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A Case of Simultaneous Resection of Recurrent Colorectal Liver Metastases as part of Colorectal Cancer Treatment Journey 结直肠癌复发性肝转移同时切除1例
Pub Date : 2023-03-02 DOI: 10.46889/jsrp.2023.4103
A. Nugroho
Combining systemic treatments with liver resection in patients with colorectal liver metastases has been proven to be successful in delivering favorable survival outcomes. We describe a 68-year-old man who underwent six cycles of chemotherapy before developing recurrent colon cancer with liver metastases. Prior to this, he underwent a Hartmann’s procedure for obstructive malignant rectal cancer. Shortly after the initial procedure, he underwent a Hartmann’s reversal. Imaging revealed locoregional recurrence with increased CEA as well as metastatic lesions in segments 4b and 8 of the liver at the time of recurrence. After a complete multidisciplinary evaluation, the simultaneous resection of the liver metastasis and the bowel recurrence was carried out without incident, and adjuvant therapy was then administered. This case report detailed the patient’s experience with many chemotherapy treatments and an early recurrence of CRLM, followed with surgical resection of recurrent primary and liver metastatasis. As part of multidisciplinary therapy, we propose that simultaneous excision of the recurring bowel location and the liver metastases offers the potential for superior care.
结直肠肝转移患者的全身治疗与肝切除相结合已被证明是成功的,可提供良好的生存结果。我们描述了一位68岁的男性,他在发生复发性结肠癌并肝转移之前接受了6个周期的化疗。在此之前,他接受了哈特曼手术治疗梗阻性恶性直肠癌。在最初的手术后不久,他接受了哈特曼逆转手术。影像学显示局部复发,CEA升高,复发时肝4b段和8段有转移灶。经过全面的多学科评估,同时切除肝转移和肠道复发,无任何事件发生,并给予辅助治疗。本病例报告详细介绍了患者多次化疗和早期复发的CRLM,随后手术切除复发的原发性和肝转移灶的经验。作为多学科治疗的一部分,我们建议同时切除复发的肠道部位和肝脏转移提供了更好的治疗潜力。
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引用次数: 0
A Rare Case of a Giant Tumor of Sebaceous Glands in the Posterior Chest Wall 一例罕见的后胸壁皮脂腺巨大肿瘤
Pub Date : 2023-02-19 DOI: 10.46889/jsrp.2023.4102
Garritano C
Sebaceous gland carcinoma is a rare and aggressive tumor that accounts for less than 1% of all cutaneous malignancies. It is classified as intraocular and extraocular and is rarely found in the chest wall. Imaging tests such as Computed Tomography and Magnetic Resonance help to identify the location, size, and evaluation of the involvement of adjacent structures. The treatment is surgical excision, and diagnosis is confirmed postoperatively by the immunohistochemical analysis.
