ABSTRACT
Objective To compare the efficacy of traditional laparoscopic radical resection of sigmoid colon and rectal specimens without abdominal incision laparoscopic surgery. Methods From January 2015 to December 2016 in our hospital to implement selected laparoscopic assisted sigmoid colon cancer surgery patients in 34 patients with abdominal incision rectal specimens of laparoscopic sigmoid colon resection of colorectal cancer patients without abdominal incision group. As to the choice of 1 ~ 2 pairs in the same period of age, gender, as the control group were given laparoscopic assisted sigmoid colon body mass index similar to radical surgery in 68 patients with operation time. Comparing the two kinds of laparoscopic surgery, perioperative bleeding, postoperative exhaust time postoperative pain score, complications, surgery, postoperative hospital stay, additional analgesic treatment, length of bowel resection, proximal and distal margin, tumor size, lymph node dissection the number of pTNM staging. Results The abdominal surgery time without incision group of sigmoid colon cancer patients, intraoperative bleeding was significantly higher than control group, abdominal incision group of sigmoid colon cancer patients with postoperative exhaust time, postoperative pain awake score, postoperative 1 d pain score was significantly lower than the control group, there was statistical significance the difference (P < 0.05); the two group of sigmoid colon cancer patients with bowel resection length of proximal margin, tumor size, number of lymph node dissection, there was no significant difference in pTNM staging (P > 0.05). Abdominal incision group were followed up for 5~8 months, average 6 months; the control group were followed up for 6 ~ 9 months, an average of 7 in August, there were no tumor recurrence and metastasis. Conclusion Compared with traditional laparoscopic surgery, abdominal incision rectal specimens of laparoscopic radical resection of sigmoid colon cancer can significantly reduce the pain of patients, shorten the postoperative exhaust time, tumor root Treatment effect is similar
ABSTRACT
<p><b>OBJECTIVE</b>To discusses the necessity and methods of replantation for complete amputation of finger composite lateral tissue.</p><p><b>METHODS</b>From March 2012 to April 2015, 62 cases of complete amputated finger lateral tissue for various causes were retrospectively analyzed, including 34 males and 28 females with an average age of 29.1 years old ranging from 17 to 52 years old, involved 27 cases of thumb, index finger in 15 cases, 13 cases of middle finger, ring finger in 8 cases, 2 cases of the little finger, 2 fingers were injured in 3 cases, 14 cases involving the distal interphalangeal joint. The time from injury to treatment was 30 min to 2 hour with an average of 1 hour. The appearance of the fingers, finger tip sensation and the recovery of the functional of the patients were followed up and observed.</p><p><b>RESULTS</b>Of 62 cases, 58 cases survived, the survival time was 3 to 15 months with an average of 6.5 months. According to the Chinese medical association upper part of replantation function evaluation standard to assess efficacy trial, 52 cases were excellent, 3 cases were good, 3 cases were good, the excellent and good rate was 94.8%.</p><p><b>CONCLUSIONS</b>The appearance and function is good after block from the broken replantation finger lateral organizations survive, as long as the patient general condition allows, away from the broken body is complete, there are available for blood vessels and nerves anastomosis, it should strive to reattach it.</p>
ABSTRACT
ObjectiveTo introduction of perforator flaps,muscle flaps pedicled by descending branch of lateral circumflex femoral artery,method and their clinical application that multiple soft tissue defects of hand are repaire by muliplefoliated tissue flap only branch lateral circumflex femoral artery.MethodsFifteen patients with multiple soft tissue defects of hand were repaired muliplefoliated tissue flap only pedicled bydescending branch lateral circumflex femoral artery.At first,the anterolateral thigh perforator flap was designed and harvested according to the soft tissue defects of hand, then the descending branch lateral circumflex femoral artery was dissected at the same time the segmented perforator flap,fascia lata flap,rectus femoris muscle flap, vastus lateralis muscle flap, vastus intermedius muscle flap and distal spatium intermusculare flap were harvested in need according to distance among soft tissue defects.The muliplefoliated tissue flap was harvested only pedicled by descending branch lateral circumflex femoral artery, at last muscle flaps and fascia lata flaps were covered by skin graft, so the multiple soft tissue defects of hand were repaired in one time.ResultsNo vascular crisis happened. All skin grafts survived well, the contour of all repaired soft tissue defects was good and protective feeling was recovered by skin grafts of all flaps. All cases were got follow-up and the range was from 6 to 20 months(the average was 8.7 months).Wound of donor site healed well, muscle strength of quadriceps and motion of knee were normal. Three cases were excellent,nine cases were well and 3 cases were good, according to upper extremity function evaluation criteria of Chinese Medical Society for the Surgery of the Hand, the rate of good was 80 percent.ConclusionMultiple soft tissue defects of hand can be repaired by muliplefoliated flap only pedicled by descending branch of lateral circumflex femoral artery. Its advantages included reduction of operation time and treatment, good recovery of hand contour and function. It is a good method to repair multiple soft tissue defects of hand.
ABSTRACT
The wrap around the toe flap from the great toe is considered to be a good reconstructive proce-dure for degloved injuries of the thumb. In this study, we used prefabricated flaps of the medial plantar skin to cover a degloved injury of the thumb of a patient unsuitable for application of this method and obtained satisfactory clinical results.