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RISS 인기검색어
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- 저자 : ( Cong Yun Huang ) (검색결과 2 건)
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Evolution of ALPPS: The Simpler, Safer and Effective One---TELPP
( Shu You Peng ),( Xu An Wang ),( Cong Yun Huang ),( You Yong Zhang ),( Jiang Tao Li ),( De Fei Hong ),( Xiu Jun Cai ),( Yi Fang Wang ),( Xiao Liang ),( Jian Wei Wang ) 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1
Aims: The characteristic of associating liver partition and portal vein ligation for staged hepatectomy(ALPPS) carries high mortality and morbidity. There is room for improvement. We suggest Terminal Branches Portal Vein Embolization (TBPVE) as a way to compart the liver. As a result, only a single surgical operation is required.This method is termed Terminal branches portal vein Embolization Liver Partition Planned hepatectomy (TELPP). Methods: Patients with unresectable primary or metastatic liver tumor were performed with TELPP. The procedure of TELPP was that in addition to PVE, embolization agent was infused to the terminal branches of portal vein of S5,S8 or S4. CT scan was taken one or two weeks later, and standard liver volume(SLV), FLR and FLR/SLV are calculated. Two weeks later when the FLR and liver function is appropriate, open or laparoscopic hepatectomy is performed. Results: The study included 11patients including hepatocellular carcinoma: n =8, intrahepatic cholangiocarcinoma: n = 1, hilarcholangiocarcinoma: n =1, colorectal liver metastasis: n =1. After a waiting period of 14 days, the volume of theFLR had increased from 382mlto 578ml, representing a median volume increase of 51% (range =32.5%-86.7%). Of the 11patients with hepatectomy, right hemihepatectomy (n=2), extended right hemihepatectomy (n=5), right trisecmentectomy(2), extended left hemihepatectomy (n=1) and left trisecmentectomy(1). No patient died, and no serve perioperative morbidity occurred. Conclusions: ALPPS and all modifications need two-stage operations with a high morbidity and mortality rate. It seems that TELPP is very promising. It has the merit of ALPPS as extraordinarily rapid increasement of FLRvolume, yet the morbidity and mortality is much lower, owing to the fact that unlike ALPPS, there is no two liver raw surfaces left behind in the abdominal cavity to produce bile leak, as only single surgical operation is required
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Dongjie Zhang,Li Mei,Yuanping Hao,Bingcheng Yi,Jilin Hu,Danyang Wang,Yaodong Zhao,Zhe Wang,Hailin Huang,Yongzhi Xu,Xuyang Deng,Cong Li,Xuewei Li,Qihui Zhou,Yun Lu 한국생체재료학회 2023 생체재료학회지 Vol.27 No.00
Background Clinical tissue adhesives remain some critical drawbacks for managing emergency injuries, such as inadequate adhesive strength and insufficient anti-infection ability. Herein, a novel, self-healing, and antibacterial carboxymethyl chitosan/polyaldehyde dextran (CMCS/PD) hydrogel is designed as the first-aid tissue adhesive for effective trauma emergency management. Methods We examined the gel-forming time, porosity, self-healing, antibacterial properties, cytotoxicity, adhesive strength, and hemocompatibility. Liver hemorrhage, tail severance, and skin wound infection models of rats are constructed in vivo, respectively. Results Results demonstrate that the CMCS/PD hydrogel has the rapid gel-forming (~ 5 s), good self-healing, and effective antibacterial abilities, and could adhere to tissue firmly (adhesive strength of ~ 10 kPa and burst pressure of 327.5 mmHg) with excellent hemocompatibility and cytocompatibility. This suggests the great prospect of CMCS/ PD hydrogel in acting as a first-aid tissue adhesive for trauma emergency management. The CMCS/PD hydrogel is observed to not only achieve rapid hemostasis for curing liver hemorrhage and tail severance in comparison to commercial hemostatic gel (Surgiflo ®) but also exhibit superior anti-infection for treating acute skin trauma compared with clinical disinfectant gel (Prontosan ®). Conclusions Overall, the CMCS/PD hydrogel offers a promising candidate for first-aid tissue adhesives to manage the trauma emergency. Because of the rapid gel-forming time, it could also be applied as a liquid first-aid bandage for mini-invasive surgical treatment.
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