1.Anesthesia Management and Outcomes of Laparoscopic Surgery for Early Pregnant Women with Tubal Pregnancy:a Report of 48 Cases
Chengmei SHI ; Xueling SONG ; Mao XU
Chinese Journal of Minimally Invasive Surgery 2016;16(2):154-157
Objective To summarize the anesthesia management in laparoscopic surgery for early pregnant women with tubal pregnancy. Methods Forty-eight women diagnosed as early intrauterine pregnancy combined with tubal pregnancy from January 2010 to July 2014 were enrolled in this retrospective study.All the patients received laparoscopic surgery under endotracheal intubation and total intravenous anesthesia.Their general conditions, perioperative conditions, pregnant complications, pregnant outcomes and newborns status were recorded. Results All the patients were operated successfully and recovered uneventfully.Among the 48 patients, spontaneous abortion occurred in 7 patients (14.6%).Among the remaining 41 patients who continued on their gestation, 39 cases (95.1%) had full term deliveries, 2 cases (4.9%) terminated pregnancy with premature birth, 8 cases (19.5%) got different complications related to pregnancy, and 34 cases (82.9%) received cesarean sections.All the newborns survived, with an average weight of 3429.2 ±499.4 g.There were 2 cases (4.9%) of low birth weight.No asphyxia or congenital malformation was seen in all the newborns. Conclusions Total intravenous anesthesia can be applied to laparoscopic surgery smoothly for early pregnant women with tubal pregnancy.When surgery is indicated during pregnancy, maintenance of marternal oxygenation, perfusion and homeostasis with the minimum effective anesthetic dose will assure the best outcomes for the fetus.
2.Clinical analysis of liver transplant from a child of brain death to an adult
Jun SHI ; Wenfeng LUO ; Limin DING ; Zhidan XU ; Yonggang WANG ; Xinchang LI ; Laibang LUO ; Chengmei LONG
Chinese Journal of Hepatobiliary Surgery 2011;17(5):359-363
Objective To explore clinical feasibility of liver transplant from child of brain death to adult, to summarize the clinical experiences that a child of brain death transplants liver to an adult. Methods The recipient was a 39-year-old woman patient with primary hepatic carcinoma and posthepatitis cirrhosis (decompensation stage); while the donor was a 8-old-year child of brain death because of brain neoplasms. Donated liver was gained by the method of en bloc multivisceral procurement in a short time; the operative method was classic orthotopic liver transplantation. The postoperative managements included immunosuppression, prevention of infection, hepatic protection, and other relevant supports etc. Results The transplantation operative duration was 6 hours, after which not only did the recipient survive but also her body functioned well including the liver part, with no severe postoperative complications. Conclusions The technology of transplanting livers from children to adults is feasible. The key to ensure the success of transplant operation is systematic preoperative evaluation, excellent operative technique, and perfect postoperative treatment.
3.Combined liver-kidney transplantation in one case
Wenfeng LUO ; Jun SHI ; Dongliang MENG ; Xinchang LI ; Zhidan XU ; Chengmei LONG
Chinese Journal of Tissue Engineering Research 2009;13(5):988-990
A 32-year old male who had liver cirrhosis accompanying with chronic renal insufficiency (uremia) was suffered from homochronous allograft transplantation of liver-kidney. The blood and other tissue typing were in concord between the donor and recipient. The liver transplantation took typical orthotopic transplantation technique while the kidney transplantation took general operation method to place the transplanted kidney at the recipient's right lilac fossa. Daclizumab was taken for the immunity induction treatment before transplantation while the trigeminy of tacrolimus+mycophemocate mofeil+methylprednisolone were taken as immunosuppressant after transplantation. The transplanted liver and kidney recovered well which could work at once without any serious complications after transplantation, suggesting that combined liver-kidney transplantation was an effective treatment method for homochronous function failure of liver and kidney characterizing by perfect tissue typing, excellent operation skill, reasonable usage of immunosuppresant being the key point of success for transplantation.
4.Application of rotation record in a surgical residency in anesthesiology rotation period
Chengmei SHI ; Huili LIU ; Min LI ; Xiangyang GUO ; Jun WANG ; Mao XU ; Changyi WU
Chinese Journal of Medical Education Research 2015;(9):946-948
Anesthesiology rotation is an important part in resident standardization training of surgery. However, there are many problems in the teaching process. For example, the key points of teaching is not clear, the process of teaching is not coherent, and teachers and students lack interaction. The Rotation Record is introduced in order to solve those problems. The Rotation Record effectively reflects the fundamental process and major learning point of anesthesiology department which contains three items: the usage and recording of instrument; the communication and the basic knowledge and operating skills of anesthesia. The Rotation Record can initiate learning activity, emphasize important contents, supervise and urge teaching and improve the learning effect. By introducing Rotation Record, the assessment results in the surgical residency in anesthesiology has greatly improved compared to the previous ones, and has effectively improved the teaching quality of anesthesia.