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Hand-assisted laparoscopic splenectomy plus portozygos disconnection procedure for patients with portal hypertension

Xuefeng ZHANG ; Guoqiang WU ; Hongxu JIN ; Jin LI ; Huiyong JIANG ; Xiukun ZONG

China Journal of Endoscopy.2005;11(8):785-788,791.

[Objective] To explore the techniques of hand-assisted laparoscopic splenectomy plus portozygos disconnection procedure. [Methods] 18 patients with portal hypertension were operated by hand-assisted laparoscopic splenectomy plus portozygos disconnection. [Results] The operations were completed successfully. The mean operative time was 180(150～260) minutes, the mean blood loss estimated was 540(200～2 000) mL, the mean weight of spleen was 910 (500～2000) g and the mean length of hospital stay was 9.7 (8～18) days after operation. All patients had recovered rapidly and suffered less pain and only 5 patients needed analgesic. The mean recovery time of the bowel function was 52(24～74) hours. The hand incisions healed well, and only one occurred complications and another suffered death. [ Conclusions ] Hand-assisted laparoscopic splenectomy plus portozygos disconnection procedure is to be feasible and safe, and has the merits of minimally invasive surgery.

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Clinical research on laparascopic management for patients with both gallbladder and common bile duct stones

Yangde ZHANG ; Xiaolin LU ; Xiaoping WAN ; Nianfeng LI ; Liansheng GONG ; Weidong LIU

China Journal of Endoscopy.2005;11(2):113-115,118.

[Objective] To investigate the therapeutic status of laparoscopic management for gallbladder stones and common bile duct stones. [Methods] A Retropective study were adopted to analysize the therapeutic scheme,effect for patients with gallbladder stones and common bile duct stones who were treated from January 1996 to September 2004. [Results] 68 cases were diagnosed, and most of them underwent single stage laparoscopic cholecystectomy (LC) and common bile duct exploration (LC BDE). A few of them were treated through endoscopic procedure in combination with LC, or open surgery when the minimal invasive surgery failed. [Conclusions] Both them indicated that patients by LC+LCBDE have shorter hospital stay, easier recovery and less complications. LC+LCBDE has obvious advantage over the other methods with appropriate operative time and high success rate. For choledochlithiasis patients, the single laparoscopic management should be a better, major option.

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RETROPERITONEAL LAPAROSCOPIC SURGERY FOR ADRENAL DISEASES (REPORT OF 136 CASES)

Shaopeng QIU ; Min TANG ; Junxing CHEN

China Journal of Endoscopy.2003;9(1):1-3,6.

Objective: To summarize experiences in 136 cases of retroperitoneal laparoscopic surgery. Methods:From April 1997 to May 2002, retroperitoneal laparoscopic surgery were performed for 136 cases of adrenal dis-eases. There were 63 aldosterone- producing adenoma, 22 adrenalcortical adenoma, 39 nonfunctional adrenal tu-mor, 7 adrenal cyst and 5 phenochromocytoma. Results: Except for one case converts to open surgery, success hasbeen achieved in all cases without major complications. Intraoperative blood loss was 76 + 32ml without blood trans-fusion. Postoperative hospital stay was 6 + 3 days. There were statistical differences among these indices when com-paring to those of open surgery for 126 cases with adrenal diseases( P ＜ 0.05). But operative time was little longer inlaparoscopic group than in group of open surgery(P＜0.05) ,whereas it has been changed to similar in those recentcases. Conclusion:Retroperitoneal laparoscopic surgery was less traumatic to the patients, with less postoperative dis-comfort and quicker recovery and should be considered the first choice of therapy for adrenal disorders.

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EXPERIENCE WITH THE TREATMENT OF BILATERAL SYNCHRONOUS MULTIPLE PRIMARY LUNG CANCERS

Gang LIN ; Tonglin LIU ; Hongyi CHEN

China Journal of Endoscopy.2001;7(1):30-32.

