A new laparoscopic method was used for percutaneous placement of the peritoneal end of cerebrospinal fluid shunts in patients with obstructive or normal-pressure hydrocephalus. The peritoneal end of shunts were placed...
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A new laparoscopic method was used for percutaneous placement of the peritoneal end of cerebrospinal fluid shunts in patients with obstructive or normal-pressure hydrocephalus. The peritoneal end of shunts were placed and fixed upward between liver and diaphragm by two-Trocar method under direct laparoscopic vision. Meanwhile, patients with post-operation obstruction at peritoneal end of shunts underwent laparoscopic exploring and adjusting. One obstruction case at the peritoneal pipe end occurred on the third day after operation, two obstructed by the first month and the other obstructed by the sixth month after operation. All operations have been completed successfully, as well as all obstructions were adjusted successful under the laparoscope. All patients were followed up from 6 to 38 months and kept unobstructed. Compared with the traditional open-abdominal method, this method has fewer traumas, quicker recovery and lower ratio of the pipe end obstructions. Besides, it' s convenient to adjust obstructed peritoneal end of shunts.
Background: The role of surgical resection and thrombectomy for hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT) is controversial. This study aimed to evaluate the effects of the location and exte...
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Background: The role of surgical resection and thrombectomy for hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT) is controversial. This study aimed to evaluate the effects of the location and extent of PVTT on the long-term outcomes of surgical treatment for HCC. Methods: A total of 438 patients with HCC and PVTT underwent liver resection with or without thrombectomy. These 438 patients were divided into 2 groups: in group A, PVTT was located in the hepatic resection area or protruded into the first branch of the main portal vein beyond the resection line for < 1 cm (286 patients), and in group B, PVTT extended into the main portal vein (1S2 patients). Concomitant thrombectomy was performed in 147 patients (51.4%) of group A and in all patients of group B. Results: PVTT recurrence within 6 months after surgery in group B was significantly higher than that in group A: 76.9% vs. 11.3%. Remnant liver recurrence within 1 year after surgery was 43.0% in group A and 78.8% in group B. The cumulative 1-, 2-. 3-, and 5-year overall survival rates were 58.7%, 39.9%, 22.7%, and 18.1% for group A and 39.5%. 20.4%, 5.7%, and 0% for group B, respectively. The overall survivals were significantly better in group A than group B (P < .02). Conclusions: Liver resection with thrombectomy yielded better outcomes in the HCC patients with PVTT confined to the first or second branch of the main portal vein compared with PVTT extending into the main portal vein.
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