<meta charset="utf8"></head><body>局部麻醉下显微外科精索静脉曲张摘除术

<ol>
	<li>Alsaikhan, B., Alrabeeah, K., Delouya, G., Zini, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Epidemiology+of+varicocele.">Epidemiology of varicocele.</a> Asian J Androl. 18 (2), 179-181 (2016).</li><li>Damsgaard, J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Varicocele+is+associated+with+impaired+semen+quality+and+reproductive+hormone+levels:+A+study+of+7035+healthy+young+men+from+six+European+countries.">Varicocele is associated with impaired semen quality and reproductive hormone levels: A study of 7035 healthy young men from six European countries.</a> Eur Urol. 70 (6), 1019-1029 (2016).</li><li>Gupta, C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Microscopic+varicocelectomy+as+a+treatment+option+for+patients+with+severe+oligospermia.">Microscopic varicocelectomy as a treatment option for patients with severe oligospermia.</a> Investig Clin Urol. 59 (3), 182-186 (2018).</li><li>Addar, A. M., Nazer, A., Almardawi, A., Al Hathal, N., Kattan, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+yield+of+microscopic+varicocelectomy+in+men+with+severe+oligospermia.">The yield of microscopic varicocelectomy in men with severe oligospermia.</a> Urol Ann. 13 (3), 268-271 (2021).</li><li>Saredi, G., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Feasibility+of+local+anesthesia+for+varicocele+correction+in+one-day-surgery+setting.+A+single+center+experience.">Feasibility of local anesthesia for varicocele correction in one-day-surgery setting. A single center experience.</a> Arch Ital Urol Androl. 93 (2), 233-236 (2021).</li><li>Jensen, C. F. S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Varicocele+and+male+infertility.">Varicocele and male infertility.</a> Nat Rev Urol. 14 (9), 523-533 (2017).</li><li>Baazeem, A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Varicocele+and+male+factor+infertility+treatment:+A+new+meta-analysis+and+review+of+the+role+of+varicocele+repair.">Varicocele and male factor infertility treatment: A new meta-analysis and review of the role of varicocele repair.</a> European Urol. 60 (4), 796-808 (2011).</li><li>Maheshwari, A., Muneer, A., Lucky, M., Mathur, R., Mceleny, K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+review+of+varicocele+treatment+and+fertility+outcomes.">A review of varicocele treatment and fertility outcomes.</a> Hum Fertil (Camb). 25 (2), 209-216 (2020).</li><li>&#199;ayan, S., Akbay, E., Saylam, B., Kad&#305;o&#287;lu, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Effect+of+varicocele+and+its+treatment+on+testosterone+in+hypogonadal+men+with+varicocele:+Review+of+the+literature.">Effect of varicocele and its treatment on testosterone in hypogonadal men with varicocele: Review of the literature.</a> Balkan Med J. 37 (3), 121-124 (2020).</li><li>Ulusoy, O., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Successful+outcomes+in+adolescent+varicocele+treatment+with+high-level+laparoscopic+varicocelectomy.">Successful outcomes in adolescent varicocele treatment with high-level laparoscopic varicocelectomy.</a> J Pediatr Surg. 55 (8), 1610-1612 (2020).</li><li>Mehta, A., Goldstein, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Microsurgical+varicocelectomy:+A+review.">Microsurgical varicocelectomy: A review.</a> Asian J Androl. 15 (1), 56-60 (2013).</li><li>Marmar, J. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+evolution+and+refinements+of+varicocele+surgery.">The evolution and refinements of varicocele surgery.</a> Asian J Androl. 18 (2), 171-178 (2016).</li><li>Wang, X., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Prospective+comparison+of+local+anesthesia+with+general+or+spinal+anesthesia+in+patients+treated+with+microscopic+varicocelectomy.">Prospective comparison of local anesthesia with general or spinal anesthesia in patients treated with microscopic varicocelectomy.</a> J Clin Med. 11 (21), 6397 (2022).</li><li>Al-Kandari, A. M., Shabaan, H., Ibrahim, H. M., Elshebiny, Y. H., Shokeir, A. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Comparison+of+outcomes+of+different+varicocelectomy+techniques:+Open+inguinal,+laparoscopic,+and+subinguinal+microscopic+varicocelectomy:+A+randomized+clinical+trial.">Comparison of outcomes of different varicocelectomy techniques: Open inguinal, laparoscopic, and subinguinal microscopic varicocelectomy: A randomized clinical trial.</a> Urology. 69 (3), 417-420 (2007).</li></ol>

