Annular ligament reconstruction - a better technique in the surgical treatment of stapes fixation

Reconstruction of the annular ligament using vein graft at the stapedotomy site gives a very good gain at low, frequencies as compared to Stapedotomy without a tissue seal It also protects against perilymph leak 1 0 8mm stapedotomy with a 0 4mm piston with 0 2 mm vein graft interposition is a better technique in the surgical treatment of stapes fixation The purpose of the present study is to determine the effectiveness of vein graft in sealing the oval window in small fenestra stapedotomy for stapedial otoselerosis We performed a prospective randomi ed trial in 80 cases of stapedial otoselerosis, 40 with and 40 without having a tissue seal at a tertiary referal center Ihere was a good air bone gap closure in both the groups There was a better gain in the lower frequencies in subjects where the vein graft was used     

颈动脉体瘤外科治疗及手术方法选择的探讨

目的　探讨颈动脉体瘤切除术及颈动脉切除患者的选择指标。方法　对拟行颈动脉切除的患者 ,术前行Matas试验和Willis环发育状况评价。术中单纯行瘤体剥离术或与颈动脉一并切除。结果　颈动脉体瘤患者 11例 ,瘤体切除 8例 ,瘤体并颈动脉切除 3例 ,无脑并发症发生及死亡。结论　颈动脉体瘤提倡以瘤体剥离为主 ,对预计瘤体剥离困难者 ,术前可应用Matas试验和Willis环发育状况测定筛选可以安全切除颈动脉的患者。     

Surgical treatment of endometrial cancer

The main treatment of endometrial cancer is surgery. Total abdominal hysterectomy (TAH) and bilateral salpingo-oophorectomy (BSO) is the principal surgery for stage I disease. Recently, pelvic lymph node dissection and para-aortic node biopsy is also being performed. For stage II, many surgeons in Japan prefer to do radical hysterectomy, however, its validity is questioned. For stages III and IV, surgery, radiation, chemotherapy and/or hormone therapy are combined, however, TAH and BSO should be performed at least. In 1988, FIGO changed the endometrial cancer staging system from clinical to surgical. According to this new staging, laparotomy should be done first and treatment plans made depending on the result of surgical finding.     

Reparative granuloma following stapes surgery

Reparative granuloma of the oval window is an uncommon complication of stapes surgery, which usually develops within one to six weeks after operation and causes a sudden hearing loss and disturbance of balance. We report 2 cases of post-stapedectomy reparative granuloma that developed during the tenure of senior surgeon (AM).     

甲状腺微小癌外科治疗进展

甲状腺微小癌（TMC）发病隐匿、病变直径小、临床症状不显著、病情进展缓慢。研究认为年龄≥45岁和≤15岁、男性、病灶≥5 mm、淋巴结转移者预后较差,应积极手术治疗。手术切除范围应考虑患者的临床资料,在完整切除病灶的基础上,尽量保留正常腺体。对颈部淋巴结转移患者可行淋巴结清扫术,淋巴结阴性者可行预防性中区淋巴结清扫。降低肿瘤复发转移风险,提高患者带瘤生存率与改善患者生命质量,成为 TMC 患者治疗随访的首要目标,对 TMC 的规范化治疗起着至关重要的作用。     

Surgical treatment of rectal cancer

The author presents on analysis of the treatment of pathological patients, admitted to the Chair of Hospital Surgery of Kuibyshev Medical Institute named after D. I. Uljyanov, for a 32-year period. A total number of patients-21.590, 1.702 of them were treated for rectal cancer, and 1.250 fo these (73.4) were radically operated upon. Three basic types of radical surgery performed by the author are described, as well as the method of the postoperative management of the patients (chemotherapy, etc). A survival over 5 years was noted 46.5% and over 10 years in 18.1% of radically operated patients.     

Surgical treatment of hepatocellular carcinoma

The result of surgical treatment for hepatocellular carcinoma in National Cancer Center Hospital is reported. Almost 80% of the cases in this series are cirrhotic. The cases were divided into two groups according to the period when hepatectomy was done, as the first half, [A], was from 1974 till 1981 when the treatment was only surgical removal and the latter half, [B], was from 1982 till the end of March, 1986 when pre- and post-operative embolization was combined with hepatectomy. The operative mortality rate was 10.1% (9/89) for [A] and 2.2% (3/121) for [B]. The cumulative survival rates of [A] for the 1st-5th year were 65.8%, 52.6%, 39.5%, 32.9% and 27.2%, respectively, and those of [B] were 86.1%, 78.1%, 65.1%, 50.6% and 50.6%.     

