目的:总结使用常规器械行经脐腹腔镜技术在腹部手术中的应用价值与前景。方法:回顾2012年5月至2015年1月施行的107例常规器械经脐单孔腹腔镜手术患者的临床资料,分析手术技巧及术后患者恢复情况。结果:2例胆囊切除患者局部致密粘连,胆...目的:总结使用常规器械行经脐腹腔镜技术在腹部手术中的应用价值与前景。方法:回顾2012年5月至2015年1月施行的107例常规器械经脐单孔腹腔镜手术患者的临床资料,分析手术技巧及术后患者恢复情况。结果:2例胆囊切除患者局部致密粘连,胆囊三角解剖困难,于剑突下增加5 mm Trocar,中转为两孔法腹腔镜手术;105例患者顺利完成单孔手术,无腹腔内出血、切口感染、穿刺孔疝等并发症发生,脐周切口疼痛轻微,腹壁几乎见不到疤痕。结论:严格筛选病例,使用常规器械行经脐单孔腹腔镜手术安全、可行,美容效果突出,疼痛轻微,值得临床推广应用。展开更多
AIM: To present the radiological results of total knee arthroplasty(TKA) with use of patient specific matched guides(PSG) from different manufacturer in patients suffering from severe osteoarthritis of the knee joint....AIM: To present the radiological results of total knee arthroplasty(TKA) with use of patient specific matched guides(PSG) from different manufacturer in patients suffering from severe osteoarthritis of the knee joint.METHODS: This study describes the results of 57 knees operated with 4 different PSG systems and a group operated with conventional instrumentation(n = 60) by a single surgeon. The PSG systems were compared with each other and subdivided into cut- and pin PSG. The biomechanical axis [hip-knee-ankle angle(HKA)], varus/valgus of the femur [frontal femoral component(FFC)] and tibia(frontal tibial component) component, flexion/extension of the femur [flexion/extension of the femur component(LFC)] and posterior slope of the tibia [lateral tibial component(LTC)] component were evaluated on long-leg standing and lateral X-rays. A percentage of > 3° deviation was seen as an outlier. RESULTS: The inter class correlation coefficient(ICC) revealed that radiographic measurements between both assessors were reliable(ICC > 0.8). Fisher exact test was used to test differences of proportions. The percentage of outliers of the HKA-axis was comparable between both the PSG and conventional groups(12.28% vs 18.33%, P < 0.424) and the cut- and pin PSG groups(14.3% vs 10.3%, P < 1.00). The percentage of outliers of the FFC(0% vs 18.33%, P < 0.000), LFC(15.78% vs 58.33%, P < 0.000) and LTC(15.78% vs 41.67%, P < 0.033) were significant different in favour of the PSGgroup. There were no significant differences regarding the outliers between the individual PSG systems and the PSG group subdivided into cut- and pin PSG.CONCLUSION: PSG for TKA show significant less outliers compared to the conventional technique. These single surgeon results suggest that PSG are ready for primetime.展开更多
文摘目的:总结使用常规器械行经脐腹腔镜技术在腹部手术中的应用价值与前景。方法:回顾2012年5月至2015年1月施行的107例常规器械经脐单孔腹腔镜手术患者的临床资料,分析手术技巧及术后患者恢复情况。结果:2例胆囊切除患者局部致密粘连,胆囊三角解剖困难,于剑突下增加5 mm Trocar,中转为两孔法腹腔镜手术;105例患者顺利完成单孔手术,无腹腔内出血、切口感染、穿刺孔疝等并发症发生,脐周切口疼痛轻微,腹壁几乎见不到疤痕。结论:严格筛选病例,使用常规器械行经脐单孔腹腔镜手术安全、可行,美容效果突出,疼痛轻微,值得临床推广应用。
文摘AIM: To present the radiological results of total knee arthroplasty(TKA) with use of patient specific matched guides(PSG) from different manufacturer in patients suffering from severe osteoarthritis of the knee joint.METHODS: This study describes the results of 57 knees operated with 4 different PSG systems and a group operated with conventional instrumentation(n = 60) by a single surgeon. The PSG systems were compared with each other and subdivided into cut- and pin PSG. The biomechanical axis [hip-knee-ankle angle(HKA)], varus/valgus of the femur [frontal femoral component(FFC)] and tibia(frontal tibial component) component, flexion/extension of the femur [flexion/extension of the femur component(LFC)] and posterior slope of the tibia [lateral tibial component(LTC)] component were evaluated on long-leg standing and lateral X-rays. A percentage of > 3° deviation was seen as an outlier. RESULTS: The inter class correlation coefficient(ICC) revealed that radiographic measurements between both assessors were reliable(ICC > 0.8). Fisher exact test was used to test differences of proportions. The percentage of outliers of the HKA-axis was comparable between both the PSG and conventional groups(12.28% vs 18.33%, P < 0.424) and the cut- and pin PSG groups(14.3% vs 10.3%, P < 1.00). The percentage of outliers of the FFC(0% vs 18.33%, P < 0.000), LFC(15.78% vs 58.33%, P < 0.000) and LTC(15.78% vs 41.67%, P < 0.033) were significant different in favour of the PSGgroup. There were no significant differences regarding the outliers between the individual PSG systems and the PSG group subdivided into cut- and pin PSG.CONCLUSION: PSG for TKA show significant less outliers compared to the conventional technique. These single surgeon results suggest that PSG are ready for primetime.