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>0.9% sodium chloride solution</td>
			<td>Guangdong Otsuka Pharmaceutical Co. LTD</td>
			<td>21M1204</td>
			<td>Preparation for injection of medication during surgery</td>
		</tr>
		<tr>
			<td>20 MHz Microvascular Doppler System</td>
			<td>Vascular Technology, Inc.</td>
			<td>102802</td>
			<td>Doppler ultrasound was used to identify the spermatic artery</td>
		</tr>
		<tr>
			<td>4-0 coated, Braided Silk</td>
			<td>Jiasheng Medical Products Co., Ltd</td>
			<td>1600-31</td>
			<td>Ligation of spermatic vein</td>
		</tr>
		<tr>
			<td>5-0 absorbable surgical suture</td>
			<td>HORCON</td>
			<td>MY313G4</td>
			<td>Skin and fascial suture</td>
		</tr>
		<tr>
			<td>6-0 absorbable surgical suture</td>
			<td>HORCON</td>
			<td>JE1264</td>
			<td>Deep tissue suturing</td>
		</tr>
		<tr>
			<td>Compound lidocaine cream</td>
			<td>Tongfang Pharmaceutical Group</td>
			<td>H20063466</td>
			<td>25mg of propacaine and 25mg of lidocaine per gram for epidermal infiltration anesthesia</td>
		</tr>
		<tr>
			<td>Dianerkang Iodophor Skin Disinfectant</td>
			<td>Shanghai Likang Disinfectant HI-Tech Co,Lid</td>
			<td>31005102</td>
			<td>For skin disinfection and the effective iodine content is from 4.5g/L-5.5g/L</td>
		</tr>
		<tr>
			<td>electrotome</td>
			<td>Shanghai Hutong Electronics Co., Ltd</td>
			<td>GD350-B</td>
			<td>Used to cut open the fascia layer</td>
		</tr>
		<tr>
			<td>Fosfomycin Trometamol Powder</td>
			<td>Shanxi C&#38;Y Pharmaceutical Group Co., Ltd.</td>
			<td>H19994124</td>
			<td>Oral antibiotics for infection prevention</td>
		</tr>
		<tr>
			<td>haemostatic forceps</td>
			<td>SHINVA</td>
			<td>ZH240RN</td>
			<td>Used in surgical procedures</td>
		</tr>
		<tr>
			<td>Lidocaine Hydrochloride Injection</td>
			<td>Shanghai Harvest Pharmaceutical Co., Ltd</td>
			<td>H20023777</td>
			<td>Mixed with Ropivocoine Hydrochloride injection for deep infiltration anesthesia</td>
		</tr>
		<tr>
			<td>methylene blue</td>
			<td>JUMPCAN</td>
			<td>H32025285</td>
			<td>Skin marker</td>
		</tr>
		<tr>
			<td>micro scissors</td>
			<td>SHINVA</td>
			<td>ZF123RN</td>
			<td>Used in surgical procedures</td>
		</tr>
		<tr>
			<td>micro tweezers</td>
			<td>SHINVA</td>
			<td>ZD274RN</td>
			<td>Used in surgical procedures</td>
		</tr>
		<tr>
			<td>needle holder</td>
			<td>SHINVA</td>
			<td>ZM234R/RN/RB</td>
			<td>Used in surgical procedures</td>
		</tr>
		<tr>
			<td>NeutroPhase</td>
			<td>NovaBay Pharmaceuticals,Inc</td>
			<td>CA 94608 USA</td>
			<td>Wound Cleanser</td>
		</tr>
		<tr>
			<td>ophthalmic scissors</td>
			<td>SHINVA</td>
			<td>ZC120R/RN/RB</td>
			<td>Used in surgical procedures</td>
		</tr>
		<tr>
			<td>Ropivocoine Hydrochloride injection</td>
			<td>Jiangsu Hengrui Pharmaceuticals Co., Ltd</td>
			<td>H20060137</td>
			<td>Mixed with Lidocaine Hydrochloride Injection for deep infiltration anesthesia</td>
		</tr>
		<tr>
			<td>Surgical Microscope</td>
			<td>Carl Zeiss Meditec AG</td>
			<td>20162224730</td>
			<td>for microscopic operations</td>
		</tr>
		<tr>
			<td>Titanium Clips</td>
			<td>WECK HORIZON</td>
			<td>002200</td>
			<td>used to clamp vena cava</td>
		</tr>
		<tr>
			<td>Titanium Clips</td>
			<td>WECK HORIZON</td>
			<td>005200</td>
			<td>used to clamp venule</td>
		</tr>
	</tbody>
</table>

microscopic varicocelectomy under local anesthesia as the treatment of varicocele

