ABSTRACT
Objective:To explore the method and effect in repairing the defect of fingertip with lateral V-Y advancement flap with one side palmar proper digital artery.Methods:From October 2014 to May 2019, Department of the Hand and Foot Surgery, the Third People's Hospital of Jining(Yanzhou District People's Hospital of Jining City) treated 34 digits of 27 cases with a defect area of 0.5 cm×0.5 cm-1.5 cm×2.0 cm. A lateral V-Y advancement flap with one side palmar proper artery was used to repair the fingertip defect, and the flap size was 1.7 cm×1.0 cm-4.5 cm×1.5 cm. Twenty cases entered long-time follow-up after operation, with 7 cases lost in follow-up, 16 cases were reviewed at outpatient and 4 by WeChat.Results:All the flaps of 34 digits of 27 cases survived. The color of the flaps were close to or completely normal to the surrounding tissue, the texture was soft and the appearance was good. The TPD of the flap was 2.0-6.0 mm. The follow-up time ranged from 22 to 77 months, with an average of 31.45 months. The flexion and extension function of the digits were good with total range of motion(ROM) of the thumb was > 90 °; total active motion (TAM) of the fingers was 260 °-200 °. The fingers of 1 case had hook nail or hook finger deformity. According to the Evaluation Trial Standard of Upper Limb Partial Function of Hand Surgery of Chinese Medical Association, 18 cases were excellent and 2 cases were good.Conclusion:The lateral V-Y advancement flap with one side palmar proper digital artery is easy to operate. The blood supply of the flap is reliable, with good sensation. The flexion and extension of the digits are good, and the appearance and texture of the flap are good.
ABSTRACT
There are many technical variations and improvements in associating liver partition and portal vein ligation for staged hepatectomy (ALPPS). Its main purpose is to reduce the incidence of complications and mortality, and at the same time, the future liver remnant compensation can be increased more faster and its function becomes more robust. In clinical practice, different researchers have studied the variation and related clinical results of liver disconnection technique in ALPPS, such as partial hepatectomy, portal vein ligation assisted radio frequency hepatectomy, laparoscopic microwave ablation and portal vein ligation staged hepatectomy, combined liver tourniquet and portal vein ligation staged hepatectomy, continuous combined liver tourniquet and portal vein ligation staged hepatectomy, in situ hepatectomy combined with portal vein embolization via anterior approach and portal vein embolization instead of hepatectomy separation of visceral substance, and so on.
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0.05). Micro-keyhole craniotomy double-channel tube lavage and drainaging group had a significant lower rehemorrhagia rate and lower mortality.And the short-term effects,the long-term follow-up of patients with pathogenetic in key-hole group was significant better than that in the other groups.there was obvious difference(P