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Objective:To introduce a surgical technique of implant-based immediate breast reconstruction using the "latent orifice" procedure after skin-sparing mastectomy and to investigate the clinical value of this procedure.Methods:Clinical data of 72 patients who underwent immediate breast reconstruction using the "latent orifice" procedure (we placed the silicone prosthesis in a "latent orifice" consisting of fascia and underlying muscles) from Jan. 2016 to Dec. 2019 were collected. Characteristics of surgical technique and the effect of the reconstruction surgery were analyzed.Results:70 patients underwent nipple-areola complex sparing mastectomy (NSM) . Two patients’ nipples were resected due to intraoperative frozen pathology suggesting carcinoma existing in the nipples. The nipple epidermal necrosis occurred in 3 patients. No seroma, incision infection or capsular contracture occurred. According to the evaluation scale, the overall aesthetic score was 9.39 points. The average score of each subscale was: 9.57 points for breast volume, 9.43 for breast contour, 9.84 for placement of implant, 9.38 for scars, 9.27 for lower pole projection and 9.21 for inframammary fold definition. BREAST-Q questionnaires were filled by patients. Scores of psychosocial well-being ranged from 62 to 93 points, with the median score of 77 points. Satisfaction with breasts scores ranged from 58 to 100 points, with the median score of 71 points.Conclusion:The "latent orifice" procedure is a simple, safe, practicable, aesthetic and satisfying type of immediate implant-based breast reconstruction, which is worth practicing and promoting.
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Objective:To compare the clinical effects of the two methods in surgical treatment of gynecomastia.Methods:The clinical data of 46 patients with gynecomastia were retrospectively analyzed, who received total removal of the glands through mastoscopic assistance (mastoscopic group) or traditional areola incision (traditional group) from Mar. 2017 to Mar. 2018. The two groups were compared in terms of blood loss, the mean operation duration, extubation time, the average hospitalization time, postoperative complications, the total cost and patients’ satisfaction at 6 month after operation. Chi-square test was used to compare the count data between groups, paired t test was used to compare the measurement data between groups, and SPSS18.0 statistical software was used for statistical analysis.Results:The operation was completed in both groups. There were no differences between the two group in age (0.473) , BMI (0.353) , lesion location (0.198) , Simon classification (0.683) , the mean blood loss ( P=0.999) , mean operation duration ( P=0.596) , extubation time ( P=0.755) , the average hospitalization time ( P=0.676) , postoperative complications and ( P=0.370) or the total cost ( P=0.486) . The difference of patients’ satisfaction at 6 month after operation had statistical significance ( P=0.012) . conclusion:Compared with traditional open surgery, mastoscopic surgery for gynecomastia is minimally invasive, beautiful and safe, which can be widely used in clinical practice.
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Objective To study the application value and safety of sentinel lymph node biopsy ( SLNB) replacing axillary lymph node dissection ( ALND) for patients with early breast cancer .Methods Data was col-lected for patients undergoing SLNB or ALND in the Second Hospital of Dalian Medical University from June 2011 to June 2014.The complication of upper extremity , axillary local recurrence and distant metastasis were retro-spectively analyzed.The patients were followed up to Nov .2014, with the median follow-up of 41 ( 18-52 ) months.Results Patients undergoing SLNB had less postoperative complications of upper extremity ( numb and painχ2 =18.174, P =0.000;Restricted movement χ2 =20.413, P =0.000; Strength loss χ2 =23.785, P =0.000;P0.05).Conclusion In early breast cancer without SLN, SLNB can achieve the equivalent effect to ALND with less damage and complications .
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Objective Lymphedema is a common complication interrupting a large percentage of breast cancer survivors .How to release the breast cancer survivors from the pain of lymphedema remains a question to breast surgeons .The rapid development of the super-microsurgical measurement allows lymphaticovenular anasto-mosis to become a better way to treat breast cancer related lymphedema .Methods We followed a breast cancer related lymphedema case amd offered super-microsurgical lymphaticovenular anastomosis to her .Results The surgery lasted 4.5 h, and contained 11 anastomosis of lymph ducts .Improvement of edema could be seen during the surgery and the measurement of the upper limb became smaller just one day after surgery .Conclusion Su-per-microsurgical lymphaticovenular anastomosis is a safe improvement for extremity lymphedema after mastectomy and it can provide a better prognosis and appearance .