<meta charset="utf8"></head><body>作者聚焦:通过增强的手术技术推进精索静脉曲张治疗

局部麻醉下显微精索静脉曲张切除术治疗精索静脉曲张

Varicocele, characterized by the dilation of veins within the spermatic cord, is a prevalent disease in males, accounting for 35%-40% of infertility cases ...

microscopic-varicocelectomy-under-local-anesthesia-as-treatment

Research

JoVE Journal

Medicine

Microscopic Varicocelectomy under Local Anesthesia as the Treatment of Varicocele

1.4K 次观看.  Affiliated Hospital of Shanghai Institute for Biomedical and Pharmaceutical Technologies. 精索静脉曲张与育龄期 35% 至 40% 的男性不育病例有关。全球公认的治疗这种疾病的方法是在全身麻醉下进行显微精索静脉曲张切除术。该方案展示了这种使用局部麻醉来提高患者舒适度并降低财务成本的手术。这个新的应该会大大缩短所需的手术时间，并为不能接受全身麻醉的患者提供机会。在局部麻醉下，我们可以更清楚地观察有症状的小?...

视频: 作者聚焦:通过增强的手术技术推进精索静脉曲张治疗

Isolated Hepatic Perfusion as a Treatment for Liver Metastases of Uveal Melanoma

Isolated hepatic perfusion (IHP) is a procedure where the liver is surgically isolated and perfused with a high concentration of the chemotherapeutic agent melphalan. Briefly, the procedure starts with the setup of a percutaneous veno-venous bypass from the femoral vein to the external jugular vein. Via a laparotomy, catheters are then inserted into the proper hepatic artery and the caval vein. The portal vein and the caval vein, both supra- and infrahepatically, are then clamped. The arterial and venous catheters are connected to a heart lung machine and the liver is perfused with melphalan (1 mg/kg body weight) for 60 min. This way it is possible to locally perfuse the liver with a high dose of a chemotherapeutic agent, without leakage to the systemic circulation.
In previous studies including patients with isolated liver metastases of uveal melanoma, an overall response rate of 33-100% and a median survival between 9 and 13 months, have been reported. The aim of this protocol is to give a clear description of how to perform the procedure and to discuss IHP as a treatment option for liver metastases of uveal melanoma.

Here, we present a protocol how to perform an isolated liver perfusion (IHP) with melphalan and we also discuss IHP as a treatment option for liver metastases of uveal melanoma.

隔离肝脏灌注作为治疗葡萄膜黑色素瘤肝转移

Isolated hepatic perfusion (IHP) is a procedure where the liver is surgically isolated and perfused with a high concentration of the chemotherapeutic ...

科研

医学

MRI-guided dmPFC-rTMS as a Treatment for Treatment-resistant Major Depressive Disorder

Here we outline the protocol for magnetic resonance imaging (MRI) guided repetitive transcranial magnetic stimulation (rTMS) to the dorsal medial prefrontal cortex (dmPFC) in patients with major depressive disorder (MDD). Technicians used a neuronavigation system to process patient MRIs to generate a 3-dimensional head model. The head model was subsequently used to identify patient-specific stimulatory targets. The dmPFC was stimulated daily for 20 sessions. Stimulation intensity was titrated to address scalp pain associated with rTMS. Weekly assessments were conducted on the patients using the Hamilton Rating Scale for Depression (HamD17) and Beck Depression Index II (BDI-II). Treatment-resistant MDD patients achieved significant improvements on both HAMD and BDI-II. Of note, angled, double-cone coil rTMS at 120% resting motor threshold allows for optimal stimulation of deeper midline prefrontal regions, which results in a possible therapeutic application for MDD. One major limitation of the rTMS field is the heterogeneity of treatment parameters across studies, including duty cycle, number of pulses per session and intensity. Further work should be done to clarify the effect of stimulation parameters on outcome. Future dmPFC-rTMS work should include sham-controlled studies to confirm its clinical efficacy in MDD.

Here we outline the procedure for MRI-guided repetitive transcranial magnetic stimulation to the dorsomedial prefrontal cortex as an experimental treatment for major depressive disorder.

MRI引导dmPFC-rTMS治疗作为治疗难治性抑郁症

Here we outline the protocol for magnetic resonance imaging (MRI) guided repetitive transcranial magnetic stimulation (rTMS) to the dorsal medial ...

