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Clinical Study of Laparoscopic Decortication Therapy for Patients with Autosomal Dominant Polycystic Kidney Disease

目的:观察经后腹腔镜肾囊肿去顶减压术治疗常染色体显性遗传性多囊肾病的临床效果。方法:2004~2007年经后腹腔镜囊肿去顶减压术治疗成人型多囊肾20例，术后随访6~36月，观察手术前后肾功能指标变化术后。结果:20例手术均获成功。平均手术时间71.0±5.28分钟，术后平均住院天数5±0.38天。结论:经后腹腔镜囊肿去顶减压术治疗多囊肾具有创伤小、出血少、恢复快等优点，是外科治疗成人型多囊肾安全有效的方法。

The role of artificial intelligence robot in the development of vascular surgery technology

Artificial intelligence in robot system is mainly divided into two types: endoscopic robot system and intracavitary robot navigation system. The endoscopic robot system can effectively shorten the time of vascular anastomosis and occlusion during vascular bypass surgery, while the intracavitary robot navigation system has good localization and real-time observation function. Moreover, it has significant advantages in complex lesions and special anatomical locations. High cost and complicated equipment debugging are the main factors that limit the wide application of robot systems. Artificial intelligence represented by robot system has obvious advantages and broad prospects in the field of vascular surgery, but more research is needed to improve its shortcomings and to further clarify its standard operation and long-term results.

Interpretation of the second update to the ninth edition of antithrombotic therapy guidelines for venous thromboembolism disease published by American College of Chest Physicians

Venous thromboembolism (VTE), comprising both deep vein thrombosis and pulmonary embolism, is a chronic illness that contributes significantly to the global burden of disease. The American College of Chest Physicians (ACCP) published the 9th edition of antithrombotic treatment guidelines for VTE (AT9) in 2012, which was first updated in 2016. In October 2021, ACCP published the 2nd update to AT9, which addressed 17 clinical questions related to VTE and presented 29 guidance statements in total. In this paper we interpreted the recommendations proposed in this update of the guidelines.

人工智能在血管外科的应用前景

Comparison of Retroperitoneal Laparoscopic and Open Decortication of Renal Cysts

目的:评估经后腹腔镜与开放肾囊肿去顶减压术的临床价值。方法:回顾性调查四川大学华西医院2004年4月至2008年4月468例经后腹腔镜肾囊肿去顶减压术(A组)和2003年4月至2008年4月121例开放肾囊肿去顶减压术(B组)的临床资料并进行比较,统计分析两种术式术前,术中和术后的数据资料,比如性别、年龄、侧别、囊肿直径、手术时间、术中出血量、术后下床时间、肛门排气时间、引流管拔除时间、术后住院天数、总住院天数等。开放手术均行肋缘下切口,经后腹腔镜均行腰部常规3孔穿刺。结果:所有手术均获成功。A组手术时间5318±095分,术中出血628±033mL,术后肛门排气时间2518±030h,术后下床时间3102±022h,引流管拔除时间2715±020h,术后住院490±007d,总住院895±012d;B组手术时间6772±148分,术中出血5116±077mL,术后肛门排气时间2691±033h,术后下床时间4331±103h,引流管拔除时间2963±079h,术后住院788±018d,总住院125±029d。术前两组基线对比无统计差异。A组手术时间、术中出血量、术后下床时间、总住院天数和术后住院天数均优于B组,差异具有统计学意义(Plt;001)。术后肛门排气时间及引流管拔除时间无显著性差异(Pgt;005)。结论〓:后腹腔镜肾囊肿去顶术在手术时间、术中出血量和术后下床时间等方面明显优于开放手术。

The feasibility study of bilingual teaching rounds in vascular surgery teaching

Objective To analyze the feasibility, possible problems and application of bilingual teaching rounds in vascular surgery teaching. Methods Ninety participants included internship, interns and residents of standardized training from 2015 to 2016 in vascular department of West China Hospital of Sichuan University were included. The questionnaire named the feasibility of bilingual rounds in surgery teaching was done and analyzed in all of these students. The results of the evaluation score from different teachers on their teaching process were also analyzed. Results Three groups could accept bilingual teaching rounds of this teaching form, and all of them were willing to be involved in, but their English levels and acceptance participate times were different. The CET4 levels of three groups did not have any difference; however, the CET6 levels had significant difference. There were significant differences in the preparation times and the review times (all P values <0.05), and there were no difference in acceptance, value and promote degree (all P values >0.1). In different teaching teachers' self assessment on the same objective, there was significant differences (all P values <0.05). Conclusion Bilingual rounds in surgery teaching have certain feasibility. Different adjustments are needed according to the English level and the grade, and higher request of the teacher is necessary.

