Background: The latissimus dorsi (LD) muscle flap plays an essential role in breast reconstruction after partial mastectomy for cancer because of its stability and versatility. We evaluated both oncologic and aestheti...Background: The latissimus dorsi (LD) muscle flap plays an essential role in breast reconstruction after partial mastectomy for cancer because of its stability and versatility. We evaluated both oncologic and aesthetic outcomes in addition to the related complications of this flap as an adjunct to breast conserving surgery in the management of breast cancer patients. Methods: All patients underwent a one-stage procedure with immediate reconstruction through two-steps operation;wider local excision utilizing oncoplastic principles and mini flap harvest & volume replacement. Results: The study included 34 cases with early breast cancer;30 patients had partial breast resection and defect refilling by LD mini-flap, three patients underwent mastectomy and one patient underwent extended LDF. The mean defect volume was (212.63 cm<sup>3</sup> ± 59.57) cm<sup>3</sup>, while the mean flap volume was (218.27 cm<sup>3</sup> ± 53.64 cm<sup>3</sup>). Patient self-evaluation of the cosmetic outcome was excellent in 20%, good in 60% and satisfactory in 20% of patients. Panel evaluation according to Harvard scale showed excellent in 36.7%, good in 36.7%, fair in 26.7% of patients. The median hospital stay was 4 days. The postoperative complications included wound gap in 4 patients (13.3%), postoperative donor site seroma in 16 patients (53.3%). No flap loss or necrosis, no affection on arm or shoulder mobility occurred. Lastly, no tumor recurrence till now. Conclusion: Latissimus dorsi mini-flap can achieve adequate cosmetic and oncologic outcomes with a low incidence of complications in patients with early stage (I/II) breast cancer and small to medium sized breasts.展开更多
目的探讨神经内镜微创手术与显微镜辅助骨瓣开颅血肿清除手术治疗高血压脑出血的疗效。方法纳入2017-01—2020-05蚌埠医学院第二附属医院收治的高血压脑出血患者64例,其中观察组29例,对照组35例。观察组实施神经内镜微创手术治疗,对照...目的探讨神经内镜微创手术与显微镜辅助骨瓣开颅血肿清除手术治疗高血压脑出血的疗效。方法纳入2017-01—2020-05蚌埠医学院第二附属医院收治的高血压脑出血患者64例,其中观察组29例,对照组35例。观察组实施神经内镜微创手术治疗,对照组实施显微镜辅助骨瓣开颅血肿清除手术。统计2组手术时间、术中出血量、血肿清除率、非计划二次手术、术后1 d及7 d GCS评分、住院时间、术后并发症及GOS评分。结果所有病例均随访3个月。观察组手术时间、术中出血量及住院时间与对照组比较差异有统计学意义(P<0.05)。观察组血肿清除率与对照组比较无明显差异(P>0.05)。观察组非计划二次手术发生率为6.8%,对照组为11.4%,2组比较差异无统计学意义(P>0.05),术后7 d GCS评分差异有统计学意义(P<0.05)。观察组术后常见并发症发生率13.8%,对照组为37.1%,差异有统计学意义(P<0.05)。观察组良好预后率48.3%,明显高于对照组20.0%,差异有统计学意义(P=0.02)。结论神经内镜微创手术在高血压脑出血治疗中能够缩短手术时间,减少术中出血量及术后并发症,改善患者预后。展开更多
文摘Background: The latissimus dorsi (LD) muscle flap plays an essential role in breast reconstruction after partial mastectomy for cancer because of its stability and versatility. We evaluated both oncologic and aesthetic outcomes in addition to the related complications of this flap as an adjunct to breast conserving surgery in the management of breast cancer patients. Methods: All patients underwent a one-stage procedure with immediate reconstruction through two-steps operation;wider local excision utilizing oncoplastic principles and mini flap harvest & volume replacement. Results: The study included 34 cases with early breast cancer;30 patients had partial breast resection and defect refilling by LD mini-flap, three patients underwent mastectomy and one patient underwent extended LDF. The mean defect volume was (212.63 cm<sup>3</sup> ± 59.57) cm<sup>3</sup>, while the mean flap volume was (218.27 cm<sup>3</sup> ± 53.64 cm<sup>3</sup>). Patient self-evaluation of the cosmetic outcome was excellent in 20%, good in 60% and satisfactory in 20% of patients. Panel evaluation according to Harvard scale showed excellent in 36.7%, good in 36.7%, fair in 26.7% of patients. The median hospital stay was 4 days. The postoperative complications included wound gap in 4 patients (13.3%), postoperative donor site seroma in 16 patients (53.3%). No flap loss or necrosis, no affection on arm or shoulder mobility occurred. Lastly, no tumor recurrence till now. Conclusion: Latissimus dorsi mini-flap can achieve adequate cosmetic and oncologic outcomes with a low incidence of complications in patients with early stage (I/II) breast cancer and small to medium sized breasts.
文摘目的探讨神经内镜微创手术与显微镜辅助骨瓣开颅血肿清除手术治疗高血压脑出血的疗效。方法纳入2017-01—2020-05蚌埠医学院第二附属医院收治的高血压脑出血患者64例,其中观察组29例,对照组35例。观察组实施神经内镜微创手术治疗,对照组实施显微镜辅助骨瓣开颅血肿清除手术。统计2组手术时间、术中出血量、血肿清除率、非计划二次手术、术后1 d及7 d GCS评分、住院时间、术后并发症及GOS评分。结果所有病例均随访3个月。观察组手术时间、术中出血量及住院时间与对照组比较差异有统计学意义(P<0.05)。观察组血肿清除率与对照组比较无明显差异(P>0.05)。观察组非计划二次手术发生率为6.8%,对照组为11.4%,2组比较差异无统计学意义(P>0.05),术后7 d GCS评分差异有统计学意义(P<0.05)。观察组术后常见并发症发生率13.8%,对照组为37.1%,差异有统计学意义(P<0.05)。观察组良好预后率48.3%,明显高于对照组20.0%,差异有统计学意义(P=0.02)。结论神经内镜微创手术在高血压脑出血治疗中能够缩短手术时间,减少术中出血量及术后并发症,改善患者预后。
