检索结果-南通市图书馆

Rethinking elective colectomy for diverticulitis: A strategic approach to population health

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2014年第44期20卷 16609-16614页

作者： Vlad V Simianu David R Flum department of surgery Surgical Outcomes Research Center UW Medical Center University of Washington

Diverticulitis is one of the leading indications for elective colon resection. Surgeons are trained to offer elective operations after a few episodes of diverticulitis in order to prevent future recurrences and potential emergency. However, most emergency surgery happens during the initial presentation. After recovery from an episode, much of the subsequent management of diverticulitis occurs in the outpatient setting, rendering inpatient "episode counting" a poor measure of the severity or burden of disease. Evidence also suggests that the risk of recurrence of diverticulitis is small and similar with or without an operation. Accordingly, contemporary evaluations of the epidemiologic patterns of treatments for diverticulitis have failed to demonstrate that the substantial rise in elective surgery over the last few decades has been successful at preventing emergency surgery at a population level. Multiple professional societies are calling to "individualize" decisions for elective colectomy and there is an international focus on "appropriate" indications for surgery. The rethinking of elective colectomy should come from a patient-centered approach that considers the risks of recurrence, quality of life, patient wishes and experiences about surgical and medical treatment options as well as operative morbidity and risks.

关键词： Diverticulitis Colectomy Colostomy Indica-tions El

State of telemedicine use in pediatric surgery in the USA-where we stand and what we can gain from the COVID-19 pandemic: a scoping review

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Pediatric surgery 2021年第1期4卷 43-48页

作者： Gregory Metzger Kris Jatana Jordan Apfeld Katherine J Deans Peter C Minneci Ihab Halaweish department of surgery The Ohio State University Wexner Medical CenterColumbusOhioUSA department of Pediatric surgery Nationwide Children's HospitalColumbusOhioUSA department of Pediatric Otolaryngology Nationwide Children's HospitalColumbusOhioUSA center for surgical outcomes research Nationwide Children's HospitalColumbusOhioUSA

Background Within the last decade,the use of telemedicine within in primary care in the USA has greatly expanded;however,use remains uncommon in surgical specialties.The spread of Coronavirus disease 2019(COVID-19)prompted healthcare institutions to limit in-person contact,resulting in an increase in telemedicine across all specialties,including pediatric surgery.The aims of this review were to evaluate potential barriers that limited the use of telemedicine in pediatric surgery prior to the COVID-19 period and to define how best to incorporate its use into a pediatric surgical practice going forward.Methods A scoping review was performed to identify gaps in the literature pertaining to the use of telemedicine within general pediatric surgery in the USA prior to the outbreak of COVID-19.Next,a focused evaluation of the legislative and organizational policies on telemedicine was performed.Lastly,findings were summarized and recommendations for future research developed in the context of understanding and overcoming barriers that have plagued widespread adoption in the past.Results Despite evidence of telemedicine being safe and well received by adult surgical patients,a total of only three studies representing original research on the use of telemedicine within pediatric surgery were identified.Legislative and organizational policies regarding telemedicine have been altered in response to COVID-19,likely resulting in an increase in the use of telemedicine among pediatric surgeons.Conclusions Telemedicine offers a safe and effective option for patients seeking an alternative to the in-person clinic appointment.The increased utilization of telemedicine during the COVID-19 pandemic will provide an opportunity to learn how best to leverage the technology to decrease disparities and to overcome previous barriers.

