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Device-tissue interactions: a collaborative communications system. 设备-组织交互:一个协作通信系统。
Pub Date : 2013-07-29 DOI: 10.1186/1750-1164-7-10
Edward Chekan, Richard L Whelan, Alexander H Feng

Medical devices, including surgical staplers, energy-based devices, and access enabling devices, are used routinely today in the majority of surgical procedures. Although these technically advanced devices have proved to be of immense benefit to both surgeons and patients, their rapid development and continuous improvement have had the unintended consequence of creating a knowledge gap for surgeons due to a lack of adequate training and educational programs. Thus, there is an unmet need in the surgical community to collect existing data on device-tissue interactions and subsequently develop research and educational programs to fill this gap in surgical training. Gathering data and developing these new programs will require collaboration between doctors, engineers, and scientists, from both clinical practice and industry. This paper presents a communications system to enable this unique collaboration that can potentially result in significantly improved patient care.

医疗设备,包括外科订书机、能量设备和访问设备,目前在大多数外科手术中常规使用。尽管这些技术先进的设备已被证明对外科医生和患者都有巨大的好处,但由于缺乏足够的培训和教育计划,它们的快速发展和不断改进产生了意想不到的后果,即为外科医生创造了知识差距。因此,在外科社区中,收集设备与组织相互作用的现有数据,并随后开发研究和教育计划,以填补手术培训中的这一空白,这是一个未满足的需求。收集数据和开发这些新项目需要临床实践和工业界的医生、工程师和科学家之间的合作。本文提出了一个通信系统,以实现这种独特的协作,这可能会显著改善患者的护理。
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引用次数: 10
Potential of the SPY intraoperative perfusion assessment system to reduce ischemic complications in immediate postmastectomy breast reconstruction. SPY术中灌注评估系统减少乳房切除术后即刻重建中缺血性并发症的潜力。
Pub Date : 2013-07-23 DOI: 10.1186/1750-1164-7-9
Mohit Sood, Paul Glat

Background: The quality and viability of mastectomy flaps remain a central challenge in reconstructive surgery, particularly for immediate breast reconstruction. Insufficient perfusion in tissue flaps is a leading cause of early complications following reconstructive procedures, and clinical judgment alone is not completely reliable for the assessment of flap viability. Accurate and reliable intraoperative methods for assessment of tissue perfusion are needed to help surgeons identify tissue at risk for ischemia and necrosis, thereby allowing for maneuvers to improve tissue flap viability.

Methods: This study evaluates the use of intraoperative laser angiography using the SPY System (LifeCell Corp., Branchburg, NJ) for the assessment of perfusion in mastectomy flaps for immediate breast reconstruction. The SPY System uses the contrast agent indocyanine green, which has an excellent safety profile and pharmacokinetics that allow for repeat evaluations during the same surgical procedure. In recent work, the SPY System has demonstrated high sensitivity and specificity for detection of tissues at risk for ischemia and necrosis during reconstructive surgery. Using a retrospective, chart-review design, the authors compared consecutive cases of immediate breast reconstruction using a prosthesis, before and after implementation of the SPY System.

Results: Ninety-one subjects were included in the analysis: 52 prior to SPY (Pre-SPY) and 39 after implementation of SPY (Post-SPY). Baseline characteristics were similar between the groups. Both groups had high rates of comorbidities, chemotherapy, and radiation therapy. The rate of postoperative complications was two-fold higher in the Pre-SPY group compared to the Post-SPY group (36.5% vs. 17.9%); this difference was of borderline significance (P = 0.0631). However, mean number of repeat visits to the OR per patient was significantly higher in the Pre-SPY group (1.21 ± 1.47 vs. 0.41 ± 0.71; P = 0.0023). Of the seven patients with complications in the Post-SPY group, five were identified by SPY as having poor flap perfusion; none were identified by clinical judgment alone.

Conclusions: This study suggests that the SPY System can contribute to reduced ischemia-related complications in a population of women undergoing immediate breast reconstruction following mastectomy for breast cancer.

