A Reproducible Technique for Arthroscopic Acromioclavicular Joint Excision

Arthroscopic acromioclavicular joint excision is a commonly performed but technically demanding procedure. Incomplete excision can leave residual symptoms. We present a simple, reproducible technique ensuring satisfactory excision of the joint.     

原发性腹膜后脂肪肉瘤20例报告

自１９６５年５月至１９９１年７月共收治原发性腹膜后脂肪肉瘤２０例，均经手术及病理证实。２０例中完全切除者１５例，部分切除者４例，活检１例。肿瘤切除合并肾，肠襻等邻近器官切除者达１２例。全组的５年，１０年生存率分别是５７．１％和２０．０％，完全切除组的５年１０年生存率分别是６３．６％和２８．６％。２０例病人共进行了４８次切除手术。首次手术死亡２例。着重讨论了本病的诊断、治疗和突出的临床特点。     

Angiolymphoid hyperplasia with eosinophilia: report of a large-sized scalp lesion

In this report, a case is presented with large recurrent, benign, vascular and proliferative lesion on the scalp. Complete surgical excision of the tumor mass and split thickness skin grafting of the defect had favorable results with no recurrences after 24-month follow-up.     

Ectopic cervical salivary glands

Summary Ectopic salivary glands in the neck are very unusual lesions. Generally they are localized to the oropharyngeal region, near the mandible and para-parotid lymph nodes. They occur occasionally on the anterior border of the sternocleidomastoid muscle in the soft tissues of the neck. We wish to report on a singular association of ectopic salivary glands with partial hearing loss, preauricular fistula, palatoschisis, anal fistula, and an arteria lusoria. Morphological, histological and embryological aspects are discussed.     

腹腔镜胆囊切除362例分析

目的：提高腹腔镜胆囊切除愈率减少术后并发症的发生。方法：回顾分析1997年4月至2000年11月我院开展腹腔镜胆囊切除362例。结果：术后1－6d出院,平均2.3d;中转开腹手术9例,占2.48%;胆总管损作伤2例,占0.55%;术后并发症6例,占1.6%;其中胆漏3例,胆总管残余结石3例。结论：术中融损伤与术后并发症的发生和腹腔镜的局限性、特殊性与手术操作技巧有关。     

Analer Schließmuskelersatz mittels dynamischer Gracilisplastik – Ergebnisse der Anwendung an 50 Patienten

During the period from 1992 to 1998, 50 patients underwent anal sphincter restoration by dynamic graciloplasty for primary (n = 26) or secondary (n = 6) total anorectal reconstruction (TAR) following abdominoperineal rectal resection (APR) or acquired (n = 9) or congenital (n = 9) fecal incontinence, respectively. Forty-seven patients were operated on by a single-stage procedure using a modified technique for the muscle wrap ("split sling"). Muscle fiber transformation by controlled stimulation was achieved at the beginning of the learning curve within 8 weeks and in the meantime within 4 weeks. Rectal injury (n = 10) turned out to be the most serious postoperative complication and was observed mainly in patients following TAR (n = 8). As the most prominent functional problem constipation in patients following TAR hampered the postoperative functional result; however, this was overcome by regular enemas. An improvement in the continence status was observed in 80% of the patients treated for fecal incontinence, and following APR 66% of the patients had acceptable results without a permanent colostomy.     

切除修复交叉互补基因1与铂类药物耐药

铂类药物耐药是多种复杂机制共同作用的结果.其中,肿瘤细胞切除修复交叉互补基因1(ERCC1)表达及其多态性是肿瘤细胞产生铂类药物耐药的重要机制之一.抑制ERCC1的表达可逆转铂类药物耐药性.     

Paraaortic sentinel lymph node detection in intermediate and high-risk endometrial cancer by transvaginal ultrasound-guided myometrial injection of radiotracer (TUMIR)

ObjectiveWe aimed to evaluate the accuracy of sentinel lymph node (SLN) mapping with transvaginal ultrasound-guided myometrial injection of radiotracer (TUMIR) to detect lymph node (LN) metastases, in patients with intermediate and high-risk endometrial cancer (EC), focusing on its performance to detect paraaortic involvement.MethodsProspective study including women with preoperative intermediate or high-risk EC, according to ESMO-ESGO-ESTRO consensus, who underwent SLN mapping using the TUMIR approach. SLNs were preoperatively localized by planar and single photon emission computed tomography/computed tomography images, and intraoperatively by gamma-probe. Immediately after SLN excision, all women underwent systematic pelvic and paraaortic lymphadenectomy by laparoscopy.ResultsThe study included 102 patients. The intraoperative SLN detection rate was 79.4% (81/102). Pelvic and paraaortic drainage was observed in 92.6% (75/81) and 45.7% (37/81) women, respectively, being exclusively paraaortic in 7.4% (6/81). After systematic lymphadenectomy, LN metastases were identified in 19.6% (20/102) patients, with 45.0% (9/20) showing paraaortic involvement, which was exclusive in 15.0% (3/20). The overall sensitivity and negative predictive value (NPV) of SLNs by the TUMIR approach to detect lymphatic involvement were 87.5% and 97.0%, respectively; and 83.3% and 96.9%, for paraaortic metastases. After applying the MSKCC SLN mapping algorithm, the sensitivity and NPV were 93.8% and 98.5%, respectively.ConclusionThe TUMIR method provides valuable information of endometrial drainage in patients at higher risk of paraaortic LN involvement. The TUMIR approach showed a detection rate of paraaortic SLNs greater than 45% and a high sensitivity and NPV for paraaortic metastases in women with intermediate and high-risk EC.     

进展期胃癌手术加早期腹腔内化疗疗效观察

目的探讨进展期胃癌行胃癌根治或扩大根治术后及早期腹腔内化疗的效果。方法回顾分析我院共诊治123例进展期胃癌患者(其中行胃癌根治或扩大根治术76例)的临床资料。结果其手术根治切除率为61.8%,死亡率为5.3%,3年以上存活率为62.5%。结论进展期胃癌应早期诊断、治疗。胃癌根治或扩大根治后并早期腹腔内化疗效果满意。     

宫颈性质不明的不典型鳞状细胞患者电环术后疗效及影响因素研究

目的对性质不明的不典型鳞状细胞(ASCUS)患者进行规范诊疗,观察电环术后TCT和Hc2的变化及影响因素。方法对ASCUS及Hc2阳性患者,以小电环(手术组)及活检钳(非手术组)进行分组活检,术后定期复查TCT和Hc2。结果术后3~6月复查TCT和Hc2,手术组与非手术组比较,差异有显著性(χ2分别为49.12、29.01,P均<0.01);术后1年复查,手术组与非手术组,差异无显著性χ2(χ2为0.41、0.04,P均>0.05);术后2年复查,两组无显著性差异(χ2为、1.32,P>0.05)。患者可根据治疗的依从性任选方案。ASCUS发病人群中,婚育史:孕次>3次以上,占43.3%,孕次2次,占21.6%,孕次1次占20.6%,未孕者占14.5%;性行为史:初次性行为<20岁者,占34.2%,初次性行为>20岁者,占65.8%;避孕史:未避孕占71.5%,工具避孕占23.2%,药物避孕占4.2%;绝育占1.1%。结论两组TCT及Hc2在术后3~6月差异显著,术后1年及2年无显著差异。ASCUS中未避孕、初次性行为>20岁、多孕及未孕者是值得重视的人群。