关键词： pediatric overcome prompt

Update on Liver Failure Following Hepatic Resection: Strategies for Prediction and Avoidance of Post-operative Liver Insufficiency

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Journal of Clinical and Translational Hepatology 2018年第1期6卷 97-104页

作者： Amir A. Rahnemai-Azar Jordan M. Cloyd Sharon M. Weber Mary Dillhoff Carl Schmidt Emily R. Winslow Timothy M. Pawlik department of surgery Division of Surgical OncologyUniversity of Wisconsin HospitalMadisonWIUSA department of surgery Division of Surgical OncologyThe Ohio State University Wexner Medical CenterColumbusOHUSA department of surgery Division of Surgical OncologyThe Ohio State University Wexner Medical CenterColumbusOH 43210USA

Liver resection is increasingly used for a variety of benign and malignant conditions.Despite advances in preoperative selection,surgical technique and perioperative management,posthepatectomy liver failure(PHLF)is still a leading cause of morbidity and mortality following liver resection.Given the devastating physiological consequences of PHLF and the lack of effective treatment options,identifying risk factors and preventative strategies for PHLF is paramount.In the past,a major limitation to conducting high quality research on risk factors and prevention strategies for PHLF has been the absence of a standardized definition.In this article,we describe relevant definitions for PHLF,discuss risk factors and prediction models,and review advances in liver assessment tools and PHLF prevention strategies.

关键词： Complication Hepatectomy Liver failure Liver resection Prevention Risk models

Long-term experience with debulking surgery in extensive hepatic alveolar echinococcosis:A case series and literature review

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Asian Pacific Journal of Tropical Medicine 2022年第10期15卷 468-473页

作者： Mohsen Aliakbarian Marcello Di Martino Sara Saeidi department of General surgery Surgical Oncology Research CenterMashhad University of Medical SciencesMashhadIran Division of Hepatobiliary and Liver Transplantation surgery.A.O.R.N.Cardarelli NapoliItaly

Objective:To assess the role of debulking surgery in extensive hepatic alveolar echinococcosis(HAE).Methods:Five cases of extensive HAE undergoing debulking surgery with their long-term follow-ups were reported.Additionally,a systematic review was carried out.Results:The average age of patients in the study was(50.8±17.1)years(range 36 to 77 years).Three cases were female.The median follow-up period was 61 months(range 12 to 84 months).Left liver resections were performed in 2 cases and right hemihepatectomies were undertaken in 2 cases.Two patients(cases 2 and 4)developed early surgical complications,while one of them(case 4)who suffered from the recurrent sub-hepatic abscess died at 12 months postoperatively.Conclusions:This study highlights the importance of debulking surgery for the management of complex symptomatic HAE lesions in patients with no curative option available.

关键词： Alveolar echinococcosis Debulking surgery Reduction Palliative Echinoccocosis multilocularis Case series

Gender differences in trauma,shock and sepsis

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Military Medical research 2019年第1期6卷 67-77页

作者： Florian Bosch Martin K.Angele Irshad H.Chaudry department of General Visceraland Transplant SurgeryLudwig Maximilians-University Munich center for surgical research and department of surgery University of Alabama at Birmingham

Despite efforts in prevention and intensive care, trauma and subsequent sepsis are still associated with a high mortality rate. Traumatic injury remains the main cause of death in people younger than 45 years and is thus a source of immense social and economic burden. In recent years, the knowledge concerning gender medicine has continuously increased. A number of studies have reported gender dimorphism in terms of response to trauma, shock and sepsis.However, the advantageous outcome following trauma-hemorrhage in females is not due only to sex. Rather, it is due to the prevailing hormonal milieu of the victim. In this respect, various experimental and clinical studies have demonstrated beneficial effects of estrogen for the central nervous system, the cardiopulmonary system, the liver, the kidneys, the immune system, and for the overall survival of the host. Nonetheless, there remains a gap between the bench and the bedside. This is most likely because clinical studies have not accounted for the estrus cycle. This review attempts to provide an overview of the current level of knowledge and highlights the most important organ systems responding to trauma, shock and sepsis. There continues to be a need for clinical studies on the prevailing hormonal milieu following trauma, shock and sepsis.

