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[PMID]:29376595
[Au] Autor:Usupbaev AC; Kurbanaliev RM; Chernetsova GS; Kolesnichenko IV; Sultanov BM; Myrzakanov NM; Zolotukhin AO; Vagner NA
[Ad] Endereço:M.T. Tynaliev Department of Urology and Andrology of pre- and postgraduate education. I. K. Akhunbaev Kyrgyz State Medical Academy, Bishkek, Kyrgyzstan.
[Ti] Título:[Experimental work: reconstruction of the pelvi-ureteric junction and ureter using testicular tunica vaginalis autograft].
[So] Source:Urologiia;(6):50-54, 2017 Dec.
[Is] ISSN:1728-2985
[Cp] País de publicação:Russia (Federation)
[La] Idioma:rus
[Ab] Resumo:AIM: To evaluate the results of surgical reconstruction of the upper urinary tract using an autograft of testicular tunica vaginalis in experimental animals. MATERIALS AND METHODS: The article presents the results of partial replacement of the renal pelvis and ureter with an autograft in 25 male dogs. The grafts were harvested by resection of the parietal layer of the testicular tunica vaginalis, which was transplanted into the region of the pelvi-ureteric junction and the proximal ureter. The upper urinary tract was drained using a ureteral stent catheter. The results were evaluated at week 1 and months 1, 3 and six after the operation. The functional state of the kidneys and ureters was analyzed using excretory urography and ultrasound; the autograft biopsy specimens were examined histologically. RESULTS: In all cases, the viability of the autograft was completely preserved, there were no signs of secondary infection, necrosis and impaired patency in the anastomosis zone. Histological examination revealed signs of epithelialization, connective tissue substitution and neovasculogenesis in the implantation zone. CONCLUSION: The proposed surgical modality is an alternative method to restore normal urine flow in the upper urinary tract in obstructive urological diseases. The group of obstructive urological diseases was studied using the model of the strictures of the pelvi-ureteric junction in the intrarenal pelvis and ureteral strictures measuring up to 3-4 cm in length.
[Mh] Termos MeSH primário: Pelve/cirurgia
Procedimentos Cirúrgicos Reconstrutivos/métodos
Ureter/cirurgia
[Mh] Termos MeSH secundário: Animais
Autoenxertos
Cães
Feminino
Pelve/diagnóstico por imagem
Ureter/diagnóstico por imagem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180130
[St] Status:MEDLINE


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[PMID]:28452709
[Au] Autor:Al-Asousi F; Okpaleke C; Dadgostar A; Javer A
[Ad] Endereço:Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, St. Paul's Sinus Centre, University of British Columbia, Vancouver, British Columbia, Canada.
[Ti] Título:The use of polydioxanone plates for endoscopic skull base repair.
[So] Source:Am J Rhinol Allergy;31(2):122-126, 2017 Mar 01.
[Is] ISSN:1945-8932
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Many reconstructive techniques and materials have been reported for repair of skull base defects after sinonasal tumor excision, cerebrospinal fluid (CSF) leaks, and coverage of denuded bone. Synthetic materials have been developed for endoscopic skull base repair to avoid donor-site morbidity. Polydioxanone plate is a bioabsorbable implant designed for nasal septal reconstruction and has the ability to retain strength for at least 10 weeks and absorbs in 6 months. OBJECTIVES: This study aimed to describe the use of polydioxanone plates in endoscopic skull base defect and CSF leak repair, and to describe our experience with the surgical technique and postoperative management. METHODS: This was a retrospective case series of patients who, between May 2013 and December 2015, underwent endoscopic sinus surgery and skull base repair for CSF leak or after excision of a skull base tumor by using polydioxanone plates. Patients who presented with sinonasal inflammatory disease or skull base tumors underwent endoscopic skull base repair by using polydioxanone plates in an underlay fashion and mucosal membrane grafts with or without adjuvant materials in an overlay fashion. The patients were reviewed at 6 days, 6 weeks, and 3 months after surgery. Postoperative adverse events, including CSF leak, infection, bleeding, headache, and graft failure, were recorded. RESULTS: The cases of seven patients (five women, two men; mean age, 53.9 years) were reviewed. Five patients underwent sinonasal tumor resection and two underwent repair for CSF leak. The mean (standard deviation) defect size was 16.4 ± 11.4 mm. There was no evidence of postoperative CSF leak, and lumbar drains were not used. One patient reported transient headache and facial pressure at the 6-week follow-up visit. The surgeons' experience with polydioxanone plate placement, postoperative healing, and follow-up was satisfactory. CONCLUSION: Polydioxanone could be used to achieve rigid repair of endoscopic skull base defects. These early results, although promising, require validation in clinical trials.
