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Transplantation Principles 移植的原则
Pub Date : 2020-02-28 DOI: 10.2310/ps.10007
M. Siemionow, F. Zor
Transplantation is a truly multidisciplinary specialty where a surgical procedure requires inputs from both, the specialists of the specific organ e.g. nephrologist for kidney transplant or hepatologist for liver transplant, as well as from experts of other specialties such as immunology, infectious diseases etc. It is also a rapidly grooving field with the advances in surgical techniques, immunological knowledge and pharmacology. A recent, major advance in the field of transplantation is the emergence of new procedure of vascularized composite allotransplantation, which includes transplantation of non-lifesaving organs such as face, hands, abdominal wall or uterus. Additionally, organ shortage in transplantation yielded a new area of research such as xenotransplantation and regenerative medicine. The specialty of transplantation may be difficult to comprehend for those entering the field; thus, the goal of this chapter is to provide a comprehensive overview of the most important aspects of transplantation.This review contains 2 figures, 3 tables, and 67 references.Keywords: transplantation, solid organ transplantation (SOT), vascularized composite allotransplantation (VCA), transplant immunology, allorecognition, acute rejection, chronic transplant rejection, principles of transplantation, transplantation terminology, immunosuppressive drugs
移植是一个真正的多学科专业,外科手术需要来自特定器官的专家,如肾移植的肾病专家或肝移植的肝病专家,以及其他专业的专家,如免疫学、传染病等。随着外科技术、免疫学知识和药理学的进步,这也是一个快速发展的领域。近年来,移植领域的一项重大进展是血管化复合异体移植新技术的出现,该技术包括面部、手部、腹壁或子宫等非救生器官的移植。此外,器官移植的短缺产生了异种移植和再生医学等新的研究领域。对于刚进入这一领域的人来说,移植的特殊性可能很难理解;因此,本章的目的是提供移植最重要方面的全面概述。本综述包含2张图,3张表,67篇参考文献。关键词:移植,实体器官移植(SOT),血管化复合异体移植(VCA),移植免疫学,同种异体识别,急性排斥反应,慢性移植排斥反应,移植原理,移植术语,免疫抑制药物
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引用次数: 0
Gastroesophageal Reflux Disease and Hiatal Hernia 胃食管反流病和食管裂孔疝
Pub Date : 2020-02-25 DOI: 10.2310/surg.2046
K. Perry, V. Wang
Gastroesophageal reflux disease (GERD) is common, affecting approximately 18 to 27% of adult Americans, and can have a considerable impact on quality of life. Hiatal hernias are present in 80% of patients with symptomatic GERD. This review covers the basic pathophysiology, evaluation, and treatment algorithms for patients with GERD and hiatal hernia. Figures show normal gastroesophageal junction anatomy, treatment algorithm for patients with symptomatic GERD, schematic and endoscopic images of long segment Barrett's esophagus, a normal barium esophagogram, esophageal intraluminal pressures assessed by esophageal manometry, test results from a 48-hour wireless pH study, laparoscopic Nissen fundoplication, laparoscopic gastroesophageal junction reinforcement, classification of paraesophageal hernia, and endoscopic view of Cameron ulcers at the level of the diaphragm in the setting of a type III paraesophageal hernia. Tables list risk factors for GERD and a standardized approach to Nissen fundoplication.This review contains 10 figures, 3 tables, and 68 references.Keywords: Gastroesophageal reflux disease, GERD, hiatal hernia, paraesophageal hernia, anti-reflux surgery, Nissen fundoplication, Barrett's esophagus, manometry, pH study
胃食管反流病(GERD)很常见,约影响18%至27%的美国成年人,并对生活质量产生相当大的影响。80%的有症状的胃反流患者存在裂孔疝。本文综述了胃食管反流和裂孔疝的基本病理生理学、评估和治疗方法。图中显示正常胃食管交界处解剖、症状性胃食管反流患者的治疗方法、长段Barrett食管示意图及内镜图像、正常食管钡餐片、食管测压法评估的食管腔内压力、48小时无线pH值研究的测试结果、腹腔镜Nissen底翻术、腹腔镜胃食管交界处强化、食管旁疝分类、III型食道旁疝膈面Cameron溃疡的内窥镜观察。表列出了GERD的危险因素和尼森基金应用的标准化方法。本综述包含10个图,3个表,68篇参考文献。关键词:胃食管反流病,胃食管反流,食管裂孔疝,食管旁疝,抗反流手术,Nissen底复制,Barrett食管,测压,pH值研究