Network Analysis of Foramen Ovale Electrode Recordings in Drug-resistant Temporal Lobe Epilepsy Patients

Approximately 30% of epilepsy patients are refractory to antiepileptic drugs. In these cases, surgery is the only alternative to eliminate/control seizures. However, a significant minority of patients continues to exhibit post-operative seizures, even in those cases in which the suspected source of seizures has been correctly localized and resected. The protocol presented here combines a clinical procedure routinely employed during the pre-operative evaluation of temporal lobe epilepsy (TLE) patients with a novel technique for network analysis. The method allows for the evaluation of the temporal evolution of mesial network parameters. The bilateral insertion of foramen ovale electrodes (FOE) into the ambient cistern simultaneously records electrocortical activity at several mesial areas in the temporal lobe. Furthermore, network methodology applied to the recorded time series tracks the temporal evolution of the mesial networks both interictally and during the seizures. In this way, the presented protocol offers a unique way to visualize and quantify measures that considers the relationships between several mesial areas instead of a single area.

This protocol describes a procedure to track the evolution of mesial network measures in temporal lobe epilepsy (TLE) patients. It is based on the combination of intracranial recordings with a novel numerical technique for data analysis. Specifically, we present a protocol for network analyses of foramen ovale recordings.

在耐药性颞叶癫痫患者卵圆孔电极记录的网络分析

Approximately 30% of epilepsy patients are refractory to antiepileptic drugs. In these cases, surgery is the only alternative to eliminate/control ...

Topical Airway Anesthesia for Awake-endoscopic Intubation Using the Spray-as-you-go Technique with High Oxygen Flow

A patient&#39;s willingness to cooperate is an absolute precondition for successful awake intubation of the trachea. Whilst drug-sedation of patients can jeopardize their spontaneous breathing, topical anesthesia of the airway is a popular technique. The spray-as-you-go technique represents one of the simplest opportunities to anesthetize the airway mucosa. The application of local anesthetic through the working channel of the flexible endoscope is a widespread practice for anesthetists as well as pulmonologists. There is neither need for additional devices nor special training as a pre-requisite to perform this technique. However, a known clinical problem is the coughing and gagging reflex that may occur when the liquid anesthetic strikes the airway mucosa and other sensitive structures like the vocal cords. This can be avoided by the use of oxygen applied through the working channel with the aim of fogging the local anesthetic into finer particles. Furthermore, the oxygen flow provides a higher oxygen supply and contributes to a better view, dispersing mucus secretions and blood away from the lens. Using an atomizer with a high oxygen flow of 10 L/min we maximized these benefits, caused less coughing and had more satisfied and therefore cooperative patients. Possible, but very rare complications of using oxygen flow including gastric insufflation, organ rupture or barotrauma did not arise. We attribute the complication-free use of high oxygen flow to the design of the set, which permits flow and pressure release.

The topical anesthetic lidocaine was atomized using a high oxygen flow through the working channel of a flexible intubating endoscope to achieve topical airway anesthesia for awake endotracheal intubation. We prefer this modified spray-as-you-go technique for endoscopic intubation to classical bolus application because of higher patient satisfaction and better compliance.

气道局部麻醉清醒用于内镜插管使用喷雾为你去技术在高氧流量

A patient&#39;s willingness to cooperate is an absolute precondition for successful awake intubation of the trachea. Whilst drug-sedation of patients can ...

Novel Methods for Intranasal Administration Under Inhalation Anesthesia to Evaluate Nose-to-Brain Drug Delivery

Intranasal administration has been reported to be a potential pathway for nose-to-brain delivery of therapeutic agents that circumvents the blood-brain barrier. However, there have been few reports regarding not only the quantitative analysis but also optimal administration conditions and dosing regimens for investigations of nose-to-brain delivery. The limited progress in research on nose-to-brain pathway mechanisms using rodents represents a significant impediment in terms of designing nose-to-brain delivery systems for candidate drugs.
To gain some headway in this regard, we developed and evaluated two novel methods of stable intranasal administration under inhalation anesthesia for experimental animals. We also describe a method for the evaluation of drug distribution levels in the brain via the nose-to-brain pathway using radio-labeled [14C]-inulin (molecular weight: 5,000) as a model substrate of water-soluble macromolecules.
Initially, we developed a pipette-based intranasal administration protocol using temporarily openable masks, which enabled us to perform reliable administration to animals under stable anesthesia. Using this system, [14C]-inulin could be delivered to the brain with little experimental error.
We subsequently developed an intranasal administration protocol entailing reverse cannulation from the airway side through the esophagus, which was developed to minimize the effects of mucociliary clearance (MC). This technique led to significantly higher levels of [14C]-inulin, which was quantitatively detected in the olfactory bulb, cerebrum, and medulla oblongata, than the pipette method. This appears to be because retention of the drug solution in the nasal cavity was substantially increased by active administration using a syringe pump in a direction opposite to the MC into the nasal cavity.
In conclusion, the two methods of intranasal administration developed in this study can be expected to be extremely useful techniques for evaluating pharmacokinetics in rodents. The reverse cannulation method, in particular, could be useful for evaluating the full potential of nose-to-brain delivery of drug candidates.

