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find Author "胡杨" 18 results
  • 颈内静脉大隐静脉转流术在上腔静脉破裂中的应用一例

    Release date:2018-06-26 05:41 Export PDF Favorites Scan
  • 华西食管新技术高峰论坛暨华西首届纵隔镜食管癌切除术学习班顺利召开

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  • 内源性亚硝胺在食管癌一级预防中的作用及意义

    亚硝胺是一类公认的食管癌化学致癌物。它们广泛存在于人类生存环境中(外源性亚硝胺),也可在一定条件下于人体内合成(内源性亚硝胺)。我国通过控制人群外源性亚硝胺暴露的措施,并未使食管癌发病率明显下降,故内源性亚硝胺诱发人类食管癌的作用可能强于外源性亚硝胺。内源性合成是人体亚硝胺的主要来源,且内源性亚硝胺可致人类食管癌,因而减少人体内源性亚硝胺的暴露可成为食管癌一级预防的重要措施。关于内源性亚硝胺与食管癌预防的可能研究方向总结如下:① 减少亚硝胺底物的摄入及形成、抑制亚硝胺合成反应可减少内源性亚硝胺的暴露;② 亚硝胺在体内的吸收过程可能为被动扩散,干预其吸收过程仍存在困难;③ 亚硝胺本身不致突变,其致突变活性决定于其在体内的代谢或诱导产物,故抑制亚硝胺体内代谢活化也可能抑制食管癌的发生。

    Release date:2016-08-26 02:09 Export PDF Favorites Scan
  • Clinical Significance of Para Left Gastric Artery Lymph Node Resection in Radical Operation of Esophageal Cancer

    Objective To investigate the related factors affecting the metastases to left gastric artery lymph nodes in patients of esophageal cancer, and evaluate the clinical significance of resection of left gastric artery. Methods One hundred and eighty-six patients with esophageal cancer undergone esophagectomy and esophagogastrostomy were involved in these case-control study. The left gastric artery, lymph nodes and fat tissue around it were removed in these patients. Patients were divided into 2 groups according to the occurrence of metastases to para left gastric artery lymph nodes. Chi-square test, rank sum test, t-test and the logistic regression were adopted to analyze the correlations between these related factors and the metastases to para left gastric artery lymph nodes. Results Thirty-three patients had para left gastric artery lymph nodes metastases (17. 74%). Related factors that affect the metastases to para left gastric artery lymph nodes were showed by monovariate analysis as follows: TNM staging of tumor, the metastases to paraesophageal nodes, paracardial nodes and subcarinal nodes (P〈0.001, P=0.025, 0.047,0.038). Multivariate analysis showed that location of tumor was the only independent factor that influences the metastases of para left gastric artery lymph nodes(P= 0. 002). Skip metastasis was a distinct feature of esophageal cancer, with a frequency of 78.79%(26/33). Conclusions This study suggests that the major correlative factor of para left gastric artery lymph node metastasis is location of tumor. Resection of left gastric artery as a routine procedure in radical operation of esophageal cancer should be considered.

    Release date:2016-08-30 06:26 Export PDF Favorites Scan
  • Effects of Lymphatic Chemotherapy on Immune Functions of Patients after Esophageal Carcinoma Resection

    ObjectiveTo explore the effects of intraoperative lymphatic chemotherapy (LC) on immune functions of patients after esophageal carcinoma resection. MethodsPatients who underwent intraoperative LC during esophageal carcinoma resection in the Department of Thoracic Surgery of West China Hospital from March to October,2013 were prospectively included in this study, and patients who underwent esophageal carcinoma resection without intraoperative LC during the same period were also included as the control group. All the patients were divided into a pacitaxel LC group,a fluorouracil LC group,and a control group without LC. A total of 37 patients were included in this study including 25 male and 12 female patients with their age of 42-76 (61.89±7.95) years. There were 15 patients in the pacitaxel LC group,15 patients in the fluorouracil LC group,and 7 patients in the control group. Representative indexes of humoral immunity and cellular immunity in peripheral blood of all the patients were examined preoperatively and on the third and seventh postoperative day, and then compared among the 3 groups. ResultsAll the immune indexes of the 3 groups decreased after surgery to different extent. There was no statistical difference in preoperative and postoperative difference of immunoglobulin concentration between LC groups and the control group (P>0.05). CD8+ T cell count recovered more rapidly after surgery in LC groups than the control group. CD3+ T cells recovered most rapidly after surgery in the fluorouracil LC group. ConclusionLC is beneficial for the recovery of cytotoxic effects of T lymphocytes but may not promote humoral immunity for patients after esophageal carcinoma resection.

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  • Effect of perioperative fluid management on postoperative pulmonary complications of esophagectomy: A retrospective cohort study

    Objective To evaluate the effect of perioperative fluid management on postoperative pulmonary complications (PPCs) of esophagectomy, and to find out the optimal scheme for perioperative fluid administration. Methods This retrospective cohort study enrolled 75 patients with esophageal squamous cell cancer who have received esophagectomy in West China Hospital from June to December 2014. We used the Kroenke's postoperative pulmonary complications classification system to define the PPCs. Patients with PPCs of grade Ⅱ-Ⅳ were considered as PPCs group (n=13, 12 males, 1 female, age of 64.62±8.64 years), and others were considered as non-complication group (n=62, 50 males, 12 females, age of 60.55±8.73 years). Intraoperative and postoperative fluid inputs and outputs as well as clinical characteristics between groups were compared. Results Between two groups, there was a great difference in postoperative albumin infusion, intraoperative fluid administration [net input, total input, net input/kg, total input/kg, net input/(kg·h) and total input/(kg·h)] and fluid input on the first postoerative 1–3 days (total input and total input/kg). The cutoff value for total input/(kg·h) in operation and total input on the first 1–3 postoerative days was 12.07 ml/(kg·h) and 178.57 ml/kg, respectively. Conclusion The speed of fluid infusion in operation and total input on postoperative 1-3 days are most important influence factors of PPCs. The speed in operation should not exceed 12.07 ml/(kg·h) and the total input on postoperative 1-3 days should not exceed 178.57 ml/kg. Within this range, an appropriate increase in fluid volume can make patients feel better.

