enucleation

去核
  • 文章类型: Journal Article
    这项研究调查了通过眶上窝摘除马眼的外科手术的描述和可行性。对本地品种驴(Equusasinus)的四个尸体头部的双眼进行了初步研究,以描述手术解剖结构并证明了一种新的眶上摘除手术方法。对于临床研究,八头驴因单侧摘除而入院。在吸入麻醉和球后神经阻滞的影响下,所有程序均以侧卧位进行。在眶上窝的皮肤和筋膜上做了一个半圆形切口,以进入眶腔,之后,解剖并去除眶周脂肪。通过电灼术控制出血,结扎大血管,然后眼球被锐利地解剖,从它的骨附件中解脱出来。该程序在所有临床病例中均成功完成,术后随访期间或整个随访期间无明显并发症发生。初步结果表明,本研究中描述的眶上摘除技术用于马眼摘除的可行性和安全性。由于其可行性,这项新技术似乎很有前途,安全,以及在尸体和临床研究中观察到的积极结果。
    This study investigated the description and feasibility of a surgical procedure for enucleation-exenteration of the equine eye via the supraorbital fossa. A preliminary study was performed on both eyes of four cadaveric heads of native breed donkeys (Equus asinus) to describe the surgical anatomy and demonstrate a new supraorbital enucleation surgical approach. For the clinical study, eight donkeys were admitted for unilateral enucleation. All procedures were performed in a lateral recumbent position under the influence of inhalation anesthesia in combination with a retrobulbar nerve block. A semi-circular incision was made in the skin and fascia of the supraorbital fossa to gain access into the orbital cavity, after which the periorbital fat was dissected and removed. Bleeding was controlled by electrocautery and large blood vessels were ligated, then the eyeball was dissected sharply and freed from its bony attachment. The procedure was successfully accomplished in all clinical cases, and no significant complications occurred during or throughout the postoperative follow-up period. The initial results suggest the feasibility and safety of the supraorbital enucleation technique described in this study for equine eye enucleation. This new technique seems promising due to its feasibility, safety, and positive outcomes observed in both cadaveric and clinical studies.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    在甲状腺手术领域,如何选择结节切除术和肺叶切除术来管理甲状腺结节是一个有争议的话题。本研究旨在分享2023年1月至2023年10月通过结节性结节切除术管理单发甲状腺结节的经验。纳入标准包括有症状或可疑的孤立性结节和医学需要的病例。提取的数据包括患者的人口统计,病史,症状,诊断详细信息,手术适应症,手术结果和组织病理学发现。随访包括诊所访问和电话。患者平均年龄为36.64±11.63岁,女性占85.0%,男性占15.0%。主要是,患者为家庭主妇(58.5%)。颈部肿胀(62.3%)是最常见的表现。超声检查发现一半以上的病例有混合结节(54.7%)。右侧结节性切除术26例(49.1%),左侧结节性切除术23例(43.4%),4例(7.5%)接受峡部切除术。平均手术时间为36.04±9.37min,所有病例均未使用引流管。1例(1.9%)血清肿是观察期间唯一观察到的并发症。结节切除术可能是治疗良性疾病的合适选择,大,单发甲状腺结节,小的可疑结节或微小癌。
    The choice between nodulectomy and lobectomy for managing thyroid nodules is a subject of debate in the field of thyroid surgery. The present study aims to share the experience of a single center in managing solitary thyroid nodules through nodulectomy from January 2023 to October 2023. The inclusion criteria encompassed symptomatic or suspicious solitary nodules and medically necessitated cases. The extracted data included patient demographics, medical history, symptoms, diagnostic details, surgery indication, procedure outcome and histopathological findings. The follow-up included clinic visits and phone calls. The mean age of the patients was 36.64±11.63 years, with 85.0% females and 15.0% males. Predominantly, patients were housewives (58.5%). Neck swelling (62.3%) was the most common presentation. Ultrasound examination revealed mixed nodules in more than half of the cases (54.7%). Right nodulectomy was performed in 26 cases (49.1%) and left nodulectomy in 23 (43.4%), and four cases (7.5%) underwent isthmusectomy. The mean operation time was 36.04±9.37 min and no drainage tube was used in any of the cases. One case (1.9%) of seroma was the only observed complication during the observational period. Nodulectomy may be a suitable choice for managing benign, large, solitary thyroid nodules, small suspicious nodules or microcarcinomas.