关键词： Trauma-hemorrhage Cardiopulmonary bypass Gender morphism Hormonal milieu Estrogens

Magnetic-assisted laparoscopic liver transplantation in swine

在线全文

学校读者我要写书评

暂无评论

Hepatobiliary & Pancreatic Diseases International 2022年第4期21卷 340-346页

作者： Zhe Feng Shan-Pei Wang Hao-Hua Wang Qiang Lu Wei Qiao Kai-Ling Wang Hong-Fan Ding Yue Wang Rong-Feng Wang Ai-Hua Shi Bing-Yi Ren Yu-Nan Jiang Bin He Jia-Wei Yu Rong-Qian Wu Yi Lv department of Hepatobiliary surgery the First Affiliated Hospital of Xi’an Jiaotong UniversityXi’an 710061China National Local Joint Engineering research center for Precision surgery&Regenerative Medicine Shaanxi Provincial Center for Regenerative Medicine and Surgical EngineeringInstitute of Advanced Surgical Technology and Engineeringthe First Affiliated Hospital of Xi’an Jiaotong UniversityXi’an 710061China department of Geriatric surgery the First Affiliated Hospital of Xi’an Jiaotong UniversityXi’an 710061China department of Hepatobiliary surgery Shaanxi Provincial People’s HospitalXi’an 710000China Zonglian College Xi’an Jiaotong UniversityXi’an 710000China

Background:Although laparoscopic technology has achieved rapid development in the surgical field,it has not been applied to liver transplantation,primarily because of difficulties associated with laparoscopic vascular anastomosis.In this study,we introduced a new magnetic-assisted vascular anastomosis technique and explored its application in laparoscopic liver transplantation in pigs.Methods:Two sets of magnetic vascular anastomosis rings(MVARs)with different diameters were developed.One set was used for anastomosis of the suprahepatic vena cava(SHVC)and the other set was used for anastomosis of the infrahepatic vena cava(IHVC)and portal vein(PV).Six laparoscopic orthotopic liver transplantations were performed in pigs.Donor liver was obtained via open surgery.Hepatectomy was performed in the recipients through laparoscopic surgery.Anastomosis of the SHVC was performed using hand-assisted magnetic anastomosis,and the anastomosis of the IHVC and PV was performed by magnetic anastomosis with or without hand assistance.Results:Liver transplants were successfully performed in five of the six cases.Postoperative ultrasonographic examination showed that the portal inflow was smooth.However,PV bending and blood flow obstruction occurred in one case because the MVARs were attached to each other.The durations of loading of MVAR in the laparoscope group and manual assistance group for IHVC and PV were 13±5 vs.5±1 min(P<0.01)and 10±2 vs.4±1 min(P<0.05),respectively.The durations of MVAR anastomosis in the laparoscope group and manual assistance group for IHVC and PV were 5±1 vs.1±1 min(P<0.01),and 5±1 vs.1±1 min(P<0.01),respectively.The anhepatic phase was 43±4 min in the laparoscope group and 23±2 min in the manual assistance group(P<0.01).Conclusions:Our study showed that magnetic-assisted laparoscopic liver transplantation can be successfully carried out in pigs.

关键词： Liver transplantation Laparoscopy Magnetic surgery Vascular anastomosis

Borderline resectable pancreatic cancer: Definitions and management

在线全文

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2014年第31期20卷 10740-10751页

作者： Nicole E Lopez Cristina Prendergast Andrew M Lowy Division of surgical Oncology Department of Surgery Moores Cancer Center University of California San Diego

Pancreatic cancer is the fourth leading cause of cancer death in the United States. While surgical resection remains the only curative option, more than 80% of patients present with unresectable disease. Unfortunately, even among those who undergo resection, the reported median survival is 15-23 mo, with a 5-year survival of approximately 20%. Disappointingly, over the past several decades, despite improvements in diagnostic imaging, surgical technique and chemotherapeutic options, only modest improvements in survival have been realized. Nevertheless, it remains clear that surgical resection is a prerequisite for achieving longterm survival and cure. There is now emerging consensus that a subgroup of patients, previously considered poor candidates for resection because of the relationship of their primary tumor to surrounding vasculature, may benefit from resection, particularly when preceded by neoadjuvant therapy. This stage of disease, termed borderline resectable pancreatic cancer, has become of increasing interest and is now the focus of a multiinstitutional clinical trial. Here we outline the history, progress, current treatment recommendations, and future directions for research in borderline resectable pancreatic cancer.

