Soft tissue repair of large defects of lower limbs with deep inferior epigastric perforator flap / 中华显微外科杂志

Objective To study the method and effect of deep inferior epigastric perforator flap(DIEP)in repairing the large defects of lower limbs.Methods Eight cases,from July 2009 to November 2011,including 3 cases of plantar skin defects with bone exposure after foot injuries,three cases of plate exposure after tibia fracture surgery and 2 cases of heel repeated ulceration after skin graft,were repaired by deep inferior epigastric perforator flap.Results All deep inferior epigastric perforator flaps survived with good functions,except 1 case whose distal with poor blood supply and the flap survived after treatmenting,three cases of flap bloated with good appearances after second operation.Conclusion DIEP is a proper option for repair of large defects of lower limbs.It has the advantages of abundant blood supply,large flap area,abdomen can suturing without abdominal complications.

Influencing factors of the survival rate of free autogenous pellet fat graft / 中华医学美学美容杂志

Objective To investigate a new technique to increase the survival rate of free autogenous pellet fat graft. Methods Many methods were used to graft free autogenous fat, and the results compared to look for the best method for it. Results After 3 and 6 months, the volume rate in the treatment group and control group were 70%, 60% and 40%, and 30%. The times of fat injection were 2 and 4 . Conclusion Some vasodilators, low negative pressure and plasma can enhance the survival rate of free autogenous pellet fat graft.

Clinical Comparison of Complications Between Esophagogastrostomy and Jejunal Free Transfer After Resection of Thoracic Esophageal Cancer / 대한흉부외과학회지

BACKGROUND: Replacement of the esophagus remains a challenge for surgeons involved in esophageal disease. From 1996 to 1999, a total of 27 patients with esophageal cancer underwent free jejunal transfer(12cases) or esophagogastrostomy(15cases). To determine the results such as leakage of anastomosis site, stenosis, reflux esophagitis and operation time, respiratory complications, etc. we reviewed the 4 years experiences. MATERIAL AND METHOD: Palliative bypass surgery or esophageal prosthesis and cancers of the pharyngoesophageal or esophagogastric junction were excluded in this study. Resection was usually peformed through right thoracotomy and anastomosis was made with EEA staplers in esophagogastrstomy. In cases of jejunal free transfer, 6cases of proximal esophagojejunostomy were stapled anastomosed and remaining 6 cases and all distal site were hand-sewn anastomosed. All reconstruction was done through posteromediastinal route. RESULT: There were two mortalities from thoracic esophagogastrostomy and one from jeunal free transfer. Major and minor complications(anastomosis site leakage: 3 cases, graft failure: 2cases etc) occurred in 27 cases. In 15 thoracic esophagogastrostomy cases, 11 patients had mild to moderate reflux esophagitis and 5 patients incurred stricture of the anastomosis. Operation time was about 550 280 minutes in jejunal free transfer, and about 300 160 minutes in esophagogastromy patients. CONCLUSION: Post operative reflux esophagitis and dysphagia were more frequent in Ivor-Lewis operation group than jejunal free transfer group; however, respiratory complications and operation time were significantly longer in jejunal free transfer group(p<0.05). To minimize the incidence of postoperative reflux esophagitis and dysphagia,patient evaluation focused on jejunal free transfer surgery is better than esophagogastrostomy followed by adequate post operative care.

Surgical Repair of Cerebrospinal Fluid Rhinorrhea with Mucoperichondrial Free Graft

Three cases of cerebrospinal fluid (CSF) rhinorrhea and anterior skull base defects were successfully treated by applying mucoperichondrial free graft through the endonasal endoscopic technique. The causes of the skull base defects were trauma in two cases and endoscopic sinus surgery in one case. The defects were located in the sphenoid sinus in one case and the fovea ethmoidalis in two cases. In these cases, contralateral side septal mucoperichondrial free grafts were used to seal the defects and were supported with fibrin glue and Spongostan(R). Endoscopic repair with mucoperichondrial free graft appeared to be a safe and successful approach to the treatment of the anterior skull base defects.

Surgical Treatment in Local Recurrence of Esophageal Cancer with Free Jejunal Graft: A Case Report / 대한흉부외과학회지

We managed surgically a case of local recurrence in esophageal cancer Twenty month after transthoracic subtotal esophagectomy and csophago-gastrostomy, he su(fared from dysphagia. Chest CT and percutaneous needle aspiration biopsy showed. Local recurrence involving residual esophagus, thyroid gland, posterior membraneous portion of trachea. We did cervical esophagectomy, laryngectomy thyroidectomy, partial resection of trachea and reconstruction with free jejunal antograft successfully.