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    目标:比较两个不同机构的新手或专家机器人外科医生接受无缝线无钳夹机器人肾部分切除术(sl-ocRAPN)治疗的患者的围手术期结果。方法:在过去的4年中,从前瞻性填充的机构数据库中提取了有关由新手或专家外科医生用sl-ocRAPN治疗的两个连续系列的cT1-2N0M0肾肿瘤患者的数据。通过使用χ2和Mann-Whitney检验对分类和连续变量进行比较,比较了围手术期结果以及患者和肿瘤的基线特征。分别。1:1倾向匹配评分分析(PMSa)产生两个同质队列。进行Logistic回归分析以评估三联结局的预测因子,定义为阴性手术切缘,无Clavien-Dindo≥3级并发症,术后eGFR降低不≥30%。结果:总体而言,328名患者由专业外科医生治疗,而40人由一名新手外科医生治疗。经过PMSa分析,两组共23名患者,所有基线变量的齐次(p≥0.07)。住院时间是两组之间观察到的唯一显着差异的结果(5天与2天;p<0.001)。比较三联结局时,没有统计学上的显著差异(专家:100%与新手:87%;p=0.07)。在逻辑回归分析中,没有记录到有统计学意义的三fecta结局预测因子.结论:sl-ocRAPN是一种可行、安全的肾单位保留技术,即使是由新手机器人外科医生执行的。
    Objectives: To compare perioperative outcomes of patients treated with sutureless off-clamp robotic partial nephrectomy (sl-oc RAPN) by either a novice or an expert robotic surgeon at two different institutions. Methods: Data concerning two continuous series of patients with cT1-2N0M0 renal tumors treated with sl-oc RAPN either by a novice or an expert surgeon were extracted from prospectively populated institutional databases over the last 4 years. Perioperative outcomes as well as the baseline characteristics of patients and tumors were compared by using χ2 and Mann-Whitney tests for categorical and continuous variables, respectively. A 1:1 propensity match score analysis (PMSa) generated two homogeneous cohorts. Logistic regression analysis was performed to assess predictors of trifecta outcomes, defined as negative surgical margins, no Clavien-Dindo ≧ 3 grade complications, and no ≧ 30% postoperative eGFR reduction. Results: Overall, 328 patients were treated by an expert surgeon, while 40 were treated by a novice surgeon. After PMSa analysis, two cohorts of 23 patients each were generated, homogeneous for all baseline variables (p ≥ 0.07). Hospital stay was the only significantly different outcome observed between the two groups (5 days vs. 2 days; p < 0.001). No statistically significant differences were recorded when comparing trifecta outcomes (expert: 100% vs. novice: 87%; p = 0.07). In the logistic regression analysis, no statistically significant predictors of trifecta outcomes were recorded. Conclusions: sl-oc RAPN is a feasible and safe nephron sparing technique, even when performed by a novice robotic surgeon.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    (1)背景:分析COVID-19大流行对波兰国家转诊中心葡萄膜黑色素瘤(UM)的特征和管理的影响。(2)材料与方法:回顾性分析1336例眼科及眼科肿瘤初诊UM患者,Jagiellonian大学克拉科夫大学,2018年1月1日至2021年12月31日期间的波兰。收集了人口统计学和临床数据,包括本地化,尺寸,以及肿瘤的治疗方法。(3)结果:总的来说,在COVID-19大流行之前,纳入了728例UM患者,在2018-2019年,在COVID-19大流行期间包括608人,在2020-2021年。2020年和2021年,波兰国家转诊中心葡萄膜黑色素瘤发病率(基准年2018年)的固定基础动力学指标分别为80.22%和86.81%。与2018年相比,2021年的UM在统计学上显着较大,并且更频繁地定位在眼球赤道前方(卡方皮尔逊检验p=0.0001和p=0.0077)。接受眼球摘除治疗的患者比例从2018年的15.94%增加到2021年的26.90%(卡方皮尔森检验p=0.0005)。(4)结论:在COVID-19大流行期间,波兰国家转诊中心葡萄膜黑色素瘤的管理存在统计学上的显着差异,肿瘤更大,更常见的是位于眼球赤道前方,更常被摘除。
    (1) Background: to analyze the impact of the COVID-19 pandemic on the characteristics and management of uveal melanoma (UM) in the National Referral Center in Poland. (2) Materials and Methods: the retrospective analysis of 1336 patients who were newly diagnosed with UM at the Department of Ophthalmology and Ophthalmic Oncology, Jagiellonian University Collegium Medicum Krakow, Poland between 1 January 2018 and 31 December 2021. The demographic and clinical data were compiled, including localization, size, and treatment methods of tumors. (3) Results: In total, 728 patients with UM were included before the COVID-19 pandemic, in the years 2018-2019, and 608 were included during the COVID-19 pandemic, in the years 