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  • 简介:Duodenalpolypsorlesionsareuncommonlyfoundonupperendoscopy.Duodenallesionscanbecategorizedassubepithelialormucosally-based,andthetypeoflesionoftendictatesthework-upandpossibletherapeuticoptions.Subepitheliallesionsthatcanariseintheduodenumincludelipomas,gastrointestinalstromaltumors,andcarcinoids.Endoscopicultrasonographywithfineneedleaspirationisusefulinthecharacterizationanddiagnosisofsubepitheliallesions.Duodenalgastrointestinalstromaltumorsandlargeormultifocalcarcinoidsarebestmanagedbysurgicalresection.Brunner'sglandtumors,solitaryPeutz-Jegherspolyps,andnon-ampullaryandampullaryadenomasaremucosally-basedduodenallesions,whichcanrequireremovalandaretypicallyamenabletoendoscopicresection.Severalanatomiccharacteristicsoftheduodenummakeendoscopicresectionofduodenallesionschallenging.However,advancedendoscopictechniquesexistthatenabletheresectionoflargemucosally-basedduodenallesions.Endoscopicpapillectomyisnotwithoutrisk,butthisprocedurecaneffectivelyresectampullaryadenomasandallowspatientstoavoidsurgery,whichtypicallyinvolvespancreaticoduodenectomy.Endoscopicmucosalresectionanditsvariations(suchascap-assisted,cap-band-assisted,andunderwatertechniques)enablethesafeandeffectiveresectionofmostduodenaladenomas.Endoscopicsubmucosaldissectionispossiblebutverydifficulttosafelyperformintheduodenum.

  • 标签: DUODENUM POLYP Subepithelial Lesion AMPULLA Adenoma
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  • 简介:研究Gross-Pitaevskii无穷线性级联的Cauchy问题.通过在密度矩阵序列的Sobolev型空间中引进一个(F)-范数,我们建立了解的局部存在性,唯一性和稳定性;也得到了解的明显空时估计.特别是,当初始值为分离形式时这个(F)-范数与通常的Sobolev范数是一致的.

  • 标签: Gross-Pitaevskii级联 CAUCHY问题 局部适定性
  • 简介:EarthquakelosestimationbyusingGrosDomesticProductandpopulationdataQI-FUCHEN1)(陈棋福)YONGCHEN1)(陈禺页)LINGCHEN2)(陈凌)1)CenterforAn...

  • 标签: EARTHQUAKE DISASTER LOSS estimation assumed EARTHQUAKE
  • 简介:AbstractBackground:Historically sinonasal malignancies were always addressed via open craniofacial surgery for an oncologic resection. Increasingly esthesioneuroblastomas are excised using an exclusively endoscopic approach, however, the rarity of this disease limits the availability of long-term and large scale outcomes data.Objective:The primary objective is to evaluate the treatment modalities used and the overall survival of patients with esthesioneuroblastoma managed with exclusively endoscopic surgery.Methods:In accordance with PRISMA guidelines, PubMed was queried to identify studies describing outcomes associated with endoscopic management of esthesioneuroblastomas.Results:Forty-four out of 2462 articles met inclusion criteria, totaling 399 patients with esthesioneuroblastoma treated with an exclusively endoscopic approach. Seventy-two patients (18.0%) received adjuvant chemotherapy and 331 patients (83.0%) received postoperative radiation therapy. The average age was 50.6 years old (range 6-83). Of the 399 patients, 57 (16.6%) were Kadish stage A, 121 (35.2%) were Kadish stage B, 145 (42.2%) were Kadish stage C, and 21 (6.1%) were Kadish stage D. Pooled analysis demonstrated that 66.0% of patients had Hyams histologic Grade Ⅰ or Ⅱ, while 34.0% of patients had Grade Ⅲ or Ⅳ disease. Negative surgical margins were achieved in 86.9% of patients, and recurrence was identified in 10.3% of patients. Of those with 5-year follow-up, reported overall survival was 91.1%.Conclusion:Exclusively endoscopic surgery for esthesioneuroblastoma is performed for a wide range of disease stages and grades, and the majority of these patients are also treated with adjuvant chemotherapy or radiation therapy. Reported overall recurrence rate is 10.3% and 5-year survival is 91.1%.

