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Objective To compare the effect between autologous fascia and artificial duramater in duramatral neoplas ty.Methods A total of 140 patients with hypertensive intracerebral hemorrhage who underwent craniotomy in Zhoukou Hospital of Traditional Chinese Medicine from February 2014 to May 2017 were selected.The patients were divided into observation group (n =90) and control group (n =50) according to dural repair method.The autologous fascia was used to repair dura mater in the observation group,and the artificial duramater was used to repair dura mater in the control group.The Glasgow Coma Scale (GCS) score,activity of daily living(ADL) and the incidence of postoperative complication were compared between the two groups.Results The eusemia rate of ADL in the observation group and the control group was 98.89％ (89/90) and 90％ (45/50) respectively at three months after operation,the eusemia rate of ADL in the observation group was significantly higher than that in the control group (x2 =6.191,P ＜ 0.05).There was no significant difference in GCS score between the two groups before operation (t =2.362,P ＞ 0.05),the GCS score at three months after operation were significantly higher than that before operation in the two groups (t =7.123,9.612;P ＜ 0.05),the GCS score in the observation group was significantly higher than that in the control group at three months after operation (t =5.710,P ＜ 0.05).The incidence of postoperative cerebrospinal leak,incision infection,cenencephalocele and epilepsy was 1.11％ (1/90),1.11％ (1/90),2.22％ (2/90) and 3.33％ (3/90) respectively in the observation group;and the incidence of postoperative cerebrospinal leak,incision infection,cenencephalocele and epilepsy was 10.00％ (5/50),8.00％ (4/50),12.00％ (6/50) and 14.00％ (7/50) respectively in the control group;the incidence of postoperative cerebrospinal leak,incision infection,cenencephalocele and epilepsy in the observation group was significantly lower than that in the control group (x2 =6.191,5.704,5.514,4.429;P ＜ 0.05).Conclusion The autologous fascia is easy to suture,and there is no rejection reaction.It can significantly improve the prognosis of patients and reduce the incidence of complications in duramatral neoplasty.
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Objective To analyze the safety and efficacy of autogenous femoral lateral iliotibial fascia(autologous fascia lata) in the treatment of female stress incontinence.Methods The clinical data of 7 female patients with stress incontinence admitted from January 2016 to June 2017 were retrospectively analyzed.The mean age was 58.2 years (range 45-72 years).The mean disease duration was 10.7 years (range 5-21 years).The mean Body mass index (BMI) was 24.1 kg/m2 (range 20.3-31.4 kg/m2).7 patients had severe subjective scores according to clinical symptoms.The average score of urinary incontinence questionnaire-simple form (ICIQ-SF) of international urinary incontinence advisory committee was 14.3 ± 1.1,the score of incontinence-quality of life (I-QOL) was 24.3 ± 4.8,respectively.During general anesthesia,the patient was placed in a half-recumbent position with the right leg straight down and the left leg bent over.The position of patella as well as the iliotibial band of the lateral femoral muscles were marked on the body surface.The iliotibial fascia of the lateral femoral muscle was exposed through a transverse incision 4-6 cm perpendicular to the iliotibial fascia of the lateral femoral muscle.The fascia of the lateral iliac tibial fascia of the lateral vastus with a width of 1.5 to 2.0 cm and a length of 12 to 14 cm was cut.The fascia was immersed in physiological saline and sutured with two 2-0 CT1PDS absorbable sutures or 2-0 vascular sutures at both ends of the fascia for 3 consecutive needles to form a sling.Then the urethral catheter was placed in the position of lithotomy,and then urethral suprapubic suspension was performed using autologous fascia through bilateral paravaginal incisions.The duration of surgery,intraoperative blood loss,intraoperative complications,postoperative catheter indwelling time,the length of hospital stay and postoperative complications were recorded.The situation of urinary incontinence as well as life quality before and after surgery were compared respectively.Results The operation was successfully performed.The mean operative time was 117.6 min(range 95-140 min).The mean intraoperative blood loss was 70.3 ml (range 50-90 ml).No complication was observed during the operation.The mean postoperative indwelling catheterization was 5.8 days (range 5-7 days).The mean postoperative hospital stay was 6.3 days (range 5-8 days).All 7 patients were cured after surgery,2 patients experienced urinary retention after removal of the catheter.The mean follow-up time was 18.2 months(range 13-24 months).No urinary incontinence or complications was observed postoperatively in all cases.Patient ICIQ-SF urinary incontinence questionnaire summary score and quality of life score of I-QOL questionnaire of 1 year post operation were 0.6 ± 0.5 and 96.1 ± 4.3,which were significantly improved compared with that before surgery(P ＜ 0.01).Conclusion It is safe to use autologous femoral lateral muscle iliotibial fascia in the middle segment of urethra suspension for the treatment of female stress incontinence,and the curative effect is affirmative through one-year observation.