2020-2021. Fixed-base dynamics indicators for the incidence of uveal melanoma (base year 2018) in the National Referral Center in Poland were 80.22% and 86.81% in the years 2020 and 2021, respectively. UMs were statistically significantly larger and more frequently localized anterior to the equator of the eye globe in the year 2021 than in the year 2018 (Chi-square Pearson test p = 0.0001 and p = 0.0077, respectively). The rate of patients treated with enucleation increased from 15.94% in the year 2018 to 26.90% in the year 2021 (Chi-square Pearson test p = 0.0005). (4) Conclusions: Statistically significant differences were found in the management of uveal melanoma in the National Referral Center in Poland during the COVID-19 pandemic with tumors being larger, more frequently localized anterior to the equator of the eye globe, and more often enucleated.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Case Reports
    世界卫生组织的牙源性角化囊肿(OKC)的分类和治疗方案,以前被称为角化囊性牙源性肿瘤,是根据文献研究进行检查的。因为不是所有的OKC都有一个可识别的蛋白质补丁同源突变,针对肿瘤类别的这种转变,改变OKC管理方案的想法受到了质疑,并未得到广泛采纳.这项研究的目的是概述23岁患者的牙源性角化囊肿的成功治疗计划。治疗程序涉及有袋化,然后是摘除,外周截骨,和5FFU的注射。经过2年的观察期(临床和放射学监测),发现骨再生正常,没有复发的迹象。
    The World Health Organisation classification and the treatment protocol for the odontogenic keratocyst (OKC), previously referred to as the keratocystic odontogenic tumour, were examined based on a study of the literature. Because not all OKCs have an identifiable protein patched homolog mutation, the idea of changing the management protocol for OKC in response to this shift in tumour category was met with scepticism and was not widely adopted. This study\'s objective was to outline a successful management plan for an odontogenic keratocyst in a patient who was 23 years old. The procedure for therapy involved marsupialisation, which was followed by enucleation, peripheral osteotomy, and the injection of 5 FFU. Following a 2-year observation period (clinical and radiological monitoring), it was found that bone regeneration was normal and there was no sign of a recurrence.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    背景:为了调查放射学和人口统计学特征,类型,分布,和治疗方法的牙科囊肿(DC)。
    方法:检查了根据2020年1月至2023年12月的活检结果诊断为DC的患者的全景X线照片和锥形束计算机断层扫描(CBCT)图像。在不同年龄段的患者中,数字,类型和位置,和DC的放射学特征,周围组织的相关变化,并对所采用的治疗方法进行综述。
    结果:在95例DC患者中(66例男性,29名女性),单个囊肿(n=86)和两个囊肿(n=9)的性别和年龄分布相当。在104个DC中,44是中央的,38是横向的,和22个是圆周的。DC类型受性别影响不显著,年龄组,或解剖位置。周向DC通常导致下颌管移位。虽然摘除是治疗中枢DC的首选方法,周围的DCs进行有袋化处理。
    结论:在这项研究中,这是第一个评估CBCT图像上的DC类型,中心型是最常见的。环状DCs大多采用有袋化处理。CBCT成像可以帮助确定DC类型,并可能为治疗计划提供指导。
    BACKGROUND: To investigate the radiological and demographic features, types, distribution, and treatment methods of dentigerous cysts (DC).
    METHODS: Panoramic radiographs and cone beam computed tomography (CBCT) images of patients diagnosed with DC based on biopsy results between January 2020 and December 2023 were examined. In patients from different age groups, the numbers, types and locations, and radiological features of DCs, associated changes in surrounding tissues, and treatment methods used were reviewed.
    RESULTS: Among 95 patients with DC (66 males, 29 females), sex and age distributions were comparable between those with a single cyst (n = 86) and those with two cysts (n = 9). Of 104 DCs, 44 were central, 38 were lateral, and 22 were circumferential. DC types were not significantly affected by sex, age group, or anatomical location. Circumferential DCs often caused displacement of the mandibular canal inferiorly. While enucleation was preferred for the treatment of central DCs, circumferential DCs were treated with marsupialization.
