RESUMEN
In order to find out appropriate model to best disseminate laparoscopy for colorectal cancer clinical advanced technologies,it is necessary to establish a whole set of training system,which included selecting training site,intensive training,operation observation,advanced study at home and abroad,technical support,etc..Evaluation was based on operation time,hemorrhage in surgery,other injuries in surgery,conversion to open surgery and the ratio of in situ relapse in one year post surgery.These five indexes were compared between the training group and the control group with the gradually stable trend of learning curve as standard.Without previous laparoscopic surgery experience,the training group required 13.8±0.75,14±0.89,10.2±0.74,16.4±0.49 and 20.4±0.49 cases,respectively,to achieve expected proficiency,and the control group required 28.6± 1.69,29.2±1.16,27.8 ± 0.74,22.8 ± 0.40 and 25.4± 1.03 cases,respectively.The learning time required 13.4± 1.02 months on average for the training group and 27.8±2.13 months for the control group.In conclusion,the training system achieved obvious superiority to the controls to achieve expected skills and proficiency in laparoscopy for colorectal cancer.
RESUMEN
Objective To report the results of distally based lateral supramalleolar flap for the reconstruction of dorsal aspect of foot. Methods Twelve patients with soft tissue defects in the dorsal aspect of foot were treated with distally based lateral supramalleolar flap. The largest flap size was 9 cm? 6 cm, the smallest was 5 cm? 4 cm, with an average of 6 cm? 5 cm. Results The flap survived in all 12 patients. The color and texture of the flaps were nearly normal. Their appearance and function were satisfactory after 3 weeks to 24 months follow- up. Conclusion Distally based lateral supramalleolar flap is a reliable flap. The dissection is easy. The flap has a rich blood supply without sacrifice of major artery. It can be used reliably for the reconstruction of dorsal aspect of foot.