Progress of minimally invasive surgery of the treatment of lumbar disc herniation / 中国矫形外科杂志

In recent years,with the rapid development of minimally invasive spine surgery,lumbar disc herniation of minimally invasive treatment is an important progress.The operative injury is small,the duration is short and the effect is satisfactory.Correct recognition of microinvasive surgery,strictly grasp of its indication and perfect operative techniques are the keys to get good therapeutic efficacy.In this review,various methods of minimally invasive techniques and their clinical applications are summarized.

The application of cardiac operation under direct vision through lower median ministernotomy / 中国基层医药

Objective To explore the application of cardiac operation under direct vision through Lower median ministernotomy,and to search the new methods to improve the orthodox cardiac operation under direct vision.Methods The method of the cardiac operation under direct vision through lower median ministernotomy was used to 296 cases with heart disease who needed cardiac surgery,including 250 cases with congenital heart disease,40 cases with rheumatic heart disease,5 cases with left atrial myxom and 1 case with coronary heart disease.Results All cases performed the cardiac operation under direct vision through lower Median ministernotomy successfully without death and any residual.Conclusion The cardiac operation under direct vision through lower median ministernotomy can be used in majority cardiac operation under direct vision,it has well surgical and cosmetic result,but cannot be used in treating some patients with complex cardiac deformity or large heart.

Applied microanatomy of cervical nerve and its related structure / 第三军医大学学报

Objective To study the course of different cervical nerve segments and their related intervertebral foramen’s size so as to increase safety and decrease complications in microinvasive surgery for cervical syndrome. Methods Fifteen human cervical specimens (30 sides) were anatomically observed for the course, branches and distribution of cervical nerves. Results The diameter of intervertebral foramen ranges from 0.54 to 0.65 cm, and increases gradually from top to bottom. The vertical diameter and anteroposterior diameter between C4, C5 and C6 vertebrae are smaller, and those between C3 and C7 are larger, but the diameter line of nerve root in intervertebral foramen from up to down gradually increases. The anteversion angle between nerve root and spine cord on horizontal plane is from 15? to 19?, within a small variation, while the declination angle on coronal plane gradually decreases from C3 to C7. There exist plenty of anastomosis branches among the cervical dorsal rami. Conclusion In the range of 0.6 cm around articular process at the entrance of intervertebral foramen, it is the narrowest part, the removal of which may alleviate the pressure on nerve root and benefit spinal stability. Because of the general existence of anastomosis branches of cervical nerve, the symptoms of cervical syndrome are not completely consistent to innervation. The intervertebral foramen between C4, C5, C6 is relatively small and the diameter line of nerve root is comparatively large, so the nerve root at C4, C5, C6 is most likely to be pressed.

Excision of Intraductal Lesions under the Guidance of Breast Localization Needle / 中国微创外科杂志

Objective To evaluate the value of breast duct endoscopy and breast localization needle for the diagnosis and microinvasive treatment of intraductal lesions. Methods A total of 103 patients with nipple discharge without breast lumps were examined by breast duct endoscopy in our hospital. Of them, 63 cases of intraductal lesions were localized with breast localization needle and received arc incision of the areola of the breast and excision of the localized breast duct with 1-cm adjacent tissues, which were sent for intraoperative frozen. After the frozen pathological examination, the operation was ended for the patients with intraductal papilloma; simple mastectomy was performed on those with duct papillomatosis; and simple mastectomy combined with DIEP reconstruction was carried out for the patients with intraductal carcinoma. Results Frozen and postoperative pathological examinations showed single intraductal papilloma in 59 of the patients (59/63, 93.6%), duct papillomatosis in 2 (2/63, 3.2%) , and intraductal carcinoma in 2 (2/63, 3.2%). The 59 patients with single intraductal papilloma were reexamined in 3 months after the operation, none of them had nipple discharge or other symptoms. Conclusions Resection of intraductal lesions under the guidance of breast localization needle is less traumatic with good cosmetic outcomes. By using the method, high rates of complete resection and accuracy of pathological examination can be achieved.

Cases,preventing and treatment of the complications of microinvasive surgery for osmidrosis / 重庆医科大学学报

Objective:To investigate the complication of microinvasive surgery for osmidrosis and find ways of preventing and treatment.Methods:284 osmidrosis patients undergoing minimally invasive surgery were retrospectively analyzed,the reasons and presentations of the complication were reviewed.Results:Complications occurred only by 13%,including haematoma,epidermal necrosis,scan,recurrence and nerve injury.Conclusion:Microinvasive surgery is a new technique for treating osmidrosis.The skilled operation makes success of the surgery,so the doctors should get hard training for the microinvasive surgery in order to reduce the complications and obtain good results.