皮脂腺癌是一种罕见的侵袭性肿瘤,占所有皮肤恶性肿瘤的不到1%。它分为眼内和眼外,在胸壁很少发现。成像测试,如计算机断层扫描和磁共振有助于确定位置,大小和评估邻近结构的累及。治疗方法为手术切除,术后通过免疫组化分析确诊。
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引用次数: 0
Gastrointestinal Bleeding on Anticoagulant Therapy: Comparison of Patients Receiving Vitamin K Antagonists and Non-Vitamin K Oral Antagonists 胃肠出血抗凝治疗:服用维生素K拮抗剂和非维生素K口服拮抗剂的患者的比较
Pub Date : 2023-02-01 DOI: 10.46889/jsrp.2023.4101
Raphael Fedidat
Objectives: Prior studies comparing Gastrointestinal (GI) bleeding in patients receiving Vitamin-K Antagonists (VKA) and Non-Vitamin K Antagonist Oral Anticoagulants (NOAC) focused on the crude rate of GI bleeding and less on severity of such events. The aim of our study was to assess characteristics of GI bleeding in patients on VKA therapy versus NOAC therapy.Methods: Retrospective data was collected from patients hospitalized with GI bleeding at Hadassah University Medical Center between January 2010 and July 2017. Retrieved data included demographics, laboratory results, clinical outcomes and details regarding the bleeding characteristics, evaluation, treatment and hospitalization. Patients were divided into two groups – those receiving VKA and those receiving NOAC.Results: 514 patients who presented with GI bleeding were included. 439 patients were on VKA treatment and 75 on NOAC treatment. Atrial fibrillation was the indication for anticoagulation in 64% of VKA patients and in 91% of NOAC patients. The mean HAS-BLED score was the same in VKA and NOAC patient groups. Major bleeding events were seen in 38.3% of VKA patients and 30.7% of NOAC patients and life-threatening bleeding was seen in 34.4% of VKA patients and 26.7% of NOAC (p<0.05). Packed red blood cell and fresh-frozen plasma transfusions were administered less in the NOAC patients as compared to the VKA patients. No statistically significant differences in length of hospitalization, re-bleeding, or mortality were seen between groups.Conclusions: GI bleeding events on NOAC therapy are less severe and use fewer hospital resources as compared to those treated with VKA.
目的:先前比较服用维生素K拮抗剂(VKA)和非维生素K拮抗剂口服抗凝剂(NOAC)患者胃肠道出血的研究主要集中在胃肠道出血的发生率上,而较少关注此类事件的严重程度。本研究的目的是评估VKA治疗与NOAC治疗患者的胃肠道出血特征。方法:回顾性收集2010年1月至2017年7月在哈达萨大学医学中心住院的胃肠道出血患者的数据。检索到的数据包括人口统计、实验室结果、临床结果以及有关出血特征、评估、治疗和住院的详细信息。患者分为两组:VKA组和NOAC组。结果:514例出现消化道出血的患者被纳入研究。VKA组439例,NOAC组75例。在64%的VKA患者和91%的NOAC患者中,房颤是抗凝的指征。VKA组和NOAC组的平均ha - bled评分相同。38.3%的VKA患者和30.7%的NOAC患者出现大出血,34.4%的VKA患者和26.7%的NOAC患者出现危及生命的出血(p<0.05)。与VKA患者相比,NOAC患者使用的填充红细胞和新鲜冷冻血浆输注较少。两组间住院时间、再出血或死亡率无统计学差异。结论:与VKA治疗相比,NOAC治疗的胃肠道出血事件较轻,使用的医院资源较少。
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引用次数: 0
Internal Hernia After Bariatric Surgery: A Comprehensive Review 减肥手术后的内部疝:一项全面的综述
Pub Date : 2022-11-26 DOI: 10.46889/jsrp.2022.3302
Vilallonga Ramon
defect) seem to play an essential role. The aim of this review is to elucidate and show evidence regarding IH and RYGB. Materials and Methods: Research was carried out in Pubmed to identify those articles and studies containing data referring to incidence, treatment, pathogenesis and prevention of internal hernia. All randomized controlled trials, clinical trials, review papers, and meta-analysis were included. Results: Out of the 44 initially found studies, 26 were finally chosen for further review, being 7 of them the only ones that met the inclusion criteria. Conclusion: The antecolic orientation of the alimentary limb and closure of mesenteric defects shows lower incidence of internal hernias, yet being the available scientific evidence not conclusive enough so as to define a single trend when performing this surgical procedure. More comparative studies are needed to define the real impact of closing mesenteric defects in the prevention of internal hernias.
