【摘要】 目的 观察运用涎腺镜对慢性下颌下腺炎诊断和治疗的临床效果。 方法 应用涎腺镜观察32例慢性下颌下腺炎患者导管,根据不同病因给予相应治疗。分别于手术前当天,手术后2、7 d,4周,6、12个月观察治疗效果。 结果 32例慢性下颌下腺炎患者中,28例存在导管结石。手术后2 d大部分患者胀痛症状明显缓解,之后1个月内呈逐渐缓慢缓解趋势,手术后6~12个月胀痛感略有回升表现。结论 运用涎腺镜治疗慢性下颌下腺炎是微创、有效的。【Abstract】 Objective To observe the clinical effect of chronic inflammation of submandibular gland treated by sialoendoscopy. Methods The conduit of 32 patients with chronic inflammtion of submandibular gland under sialoendoscopy, and to observe the curative effect after two, seven days, four weeks, six and 12 months. Results Of the all of 32 patients, 28 had stones in duck. Two days after surgery, the most patients has bursting pain palliation, and then relieved gradually; from six to 12 months after surgery, bursting pain rebounded slightly. Conclusions Use of sialoendoscopy on chronic inflammtion of submandibular gland is minimally invasive and effective treatment.
ObjectiveTo explore and compare the therapeutic effects of neuro-endoscopic and craniotomic hematoma evacuation for hypertensive hematomas in the basal ganglia region. MethodsEighty-six patients with hypertensive hematomas in the basal ganglia regions treated between January 2010 and September 2014 were divided into neuro-endoscopy and craniotomy groups randomly with 43 in each. Hematoma was removed directly under neuro-endoscope in the endoscopic group, while it was removed under the operating microscope in the craniotomy group. The average operation bleeding amount, residual hematoma after operation, hematoma evacuation rate, the changes of National Institutes of Health Stroke Scale (NIHSS) and Barthel index (BI) scores before operation, 1 and 3 months after operation were compared between the two groups. All data were analyzed statistically. ResultsThe average amount of operation bleeding was (127±26) mL, postoperative residual hematoma was (6±4) mL, and the hematoma clearance rate was (86±9)% in the neuro-endoscopy group, while those three numbers in the craniotomy group were respectively (184±41) mL, (11±6) mL, and (72±8)%, with all significant differences (P < 0.05). The NIHSS and BI scores were not significantly different between the two groups before surgery (P > 0.05). Seven days, one month and three months after surgery, the NIHSS score was significantly lower, and the BI score was significantly higher in the neuro-endoscopy group than the craniotomy group (P < 0.05). ConclusionNeuro-endoscopic surgery for hypertensive hematomas in basal ganglia region is proved to have such advantages as mini-invasion, direct-vision, complete clearance and good neural function recovery after surgery, which is a new approach in this field.
Lumbar spondylolisthesis is a common condition in spinal surgery, which is often characterized by lower back and leg pain and numbness. There are various treatment methods for this condition, and different treatment plans should be adopted according to different situations. Traditional open surgery methods are relatively traumatic and have longer recovery times, while minimally invasive spine techniques have advantages such as smaller incisions, less bleeding, higher fusion rates, and faster recovery. This review summarizes the relevant literature on the application of minimally invasive techniques in the treatment of lumbar spondylolisthesis in recent years, analyzes and compares the advantages and disadvantages of different approaches and endoscopic techniques, as well as reduction, decompression, and fusion effects. The aim is to provide reference for surgeons in selecting surgical procedures for the treatment of lumbar spondylolisthesis.
ObjectiveTo summarize the research progress of functional surgery in upper and middle gastric cancer.Method" functional gastric surgery” " pylorus-preserving gastrectomy” and " proximal gastrectomy” were used as search terms to retrieve the literatures, and various surgical methods and their application status were reviewed.ResultsFunctional gastric surgery can effectively improve the postoperative quality of life of patients with early gastric cancer in the upper and middle stomach.ConclusionFunctional gastric surgery is a feasible surgical method for early gastric cancer.
