AIM： To evaluate the clinical value of wedge resection at corneal limbus in patients with traumatic corneal scarring and high irregular astigmatism. METHODS： Patients with traumatic corneal astigmatism received wed...AIM： To evaluate the clinical value of wedge resection at corneal limbus in patients with traumatic corneal scarring and high irregular astigmatism. METHODS： Patients with traumatic corneal astigmatism received wedge resection at least 6mo after suture removal from corneal wound. The uncorrected distance visual acuities （UCVA） and best corrected distance visual acuities （BCVA）, pre- and post-operation astigmatism, spherical equivalent （SE）, safety and complications were evaluated. RESULTS： Ten eyes （10 patients） were enrolled in this study. Mean follow-up time after wedge resection was 37.8±15.4mo （range, 20-61mo）. The mean UCVA improved from ＋1.07±0.55 IogMAR to ＋0.43±0.22 IogMAR （P=0.000） and the mean BCVA from ＋0.50±0.30 IogMAR to ＋0.15± 0.17 IogMAR （P=0.000）. The mean astigmatism power measured by retinoscopy was -2.03±2.27 D postoperatively and -2.83±4,52 D preoperatively （P=0.310）. The mean SE was -0.74±1.61 D postoperatively and -0.64±1.89 D preoperatively （P=0.601）. Two cases developed mild pannus near the sutures. No corneal perforation, infectious keratitis or wound gape occurred. CONCLUSION： Corneal-scleral limbal wedge resection with compression suture is a safe, effective treatment for poor patients with high irregular corneal astigmatism after corneal-scleral penetrating injury. Retinoscopy can prove particularly useful for high irregular corneal astigmatism when other measurements are not amenable.展开更多
BACKGROUND Gastroesophageal junction(GEJ)or gastrointestinal stromal tumor(GIST)are located in unfavorable parts of the stomach,due to the anatomical complexity of these regions,protecting the cardia while ensuring R0...BACKGROUND Gastroesophageal junction(GEJ)or gastrointestinal stromal tumor(GIST)are located in unfavorable parts of the stomach,due to the anatomical complexity of these regions,protecting the cardia while ensuring R0 resection is a major challenge for surgeons.CASE SUMMARY Two cases of GEJ stromal tumors were reported.Abdominal computed tomography scans revealed that both tumors were located at the GEJ,close to the posterior wall,with one tumor measuring greater than 5 cm.Both patients successfully underwent robot-assisted laparoscopic wedge resection of the stomach.The surgeries achieved R0 resection while preserving the cardia sphincter and maximizing gastric tissue preservation.Postoperatively,no symptoms such as gastroesophageal reflux or cardia stenosis were observed.Case 1:Postoperative pathology:GIST.Immunohistochemical results:Tumor cells were positive for CD34,CD117,and DOG1,and negative for SMA,desmin,S-100,and SDHB(normal expression).The Ki-67 proliferation index was approximately 5%.Case 2:Postoperative pathology:GIST.Immunohistochemical results:Tumor cells were positive for CD117(++),CD34(++),DOG1(+++),and focal positivity for SMA.Negative for desmin,S-100(few cells positive),and SDHB(preserved expression).The Ki-67 proliferation index was approximately 10%.CONCLUSION The gastric tube-guided robotic-assisted laparoscopic resection is a safe and effective method for tumor resection while preserving the cardia,and it is worth further promotion in clinical practice.展开更多
Although major contributions have been made in the field of reconstructive surgery,reconstructive surgery of the auricle is a daunting prospect even for the most experienced surgeons.Here,we present a case who present...Although major contributions have been made in the field of reconstructive surgery,reconstructive surgery of the auricle is a daunting prospect even for the most experienced surgeons.Here,we present a case who presented to us in the emergency surgical ward with a history of an accidental laceration of right ear.Primary repair of the ear laceration after wedge resection of the avulsed part was done.The cosmesis achieved by this technique is discussed.展开更多
BACKGROUND The inflammatory myofibroblastic tumor(IMT)is a rare mesenquimal tumor of doubtful biological behaviour.It’s characterised for affecting mainly children and young adults,although it can appear at any age,b...BACKGROUND The inflammatory myofibroblastic tumor(IMT)is a rare mesenquimal tumor of doubtful biological behaviour.It’s characterised for affecting mainly children and young adults,although it can appear at any age,being the lungs the primary affected organ(in children it represents 20%of all primary pulmonary tumors).CASE SUMMARY We present the case of a 45 year old woman,with a computed tomography(CT)finding of injury on the anterior surface of the fundus/gastric body and a solid perigastric injury of 12 mm in the ecoendoscopy.The case is presented in the tumor committee deciding to perform a laparoscopic wedge resection.The histological diagnosis was a IMT.The diagnosis is based on imaging tests like the abdominal CT,abdominal ecography and the ecoendoscopy but to confirm the diagnosis a pathological study is necessary.CONCLUSION Due to the unpredictable nature of this tumor,surgical resection is the best therapeutic option.展开更多
