： intraoperative ultrasonography intracranial meningioma

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Diagnostic value of contrast-enhanced intraoperative Doppler sonography for cerebral arteriovenous malformations compared with angiography

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Chinese Medical Journal 2010年第20期123卷 2812-2815页

作者： XU Hong-zhi QIN Zhi-yong GU Yu-xiang ZHOU Ping CHEN Xian-cheng Department of Neurosurgery Huashan HospitalFudan University Shanghai Neurosurgical Center Shanghai 200040China

Background intraoperative Doppler sonography has been used in the neurosurgical operating room for the localization and description of cerebral arteriovenous malformations （AVMs）. This study aimed to investigate the clinical value of contrast-enhanced intraoperative Doppler sonography, including its ability to assess the location and identify of feeding arteries in patients with AVMs and to compare this method with *** Twenty-three patients with cerebral AVMs who were diagnosed using angiography, were examined with contrast-enhanced intraoperative Doppler sonography. As an echo-enhancing agent, Sulphur Hexafluoride Microbubbles for Injection （＂SonoVue＂） was administered intravenously in all patients. Sonogram results were reviewed and correlated with angiographic findings. For statistical analysis, the Wilcoxon signed-rank test was *** Angiography identified 20 AVM lesions in the anterior or middle fossa and 3 in the posterior ***-enhanced intraoperative Doppler was somewhat less sensitive for only detecting 21/23 （91.3%） of the AVM lesions. Additionally, contrast-enhanced intraoperative Doppler slightly underestimated AVM size compared with angiographic findings but showed feeding arteries with sufficient acoustic properties. In 15 patients, angiography revealed a coincidental blood supply from another intracranial vessel, which was missed by contrast-enhanced intraoperative Doppler *** In a limited group of patients with AVMs, contrast-enhanced intraoperative Doppler sonography was a less sensitive but useful and simple method for the detection of AVMs in contrast to angiography. No specific untoward effects were attributed to the use of ＂SonoVue＂ as a contrast-enhancing substance.

关键词： arteriovenous malformations intraoperative ultrasonography ultrasound contrast agent

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Circumferential decompression via the posterior approach for the surgical treatment of multilevel thoracic ossification of the posterior longitudinal ligaments： a single institution comparative study

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Chinese Medical Journal 2014年第19期127卷 3371-3377页

作者： Liu Xiao Zhu Bin Liu Xiaoguang Liu Zhongjun Dang Gengting Department of Orthopaedics Peking University Third HospitalBeijing 100191

Background The treatment strategies for multilevel thoracic ossification of the posterior longitudinal ligaments （T-OPLL） were rarely reported. The aim of this study was to investigate the clinical outcomes and complications of circumferential decompression for multilevel T-OPLL and compare two different methods in the management of the OPLL （resection or floating）. Methods Data of sequentially treated patients who received surgical treatment for thoracic spinal stenosis caused by multilevel T-OPLL from January 2005 to February 2012 were retrospectively reviewed. Based on the surgical approaches applied, the patients were divided into two groups. Group A consisted the patients who received posterior decompression and group B consisted the patients who received circumferential decompression via the posterior approach. Group B was further divided into two subgroups： subgroup 1 （the resection group） where the OPLL was completely resected and subgroup 2 （the floating group） where the OPLL was floated. Results A total of 49 patients were included in the study. Fourteen patients with single posterior decompression were included in group A and 35 patients who received circumferential decompression were included in group B. In group B, 29 patients had complete resection of the ossified posterior longitudinal ligaments, while the other six underwent a flotation procedure. The follow-up data were available in 39 patients. Mean JOA scores improved from 5.4 ± 1.8 to 7.5 ± 2.8 in group A and from 3.7 ± 1.8 to 7.9 ± 2.4 in group B. The main complications included cerebrospinal fluid （CSF） leakage and postoperative neurelogic deterioration （ND）. Twenty-three of the 25 cases with postoperative CSF leakage achieved a complete recovery at the last follow-up and 12 of the 15 cases with ND achieved some neurological improvement at the last follow-up. Conclusions Circumferential decompression via the posterior approach is an effective surgical method for thoracic spinal stenosis caused

关键词： ossification of the posterior longitudinal ligament multilevel thoracic spinal stenosis intraoperative ultrasonography

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Simultaneous colorectal and parenchymal-sparing liver resection for advanced colorectal carcinoma with synchronous liver metastases:Between conventional and mini-invasive approaches

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World Journal of Gastroenterology 2020年第42期26卷 6529-6555页

作者： Emilio De Raffele Mariateresa Mirarchi Dajana Cuicchi Ferdinando Lecce Riccardo Casadei Claudio Ricci Saverio Selva Francesco Minni Division of Pancreatic Surgery Department of Digestive DiseasesAzienda Ospedaliero-Universitaria di BolognaPoliclinico S.Orsola-Malpighi40138 BolognaItaly Dipartimento Strutturale Chirurgico Ospedale SS Antonio e Margherita15057 Tortona(AL)Italy Surgery of the Alimentary Tract Department of Digestive DiseasesAzienda Ospedaliero-Universitaria di BolognaPoliclinico S.Orsola-Malpighi40138 BolognaItaly Division of Pancreatic Surgery Department of Medical and Surgical Sciences(DIMEC)Alma Mater StudiorumUniversity of Bologna40138 BolognaItaly

The optimal timing of surgery in case of synchronous presentation of colorectal cancer and liver metastases is still under *** approach,with initial colorectal resection followed by liver resection(LR),or even the reverse,liver-first approach in specific situations,is traditionally *** resections,however,represent an appealing strategy,because may have perioperative risks comparable to staged resections in appropriately selected patients,while avoiding a second surgical *** patients with larger or multiple synchronous presentation of colorectal cancer and liver metastases,simultaneous major hepatectomies may determine worse perioperative outcomes,so that parenchymal-sparing LR should represent the most appropriate option whenever ***-invasive colorectal surgery has experienced rapid spread in the last decades,while laparoscopic LR has progressed much slower,and is usually reserved for limited tumours in favourable ***,mini-invasive parenchymal-sparing LR is more complex,especially for larger or multiple tumours in difficult *** remains to be established if simultaneous resections are presently feasible with mini-invasive approaches or if we need further technological advances and surgical expertise,at least for more complex *** review aims to critically analyze the current status and future perspectives of simultaneous resections,and the present role of the available miniinvasive techniques.

关键词： Synchronous colorectal liver metastases Colorectal surgery Liver surgery Simultaneous resection Parenchymal-sparing liver resection Mini-invasive surgery intraoperative ultrasonography

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