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.     

动脉栓塞对骨盆肿瘤手术疗效的影响

[目的]探讨供血动脉栓塞对骨盆肿瘤手术疗效的影响。[方法]本组16例，脊索瘤7例，骨巨细胞瘤3例，骨转移瘤3例，骨肉瘤2例，神经纤维瘤1例。术前1d行肿瘤血管造影并用明胶海绵进行供血动脉栓塞。与对照组（结扎双侧髂内动脉骨盆肿瘤切除术）比较，观察其对术中出血量、手术时间、住院时间、术后下床时间、伤口愈合时间及术后各种功能恢复的影响。[结果]骨盆肿瘤切除术前肿瘤供血动脉栓塞与结扎双侧髂内动脉比较，除术中出血量外（P〉0．05），手术、住院、术后下床及伤口愈合时间在统计学上均有非常显著性差异（P〈0．001），而且结扎双侧髂内动脉可能对患者的性功能、排便功能等存在着不良的影响。[结论]肿瘤供血动脉栓塞骨盆肿瘤切除术可大大缩短手术、住院、术后下床、伤口愈合时间，且能更好地保护盆腔内外各组织器官的血运，从而避免其功能的损害。     

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.     

PROPELLER DUO DWI序列+常规MRI在直肠癌术前T分期中的应用价值

目的研究螺旋桨采集技术扩散加权成像(PROPELLER DUO DWI)+核磁共振成像(MRI)诊断直肠癌术前T分期的应用价值。方法选取我院2018年6月至2020年6月直肠癌患者65例,均进行MRI及DWI扫描检查,以病理学诊断结果为“金标准”。比较常规MRI与常规MRI+DWI诊断直肠癌T分期的结果及准确率。结果65例直肠癌患者常规MRI诊断T1~T2期33例,T3期22例,T4期10例。MRI+PROPELLER DUO DWI诊断T1~T2期37例,T3期21例,T4期7例。MRI+PROPELLER DUO DWI诊断总准确率为92.3%(60/65),高于MRI[80.0%(52/65,P<0.05)]。结论与MRI常规序列比较,PROPELLER DUODWI技术+常规MRI在直肠癌患者术前T分期诊断中准确率更高,有助于临床治疗方案的制定。     

The breast lesion excision system (BLES) under stereotactic guidance cannot be used as a therapeutic tool in the excision of small areas of microcalcifications in the breast

ObjectiveThe breast lesion excision system (BLES) is a new, automatic percutaneous breast biopsy device that excises single large specimens using radiofrequency cutting. The aim of this study was to determine whether BLES, under stereotactic guidance, can be used as a therapeutic tool in the assessment of small areas of microcalcifications in the breast by providing samples with clear margins.Material and methodsIn this retrospective study, 149 patients with suspicious (BIRADS 4 or 5) small areas of microcalcifications underwent stereotactic-guided BLES. Of these, 34 patients (22.8%) with microcalcifications that had a diameter smaller than the basket size (≤15 mm) underwent both BLES and subsequent surgery. Histopathology findings from BLES and subsequent surgery were compared. Identical, underestimation and total excision findings were assessed.ResultsBLES revealed fourteen (41.1%) high-risk lesions, ten (29.4%) ductal carcinomas in situ, and ten (29.4%) invasive cancers. Identical results between BLES and surgery were seen in 17/34 (50%) lesions. Surgery confirmed total excision of BLES in 15/34 (44.1%) lesions. Underestimation was seen in 2/34 (5.8%) lesions.ConclusionBLES allows accurate diagnosis of small areas of microcalcifications, with few underestimates. BLES is a diagnostic, but cannot be considered to be a therapeutic tool in the case of suspicious microcalcifications because total excision was seen in only 44.1% of these lesions. Studies are needed to address the therapeutic benefit of this procedure in solid lesions.