缺陷)似乎起着至关重要的作用。本综述的目的是阐明和展示有关IH和RYGB的证据。材料和方法:在Pubmed检索含有有关疝的发生率、治疗、发病机制和预防资料的文章和研究。所有的随机对照试验、临床试验、综述论文和荟萃分析均被纳入。结果:在最初发现的44项研究中,最终选择了26项进行进一步审查,其中只有7项符合纳入标准。结论:消化肢前结肠位和肠系膜缺损闭合可降低内疝的发生率,但现有的科学证据不足以确定该术式的单一趋势。需要更多的比较研究来确定关闭肠系膜缺损对预防内疝的真正影响。
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引用次数: 0
Complications Post Extracorporeal Shock Wave Lithotripsy: Literature Review Study 体外冲击波碎石术后并发症:文献回顾研究
Pub Date : 2022-09-07 DOI: 10.46889/jsrp.2022.3301
H. Albadawe
Since its introduction in 1980, Extracorporeal Shock Wave Lithotripsy (ESWL) has completely changed how urolithiasis is treated. A recognised, secure and efficient therapeutic alternative to surgical urolithiasis treatment is Electroshock Wave Therapy (ESWL). A tiny percentage of individuals do experience ESWL complications and when they do, the kidney is frequently involved. The important literature on extracorporeal Shock Wave Lithotripsy (SWL) treatment and complications was examined and reviewed in order to pinpoint potential issues following SWL. The development and transit of fragments, infections, effects on renal and non-renal tissues and impacts on kidney function are the main causes of complications after SWL. Each of these risks can be avoided by taking the proper precautions, such as adhering to the contraindications, identifying and treating concurrent disorders or infections and using the SWL in the safest and most effective manner possible while personalising the treatment for each patient. In conclusion, SWL is a successful and largely non-invasive method of treating kidney stones. There are various contraindications and potential consequences, just like with any other sort of therapy, though. The danger of the emergence of others might be significantly reduced by strict adherence to the first; however, this must be completely understood in order to put every preventive step at our disposal into action. Different studies mentioning different cases and statistics related to the complications post ESWL were considered and reviewed for this document.
自1980年推出以来,体外冲击波碎石术(ESWL)已经完全改变了尿石症的治疗方式。一种公认的、安全的、有效的替代手术治疗尿石症的疗法是电击疗法(ESWL)。一小部分人确实经历过ESWL并发症,当他们这样做时,肾脏经常受到影响。本文对体外冲击波碎石术(SWL)治疗及其并发症的重要文献进行了分析和回顾,以确定SWL后可能出现的问题。碎片的发展和转运、感染、对肾和非肾组织的影响以及对肾功能的影响是SWL术后并发症的主要原因。这些风险都可以通过采取适当的预防措施来避免,例如遵守禁忌症,识别和治疗并发疾病或感染,并以最安全和最有效的方式使用SWL,同时为每位患者提供个性化治疗。总之,SWL是治疗肾结石的一种成功且无创的方法。然而,就像任何其他类型的治疗一样,它也有各种禁忌症和潜在的后果。通过严格遵守第一个原则,其他原则出现的危险可能会大大降低;但是,必须完全理解这一点,以便将我们掌握的每一个预防步骤付诸行动。不同的研究提到不同的病例和统计数据相关的ESWL后的并发症是考虑和回顾本文。
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引用次数: 0
On the Colorimetry of Neuropeptide Y Hypothalamus and Ligamentous Parts in Male and Female Deer: Immunohistochemical Analysis Report- May 2021 关于雄性和雌性鹿下丘脑和韧带部分神经肽Y的比色法:免疫组织化学分析报告- 2021年5月
Pub Date : 2022-08-26 DOI: 10.46889/jsrp.2022.3208
Dominique Pianel
It is since 1992 that this research began after reading numerous articles which placed Neuropeptide Y (NPY) antibody in the regulation of calcium and stomach function. Research in posturology and osteopathy carried out since 1988 highlights the oral afferents in the postural balance of verticalization and hominization.In parallel, paleontological research, on the ventro-caudal concavity flexion of the sphenoid, by Pr Anne Dambricourt, CNRS and the study on the evolution of the neurocranium by Pr Yves Lignereux of the Toulouse natural history museum, have allowed this research to position itself on the anatomical and embryological level.Researchers such as Gulgun Sengul and Charles Watson took up the work of Dr.Yew Chan, et al., in 1999 showed the relevance of NPY, at the high dorsals level, up to the 12th week of gestation in humans.In their work on the spine, Lumbar Spine Discover, the authors Aspden and Porter showed that this ligament relevance would be verifiable on the whole of the supraspinous ligament up to the lumbar vertebrae, which was further studied in the 2016.