ObjectiveTo systematically review the diagnostic value of capsule endoscopy and enteroscopy in small intestinal diseases.MethodsPubMed, The Cochrane Library, Web of Science, CNKI, WanFang Data, and VIP databases were electronically searched to collect studies on the diagnosis of intestinal diseases by capsule endoscopy and enteroscopy from inception to August 31st, 2020. Two reviewers independently screened literature, extracted data and assessed risk bias of included studies. Meta-analysis was then performed by using RevMan 5.3 and Meta-DiSc software.ResultsA total of 20 studies were included. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio for capsule endoscopy were 0.86 (95%CI 0.83 to 0.87), 0.81 (95%CI 0.78 to 0.84), 117.07 (95%CI 37.98 to 360.92), 7.20 (95%CI 2.81 to 18.45), 0.11 (95%CI 0.06 to 0.21), and those for enteroscopy were 0.89 (95%CI 0.87 to 0.90), 0.91 (95%CI 0.89 to 0.93), 196.99 (95%CI 72.63 to 534.26), 13.26 (95%CI 5.00 to 35.14), 0.12 (95%CI 0.07 to 0.21). The areas under the working characteristic curve (SROC) of capsule endoscopy and enteroscopy were 0.9692 and 0.9783, respectively.ConclusionsBoth capsule endoscopy and enteroscopy have high specificity and sensitivity in the diagnosis of small intestinal diseases, and enteroscopy has higher clinical value in the diagnosis of some small intestinal diseases than capsule endoscopy. Due to limited quantity and quality of the included studies, the above conclusions are required to be verified by more high-quality studies.
ObjectiveTo compare the effectiveness of unilateral biportal endoscopic decompression and unilateral biportal endoscopic lumbar interbody fusion (ULIF) in the treatment of degreeⅠdegenerative lumbar spondylolisthesis (DLS). MethodsA clinical data of 58 patients with degreeⅠDLS who met the selection criteria between October 2021 and October 2022 was retrospectively analyzed. Among them, 28 cases were treated with unilateral biportal endoscopic decompression (decompression group) and 30 cases with ULIF (ULIF group). There was no significant difference between the two groups (P>0.05) in the gender, age, lesion segment, and preoperative visual analogue scale (VAS) score of low back pain, VAS score of leg pain, Oswestry disability index (ODI), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), disk height (DH), segmental lordosis (SL), and other baseline data. The operation time, postoperative drainage volume, postoperative ambulation time, VAS score of low back pain, VAS score of leg pain, ODI, laboratory examination indexes (CRP, ESR), and imaging parameters (DH, SL) were compared between the two groups. ResultsCompared with the ULIF group, the decompression group had shorter operation time, less postoperative drainage, and earlier ambulation (P<0.05). All incisions healed by first intention, and no complication such as nerve root injury, epidural hematoma, or infection occurred. All patients were followed up 12 months. Laboratory tests showed that ESR and CRP at 3 days after operation in decompression group were not significantly different from those before operation (P>0.05), while the above indexes in ULIF group significantly increased at 3 days after operation compared to preoperative values (P<0.05). There were significant differences in the changes of ESR and CRP before and after operation between the two groups (P<0.05). Except that the VAS score of low back pain at 3 days after operation was not significantly different from that before operation in decompression group (P>0.05), there were significant differences in VAS score of low back pain and VAS score of leg pain between the two groups at other time points (P<0.05). The VAS score of low back pain in ULIF group was significantly higher than that in decompression group at 3 days after operation (P<0.05), and there was no significant difference in VAS score of low back pain and VAS score of leg pain between the two groups at other time points (P>0.05). The ODI of the two groups significantly improved after operation (P<0.05), but there was no significant difference between 3 days and 6 months after operation (P>0.05). There was no significant difference between the two groups at the two time points after operation (P<0.05). Imaging examination showed that there was no significant difference in DH and SL between pre-operation and 12 months after operation in decompression group (P>0.05). However, the above two indexes in ULIF group were significantly higher than those before operation (P<0.05). There were significant differences in the changes of DH and SL before and after operation between the two groups (P<0.05). ConclusionUnilateral biportal endoscopic decompression can achieve good effectiveness in the treatment of degree Ⅰ DLS. Compared with ULIF, it can shorten operation time, reduce postoperative drainage volume, promote early ambulation, reduce inflammatory reaction, and accelerate postoperative recovery. ULIF has more advantages in restoring intervertebral DH and SL.