Background Adenomyoma is a very serious disease which influence the quality of life and leads to the infertility, and hysterectomy at the end. Unfortunetly, we still have no effective way to treat this kind of disease...Background Adenomyoma is a very serious disease which influence the quality of life and leads to the infertility, and hysterectomy at the end. Unfortunetly, we still have no effective way to treat this kind of diseases. This study was aimed to evaluate the efficacy and surgical characteristics of modified adenomyomectomy. Methods This is a retrospective study and the subjects were collected in the past 5 years. We divided the subjects by the two different surgical procedures. Cases of adenomyoma patients who underwent conservative surgery, modified adenomyomectomy or wedge resection of the adenomyoma lesion were distributed to two groups retrospectively. Surgical characteristics, symptom relief, and recurrence were analysed in each group. Results General characteristics, including operation time, blood loss, and postoperative complication were similar in both groups. In the modified adenomyometomy group, the median follow-up time was 27.6 months and the rate of relief of dysmenorrhea and menorrhagia symptoms were 91.2% and 40.0%, respectively. In the wedge resection group, the rate of reliefe of dysmenorrhea and menorrhagia symptoms were 88.9% and 50.0%, respectively. Patients in both groups had statistically significant symptom relief, but there was no statistical difference between them. During the following time, ultrasonography relapse rate in modified modified adenomyomectomy group is significantly lower than the wedge resection group 15.0% vs. 69.2% （P 〈0.001）. The relapse rate, in terms of symptoms, was 5.0% in the modified adenomyomectomy group, which was similar to the relapse rate in the wedge resection group. In terms of reproductive outcome, 33.3% of the patients with infertility complications in the modified adenomyomectomy group became pregnant. Among them, the rate of pregnancy by assisted reproductive techniques was 45.5%, which was significantly higher than the rate of natural pregnancy, 23.1% （P =0.039）. Conclusion Modified adenomyomectomy appears to be a safe and effective operative method that shows advantages in reducing the rate of relapse after surgery.展开更多
The occurrence of foreign body is uncommon in youths and adults. We report here a case of 16-year-old boy who inhaled a foreign body which was overlooked for 6 months. The patient suffered productive cough and receive...The occurrence of foreign body is uncommon in youths and adults. We report here a case of 16-year-old boy who inhaled a foreign body which was overlooked for 6 months. The patient suffered productive cough and received antibiotic treatment for 10 days. But the symptoms did not improve. Chest radiography and CT scan revealed a 1-cm-long needle-like foreign object in the right inferior lobar bronchus. Wedge resection of lung was finally performed because of severe hemorrhage caused by prior bronchoscopy.展开更多
基金Supported by Science and Technology Research Project of Henan Province (No. 102102310117)
文摘AIM： To evaluate the clinical value of wedge resection at corneal limbus in patients with traumatic corneal scarring and high irregular astigmatism. METHODS： Patients with traumatic corneal astigmatism received wedge resection at least 6mo after suture removal from corneal wound. The uncorrected distance visual acuities （UCVA） and best corrected distance visual acuities （BCVA）, pre- and post-operation astigmatism, spherical equivalent （SE）, safety and complications were evaluated. RESULTS： Ten eyes （10 patients） were enrolled in this study. Mean follow-up time after wedge resection was 37.8±15.4mo （range, 20-61mo）. The mean UCVA improved from ＋1.07±0.55 IogMAR to ＋0.43±0.22 IogMAR （P=0.000） and the mean BCVA from ＋0.50±0.30 IogMAR to ＋0.15± 0.17 IogMAR （P=0.000）. The mean astigmatism power measured by retinoscopy was -2.03±2.27 D postoperatively and -2.83±4,52 D preoperatively （P=0.310）. The mean SE was -0.74±1.61 D postoperatively and -0.64±1.89 D preoperatively （P=0.601）. Two cases developed mild pannus near the sutures. No corneal perforation, infectious keratitis or wound gape occurred. CONCLUSION： Corneal-scleral limbal wedge resection with compression suture is a safe, effective treatment for poor patients with high irregular corneal astigmatism after corneal-scleral penetrating injury. Retinoscopy can prove particularly useful for high irregular corneal astigmatism when other measurements are not amenable.
基金Supported by Jiangsu Provincial Administration of Traditional Chinese Medicine,No.MS2023017 and No.SLJ0311the Jiangsu Provincial Health Commission,No.ZDXK202251.