[Mh] Termos MeSH primário: Implantes Absorvíveis/utilização
Vazamento de Líquido Cefalorraquidiano/cirurgia
Endoscopia
Seios Paranasais/cirurgia
Procedimentos Cirúrgicos Reconstrutivos
Neoplasias da Base do Crânio/cirurgia
Base do Crânio/cirurgia
[Mh] Termos MeSH secundário: Materiais Biocompatíveis/química
Feminino
Seguimentos
Seres Humanos
Masculino
Meia-Idade
Seios Paranasais/patologia
Polidioxanona/química
Complicações Pós-Operatórias
Estudos Retrospectivos
Base do Crânio/anormalidades
Base do Crânio/patologia
Neoplasias da Base do Crânio/patologia
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biocompatible Materials); 31621-87-1 (Polydioxanone)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.2500/ajra.2017.31.4411


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[PMID]:27771423
[Au] Autor:Chrzan R; Panek W; Kuijper CF; Dik P; Klijn AJ; de Mooij KL; de Jong TP
[Ad] Endereço:Department of Pediatric Urology, University Children's Hospital AMC/EKZ, Amsterdam, The Netherlands; Department of Pediatric Urology, UMC/WKZ, Utrecht, The Netherlands. Electronic address: r.chrzan@amc.nl.
[Ti] Título:Short-term Complications After Pyeloplasty in Children With Lower Urinary Tract Anomalies.
[So] Source:Urology;100:198-202, 2017 Feb.
[Is] ISSN:1527-9995
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To investigate whether children with lower urinary tract (LUT) anomalies are at greater risk for postoperative complications after laparoscopic pyeloplasty stented with a double-J catheter (JJC). MATERIALS AND METHODS: Prospectively collected data of laparoscopic pyeloplasty (LP) performed between 2006 and 2015 were analyzed. Inclusion criteria are (1) toilet-trained child and (2) unilateral dismembered pyeloplasty stented with a JJC done by the same surgeon. Our pyeloplasty protocol includes cystoscopy and retrograde pyelography. JJC is left in for 3weeks. Asymptomatic patients with infravesical LUT anomalies (a-LUTA) and those with history of LUT symptoms (LUTS) were identified. Any short-term complication was classified according to Clavien-Dindo. Fisher's exact test was used for statistical analysis. RESULTS: Fifty-four children (mean 9.8 years) were included. Ten of 54 patients had LUTS. In 4 of those 10, anatomical infravesical anomaly was found during cystoscopy. Accidental urethral anomaly was found in 11 patients (a-LUTA). The control group (CG) consisted of 33 patients. Postoperative hospital stay ranged from 1 to 8 days (mean 2 days). Overall complication rate was 8 of 54 (14%). Grade 1 complications occurred in 3 patients in the CG. Five patients had grade 3 complications (2 needed replacement of bladder catheter, and 3 had diversion of the upper tract). Those problems occurred in 1 of 10 patients with LUTS and 3 of 11 patients with a-LUTA compared to 1 of 33 in the CG. This difference was statistically significant (P < .05). CONCLUSION: Careful history should be taken in toilet-trained children before pyeloplasty. If any infravesical abnormality is discovered, internal diversion should probably be avoided. Special attention must be paid to bladder function in the postoperative period.
