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find Author "吕涛" 8 results
  • Effect of PD-1 and PD-L1 preoperative treatment on rejection after liver transplantation of liver cancer

    Objective To summarize the research progress of programmed cell death protein 1 (PD-1)/programmed cell death protein-ligand 1 (PD-L1) inhibitors before liver transplantation of liver cancer. Method The literatures on the application of PD-1/PD-L1 inhibitors before liver transplantation of liver cancer were collected and reviewed. Results PD-1/PD-L1 inhibitors preoperatively treated liver transplantation recipients had a low incidence of postoperative rejection, and routine usage of hormone and immune tolerance induction therapy in liver transplantation recipients might reduce the incidence of rejection caused by PD-1/PD-L1 inhibitors. Conclusion Preoperative usage of PD-1/PD-L1 inhibitors have more benefits than risks for patients with advanced liver cancer.

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  • 射频消融在脾脏外伤后保脾手术中的临床应用

    目的 探讨射频消融在保脾手术治疗脾脏外伤中的临床应用效果。 方法 回顾性分析笔者所在医院科室于 2010 年 7 月至 2015 年 3 月期间行保脾手术治疗的 23 例脾脏外伤患者的临床资料,术中均利用了射频消融技术。 结果 23 例患者均保脾成功,其中 11 例行射频消融止血修补术,12 例行射频消融联合部分脾脏切除术。手术时间为 75~150 min,平均 117 min;术中出血量为 40~500 mL,平均 223 mL;术中见腹腔出血量 800~2 000 mL,平均 1 452 mL,均行自体血回输;术中见脾脏裂伤程度:Ⅰ 度 10 例,Ⅱ 度 11 例,Ⅲ 度 2 例;拔除引流管时间为术后 2~5 d,平均 2.8 d;术后住院时间为 6~15 d,平均 8.5 d。术后出现发热 3 例,腹腔再次出血 1 例,血小板计数升高 7 例。术后获访 16 例,随访时间 8~26 个月,中位数为 11 个月。随访期间患者健康情况良好,未见血小板计数异常、脾脓肿等情况。 结论 射频消融在保脾手术治疗脾脏外伤中的应用是可行的。

    Release date:2017-10-17 01:39 Export PDF Favorites Scan
  • Clinical Analysis of Trans-umbilical Single-port Laparoscopic Cholecystectomy

    【摘要】 目的 探讨经脐单孔腹腔镜胆囊切除术的临床可行性及其优缺点。 方法 回顾分析2010年7-9月行经脐单孔腹腔镜胆囊切除术34例患者临床资料。 结果 患者均顺利完成单孔腹腔镜胆囊切除术,手术平均时间为65 min,术后平均住院时间为3 d,术后未发生出血、感染、胆瘘等并发症。 结论 单孔腹腔镜胆囊切除术是安全可行的,术后腹部无明显瘢痕,美容效果明显。【Abstract】 Objective To evaluate the feasibility and value of the trans-umbilical single-port laparoscopic cholecystectomy. Methods The clinical data of 34 patients who underwent trans-umbilical single-port laparoscopic cholecystectomy from July to September 2010 were retrospectively analyzed. Results The operations of 34 patients were successfully performed. The mean operative duration was 65 minutes, and the mean duration in hospital after the operation was 3 days. No infection, postoperative bleeding, and biliary leakage occurred postoperatively. Conclusion Trans-umbilical single-port laparoscopic cholecystectomy is safe and feasible with good cosmetic effect.

    Release date:2016-08-26 02:21 Export PDF Favorites Scan
  • The Effect of Anatomical Distribution of Multiple Tumors for HCC Patients Meeting The Milan Criteria after Hepatic Resection

    ObjectiveTo exclusively compare the short-and long-term outcomes of hepatic resection (HR) patients with multifocal tumors meeting the Milan criteria between locating in same and different sections. MethodsA total of 219 consecutive HR patients with multifocal tumors meeting the Milan criteria were divided into group SS (n=97, same section) and group DS (n=122, different sections) according to their anatomical location (Couinaud's segmentation). ResultsThe 1-, 3-, and 5-year overall survival (OS) and recurrence-free survival (RFS) rates were significantly higher in the group SS than those in the group DS (P < 0.05). The subgroup analysis showed that patients with 2 tumors and those undergoing en bloc resection were associated with better OS and RFS (P < 0.05). ConclusionsFor HCC patients with multifocal tumors meeting the Milan criteria, those with tumors locating in same hepatic section may have better longterm survival and lower HCC recurrence rates than those locating in different sections after HR.