从1992年开始,在阅读了大量关于神经肽Y (NPY)抗体调节钙和胃功能的文章后,这项研究开始了。自1988年以来,在姿势学和骨病方面的研究强调了直立和人格化的姿势平衡中的口腔事件。与此同时,法国科学研究中心Anne Dambricourt博士对蝶骨腹尾侧凹弯曲的古生物学研究,以及图卢兹自然历史博物馆Yves Lignereux博士对神经头盖骨进化的研究,使这项研究能够在解剖学和胚胎学水平上定位自己。1999年,Gulgun Sengul和Charles Watson等研究人员继承了Dr.Yew Chan等人的工作,在高背侧水平上显示了NPY与人类妊娠12周的相关性。作者Aspden和Porter在他们关于脊柱的研究《腰椎发现》(腰椎Discover)中表明,这种韧带相关性可以在整个直至腰椎的棘上韧带上得到验证,并在2016年进行了进一步研究。
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引用次数: 0
Canal of Nuck Hernia in an Elderly Patient- A Case Report 老年患者颈疝管术1例报告
Pub Date : 2022-08-19 DOI: 10.46889/jsrp.2022.3207
Garritano C
The hernia of the canal of Nuck is a female exclusivity and appears as the result of failure to close the vaginalis process. It is found more frequently in children and rarely in elderly women. This type of hernia usually contains parts of the uterus, ovary and fallopian tube and rarely intestinal loops are observed. The diagnosis is made through Ultrasound (US), which allows the identification of herniated structures and the treatment is always surgical.
努克管疝是女性独有的,是由于未能关闭阴道突而出现的。它多见于儿童,很少见于老年妇女。这种类型的疝通常包括子宫、卵巢和输卵管的部分,很少观察到肠袢。诊断是通过超声(US),它允许识别突出的结构和治疗总是手术。
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引用次数: 0
Bladder Explosion during Transurethral Resection Surgery-Case Series 经尿道膀胱切除术中膀胱爆炸-病例系列
Pub Date : 2022-08-07 DOI: 10.46889/jsrp.2022.3205
H. Albadawe
The explosion of the bladder or intravesical explosion is a rare but possible complication in Transurethral Resection (TUR) procedures. The chances of a bladder rupture occurring during TUR are approximately 0.02%. In all types of transurethral surgeries which involve diathermy, the possibility of bladder explosion remains. It can be in the form of a mucosal tear which is a simple or a deep rupture in the bladder. Immediate and quick intervention is important for repairing the bladder when this complication occurs. The initial cases of this complication were reported in 1926. Since then, there have only been thirty reports of such complications.