[Mh] Termos MeSH primário: Pelve Renal/cirurgia
Laparoscopia/efeitos adversos
Complicações Pós-Operatórias/epidemiologia
Procedimentos Cirúrgicos Reconstrutivos/efeitos adversos
Obstrução Ureteral/cirurgia
Anormalidades Urogenitais/cirurgia
[Mh] Termos MeSH secundário: Doenças Assintomáticas
Criança
Cistoscopia
Feminino
Seres Humanos
Sintomas do Trato Urinário Inferior/etiologia
Sintomas do Trato Urinário Inferior/cirurgia
Masculino
Stents
Obstrução Ureteral/etiologia
Urografia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE


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[PMID]:29489700
[Au] Autor:Chen Q; Liu Q; Suo Y; Xie Q
[Ad] Endereço:Department of Hand Surgery, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, Zhejiang, China.
[Ti] Título:A new surgical treatment for abdominal wall defects: A vascularized ribs-pleural transfer technique that can be used with or without a thoracic umbilical flap a case report.
[So] Source:Medicine (Baltimore);97(9):e9993, 2018 Mar.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Abdominal wall defects are common after tumor resection. PATIENT CONCERNS: We report an 83-year-old male patient with recurrent tumors in his abdomen, and who had an incision wound that could not be directly closed. Mesh was not suitable because the wound was infected. DIAGNOSES: Abdominal wall defect result from the resection of recurrent tumor. INTERVENTIONS: We carried out a vascularized ribs-pleural transfer operation. OUTCOMES: After the surgery, the patient gained a functional recovery. No evidence of recurrence was noted 1 year after operation, and the patient showed no symptoms of abdominal compression syndrome. LESSONS: We discuss the clinical diagnosis, treatment, and follow up and argue that the vascularized ribs-pleural transfer technique is a good method to deal with abdominal wall defects.
[Mh] Termos MeSH primário: Parede Abdominal/cirurgia
Pleura/transplante
Complicações Pós-Operatórias/cirurgia
Procedimentos Cirúrgicos Reconstrutivos/métodos
Costelas/transplante
[Mh] Termos MeSH secundário: Neoplasias Abdominais/cirurgia
Idoso de 80 Anos ou mais
Seres Humanos
Masculino
Recidiva Local de Neoplasia/cirurgia
Retalhos Cirúrgicos
Umbigo/transplante
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180301
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009993


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[PMID]:29403332
[Au] Autor:Temnogorod J; Shinder R
[Ad] Endereço:Department of Ophthalmology, SUNY Downstate Medical Center, Brooklyn, New York.
[Ti] Título:The best of the best: a review of select oculoplastic case series published in 2015.
[So] Source:Digit J Ophthalmol;23(4):1-3, 2017.
[Is] ISSN:1542-8958
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:This review summarizes three case series published in the field of oculoplastic surgery in the year 2015. The first article describes the use of hedgehog pathway inhibitors for medical therapy of advanced periocular basal cell carcinoma and basal cell nevus syndrome. The second describes the use of c-reactive protein as a marker for starting treatment with steroids in children with orbital cellulitis. The third article presents an endoscopic medial orbital fat decompression technique for treatment of proptosis in thyroid eye disease.
[Mh] Termos MeSH primário: Oftalmopatias/cirurgia
Procedimentos Cirúrgicos Oftalmológicos
Publicações Periódicas como Assunto
Procedimentos Cirúrgicos Reconstrutivos/métodos
[Mh] Termos MeSH secundário: Seres Humanos
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180207
[St] Status:MEDLINE
[do] DOI:10.5693/djo.01.2017.09.001


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[PMID]:28744748
[Au] Autor:Azzam AZ; Tanaka K
[Ad] Endereço:General Surgery Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt. aazzam70@yahoo.com.