  • 标签: anterior skull base endoscopic skull base surgery esthesioneuroblastoma olfactory neuroblastoma skull base
  • 作者: Li Lianwang Wang Yinyan Li Yiming Fang Shengyu Jiang Tao
  • 学科: 医药卫生 >
  • 创建时间:2020-08-10
  • 出处:《中华神经外科杂志(英文)》 2020年第02期
  • 机构:Beijing Neurosurgical Institute, Capital Medical University, No. 119 South 4th Ring West Road, Fengtai District, Beijing 10070, China,Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, No. 119 South 4th Ring West Road, Fengtai District, Beijing 10070, China,Beijing Neurosurgical Institute, Capital Medical University, No. 119 South 4th Ring West Road, Fengtai District, Beijing 10070, China; Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, No. 119 South 4th Ring West Road, Fengtai District, Beijing 10070, China
  • 简介:AbstractNew discoveries based on genetic and epigenetic evidence have significantly expanded the understanding of diffuse gliomas. Molecular biomarkers detected in diffuse gliomas are not only potential targets for radiotherapy, chemotherapy, and immunotherapy, but are also able to guide surgical treatment. Previous studies have suggested that the optimal extent of resection of diffuse gliomas varies according to the expression of specific molecular biomarkers. However, the specific guiding role of these biomarkers in the resection of diffuse gliomas has not been systemically analyzed. This review summarizes several critical molecular biomarkers of tumorigenesis and progression in diffuse gliomas and discusses different strategies of tumor resection in the context of varying genetic expression. With ongoing study and advances in technology, molecular biomarkers will play a more important role in glioma resection and maximize the survival benefit from surgery for diffuse gliomas.

  • 标签: Glioma Molecular biomarkers Guidance Resection
  • 简介:ObjectivesConventionalapproachesforremovaloflateralskullbasetumors,includingtransmandibular,infratemporalfossa,preauriculartranszygmaticsubtemporalapproaches,aremajorinvasiveproceduresthatoftensacrificehearingandcauseabnormalocclusionandcosmeticdefects.Reportsofthetranscervicalapproachforresectionofskullbasetumorsarerare,althoughitwasdescribedforresectionofclivalchordomasinasearlyas1966.Thepurposeofthisstudyistoreviewourexperiencesinmanagementoflateralskullbasetumorsusingthetranscervicalapproach.StudyDesignRetrospectivechartreview.MethodsSixlateralskullbasetumorcasestreatedwithtranscervicalapproachprocedureswerereviewed,includingthemedicalrecords.ResultsTherewere4malesand2females.Agerangedfrom12through52years.Histopathologicaldiagnosesincludedmalignantschwannoma(n=1),malignantcarotidbodytumor(n=1),heamangioma(n=1),schwannoma(n=2)andpleomorphicadenoma(n=1).Transcervicaltechniqueswereusedinallcaseswiththeuseofmicroscopeinthelateralskullbasearea.Completetumorremovalwasachievedinallcases.Postoperativeradiotherapywasimplementedin1caseofmalignantschwannomaand1caseofmalignantcarotidbodytumor.Jugularforamensyndromeoccurredasasurgicalcomplicationin1caseofmalignantSchwannomaofthevagusnerve.Therewasnotumorrecurrenceduringthe10-42monthfollow-upperiod.ConclusionComparedwithconventionalapproaches,thetranscervicalapproachprovidesaeasy,safe,minimalinvasiveandeffectiveprocedureforremovalofselectedlateralskullbasetumors.

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  • 简介:Duringthepastdecade,roboticsurgicalsystemshavebeenincreasinglyutilizedtoperformhighlycomplexsurgicalprocedures.Infact,therobotic-assistedapproachtothetreatmentofmanygynecologicalandurologicalsurgicalprocedureshasbecomethestandard-of-care.Theuseofroboticsurgicalsysteminthoracicsurgeryisinitsearlydevelopment.Video-assistedthoracoscopicsurgery(VATS)

  • 标签: 机器人手术 腔镜 切除术 外科手术 手术治疗 泌尿外科
  • 简介:ChildsNervSyst.2008Jun18.OBJECTIVES:Despiterevolutionarytechnicaladvancementinneuroimagingandoperativeneurosurgery,surgicalextirpationoffocalbrainstemglioma(BSG)remainssteepedincontroversy.Inthisstudy,weevaluatedourseniorauthor's(CT)surgical

  • 标签: 神经胶质瘤 临床分析 诊断方法 脑干
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  • 简介:In2000,theEastChinaPowerCorporationundertheauspicesoftheStatePowerCorporationtogetherwithShanghai,Jiangsu,ZhejiangandAnhuithreeprovincialandonemunicipalpowercompanieshavecompletedelectricitysalesof200TWhandrealizedagrossprofitof2.85billionyuanin2000,inwhich

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