Objective To observe eflect uf fascial flaps of supraclavicular artery on treatment of neck scar contracture. Methods The supraclavicular flaps were designed according to direction of supraclavicular arteries and tran...Objective To observe eflect uf fascial flaps of supraclavicular artery on treatment of neck scar contracture. Methods The supraclavicular flaps were designed according to direction of supraclavicular arteries and transferred into detective areas caused by scar releasing.展开更多
A systematic review was conducted to evaluate the impact of bladder neck preservation on retrograde ejaculation,bladder neck contracture,and incontinence following standard transurethral resection of the prostate(TURP...A systematic review was conducted to evaluate the impact of bladder neck preservation on retrograde ejaculation,bladder neck contracture,and incontinence following standard transurethral resection of the prostate(TURP).A comprehensive literature search was conducted in PubMed,Scopus,Google Scholar,and the World Health Organization International Clinical Trials Registry Platform databases up to September 22,2024.Original research articles meeting the inclusion criteria were selected to assess the preventive effect of bladder neck preservation on retrograde ejaculation compared with standard TURP.Two studies specifically assessing the efficacy of bladder neck preservation in preventing retrograde ejaculation during TURP were included in the analysis.The findings indicate that bladder neck preservation significantly reduces the incidence of retrograde ejaculation,with an odds ratio(OR)of 0.08(95%confidence interval[CI]:0.02-0.30).Bladder neck preservation appears to provide substantial benefits in reducing retrograde ejaculation while showing no notable differences in bladder neck contracture and incontinence rates compared with standard TURP.展开更多
Background Because patients with scar contracture of the neck are at a high risk of loss of the airway control after anesthesia induction, awake intubation is usually recommended. This retrospective clinical study was...Background Because patients with scar contracture of the neck are at a high risk of loss of the airway control after anesthesia induction, awake intubation is usually recommended. This retrospective clinical study was designed to evaluate the possibility, safety and efficacy of airway management and tracheal intubation under general anesthesia in such patients. Methods This retrospective study included 1683 patients from January 1994 to December 2006 with scar contracture of the neck, aged 1.5--67.0 years, who were scheduled for elective plastic surgery under general anesthesia in Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College. Based on the results of the preoperative airway assessment, the patients were classified into group 1 （including 1375 patients with the atlanto-occipital extension of 〉20° and the Mallampatti＇s grade I or II） and group 2 （containing 308 patients with the atlanto-occipital extension of 〈20° and the Mallampatti＇s grade III or IV. In group 1, the intravenous induction and maintenance of anesthesia and succinylcholine for muscle relaxation were used. The intubation was done using a modified Macintosh technique. In group 2, the total intravenous anesthesia （TIVA） or the sevoflurane inhalation anesthesia was chosen and the spontaneous breathing was reserved during anesthesia. The intubation was performed by a fiberoptic stylet laryngoscope （FOSL）. The number of intubation attempts, intubation time and relative complications were observed and recorded in all patients. Results In group 1, the intubation was accomplished during the first attempt in 1279 cases （93%） and the intubation time was 〈3 minutes in 1304 cases （95%）. In group 2, the intubation was completed by the first attempt in 114 patients （37%） and 123 patients had an intubation time of 〈3 minutes （40%）. Tracheal intubation was successful by the second or third attempt in 96 patients in group 1 and 156 patients in group 2. Thirty-eight patients required four or more attempts which only occurred in group 2. The incidence of traumatic complication was 2.6% and 9.7% with one intubation attempt in groups 1 and 2, respectively, 12.5% and 17.0% with multiple intubation attempts （one vs multiple attempts in both groups, P 〈0.001）. All nontrauamatic complications occurred in group 2 and laryngospasm and hypoxemia were more common in patients using the TIVA compared to those using the sevoflurane inhalational anesthesia （P 〈0.001）. Conclusions This study demonstrated that with a precise airway evaluation, an adequate preoperative preparation and a pre-planned failed intubation strategy, the anesthetist who was experienced in the difficult airway management could safely perform airway control and tracheal intubation under general anesthesia in patients with scar contracture of the neck. We believe that this technique may be very valuable for the management of a known difficult airway because it is comfortable for the patient and saves time for the anesthetist.展开更多
Benign prostatic hyperplasia(BPH)is one of the most frequently diagnosed benign disorders that cause dysuria in middle-aged and elderlymen.Some patientswith BPH have relatively small prostates(referred to as small-vol...Benign prostatic hyperplasia(BPH)is one of the most frequently diagnosed benign disorders that cause dysuria in middle-aged and elderlymen.Some patientswith BPH have relatively small prostates(referred to as small-volume BPH)but still experience the lower urinary tract infection.Medication treatment is typically not successful in these patients.In addition,their pathophysiologic pathways deviate from those previously observed.Furthermore,as there is no accepted protocol for the diagnosis and treatment of small-volume BPH,patients can experience great difficulties inmanaging surgical complications such as bladder neck contracture.Thus,we reviewed the features of small-volume prostates,preoperative assessment,surgical technique,and management of complications.展开更多
Posterior urethral stenosis(PUS)is a known complication following prostate cancer treatment as well as other benign endoscopic treatments.Patients with PUS often fail initial endoscopic treatments and have persistent ...Posterior urethral stenosis(PUS)is a known complication following prostate cancer treatment as well as other benign endoscopic treatments.Patients with PUS often fail initial endoscopic treatments and have persistent symp-toms negatively affecting quality of life.In the past decade,a variety of dif-ferent surgical techniques and approaches have changed the landscape of PUS management.The goal of this review is to provide details on the his-torical,current,and future direction of the surgical management for PUS.展开更多
文摘Objective To observe eflect uf fascial flaps of supraclavicular artery on treatment of neck scar contracture. Methods The supraclavicular flaps were designed according to direction of supraclavicular arteries and transferred into detective areas caused by scar releasing.