关键词： Pancreatic cancer Borderline resectable pancreatic

Expert consensus on the application of the magnetic anchoring and traction technique in thoracoscopic and laparoscopic surgery

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Hepatobiliary & Pancreatic Diseases International 2022年第1期21卷 7-9页

作者： Ji-Gang Bai Yue Wang Yong Zhang Yi Lv Scientific Committee of the Third International Conference of Magnetic surgery department of Hepatobiliary surgery Institute of Advanced Surgical Technology and EngineeringThe First Affiliated Hospital of Xi’an Jiaotong UniversityXi’an 710061China National Local Joint Engineering research center for Precision surgery&Regenerative Medicine The First Affiliated Hospital of Xi’an Jiaotong UniversityXi’an 710061China Shaanxi Provincial center for Regenerative Medicine and surgical Engineering The First Affiliated Hospital of Xi’an Jiaotong UniversityXi’an 710061China department of Thoracic surgery The First Affiliated Hospital of Xi’an Jiaotong UniversityXi’an 710061China 不详

Introduction The mutual interference between surgical instruments in tho-racoscopic and laparoscopic surgery and the effective exposure of the surgical field are important factors affecting surgical op-erability[1].Magnetic anchoring and traction is one of the core techniques of magnetic surgery,which uses magnetic materials to generate force through indirect contact to achieve traction expo-sure of the target organs[2](Fig.1).

关键词： surgery organs traction

Minimally invasive spleen-preserving distal pancreatectomy: Does splenic vessel preservation have better postoperative outcomes? A systematic review and meta-analysis

在线全文

学校读者我要写书评

暂无评论

Hepatobiliary & Pancreatic Diseases International 2015年第4期14卷 346-353页

作者： Fady Elabbasy Rahul Gadde Mena M Hanna Danny Sleeman Alan Livingstone Danny Yakoub Division of surgical Oncology Department of Surgery Sylvester Comprehensive Cancer Center University of Miami-Miller School of Medicine

BACKGROUND： Minimally invasive spleen-preserving distal pancreatectomy （SPDP） can be performed with either splenic vessel preservation （SVP） or resection [Warshaw procedure （WP）]. The aim of this study was to evaluate the postoperative clinical outcomes of patients undergoing both methods. DATA SOURCES： Database search of PubMed, Embase, Scopus, Cochrane, and Google Scholar was performed （2000-2014）; key bibliographies were reviewed. Qualified studies compar- ing patients undergoing SPDP with either SVP or WP, and as- sessing postoperative complications were included. Calculated pooled risk ratio （RR） with the corresponding 95% confidence interval （CI） by random effects methods were used in the meta-analyses. RESULTS： The search yielded 215 studies, of which only 14 observational studies met our selection criteria. The studies included 943 patients in total; 652 （69%） underwent SVP and 291 （31%） underwent WP. Overall, there was a lower incidence of splenic infarction （RR=0.17; 95% Ch 0.09-0.33; P〈0.001）, gastric varices （RR=0.16; 95% Ch 0.05-0.51; P=0.002）, and intra/postoperative splenectomy （RR=0.20; 95% Ch 0.08-0.49; P〈0.001） in the SVP group. There was no difference in in- cidence of pancreatic fistula （WP vs SVP, 23.6% vs 22.9%;P=0.37）, length of hospital stay, operative time or blood loss. There was moderate cross-study heterogeneity. CONCLUSIONS： SVP is a safe, efficient and feasible technique that may be used to preserve the spleen. WP may be more suit- able for large tumors dose to the splenic hilum or those associ- ated with splenomegaly. Randomized clinical trials are justified to examine the long-term benefits of SVP-SPDP.

关键词： splenic infarction spleen-preserving distal pancreatectomy splenic vessel preservation Warshaw procedure gastric varices