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Objective:To compare the effect of modified postauricular transverse incision and traditional vertical incision for microvascular decompression in the treatment of hemifacial spasm.Methods:Prospective study method was used. A total of 116 patients with hemifacial spasm in Handan Central Hospital from January 1, 2019 to January 1, 2020 were selected, and divided into two groups according to the admission order. Both groups underwent microvascular decompression; control group (57 cases) received traditional vertical incision, while treatment group (59 cases) received modified postauricular transverse incision. The brainstem auditory evoked potential (BAEP), pain degree, surgical indicators, facial aesthetic satisfaction and complications were compared between two groups.Results:After treatment, the BAEP of latency, wave interval and wave amplitude in the two groups increased compared with that before treatment, and the BAEP of latency, wave interval and wave amplitude in the treatment group were higher than those in the control group: (1.89 ± 0.15) ms vs. (1.62 ± 0.21) ms, (7.89 ± 0.15) ms vs. (6.25 ± 0.41) ms, (1.79 ± 0.19) ms vs. (1.54 ± 0.11) ms ( P<0.05). After treatment, the visual analogue score (VAS) of patients in the two groups decreased compared with that before treatment, and the VAS of patients in the treatment group was lower than that in the control group: (1.15 ± 0.27) points vs. (2.18 ± 0.24) points ( P<0.05). The operation time, intraoperative bleeding volume and postoperative scar length of patients in the treatment group were less than those in the control group: (60.41 ± 3.81) h vs. (76.87 ± 3.87) h, (30.18 ± 4.19) ml vs. (56.87 ± 4.15) ml and (4.18 ± 1.07) cm vs. (6.87 ± 1.05) cm ( P<0.05). The satisfaction rate of patients in the treatment group was higher than that in the control group: 91.53% (54/59) vs. 71.93% (41/57) ( P<0.05). The complication rate of patients in the treatment group was lower than that in the control group: 5.08% (3/59) vs. 21.05% (12/57) ( P<0.05). Conclusions:Compared with traditional vertical incision, the modified transverse incision for microvascular decompression in the treatment of hemifacial spasm can reduce intraoperative blood loss and postoperative scar area, enhance brainstem auditory evoked potential, and improve facial aesthetics, which is worthy of recommendation.
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Resumen ANTECEDENTES: El sobrepeso y la obesidad van en aumento, sobre todo en los países con bajos y medios ingresos. La obesidad en el embarazo aumenta el riesgo de complicaciones, incluida la infección del sitio quirúrgico. OBJETIVO: Documentar la aplicación de una técnica quirúrgica adaptada para disminuir la infección del sitio quirúrgico en la cesárea de una paciente con obesidad mórbida. CASO CLÍNICO: Paciente de 43 años, con 35 semanas de embarazo, con alrededor de 6 horas de percepción de disminución de los movimientos fetales y dolor abdominal, tipo contracción de moderada intensidad. Con diagnósticos de diabetes gestacional no compensada, amenaza de parto pretérmino, obesidad mórbida, añosa, preeclampsia con signos de severidad, síndrome de HELLP y alto riesgo obstétrico. Por estas características, se decidió que la incisión para la cesárea fuera transversa infraumbilical. CONCLUSIONES: La técnica de incisión aplicada en la paciente del caso evitó el contacto con el pliegue subpanicular y disminuyó las complicaciones quirúrgicas.
Abstract BACKGROUND: Overweight and obesity are increasing every day mainly in low- and middle-income countries. Obesity in pregnancy increases the risk of complications, including surgical site infection. OBJECTIVE: To document the application of a surgical technique adapted for cesarean delivery of a pregnant woman with morbid obesity in a hospital in Ecuador, carried out to reduce the infection of the surgical site. CLINICAL CASE: a 43-year-old pregnant patient who came to the hospital due to decreased fetal movements accompanied by contraction-type abdominal pain of moderate intensity. Based on the tests performed, a 35.1-week twin pregnancy + uncompensated gestational diabetes + threat of preterm birth + morbid obesity + elderly mother + pre-eclampsia with signs of severity + HELLP syndrome + high obstetric risk was diagnosed. Due to the characteristics of the patient, it was decided to perform an infraumbilical transverse incision. CONCLUSIONS: the technique used can be an effective alternative in obese patients to reduce the infection of the surgical site; Compliance with aseptic measures and preoperative antibiotic prophylaxis should also be taken into consideration.