膀胱爆炸或膀胱内爆炸是经尿道切除(TUR)手术中一种罕见但可能的并发症。TUR期间膀胱破裂的几率约为0.02%。在所有涉及透热的经尿道手术中,膀胱爆炸的可能性仍然存在。它可以是粘膜撕裂的形式,这是膀胱的简单或深度破裂。当这种并发症发生时,及时和快速的干预对于修复膀胱是很重要的。1926年首次报道了这种并发症的病例。从那时起,只有30例此类并发症的报道。
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引用次数: 0
Magnitude and Associated Factor of Acute Appendicitis among Adult Patient Admitted At Hawassa University Comprehensive Specialized Hospital in Surgical Ward 阿瓦萨大学综合专科医院外科病房成人急性阑尾炎的大小及相关因素
Pub Date : 2022-08-05 DOI: 10.46889/jsrp.2022.3206
Lascu Rodica
The pathology of the elderly is the direct result of the aging process, aggravated by the physical and mental involution that occurs with advancing age. Age-related eye changes are present, such as: presbyopia, decreased tears, peripheral visual field reduction, vitreous liquefaction (with posterior vitreous detachment and retinal detachment), decreased vision due to cataracts, glaucoma, diabetic retinopathy, macular lesions, Age-Related Macular Degeneration (AMD), optic atrophy. At the same time, there are multiple systemic diseases in the elderly, at the cardiovascular, respiratory, locomotor, neurological, auditory level. The diseases of the elderly can be multiple, with a long, chronic evolution, with periods of exacerbation, frequent complications, prolonged convalescence. Aging is a continuous, dynamic process that must be followed because in its evolution new connections and balances are created that must be identified and treated properly, old age being a distinct stage of ontogenesis that should not beseen as a state of disease. In an elderly patient, the normal aging should be differentiated from pathology.
老年人的病理是衰老过程的直接结果,随着年龄的增长,身体和精神上的退化会加剧。存在与年龄相关的眼部变化,如:老花眼、泪液减少、周围视野缩小、玻璃体液化(伴有后玻璃体脱离和视网膜脱离)、白内障、青光眼、糖尿病视网膜病变、黄斑病变、年龄相关性黄斑变性(AMD)、视神经萎缩。同时,老年人还存在心血管、呼吸、运动、神经、听觉等多种全身性疾病。老年人的疾病可以是多重的,具有长期的慢性演变,有加重期,并发症频繁,恢复期延长。衰老是一个持续的、动态的过程,必须遵循这个过程,因为在它的进化过程中,新的联系和平衡被创造出来,必须被识别和正确对待,老年是个体发育的一个独特阶段,不应该被视为一种疾病状态。在老年患者中,应将正常衰老与病理区分开来。
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引用次数: 2
Soft Tissue Sarcoma in a Malignancy Prone Patient: An Update 一个易患恶性肿瘤患者的软组织肉瘤:最新进展
Pub Date : 2022-06-28 DOI: 10.46889/jsrp.2022.3204
Badr M. I. Abdulrauf
It is possible to encounter a patient who might have more than one type of a primary malignant tumor. The literature supports increasing tendencies for subsequent development of malignancies within same individual. A case example of a young woman is given who was diagnosed with a pleomorphic Liposarcoma, while she is been followed up for metastatic ductal breast carcinoma and with a past history of treated acute lymphoblastic Leukemia. As per our review, various associations of malignant conditions are encountered, but are more likely to be metachronous rather than synchronous. The duration between diagnosing a second and third malignancy tends to be relatively short. Soft tissue sarcoma as a synchronous malignancy has been shown to be associated with breast cancer more often. Patients diagnosed with new subsequent malignancy including soft tissue sarcomas must be managed holistically and with full measures; as per current data, their prognosis is not necessarily poorer than regular cancer patients.
可能会遇到患有多种原发性恶性肿瘤的患者。文献支持在同一个体中恶性肿瘤的后续发展趋势增加。一位年轻女性被诊断为多形性脂肪肉瘤,同时她被随访为转移性导管性乳腺癌,并有治疗过的急性淋巴细胞白血病的病史。根据我们的综述,恶性疾病的各种关联是遇到的,但更有可能是同时而不是同步的。诊断第二次和第三次恶性肿瘤之间的时间往往相对较短。软组织肉瘤作为一种同步恶性肿瘤已被证明与乳腺癌有更多的联系。诊断为包括软组织肉瘤在内的新的后续恶性肿瘤的患者必须进行全面和全面的治疗;根据目前的数据,他们的预后并不一定比普通癌症患者差。
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引用次数: 0
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Journal of Surgery Research and Practice
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