endoscopic

摘要： Several papers have identified supplements that may relieve symptoms of carpal tunnel syndrome and improve recovery when carpal tunnel surgery is required. 64 patients with clinically and electromyographically confirmed carpal tunnel syndrome were enrolled in a prospective study to evaluate the effectiveness of a nerve supplement on patient rated outcome assessment after carpal tunnel surgery. All the patients underwent endoscopic carpal tunnel surgery. 18 patients also took the NeuroGen nerve supplement as part of their perioperative treatment. Both groups demonstrated a statistically significant improvement in BCTQ (both symptoms and function) at 2 weeks follow up. The supplement group demonstrated a statistically significant difference in improvement on the BCTQ (both symptoms and function) compared to the control group without the supplement. The NeuroGen nerve supplement appears to improve recovery on both the symptoms and function component of the BCTQ after endoscopic carpal tunnel surgery within 2 weeks.

摘要： 经皮内镜椎板间入路椎间盘切除术(percutaneous endoscopic interlaminar lumbar decompression,PEID)作为近年兴起的微创技术,治疗腰椎间盘突出症安全有效且并发症少。本次研究总结2例比较罕见的PEID患者苏醒期发生强直痉挛,总结其临床资料并结合相关文献进行分析,以期提高对该类手术的认识和更好地围术期管理。现报道如下。

摘要： Objective: The management of traumatic facial nerve paralysis(FNP) has remained a controversial issue with conflicting findings arguing between surgical decompression and conservative management.However, recent advances in endoscopic surgery may consolidate the management plan for this condition.Methods: This prospective clinical study included patients with posttraumatic FNP at a tertiary referral center. Patients were categorized in two main groups: surgical and conservative. Indications for surgery included patients with immediate and complete FNP, no improvement in facial function on medical treatment, with electroneurography showing >90% degeneration or electromyography showing fibrillation potential. Patients who did not satisfy this criterion received the conservative approach. The transcanal endoscopic approach(TEA) or endoscopic assisted transmastoid approach was performed for facial nerve decompression in the surgical group.Outcome: The main outcome was facial function improvement, assessed using the House Brackmann grading scale(HBGS) 6 months after surgery, and hearing state assessed using the air bone gap(ABG).Results: The study included 38 patients, of whom 15 underwent had surgical decompression and 23underwent conservative therapy. A significant improvement in facial nerve function from a mean of4.66 ± 0.97 to 1.71 ± 0.69(P = 0.001) and ABG from a median of 30(10-40) to 20(10-25)(P = 0.002)was observed.Conclusion: Decision-making in cases of traumatic FNP is critical. The geniculate ganglion and tympanic segment were the most commonly affected areas in FNP cases. The TEA represents the most direct and least invasive approach for this area.

摘要： Objective:We through the anatomy of cadavers to study the"Kambin’s triangle"in the safe working area of lumbar intervertebral foramen and to provide anatomical reference for clinical lumbar fusion through Kambin’s triangle approach.Methods:five complete cadaveric specimens were taken,the soft tissue of the lumbar back was removed,the transverse process,upper and lower articular processes and part of the vertebral lamina were bitten,the Kambin’s triangle area of the lumbar spine was completely exposed,the bottom edge and height of the Kambin’s triangle were measured,and the area of the Kambin’s triangle was calculated;Using Kirschner wire,pull and fix the traveling nerve root to make the Kambin’s triangle into a rectangle,measure the length of the bottom edge and height again,calculate the area,and compare the two groups of data.Results:the average height of the Kambin’s triangle was 11.20mm±2.10mm,and the average height of the improved four corners was 11.19mm±1.93mm.The height of the improved four corners was slightly shorter than that of the Kambin’s triangle.There was a significant correlation between the two,but the difference was not statistically significant.The average bottom of Kambin’s triangle is 10.78mm±1.95mm,and the average bottom of improved four corners is 12.14mm±1.78mm.The length of the bottom edge of improved four corners is greater than that of Kambin’s triangle.There is a significant correlation between them,and the difference is statistically significant;The average area of Kambin’s triangle is 61.79mm^(2)±20.71mm^(2),and the area of improved four corners is 137.71mm^(2)±38.20mm^(2).The area of improved four corners is significantly larger than that of Kambin’s triangle.There is a significant correlation between the two,and the difference is statistically significant.Conclusion:there is a narrow right angle triangle area surrounded by traveling nerve root,dural sac and superior endplate of lower vertebral body in the lumbar intervertebral foramen.If the traveling nerve root is pulled and fixed to turn the traditional Kambin’s triangle into a quadrilateral,the bottom edge of the Kambin’s triangle area can be significantly longer and the area can be significantly expanded,which can be operated more safely.