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PURPOSE: Traditional longitudinal incision for carotid endarterectomy (CEA) can be painful, aesthetically displeasing, and associated with a high incidence of cranial nerve injury (CNI). This study describes the outcomes of CEA performed through small (<5 cm long), transversely oriented incisions located directly over the carotid bifurcation, as identified by color-enhanced duplex ultrasound. MATERIALS AND METHODS: Patient demographics and operative data were collected retrospectively from an in-house database of consecutive vascular patients undergoing CEA with a small transversely oriented incision for both symptomatic and asymptomatic carotid artery stenoses. RESULTS: A total of 52 consecutive patients underwent CEA between 2012 and 2016 (median age, 73.5 years; interquartile range, 67-80.3; male/female ratio, 40:12). CEA was performed under regional/local anesthesia (LA) in 48 (92.3%) patients, with 4 (7.7%) being performed under general anesthesia. One patient under LA experienced intraoperative neurological dysfunction intraoperatively (manifesting as an inability to count out loud) that resolved with insertion of shunt. One patient experienced a transient neurological event (expressive dysphasia) within the immediate postoperative period, which resolved within 6 hours. No in-hospital death or perioperative major adverse cardiovascular events were noted. Follow-up data were available for a median period of 3.1 years and for all patients. Three patients experienced strokes following discharge (2 strokes contralateral to the operated side and 1 transient ischemic attack ipsilateral to the operated side). No persistent CNIs nor bleeding complications necessitating re-exploration were reported. CONCLUSION: Small, transversely orientated incisions, hidden within a neck skin crease can be safely performed in the majority of patients undergoing CEA.
Subject(s)
Humans , Anesthesia , Anesthesia, General , Carotid Stenosis , Cranial Nerve Injuries , Demography , Endarterectomy, Carotid , Follow-Up Studies , Hemorrhage , Incidence , Ischemic Attack, Transient , Neck , Postoperative Period , Retrospective Studies , Skin , Stroke , UltrasonographyABSTRACT
Most renal artery aneurysms are asymptomatic and the indication of surgery for renal artery aneurysm is controversial. We encountered 3 cases of renal artery aneurysms that were found incidentally during imaging studies. We used urological approach to undergo renal or adrenal surgery and we injected renal protection solution into the kidney after clamping the renal artery, later we underwent renal artery aneurysmectomy. In all cases, we got good operative field, and they went an uneventful postoperative course without deterioration of renal function. In surgical treatment of renal artery aneurysm, this approach method, reconstructive procedure, and renal protection are satisfied enough.
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Objective:To explore the short,long term efficacy and improvement of quality of life of patients with breast cancer after radical mastectomy by Stewart transverse incision.Methods:Collecting 104 patients with breast cancer from May 2009 to May 2013 in the hospital,55 cases of breast cancer were treated with Stewart transverse incision (the experimental group)and 49 cases were treated with traditional vertical incision for breast cancer (the control group).All the patients were treated with adjuvant chemotherapy.To observe the skin healing of the incision in the two groups after operation.Patients were followed up for 3-48 months,compared with two groups the incidence of postoperative complications,recurrence and metastasis and improve the quality of life.Results:Compared with the control group,the healing rate of grade A was significantly improved in the experimental group,the difference was statistically significant(P＜0.05).There was significant difference between the experimental group and the control group (P＜0.05).The incidence of complications such as flap fluid and upper limb edema was lower in the experimental group than in the control group,but the difference was not statistically significant (P＞0.05).The local recurrence,remote metastasis and 4-year survival rate of the experimental group were better than the control group,but the difference was not statistically significant (P＞0.05).The quality of life of the two groups of patients,the experimental group score in all areas were higher than the control group,the difference was statistically significant (P＜0.05).Conclusion:Stewart transverse incision breast cancer radical surgery is more conducive to wound healing,postoperative local recurrence rate,incidence of complications and psychological impact on patients were significantly reduced.And effectively improve the quality of life of patients after surgery.
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Objective:To explore the short,long term efficacy and improvement of quality of life of patients with breast cancer after radical mastectomy by Stewart transverse incision.Methods:Collecting 104 patients with breast cancer from May 2009 to May 2013 in the hospital,55 cases of breast cancer were treated with Stewart transverse incision (the experimental group)and 49 cases were treated with traditional vertical incision for breast cancer (the control group).All the patients were treated with adjuvant chemotherapy.To observe the skin healing of the incision in the two groups after operation.Patients were followed up for 3-48 months,compared with two groups the incidence of postoperative complications,recurrence and metastasis and improve the quality of life.Results:Compared with the control group,the healing rate of grade A was significantly improved in the experimental group,the difference was statistically significant(P＜0.05).There was significant difference between the experimental group and the control group (P＜0.05).The incidence of complications such as flap fluid and upper limb edema was lower in the experimental group than in the control group,but the difference was not statistically significant (P＞0.05).The local recurrence,remote metastasis and 4-year survival rate of the experimental group were better than the control group,but the difference was not statistically significant (P＞0.05).The quality of life of the two groups of patients,the experimental group score in all areas were higher than the control group,the difference was statistically significant (P＜0.05).Conclusion:Stewart transverse incision breast cancer radical surgery is more conducive to wound healing,postoperative local recurrence rate,incidence of complications and psychological impact on patients were significantly reduced.And effectively improve the quality of life of patients after surgery.