背景:乳房切除术皮瓣的质量和生存能力仍然是重建手术的核心挑战,特别是对于立即乳房重建。组织皮瓣灌注不足是重建手术后早期并发症的主要原因,仅凭临床判断评估皮瓣活力并不完全可靠。需要准确可靠的术中组织灌注评估方法来帮助外科医生识别有缺血和坏死风险的组织,从而允许操作来提高组织瓣的活力。方法:本研究评估使用SPY系统(LifeCell Corp., Branchburg, NJ)术中激光血管造影评估乳房切除术皮瓣在立即乳房重建中的灌注情况。SPY系统使用造影剂吲哚菁绿,具有良好的安全性和药代动力学,允许在同一手术过程中重复评估。在最近的工作中,SPY系统在重建手术中检测有缺血和坏死危险的组织方面表现出了高灵敏度和特异性。采用回顾性、图表回顾设计,作者比较了SPY系统实施前后使用假体立即乳房重建的连续病例。结果:共纳入91例受试者,其中实施前52例(Pre-SPY),实施后39例(Post-SPY)。两组的基线特征相似。两组患者的合并症、化疗和放疗的发生率都很高。spy前组的术后并发症发生率是spy后组的2倍(36.5% vs. 17.9%);差异有临界意义(P = 0.0631)。然而,Pre-SPY组每位患者的平均重复就诊次数显著高于对照组(1.21±1.47 vs 0.41±0.71;p = 0.0023)。SPY后组出现并发症的7例患者中,有5例经SPY鉴定为皮瓣灌注不良;没有一个是单独通过临床判断确定的。结论:本研究表明SPY系统有助于减少乳腺癌切除术后立即进行乳房重建的女性人群中的缺血相关并发症。
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引用次数: 68
Vaccum drainage system application in the management of operation-related non-regional epidural hematoma. 真空引流系统在手术相关非区域硬膜外血肿治疗中的应用。
Pub Date : 2013-07-10 eCollection Date: 2013-01-01 DOI: 10.1186/1750-1164-7-7
Jun Ma, Huan Li, Linggang Cheng, Song Lin

Background: Epidural intracranial hematoma is one of the most common complications of surgeries for intracranial tumors. The non-regional epidural hematoma is related to severe fluctuation of the intracranial pressure during the operation. The traditional management of hematoma evacuation through craniotomy is time-consuming and may aggravate intracranial pressure imbalance, which causes further complications. We designed a method using vaccum epidural drainage system, and tried to evaluate advantage and the disadvantage of this new technique.

Methods: Seven patients of intracranial tumors were selected. All of the patients received tumor resection and intra-operative non-regional epidural hematoma was confirmed through intra-operative ultrasound or CT scan. The vaccum drainage system was applied. Another ten patients who received craniotomy for intra-operative non-regional epidural hematoma evacuation were selected as comparison. Regular tests, like serial CT scan, were performed afterward to evaluate the effectiveness and to help deciding when to remove the drainage system.

Results: The vaccum drainage method was effective in epidual hemotoma clearance and prevented recurrent epidural hemorrhage. The drainage systems were removed within 4 days. All of the patients recovered well. No complications related to the drainage system were observed.

Conclusions: Compared to the traditional craniotomy, the new method of epidural hemoatoma management using vaccum epidural drainage system proved to be as effective in hematoma clearance, and was less-invasive and easier to perform, with less complication, shorter hospitalization, less economic burden, and better prognosis.

背景:硬膜外颅内血肿是颅内肿瘤手术最常见的并发症之一。非区域硬膜外血肿与术中颅内压剧烈波动有关。传统的开颅血肿引流方法耗时长,且可能加重颅内压失衡,造成并发症。我们设计了一种采用真空硬膜外引流系统的方法,并尝试评价这种新技术的优缺点。方法:选取7例颅内肿瘤患者。所有患者均行肿瘤切除术,术中超声或CT扫描证实术中非区域性硬膜外血肿。采用真空排水系统。选择10例行开颅术进行术中非区域硬膜外血肿清除的患者作为对照。之后进行常规测试,如连续CT扫描,以评估有效性,并帮助决定何时拆除引流系统。结果:真空引流术能有效清除个体化血肿,防止复发性硬膜外出血。排水系统在4天内被拆除。所有病人都恢复得很好。未见与引流系统相关的并发症。结论:与传统开颅术相比,采用真空硬膜外引流系统处理硬膜外血肿的新方法清除血肿效果相同,且创伤小,操作简单,并发症少,住院时间短,经济负担轻,预后好。
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引用次数: 0
Giant fibroepithelial stromal polyp of the vulva: largest case reported. 外阴巨大纤维上皮间质息肉:报告最大一例。
Pub Date : 2013-07-10 eCollection Date: 2013-01-01 DOI: 10.1186/1750-1164-7-8
Obianuju Sandra Madueke-Laveaux, Radhika Gogoi, Gary Stoner

Background: Fibroepithelial stromal polyps are site-specific mesenchymal lesions that are commonly found in the vulvovaginal region in premenopausal females. These polyps usually are less than 5 cm in diameter and are most commonly identified during routine gynecological examination. Although the stromal polyp is benign, its differential diagnosis includes some malignant vulva lesions making it critical to ensure that an accurate pathologic diagnosis is made.