文摘BACKGROUND Gastroesophageal junction(GEJ)or gastrointestinal stromal tumor(GIST)are located in unfavorable parts of the stomach,due to the anatomical complexity of these regions,protecting the cardia while ensuring R0 resection is a major challenge for surgeons.CASE SUMMARY Two cases of GEJ stromal tumors were reported.Abdominal computed tomography scans revealed that both tumors were located at the GEJ,close to the posterior wall,with one tumor measuring greater than 5 cm.Both patients successfully underwent robot-assisted laparoscopic wedge resection of the stomach.The surgeries achieved R0 resection while preserving the cardia sphincter and maximizing gastric tissue preservation.Postoperatively,no symptoms such as gastroesophageal reflux or cardia stenosis were observed.Case 1:Postoperative pathology:GIST.Immunohistochemical results:Tumor cells were positive for CD34,CD117,and DOG1,and negative for SMA,desmin,S-100,and SDHB(normal expression).The Ki-67 proliferation index was approximately 5%.Case 2:Postoperative pathology:GIST.Immunohistochemical results:Tumor cells were positive for CD117(++),CD34(++),DOG1(+++),and focal positivity for SMA.Negative for desmin,S-100(few cells positive),and SDHB(preserved expression).The Ki-67 proliferation index was approximately 10%.CONCLUSION The gastric tube-guided robotic-assisted laparoscopic resection is a safe and effective method for tumor resection while preserving the cardia,and it is worth further promotion in clinical practice.
文摘Although major contributions have been made in the field of reconstructive surgery,reconstructive surgery of the auricle is a daunting prospect even for the most experienced surgeons.Here,we present a case who presented to us in the emergency surgical ward with a history of an accidental laceration of right ear.Primary repair of the ear laceration after wedge resection of the avulsed part was done.The cosmesis achieved by this technique is discussed.
文摘BACKGROUND The inflammatory myofibroblastic tumor(IMT)is a rare mesenquimal tumor of doubtful biological behaviour.It’s characterised for affecting mainly children and young adults,although it can appear at any age,being the lungs the primary affected organ(in children it represents 20%of all primary pulmonary tumors).CASE SUMMARY We present the case of a 45 year old woman,with a computed tomography(CT)finding of injury on the anterior surface of the fundus/gastric body and a solid perigastric injury of 12 mm in the ecoendoscopy.The case is presented in the tumor committee deciding to perform a laparoscopic wedge resection.The histological diagnosis was a IMT.The diagnosis is based on imaging tests like the abdominal CT,abdominal ecography and the ecoendoscopy but to confirm the diagnosis a pathological study is necessary.CONCLUSION Due to the unpredictable nature of this tumor,surgical resection is the best therapeutic option.
文摘Background Adenomyoma is a very serious disease which influence the quality of life and leads to the infertility, and hysterectomy at the end. Unfortunetly, we still have no effective way to treat this kind of diseases. This study was aimed to evaluate the efficacy and surgical characteristics of modified adenomyomectomy. Methods This is a retrospective study and the subjects were collected in the past 5 years. We divided the subjects by the two different surgical procedures. Cases of adenomyoma patients who underwent conservative surgery, modified adenomyomectomy or wedge resection of the adenomyoma lesion were distributed to two groups retrospectively. Surgical characteristics, symptom relief, and recurrence were analysed in each group. Results General characteristics, including operation time, blood loss, and postoperative complication were similar in both groups. In the modified adenomyometomy group, the median follow-up time was 27.6 months and the rate of relief of dysmenorrhea and menorrhagia symptoms were 91.2% and 40.0%, respectively. In the wedge resection group, the rate of reliefe of dysmenorrhea and menorrhagia symptoms were 88.9% and 50.0%, respectively. Patients in both groups had statistically significant symptom relief, but there was no statistical difference between them. During the following time, ultrasonography relapse rate in modified modified adenomyomectomy group is significantly lower than the wedge resection group 15.0% vs. 69.2% （P 〈0.001）. The relapse rate, in terms of symptoms, was 5.0% in the modified adenomyomectomy group, which was similar to the relapse rate in the wedge resection group. In terms of reproductive outcome, 33.3% of the patients with infertility complications in the modified adenomyomectomy group became pregnant. Among them, the rate of pregnancy by assisted reproductive techniques was 45.5%, which was significantly higher than the rate of natural pregnancy, 23.1% （P =0.039）. Conclusion Modified adenomyomectomy appears to be a safe and effective operative method that shows advantages in reducing the rate of relapse after surgery.
文摘The occurrence of foreign body is uncommon in youths and adults. We report here a case of 16-year-old boy who inhaled a foreign body which was overlooked for 6 months. The patient suffered productive cough and received antibiotic treatment for 10 days. But the symptoms did not improve. Chest radiography and CT scan revealed a 1-cm-long needle-like foreign object in the right inferior lobar bronchus. Wedge resection of lung was finally performed because of severe hemorrhage caused by prior bronchoscopy.