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Objective To investigate the effect of modified abdominal transverse incision and longitudinal incision of lower uterine cesarean section.Methods 50 cases of cesarean section pregnant women were selected from December 2012 to January 2014 in TCMhospital of Dongming.They were divided into the observation group(546 cases) and the control group(104 cases)according to the list of numbers.The control group underwent abdominal longitudinal incision of lower uterine cesarean section,while the observation group underwent modified abdominal transverse incision cesarean section.The intraoperative blood loss,tire taking time,average operation time,postoperative exhaust recovery time,neonatal birth weight and Apgar score,and postoperative adverse reaction of the two groups were compared.Results (1 )The intraoperative blood loss,average fetal time,operation time and postoperative exhaust recovery time of the observation group were shorter than the control group,the differences between the two groups were statistically significant (t1 =5.938,t2 =5.427,t3 =4.874,t4 =6.018,all P <0.05);(2)The postoperative pain occurrence rate in the observation group was 32.60%,which was significantly lower than 55.77% in the control group,the difference was statistically significant (χ2 =9.309,P <0.05).The hematuria incidence rate of the observation group was 2.01%,which was significantly lower than 6.73% of the control group,the difference was statistically significant (χ2 =8.213,P <0.05 ).The incision extending crack occurrence rate of the observation group was 4.03%,which was significantly lower than 11.54% of the control group,the difference was statistically significant (χ2 =9.309,P <0.05 ).(3)The neonatal weight[(3 421.4 ±115.6)g]and Apgar neonates score [(9.49 ± 0.15)points]of the observation group were lower than the control group,the differences between the two groups were statistically significant (t5 =5.129,t6 =4.872,all P <0.05).Conclusion Modified abdominal transverse incision cesarean section has a better clinical curative effect than the longitudinal incision of lower uterine cesarean section, with less adverse reaction,which is safe,reliable and worthy of clinical application.
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Objective To explore epicanthus correction by transverse incision method and concurrent double-eyelid incision operation.Methods The transverse straight-line incision was performed in new inner canthus to the original canthal corner point; after the original inner canthus corner point was reached,the oblique-line parallel incision was performed along the lower eyelid so that full subcutaneous separation was obtained on the upper and lower incision; the malpositioned isomerous orbicular muscle and thickened tissue were released and excised so that the epicanthus skin was naturally restored; the superficial head of the inner canthus ligament was folded and sutured when necessary ; after small cat ears at the temporal side of the inner canthal incision was removed,routine double eyelid plasty was then performed,but the double eyelid and the inner canthus incisions were not continuous.Results The procedures were clinically applied in 258 cases and followed up for 3-18 months,showing that the epicanthus has disappeared,new inner canthus was in good appearance,the scar was not obvious,recurrence of the epicanthus was not found and double eyelids were beautiful in appearance.Conclusions The epicanthus correction by transverse incision and concurrent double-eyelid plasty is a simple and ideal approach for correction of single-edged eyelid with epicanthus and it is worthy of clinical promotion.
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Objective: To discuss the value of preserving ICBN during modified radical mastectomy for breast neoplasms. Methods: Sixty-three cases of breast carcinoma who underwent modified radical mastecto-my were studied. Of them, ICBN was completely preserved in 33 cases and was dissected in 30 cases. Sen-sory function of the medial upper arm of all patients was followed up after surgery. Results: No local recur-rence or metastasis was found among the 63 patients during the first, sixth, and twelveth month of follow-up period. Among the 33 cases with ICBN reserved, 29 cases (87.88%) had normal sensation of the skin in up-per medial arm and axilla, while 4 cases (12.12%) had paresthesia. Conclsion: Preserving ICBN can en-hance the quality of life of breast cancer patients after surgery.
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Transverse incision astigmatic keratotomy procedures were performed, combined with radial keratotomy, in 16 eyes for correction of astigmatism and coexisting myopia. We used a transverse incision technique in which T-incisions vertically intersected radial incisions of the steepest corneal meridian. After a mean follow-up period of 10 months with a range of six to 27 months, an average 1.92 diopters of the cylinder was corrected. In comparison with 2.11 diopters of the cylinder corrected at postoperative one day, there was a 22.8% decrease in the effect of astigmatism correction after a postoperative period averaging 10 months.