Case: We present a case of a 21 year old female with a giant fibroepithelial stromal polyp of the vulva. Upon review of the literature this is the largest reported fibroepithelial stromal polyp to date.

Conclusion: Fibroepithelial stromal polyps can grow as large as 390 grams and can be 18.5-cm in diameter. Microscopic evaluation of the polyp is critical in the exclusion of malignancy with this diagnosis.

背景:纤维上皮间质息肉是一种部位特异性间质病变,常见于绝经前女性外阴阴道区域。这些息肉通常直径小于5厘米,最常在常规妇科检查中发现。虽然间质息肉是良性的,但其鉴别诊断包括一些恶性外阴病变,因此确保准确的病理诊断至关重要。病例:我们报告一例21岁女性外阴巨大纤维上皮间质息肉。回顾文献,这是迄今为止报道的最大的纤维上皮间质息肉。结论:纤维上皮间质息肉可长至390克,直径可达18.5 cm。息肉的显微检查是排除恶性肿瘤的关键。
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引用次数: 36
A rare case of Endometriosis in vaginal hysterectomy scar. 子宫内膜异位症并发阴道子宫切除术瘢痕1例。
Pub Date : 2013-07-01 DOI: 10.1186/1750-1164-7-6
Rajiv Mahendru, Sunita Siwach, Deepti Aggarwal, Parveen Rana, Amrita Duhan, Tanya Aggarwal, Tina Anand Mahendru

Presented hereunder is probably the first reported case of endometriosis at the vaginal apex following vaginal hysterectomy. No other similar case could be traced in the review of the literature.

本文报告的可能是阴道子宫切除术后阴道顶点子宫内膜异位症的第一例。在文献综述中没有发现其他类似的病例。
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引用次数: 6
Modified Quad surgery significantly improves the median nerve conduction and functional outcomes in obstetric brachial plexus nerve injury. 改良股四头肌手术可显著改善产科臂丛神经损伤的正中神经传导和功能预后。
Pub Date : 2013-05-28 eCollection Date: 2013-01-01 DOI: 10.1186/1750-1164-7-5
Rahul K Nath, Nirupuma Kumar, Chandra Somasundaram

Background: Nerve conduction studies or somatosensory evoked potentials (SSEPs) have become an important tool in the investigation of peripheral nerve lesions, and is sensitive in detecting brachial plexus nerve injury, and other nerve injuries. To investigate whether the modified Quad surgical procedure improves nerve conductivity and functional outcomes in obstetric brachial plexus nerve injury (OBPI) patients.

Methods: All nerves were tested with direct functional electrical stimulation. A Prass probe was used to stimulate the nerves, and recording the response, the compound motor action potential (CMAP) in the muscle. SSEP monitoring was performed pre- and post modified Quad surgery, stimulating the median and ulnar nerves at the wrist, the radial nerve over the dorsum of the hand, recording the peripheral, cervical and cortical responses. All patients have had the modified Quad surgery (n = 19). The modified Quad surgery is a muscle release and transfer surgery with nerve decompressions. All patients were assessed preoperatively and postoperatively by evaluating video recordings of standardized movements, the modified Mallet scale to index active shoulder movements.

Results: The cervical responses were significantly lower in amplitude in the affected arm than the un-affected arm. The median nerve conduction was significantly improved from 8.04 to 9.26 (P < 0.022) post-operatively. The shoulder abduction was also significantly improved (pre-op 30° ± 23.3 to 143° ± 33.7, p < 0.0001), with a mean follow-up of 43 months after the modified Quad surgery in these patients.

Conclusion: Median nerve conduction, and shoulder abduction were significantly improved in OBPI children, who have undergone the modified Quad procedure with neuroplasty, internal microneurolysis and tetanic stimulation of the median nerve.