    CONCLUSIONS: In this study, which is the first to evaluate the DC types on CBCT images, the central type was the most common. Circumferential DCs were mostly treated with marsupialization. CBCT imaging can assist in determining DC types, and may provide guidance for treatment planning.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    目的:。本系统综述旨在评估超过4厘米的良性上颌骨放射性骨病变的不同治疗方法,以提出一种管理算法。
    方法:使用MEDLINE/PubMed进行了文献检索,Scopus,谷歌学者,虚拟健康图书馆数据库,灰色文学随机或非随机临床试验和病例系列,10名或更多患者,至少随访1年。在2023年8月之前以法语或英语出版,都包括在内。评估了所有论文的偏倚风险。
    结果:在确定的1433条记录中,这次审查包括22人,报告1364个病灶的数据。成釉细胞瘤是最常见的病变(51.22%),下颌骨是最常见的病变部位(81.21%)。最初的保守治疗很普遍(71.04%)。保守治疗后复发(13.8%)高于根治性治疗后复发(6.5%)。多局部性,皮质穿孔,保留牙齿元素与较高的复发风险有关。
    结论:本研究表明了解上颌下颌关节良性溶骨性病变的具体特征和复发风险的重要性。多学科团队批准,基于病变类型和患者的个性化方法至关重要。至少一个危险因素的存在可能导致治疗决策。尽管有局限性,本研究为病变管理提供了信息,并提供了准确的建议.
    OBJECTIVE: This systematic review aimed to assess the different treatments of benign maxillo-mandibular radiolucent bone lesions over 4 cm to propose a management algorithm.
    METHODS: A literature search was conducted using MEDLINE/PubMed, Scopus, Google Scholar, Virtual Health Library databases, and gray literature. Randomized or non-randomized clinical trials and case series with 10 or more patients with a minimum follow up of 1 year, published in French or English until August 2023, were included. The risk of bias was assessed for all papers included.
    RESULTS: Of 1433 records identified, 22 were included in this review, reporting data from 1364 lesions. Ameloblastoma was the most common lesion (51.22%) and mandible was the most common site (81.21%). Initial conservative treatment was prevalent (71.04%). Recurrence was higher after conservative (13.8%) than after radical treatments (6.5%). Multilocularity, cortical perforation, dental element preservation were linked to a higher recurrence risk.
    CONCLUSIONS: This study has shown importance of understanding specific characteristics and recurrence risk in benign maxillomandibular osteolytic lesions. Multidisciplinary team approval, personalized approach based on lesion type and patient are crucial. The presence of at least one risk factor could lead to therapeutic decision. Despite limitations, the study informed lesion management and provided precise recommendations.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    我们旨在研究良性前列腺增生(BPH)患者使用30W和60Wthulium前列腺摘除术(ThuLEP)是否会影响术后预后。
    我们前瞻性地确定了男性患者由于BPH而出现中度或重度下尿路症状。我们将患者随机分为30W(第1组)或60W(第2组),分别使用550μm激光光纤和26Fr连续流动电切镜。我们收集了与前列腺大小有关的数据,摘除时间,分折时间,激光时间,围手术期并发症,和1年功能成果。
    共纳入120名患者,平均年龄67岁,平均前列腺大小105g。两组的术前特征相似。60W组平均手术时间较短,74±27vs.30W组91±33分钟(P=0.001),平均激光时间为60W中55±20,30W中71±25(P=0.0001)。两组平均住院时间为1天,随访1年;平均Qmax和国际前列腺症状评分症状评分均有相似的改善。
    对于60W组,30和60WThuLEP均提供了安全且可比的结果,手术时间相对较短。也许使用30W的设置将有利于早期的学习曲线或有更多出血的包膜穿孔器的情况;此外,制造低成本低功耗设备的经济利益,这可能有助于AEEP的普及。
    UNASSIGNED: We aimed to study whether using 30 W versus 60 W thulium enucleation of the prostate (ThuLEP) would affect postoperative outcomes in patients with benign prostatic hyperplasia (BPH).
    UNASSIGNED: We prospectively identified male patients with moderate or severe lower urinary tract symptoms due to BPH. We randomized patients into 30 W (Group 1) or 60 W (Group 2) thulium yag laser with a 550 μm laser fiber and a 26 Fr continuous flow resectoscope. We collected data related to prostate size, enucleation time, morcellation time, laser time, perioperative complications, and 1-year functional outcomes.
    UNASSIGNED: A total of 120 patients were included, with a mean age of 67 years and a mean prostate size of 105 g. The preoperative characteristics were similar across both groups. The mean operative time was shorter in the 60 W group, 74 ± 27 vs. 91 ± 33 min in the 30 W group (P = 0.001), and the mean laser time was 55 ± 20 in 60 W versus 71 ± 25 in 30 W (P = 0.0001). The mean hospital stay was 1 day in both groups and at 1-year follow-up; there was a similar improvement in mean Qmax and International Prostate Symptom Score symptom scores.
