Objective To discuss the surgical management in resection of primary peritoneal tumors involving iliac vessels. Methods The clinical data of 124 patients with primary peritoneal tumors involving iliac vessels， that underwent surgical procedures from December 2006 to December 2011 were analyzed retrospectively. There were 68 menand 56 women with an age raging from 16-72 years old （mean 44 years old）. Results All patients underwent operative treatment. Fifty-two patients with tumors infiltrating or surrounding the major illiac vessels， 72 patients with tumors compressing the iliac vessels. Primary peritoneal tumors involving iliac vessels were completely resected in 90 patients， were incompletely resected in 31 patients， and were palliatively resected in 3 patients. Resectoin of primary peritoneal tumors and iliac vessel reconstruction were performed in 42 patients with tumors infiltrating or surrounding the major illiac vessels. There was no death during perioperative period. There were complications in 2 patients， that including urinary fistula in 1 patient and fat liquefaction of incision in 1 patient. Complications were not found in the rest of the patients. All patients were followed-up from 12-24 months （mean 16 months）. Thirty-eight patients relapsed locally in 90 patients with tumor completely resected. Nine patients died in those tumor incompletely resected（6 patients died because of recurrence， 3 patients died because of cadiovasuclar and cerebrovascular accidents）. Three patients follwing palliative resected were dead during the follow-up period （3 patients died because of recurrence）. Among the 42 patients underwent the procedure of iliac vessels， recurrence occured in 3 patients without involving iliac vessels， 1 patient relapsed involving inferior vena cava （IVC） which resulted in IVC obstruction and deep venous thrombosis following 7 months after operation. Recurrence occured in 2 patients involving common iliac veins following 8 months after operation. Venous thrombus of common iliac vein graft occured in 1 patientin in 10 months after operation. Conclusion Resection completely and involved iliac vessel reconstruction would reduce recurrence of tumor and promote long term survival in patients with primary peritoneal tumors involving iliac vessels
ObjectiveTo discuss the risk factors of type Ⅱ endoleak after endovascular aneurysm repair(EVAR). MethodsThe clinical data of 197 cases of abdominal aortic aneurysm who underwent EVAR in our hospital from Jan. 2006 to Mar. 2011 were analyzed retrospectively, and risk factors of type Ⅱ endoleak were explored by logistic regression. ResultsOf the 197 cases, 18 cases suffered from type Ⅱ endoleak. Result of logistic regression showed that the risk of type Ⅱ endoleak increased per 1 of the increase of lumbar artery number(OR=1.822, P=0.010) and per 1 mm of the increase of lumbar artery diameter(OR=1.256, P=0.040). All of the cases were followed up for 1-36 months(median value of 16.8 months). Only 1 case was intervened by inferior mesenteric artery embolism for the growth rate larger than 5 mm during half a year, who was not found growth of diameter after the embolism. The type Ⅱ endoleaks of other 17 cases closed ultimately or keeping stable. ConclusionsType Ⅱ endoleak after EVAR is affected by the number and diameter of lumbar artery. Persistent type Ⅱ endoleak without enlargement of diameter of aneurysm sac needs to beclosely followed-up instead of re-intervention.
Objective To summarize the present research progress of venous thromboembolism in the elderly. Methods Reviewed the literatures in recent years about the epidemiology, risk factors, diagnosis, prevention, and prognosis of venous thromboembolism in the elderly. Results Venous thromboembolism was a more common cardiovascular system diseases for the elderly, the incidence was higher, but the elderly didn’t pay much attention on it. The clinical manifestations of venous thromboembolism in elderly were different from young people, and all kinds of inspection methods had advantages and disadvantages. It gave priority to anticoagulation therapy, but we should pay attention to the risk of bleeding. Conclusions High incidence of venous thromboembolism was observed in the elderly, and diagnostic measures for venous thromboembolism were various. In the process of treatment, classification, the pros and cons were especially needed to pay attention to, and its special researches were necessary.
ObjectiveReporting a case of hybrid procedure of extensive thoracoabdominal aortic aneurysm (TAAA) with type B dissection due to Marfan syndrome (MFS) using a prosthetic graft as the distal landing zone for stent-graft.MethodsRetrospectively summarize in-hospital profiles of a patient for who was diagnosed as MFS complicated with TAAA and type B dissection and admmited to Vascular Surgery Department of West China Hospital in May 2018. A GORE-TEX 18 mm×9 mm Y-shaped graft was sewn side-to-end to the bifurcation of left common iliac artery as the inflow site, and a self-made penta-limb graft was sewn side-to-end to the bifurcation of the 18 mm graft. The visceral and bilateral iliac arteries were reconstructed subsequently. Then, the release of the stent-graft was designed from distal to proximal. The distal part of the stent-graft was anchored into the main body of the 18 mm Y-shaped graft.ResultsThe patient underwent the operation successfully with a duaration of 6 h, blood loss of about 800 mL. No serious postoperative complications occurred. Computed tomography angiography at 2-year follow-up showed that the bypass grafts were patent without endoleak, stent migration, stent infolding or infections of the vessel graft and endograft.ConclusionThis modified management of the landing zone could be a proper choice for this kind of rare case as extensive aneurysm or dissection involved in patients with MFS.
Main iliac artery disease is a common lesion that leads to arteriosclerosis and occlusion of the lower limbs. Effective treatment of complex main iliac artery disease has always been a difficult problem. The author’s team successfully treated a patient with long segment iliac artery occlusive disease from the left common iliac artery to the opening of the left femoral artery (118 mm) with Gore viabahn VBX balloon dilated intravascular covered stent and viabahn covered stent, and be reported.
Objective To learn and analyse the current clinicians’ knowledge and attitudes towards patient safety, and to provide relevant evidence for future medical education. Method We conducted a survey on clinicians mainly in West China Hospital of Sichuan University with group random sampling method. We analysed the data on the clinicians’ knowledge and attitudes with SPSS softerware. Result Totally 300 questionnaires were distributed, of which 258 were completed adequately. The results showed the clinicians’ knowledge on patient safety was poor, however, the respcnse from the clinicians in Outpatient Department were better than those in Inpatient Department. The majority of the clinicians (above 95.00%) were willing to learn the knowledge of patient safety. Conclusion As the clinicians are willing to learn the knowledge of patient safety positively, it is necessary to integrate patient safety education into the current medical education curriculum.
ObjectiveTo summarize the current research progress on the relationship between thyroid cancer and venous thromboembolism.MethodsRetrieved the literatures about risk factors associated with thyroid cancer and venous thromboembolism both at home and abroad in recent years and reviewed the literatures.ResultsThe incidence of venous thromboembolism in patients with thyroid cancer was not high, and there were few factors related to risk factors, it might be related to the age of patient and the time of diagnosis of thyroid cancer. In addition, various types of therapeutic drugs for thyroid cancer might lead to the occurrence of venous thromboembolism.ConclusionsThe study of thyroid cancer and venous thromboembolism related factors and prethrombotic state occurrence are necessary to reduce the incidence of venous thromboembolism in thyroid cancer and improve prognosis.