Ear ; surgery ; Humans ; Parotid Neoplasms ; surgery ; Surgical Procedures, Operative ; methods

Repair of inguinal hernia is widely regarded as a simple procedure, requiring no great surgical skill. Published recurrence rates are high, indicating that there is need for improvement in technique. This paper gives details of a satisfactory method which uses local anaesthesia.
Anesthesia, Local ; Hernia, Inguinal - surgery ; Humans ; Surgical Procedures, Operative - methods

OBJECTIVE: Decompressive craniectomy (DC) is a useful surgical method to achieve adequate decompression in hypertensive intracranial patients. This study suggested a new skin incision for DC, and analyzed its efficacy and safety. METHODS: In the retrograde reviews, 15 patients underwent a newly suggested surgical approach using n-shape skin incision technique (Group A) and 23 patients were treated with conventional question mark skin incision technique (Group B). Two groups were compared in the terms of the decompressed area of the craniectomy, protruded brain volume out of the skull layer, the operation time from skin incision to bone flap removal, and modified Rankin Scale (mRS) which was evaluated for 3 months after surgery. RESULTS: The decompressed area of craniectomy (389.1 cm² vs. 318.7 cm², p=0.041) and the protruded brain volume (151.8 cm³ vs. 116.2 cm³, p=0.045) were significantly larger in Group A compared to the area and the volume in Group B. The time interval between skin incision and bone flap removal was much shorter in Group A (23.3 minutes vs. 29.5 minutes, p=0.013). But, the clinical results were similar between 2 groups. Group A showed more favorable outcome proportion (mRS 0-3, 6/15 patients vs. 5/23 patients, p=0.225) and lesser mortality cases proportion 1/15 patients vs. 4/23 patients, but these differences were not significantly observed (p=0.225 and 0.339). CONCLUSION: DC using n-shaped skin incision was a feasible and safe surgical technique. It may be an easier and faster method for the purpose of training neurosurgeons.
Brain ; Decompression ; Decompressive Craniectomy* ; Dermatologic Surgical Procedures ; Humans ; Methods ; Mortality ; Neurosurgeons ; Skin* ; Skull ; Surgical Flaps ; Surgical Procedures, Operative

Adhesiveness ; Gastrointestinal Hemorrhage ; prevention & control ; surgery ; Hand ; Humans ; Surgical Instruments ; Surgical Procedures, Operative ; methods

OBJECTIVETo compare the short-term efficacy of laparoscope-assisted transanal total mesorectal excision (LA-taTME) and conventional laparoscopic TME (LTME) for rectal cancer by meta-analysis.

METHODSClinical studies that compared clinical outcomes of LA-taTME and LTME were searched from form PubMed, Embase, Ovid, CNKI and Wanfang database before January 2016. Two reviewers independently screened the articles and assessed the quality of the included studies by using the MINORS standard which involves 12 items. The score is 0-2 for each item and the maximum score is 24, and the ideal global score should be above16. RevMan 5.3 software was used for meta-analysis and outcome measures included operation time, hospital stay, number of harvested lymph node, rate of conversion, positive rate of circumferential resection margin and the rate of incomplete mesorectum.

RESULTSSeven studies were included in the analysis, and the score of all the studies was more than 16 points. A total of 479 patients (208 in LA-taTME, 271 in LTME) were enrolled. There were no significant differences in terms of age, sex, tumor location and clinical stage between two groups (all P>0.05). Results of meta-analysis showed that LA-taTME had lower rate of incomplete mesorectum (OR=0.29, 95% CI:0.10 to 0.84, P=0.02), lower rate of complications (OR=0.59, 95% CI:0.35 to 0.97, P=0.04) and shorter hospital stay (MD=-1.66, 95% CI:-3.22 to -0.11, P=0.04) than those of LTME, with significant differences. In terms of operation time (MD=-14.49, 95% CI:-37.87 to 8.90, P=0.22), number of harvested lymph node (MD=-0.45, 95% CI:-1.98 to 1.08, P=0.56), the rate of conversion (OR=0.31, 95% CI:0.08 to 1.24, P=0.10) and positive rate of circumferential resection margin (OR=0.43, 95% CI:0.17 to 1.04, P=0.06), there were no significant differences between two groups.

