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Objective:To explore the clinical application of lateral thoracic artery perforator flap in repairing local defect after breast conserving surgery.Methods:The clinical data of 48 breast cancer patients planned to finish breast conserving surgery were retrospectively analyzed. The patients were divided into plastic breast-conserving group and routine breast conserving group. In the plastic breast-conserving group, 24 patients local defect repaired with the lateral thoracic artery perforator flap. In the routine breast conserving group, 24 patients local defect repaired with the fascial flap around the cutting edge. The operation related indexes and cosmetic effect from two groups were compared.Results:Both groups of patients successfully completed breast conserving surgery. The plastic breast-conserving group patients had significantly increased in operation time, operative blood loss, incision length and drainage tube indwelling time compared with the routine breast conserving group; the differences were statistically significant ( t=6.99, 9.37, 21.74, 8.80, P<0.05). The rate of secondary surgery enlarged was lower than fhat in the routine breast conserving group, and the difference was statistically significant (χ 2=4.76, P<0.05). There were 3 cases in the plastic breast conserving group and 1 case in the conventional breast conserving group. The skin at the edge of the flap was ischemic necrosis in the 4 cases, which healed after dressing change and drainage, and there was no significant difference ( P>0.05). The evaluation of postoperative cosmetic effect showed that the excellent and good rate of the observation group was 91.7%, compared with the routine breast conserving group (58.3%); the difference was statistically significant (χ 2=7.11, P<0.05). All patients were followed up for average 24 months, and local recurrence and distant metastasis were not observed. Conclusions:The lateral thoracic artery perforator flap for filling local defects in the lateral quadrant or central region of breast cancer is feasible, easy to operate, hides incision scar, better cosmetic effect and worthy of clinical promotion.
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Objective:To investigate the effects of sentinel lymph node biopsy utilization on operative time, intraoperative blood loss and extubation time.Methods:Sixty-two patients with breast cancer who received treatment in the First Hospital of China Medical University from January to December 2019 were included in this study. They were randomly assigned to receive either conventional breast cancer surgery (control group, n = 31) or sentinel lymph node biopsy combined with breast cancer surgery (study group, n = 31). Extubation time, operative time, intraoperative blood loss, drainage volume, breast cosmetic effect, upper limb function and complications were compared between the two groups. Results:Extubation time and operative time in the study group were (16.3 ± 1.1) hours and (61.6 ± 11.3) minutes, respectively, and they were (28.2 ± 6.4) hours and (124.2 ± 28.5) minutes, respectively in the control group. There were significant differences in extubation time and operative time between the two groups ( t = 14.922 and 16.479, both P < 0.05). Intraoperative blood loss and postoperative drainage volume in the study group were (68.7 ± 17.9) mL and (105.9 ± 19.5) mL respectively, and they were (122.4 ± 23.1) mL and (257.2 ± 36.4) mL respectively in the control group. There were significant different differences in intraoperative blood loss and postoperative drainage volume between the two groups ( t = 15.928 and 18.797, both P < 0.05). The excellent and good rate of breast cosmetic effect in the study group was significantly higher than that in the control group (93.6% vs. 83.8% , χ2 = 5.584, P < 0.05). After treatment, the difference in the upper arm circumference between the healthy and affected sides, and shoulder abduction and shoulder function score in the study group were (0.5 ± 0.1) cm, (123.7 ± 6.6) ° and (75.9 ± 4.9) points respectively, and they were (0.7 ± 0.1) cm, (120.1 ± 6.1) °, (73.5 ± 4.4) points, respectively in the control group. There were significant differences in these indices between the two groups ( t = 11.432, 12.450, 12.647, all P < 0.05). The incidence of complications in the study group was significantly lower than that in the control group (12.9% vs. 38.8%, χ2 = 6.309, P < 0.05). Conclusion:Sentinel lymph node biopsy can help improve therapeutic effects, shorten the operative time, reduce the amount of intraoperative bleeding, shorten the extubation time, and reduce the incidence of complications in breast cancer patients.
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This study was performed to summarize our clinical experience with testicular descent and fixation through a scrotal stria incision for the treatment of palpable cryptorchidism in children. This study included 1034 children with palpable cryptorchidism from March 2009 to March 2019. A scrotal stria incision was used to perform testicular descent and fixation. Overall, 1020 children successfully underwent surgical testicular descent and fixation through a scrotal stria incision, and 14 patients underwent conversion to inguinal incision surgery. All patients were discharged 1-2 days after the operation. During hospitalization and follow-up, 55 patients developed complications, including 10 patients with testicular retraction, 7 with poor healing of the incision, and 38 with a scrotal hematoma. No patients developed testicular atrophy, an indirect inguinal hernia, or a hydrocoele. Testicular descent and fixation through a scrotal stria incision for the treatment of palpable cryptorchidism in children is safe and feasible in well-selected cases. This method has the advantages of no scarring and a good cosmetic effect.
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Objective To compare a novel mirror-overlap method with the traditional manual measurement and the subjective assessment in assessing breast symmetry after oncoplastic surgery.Methods 59 patients with breast cancer who underwent conservation/reconstruction surgery were recruited.The post-operative assessment for breast symmetry was conducted using manual measurement,subjective assessment by the patient,their family member and a nurse,and the mirror-overlap method respectively.The latter method involved using the Photoshop to assess the area differences in breast outlines and shadows created by a flashlight when bilateral images were overlapped in the axis of midline.Results The distance differences between bilateral breasts measured using manual method were negatively correlated with symmetric coefficients in the mirror-overlap method (P＜0.05).There was a positive correlation between the average scores in the subjective assessment and symmetric coefficients of mirror-overlap method (P＜0.05).Conclusion The mirror-overlap method is an easy,feasible and cheap method which collects 3D breast information and provides an effective approach to assess breast symmetry after oncoplastic surgery.