【Abstract】Objective To evaluate the application of duct endoscopy in the diagnosis of breast diseases characterized by nipple discharge. Methods One hundred and sixtynine consecutive cases from October 2003 to September 2004 who had duct endoscopy for nipple discharge were reviewed and followed up. Results Of 169 cases, 79 ductitis, 62 intraductal papilloma, 9 intraductal carcinoma in situ, 19 without breast diseases were diagnosed under duct endoscopy. During following up, the diagnostic accuracy of intraductal papilloma and intraductal carcinoma in situ with duct endoscopy was 89.8%(44/49) and 55.6%(5/9),respectively. There was only one patient who had breast pain and mild skin redness which was cured with oral antibiotics for 3 days. Conclusion Duct endoscopy is an only technique to explore the etiology for duct discharge under vision. It is direct, safe and effective, with a high accuracy.
Objective To explore the clinical comprehensive therapy of Peutz-Jeghers syndrome. Methods From January 2000 to December 2010，71 cases of Peutz-Jeghers syndrome underwent endoscopic polyp resection firstly，and those with unresectable lesions or with severe complications underwent rescue laparotomy. After endoscopic or surgical treatment，the patients took Celecoxib capsules voluntarily for 6 to 9 months under informed consents. All cases were followed up from 6 months to 8 years. Results Twenty-nine patients had familial history of Peutz-Jeghers syndrome among the 71 patients （41 males and 30 females）. Sixty-two cases underwent 94 surgeries and intussusception was the most common cause of laparotomy. Sixty-five patients underwent 169 double-balloon endoscopy （DBE） therapies，and a total of 1 714 polyps were resected by DBE polypectomy. The largest major axis of small-bowel polyp was 8 cm. No severe complications occurred after DBE polypectomy except for 3 cases of intestinal perforation. Eight patients took Celecoxib capsule，3 of them were treated more than 6 months，and DBE examination showed the gastrointestinal polyps reduced in number and size. Conclusion The comprehensive treatment （including of endoscopic therapy，operation，and drug intervention） is a safe and effective clinical model to treat Peutz-Jeghers syndrome．
Objective To determine the independent influencing factors of intraoperative choking during painless gastrointestinal endoscopy (PGIE) after coronavirus disease 2019 (COVID-19). Methods The data of patients undergoing PGIE with COVID-19 in Northern Jiangsu People’s Hospital between December 2022 and April 2023 were retrospectively collected. Multiple logistic regression analysis was used to screen the influencing factors of intraoperative coughing events that occurred during the diagnosis and treatment process. Results A total of 948 patients were included, with 93 (9.8%) cases of choking. The results of the multiple logistic regression analysis showed that smoking and unresolved cough were independent risk factors for coughing (P<0.05), while colonoscopy and infection duration beyond 14 days between diagnosis and treatment were independent protective factors for coughing (P<0.05). ConclusionsWhen patients with COVID-19 undergoing PGIE, special attention should be paid to high-risk groups such as smoking and unresolved cough. It is necessary to strengthen intraoperative monitoring and implementation of prevention and control measures to reduce the incidence of coughing and improve the safety of diagnosis and treatment for patients.
Latissimus dorsi muscle flap (LDMF) is an important autogenous tissue for autogenous breast reconstruction after mastectomy. LDMF harvesting using a conventional open method is traumatic, and the scar is obvious. With the application of minimally invasive technology in various surgical fields, endoscopic and robotic technology for breast surgery, especially LDMF breast reconstruction, is also becoming mature. Endoscopic or robotic LDMF breast reconstruction has the advantages of no incision in the back, superior cosmetic effect of back, clear vision of surgical field, and low incidence of postoperative complications. It is a safe and effective method of breast reconstruction.