Here, we describe two novel methods of stable intranasal administration under inhalation anesthesia with minimal physical stress for experimental animals. We also describe a method for quantitative evaluation of drug distribution levels in the brain via the nose-to-brain pathway using radiolabeled [14C]-inulin as a model substrate of water-soluble macromolecules.

吸入麻醉下鼻内给药评价鼻腔给脑药物的新方法

Intranasal administration has been reported to be a potential pathway for nose-to-brain delivery of therapeutic agents that circumvents the blood-brain ...

CO2-Lasertonsillotomy Under Local Anesthesia in Adults

Tonsil-related complaints are very common among the adult population. Tonsillectomy under general anesthesia is currently the most performed surgical treatment in adults for such complaints. Unfortunately, tonsillectomy is an invasive treatment associated with a high complication rate and a long recovery time. Complications and a long recovery time are mostly related to removing the vascular and densely innervated capsule of the tonsils. Recently, CO2-lasertonsillotomy under local anesthesia has been demonstrated to be a viable alternative treatment for tonsil-related disease with a significantly shorter and less painful recovery period. The milder side-effect profile of CO2-lasertonsillotomy is likely related to leaving the tonsil capsule intact. The aim of the current report is to present a concise protocol detailing the execution of CO2-lasertonsillotomy under local anesthesia. This intervention has been performed successfully in our hospital in more than 1,000 patients and has been found to be safe and to be associated with a steep learning curve.

CO2-Lasertonsillotomy Under Local Anesthesia in Adults

CO2-lasertonsillotomy under local anesthesia is an interesting alternative treatment method for tonsillectomy under general anesthesia for tonsil-related complaints in adults. This report presents a step-by-step protocol detailing the execution of CO2-lasertonsillotomy under local anesthesia.

CO2- 成人局部麻醉下的激光切除术

Tonsil-related complaints are very common among the adult population. Tonsillectomy under general anesthesia is currently the most performed surgical ...

Electroretinogram Recording for Infants and Children under Anesthesia to Achieve Optimal Dark Adaptation and International Standards

Electroretinogram (ERG) is the only clinical objective test available to assess retinal function. Full-field ERG (ffERG) measures the panretinal rod and cone photoreceptor function as well as inner retinal function and is an important measure in the diagnosis and management of inherited retinal diseases as well as inflammatory, toxic, and nutritional retinopathies. Adhering to international standards and maintaining retinal dark adaptation are critical to acquire valid and reliable dark-adapted (scotopic) and light-adapted (photopic) ffERG responses. Performing ffERG in infants and children is challenging and often requires general anesthesia in the operating room. However, maintaining retinal dark adaptation in the operating room is becoming increasingly difficult given the numerous light sources from anesthesiology monitoring systems and other equipment. A practical and widely applicable method for ffERG testing is described in the operating room that optimizes retinal dark adaptation. The method reduces operating room time by dark-adapting the patient before general anesthesiology is instituted. The operating room is modified for dark adaptation and any remaining light source in the darkened operating room is minimized with the use of a modified portable foldable darkroom that encloses the patient&#8217;s head and the ERG examiner during ffERG scotopic recordings. The simple method adheres to ffERG international standards and provides valid reliable scotopic and photopic ffERG recordings that are critical to assess objective retinal function in this young age group where subjective assessment of visual function such as visual acuity and visual fields are not possible. Furthermore, the ffERG is the gold standard clinical test in detecting early onset inherited retinal diseases including Leber congenital amaurosis where approved gene therapy has become available. In sedated conditions, very low amplitude ffERG signals can be detected due to minimal orbicularis muscle activity interference, which is particularly relevant in patients after gene therapy to detect improved amplitude responses.

