Yamagata University Academic Repository
Not a member yet
6724 research outputs found
Sort by
16歳の非交通性副角子宮を伴う単角子宮に対し腹腔鏡下手術を行った1例
Get PDF論文(Article)非交通性副角子宮を伴う単角子宮はミュラー管発生異常による希な先天性子宮奇形である。典型的な症状は子宮留血腫と子宮内膜症による進行性の下腹部痛と月経困難症である。また、高頻度に腎尿路系の奇形を伴う。我々は重度の下腹部痛と月経困難症を呈した非交通性副角子宮を有する単角子宮の16歳の患者に対し、腹腔鏡による診断と加療を行った。診断的腹腔鏡検査と子宮鏡検査を施行し、非交通性副角子宮を伴う単角子宮と診断した。さらにGn-RH作動薬を投与して症状と子宮内膜症を改善させた後、腹腔鏡下に副角子宮摘出術を施行した。低侵襲で審美性に優れた腹腔鏡下手術は、非交通性副角子宮を伴う単角子宮の治療に有用である
Hepatic cyst reduction surgery and its significance for polycystic liver disease
Get PDF論文(Article)Purpose.
Although there have been many studies on polycystic liver disease (PCLD), most have not considered the effectiveness of computed tomography volumetry for liver resection as part of reduction surgery. In this study, we report the techniques used for liver resection in reduction surgery for PCLD and describe the theoretical basis.
Methods.
We performed clinical and imaging investigations in five patients with PCLD whose chief complaints were abdominal distention and early satiety.
Results.
The average plasma indocyanine green retention at 15 min (ICG R15), which indicates hepatic functional reserve, was 11.3 ± 6.7%, indicating moderate liver damage. The average galactosyl human serum albumin uptake during single photon emission tomography uptake for assessing asialoscintigraphy was 50.6% ± 17.8%, indicating slightly decreased uptake. The disease was present in both lobes of the liver in all patients except one, in whom PCLD was localized in the left lobe.
Because multiple cysts were present in the hepatic radial margin, we only resected cysts without the surrounding parenchyma when possible. The cyst walls were comparatively tough and firm. Because Glisson’s capsule was present between the cysts, resection was performed with double or triple ligation with transfixing sutures to prevent suture failure and postoperative biliary leakage. Only one patient reported symptom recurrence because of enlargement of cyst remnants.
The average preoperative and postoperative total liver volumes were 4644 ± 1813 cm3 and 2698 ± 1615 cm3, respectively, indicating a significant decrease (p < 0.01). The average preoperative cyst volume was 3765 ± 1780 cm3, which decreased to 1894 ± 1546 cm3 after surgery, indicating a significant 35% decrease in cyst volume (p < 0.01). The average preoperative and postoperative noncystic volumes were 880 ± 80 cm3 and 805 ± 173 cm3, respectively, indicating no significant loss of liver parenchyma.
Conclusion.
The goal of liver resection in PCLD is bulk reduction to alleviate abdominal distention and early satiety. All patients in this study were alive at the time of publication, indicating that the surgery allows patients to survive beyond a few years
算法貫通術（6）
Get PDF図書巻八は前編後編の2冊、巻十三に序あり、寛政5年12月、巻三十は２冊。巻三十五に逐斜内逐斜及累円整数術（会田）を附す。巻三十六は附録と合わせて７冊。巻二十四に算法貫通術巻之下（会田安明編）を附す。 佐久間文庫 . 最上流算
算法貫通術（7）
Get PDF図書巻八は前編後編の2冊、巻十三に序あり、寛政5年12月、巻三十は２冊。巻三十五に逐斜内逐斜及累円整数術（会田）を附す。巻三十六は附録と合わせて８冊。巻二十四に算法貫通術巻之下（会田安明編）を附す。 佐久間文庫 . 最上流算
算法貫通術（10）
Get PDF図書巻八は前編後編の2冊、巻十三に序あり、寛政5年12月、巻三十は２冊。巻三十五に逐斜内逐斜及累円整数術（会田）を附す。巻三十六は附録と合わせて１２冊。巻二十四に算法貫通術巻之下（会田安明編）を附す。 佐久間文庫 . 最上流算