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引用次数: 5
Coma, Cognitive Impairment, and Seizures 昏迷、认知障碍和癫痫发作
Pub Date : 2020-02-13 DOI: 10.2310/surg.2158
Melissa H. Coleman, A. Salim
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引用次数: 0
Esophageal Adenocarcinoma 食管腺癌
Pub Date : 2020-02-07 DOI: 10.32388/tbqwdt
S. Hochwald, R. Shah
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引用次数: 9
Mediastinal Procedures 纵隔手术
Pub Date : 2020-01-28 DOI: 10.2310/surg.2054
J. Shrager, V. Patel
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引用次数: 0
Adjuvant and Neoadjuvant Management of Colorectal Cancer 结直肠癌的辅助和新辅助治疗
Pub Date : 2020-01-24 DOI: 10.2310/surg.2270
C. Bailey, E. Vilar, Y. You
Colorectal cancer (CRC) is the third most common and lethal cancer in men and women in the United States. At presentation, a significant proportion of patients with CRC are able to undergo resection with curative intent, but up to 50% of these patients will develop recurrent disease. Fortunately, recurrence rates for both colon and rectal cancer have improved with the introduction of multimodality therapies, which include chemotherapy, chemoradiation therapy, and radiation therapy. These therapies are adjuncts to surgery and can be administered before (i.e. neoadjuvant) or after (i.e. adjuvant) surgery. This review summarizes the current evidence for the use of adjuvant and neoadjuvant therapies in colon and rectal cancer.This review contains 2 figures, 7 tables, and 77 references.Keywords: Colon cancer, rectal cancer, neoadjuvant therapy, adjuvant therapy, total neoadjuvant therapy, induction chemotherapy in rectal cancer, chemoradiation, organ preservation, non-operative management
结直肠癌(CRC)是美国男性和女性中第三大常见和致命的癌症。目前,有相当比例的CRC患者能够以治愈为目的进行切除,但高达50%的患者会复发。幸运的是,随着包括化疗、放化疗和放射治疗在内的多模式治疗的引入,结肠癌和直肠癌的复发率都有所提高。这些疗法是手术的辅助手段,可以在手术前(即新辅助)或手术后(即辅助)进行。本文综述了目前结肠癌和直肠癌中使用辅助和新辅助治疗的证据。本综述包含2张图,7张表,77篇参考文献。关键词:结肠癌,直肠癌,新辅助治疗,辅助治疗,全新辅助治疗,直肠癌诱导化疗,放化疗,器官保存,非手术治疗
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引用次数: 0
Developmental Biology II: The Role of WNT Signaling in Bone Regeneration 发育生物学II: WNT信号在骨再生中的作用
Pub Date : 2019-12-25 DOI: 10.2310/ps.10122
M. Borrelli, L. Ngaage, D. Wan, M. Longaker, H. Lorenz
Wingless-related integration site (Wnt) signaling is an important regulator of bone development and regeneration. Wnts are short-range signaling molecules which act within the skeletal stem cell niche to influence cell proliferation and differentiation. Nineteen different Wnts have been identified in humans. Disruptions to Wnt signaling can lead to impairments in bone healing. Recent work has elucidated the complexities of Wnt signaling during bone development, repair, and regeneration, and highlighted its value as a potential therapeutic target for tissue regeneration. Here, we discuss the role of the canonical-Wnt-signaling pathway, its regulatory role in bone regeneration, and the recent clinical advance made towards its manipulation in regenerative medicine.This review contains 3 figures and 50 references. Keywords: osteogenesis, bone regeneration, bone remodeling, endochondral ossification, osteoblast, osteoprogenitor, lithium, fracture healing
无翅相关整合位点(Wnt)信号是骨发育和再生的重要调节因子。wnt是一种短距离信号分子,在骨骼干细胞生态位内起作用,影响细胞增殖和分化。已经在人类身上发现了19种不同的wnt。破坏Wnt信号可导致骨愈合受损。最近的研究已经阐明了Wnt信号在骨骼发育、修复和再生过程中的复杂性,并强调了其作为组织再生的潜在治疗靶点的价值。在这里,我们讨论了经典wnt信号通路的作用,它在骨再生中的调节作用,以及最近在再生医学中对其操纵的临床进展。本综述包含3张图和50篇参考文献。关键词:成骨,骨再生,骨重塑,软骨内成骨,成骨细胞,骨祖细胞,锂,骨折愈合