Practice and thought on the application of new media-assisted teaching in clinical medical postgraduate education

The cultivation of clinical medical postgraduates is a way to provide qualified doctors for clinical practice, which is more focused on clinical practice. The cultivation of clinical medical postgraduates depends on their understanding of knowledge. In response to the problems existing in traditional education, the Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University has introduced new media into the cultivation of clinical medical postgraduates. New media can concretize abstract content, which is more conducive to improve learning efficiency. This article combines practical experience to explain the advantages, teaching effectiveness, challenges faced of new media, and how to better apply new media teaching.

颈动脉体瘤术中颈总- 颈内动脉转流及静脉移植血管重建

目的 总结颈动脉体瘤（carotid body tumor，CBT）外科治疗术中颈总- 颈内动脉转流、自体大隐静脉或颈内静脉移植血管重建的应用及效果。 方法 1991 年1 月－ 2008 年12 月，对4 例CBT 累及动脉壁者采用术中转流下切除CBT，自体大隐静脉或颈内静脉移植血管重建。男3 例，女1 例；年龄30 ～ 58 岁。左侧3 例，右侧1 例。瘤体大小4.5 cm × 3.0 cm × 2.5 cm ～ 8.0 cm × 6.0 cm × 5.0 cm。术前经彩超、MRI、CT 等明确诊断。 结果 4 例均顺利完成手术。术后发生声嘶和舌偏各2 例、呛咳和面部麻木各1 例，经对症治疗后好转。无呼吸困难、吞咽困难、脑梗死等并发症发生，无死亡。4 例均获随访，随访时间1 个月～ 5 年，未见复发，颈部未扪及包块。 结论 CBT 首选手术治疗，对累及动脉壁的CBT 术中采用颈总- 颈内动脉转流下切除瘤体、自体静脉移植血管重建，是一种安全、有效的治疗手段。

Interpretation of the European Society for Vascular Surgery (ESVS) 2022 clinical practice guidelines on the management of chronic venous disease of the lower limbs: Iliac vein diseases

The European Society for Vascular Surgery (ESVS) 2022 clinical practice guidelines showed us venous thrombosis management in January 2022. In terms of iliac vein diseases, it retained some guiding views, upgraded some guiding views, and added some new views compared with the version 2015. It has good guidance and reference significance for medical staff and patients. The part of the guidelines about iliac vein disease is worth our interpretation.

Correlation analysis of nutrition risk index in elderly patients with postoperative complications of abdominal aortic aneurysm

ObjectiveTo assess whether the geriatric nutritional risk index (GNRI) of elderly patients can be used as an evaluation index for complications after endovascular aneurysm repair (EVAR) of abdominal aortic aneurysm (AAA).MethodsA total of 265 patients with EVAR who received abdominal aortic aneurysm between January 2011 to December 2017 were included in this study from West China Hospital of Sichuan University. All patients included in this study were subrenal arterial AAA. Statistical analysis of clinical data was performed. The value of GNRI in evaluating postoperative complications of EVER patients was evaluated.ResultsOf the 372 patients, 158 were included in the GNRI abnormal group (GNRI≤98), and 214 were included in the normal group (GNRI>98). Univariate analysis showed that the age (P=0.04), drinking (P=0.04), serum albumin level (P<0.001), BMI (P<0.001), GNRI (P=0.004), and stroke (P<0.05) were risk factors that affects postoperative complications of AAA. Multivariate analysis showed that preoperative GNRI [HR=0.687, 95%CI: (0.487, 0.968), P=0.032] abnormality was one of the risk factors affecting postoperative complications of AAA.ConclusionFor patients undergoing endovascular aneurysm repair of abdominal aortic aneurysm, the GNRI is one of the important indicator for predicting postoperative complications.