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Objective:To investigate the relationship between clinicopathological features and lymph node metastasis(LNM)of early gastric cancer(EGC), so as to provide and theoretical guidance for the normative treatment of EGC.Methods:A retrospective analysis was performed on 128 patients with EGC who received surgical treatment from January 2016 to December 2019 in Anhui Medical University Affiliated Anqing hospital.Results:The total LNM ratio of EGC was 10.1% (13/128). Univariate analysis showed that the LNM ratio was 18.0% in patients with the largest diameter of >2 cm, higher than 5.1% in patients with the largest diameter of ≤2 cm. The LNM ratio of submucosal carcinoma (T 1b) was 21.6%, higher than 2.6% of intramucosal carcinoma (T 1a). The LNM ratio of patients with vascular invasion was 71.4%, higher than 6.7% of patients without vascular invasion. The LNM ratio was 13.1% in the total dissected lymph node group ≥15, higher than 0 in the total dissected lymph node group <15. The difference between the these groups was statistically significant( χ2=5.532, 12.101, 23.778, 4.239, P<0.05). There was no significant difference in the correlation between age, gender, tumor site, general type, degree of differentiation, and the LNM of EGC ( P>0.05). Multivariate analysis showed that submucosal carcinoma(RR=10.688, 95% CI: 1.714-66.651, P=0.011) and vascular infiltration(RR=27.209, 95% CI: 3.749-197.450, P=0.001) were the independent risk factor for the LNM of EGC. Conclusions:Patients of EGC with tumor infiltration to submucosa(T 1b), maximum diameter of lesion >2 cm, and vascular infiltration have a higher risk of LNM. Standardized D1+ or D2 lymph node dissection (≥15) should be performed for EGC patients.
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Objective To explore the clinical effect of endoscopic-assisted intraoral reduction mandibuloplasty.Methods From January 2010 to December 2014,a total of 186 patients with prominent mandibular angles underwent one stage long-curved ostectomy combined with splitting corticectomy through an intraoral approach with endoscopic assistence according to preoperative design for reduction mandible three-dimensionally,and achieved reduced width of the lower face with smooth curve of mandibular edge.The distance between both gonions was measured and the complications recorded to evaluate the clinical effect of the surgery during follow-up.Results All the 186 patients had no complications of bleeding and infection.The mean distance between both gonions measurement was (117.3±2.5) mm before surgery and (102.6±2.3) mm after operation;it was reduced (14.1 ±2.4)mm.After 1 month to 2 years of follow up,the width of the lower face was reduced in the frontal view and the mandibular angle appeared natural and inconspicuous in the lateral view.The patients were satisfied with both their frontal and lateral appearances.Conclusions Intraoral approach mandibular ostectomy with endoscopic-assisted allows surgeons to perform accurate,safe and reproducible ostectomies and to recontour mandible symmetrically and reduce the complications.
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Objective To discuss the surgical methodology for sunken upper eyelid and its curative effect by eyelid orbital fat reset.Methods 26 patients with the sunken upper eyelid were operated,in which blepharoplasty incision was used to open musculus orbicularis oculi and septum orbitale,dissected levator,displaced orbital fat were extended and replaced to the sunken region of upper eyelid,to mild-to-moderate ptosis evator tendon membrane folding suture was carried out at the same time and the wound was routinely sutured through 7-0 nylon thread.Results All cases were followed up for 12 months after operation.There was no obvious complication occurred,All cases got ideal outcomes,with smooth and symmetry lid folds.Conclusions The postoperative effects of upper eyelid orbital fat reset for correction of eyelid sunken are satisfactory,without inequality complications,and therefore it is worth promoting.
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Objective To explore the effect of subcutaneous composite flaps by crossed filling and supporting within areola combined with continuous distraction on moderate and severe inverted nipple.Methods 33 patients with 59 moderate and severe inverted nipples were involved in this study.The bilateral subcutaneous triangular composite tissue flaps pedicled with the base of the nipple were harvested within areola,the two triangular composite tissue flaps were revolved and advanced either horizontally to the opposite pedicle through the tunnel beneath the nipple and fixed as supporting.After the operation,the continuous distraction of the nipple lasted for two to four weeks,clinical effect and complications were analyzed.Results None of these 59 nipples appeared blood circulation disorder after operation.Postoperative follow-up for 6 months to 3 years showed that 54 inverted nipples were corrected completely without complications,such as nipple and areola necrosis,and there were no recurrence.The patients and doctors were satisfied with the appearance of the nipples.Conclusions Correcting the moderate and severe inverted nipple with subcutaneous composite flaps by crossed filling and supporting within areola combined with continuous distraction is simple,microinvasive,effective,and the incision scar is invisible,and it therefore is an ideal method for correcting the inverted nipple.
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Objective The purpose of this paper is to study the variations of the bone conduction hearing in the patients with chronic suppurative otitis media complicated by bone conduction deterioration after tympanoplasty and to analyze the relative factors. Methods In 54 cases (61 ears) of decreased bone conduction thresholds associat-ed with chronic suppurative otitis media, reviewed retrospectively were the data before the operation and during the follow-ups from 3 to 27 months. The bone conduction thresholds at 0. 5,1, 2 and 4 kHz were studied in relation to the courses of disease, the complications of cholesteatoma, the operation procedures and the reconstructions of os-sicular chains before and after surgeries. Results Before operation the most obvious hearing loss of bone conduction was found at 4 kHz in 61 ears, while after operation the average bone conduction hearing at the 4 frequencies was improved at different degrees with the most at 2 k Hz. Thirty-two of 61 cases (52.50%) were found to have their hearing improved at least by more than 10 dE at two frequencies without any deterioration at the 4 frequencies. Con-clusion The factors of the duration of disease and complications of cholesteatoma are obviously not related to the improvement of hearing after operation. A patient with reconstruction of ossicular chain is markedly superior to one without the reconstruction in improvement of hearing. When the auditory ossicular chains and functions of the oval and/or round windows are damaged, the bone conduction hearing can be affected accordingly. However the hearing of some cases will be improved after tympanoplasty. Also, the possible improvement is also related to different sur-geries in treating patients with middle ear infections.