    UNASSIGNED: Both 30 and 60 W ThuLEP provided a safe and comparable outcome with a relatively shorter operative time for the 60 W groups. Perhaps using a 30-W setting would be beneficial in the early learning curve or cases with more bleeding capsular perforators; besides, the financial benefit of manufacturing low-cost low-power devices that may help in the widespread of AEEP.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    通过卵母细胞去核制备受体细胞质体是动物克隆和人类辅助生殖技术的基本任务。飞秒激光是一种精确和低侵入性的卵母细胞摘除工具,它应该是传统的微针穿刺摘除术的适当替代方法。然而,直到最近,激光去核仅在应用荧光染料的情况下进行。
    这项工作旨在(1)在不应用荧光染料的情况下实现飞秒激光卵母细胞摘除和(2)研究激光破坏染色体对纺锤体结构和动力学的影响。
    我们应用偏振光显微镜进行纺锤体可视化,并用1033nm飞秒激光进行了无染色的小鼠和人类卵母细胞摘除。此外,我们通过共聚焦显微镜研究了中期板消除后纺锤体的转化。
    我们证明了在不施加荧光染料的情况下,通过1033nm飞秒激光辐射使小鼠和人卵母细胞中的中期板失活的基本可能性。主轴区域的辐照,通过偏振光显微镜观察,导致部分或完全的中期板破坏,但避免了微管损伤。中期平板消除后,重新组织了主轴,然而,这不是完全解聚。
    这种受体细胞质体制备的方法有望用于动物克隆和辅助生殖技术。
    UNASSIGNED: Preparation of a recipient cytoplast by oocyte enucleation is an essential task for animal cloning and assisted reproductive technologies in humans. The femtosecond laser is a precise and low-invasive tool for oocyte enucleation, and it should be an appropriate alternative to traditional enucleation by a microneedle aspiration. However, until recently, the laser enucleation was performed only with applying a fluorescent dye.
    UNASSIGNED: This work is aimed to (1) achieve femtosecond laser oocyte enucleation without applying a fluorescent dye and (2) to study the effect of laser destruction of chromosomes on the structure and dynamics of the spindle.
    UNASSIGNED: We applied polarized light microscopy for spindle visualization and performed stain-free mouse and human oocyte enucleation with a 1033 nm femtosecond laser. Also, we studied transformation of a spindle after metaphase plate elimination by a confocal microscopy.
    UNASSIGNED: We demonstrated a fundamental possibility of inactivating the metaphase plate in mouse and human oocytes by 1033 nm femtosecond laser radiation without applying a fluorescent dye. Irradiation of the spindle area, visualized by polarized light microscopy, resulted in partly or complete metaphase plate destruction but avoided the microtubules impairment. After the metaphase plate elimination, the spindle reorganized, however, it was not a complete depolymerization.
    UNASSIGNED: This method of recipient cytoplast preparation is expected to be useful for animal cloning and assisted reproductive technologies.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Case Reports
    神经根囊肿是颌骨中最常见的囊肿形式。它们是由牙髓坏死后根尖周感染引起的牙周膜上皮残留形成的。这种情况通常是无症状的,主要影响牙齿的顶点。它主要影响非生命牙齿,并以炎症为特征。囊肿发育是根尖周感染后炎症过程的最后阶段;因此,它经常发生在以后的生活中。上颌骨的囊肿偶尔会扩散到上颌窦。根性囊肿可以用外科牙髓治疗,去除有问题的牙齿,初次闭合摘除,或有袋化和摘除。此病例报告讨论了感染的根性囊肿的成功手术治疗。
    Radicular cysts are the most common forms of cysts in the jaws. They develop from epithelial residues in the periodontal ligament in response to periapical infection following pulpal necrosis. This condition is typically asymptomatic and mostly affects the tooth\'s apices. It primarily affects non-vital teeth and is characterized by inflammation. Cyst development is the final stage of the inflammatory process after a periapical infection; hence, it often occurs later in life. A cyst in the maxilla can occasionally spread across the maxillary sinus. Radicular cysts can be treated with surgical endodontics, the removal of the problematic tooth, enucleation with primary closure, or marsupialization and enucleation. This case report discusses a successful surgical therapy for an infected radicular cyst.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

公众号