Selection of surgical access for CT type-Ⅱ adenocarcinoma of the esophagogastric junction and its influen-cing factors / 医学研究生学报

Objective Few studies are reported on the factors influencing the selection of the surgical access for adenocarci-noma of the esophagogastric junction (AEG). This study aimed to investigate the factors influencing the selection of the surgical access for CT type-ⅡAEG. Methods We retrospectively analyzed 118 cases of CT type-ⅡAEG surgically treated in the Second Affiliated Hospital of Zhengzhou University and Henan Tumor Hospital from January 2015 to January 2017,92 via the abdominal access and the other 26 via the thoracoabdominal access. We performed univariate and multivariate logistic regression analyses on the factors that might influence the surgical approaches,such as gender,body mass index (BMI),degrees of the epigastric angle,pathological classifica-tion,and clinical stages. Results Logistic regression analysis showed that the degree of the epigastric angle was an independent fac-tor influencing the selection of the access of AEG (OR=0.250,95% CI: 0.098-0.639) (P<0.05). Conclusion In the surgical treatment of CT type-ⅡAEG,the abdominal access is preferable for patients with the epigastric angle> 90 degrees and the thoracoab-dominal access is recommended for those with the epigastric angle≤90 degrees.

Secuelas en pacientes con fracturas cigomáticas tratados con osteosíntesis semirrígida / Sequelae in patients with zygomatic fractures treated with semirigid osteosynthesis

Se realizó un estudio descriptivo, transversal y aleatorizado de 102 pacientes con fracturas del complejo cigomático, tratados con osteosíntesis semirrígida en el Servicio de Cirugía Maxilofacial del Hospital Provincial Docente Clinicoquirúrgico Saturnino Lora Torres de Santiago de Cuba, desde enero de 2005 hasta diciembre de 2011, con vistas a caracterizarles según variables demográficas y terapéuticas en las fases preoperatoria, intraoperatoria y posoperatoria. En la casuística predominaron los accidentes del tránsito como mecanismos causales de las lesiones (55,8 por ciento), la depresión de la eminencia cigomática y la presencia de escalones óseos palpables en el marco orbitario inferior y/o lateral como síntomas principales (92,1 por ciento, respectivamente), y la exposición escleral como complicación posoperatoria (55,2 por ciento), entre otros; asimismo, el valor del tiempo preoperatorio incrementó el riesgo de secuelas y la vía de acceso subciliar se asoció con un mayor riesgo de exposición escleral para el acceso al marco inferior y/o suelo orbitario. Por otra parte, tanto el enoftalmos como el hipoftalmos son de difícil solución y tienen una tendencia significativa de convertirse en secuelas posoperatorias

A descriptive, cross-sectional and randomized study of 102 patients with fractures of the zygomatic complex, treated with semirigid osteosynthesis in the Maxillofacial Surgery Service of Saturnino Lora Torres Teaching Clinical Surgical Provincial Hospital was carried out in Santiago de Cuba, from January, 2005 to December, 2011, aimed at characterizing them according to demographic and therapeutic variables in the presurgical, intrasurgical and postsurgical phases. In the case material there was a prevalence of traffic accidents as causal mechanisms of the lesions (55.8 percent), depression of the zygomatic eminence and presence of palpable bony steps in the lower and/or lateral orbitary edge as main symptoms (92.1 percent, respectively), and the scleral exhibition as postsurgical complication (55.2 percent), among others; also, the value of the presurgical time increased the risk of sequelae and the subciliary approach was associated with a higher risk of scleral exhibition for approaching to the lower edge and/or orbitary floor. On the other hand, either enophthalmos or hypophthalmos are of difficult solution and have a significant tendency of becoming postsurgical sequelae

Tumores intraventriculares supratentoriales de origen glial / Supratentorial intraventricular tumors of glial origin

Los tumores gliales intraventriculares representan un gran reto de acceso neuroquirúrgico debido a su localización profunda, asociación intima con numerosas estructuras vasculares de áreas críticas cerebrales y su relación circunferencial a múltiples tractos subcorticales. Debido a todo esto, el acceso quirúrgico a estas regiones, debe incluir una serie de consideraciones minuciosas anatómicas para minimizar el riesgo de lesión a estructuras de considerable importancia y funcionabilidad y lograr una resección máxima posible. Presentamos una reseña de 4 casos los cuales fueron ingresados y atendidos por el servicio de neurocirugía del Hospital México, los cuales ingresaron en un intervalo de 8 meses entre agosto del 2012 y febrero del 2013.

Intraventricular tumor represent a big neurosurgical approach challenge because of thier deep localization, intimal association with critical arterial vessels, and circunferential relations with withe matter tracts. It is why, surgical access to these regions must include anatomical issues to minimize injuries to structures of vital importance and functionability. We present a resume of 4 cases which where admitted to Neusurgical Service of Hospital Mexico between august 2012 and february 2013.

A Rare Incidence of Dentigerous Cyst Associated with Impacted Mandibular Canine.

The dentigerous cyst, theoretically, must be associated with the crown of an unerupted or developing tooth or an odontoma. Most cases are reported in second and third decade of life, and it shows slight male predilection. In most of the cases, dentigerous cyst is an accidental finding when a radiograph is taken for some other therapeutic purpose. A dentigerous cyst is a benign lesion, but it has the potentiality to become an aggressive lesion. Radiographic fi ndings cannot be considered as final tool to diagnose dentigerous cyst because odontogenic keratocysts, unilocular, ameloblastomas, and many other tumors show similar radiological fi ndings as that of the dentigerous cyst. Thus, histopathological examination is utmost important in the large cystic lesion. Cyst size and site, involvement of dentition and surrounding structures should be considered while treatment planning. On the basis of these criteria, different treatment modalities should be chosen. This includes cyst enucleation and extraction of impacted tooth, cyst enucleation, and preservation of impacted tooth or decompression with surgical access. Th e most common sites for dentigerous cysts are mandibular third molar region and maxillary canine region, as they are the most commonly impacted teeth. We are presenting a case of dentigerous cyst at an unusual place, mandibular canine region.

Clinical observation on the efficacy of surgical treatment of mandibular condylar fracture by a direct approach / 实用口腔医学杂志

Objective:To explore the therapeutic efficacy of a new access to internal rigid fixation for mandibular condylar fracture. Methods: 7 patients with 9 unilateral mandibular condylar fractures were treated with preauricular beeline incisions. The two trunks of facial nerve were dissected and separated along the surface of the superficial temporal veins. Mandibular ramus periosteum was dissected. The fracture segments were reduced and fixed under sufficient exposure. Results: This operation access provided a sufficient exposure and was convenient for reduction and fixation. All the patients recovered effectively.Conclusion: This surgical approach is one of the feasible methods for reduction and fixation of mandibular condylar fracture.