Objective:Evaluate the role of video-assisted thoracic surgery (VATS) in the treatment of bilateral synchronous multiple primary lung cancers.Methods and Results:Two paitents diagnosised as bilateral synchronous multiple primary lung cancers received one-stage treatment combined conventional thoracotomy with video-assisted thoracic surgery,performing open lobectomy to remove the larger tumor,performing wedge resection using thoracoscopy to excise the smaller one.The surgery time is short.Patients all recover smoothly without complications.To date,these two patients all alive without any sign of recurrence or metastasis of tumor,median follow-up time is 5 months (2 months+8 months).Conclusions:It is feasible to carry out one-stage treatment combined conventional thoracotomy with video-assisted thoracic surgery on patients with bilateral synchronous multiple prima-ry lung cancers,when one of the tumors of bilateral synchronous multiple primary lung cancers is classificated as T1N0M0.

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ENDOSCOPIC LIGATION FOR CARCINOMA AND POIYP OF STOMACH

Feng XU ; Yanjiai LI ; Yunong CHENG

China Journal of Endoscopy.2001;7(1):25-26.

Objective:To study the effect of endoscopic ligation for early stage carcinoma and benign polyp of stomach.Methods:The early stage cancer in situ and polyp (d＜1.0cm) of stomach were sucked and resected with the endoscopic ligation advice which is used in esophgeal varice ligation.The remained tissue were observed histopathologically whether there had any malignant cell in it and follow-up of 3～6 months was mode by endoscopy.Results:Form 1996 to 1999,56 patients received endscopic ligation.Of these patients,8 cases had gastric early carcinoma (2 cases superficial flat type,4 cases superficial elevated type,2 cases carcinoma in situ),48 cases had gastric benign polyps (38 cases infammatory polpy,10 cases polpypous adeoma).After the endscopic ligation,no malignnant cell was found in remained tissues and no polyp recured within the follow-up period.So this method was demonstrated to be safe,cheap and good effective method for early stage carcinoma,minicarcinoma,carcinoma in situ and benign polyp (d＜1.5cm) of stomach.It deserves being widespread.

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THE EFFECT OF ENDOSCOPE ON THE TREATMENT OF HEPATOCELLULLAR CARCINOMA COMBINED WITH BILLIARY TRACT OBSTRUCTION

Ping XUE ; De CHEN ; Yezi HU ; Hiwu LU ; Duan ZHAN ; Qiaoqun YIN

China Journal of Endoscopy.2001;7(1):22-23.

Objective:To study the effect of endoscope on the treatment of Hepatocellular Carcinoma (HCC) combined with biliary tract obstrucition (BTO).Methods:We have analyzed retrospectively the results of twelve patients suffering from HCC combined with BTO from 5,1990 to 5,2000.Among these cases,various reasons were found.5 of them were intrabilitary cancer embolus,7 were billary calculus.7 of them were treated with endoscope and following surgical resection,1 was treated with endoscope、TAE and resection,the 3 rest of them were solely treated with endoscope.Results:Of all the 12 cases,1 died of resection,2 failed to follow the survey,these 3 cases above took 25%;among the rest of 9 cases,2 of them survived for 3 to 6 months,3 for half to 1 year,3 for 1 to 2 year,1 for at least 2 years.Those cases suviving for more than 1 year were received surgical resection.Conclusions:We should have no fixed way but to deal with each patient of HCC combined with BTO on his/her merits.As our recognition towards them began accumulating,we found that,in the early stage of obstruction,active endoscopic treatment would prove to be preferable.If combined with other therapy such as surgical resection and TAE,Endoscopy would improve the curative effect of HCC combined with BTO substantially.

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THE INVESTIGATION OF THE ANESTHETIZATION OF FOREIGN BODY EXTRACTION IN RESPIRATORY TRACT OF INFANTS

Zhenghua HE ; Shuwen ZHOU ; Xiying ZHANG

China Journal of Endoscopy.2001;7(1):20-21.