背景:神经传导研究或体感诱发电位(ssep)已成为研究周围神经病变的重要工具,在检测臂丛神经损伤和其他神经损伤方面具有敏感性。目的:探讨改良的四头神经外科手术是否能改善产科臂丛神经损伤(OBPI)患者的神经传导和功能预后。方法:采用直接功能电刺激法检测所有神经。用Prass探针刺激神经,记录肌肉的反应,即复合运动动作电位(CMAP)。在改良四头肌手术前后进行SSEP监测,刺激腕部正中神经和尺神经、手背桡神经,记录外周、颈椎和皮质反应。所有患者均行改良股四边形手术(n = 19)。改良的四头肌手术是一种带神经减压的肌肉释放和转移手术。术前和术后对所有患者进行评估,通过评估标准化运动录像,改进的Mallet量表来衡量活跃的肩部运动。结果:受累臂的颈椎反应幅度明显低于未受累臂。结论:经改良Quad手术联合神经成形术、内微神经松解术及正中神经强直刺激后,OBPI患儿正中神经传导及肩外展明显改善。
{"title":"Modified Quad surgery significantly improves the median nerve conduction and functional outcomes in obstetric brachial plexus nerve injury.","authors":"Rahul K Nath,&nbsp;Nirupuma Kumar,&nbsp;Chandra Somasundaram","doi":"10.1186/1750-1164-7-5","DOIUrl":"https://doi.org/10.1186/1750-1164-7-5","url":null,"abstract":"<p><strong>Background: </strong>Nerve conduction studies or somatosensory evoked potentials (SSEPs) have become an important tool in the investigation of peripheral nerve lesions, and is sensitive in detecting brachial plexus nerve injury, and other nerve injuries. To investigate whether the modified Quad surgical procedure improves nerve conductivity and functional outcomes in obstetric brachial plexus nerve injury (OBPI) patients.</p><p><strong>Methods: </strong>All nerves were tested with direct functional electrical stimulation. A Prass probe was used to stimulate the nerves, and recording the response, the compound motor action potential (CMAP) in the muscle. SSEP monitoring was performed pre- and post modified Quad surgery, stimulating the median and ulnar nerves at the wrist, the radial nerve over the dorsum of the hand, recording the peripheral, cervical and cortical responses. All patients have had the modified Quad surgery (n = 19). The modified Quad surgery is a muscle release and transfer surgery with nerve decompressions. All patients were assessed preoperatively and postoperatively by evaluating video recordings of standardized movements, the modified Mallet scale to index active shoulder movements.</p><p><strong>Results: </strong>The cervical responses were significantly lower in amplitude in the affected arm than the un-affected arm. The median nerve conduction was significantly improved from 8.04 to 9.26 (P < 0.022) post-operatively. The shoulder abduction was also significantly improved (pre-op 30° ± 23.3 to 143° ± 33.7, p < 0.0001), with a mean follow-up of 43 months after the modified Quad surgery in these patients.</p><p><strong>Conclusion: </strong>Median nerve conduction, and shoulder abduction were significantly improved in OBPI children, who have undergone the modified Quad procedure with neuroplasty, internal microneurolysis and tetanic stimulation of the median nerve.</p>","PeriodicalId":87428,"journal":{"name":"Annals of surgical innovation and research","volume":"7 ","pages":"5"},"PeriodicalIF":0.0,"publicationDate":"2013-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1750-1164-7-5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31554873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 8
Gastroduodenal artery aneurysm, diagnosis, clinical presentation and management: a concise review. 胃十二指肠动脉瘤,诊断,临床表现和治疗:简要回顾。
Pub Date : 2013-04-16 DOI: 10.1186/1750-1164-7-4
Nicholas Habib, Samer Hassan, Rafik Abdou, Estelle Torbey, Homam Alkaied, Theodore Maniatis, Basem Azab, Michel Chalhoub, Kassem Harris

Gastroduodenal artery (GDA) aneurysms are rare but a potentially fatal condition if rupture occurs. They represent about 1.5% of all visceral artery (VAA) aneurysms and are divided into true and pseudoaneurysms depending on the etiologic factors underlying their development. Atherosclerosis and pancreatitis are the two most common risk factors. Making the diagnosis can be complex and often requires the use of Computed Tomography and angiography. The later adds the advantage of being a therapeutic option to prevent or stop bleeding. If this fails, surgery is still regarded as the standard for accomplishing a definite treatment.

