Objective To explore the operative result of intrarectal proctoptosis accompanying hernia of pelvic floor due to common outlet obstructive constipation(OOC).MethodsEleven cases of intrarectal proctoptosis with of pelvic floor surgically treated were analysed. Results In a week following operation, 9 of 11 patients’ symptoms disappeared, the other 2 cases recovered after 3 months, functional exercise. Conclusion Functional rectal suspension combined with repair of pelvic, partial sigmoidectomy, surgical elevation of pelvic floor and hysteropexy are highly effective in alleviating symptoms in patients with intrarectal proctoptosis accompanying pelvic floor herniation.
ObjectiveTo explore the effect of using a stent graft to treat a Stanford type A aortic dissection with the ascending aorta in the cavity.MethodA retrospective review was made of the clinical data of a patient with Stanford type A aortic dissection admitted to Zhangye People’s Hospital Affiliated to Hexi University in December 2016.ResultsAfter the patient underwent general anesthesia aortic dissection and stent graft treatment, the dissection fracture completely disappeared. After 2 years of follow-up, the patient’s pseudocavity hematoma was completely absorbed. The operative time was 30 min and the blood loss was about 5 mL. There were no complications such as avulsion of dissection, internal leakage, cerebral infarction, myocardial infarction, nervous system, and other complications occurred.ConclusionFor Stanford type A aortic dissection with a tear located in the ascending aorta, intracavitary treatment with coated stent is feasible for ascending aortic dissection with good vascular conditions and tear location through accurate preoperative assessment.
Objective To explore the clinical presentation and diagnosis and treatment of prehepatic portal hypertension （PPH） and discuss its surgical strategies. Methods Forty-six cases of PPH treated in the 2nd Artillery General Hospital and Peking Union Medical College Hospital from January 2000 to May 2009 were analyzed retrospectively, including 2 cases of Abernethy abnormality. All patients were evaluated by indirect portal vein angiography, CT angiography and (or) portal duplex system Doppler ultrasonography before treament. Surgical strategies included: 23 cases with meso-caval shunt, 8 cases with splenectomy and spleno-renal vein shunt, 1 case with porta-caval shunt, 2 cases with paraumbilical vein-jugular vein shunt, 3 cases with portal azygous disconnection, 1 cases with splenectomy and portal azygous disconnection, 1 case with sigmoidostomy and closed the fistula of sigmoid six months later, 1 case with resection of part of small intestine due to acute extensive thrombosis of portal vein system, 4 cases with selective superior mesenteric artery and (or) splenic artery thrombolytic infusion therapy, 2 cases remained no-surgical option and underwent conservative treatment. Results Forty-four patients were followed-up from 2 months to 5 years， average of 23.4 months, one patient without surgical treatment was lost. Satisfactory outcomes were obtained in 34 patients with various shunts, which expressed as a release of hypersplenism and gastrointestinal hemorrhage. Two cases were treated with meso-caval shunt because of rehemorrhage in month 13 and 24 and one died in month 8 after disconnection, one died on day 40 after thrombolytic therapy due to putrescence of intestines, one who remained no-surgical option underwent hemorrhage 4 months later, and then went well by conservative treatment. Conclusion The key of treatment of PPH is to reduce the pressure of hepatic portal vein. Surgical managements of shunt and selective superior mesenteric artery and (or) splenic artery thrombolytic infusion therapy are safe and effective, but individual treatment strategy should be performed.