CONCLUSIONCompared to LTME, LA-taTME has similar short-term efficacy for rectal cancer, but it can reduce the rate of complications and rate of incomplete mesorectum.

Abdomen ; Digestive System Surgical Procedures ; methods ; Humans ; Laparoscopes ; Laparoscopy ; Length of Stay ; Operative Time ; Rectal Neoplasms ; surgery

Humans ; Postoperative Complications ; etiology ; prevention & control ; Surgical Procedures, Operative ; adverse effects ; methods ; trends

China ; Esophageal Neoplasms ; diagnosis ; surgery ; Esophagus ; pathology ; surgery ; Humans ; Surgical Procedures, Operative ; methods ; trends

Esophageal Achalasia ; surgery ; Esophagus ; pathology ; surgery ; Humans ; Surgical Procedures, Operative ; methods ; trends

There are many procedures for treatment of injuries of acromioclavicular separation but there are still con- roversies concerning the best management of these injuries. With this in mind, we treated surgically 22 cases of acromioclavicular separation of which 3 cases were old type 2 and 19 cases were type 3 in the department of orthopaedic surgery, Eul Ji General Hospital from March 1977 to darch 1982. The results were as follows: l. Of 22 cases, 21 cases (95.5%) were male with peak incidence in the 3rd and 5th decades (90.9%). 2. The most common causes of the injuries were traffic accidents (63.6%) and followed by falling from height (22.7%). 3. The diagnosis in type 2 and type 3 injuries is based on the clavicular displacement and instability at the acromioclavicular joint. 4. Operative treatment consists of Weaver and Dunn method (54.5%), modified Phemister method (18.2%), Neviaser method (13.0%), Stewart method (9.1%) and modified Henry method (4.5%). 5. The operative procedure in old type 2 and typc 3 injuries is good treatment of acromioclavicular separation.
Accidental Falls ; Accidents, Traffic ; Acromioclavicular Joint ; Diagnosis ; Hospitals, General ; Humans ; Incidence ; Male ; Methods ; Surgical Procedures, Operative

BACKGROUND AND OBJECTIVES: The purpose of this study was to compare the effectiveness of percutaneous and endonasal lateral osteotomy for the correction of deviated nose. SUBJECTS AND METHOD: Medical records of 60 patients who underwent rhinoplasty to correct deviated nose were reviewed retrospectively. Patients with unilateral osteotomy, revision rhinoplasty, spreader graft, or who had no preoperative or postoperative photos were excluded from the study. The patients were categorized into two groups, which either had C-shaped deviation or I-shaped deviation. Preoperative and postoperative deviation angles were measured and their differences were analyzed according to the approach methods. RESULTS: In the percutaneous approach group, 26 patients had C-shaped deviation and 10 patients had I-shaped deviation, whereas in the endonasal approach group, 17 patients had C-shaped deviation and 7 patients had I-shaped deviation. In the percutaneous approach, the deviation angle was statistically improved in the C-shaped deviation, but in the endonasal approach, it was statistically improved in the C-shaped and I-shaped deviation after surgery. In the C-shaped deviation, the average degrees of improvement of percutaneous and endonasal approach were 5.2°±3.6° and 7.9°±5.3°, respectively, which showed significant difference. However, in the I-shaped deviation, the average degrees of improvement of percutaneous and endonasal approach were 2.9°±1.3° and 2.9°±1.0°, respectively, with no significant difference. CONCLUSION: The improvement of deviation angle following osteotomy may be different according to the approach methods for deviated nose. Endonasal approach was more suitable than percutaneous approach in the correction of I-shaped deviated nose.
Humans ; Medical Records ; Methods ; Nose Deformities, Acquired ; Nose ; Osteotomy ; Retrospective Studies ; Rhinoplasty ; Surgical Procedures, Operative ; Transplants