Surgical treatment of brain metastasis

Treatment modalities for brain metastasis or metastatic brain tumor include surgery, conventional irradiation, stereotactic radiosurgery (SRS), chemotherapy, and supportive care with corticosteroid. In most cases, these treatments are used in combination. For a single metastasis, surgery followed by whole-brain radiation therapy (WBRT) has been the standard treatment. SRS has become increasingly popular and challenges the standard procedure, but there are still insufficient data for the outcomes of combinations including SRS. For the treatment of multiple metastases, WBRT is the standard procedure. For tumors larger than 3cm, and in life-threatening situations such as a large metastasis to the cerebellum, surgery is the only feasible approach. Histological examination is sometimes useful for characterizing metastatic tumors from unknown primary sites. Thus, although brain metastasis invariably indicates a stage 4 cancer, some patients can benefit from surgery.     

Surgical treatment of extravasation injuries

The authors present their experience of treating anti-cancer drug extravasation by means of a composite surgical technique that consists of infiltration with physiological solution and hyaluronidase and subsequent manual aspiration of solutes alternated with profuse irrigation of the infiltrated area. In the immediate post-op we carry out a medical therapy that consists of calciparine and topic antibiotic and/or steroid creams. Since the year 2000 this technique has been used on 25 patients. We have had neither complications nor scars.     

Surgical treatment of liver metastases

Approximately 50% to 60% of patients with colorectal cancer will develop hepatic metastases during the course of their illness, with 20% to 30% of patients having liver metastases at time of diagnosis. In nearly a quarter of these patients the liver is the only site of disease. Surgical resection of isolated hepatic metastases has been associated with a 27% to 37% 5-year survival and confers a survival advantage compared to patients not undergoing resection. Thorough preoperative and intraoperative evaluation is necessary to select appropriate surgical candidates who may benefit from resection. This article examines criteria useful in patient selection, and also reviews the management of recurrent hepatic metastases and the role of repeat hepatic resection.     

Surgical treatment of rectal cancer

Rectal cancer should no longer be thought of as only a surgically treated disease. Centers that treat large numbers of rectal cancer patients should provide state of the art radiotherapy and chemotherapy as well as offer anatomic tumor-specific operations for advanced-stage cancers and local treatment options for favorable, early lesions.     

Surgical treatment of hepatocellular carcinoma

The surgical treatment for hepatocellular carcinoma must be chosen by considering some factors such as liver function, position and involved area of the tumor. This article reports our guide line for surgical treatment based on liver function and long term survival. In severe cirrhotic patient with ICG retention rate ranging 30 to 40%, hepatectomy can be indicated only when they mach several conditions as follows; KICG from 0.06 to 0.08, superficially located tumor removal by resection of small area with curability. In patients with ICG retention rate lower then 30%, resection range is determined by the multiple regression equation indicating safety limit of hepatectomy. The predictability of the equation has been as high as 93%, the long term survival depends on following factor, i.e.; tumor size, VP factor, and IM factor. Hepatectomy should be first option when the tumor is less than 5 cm in size, VPO, IMO, and can be safely removable with segmentectomy or larger resection.     

Surgical treatment of livedo vasculitis

Surgical treatment for livedo vasculitis as a primary approach is not mentioned in the literature. A young female patient suffering from livedo vasculitis (atrophie blanche) was admitted with huge ulcerations and pre-ulcerative, infarcted skin areas of both feet and ankles. The lesions were promptly excised and skin grafted with excellent results. The course of treatment, including several surgical procedures, is described.     

Surgical treatment of hepatocellular carcinoma

The effect of surgical treatment for hepatocellular carcinoma (HCC) was evaluated in 149 resected cases, 83.2% of which were associated with liver cirrhosis. The 3- and 5-year survival rates were 60.1% and 39.4%, respectively. The mortality rate was 4.1%. In patients aged over 70 years, liver cirrhosis was found in 53.3% of cases and the mortality rate was 6.7%. The 3- and 5-year survival rates were 50.8% and 33.9%, respectively. Factors that significantly affected survival for more than 5 years were a tumor size of less than 3 cm, Stage I disease, vp(–), IMo, and diploid type. The 5-year survival rate for patients with a single tumor of 3 cm or less was 54.2%, regardless of the surgical procedure. All 15 patients with a solitary tumor of 2 cm or less (Stage I, small liver tumor) were alive with a 5-year survival rate of 100%. The problem is the treatment of patients with a tumor measuring 3–5 cm in diameter and associated liver cirrhosis, because their prognosis after surgery is the worst. HrS (subsegmentectomy) is the minimal procedure of limited hepatectomy for these cases with postoperative multidisciplinary therapy.Work presented at the Third International Symposium on Treatment of Liver Cancer, Seoul, Korea, 12–13 February 1993