2018年 · 第56卷第12期

Because the tumor located in segment 8 of the liver is deep and difficult to expose, the laparoscopic visual field and operation space are limited. Therefore, laparoscopic resection of segment 8 of liver cancer is still in the exploratory stage in clinic, especially for recurrent liver cancer located in segment 8 of the liver. Due to the influence of past liver surgery history, the adhesion of liver and surrounding organs will make laparoscopic surgery difficult again. At this time, laparoscopic resection of liver cancer through thoracic approach is a feasible choice. At present, only a few cases have been reported at home and abroad for laparoscopic resection of 8-segment liver cancer by thoracic approach^[1,2,3]However, laparoscopic resection of 8-segment recurrent liver cancer by thoracic approach is rarely reported. Recently, our department successfully performed a case of laparoscopic 8-segment recurrent liver cancer resection by thoracic approach. The report is as follows.

Rotator cuff injury is a common middle-aged and elderly disease. For patients with symptoms and ineffective conservative treatment, most of the surgical methods use rotator cuff suture with wire anchor, but the cost of internal fixation consumables is high, which increases the economic burden of patients. In recent years, the biomechanical and clinical research results of arthroscopic suture technique show that the suture strength of suture technique is similar to that of anchor with thread, the clinical effect is reliable, and it has many advantages, such as less bone occupation, increasing the effective contact area between tendon and bone, reducing the sliding amplitude of tendon at the inner row suture point, reducing the osteolysis probability around the postoperative fixation, obtaining better blood supply after suture of rotator cuff, and facilitating revision^{[1,2,3,4,5,6,7,8,9,10,11]}And the cost is low, which may become the development direction of rotator cuff suture technology in the future. From December 2017 to February 2018, 9 patients with rotator cuff injury were treated by arthroscopic bone-perforating suture technique in the Department of Sports Medicine of Wangjing Hospital, Chinese Academy of Chinese Medical Sciences, and the early clinical effect was observed, which was used as a reference for the clinical study of rotator cuff suture by bone-perforating suture.

Sleeve lobectomy can maximize the preservation of healthy lung tissue and improve the postoperative quality of life of patients while removing lung tumors^[1]It is especially suitable for elderly patients or patients with poor cardiorespiratory function. 2002, Santambrogio et al.^[2]The first case of total thoracoscopic sleeve lobectomy is reported. Compared with conventional multi-port thoracoscope, single-port thoracoscope technique is less invasive, but it is more difficult to operate and requires higher instruments. From August 2016 to September 2018, 128 cases of single-port total thoracoscopic sleeve lobectomy were completed in the same treatment group of thoracic surgery in our hospital. The experience is summarized and reported below.

Complex middle cerebral artery aneurysms are not uncommon in clinic, and there are many treatment methods, among which occlusion of tumor-bearing artery and tumor body is simple and effective. However, whether the tumor-bearing artery can be occluded, what methods should be used to occlude it, where to occlude it, and the compensation mode after occlusion need to be studied in depth. We have completed the superselective balloon occlusion test (BOT) and related treatment in 5 cases of complex aneurysms in the brain, and our experience is reported below.

PatientFemale, 43 years old, admitted to the ICU of our hospital on October 11, 2016 due to "abdominal pain for 3 days and dyspnea for 6 hours". The patient developed persistent epigastric pain after meals 3 days ago, accompanied by abdominal distension, nausea, and vomiting, and the vomit was stomach content. He was hospitalized in a local hospital and diagnosed with acute pancreatitis (AP). Acid inhibition, enzyme inhibition, anti-inflammation, fluid rehydration and symptomatic treatment were performed. Six hours ago, he had sudden dyspnea, so he was transferred to the ICU of our hospital for further treatment. At admission, the general condition was poor, with acute disease volume, cyanosis of the lips, coarse breathing sounds in both lungs, full abdomen, and positive total abdominal tenderness; Blood pressure 118/71 mmHg (1 mmHg =0.133 kPa), heart rate 111 beats/min, 30 breaths/min, blood oxygen saturation 85%, body temperature 38.5 ℃. Hematology: white blood cell count 15.06×10⁹/L, the percentage of neutrophils was 92.91%, and the procalcitonin was 0.16 μ g/L and the CRP was 260 mg/L by ELECSYS B·R·A·H·M·S procalcitonin kit of Roche, Switzerland. CT examination showed that the pancreas was thickened, the edges were rough, the pancreatic duct was not dilated, and the cords and dense shadows were seen around the pancreas. Consider AP, bilateral pleural effusion (Figure 1)。 Oxygen inhalation, vital signs detection, water fasting, gastrointestinal decompression, acid inhibition, enzyme inhibition, anti-inflammation, fluid rehydration, continuous renal replacement therapy, etc.

PatientMale, 58 years old. He came to our hospital on June 21, 2017 because of "anal exhaustion and defecation stopped for 3 days and persistent abdominal pain for 6 hours". Two weeks ago, the patient developed paroxysmal abdominal pain, vomiting, anal exhaustion and defecation, etc. After abstaining from drinking and fasting, the symptoms were relieved. Three days ago, the patient experienced abdominal pain again after eating a lot, showing paroxysmal distension and pain, without radioactivity and knife-like pain, accompanied by nausea and vomiting three times, which was non-jet vomiting, and the vomit was stomach contents and gastric juice, with a volume of about 50 ml/time. After vomiting, the symptoms were relieved, and then the anus stopped exhausting and defecating. After visiting a local hospital, plain CT examination showed obstruction of the colon and liver area. After treatment of fluid rehydration and abstinence from drinking and fasting, the patient's symptoms were not significantly relieved. Five hours ago, the patient had aggravated abdominal pain without obvious trigger, which was persistent without obvious relief, and his heart rate increased, ranging from 100 to 120 beats/min, and was transferred to our hospital for treatment. The patient was previously in good health.

Patient 1A 44-year-old female was admitted to hospital on 27 June 2013 for "7 years after radical resection for clear cell renal carcinoma, 1 month with anterior neck mass found". Physical examination: A ductile nodule with a maximum diameter of about 2 cm can be palpable on the front-right of the neck, and a ductile nodule with a maximum diameter of about 3 cm can be palpable on the front-left of the neck. The surface of the nodules is smooth, no tenderness, and can move up and down with swallowing. Ultrasound examination showed several mixed nodules in the left lobe of the thyroid gland, mainly solid echoes, with blood flow, the larger of which was 31.0 mm ×22.0 mm in size, and mixed nodules in the right lobe with abundant blood flow, 23.0 mm ×22.0 mm in size. There were no abnormalities in thyroid function. Partial bilobar thyroidectomy was performed. The intraoperative frozen pathological results were bilobar nodular goiter of the thyroid gland with multiple clear cell foci. Combined with the history of renal surgery, clear cell carcinoma metastasis of the kidney was not excluded. Postoperative pathological examination and immunohistochemical results showed that thyroid metastatic renal clear cell carcinoma (Figure 1)。 The patient underwent total residual thyroidectomy at 53 months after surgery due to recurrence of malignant tumor of residual thyroid glands. The postoperative pathological examination showed thyroid metastatic clear cell renal carcinoma. Current follow-up until 55th month after thyroid surgery, the patient is still alive.

The author of the paper "Multiple Technical Options for Reconstructing the Proximal Anchoring Area of Left Subclavian Artery Extension and Endovascular Repair of Thoracic Aortic Dissection" published in the 10th Issue of Volume 56 of our journal in 2018 should be "Department of Vascular Surgery, Provincial Hospital Affiliated to Shandong University", which is hereby corrected.