Objective To evaluate the effect of the combined method of l iposuction and semicircular periareolar incision glandular organ partial resection in the treatment of gynecomastia. Methods From June 2004 to June 2006, 40 patients, aged 11-41 years old, were treated, with no-nodule (n=10), nodule (n=22) and female-breast-l ike with nodules (n=8). Three patients were unilateral and 37 ones were bilateral. The levels of serum prolactin, luteinizing hormone, foll icle stimulating hormone, estradiol, testosterone and cortisol were normal in 38 patients, while in the other 2 patients, the levels ofserum prolactin, luteinizing hormone, foll icle stimulating hormone and estradiol were higher than normal, and the testosterone level was lower. Li posuction alone was performed in 10 no-nodule patients (lei po-type), and combined l i posuction and semicircular periareolar incision glandular organ partial resection were conducted in the other 30 patients (lei po-glandular type). Results Except for 2 cases in which hematoma and a small amount of effusion were found on the first and second day postoperatively and then obtained heal ing by first intention right after hematoma removal in time, all the other patients’ incisions obtained heal ing by first intention. Ni pple numbness occurred in 3 cases on the first day postoperatively and no special treatment was conducted. There was still nipple hypesthesia in these 3 cases after 6-month follow-up. There were no compl ications such as hematoma, effusion, nipple and mammary areola necrosis, and nipple hypesthesia in other patients. All the 40 patients were followed up for 6-24 months (13 months on average). They were satisfied with their chest figures and no recurrence was observed. Conclusion The combined method of l iposuction and semicircular periareolar incision glandular organ partial resection in the treatment of gynecomastia has many advantages, such as safe, micro-scars, natural and beautiful male breast figures as well as high patients’ satisfaction.
目的通过对247例小切口阑尾切除术临床体会的总结，探讨以小切口作阑尾切除术的优点、手术适应证、禁忌证以及手术注意事项。方法对247例小切口阑尾切除术病例在手术要点、手术时间、切口长度、术后恢复情况、并发症等方面进行分析，结合文献资料加以总结。结果在手术中开腹、寻找阑尾及关腹均有其特定要求； 手术时间平均18 min，术后拆线及术后住院时间平均分别为4.8 d和4.6 d； 伤口愈合： 甲级235例，乙级9例，丙级2例。结论小切口阑尾切除术具有切口小、外观美、创伤小、恢复快以及经济节省、加快病床周转等诸多优点，是一个值得推广的手术。
Objective To discuss the differences of the effects on open colorectal cancer operation between using ultracision harmonic scalpel (UHS) and monopolar electrosurgery. Methods Fifty-nine patients from April to December in 2007, suffering colorectal cancer in the same treatment group, underwent open radical operation, 29 by GEN300 UHS (UHS group) and 30 by monopolar electrosurgery as control group. There was no significant difference between two groups among the factors of age, gender, tumor location, Dukes staging, gross morphology and degree of histological differentiation (Pgt;0.05). Results Shorter incision was applied in UHS group than in the control group. The mean operation time of UHS group and control group were 126 and 119 min, respectively (Pgt;0.05). The mean operative blood loss was 50 (20-140) ml in UHS group and 90 (40-200) ml in control group (Pgt;0.05). There were no significant differences among factors of bowel function recovery, mean hospitalization and incidence of complications between two groups (Pgt;0.05). The mean time for postoperative drainage fluid changing from bloody to serous was 8 (2-20) h in UHS group, however, 48 (16-80) h in control group (Plt;0.05). Conclusion In open colorectal cancer operation, benefits of using UHS are shorter incision and minimally invasiveness.
To compare the cl inical effect of total hi p arthroplasty (THA) using posterolateral conventional or minimally invasive incision. Methods From January 2007 to November 2007, 38 patients (41 hi ps) were treated with minimally invasive THA (mini-incision group), and 15 patients (15 hi ps) underwent conventional THA (conventional incision group). Mini-incision group: 23 males (25 hi ps) and 15 females (16 hi ps) aged (53.2 ± 15.5) years old; body mass index (BMI) was 23.4 ± 3.3; there were 20 cases (20 hips) of femoral neck fracture, 2 cases (2 hips) of primary osteoarthritis, 14 cases (16 hips) of stage III or IV aseptic necrosis of the femoral head, 2 cases (3 hips) of ankylosing spondyl itis involving hip joint; Harris hip score was 47.7 ± 5.5 and the course of disease was (4.5 ± 4.3) years. Conventional incision group: 7 males (7 hips) and 8 females (8 hips) aged (54.8 ± 10.8) years old; BMI was 26.1 ± 5.1; there were 8 cases (8 hips) of femoralneck fracture, 1 case (1 hip) of primary osteoarthritis, 5 cases (5 hips) of stage III or IV aseptic necrosis of the femoral head, 1 case (1 hip) of ankylosing spondyl itis involving hip joint; Harris hip score was 51.2 ± 4.3 and the course of disease was (3.8 ± 3.7) years. There were no statistically significant differences between two groups in the general information (P gt; 0.05). Results There were statistical differences between two groups in terms of incision length, perioperative blood loss, drainage volume and blood transfusion volume (P lt; 0.05), and no statistical differences were evident in operative time, abduction angle and the anteversion angle of acetabular cup (P gt; 0.05). All incisions healed by first intention and no early postoperative compl ications occurred. Two groups were followed for 12-22 months (average 18.3 months). All patients walked without the crutch at 2-3 months after operation. The Harris score of the mini-incision group and the conventional incision group 6 months after operation was 88.6 ± 3.6 and 85.8 ± 3.3, respectively, indicating there was no significant difference between two groups (P gt; 0.05), but there was significant difference between before and after operation (P lt; 0.05). Conclusion Compared with conventional THA, the minimaly incisive using posteroplateral approach THA has the merits of mini invasion, sl ight hemorrage, short hospital stay, minor compl ication, convenient management of femoral head and accurate prosthesis location. However, strict attention should be paid to operative indications.