胃十二指肠动脉(GDA)动脉瘤是罕见的,但潜在的致命条件,如果发生破裂。它们约占所有内脏动脉(VAA)动脉瘤的1.5%,根据其发展的病因分为真动脉瘤和假性动脉瘤。动脉粥样硬化和胰腺炎是两个最常见的危险因素。诊断可能很复杂,通常需要使用计算机断层扫描和血管造影。后者增加了作为预防或止血的治疗选择的优势。如果这种方法失败,手术仍然被视为完成明确治疗的标准。
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引用次数: 82
Expandable Micro-motor Bur, design of a new device for least invasive extraction of broken teeth roots. 一种新型微创拔牙装置的设计。
Pub Date : 2013-03-05 DOI: 10.1186/1750-1164-7-2
Amir Hashem Shahidi Bonjar

Background: Extraction of a broken tooth root is often a traumatic experience for both the practitioner and the patient. To extract broken roots, generally invasive approaches as open window surgeries or mucoperiosteal flap and/or removal of buccal bone are performed.

Presentation of the hypothesis: Expandable micro-motor bur (EMB) is a hypothetical design of a dental instrument proposed for removal of broken teeth roots that cannot be extracted by the routine closed methods and in which common instrumentations cannot afford to accomplish. Implication of EMB would introduce a new technique in removal of broken teeth roots in which surgical trauma is minimized and so post-extraction disorders. It would eliminate surgical invasion to the surrounding tissues; and also it would eliminate profound hand forces by the practitioner, consequently reduces stress for both the practitioner and the patient. It would eliminate high risk aftermaths such as operative morbidity (due to bone loss), maxillary sinus exposure and probable need for additional surgery as are indicative of some conventional open access approaches.

Testing the hypothesis: Further studies are needed to confirm its effect in clinical cases. The effectiveness of EMB should be verified firstly by animal experiments. The likelihood of its negative influence on nearby vascular and nerve system should be well evaluated.

Implications of the hypothesis: Implication of EMB would be of interest to both patients and the surgeon due to the following main achievements: a) no need for mucoperiosteal flap, hence preservation of soft tissue, b) no need for osteotomy, hence retention of buccal bone, c) less risk of sinus exposure, d) minimum chance of post operative infections due to eliminated surgeries in soft tissues and bones and e) in terms of esthetics, it will have a special meaning for immediate placement of dental implants. EMB's structural components include Bur head, Spacers and Bur base. A micro motor would power its spin. In contrast to conventional surgical approaches, EMB procedure is conservative. It is anticipated that EMB would provide less traumatic and least post-operative complications in extraction of broken teeth roots.

背景:对医生和病人来说,拔牙是一种创伤性的经历。为了提取断根,通常采用开窗手术或粘膜膜瓣和/或去除颊骨等侵入性方法。假设的介绍:可扩展微型电机齿槽(EMB)是一种牙科器械的假设设计,提出用于去除常规封闭方法无法拔出的断牙根,而普通器械无法完成。EMB的应用将为牙断根的拔除提供一种新的技术,减少手术创伤,减少拔除后的疾病。它可以消除手术对周围组织的侵犯;它还能消除医生的手部压力,从而减轻医生和病人的压力。它将消除高风险的后遗症,如手术并发症(由于骨质流失),上颌窦暴露和可能需要额外的手术,这些都是一些传统开放入路的标志。验证假设:需要进一步的研究来证实其在临床病例中的效果。EMB的有效性首先需要通过动物实验来验证。应充分评估其对附近血管和神经系统的负面影响的可能性。假设的含义:由于以下主要成就,EMB的含义将引起患者和外科医生的兴趣:A)不需要粘膜瓣,因此保留了软组织;b)不需要截骨,因此保留了颊骨;c)鼻窦暴露的风险更小;d)由于消除了软组织和骨骼的手术,术后感染的机会最小;e)在美学方面,它对立即放置种植体具有特殊意义。EMB的结构部件包括铜头、垫片和铜底座。一个微型马达将为它的旋转提供动力。与传统手术方法相比,EMB手术是保守的。预计EMB在拔牙时创伤小,术后并发症少。
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引用次数: 2
Outcome of repeat surgery for genital prolapse using prolift-mesh. 使用增殖补片重复手术治疗生殖器脱垂的效果。
Pub Date : 2013-03-05 DOI: 10.1186/1750-1164-7-3
Ibrahim A Yakasai, Lawal A Bappa, Andrew Paterson

Introduction: Urogenital prolapse can have a significant impact on quality of life. The life time risk of requiring surgery for urogenital prolapse is 11%. Prolift mesh has recently been introduced to reduce repeat operation rate and for long-term benefit.

Objective: To evaluate the outcome of the treatment of urogenital prolapse with synthetic mesh.

