1.Minimally Invasive Stealth Lateral Internal Sphincter Release for Chronic Anal Fissure:a Report of 42 Cases
Weiguang Lü ; Qinfeng SUN ; Zhongliang ZHU
Chinese Journal of Minimally Invasive Surgery 2015;(6):536-537,542
Objective To investigate the safety and feasibility of minimally invasive stealth lateral release operation in the treatment of chronic anal fissure . Methods Clinical data of 42 patients with chronic anal fissure who underwent minimally invasive stealth lateral release from May 2012 to May 2014 was analyzed retrospectively .We use the homemade fine steel wire to pierce into the sphincter ditch with a distance from the anus of 1 cm, and put the steel wire out above the dentate line .Then the wire was took out from the other edge under the skin through the needle of bobbin .After the needle was fixed by an assistant , the free end of the steel wire was pulled quickly to cut the internal sphincter tissue instantly . Results All the 42 patients were successfully treated and discharged without complications .The recovery time was in 7 -14 d, with an average of 9 d.The healing standards included disappeared symptoms and totally healed wound .All the patients were followed up for 3-6 months, with an average of 4 months.No recurrence was found . Conclusion Minimally invasive stealth lateral release in the treatment of chronic anal fissure is safe and feasible, with many advantages such as simple performance , reliable curative effect, fast recovery time, and less postoperative complications .
2.Four-step Method for Transurethral Plasmakinetic Resection of the Prostate:a Report of 120 Cases
Shiping WEI ; Huiming LI ; Tiejun PAN
Chinese Journal of Minimally Invasive Surgery 2015;(8):705-706,722
Objective To explore the efficacy of four-step method for transurethral enucleation of the prostate . Methods A retrospective analysis was conducted on 120 cases of benign prostate hyperplasia ( BPH) treated with four-step method ( traction, enucleation, resection, and repair ) for transurethral plasmakinetic resection of the prostate in our hospital from January 2012 to February 2014. Results The average operation time was (91.4 ±35.3) min.The intraoperative blood loss was 78.8 ±34.1 ml. The resection of the prostate tissue weight was (32.1 ±15.7) g.The postoperative bladder infusion time was (1.5 ±0.5) days.The postoperative indwelling catheter time was 3.5 ±0.8 days.The postoperative hospital stay was (5.5 ±0.5) days.No death, blood transfusion, or TURS happened.Follow-up reviews at 3 months after surgery found postoperative international prostatic symptom score (IPSS) was significantly less than the preoperative level [4.5 ±2.2 vs.24.5 ±5.1, t=39.445, P=0.000], postoperative Qmax was significantly higher than preoperative level [(21.5 ±10.5) ml/s vs.(6.0 ±1.9) ml/s, t =15.912, P =0.000], and postoperative residual urine was significantly less than the preoperative level [(12.0 ±2.0) ml vs.(145.0 ±33.0) ml;t=44.069, P =0.000].No retrograde ejaculation, sexual dysfunction, or dysuria happened. Conclusion The four-step method for transurethral enucleation of the prostate is radical , safe, and simple.
3.Nuss Procedure for Pectus Excavatum:Current Status and Progress
Chinese Journal of Minimally Invasive Surgery 2015;(8):752-754,758
[Summary] Pectus excavatum ( PE ) is a posterior intrusion of the chest wall into the thoracic cavity . Although the physiological and psychological consequences vary , for a large number of patients the lesions are troublesome enough that they need corrective surgery .The minimally invasive repair of pectus excavatum ( Nuss procedure ) has been performed safely , effectively , and extensively .The current situations and progresses associated with the Nuss procedure were reviewed .
4.Misdiagnosis of Old Ectopic Pregnancy:Report of Two Cases
Yinshu GUO ; Ying ZHANG ; Hua DUAN
Chinese Journal of Minimally Invasive Surgery 2015;(12):1147-1149,1152
[Summary] From February 2008 to June 2008, two cases of old ectopic pregnancy were misdiagnosed: Case 1 was misdiagnosed as gestational trophoblastic disease (GTD), and Case 2 was misdiagnosed as cornual pregnancy.In order to further confirm the diagnosis, two cases were all given laparoscopic exploration.Surgery confirmed interstitial chronic ectopic pregnancy, leading to a resection of the fallopian tubes and mass lesions.Embryo tissue was pathologically confirmed postoperatively.The diagnosis of old ectopic pregnancy is difficult.Serum hCG determination is often found no positive, and ultrasound examination has no specificity.The clinical images are varied.Detailed medical history inquiry and attention to differential diagnosis are key for the diagnosis of old ectopic pregnancy.
5.Current Status and Future Trends of Minimally Invasive Treatment of Osteoporotic Vertebral Compression Fractures
Tengjiao ZHU ; Yun TIAN ; Fang ZHOU
Chinese Journal of Minimally Invasive Surgery 2015;(12):1121-1124,1128
[Summary] With the increasing global aging population, osteoporosis vertebral compression fracture ( OVCF) is getting more attention as a big challenge for orthopedic surgeons.Current therapeutic options include conservative treatment, traditional open reduction and internal fixation, percutaneous vertebroplasty (PVP), and percutaneous kyphoplasty (PKP).Due to excellent clinical results on pain relief and function improvement, PVP and PKP, as minimally invasive surgical techniques, now increasingly become more popular for painful OVCF.The review focused on a brief introduction of the current status of the two procedures and a discussion of the future trends of the two techniques.
