Since the first laparoscopic splenectomy(LS)was reported in 1991,LS has become the gold standard for the removal of normal to moderately enlarged spleens in benign conditions.Compared with open splenectomy,fewer posts...Since the first laparoscopic splenectomy(LS)was reported in 1991,LS has become the gold standard for the removal of normal to moderately enlarged spleens in benign conditions.Compared with open splenectomy,fewer postsurgical complications and better postoperative recovery have been observed,but LS is contraindicated for hypersplenism secondary to liver cirrhosis in many institutions owing to technical difficulties associated with splenomegaly,well-developed collateral circulation,and increased risk of bleeding.With the improvements of laparoscopic technique,the concept is changing.This article aims to give an overview of the latest development in laparoscopic splenectomy for hypersplenism secondary to liver cirrhosis and portal hypertension.Despite a lack of randomized controlled trial,the publications obtained have shown that with meticulous surgical techniques and advanced instruments,LS is a technically feasible,safe,and effective procedure for hypersplenism secondary to cirrhosis and portal hypertension and contributes to decreased blood loss,shorter hospital stay,and less impairment of liver function.It is recommended that the dilated short gastric vessels and other enlarged collateral circulation surrounding the spleen be divided with the LigaSure vessel sealing equipment,and the splenic artery and vein be transected en bloc with the application of the endovascular stapler.To support the clinical evidence,further randomized controlled trials about this topic are necessary.展开更多
According to the World Health Organization （WHO）, a total of 35.6 million cases of dementia were estimated in 2010, with close to 7.7 million new cases each year. In 2008, WHO declared dementia a priority condition....According to the World Health Organization （WHO）, a total of 35.6 million cases of dementia were estimated in 2010, with close to 7.7 million new cases each year. In 2008, WHO declared dementia a priority condition. 90% of all dementia cases are considered to be Alzheimer＇s disease （AD）. Therefore, great effort was made to understand the etiology of the disease and stop or slow down AD progression.展开更多
文摘Since the first laparoscopic splenectomy(LS)was reported in 1991,LS has become the gold standard for the removal of normal to moderately enlarged spleens in benign conditions.Compared with open splenectomy,fewer postsurgical complications and better postoperative recovery have been observed,but LS is contraindicated for hypersplenism secondary to liver cirrhosis in many institutions owing to technical difficulties associated with splenomegaly,well-developed collateral circulation,and increased risk of bleeding.With the improvements of laparoscopic technique,the concept is changing.This article aims to give an overview of the latest development in laparoscopic splenectomy for hypersplenism secondary to liver cirrhosis and portal hypertension.Despite a lack of randomized controlled trial,the publications obtained have shown that with meticulous surgical techniques and advanced instruments,LS is a technically feasible,safe,and effective procedure for hypersplenism secondary to cirrhosis and portal hypertension and contributes to decreased blood loss,shorter hospital stay,and less impairment of liver function.It is recommended that the dilated short gastric vessels and other enlarged collateral circulation surrounding the spleen be divided with the LigaSure vessel sealing equipment,and the splenic artery and vein be transected en bloc with the application of the endovascular stapler.To support the clinical evidence,further randomized controlled trials about this topic are necessary.
基金supported by grants from the Basal Center of Excellence in Aging and Regeneration(CONICYT-PFB 12/2007),FONDECYT No.1120156 to N.C.I.,FONDECYT No.1131065 to A.S.VRI Pre-Doctoral Fellowship to C.M.-O.from Pontificia Universidad Católica de Chile
文摘According to the World Health Organization （WHO）, a total of 35.6 million cases of dementia were estimated in 2010, with close to 7.7 million new cases each year. In 2008, WHO declared dementia a priority condition. 90% of all dementia cases are considered to be Alzheimer＇s disease （AD）. Therefore, great effort was made to understand the etiology of the disease and stop or slow down AD progression.
