Application of the "five-line division method" in selecting surgical approach for spaceoccupying lesions in the saddle area and the adjacent areas / 南方医科大学学报

OBJECTIVE@#To explore the application of the"five-line division method "in selecting the surgical approach for occupying lesions in the saddle area and its adjacent areas.@*METHODS@#Based on the natural anatomic structures, 5 lines (alpha, beta, theta line and lambda, epsilon line) were drawn on the images of the craniocerebral axial plane crossing the middle of the saddle area and the craniocerebral median sagittal plane, thus dividing the saddle area and its adjacent areas into 6 regions in the axial plane (1, 2, 3, 1', 2', and 3' regions) and into 4 regions in the sagittal plane (I, II, III, and IV regions). Based on these divisions, the large space-occupying lesions in the saddle area and adjacent areas were classified and their respective surgical approaches were determined after reviewing the commonly used approaches in the saddle area and clinical experiences. We collected the data of 116 patients undergoing surgeries for space-occupying lesions involving the saddle and the adjacent areas in our hospital between September, 2014 and August, 2017, and analyzed their classifications and the corresponding surgical approaches based on the "five- line division method " to compare the consistency between the hypothetic approaches and the approaches adopted in the actual surgeries.@*RESULTS@#The actual surgical approaches adopted in the 116 cases were all selected under the guidance of experts in our hospital. The hypothetic surgical approaches selected based on the"five- line division method "showed a good consistency with the actually adopted approaches.@*CONCLUSIONS@#The"five-line division method "can spatially classify the commonly seen space-occupying lesions involving the saddle area and its adjacent area to provide assistance in the selection of surgical approaches for such lesions.

The clinical observation of the procedure for prolapse and hemorrhoids plus external dissection and internal ligation in small incisions in the treatment of 168 patients with circumferential mixed hemorrhoids / 中国基层医药

Objective To investigate the clinical efficacy of the procedure for prolapse and hemorrhoids (PPH) plus external dissection and internal ligation in small incisions in the treatment of circumferential mixed hemorrhoids.Methods From January 2015 to January 2017,168 patients with annular mixed hemorrhoids in the People's Hospital of Qingzhou were selected.All cases were treated with PPH combined with small incision exfoliation and internal ligation.The clinical data of 168 patients were analyzed.Results Average operation time was 25 minutes;average hospital stay time was 6 days;168 cases were all cured,2 cases suffered from anal margin edema,7 cases urinary retention.There was no complications such as anal stricture,fecal incontinence etc.Conclusion PPH plus external dissection and internal ligation in small incisions in the treatment of circumferential mixed hemorrhoids has such multiple advantages as small incision,minor trauma,exact efficacy,less complications after operation and shorter hospital stay.

Micro-traumatic surgical procedure of loose seton and cutting seton in the treatment of high anorectal fistulae of 136 cases / 中华全科医师杂志

To explore the therapeutic effect of micro-traumatic surgery of loose seton and cutting seton by rubber bands in the treatment of high anorectal fistulae.Application of cutting seton (truss rubber bands) implemented the high part of fistulae and loose seton (ligation rubber band but non-fastened) for the low part of fistulae.133/136 patients undergoing micro-traumatic surgery were cured by one operation,2 cases had pseudo-healing and there was 1 recurrent case.And the curative rate was 97.8％.The microtraumatic surgery of loose seton and cutting seton by rubber bands in the treatment of high anorectal fistula has such multiple advantages as small incision,minor trauma,lesser pain,faster healing and a shorter course of treatment.And it may preserve the proper anal function and the integrity of anal skin.And its clinical efficacy is satisfactory.