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  • 新型冠状病毒性肺炎疫情时期器官移植调整策略及体会

    目的探讨新型冠状病毒性肺炎(简称新冠肺炎)疫情时期器官捐献移植工作的调整策略,总结经验。方法解读新冠肺炎疫情期间器官移植工作指南和第一版专家共识后,四川大学华西医院器官移植中心制定了器官移植调整方法。结果于 2020 年 1 月 24 日至 2020 年 2 月 6 日进行公民逝世后器官捐献 4 例,均为男性,平均年龄 39.5 岁。捐献后共行器官移植手术 8 例,其中肝脏移植 4 例,肾脏移植 4 例。移植受体平均年龄 48 岁,男 6 例,女2 例。8 例移植手术顺利,7 例患者无输血。手术后患者恢复顺利,无外科并发症发生,无感染相关并发症发生。结论新冠肺炎疫情期间,通过调整方法和流程,可以安全开展器官移植工作和实现疫情防控。

    Release date:2020-03-30 08:25 Export PDF Favorites Scan
  • Technical improvement and effect of donor red blood cell transfusion in liver transplantation with donation after citizen death

    ObjectiveTo explore modified methods and outcomes of collection of donor blood from donation after citizen death (DCD). MethodThe clinicopathologic data of 26 DCD donors underwent phase Ⅰ clinical trials and 6 patients who received donor blood by modified collection technique from May 2020 to November 2021 in the West China Hospital of Sichuan University were collected retrospectively. ResultsCompared with the data of 26 DCD donors at phase Ⅰ clinical trials, after the modified collection technique, the blood collection volume, the concentrated red blood cells following filtration, centrifugation, and the amount of concentrated red blood cell/kg body mass were more (P<0.05). In addition, compared with the components of stored red blood cell suspension, the pH value, sodium and chloride ions concentrations of the red blood cell suspension obtained after modified collection technique were higher (P<0.05), the potassium ion concentration was <1 mmol/L, and the lactic acid concentration of none of blood was >15 mmol/L. ConclusionThe adoption of the modified collection technique increases the amount of donor red blood collected, and its biochemical and electrolyte indicators are more in line with physiological requirements than those of stored blood.

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  • Impact of arterial reconstruction type on early ischemic-type biliary lesion after liver transplantation

    ObjectiveTo investigate the effect of recipient hepatic artery reconstruction site selection on early ischemic-type biliary lesion (ITBL) after liver transplantation. Methods The clinical data of 656 cadaver liver transplantation were collected retrospectively from January 2015 to January 2020 in the Liver Transplantation Center of West China Hospital of Sichuan University and the Institute of Organ Transplantation of Tongji Hospital Affiliated to Huazhong University of Science and Technology. Patients were divided into two groups according to the reconstruction sites of recipient arteries. The distal group was anastomosed at left hepatic artery, right hepatic artery or proper hepatic artery. The proximal group was anastomosed at the gastroduodenal artery, the common hepatic artery or the common hepatic artery-gastroduodenal artery bifurcation. To investigate the differences in the incidence of early postoperative complications between the two groups and the factors influencing the development of ITBL within one year after transplantation. Results Of 656 patients, 262 were in the distal group and 394 were in the proximal group. The incidence of hepatic artery thrombosis was lower in the proximal group than that in the distal group (χ²=5.675, P=0.017), while the differences in the incidences of ITBL-related graft failure and rejection-related graft failure were not statistically significant when compared (all P>0.05). Multivariate logistic regression results showed that hepatic artery thrombosis [OR=4.453, 95%CI (1.318, 15.050), P=0.016] and cold ischemia time >6 h [OR=1.844, 95%CI (1.014, 3.353), P=0.045] were risk factors for early postoperative ITBL in the liver transplant patients, while different hepatic artery reconstruction categories were not risk factors for ITBL [OR=1.166, 95% CI (0.630, 2.157), P=0.625]. Conclusion Hepatic artery anastomosis reconstruction with the recipient common hepatic artery, gastroduodenal artery, and Carrel flap at the common hepatic artery-gastroduodenal artery bifurcation can somewhat reduce the difficulty of anastomosis and does not increase the risk of postoperative ITBL.

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  • Expert consensus on dual-graft liver transplantation in West China Hospital

    Living donor liver transplantation is one of the main solutions to the organ supply-demand discrepancy at present. However, there was a risk of the recipient developing small-for-size syndrome due to insufficient graft volume, while an excessively large graft volume for donation might lead to postoperative liver failure for the donor. In this context, the dual-graft liver transplantation had emerged, which could minimize the volume of liver resection from the each donor to ensure the donor’s safety and provide the adequate volume of liver for the recipient. Yet, this procedure is less commonly performed in our country. In order to promote the steady implementation of dual-graft liver transplantation in China and serve as an important supplement to the donor pool, the West China Hospital of Sichuan University organized relevant experts and draw on the mature experiences of advanced countries in the field of transplantation jointly formulated the “Expert consensus on dual-graft liver transplantation”. The consensus had been developed around aspects such as donor evaluation and selection, surgical methods, and postoperative complications.

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