Laparoscopic excision of duodenal schwannoma

Background Benign duodenal tumours are rare and less common than malignant tumours. They comprise a wide variety of pathologies. Schwannoma is an ectodermal neoplasm arising from the nerve sheath that envelops axons. A duodenal location is extremely rare. Therapy consists in the radical excision of the tumour. Our aim was to describe a minimally invasive technique used for the excision of duodenal schwannoma, so that a laparotomy has been avoided. Methods A laparoscopic operation under general anaesthesia was undertaken with the patient in supine position with the legs abducted. No macroscopic peritoneal seedling was found. Therefore, a laparoscopic Kocher maneuver was performed. The retroperitoneum was entered using the harmonic scalpel and the dissection extended beyond the vena cava and the duodenum. The location and the size of the lesion have been confirmed using an intraoperative endoscopic ultrasound examination. The excision of the lesion was performed by use the harmonic scalpel. Then, the duodenal wall was sutured by use endoscopic stitches. The resected lesion was then placed in a retrieval bag and extracted through the port incision. Operating time was 300 min and blood loss 200 ml. Results The postoperative course was uneventful. Histological findings showed a benign schwannoma. Conclusions The minimally invasive technique may be a valid alternative to open surgery in the treatment of benign duodenal tumors. Electronic supplementary material to this article is available at and accessible for authorized users.     

CIN宫颈锥切术后病变残留临床处理

目的:探讨引起宫颈上皮内瘤变宫颈锥切术后病变残留的因素及处理。方法:2007年1月～2009年6月在我院因CIN行宫颈锥切手术的患者中切缘残留20例,无切缘残留121例。分析CIN锥切术后病变残留与切缘阳性、病变程度,以及是否专科手术者的关系。结果:141例中切缘残留20例(14.1%),重度宫颈糜烂研究组16例(80%),对照组无切缘残留121例,重度宫颈糜烂13例(10.7%)。141例宫颈锥切患者,由普通医生实施手术操作的54例,切缘阳性13例,切缘阳性率24%;由专科医生实施手术操作的87例,切缘阳性7例,切缘阳性率为8%。结论:宫颈锥切术后病变残留应行HPVDNA检测和阴道镜随诊,来确定是否行二次锥切术。     

Management of Pilonidal Sinus Disease With Oblique Excision and Primary Closure: Results of 493 Patients

Purpose Pilonidal sinus disease is a common and well-known entity. Many surgical methods have been described for the treatment of pilonidal sinus disease. The aim of this study was to determine the advantages and long-term results of oblique excision and primary closure techniques. Method Between January 1999 and December 2001, 493 patients (490 male, 3 female; average age = 23.48 ± 3.90 (range, 15–51) years) were operated on for primary or recurrent pilonidal sinus disease. An oblique fusiform-shaped incision was made and the skin was excised. The operation was completed with primary closure. All patients' follow-up examinations were made at the end of the 6 weeks and 3, 6, 12, and 18 months after surgery. Results The mean duration of symptoms was 22.09 ± 17.12 (range, 1–120) months. The mean duration of hospital stay was 5.51 ± 2.85 (range, 2–17) days. At the end of the follow-up period, the recurrence rate was 5.6 percent. Conclusion The ideal operation for pilonidal sinus disease treatment must be simple and effective. The technique of oblique excision and primary closure may be considered an alternative operation for pilonidal sinus resulting in a low recurrence rate.     

Two Cases of Congenital Cholesteatoma of the Tympanic Membrane

Congenital cholesteatoma of the tympanic membrane is rare, and lesions without a history of otitis media or any other adverse events involving the tympanic membrane are extremely rare. We report two cases of this lesion; one was a 3-year-old girl who underwent removal of a cholesteatoma using retroauricular approach and a partial myringoplasty with an underlay technique, and the other was a 2-year-old girl in whom a cholesteatoma was enucleated without grafting. This disease is thought to be of embryonic origin.     

113例剖宫产术联合子宫肌瘤剔除术临床效果评价

目的探讨剖宫产术联合子宫肌瘤剔除术的临床可行性和安全性。方法对113例住院分娩的妊娠合并子宫肌瘤产妇在剖宫产同时行子宫肌瘤剔除术,并与同期113例妊娠未合并子宫肌瘤单行剖宫产术病例进行对比,观察两组患者的手术时间、术中出血量、术后产褥病率及术后住院天数等。结果剖宫产术联合子宫肌瘤剔除术比单行剖宫产术的手术时间差异有统计学意义(P<0.05),而两组产妇术中出血量、术后产褥病率及术后住院天数的差异无统计学意义(P>0.05)。结论在恰当的病例选择前提下,剖宫产术联合子宫肌瘤剔除术是安全和可行的,未明显增加手术风险,并减少了患者日后的病痛和经济负担,值得临床推广应用。     

不同方法治疗肉芽肿性小叶性乳腺炎的对比研究

目的探讨肿物单纯切除(EX)、扩大切除(WE)以及类固醇激素治疗(ST)在肉芽肿性小叶性乳腺炎治疗中的效果对比,寻找更好的治疗方法。方法 2003～2010年间石蜡病理确诊为肉芽肿性小叶性乳腺炎患者中,基线处理排除干扰因素后选出共92例患者,随机分组,其中EX组30例,WE组31例,ST组31例,比较3组复发率、复发时间的差异。结果 WE组、ST组复发率较EX组明显较低(P<0.05),而前二者间无明显差异(P=0.694);EX组复发时间最短且与其余各组复发时间存在显著差异(P<0.05),ST组与WE组复发时间无明显统计学差异(P=0.792)。结论扩大切除及类固醇激素治疗对肉芽肿性小叶性乳腺炎患者都能达到较好的效果。     

Preliminary pharmacological evaluation of Martynia annua Linn leaves for wound healing

Objective

To evaluate the wound healing potential of fractions from ethanol extract of Martynia annua (M. annua) Linn leaves.

Methods

Ethanol extract of M. annua Linn leaves was fractionate into three different fractions (MAF-A, MAF-B and MAF-C) which were screened for wound healing potential using two models: excision and incision on rats. The thin layer chromatography (TLC) profile of all fractions were analyzed and TLC of luteolin was also done. The Povidone-Iodine Ointment was used as reference for comparision. Excision and incision wounds were created on dorsal portion of rats for study. Wound contraction, biochemical parameters (protein level and hydroxyproline level) and histopathological study were performed in excision wound model whereas incision model was used for determination of tensile strength.

Results

The wound contraction and tensile strength of skin tissues were observed significantly greater in MAF-C fraction treated group than other two fractions (P<0.01). In excision wound method (on day 18) protein content and hydroxyproline were found significantly higher in MAF-C group than control group (P<0.01). Histopathological study also showed better angiogenesis, matured collagen fibres and fibroblast cells as compared with the control group.

Conclusions

In conclusion, our findings suggest that fraction MAF-C from ethanol extract of M. annua leaves is found most effective in wound healing.     

A critical assessment on the role of sentinel node mapping in endometrial cancer

Endometrial cancer is the most common gynecologic malignancy in the developed countries. Although the high incidence of this occurrence no consensus, about the role of retroperitoneal staging, still exists. Growing evidence support the safety and efficacy of sentinel lymph node mapping. This technique is emerging as a new standard for endometrial cancer staging procedures. In the present paper, we discuss the role of sentinel lymph node mapping in endometrial cancer, highlighting the most controversies features.     

Breast Lesion Excision System in the diagnosis and treatment of intraductal papillomas – A feasibility study

Objectives

This study aims to evaluate the feasibility of Breast Lesion Excision System (BLES) in the treatment of intraductal papillomas.