Study on the operation score system for endoscopic thyroidectomy / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the clinical significance of the operation score system for endoscopic thyroidectomy.</p><p><b>METHODS</b>An operation score system based on 6 important procedure skills of endoscopic thyroidectomy was established. And a retrospective study of the first 300 consecutive patients underwent endoscopic thyroidectomy from July 2001 to December 2007 by a single surgeon was performed. The patients was divided into 10 consecutive groups chronologically, each comprising 30 cases.</p><p><b>RESULTS</b>The mean operation score of all the patients was 6.0 and the mean operation time was 98.1 min. There were significant differences in the mean operation score, every skill score and the mean operation time among the 10 groups. In the consecutive two groups comparison, significant differences in the operation scores were observed between group 2 and 3 (P < 0.05) and between group 5 and 6 (P < 0.05).</p><p><b>CONCLUSION</b>The operation score system for endoscopy thyroidectomy is a useful method to judge the proficiency and the stability of the operation.</p>

Laparoscopic small intestinal flap colpopoiesis / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the possibility of Laparoscopic reconstruction of vagina using pedicled ileal autograft and provide a new procedure of colpopoiesis.</p><p><b>METHODS</b>The abdominal and perineal approaches were performed simultaneously under a sufficiently deep general anaesthesia. Laparoscopically, a 15-18 cm segment of the ileum on its vascular pedicle, ileal branches of the superior mesenteric artery and its concomitant veins, was selected and isolated for transplantation using ultrasonically-powered instruments. The distal of the transferred ileal segment was 15cm apart from the ileocecal junction. The ileum continuity was restored immediately by end-to-end anastomosis and the distal oral of the transplant was closed using a curved intraluminal stapler. Meanwhile, a neovaginal tract was completed to dissect from the perineum into the peritoneum and the tract widened laterally. Then the ileum transplant was reversed to reach the perineum through the peritoneal incision at the top of the neovaginal tract without subjecting the mesenteric neurovascular pedicle to undue tension and subsequent necrosis. The oral edge of the ileum transplant was sutured to the perineal skin.</p><p><b>RESULTS</b>Followed up for over 1-53 months postoperatively, 36 patients who received laparoscopic vaginoplasty by transferring ileal segment flaps got satisfactory neovaginal function similar to a normal vagina with mucus and moistness.</p><p><b>CONCLUSIONS</b>The advantages of using a laparoscopic ileum colpopoiesis are that (1) satisfactory neovaginal function similar to a normal vagina with mucus and moistness, (2) no disturbance of bowel function, (minimal scarring in abdominal wall and less secondary deformity in perineum and (3) no need for frequent dilation or stent wearing to the reconstructed vagina. And so laparoscopic vaginoplasty was a preferable alternative of vaginoplasty.</p>