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ObjectiveTo retrospectively evaluate the efficacy and safety of zoledronic acid and sodium ibandronate in treating bone metastasis in breast cancer patients.MethodsThe study included 47 patients who were treated with zoledronic acid and sodium ibandronate respectively from Aug.2006 to Mar.2011. KaplanMeier curve and Log rank test were adopted to detect the difference in survival time of skeletal related event (SRE) and survival rate between patients treated with different medicine,and x2 test was uscd to rcveal thc rate difference of pain killing effects and adverse effects.Results 1.The total effective rate of pain killing was 88.9％ and 85％ respectively.The difference had no statistical significance(P =0.467).2.The 1,2 and 3-year-survival rate in zoledronic acid group and sodium ibandronate group was 88.7％,44.4％,24.2％vs 94.7％,40.5％,5.8％.The difference had no statistical significance(P =0.744).3.The 2,3,and 4-year-survival rate in zoledronic acid group and sodium ibandronate group was 70.4％,40.7％,23.1％ vs 85％,46.7％,17.5％.The difference had no statistical significance( P =0.994).4.The 1,2 and 3-year SRE-free overall survival rate of the group with metastasis first to bone only was 92％,50.8％,and 23.8％,while the rate of the group with first metastasis to visceral organs was 85.4％,21.4％,and 5.3％ ( P =0.012).5.The 2 and 3-year overall survival rate of the group with metastasis first to bone only was 95.8％ and 74.2％ respectively,while the rate of the group with first metastasis to visceral organs was 56.5％ and 10.1％ ( P ＜0.001 ).The difference of 4 and 5 had statistical significance.The difference of zoledronic acid group and sodium ibandronate group in rate of adverse effects had no statistical significance.Conclusions Compared to sodium ibandronate,zoledronic acid has no superiority in either delaying the occurrence of SRE or improving overall survival rate.The -2are similar in incidence of adverse effects and pain control.The prognosis of patients whose first presentation is complicated by metastasis to other organs is poor.
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Objective To investigate the effect of combined treatment of microwave and antibiotics for chronic prostatitis. Methods A total of 90 patients with the diagnosis of chronic prostatitis were divided into two groups. The study group (n=45) received combined treatment of pulse microwave and minocycline, and the control group(n=45)only received the minocycline therapy. Results The curative effect of the study group was much better than that of the control group after a therapy of 5 weeks, based on the NIH-CPSI and the counting of WBC in prostate fluid. Conclusions Combined treatment of pulse microwave and minocycline is effective to ameliorate the symptoms of pain and dysuria, increase the quality of lives, decrease the counting of WBC in the prostate fluid. Therefore it is a useful treatment to improve the rate of cure and utility.
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Objective To investigate the role of intestinal fatty acid-binding protein(IFABP) as a marker in the (early) diagnosis of intestinal ischemia. Methods SD rats were randomly divided into control group and superior mesenteric artery ligation group (SMA group). Blood samples were collected sequentially at pre-operation, 1, 2 and 4 hours after operation for detecting the activity of IFABP, CK, CK-BB and LDH. Results The activity of IFABP in SMA group elevated 1h and arrived to a peak at 2 hours postoperatively. Compared with control group, all the (levels) of CK, CK-BB and LDH in SMA group were elevated progressively with time after operation. Compared with control group, the significant elevation was at 1, 2 and 4 hours after opration. Conclusions I-FABP is a sensitive and specific marker in the diagnosis of intestinal ischemia.
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Objective To determine the expression of C met protein and microvessel density (MVD) in benign and malignant breast diseases and the relation with the prognosis of the patients. Methods Expression of C met and MVD were detected by immunohistochemical SP method in the histologic sections of 20 benign hyperplasia patients and 70 breast cancer patients. Results Stain of C met was located in the membrane or cytoplasm of epithelia cells.In the benign breast hyperplasia, C met expression was 100%. The stain intensity in breast cancer was stronger than that in the benign hyperplasia, but not statistical significance. The expression of C met was higher in TNM stage Ⅲ cancer than that in stage ⅠandⅡcancer. The stronger expression of C met showed higher MVD and obviously lower survival rate . Coxregression indicated C met and microvessel were prognosis factors. Conclusions C met is expressed in benign and malignant breast disease, C met and MVD are related with survival rate of breast cancer patients , so they are valuable prognosis indicators of breast cancer patients.