Our clinical experiences in reconstruction of the defects from excision of benign tumors with expanded skin flap were reported. Since 1987 we have applied this method 23 cases with satisfactory results. When we decided to use this technique, the expander was placed in a pocket adjacent to a benign tumor planned to be excised. Once the skin flap was expanded fully, the tissue expanders were removed. After excision of the benign tumor, the defect was than be covered with the expanded skin flap. The problems related to treatment were discussed in detail.
目的 探讨十二指肠良性肿瘤的诊断与治疗。方法 对1992~1998年间收治的10例患者的临床资料行回顾性总结分析。 结果术前经纤维十二指肠镜确诊7例 ,上消化道X线钡餐确诊3例。肿瘤位于十二指肠降部7例,球部3例。其中6例行手术治疗,4例因心肺脑等严重合并症行保守治疗。手术为十二指肠肿瘤局部切除连同周围肠壁组织部分切除。术后病理报告2例为平滑肌瘤,2例为布鲁氏纳氏腺瘤,2例为间质瘤。结论 十二指肠良性肿瘤可引发严重并发症,如出血、腹痛、肠梗阻、穿孔等,并约有15%的病例可发生恶变。一经诊断,应及早手术治疗,手术一般宜行局部切除。
目的 探讨十二指肠良性肿瘤的手术治疗方式及术后早期营养管理的效果。方法 回顾性分析2009年1月至2011年12月期间我科收治的15例十二指肠良性肿瘤患者的临床资料,根据肿瘤的生长部位及肿瘤大小实施不同的手术方式,术后早期给予肠内营养治疗及消化液回输,观察术后患者并发症发生率及术后2个月内的返院情况。结果 15例患者中2例患者肿瘤位于十二指肠乳头下、直径2.5cm和2.0cm,2例位于降部与水平部交界处、直径2.3cm和2.5cm,1例位于十二指肠升部、直径3.5cm,该5例患者行十二指肠节段切除并空肠吻合术。4例患者肿瘤位于十二指肠乳头、直径1.0~2.0cm,3例位于乳头上缘、直径1.5~1.8cm,2例位于球部与降部交界处、直径2.0cm和1.8cm,1例位于十二指肠乳头下、直径1.2cm,该10例患者均行肿瘤局部切除术(位于乳头部的肿瘤同时行乳头成形术)。围手术期无死亡病例。1例(1/15)发生胃排空障碍,经禁食、减压及营养支持治愈出院。术后住院时间为7~10d,平均8d。术后2个月患者均接受随访,恢复良好,无返院患者。结论 手术切除是十二指肠良性肿瘤的首选治疗手段,手术方式取决于肿瘤的生长部位和大小,术后早期营养管理安全、有效。
Objective To study the clinical and CT findings of bronchiolar adenoma. Methods Patients diagnosed with bronchiolar adenoma confirmed by surgical pathology at Linyi People's Hospital and Yantai Yuhuangding Hospital from 2016 to 2021 were collected. Their clinical and CT imaging features were retrospectively analyzed. ResultsFinally, 25 patients were collected, including 6 males and 19 females, aged 32-73 (58.6±10.1) years. The immunohistochemical Ki-67 (MIB1) of all lesions was <5%. The lesions were located in the upper and middle lobe of both lungs in 9 patients, lower lobes in 16 patients, extrapulmonary zone in 22 patients, intrapulmonary middle zone in 3 patients, round in 11 patients, irregular in 14 patients, well-defined in 22 patients, pure ground-glass/mixed ground-glass nodules in 6 patients, solid nodules in 19 patients. There were 11 patients with central small cavity, 18 patients with single bronchioles sign, 19 patients without adhesion with adjacent pleura, and 24 patients without mediastinal lymph node enlargement. ConclusionBronchiolar adenomas usually occur in the middle-aged and elderly, mostly in the lower lobe of both lungs and the distribution of the peripheral lung field, most of the patients do not have any clinical symptoms, and the postoperative prognosis is good. CT may show large nodules or masses, pure ground-glass/mixed ground-glass nodules, irregular solid nodules and central small cavities. Irregular stellate nodules, central small cavity shadow, and single bronchiolar vascular bundle connected with the lesions are relatively specific imaging findings of bronchiolar adenoma.
From 1976 to 1991, 34 cases of benign tumors of femoral neck were received in our department and 29 cases were treated surgically with either free bone graft (18 cases) or vascularized bone graft (11 cases). Fibrous dysplasia of bone and bone cyst had a high incidence in this group (75%)and most of the patients were over 30 years old. Because the femoral neck had its own anatomical characteristics and was biomechanically important and in order to accelerate. The graft healing and prevent the occurrence of pathological fracture, the choice of operations should depend on the extent of the lesion, the thickness of the cortical bone of the affected past,and the presence or absence of complications.
Objective To study the clinical significance of central pancreatectomy in treatment of benign tumor of neck and body of pancreas. Methods The clinical data of 29 patients with benign tumor of pancreas were reviewed retrospectively in our hospital during the past 5 years. Results There was no perioperative death. Mean of operative time was (165±45) min (125-270min), mean of blood loss was (173±88) mL (50-450mL). The pathological diagnosis of all the patients were benign. Pancreatic fistula occurred in 10 patients. One patient with bleeding after operation was treated with another two operations. Twenty-one patients were followed-up with the time ranged from 3 months to 4 years (average 16 months). There were no complications related to diabetes. Conclusion Central pancreatectomy is reasonable for patients with benign tumor of pancreas, it could well preserve the endocrine and exocrine function of pancreas, and improve the quality of life of patients.