6.Progress on Ultrasound-guided Thoracic Paravertebral Block
Chinese Journal of Minimally Invasive Surgery 2016;16(4):359-361,384
[Summary] Thoracic paravertebral block ( TPVB) can offer intra-postoperative analgesia for thoracic , cardiac, and breast operations .In recent years , the development of ultrasonic technology provides a platform for real-time and visual never block , which can further improve the success rate and reduce the incidence of complications .In this article, we reviewed the various approaches of ultrasound guidance for thoracic paravertebral blockade , and explored the latest progress of different technologies .
7.Single-incision Video-assisted Thoracoscopic Surgery for Inflammatory Myofibroblastic Tumor:Case Report
Jun ZHANG ; Libo HAN ; Xueshan QIU
Chinese Journal of Minimally Invasive Surgery 2016;16(5):475-477,480
[Summary] A single-incision video-assisted thoracoscopic sublobular limited resection was performed for a 2-cm pulmonary nodule at the right lower lobe of the lung in August 2014.The post-operative pathological diagnosis was inflammatory myofibroblastic tumor of the lung.No recurrence and metastasis was found after one year’s follow-up.
8.Progress of Surgical Treatment for Vocal Cord Movement Disorders
Chiyu XU ; Yan YAN ; Furong MA
Chinese Journal of Minimally Invasive Surgery 2016;16(5):455-458,474
[Summary] Vocal cord movement disorders may lead to hoarseness,dysphonia or even dyspnea.They reduce the quality of speech,destroy social communications,or even are life-threatening.For patients with vocal cord movement disorders which are not sensitive to the treatment of phonation training or medication,surgical procedures can improve the quality of phonation.At present, with operation methods for vocal fold movement disorders developing rapidly,types of the operations are exploring,while at the same time the situations of confusion or repetition of operation methods and terminologies increase.On this condition,we summarized different types of surgeries for vocal cord movement disorders by reviewing relevant literatures.
9.Clinical Efficacy of Laparoscopy Combined with Colonoscopy in the Treatment of Small Colorectal Space Occupying Lesions Cao
Chinese Journal of Minimally Invasive Surgery 2016;16(5):418-420,435
Objective To evaluate the clinical efficacy of laparoscopy combined with colonoscopy for small colorectal space occupying lesions (equal or less than 3 cm). Methods From January 2010 to January 2015,a total of 41 cases of small colorectal space occupying lesions (equal or less than 3 cm)were treated under general anesthesia with laparoscopic surgery combined with colonoscopy.The patients were placed at the lithotomy position.After the establishment of pneumoperitoneum,injection of methylene blue for staining was carried out under colonoscopy. Laparoscopic titanium clipping positioning was conducted, and then the colonoscope was withdrawn.According to the intraoperative frozen pathological results,bowel resection surgery or colorectal surgical resection was selected. Results All the 41 cases of laparoscopic combined with colonoscopic surgery were successfully completed, with no conversion to laparotomy.There were 9 cases of preoperative diagnosis of precancerous lesions,6 of which were found neoplasia in the colon epithelium with intraoperative pathological diagnosis,with 3 cases of Tis adenocarcinoma.Among 32 cases of preoperative diagnosis of stage 0 -Ⅰ colorectal cancer,there were 29 cases of intraoperative and postoperative diagnosis of stage Ⅰ (23 cases of T1 N 0 M0 adenocarcinoma and 6 cases of T2 N 0 M0 adenocarcinoma)and 3 cases of stage Ⅲ (T2 N 1 M0 adenocarcinoma).Two cases were multiple lesions.Bowel resection was performed in colon intraepithelial neoplasia and Tis lesions of colorectal cancer,while resection of colorectal cancer was conducted in stage T1 -T2 colorectal cancer.Two patients with colonic epithelial neoplasia were followed up for 9 and 12 months,without recurrence.The remaining 39 cases were followed up for 24 -49 months,with a median of 38.6 months. Among the 35 cases of colorectal cancer,colonoscopy detected local recurrence in 1 case of T2 N 1 M0 adenocarcinoma (stage Ⅲ)after 34 postoperative months.No metastasis was found in all the patients. Conclusion Laparoscopy combined with colonoscopy for small diameter (equal or less than 3 cm)benign tumor or stage Tis -T2 malignant colorectal cancer has advantages of both endoscopy,especially suitable for difficultly located or removed lesions,which can improve the positioning precision and surgical safety.
10.Application of Protective Lung Ventilation During General Anesthesia
Chinese Journal of Minimally Invasive Surgery 2016;16(7):665-668,672
ventilation mode selection , which can reduce the incidence of postoperative pulmonary complications and improve patient ’ s outcomes . This paper reviewed and summarized the application of protective lung ventilation during general anesthesia .