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Objective To compare the effectiveness of CO2 laser treatment and routine scalpel procedure for facial sebaceous cyst (SC),and to compare cosmetic effect of laser welding and routine suture skin incision.Methods Two hundred patients with SC were randomly divided into two groups:CO2 laser operative treatment group (laser group),and routine scalpel operative treatment control group (control group),with 100 patients in each group.For the laser group,skins of SC were incised and cyst were extirpated using CO2 laser beam (power 20 W,diameter of light spot 0.2 cm and power density 637 W/cm2).If cyst wall was broken,then CO2 laser was used to gasify the residual.After cleaning skin incision,both border of incision with anastomat of laser welding skin was performed,next to welding skin incision with CO2 laser (power 1 W,diameter of light spot 0.2 cm and power density 32 W/cm2) scanning radiating 2 mm/s.For the control group,skins of SC were incised and cyst or residual wall were extirpated with single-use scalpel,and skin incisions were sutured with 1-0 silk thread by whole layer interrupted suture.Results For the laser group,97 cases (97 ％) were cured,3 cases (3 ％) improved.For the control group,87 cases (87 ％) were cured,9 cases (9 ％)improved and 2 cases (2 ％) had no improvement.Cure rate of laser group was obviously higher than that of the control group (P＜0.05).The cosmetic effect of the laser group was also better than that of the control group (P＜0.01).For the laser group,successful rate of welding skin incision was 100 ％.Conclusions Surgical removal of SC on face and welding skin incision with CO2 laser is very effective.The chances of recurrence and cicatrisation are greatly reduced.In particular,laser welding skin incision establishes a new non-suture reparable method of skin incision,which has important value for the cosmetic and plastic surgery.
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Objective To observe the effect of treatment and cosmetology in cbildren patients with strawberry hemangioma (SH) on face by three kind of infrared wavelength lasers.Methods In 300 children patients aged from 5 to 12 years with SH on face were randomly divided into a semi con ductor laser group (100 cases),a Nd ∶ YAG laser group (100 cases) and a CO2 laser group (100 cases).The parameters of laser were the same in the three groups,such as 10 W,light spot 0.2 cm in diameter and 318 W/cm2.According to size of area in the semiconductor laser and Nd ∶ YAG laser groups SH were coagulated by semiconductor laser and Nd ∶ YAG laser,and in the CO2 laser group it were gasified by CO2 laser,respectively.Children patients with SH were followed up for observation of cicatrzation and evaluation of the effect of therapeutics and cosmetology at six months after laser treatment.Results The cure rates were 89 ％ in the semiconductor laser group,83 ％ in the Nd ∶ YAG laser group and 69 ％ in the CO2 laser group (P＜0.05).The excellent and faworahle rates of cosmetic effect were 87.0 ％ in the CO2 laser group,86.5 ％ in the semiconductor laser group and 57.8 ％ in the Nd ∶ YAG laser group (P＜0.01).The analysis also showed that average therapeutic time,operative time and quantity of bleeding in the semiconductor laser group were less than that of in the Nd ∶ YAG laser and CO2 laser groups (P＜0.01).Conclusions The semiconductor laser (wave length 830 nm and power 318 W/cm2) for the treatmet of children patients with SH on face has many advantages,such as higher cure rate,shorter operative time,less bleeding in operation and better cos metic effects.It might become a first selective therapy for children patients with SH on face.
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PURPOSE: Endoscopic surgery is becoming more widely used because of its low invasiveness and cosmetic effect. However reports on its use in thyroid surgery are scarce particularly with regard to exploiting the advantage of eliminating the unattractive scars that are sometimes encountered in con ventional operations on the exposed anterior part of the neck. Thus, we applied this to thyroidectomy. METHODS: This clinical trial was conducted on a total of 29 patients hospitalized in our Department from December 1998 to August 1999. Our operation method was as follows. Three trochars were inserted, one at each circumareolar area on the breast (5 mm) and one in the skin between these (15 mm). Subplatysmal and subcutaneous operative space was created with CO2 insufflation at 6-7 mmHg from straight-line between two nipples to just below the thyroid gland. The thyroidal vessels and the parenchyma of the gland were dissected and divided using an ultrasonic scalpel and commonly used-laparoscopic instruments. RESULTS: The patients consisted of 25 females and 4 males. The anesthesia and operation time was 220 10.4 minutes and 165.7 9.4 minutes respectively. We had 4 cases of conversion to a conventional thyroidectomy because of uncontrolled intraoperative bleeding (1 case), technical failure (1 case) and thyroid carcinoma (2 cases). Postoperative complications occurred in 2 cases, injury of recurrent laryngeal nerve and severe anterior chest discomfort for 3 months. The average length of postoperative stay was 6.7 days. Operative scars were completely covered by clothes, and cosmetic results were excellent. CONCLUSION: With these results, the cosmetic effect may be regarded as the only strength of an endoscopic thyroidectomy but by going through more cases, this technique could be performed safely with the other advantages of endoscopic surgery such as shortened operation time and hospital stay, et al. We hope an endoscopic thyroidectomy will be another surgery of choice for most patients with thyroid disease.