Adhering to international standards and maintaining retinal dark adaptation are critical to acquire valid full-field electroretinogram responses in the diagnosis and management of inherited retinal diseases. A practical protocol using a portable darkroom is provided to obtain full-field&#160;electroretinogram for infants and children under sedation or general anesthesia in the operating room setting.

麻醉下婴儿和儿童电雷电图记录，实现最佳黑暗适应和国际标准

Electroretinogram (ERG) is the only clinical objective test available to assess retinal function. Full-field ERG (ffERG) measures the panretinal rod and ...

Microscopic Cyst Resection for the Treatment of Patients Diagnosed with Epididymal Cyst

Epididymal cysts mostly occur in men aged 20-40 years old. Previous reports have covered concerns about postoperative complexes, including postoperative asoedema, hematoma, sustaining pain, and seminal tract obstruction in patients who have undertaken nonmicroscopic epididymal cyst resection or epididymal resection. Nonmicroscopic epididymal cyst surgery is suggested for patients with childbirth plans as a precaution. The treatment of male epididymal cysts via microtechnology is obviously a beneficial option; we took the lead in carrying out microscopic epididymal exploration and cyst resection surgery in China. From September 2017 to April 2021, 41 young and middle-aged male patients diagnosed with epididymal cysts underwent microtechnology treatment in a program titled &#34;microscopic epididymal exploration and cystectomy&#34;. The postoperative follow-up lasted for 3-50 months. The results confirmed that, as microscopic manipulation largely improved visualization of the subtle tissue structures of the epididymis, the cyst could be clearly dissected apart and completely removed intact under the microscope. Bleeding during the operation was significantly reduced (2-3 mL) and wound drainage was not required. According to follow-up data, microscopic treatment significantly reduced the incidence of postoperative scrotal hematoma, edema, and long-term postoperative pain, thereby promising a higher surgical success rate as well as recurrence prevention. Besides, preliminary experience and reflection suggest that microscopic epididymal exploration and cystectomy provide efficient preservation of the epididymal patency through refined treatment, while a better prognosis can be achieved. We recommend that surgery be carried out before the epididymal cyst develops to 0.8 cm in diameter, for fear that a larger epididymal cyst (&#62;0.9 cm in diameter) could cause the complete destruction of all tubules of the ipsilateral epididymis - a more severe case with damage to the testicular output network.

Here, we present a protocol to treat patients diagnosed with an epididymal cyst using microscopic cyst resection. Based on microscopic manipulation, a largely improved visualization of the subtle tissue structures of the epididymis was obtained, so the cyst could be clearly dissected apart and completely removed intact.

显微镜囊肿切除术治疗诊断为附睾囊肿的患者

Epididymal cysts mostly occur in men aged 20-40 years old. Previous reports have covered concerns about postoperative complexes, including postoperative ...

保留自主呼吸的视频辅助胸腔镜手术的非插管方案

Non-Intubated Video-Assisted Thoracoscopic Surgery

Double-lumen intubation under general anesthesia is currently the most commonly performed intubation technique for pneumonectomy, wedge resection of the lung, and lobectomy. However, there is a high incidence of pulmonary complications arising from general anesthesia with tracheal intubation. Non-intubation with the preservation of voluntary breathing is an alternative to anesthesia. Non-intubation procedures minimize the adverse effects of tracheal intubation and general anesthesia, such as intubation-related airway trauma, ventilation-induced lung injury, residual neuromuscular blockade, and post-operative nausea and vomiting. However, the steps for non-intubation procedures are not detailed in many studies. Here, we present a concise non-intubated protocol for the performance of video-assisted thoracoscopic surgery with preserved autonomic breathing. This article identifies the conditions necessary to convert from non-intubated to intubated anesthesia and also discusses the advantages and limitations of non-intubated anesthesia. In this work, this intervention was performed on 58 patients. In addition, the results of a retrospective study are presented. Compared with intubated general anesthesia, patients in the non-intubated video-assisted thoracic surgery group had lower rates of post-operative pulmonary complications, shorter operative times, less intraoperative blood loss, shorter PACU stays, a lower number of days to chest drain removal, less post-operative drainage, and shorter hospital stays.

作者聚焦: 一种具有多模式镇痛和七氟烷吸入麻醉的非插管视频辅助胸腔镜手术 

Here, we present a non-intubated protocol for performing video-assisted thoracoscopic surgery with preserved autonomic breathing.

非插管视频辅助胸腔镜手术

Double-lumen intubation under general anesthesia is currently the most commonly performed intubation technique for pneumonectomy, wedge resection of the ...