瘘

Methods: Fifty rabbits underwent left tube ureterocutaneostomy as a method of urinary diversion, all rabbits were divided randomly into five groups: the flushing group perfused immediately after ureterocutaneostomy, and the intrapelvic pressure is 60, 80, 100, 120 cmH2O, but the sham operated group didn't flush. Urinary albumin were examined every day after operation, we also got pathological examination of nephridial tissue continually.

分别建立左侧输尿管皮肤造口的动物模型：健康家兔50只，随机分为5组（每组10只），假手术组只造瘘不灌注，灌注组输尿管造瘘后立即行逆行灌注，灌注压力分别为60、80、100、120 cmH2O(1 cmH2O=0.098 kPa)，术后每天留取尿标本定量测定尿白蛋白，连续取肾组织行病理检查监测兔肾形态学改变。

objective:to explore the possibility and indication of surgical treatment of anastomotic recurrence following resection of cardiac carcinoma.method:reoperation was performed in 16 patients with anastomotic recurrence from 1992 to 2004.secondary resection was in 9(56.3%) and jejunostomy in 3.result:in 9 patients,pneumonia occurred in 3 and hydrothorax in 1 after secondary resection.

目的：探讨贲门癌术后吻合口复法癌再手术的可能和适应症。方法：回顾1992年至2004年我科尝试性行该手术16例，再次手术采用左胸切口和胸腹联合切口，手术切除9例（56.3%）；术中经胃造瘘术4例；行空肠造瘘术3例。结果：术后并发肺部感染3例；胸腔积液1例。

Results: All of 19 patients who received simple insertion and regular change of ureter stents experienced consistent improved renal function. Of 5 patients treated with antegrache or retrograde endoscopic ureterotomy/dilation and long-term indwelling of Di stent, 4 showed recovered and stable renal function, and 1 changed to nephrostomy because of unsatisfying outcomes. Three patients received permenant nephrostomy after unsuccessful endoscopic attempts and remained functionally uneventful.

结果：19例单纯输尿管内插入内支架管并定期更换，肾功能改善并基本保持稳定。5例采用顺行或逆行的输尿管镜内切开和／或扩张治疗，并长期停留双J管，4例肾功能有所恢复并稳定，1例效果不理想，改行肾造瘘。3例试行窥镜处理失败，改行长期肾造瘘，肾功能保持稳定。

Results In Onlay island flap group, there were 5 cases with urethral fistula （21%）, 1 case with neourethral dehiscence （4%）, and none with urethral stricture; In Snodgrass group, 7 cases with urethral fistula （18%）, 1 case with neourethral dehiscence （3%）, 1 case with outside of urethral stricture （3%）, 3 repeat surgery cases without complications.

结果：本组Onlay术有尿瘘5例（21％），阴茎头裂开1例（4％），无尿道狭窄；Snodgrass术有尿瘘7例（18％），阴茎头裂开1例（3％）。无尿道狭窄，但有尿道外口狭窄1例（3％），3例再次尿道成形术者未发生并发症。

Objective The influence of experimental perilymphatic fistula on inner ear morphology was investigated to establish an experimental model which could offer a warranty for cinical treatment.

目的：建立动物模型观察实验性外淋巴瘘对内耳形态学的影响，为临床治疗外淋巴瘘提供实验性依据。

Results CT scan indicated that cancer relapsed 3 to 84 months after surgery.For patients with colostomy,the CT scan showed nodular or lobulated mass in the areas of perineum and presacralis,as well as loss of presacral fat space.For patients without colostomy.CT finding included thickened rectal wall with unregular proximal tumor,rectal obliteration,rectostenosis and ddisplacement of perirectal fat space.

结果 肿瘤复发的CT表现：造瘘术后CT表现为会阴及骶前区肿块，呈结节状或分叶状，骶前脂肪间隙消失；无造瘘术后CT表现新直肠壁增厚伴不规则偏心性肿块，管腔狭窄及闭塞，直肠周围脂肪间隙狭窄移位。

During a median follow-up of 28.9 months, 39 (62%) of 63 suriing patients had one or more late complications: biliary stricture in 4 (6%), pseudocyst in 5 (8%), pancreatic fistula in 8 (13%), gastrointestinal fistula in 1 (2%), delayed collections in 3 (5%), and incisional hernia in 1 (2%); interention was required in 10 (16%) patients.

在接下来的平均28.9个月中，63位生存者中有39人（62%）发生一种或更多的远期并发症：胆道狭窄4人（6%），假囊肿形成5人（8%），胰瘘8人（13%），胃肠瘘1人（2%），延迟愈合3人（5%），切口疝1人（2%）；10人（16%）需要干预治疗。63位生存者中有16人（25%）的胰腺外分泌功能不全，58位无糖尿病史的病人中有19人（33%）的胰腺内分泌功能不全。

Type 3.The pudendal-thigh flap is based on the external pudendal artery.

阴道直肠瘘患者行瘘孔修复，也获得满意效果。

Objective To analyse the etiological factors of rectovaginal fistula and to summarize the experience of clinical treatment on rectovaginal fistula.

目的分析直肠阴道瘘的致病因素，总结直肠阴道瘘的临床治疗经验。

Rectovaginal Fistula/etiol ; Rectovaginal Fistula/ther ; Iatrogenic Disease

直肠阴道瘘/病因学；直肠阴道瘘/治疗；医源性疾病

The split between the two groups can hardly be papered over.

这两个团体间的分歧难以掩饰。

This approach not only encourages a greater number of responses, but minimizes the likelihood of stale groupthink.

这种做法不仅鼓励了更多的反应，而且减少跟风的可能性。