摘要： Colorectal cancer has the second highest incidence of malignant tumors and is the fourth leading cause of cancer deaths in China.Early diagnosis and treatment of colorectal cancer will lead to an improvement in the 5-year survival rate,which will reduce medical costs.The current diagnostic methods for early colorectal cancer include excreta,blood,endoscopy,and computer-aided endoscopy.In this paper,research on image analysis and prediction of colorectal cancer lesions based on deep learning is reviewed with the goal of providing a reference for the early diagnosis of colorectal cancer lesions by combining computer technology,3D modeling,5G remote technology,endoscopic robot technology,and surgical navigation technology.The findings will supplement the research and provide insights to improve the cure rate and reduce the mortality of colorectal cancer.

摘要： BACKGROUND Lumbar facet joint syndrome(LFJS)is a pain condition arising from lumbar facet joint diseases.Treatments of LFJS includes patient education,oral medication,bed rest,physical therapy,and procedural interventions.For some refractory cases that fail conservative therapies,dorsal ramus medial brunch radiofrequency ablation is warranted.However,as nerve fibers can regenerate,their efficacy is impermanent,and the recurrence rate is relatively high.Considering synovial impingement is a paramount pathogenesis of LFJS,in this case,we removed the culprit hyperplastic articular capsule and the articular process partially through a spinal endoscope.As the culprit hyperplastic joint capsule was excised,it is supposed to generate more prolonged efficacy and a lower recurrence rate than radiofrequency treatment.CASE SUMMARY A 40-year-old female patient was diagnosed with LFJS.She complained of low back pain and right buttock pain for half a year.The patient was placed in the prone position.After disinfection and draping,a 25-cm 18-gauge needle was inserted into the dorsal surface of the right L5 articular process.Subsequently,a guidewire,dilating tubes,and a working cannula was inserted successively.The spinal endoscope was positioned in the working cannula.Under the endoscope,the microvascular tissue,muscle tissue attached on the L5 inferior articular process and S1 superior articular process,as well as the capsule and minor portion of the inferior articular process were removed.After the joint space was clear and no bleeding points existed,the endoscope and working cannula were shifted,and the incision was sutured.After treatment,the symptoms were completely relieved.The patient was pain-free during the follow-up period of 6 mo.CONCLUSION The endoscopic partial joint capsule and articular process excision is an effective procedure for LFJS,especially for cases caused by synovial impingement.

摘要： Prevailing evidence declares that Helicobacter pylori (H. pylori) eradication therapycould shift precancerous gastric conditions (PGC) and positively confines gastriccancer (GC) risk during long-term endoscopic follow-up. Nonetheless, there is ayet unsolved controversy regarding the best-individualized surveillance strategiesfollowing H. pylori eradication, based on malignant risk stratification. This lastdispute is due to the uncertainty of contemporary evidence and the role of H.pylori inflammatory changes in underestimating PGC at the index endoscopy.However, the current state of the art suggests that it is reasonable that highqualityendoscopy with histological assessment for the most accurate diagnosis ofPGC may be delayed in selected high-risk patients without alarm signs formalignancy, following the eradication of H. pylori. Notwithstanding, these aspectsneed to be further examined in the next future to establish and optimize the mostbeneficial and cost-effective strategies for recognizing and managing H. pyloripositivepatients with PGC in the short- and long-term follow-up. Accordingly,additional studies are yet required to sharpen the hazard stratification of patientswith the greatest chance of GC evolution, also recognizing the evolving racial,ethnic, immigration factors and the necessity of novel biomarkers to limit GCdevelopment or accomplish a diagnosis of malignancy at an early stage.

摘要： Introduction: Endoscopic internal urethrotomy (EIU) is a technique that consists of an incision of the stenosed urethra under visual control. Its indication is widespread since the first description in 1971 by Sachse. The objective was to analyze the results of EIU in the treatment of urethral stenosis (US) at the Andro-Urology Department of the UHC of Conakry. Methodology: It is a prospective descriptive study, lasting 18 months (January 2016-30 June 2017). It involved 102 patients. The variables were: age, etiology of US, type of catheter, duration of catheter wear and recurrences. After a 12-month follow-up, our results were considered good in the absence of recurrences. Results: The average age was 54.25 years with the extremes comprising between 16 and 96 years. The main reasons for medical checkup were chronic urine retention at 58.82%. Etiology infection was the most frequent with a ratio of 81.37%, while Escherichia coli was found at 51.29%. US was bulbar (71.57%), unique (67.64%) and less than 1 cm (60.78%). Surgical complication occurred with 9 patients (8.82%) with urethrorrhagia and the external genital organs infiltration in 4 cases. Results were good for 77 patients (75.49%). Stenosis post infection, long and multiple stenoses, urethral catheterization with latex catheter and urethral catheterization of more than 4 days were strongly associated with the recurrence occurrence. Conclusion: The EIU is a minimally invasive surgical technique that offers good results.

摘要： We are delighted to announce the Best Paper and Best Reviewer 2020 for Laparoscopic,Endoscopic and Robotic Surgery to recognize the outstanding papers and reviewers.1.Best Paper Nominations,chosen from all papers published in 2019 and 2020,were made by the Editorial Office,as follows,in chronological order of publication.