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引用次数: 0
Developmental Biology I: Bone Development, Repair, and Regeneration 发育生物学I:骨骼发育、修复和再生
Pub Date : 2019-12-23 DOI: 10.2310/ps.10002
M. Borrelli, L. Ngaage, D. Wan, M. Longaker, H. Lorenz
Defects of the skeletal system are extremely common and amount to a significant biomedical burden. Bone is a unique tissue that retains its regenerative potential into adulthood. The biology behind bone development, repair, and regeneration is thus of considerable interest, and may lead to advances in patient care. There are two distinct forms of osteogenesis; bones of the craniofacial skeleton develop via intramembranous ossification, whilst bones of the appendicular skeleton form by endochondral ossification. In this review, bone regenerative mechanisms based on skeletal stem cell function during fracture repair and during distraction osteogenesis are reviewed.  Skeletal stem cell function more closely follows developmental mechanisms during distraction osteogenesis compared to fracture osteogenesis. This review contains 5 figures and 50 references.Keywords: skeletal stem cell, osteogenesis, skeletogenesis, mechanotransduction, regeneration, remodeling, focal adhesion kinase, ossification
骨骼系统的缺陷是极其常见的,并相当于一个显著的生物医学负担。骨是一种独特的组织,在成年后仍能保持其再生潜力。因此,骨发育、修复和再生背后的生物学引起了相当大的兴趣,并可能导致患者护理的进步。有两种不同的成骨形式;颅面骨骼通过膜内骨化形成,而尾骨通过软骨内骨化形成。本文就骨干细胞在骨折修复和牵张成骨过程中的再生机制作一综述。与骨折成骨相比,牵张成骨过程中骨骼干细胞的功能更接近于发育机制。本综述包含5张图和50篇参考文献。关键词:骨干细胞,成骨,骨形成,机械转导,再生,重塑,黏附激酶,骨化
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引用次数: 0
Adenocarcinoma of the Colon and Rectum 结直肠腺癌
Pub Date : 2019-12-13 DOI: 10.1016/b978-1-4377-2206-2.00164-0
W. Tan, M. Weiser
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引用次数: 0
Management of the Burn Wound 烧伤创面处理
Pub Date : 2019-12-10 DOI: 10.2310/surg.2143
N. Gibran, Jose P. Sterling, D. Heimbach
Current approaches to burn management are based on an understanding of the biology and physiology of human skin and the pathophysiology of the burn wound. The clinical evaluation and initial care of a burn wound is described and includes an assessment of burn depth, determining the need for escharatomy and daily burn wound care. Burns can be topical or surgical. Topical burn wounds require choice in the use of antibiotics. Considerations and techniques for surgical burn wound management are described and include early excision and grafting, wound excision, skin grafting, graft and donor-site dressings, postoperative wound care, biologic dressings and skin substitutes, allograft and xenograft skin, cultured epidermal autografts, and skin substitutes. Figures show the two distinct layers of the skin, various types of burns, and both fascial and tangential excision of burn wounds. This review contains 12 figures, 11 tables, and 61 references.Keywords: Burn wound, graft, partial-thickness, full-thickness, dermis, epidermis,  sloughing, dressing
目前的烧伤管理方法是基于对人类皮肤的生物学和生理学以及烧伤创面的病理生理学的理解。描述了烧伤创面的临床评估和初步护理,包括烧伤深度评估,确定结痂和日常烧伤创面护理的需要。烧伤可以是局部的,也可以是外科的。局部烧伤创面需要选择抗生素的使用。描述了外科烧伤创面处理的注意事项和技术,包括早期切除和移植,伤口切除,皮肤移植,移植物和供体部位敷料,术后伤口护理,生物敷料和皮肤替代品,同种异体和异种移植皮肤,培养表皮自体移植物和皮肤替代品。图中显示了两层不同的皮肤,不同类型的烧伤,以及烧伤创面的筋膜和切向切除。本综述包含12个图,11个表,61篇参考文献。关键词:烧伤创面,移植物,部分厚度,全层,真皮层,表皮,脱落,敷料
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DeckerMed Plastic Surgery
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