文摘A systematic review was conducted to evaluate the impact of bladder neck preservation on retrograde ejaculation,bladder neck contracture,and incontinence following standard transurethral resection of the prostate(TURP).A comprehensive literature search was conducted in PubMed,Scopus,Google Scholar,and the World Health Organization International Clinical Trials Registry Platform databases up to September 22,2024.Original research articles meeting the inclusion criteria were selected to assess the preventive effect of bladder neck preservation on retrograde ejaculation compared with standard TURP.Two studies specifically assessing the efficacy of bladder neck preservation in preventing retrograde ejaculation during TURP were included in the analysis.The findings indicate that bladder neck preservation significantly reduces the incidence of retrograde ejaculation,with an odds ratio(OR)of 0.08(95%confidence interval[CI]:0.02-0.30).Bladder neck preservation appears to provide substantial benefits in reducing retrograde ejaculation while showing no notable differences in bladder neck contracture and incontinence rates compared with standard TURP.
文摘Background Because patients with scar contracture of the neck are at a high risk of loss of the airway control after anesthesia induction, awake intubation is usually recommended. This retrospective clinical study was designed to evaluate the possibility, safety and efficacy of airway management and tracheal intubation under general anesthesia in such patients. Methods This retrospective study included 1683 patients from January 1994 to December 2006 with scar contracture of the neck, aged 1.5--67.0 years, who were scheduled for elective plastic surgery under general anesthesia in Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College. Based on the results of the preoperative airway assessment, the patients were classified into group 1 （including 1375 patients with the atlanto-occipital extension of 〉20° and the Mallampatti＇s grade I or II） and group 2 （containing 308 patients with the atlanto-occipital extension of 〈20° and the Mallampatti＇s grade III or IV. In group 1, the intravenous induction and maintenance of anesthesia and succinylcholine for muscle relaxation were used. The intubation was done using a modified Macintosh technique. In group 2, the total intravenous anesthesia （TIVA） or the sevoflurane inhalation anesthesia was chosen and the spontaneous breathing was reserved during anesthesia. The intubation was performed by a fiberoptic stylet laryngoscope （FOSL）. The number of intubation attempts, intubation time and relative complications were observed and recorded in all patients. Results In group 1, the intubation was accomplished during the first attempt in 1279 cases （93%） and the intubation time was 〈3 minutes in 1304 cases （95%）. In group 2, the intubation was completed by the first attempt in 114 patients （37%） and 123 patients had an intubation time of 〈3 minutes （40%）. Tracheal intubation was successful by the second or third attempt in 96 patients in group 1 and 156 patients in group 2. Thirty-eight patients required four or more attempts which only occurred in group 2. The incidence of traumatic complication was 2.6% and 9.7% with one intubation attempt in groups 1 and 2, respectively, 12.5% and 17.0% with multiple intubation attempts （one vs multiple attempts in both groups, P 〈0.001）. All nontrauamatic complications occurred in group 2 and laryngospasm and hypoxemia were more common in patients using the TIVA compared to those using the sevoflurane inhalational anesthesia （P 〈0.001）. Conclusions This study demonstrated that with a precise airway evaluation, an adequate preoperative preparation and a pre-planned failed intubation strategy, the anesthetist who was experienced in the difficult airway management could safely perform airway control and tracheal intubation under general anesthesia in patients with scar contracture of the neck. We believe that this technique may be very valuable for the management of a known difficult airway because it is comfortable for the patient and saves time for the anesthetist.
基金supported by the NationalNature Science Foundation of China(No.82270810).
文摘Benign prostatic hyperplasia(BPH)is one of the most frequently diagnosed benign disorders that cause dysuria in middle-aged and elderlymen.Some patientswith BPH have relatively small prostates(referred to as small-volume BPH)but still experience the lower urinary tract infection.Medication treatment is typically not successful in these patients.In addition,their pathophysiologic pathways deviate from those previously observed.Furthermore,as there is no accepted protocol for the diagnosis and treatment of small-volume BPH,patients can experience great difficulties inmanaging surgical complications such as bladder neck contracture.Thus,we reviewed the features of small-volume prostates,preoperative assessment,surgical technique,and management of complications.
文摘Posterior urethral stenosis(PUS)is a known complication following prostate cancer treatment as well as other benign endoscopic treatments.Patients with PUS often fail initial endoscopic treatments and have persistent symp-toms negatively affecting quality of life.In the past decade,a variety of dif-ferent surgical techniques and approaches have changed the landscape of PUS management.The goal of this review is to provide details on the his-torical,current,and future direction of the surgical management for PUS.
