ABSTRACT
Objective To study the clinical effect of adjacent flap on immediate breast repair in conserving surgery for upper inner quadrant breast cancer.Methods A total of 100 women with breast cancer treated in our hospital from August 2012 to August 2016 were selected as the study subjects.According to the different surgical methods,46 cases were divided into control group and 54 cases in observation group.The patients in the control group were treated with modified radical mastectomy for breast cancer.The patients in the observation group were treated with adjacent flap for immediate repair of breast defect in breast conserving surgery.The quality of life,the follow-up results and between the two groups were compared.The cosmetic effect of the observation group was evaluated.Results At 6 months after operation,the physiological function,affective function,physical pain,social function,physiological limitations,vitality,mental health and overall health score of the observation group were higher than those of the control group,the difference was statistically significant(P ＜ 0.05).There was no significant difference in local recurrence rate,distant metastasis rate,non-survival rate,loss of follow-up or mortality between the two groups (P ＞0.05).The excellent and good rate of breast cosmetic effect was 96.3％ after surgery in observation group.The satisfaction rate of observation group was 92.59％ (50/54),the control group was 45.46％ (21/46),the difference was statistically significant (x =26.582,P =0.000).Conclusion The clinical effect of repairing breast defect by using adjacent flap transfer is very effective in improving the quality of life and reducing the risk of local recurrence and distant metastasis.
ABSTRACT
A child born with spinal dysraphism and encephalocele faces the multiple and serious hazards of meningitis, hydrocephalus, paralysis and deformity of the lower limbs, and urinary bladder paralysis. The improvement in surgical management, and the advent of the shunt device for the control of hydrocephalus have so greatly altered the immediate prognosis that even a child with an extensive myelomeningocele must be considered to have a good chance of survival. We have presented a case of myelomeningocle, and two cases of meningoencephalocele and immediate repair techniques, and prognosis. 1) Surgical repair should be undertaken urgently, if possible within the first 48 hours of life and its role was the preservation of motor, sensory and intellectual function. 2) Carefully dissected the nerve filaments from the sac and replaced them into the dural canal and excised the functionless filament for prevention of spine deformity. 3) Shunt surgery should be considered before operation or immediate postoperation, in situation of huge meningoencephalocele.