Objective To evaluate the effectiveness and feasibility of a transverse small incision intrathecal “loop” minimally invasive suture for acute Achilles tendon rupture. Methods The clinical data of 30 patients with acute Achilles tendon rupture treated with transverse small incision intrathecal “loop” minimally invasive suture between January 2022 and October 2023 was retrospectively analyzed. The patients were all male, aged from 29 to 51 years, with an average of 39.8 years. The cause of injury was acute sports injury, and the time from injury to operation was 1-14 days, with an average of 3.4 days. The operation time, incision length, intraoperative blood loss, intraoperative complications, wound healing, and hospital stay were recorded. Postoperative appearance and function of ankle were evaluated by American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, Vancouver Scar Scale (VSS) score, and Arner-Lindholm score. Results The operation time ranged from 30 to 90 minutes, with an average of 54.2 minutes; the incision length ranged from 1.3 to 3.5 cm, with an average of 2.2 cm; the intraoperative blood loss ranged from 5 to 70 mL, with an average of 22.3 mL; and the hospital stay ranged from 2 to 6 days, with an average of 3.7 days. All incisions healed by first intention, and there was no incision infection, poor healing, and deep venous thrombosis. All patients were followed up 5.3-22.0 months (mean, 14.7 months). During the follow-up, all the 30 patients had returned to exercise, and there was no complication such as Achilles tendon re-rupture, postoperative infection, and gastrocnemius muscle injury. At last follow-up, the AOFAS ankle-hindfoot score was 82-100, with an average of 95.1; the VSS score was 1-4, with an average of 2.1; according to the Arner-Lindholm score, 24 cases were rated as excellent and 6 cases as good. Conclusion Transverse small incision intrathecal “loop” minimally invasive suture for the treatment of acute Achilles tendon rupture has the advantages of simple instrument, convenient operation, small trauma, quick recovery, and satisfactory effectiveness.
Objective To systematically evaluate the effectiveness and safety of minimally invasive video-assisted thyroidectomy (MIVAT) and conventional open thyroidectomy (COT) in treatment of thyroid carcinoma without lymph node metastasis. Methods Databases including PubMed, EMbase, The Cochrane Library (Issue 3, 2015), WanFang, CBM, VIP and CNKI were searched to collect the randomized controlled trails (RCTs) and non-RCTs about MIVAT and COT in treatment of thyroid carcinoma without lymph node metastasis. The retrieval time was from inception to October 2015. The studies were screened according to the inclusion and exclusion criterias, and the data was extracted and the quality of studies was evaluated by 2 reviewers independently. Then the Meta-analysis was conducted by using RevMan 5.2 software. Results A total of 13 non-RCTs involving 3 083 cases were included. The results of Meta-analysis showed that: compared with COT group, operative time of MIVAT group was longer (MD=31.36, 95% CI: 27.68-35.03, P<0.05), hospital stay (MD=-0.16, 95% CI: -0.28--0.04, P=0.01) and length of scar (MD=-1.51, 95% CI: -1.63--1.39, P<0.05) of MIVAT group were shorter, but there was no significant difference in the incidences of transient hypocalcemia (OR=1.29, 95% CI: 0.93-1.78, P=0.13), transient laryngeal nerve palsy (OR=1.42, 95% CI: 0.93-2.17, P=0.11), hemotoma (OR=1.21, 95% CI: 0.64-2.29, P=0.56), recurrence (OR=0.61, 95% CI: 0.28-1.33, P=0.22), number of retrieved central lymph nodes (MD=-0.10, 95% CI: -0.98-0.78, P=0.82), and the size of tumors (MD=-0.02, 95% CI: -0.06-0.02, P=0.39) between the 2 groups. Conclusion MIVAT is safe and feasible in treatment of thyroid carcinoma without lymph node metastasis when its indications are strictly controlled.
ObjectiveTo analyze the safety and follow-up results of on-pump coronary artery bypass grafting (CABG) for the treatment of multivessel diseases via left anterolateral minithoracotomy.MethodsFrom January 2018 to March 2020, a total of 30 patients including 18 males and 12 females with an average age of 61.3±7.5 years having multivessel coronary heart diseases were treated in our hospital with on-pump CABG via left anterolateral minithoracotomy. Among them, 14 patients had three-vessel diseases and 16 patients had two-vessel diseases.ResultsThere were 29 internal mammary artery-to-left anterior descending bypass grafts harvested in total while the rest were saphenous-vein bypass grafts. The average number of bypass vessels was 2.3±0.5. There was no perioperative death in the whole group, one patient underwent rethoracotomy due to hemorrhage, and one patient suffered acute renal insufficiency. The average time of postoperative tracheal intubation was 16.0±5.8 hours, and the postoperative ICU stay was 30.1±11.5 hours. Twenty five patients were followed up, including coronary CT angiography examinations at 6 months and 1 year after operation. Proximal anastomotic stenosis in one patient and distal anastomosis occlusion in one patient occurred.ConclusionOn-pump CABG via left anterolateral minithoracotomy is safe for appropriately selected patients.