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PURPOSE: We retrospectively evaluated and compared the success rate, and satisfaction with the operation, in patients who had undergone the modified fascial sling procedure using autologous and allograft fascia. MATERIALS AND METHODS: We compared 65 consecutive women (44%), having undergone the modified fascial sling procedure using allograft cadaveric fascia lata between September 1999 and April 2002 (group 1), with 82 consecutive women (56%), having undergone the procedure using autologous rectus fascia between December 1996 and August 1999 (group 2). The surgical outcomes, and the satisfaction of patients, were assessed by questionnaire. RESULTS: In group 1 the mean follow-up was 26 months (range 12-32), and 59 (91%) of the patients were cured, and 4 (6%) improved. In group 2, the mean follow-up was 51 months (range 32-64), and 73 (90%) of the patients were cured, and 6 (7%) improved. From the questionnaires, there was no difference in the satisfaction with the operation between the groups, but was somewhat lower than the success rate. The mean operation time for group 1 was significantly shorter than for group 2, and postoperative pain control in group 1 was significantly less than in group 2. De novo urge incontinence developed in 2 (3.1%) and 3 (3.7%) patients from groups 1 and 2, respectively. CONCLUSIONS: The modified fascial sling procedure, using allograft fascia, was more advantageous because of the decreased operation time and the reduction in pain control, although there were no significant differences in the success rates and satisfaction between the two groups. Therefore, the modified fascial sling procedure, using allograft fascia, is an effective treatment for all types of stress urinary incontinence, with a high cure rate and an acceptable low morbidity. A longer follow-up period will be required to confirm our results.
Subject(s)
Female , Humans , Allografts , Cadaver , Fascia Lata , Fascia , Follow-Up Studies , Pain, Postoperative , Surveys and Questionnaires , Retrospective Studies , Urinary Incontinence , Urinary Incontinence, UrgeABSTRACT
BACKGROUND AND OBJECTIVES: Vocal fold augmentation by injection under direct visual control is a quick, easy, and accurate operation. However, when autologous fat or bovine collagen is used, both showed considerable resorption over time and gave variable results. Autologous fascia is a newly introduced graft material and has a low metablolic requirements with also a relatively stable histological characteristics. The goal of this study was to confirm the autologous fascia as a new injection material of vocal fold augmentation and assess the impact of the fascia injection on voice acoustics. MATERIALS AND METHOD: Six subjects with vocal cord palalysis and three with sulcus vocalis were analyzed after injection. The temporalis muscle fascia and abdominal fat were harvested. The fascia was cut into small pieces and injected using the pressure syringe with a 18 G needle on the lateral aspect of the vocal fold under the direct visual control. The preoperative and postoperative parameters including jitter, shimmer, signal to noise ratio, and maximum phonation time were analyzed. RESULTS: There was significant improvement in all parameters measured in the group of vocal cord palsy. But there was no definite improvement in the sulcus vocalis group. There was only one laryngeal complication, the postoperative granuloma at leakage site of injection. CONCLUSION: According to these preliminary results, it is suggested that vocal fold augmentation by injection of autologous fascia can be a stable and effective surgical treatment for vocal cord palsy.