    Release date:2017-04-24 03:51 Export PDF Favorites Scan
  • 新辅助化疗后胸腹腔镜联合食管癌切除术视频要点

    Release date:2018-01-31 02:46 Export PDF Favorites Scan
  • 食管癌或贲门癌术后乳糜腹的压力治疗

    目的证明腹腔束带加压对于食管癌或贲门癌术后乳糜腹的有效性,并探讨其使用的条件和优缺点。 方法总结四川大学华西医院胸外科2009~2013年行食管癌或贲门癌切除术的3 859例患者中术后出现乳糜腹的4例患者接受加压治疗的情况,对其治疗经过和结局进行分析,其中男3例、女1例,年龄59~68岁。 结果4例患者中,3例加压成功患者均在两周内治愈,随访超过1年时间未见乳糜腹复发,1例患者因腹部加压后乳糜液持续漏入胸腔,导致无法成功加压,治疗失败,最终通过再次手术治愈。 结论在保证腹腔是一个封闭空间及足够压力和时间的前提下,加压治疗对腹部术后乳糜腹有效,且无创、时间短、风险低及不需禁食,其缺点是患者治疗前期有腹腔加压的不适感。

    Release date:2016-10-02 04:56 Export PDF Favorites Scan
  • Application of modified grafted tubularized incised plate urethroplasty in hypospadias

    Objective To investigate the clinical feasibility and effectiveness of the modified grafted tubularized incised plate urethroplasty (G-TIP), namely “glans G-TIP (GG-TIP) ”, in treatment of hypospadias. Methods A clinical data of 137 children with hypospadias qualified by the selection criteria between January 2021 and June 2023 was retrospectively analyzed. Among them, 75 children were treated with GG-TIP (GG-TIP group) and 62 with G-TIP (G-TIP group). There was no significant difference (P>0.05) between the two groups in terms of age, hypospadias type, penile length, penile head width, penile head height, penile curvature, meatus-apex distance, urethral plate width, and distance from the distal endpoint of navicular groove to the dorsal or ventral midline point of the glans corona, and the difference between the two. The operation time, reconstructed urethral length, distance from meatus to ventral glans corona, postoperative complications, maximum urinary flow rate at 2 weeks after operation, and the hypospadias objective scoring evaluation (HOSE) score at 6 months after operation in the two groups were recorded and analyzed. Results The operation time was significantly shorter in GG-TIP group than in G-TIP group (P<0.05); but there was no significant difference (P>0.05) between the two groups in terms of reconstructed urethral length and distance from meatus to ventral glans corona. All urinary meatus located at the tip of glans with vertical fissure shape. All children in the two groups were followed up 6-35 months (median, 26 months). During follow-up, there were 3 cases of urethral fistula, 2 cases of urethral stricture, and 1 case of glans separation in GG-TIP group, and 3, 3, and 1 cases in the G-TIP group, respectively. There was no significant difference in the incidence of complications between the two groups (P>0.05). The maximum urinary flow rate at 2 weeks and the HOSE score at 6 months after operation were significantly higher in GG-TIP group than in G-TIP group (P<0.05). Conclusion GG-TIP is safe and effective for repairing hypospadias in children. Compared with G-TIP, it has the advantages of relatively simple operation, shortened operation time, significant improvement in urinary flow rate, and better cosmetic results.

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  • Comparison of Injury Characteristics between Wenchuan and Lushan Earthquake Patients: A Report from West China Hospital of Sichuan University

    Objective To assess the impact of earthquake magnitude scale on injury characteristics of patients admitted to an earthquake rescue hospital,and provide references for rescue strategy formulation and medical resourceallocation. Methods We retrospectively analyzed clinical data of patients injured in 2008 “5 • 12” Wenchuan earthquakeand 2013 “4 • 20” Lushan earthquake who were admitted to West China Hospital of Sichuan University. Patient gender,age,time of admission,mechanisms,types and severity of injury and their prognosis were compared between the 2 groups.Results A total of 1 856 patients who were injured in Wenchuan earthquake,including 974 male and 882 female patients with their age of 45.8±22.7 years,and 316 patients who were injured in Lushan earthquake,including 174 male and 142 female patients with their age of 43.0±23.1 years,were enrolled in our study. No significant difference was found in genderor age between these 2 groups (P>0.05). Peak time of admission of Wenchuan earthquake patients was significantlylater than that of Lushan earthquake patients,and transfer duration of Wenchuan earthquake patients was significantly longerthan that of Lushan earthquake patients. The percentage of patients with crash injury of heavy objects or buried trauma ofWenchuan earthquake patients was significantly higher than that of Lushan earthquake patients. Injury severity and in-hospitalmortality of Wenchuan earthquake patients were significantly higher than those of Lushan earthquake patients. The proportionof patients with chest or cerebral injury of Lushan earthquake patients was significantly higher than that of Wenchuanearthquake patients. Conclusions Earthquake magnitude scale has a significant influence on mechanisms,types andseverity of injury of patients injured in earthquakes,as well as their timely transfer,management and prognosis. In earthquakeswith a comparatively lower magnitude scale,more thoracic surgeons and neurosurgeons are needed to ensure timelymanagement for patients with chest or cerebral injury.

    Release date:2016-08-30 05:47 Export PDF Favorites Scan
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