Objective:To investigate the methods of the anesthetization of the foreign body extraction in respiratory tract of infants.Methods:This clinical study compared two anesthetic methods in foreign body extraction of respiratory tract of infants:Ketamine+Sodium r-hydroxybutyrate intravenous (group A) and Ketamine+propofol intravenous (group B) and analyzed the advantages and disadvantages of both methods.Results:Compared with group B,the extent of the changes of heart rate and blood oxygen saturation in patients of group A is littler,and the incidence rate of breath holding and asphyxiation is littler too.Conclusions:The anesthetic effect of Ketamine+Sodium r-hydroxybutyrate intravenous in better than that of Ketmaine+propcfol intravenous.

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THE EXPRESSION OF CYCLIND1 AND P21WAF1 IN COLORECTAL CARCINOMA

Xiaohong LU ; Zhixiang SENN ; Jieping YU

China Journal of Endoscopy.2001;7(1):15-16.

Objective:To investigate expression of cyclinD1 and p21WAF1 and their relationship with multistage process of colon carcinogenesis.Methods:Immunohistochemical staining was performed with SP assay on archival materials from 40 colorectal carcinomas,28 colorectal adenomas,and 14 normal mucosa,cyclinD1 and p21WAF1 expression were compared.Results:The positive staining rate for cyclinD1 in colorectal adenomas and carcinomas is 92.9% and 67.5% respectively,which are both higher than that in the normal mucosa (35.7%) (Padenoma＜0.01，Pcarcinoma＜0.05) and the expression of cyclinD1 is not correlate with differentiation and lymph node metastasis of colorectal carcinoma.The positive stainimg rate for p21WAF1 in normal mucosa (92.9%) is higher than that in colorectal carcinoma(37.5%) (P＜0.01) and the expression of p21WAF1 is correlate with differentiation and lymph node metastasis of colorectal carcinonma.Conclusions:The aberrant expression of cyclinD1 and p21WAF1 is a common event during multistage process of colon carcinogenesis.

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CLINICAL ANALYSIS OF HEPATOGENIC ULCER

Renyi WU ; Wenhuan WANG ; Xichun ZHANG

China Journal of Endoscopy.2001;7(1):12-13.

Objective:With a scrutiny of the gastroscope aspects of hepatogenic ulcer (HU),this sutdy was to find out the relationship between HU and hepatocelluar damage and portal hypertension.Methods:262 cases of portal hyprtension of cirrhosis were reviewed with HU being grouped according to the clinical gravity of cirrhosis and the gravity of esophageal varies (EV).Results:①Duodenal ulcer prevails under endoscopy.Superficial ulceration accounted for 70.49% while ulceration less than 0.5cm in full diameter made up 55.74%.The figure was 62.3% with erosive gastritis.②Out of a total of 262,61(23.28%) cases of HU were found in connection with portal hypertension.The χ2 test showed that HU was related with hepatocellular grade and the gravity of EV (P＜0.05).Conclusions:The incidence of HU were higher than normal.indicating that the onset of HU responded positively to the clinical intensity of cirrhosis and the gravity of EV.

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SIMPLIFICATION URETEROSCOPE TREATMENT THE OBSTRUCT IN URETER (REPORT OF 768 CASES)

Xing ZHOU ; Chunxiao LIU ; Shaobo ZHEN

China Journal of Endoscopy.2001;7(1):10-11.

Objective:To study and sum up the experience of diagnosis and treatment of ureter obstruct by Simplification ureteroscope.Methods:the patients of 750 cases for ureterolith underwent ureteroscopic lithotomy and pressune orbit lithotripsy by using caudal anesthesia in outpatient the 11 cases ureterostensis were treated by watery capus expand,ureteroscopic hard expand and ureterotectomy by using of self-made electrode.Then,transurethral electro incisions of ureterocles were carried out for 2 patients.Results:Successful rate of ureteroscopic lithotomy is 98.4%;12 patient of upper ureter stone received ESWL because of stone entering the renal pelvis,and 3 cases complicated ureteral perforation;11 cases ureterostensis and 7 cases ureterocele were cured.Conclusions:It is frist chosen for ureteroscope to ureteral stone,ureteral stricture,and ureteroceles with a diameter of ≤3cm,and the method have ideal cure effect and the patients will receive.

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