Methods: A retrospective review of case notes of all women who underwent prolift mesh insertion for prolapse between July 2004 and June 2005, at Royal Alexandra Hospital Paisley UK. We looked at the presenting complaints, previous operation, intraoperative complications and complications at six weeks and six months follow-up.

Results: Twenty-two procedures were carried out in the twelve months period. Age of the patients ranged from 55 to 82 years (median 64 yrs). Eleven had anterior Prolift (50%), Seven had posterior Prolift 31.8% and four total Prolift 18%. There were no intraoperative complications. All the patients had previous surgery for prolapse. Eight patients had anterior repair, six patients had posterior repair, and three patients had abdominal hysterectomy. Vaginal hysterectomy was carried out with mesh insertion as a concomitant procedure in seven cases (31.25%). All patients were seen at six weeks and six months after the surgery. Complications rate included mesh erosion one patient and suture material protruding in the vagina one patient, one patient had failed prolift operation. All the twenty-one patients were cured giving 95.4% success rate.

Conclusion: The use of prolene mesh in pelvic reconstructive surgery was associated with good outcome and minimal complications in this study.

导读:泌尿生殖系统脱垂对生活质量有显著影响。泌尿生殖脱垂患者一生中需要手术的风险为11%。proflift网最近被引入,以减少重复作业率并获得长期效益。目的:评价人工合成补片治疗泌尿生殖脱垂的效果。方法:回顾性分析2004年7月至2005年6月在英国佩斯利皇家亚历山德拉医院接受脱垂手术的所有妇女的病例记录。我们观察了患者的主诉,既往手术,术中并发症以及随访6周和6个月后的并发症。结果:12个月内共行22例手术。患者年龄55 ~ 82岁(中位64岁)。前凸11例(50%),后凸7例(31.8%),总凸4例(18%)。无术中并发症。所有患者均有脱垂手术史。8例患者行前路修复,6例患者行后路修复,3例患者行腹部子宫切除术。阴道子宫切除术伴置入补片7例(31.25%)。所有患者分别于术后6周和6个月随访。并发症发生率为补片糜烂1例,缝合材料突出阴道1例,剖腹手术失败1例。21例患者全部治愈,成功率95.4%。结论:在本研究中,在骨盆重建手术中使用prolene补片具有良好的预后和最小的并发症。
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引用次数: 4
Intraoperative laser angiography using the SPY system: review of the literature and recommendations for use. 术中使用SPY系统的激光血管造影:文献综述和使用建议。
Pub Date : 2013-01-07 DOI: 10.1186/1750-1164-7-1
Geoffrey C Gurtner, Glyn E Jones, Peter C Neligan, Martin I Newman, Brett T Phillips, Justin M Sacks, Michael R Zenn

Inadequate tissue perfusion is a key contributor to early complications following reconstructive procedures. Accurate and reliable intraoperative evaluation of tissue perfusion is critical to reduce complications and improve clinical outcomes. Clinical judgment is the most commonly used method for evaluating blood supply, but when used alone, is not always completely reliable. A variety of other methodologies have been evaluated, including Doppler devices, tissue oximetry, and fluorescein, among others. However, none have achieved widespread acceptance. Recently, intraoperative laser angiography using indocyanine green was introduced to reconstructive surgery. This vascular imaging technology provides real-time assessment of tissue perfusion that correlates with clinical outcomes and can be used to guide surgical decision making. Although this technology has been used for decades in other areas, surgeons may not be aware of its utility for perfusion assessment in reconstructive surgery. A group of experts with extensive experience with intraoperative laser angiography convened to identify key issues in perfusion assessment, review available methodologies, and produce initial recommendations for the use of this technology in reconstructive procedures.

组织灌注不足是重建手术后早期并发症的关键因素。准确可靠的术中组织灌注评估对于减少并发症和改善临床结果至关重要。临床判断是评估血液供应最常用的方法,但单独使用时,并不总是完全可靠的。已经评估了各种其他方法,包括多普勒装置,组织血氧仪和荧光素等。然而,没有一种方法被广泛接受。最近,术中使用吲哚菁绿的激光血管造影被引入到重建手术中。这种血管成像技术提供了与临床结果相关的组织灌注的实时评估,可用于指导手术决策。虽然这项技术已经在其他领域使用了几十年,但外科医生可能没有意识到它在重建手术中灌注评估的实用性。一组具有丰富术中激光血管造影经验的专家聚集在一起,确定灌注评估中的关键问题,回顾现有方法,并提出在重建过程中使用该技术的初步建议。
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引用次数: 214
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Annals of surgical innovation and research
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