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【medical-news】首例“经口”阑尾切除术患者恢复
Surgery Is First in U.S.; Patient Recovering Smoothly 本人已认领该文编译，若48小时后未上交译文，请其他战友自行认领 Appendix Removed via Patient's Mouth
Surgery Is First in U.S.; Patient Recovering Smoothly
March 19, 2008 -- Last week Jeff Scholz of San Diego became the first person in the U.S. to have his appendix removed through his mouth.
就在上周，圣地亚哥的Jeff Scholz做了一回“第一个吃螃蟹的人”——外科医生经口切除了他的阑尾，这种手术方式在美国还是首例。
Other than what he describes as a very mild sore throat, the 40-year-old former Marine says he felt very little pain after the surgery and was back to normal within a few days.
这位40岁的前海军陆战队队员说，术后他只觉得有一点轻微的喉咙痛，除此之外几乎没有太多的疼痛感，并且在术后几天就完全康复了。
"They told me to take it easy, but I feel great," he told WebMD Tuesday afternoon -- six days after having his diseased appendix removed in a procedure known as Natural Orifice Transluminal Endoscopic Surgery (NOTES).
“当时手术医生要我尽量放松，手术过程中我觉得很好，” 周四下午他向医疗网站的采访人员这样说道，而就在六天之前他刚刚接受了经口阑尾切除术，这种手术被称为经自然腔道手术（NOTES)。
"Two days ago I started to do sit-ups again, and I ended up working a 10-hour day yesterday."
“两天前我又开始做仰卧起坐了，而且昨天我的工作时间长达10个小时。”
Appendectomy via Mouth
经口阑尾切除术
Surgeons at the University of California San Diego's Center for the Future of Surgery performed the highly experimental operation, which involved guiding surgical instruments through the mouth, down the esophagus, and into the stomach with a tube-like device known as a flexible endoscope.
加州大学圣地亚哥中心的外科医生为未来无手术刀的外科手术进行了一个实验性操作，具体包括引导手术器械经口穿过食道，进入胃部，这个器械是一种管样装置即一个能灵活转向的内窥镜。
Once inside the stomach, a small incision was made into the stomach wall to allow access to the appendix.
进入胃之后，医生在胃壁上作了一个小切口，通过这个口可以到达阑尾。
These days most appendectomies are performed laparoscopically, which is much less invasive than traditional surgery but still requires cuts through the abdomen wall.
最近几年，多数的阑尾切除术都是通过腹腔镜来完成，这种手术方式与传统的开腹手术相比创伤小很多，但是依然要在腹部开几个小口来进行操作。
The NOTES procedure is even less invasive than laparoscopic appendectomy, lead surgeon Santiago Horgan, MD, said in a news statement.
而NOTES甚至比腹腔镜阑尾切除术创伤更小，学科带头人Santiago Horgan博士在一次新闻声明中如是说。
"Only one small incision to insert a small camera in the belly button was required to complete the surgery vs. three incisions required for a laparoscopic procedure," he says.
“只需要在肚脐处开个小口插入一个小小的摄像头就可以完成手术，而腹腔镜手术则是要在腹部开三个口。”他补充说道。
Scholz's surgery went off without a hitch, and the University of California, San Diego (UCSD) surgical team hopes to perform one more appendectomy through the mouth soon.
Scholz的手术进行地很顺利，加州大学圣地亚哥中心的外科手术小组希望能再做一例。
Safety Concerns Remain
仍有手术是否安全的顾虑
If all goes well, the two initial surgeries will be followed by a pilot study of the procedure, UCSD department of surgery chairman Mark A. Talamini, MD, tells WebMD.
加州大学圣地亚哥分校部外科主任Mark A. Talamini博士告诉医疗网站，如果一切进展顺利，这两次手术之后将在医院进行一个试点研究。
Talamini is also president elect of the Society of American Gastrointestinal and Endoscopic Surgeons.
Talamini也是美国胃肠和内镜外科医生学会的候选主席。
"These are the first baby steps to look at this type of surgery to see if it is feasible, and to see if it is a potentially better way to approach appendix removal," he says.
这些手术是为了证实NOTES这种方式是否可行，是我们迈出的第一步，我们还会研究它对于阑尾切除来说是否是一种更好的手术方式。
The procedure has also been used to remove diseased gallbladders, with endoscopes inserted through the mouth or the vagina.
这种类型的操作还可以经口或阴道插入内窥镜来切除坏死的胆囊。
"The paradigm shift here may be that the stomach or vagina may heal better than the skin and [connective tissue] do," Talamini says. "We aren't ready to say that this is the case, but it is worth investigating."
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作者:admin@医学,生命科学 2010-10-09 05:11
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