An anatomic study of superficial temporal artery to anterior cerebral artery bypass using ipsilateral parietal branch of superficial temporal artery as graft / 中华显微外科杂志

Objective Revascularization of the distal segment of the anterior cerebral artery (ACA) using extracranial donors requires long interposition grafts.A novel bypass procedure which uses the two main branches of the superficial temporal artery (STA) to reach the A3 segment of the anterior cerebral artery with a single skin incision was designed.Methods Ten cadaveric specimens were dissected through a single skin incision to harvest the frontal and parietal branches of the STA from June,2017 to September,2017.An anterior interhemispheric approach provided access to the middle internal frontal artery (MIFA).The parietal STA was used as an interposition graft between the frontal STA and MIFA.Lengths and calibers of the distal branches of STA and MIFA were measured at the anastomotic sites.All data was statistical analysis by t-test.Results The average caliber of MIFA was (1.4±0.2) mm,which matched the caliber of both frontal and parietal branches of STA.The mean distance for an end-to-side bypass from STA to MIFA was (144.5±7.4) mm and the average harvested donor-graft complex length was (203.1±27.9) mm.This bypass construct provided around 140％ donor graft length.Conclusion Using the parietal branch of the STA as an interposition graft enabled a successful tension-free STA-MIFA bypass.The advantages of this technique over existing approaches include sufficient graft length,caliber match and relative technical ease.

Reconstruction of anterior inferior cerebellar artery by occipital artery through extended retrosigmoid approach / 中华显微外科杂志

Objective To explore the feasibility of occipital artery(OA) to anterior inferior cerebellar artery (AICA) through the extended retrosigmoid approach,also perform a systemic microanatomical study of OA and AICA with the exposure of extended retrosigmoid approach,find the easy way to perform the procedure.Methods From September,2016 to January,2017,5 adult cadaveric heads injected with colored latex (total 10 sides) were performed the extended retrosigmoid approach,and measured the caliber of distal occipital artery (OA),the final length of the OA harvest,the reliable landmark of the OA harvest,and the distance from the flocculonodular segment of anterior inferior cerebellar artery (AICA) to the OA,the diameter of AICA flocculonodular segment branch.Whole procedure of OA to IACA bypass also be performed.Statistical analysis was performed.Results By the extended retrosigmoid approach,AICA flocculonodular segment could be easily exposure,the average diameter was 1.2 mm,the OA branch could be harvested in average was (72.3±3.3)mm in length from the occipital sulcus,and the average distance between occipital sulcus and AICA flocculonodular segment was (47.6±l.9)mm.The bypass procedure also could be performed through the proper corridor.Conclusion The Extended retrosigmoid approach is a safe and efficient way to perform the OA-AICA bypass procedure,and the procedure is easier to be performed than other surgical approaches.

Microsurgical treatment of solitary fibrous tumor in the central nervous system / 中华显微外科杂志

Objective To explore the clinicopathological features,imaging manifestation and treatment of solitary fibrous tumor in the central nervous system(cSFT),in order to improve the diagnosis and treatment.Methods Fourteen cases of cSFT that had been received microsurgery treatment from June,2010 to July,2016 were analyzed retrospectively.The clinicopathological features,treatment and prognosis were concluded and analyzed.Results In 14 patients with cSFT treated with microsurgery,and 1 case in the foramen magnum region for the first time,and enriched the understanding of this disease.Of 14 patients with cSFT,12 received total resection and 2 subtotal or part.The cSFT were pathologically diagnosed as benign tumors in 11 patients and low grade cSFT in 3.The microscopical presence of spindle-shaped tumor cells arranged in fascicles that alternate hypocellular and hypercellular areas separated from each other by collagenous fibre.Immunohistochemistry was positive for Vimentin,and CD34,Bcl-2 of 14 patients,and positive for CD99 in 12 patients.Followed-up time was from 6 to 49 months.Twelve cases had good prognosis to total resection and 2 recurrence due to subtotal or part resection.Conclusion cSFT is extremely rare,and it has some characteristics on MRI,final diagnosis should be depended on pathological and immunohistochemical examination.There are good prognoses in the patients with cSFT after the total removal of cSFT,but when the lesion could not be totally resected,radiotherapy should be considered,the curative effect of chemotherapy on cSFT is not definitive.

Experience on Laparoscopic Surgery for Ventriculoperitoneal Shunt / 中国微创外科杂志

Objective To investigate the value of laparoscopy in the treatment of ventriculoperitoneal shunt(VPS).Methods From August 2000 to August 2008,156 patients with hydrocephalus received VPS in our hospital.During the operation,a drainage tube was placed under the right diaphragm,and then fixed to the round ligament.Results The laparoscopic surgery was successfully completed in all of the cases.A mean of 17-month follow-up(14 to 24 months) was achieved in 133 of them.During the period,no distal VPS obstruction,gastrointestinal symptoms,intra-abdominal organs injury or infection occurred.Seven patients presented with obstruction of the VPS at the ventricle side.Conclusion Laparoscopy is a minimally invasive technique for the treatment of VPS with good outcomes and few complications.