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Objective To explore the technique and clinical efficacy of retroperitoneoscopic nephrectomy (RN) at different anatomical plane for benign non-functioning kidneys. Method We retrospectively reviewed the clinical data of 84 patients who underwent RN for benign non-functioning kidneys from February 2010 to November 2016. Various anatomical plane was performed for differing etiology, image and plane, included radical nephrectomy (A group, n = 35), simple nephrectomy (B group, n = 27) and subcapsular nephrectomy (C group, n = 22). Clinical data and preoperative information was collected and analyzed. Result Nephrectomy was performed successfully in 84 patients. There are significantly longer mean operative time and more estimated blood loss in the C group than that in A group and B group (P < 0.05), however, postoperative hospital stay, complications and recovery time were significantly less in the three groups. There was longer mean operative time and more estimated blood in specific and nonspecific infection group compared with the other two groups (P < 0.05). Conclusion Retroperitoneoscopic nephrectomy, although challenging, is safe, reliable, and successful for treatment of benign non-functioning kidneys.Anatomical plane of avascular zone should be offered as the choice of modality to all patients with benign non-functioning kidney.
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BACKGROUND: A study combined medical CT technology and digital three-dimensional (3D) interactive control system Mimics software and computer simulation software tools for 3D reconstruction and simulation reconstruction of the femur. Customized individualized femoral prosthesis has high matching degree with human body structure, and has high application value in clinical research. OBJECTIVE: To investigate the application value of 3D simulation of femoral prosthesis in artificial femoral prosthesis replacement. METHODS: Totally 82 cases, who received femoral prosthesis replacement from July 2014 to June 2016 in Taihe Hospital of Shiyan, were enrolled and randomly assigned to three groups: personalized group (n=28), cementless group (n=27) and cemented group (n=27). Different types of femoral prosthesis were designed in each group. 3D model reconstruction in femur was designed using medical CT technology combined with computer. Prosthesis implantation was simulated in computer, and the relevant information was recorded. Simulated operation was conducted on the mechanical experiment of femoral prosthesis in the biped and single foot loads so as to provide the most suitable operation plan. The possible risk was forecasted and assessed for preoperative preparation. RESULTS AND CONCLUSION: (1) In the simulation of mechanical experiment, under double foot and single foot loads, after prosthetic replacement, stress in the femur was significantly better in the personalized group than in the cementless group and cemented group (P <0.05). (2) After replacement, normal stress and shear stress were significantly better in the personalized group than in the cementless group and cemented group (P < 0.05). (3) The initial, horizontal and vertical micromovement was significantly better in the personalized group than in the cementless group and cemented group (P < 0.05). (4) In summary, the use of computer technology and 3D CT software can make individualized femoral prosthesis for patients. Compared with the cementless and cemented prostheses, personalized prosthesis has obvious advantages in stress distribution, interface stress and initial micromovement.
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<p><b>OBJECTIVE</b>To evaluate the midterm follow-up results of extended release of posterior clearance in total knee arthroplasty.</p><p><b>METHODS</b>A total of 120 patients with knee osteoarthritis were equally randomly assigned to the experimental group and control group, and underwent unilateral TKA from March 2010 to March 2012. In experimental group, there were 21 males and 39 females with an average age of (62.2±10.9) years old. In the control group, there were 25 males and 35 females with an average age of (64.9±11.4) years old. All the patients were performed using the anterior knee approach. During operation, after osteotomy of the tibia and the femoral condyle, extended release of the posterior knee clearance were taken in experimental group, while only the clearance of osteophyte in the posterior condyle were performed in the control group. The KSS scores including knee functional score and knee clinical score,as well as the range of motion (ROM) of patients, were compared between the two groups at midterm follow-up.</p><p><b>RESULTS</b>Totally 49 patients in the experimental group and 54 patients in the control group were followed up, and the median follow-up time was 46 months. The knee functional score of patients in the experimental group was 91.3±3.4, which was better than 86.4±3.9 of patients in the control group; initiative ROM of flexion of patients in the experimental group was (133.2±5.9)°, which was better than (126.9±7.4)° of patients in the control group. There were no significant difference of knee clinical score between 86.9±4.6 of patients in the experimental group and 85.7±5.1 of patients in the control group, and the initiative ROM of extension between (0.5±1.1)° and (0.3±1.2)°.</p><p><b>CONCLUSION</b>Extended release of the posterior knee clearance contributes to the knee function and initiative flexion ROM during a midterm follow-up and patients benefit.</p>