[Ti] Título:Biliary complications after living donor liver transplantation: A retrospective analysis of the Kyoto experience 1999-2004.
[So] Source:Indian J Gastroenterol;36(4):296-304, 2017 Jul.
[Is] ISSN:0975-0711
[Cp] País de publicação:India
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND AIM: In living donor liver transplantation (LDLT), biliary complications continue to be the most frequent cause of morbidity and may contribute to mortality of recipients although there are advances in surgical techniques. This study will evaluate retrospectively the short-term and long-term management of biliary complications. METHODS: During the period from May 1999, to May 2004, 505 patients underwent 518 LDLT in the Department of Liver Transplantation and Immunology, Kyoto University Hospital, Japan. The data was collected and analyzed retrospectively. RESULTS: The recipients were 261 males (50.4%) and 257 females (49.6%). Biliary complications were reported in 202/518 patients (39.0%), included; biliary leakage in 79/518 (15.4%) patients, leakage followed by biloma in 13/518 (2.5%) patients, leakage followed by stricture in 9/518 (1.8%) patients, and biliary strictures in 101/518 (19.3%) patients. Proper management of the biliary complications resulted in a significant (p value 0.002) success rate of 96.5% compared to the failure rate which was 3.5%. CONCLUSION: Careful preoperative evaluation and the proper intraoperative techniques in biliary reconstruction decrease biliary complications. Early diagnosis and proper management of biliary complications can decrease their effect on both the patient and the graft survival over the long period of follow up.
[Mh] Termos MeSH primário: Fístula Anastomótica/epidemiologia
Doenças Biliares/epidemiologia
Sistema Biliar/patologia
Transplante de Fígado
Doadores Vivos
Complicações Pós-Operatórias/epidemiologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Fístula Anastomótica/prevenção & controle
Doenças Biliares/mortalidade
Doenças Biliares/patologia
Doenças Biliares/prevenção & controle
Procedimentos Cirúrgicos do Sistema Biliar/métodos
Criança
Pré-Escolar
Constrição Patológica
Feminino
Sobrevivência de Enxerto
Seres Humanos
Japão
Transplante de Fígado/mortalidade
Masculino
Meia-Idade
Complicações Pós-Operatórias/mortalidade
Complicações Pós-Operatórias/prevenção & controle
Procedimentos Cirúrgicos Reconstrutivos/métodos
Estudos Retrospectivos
Taxa de Sobrevida
Fatores de Tempo
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170727
[St] Status:MEDLINE
[do] DOI:10.1007/s12664-017-0771-3


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[PMID]:29352303
[Au] Autor:Gerli MFM; Guyette JP; Evangelista-Leite D; Ghoshhajra BB; Ott HC
[Ad] Endereço:Center for Regenerative Medicine, Massachusetts General Hospital, Boston, Massachusetts, United States of America.
[Ti] Título:Perfusion decellularization of a human limb: A novel platform for composite tissue engineering and reconstructive surgery.
[So] Source:PLoS One;13(1):e0191497, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Muscle and fasciocutaneous flaps taken from autologous donor sites are currently the most utilized approach for trauma repair, accounting annually for 4.5 million procedures in the US alone. However, the donor tissue size is limited and the complications related to these surgical techniques lead to morbidities, often involving the donor sites. Alternatively, recent reports indicated that extracellular matrix (ECM) scaffolds boost the regenerative potential of the injured site, as shown in a small cohort of volumetric muscle loss patients. Perfusion decellularization is a bioengineering technology that allows the generation of clinical-scale ECM scaffolds with preserved complex architecture and with an intact vascular template, from a variety of donor organs and tissues. We recently reported that this technology is amenable to generate full composite tissue scaffolds from rat and non-human primate limbs. Translating this platform to human extremities could substantially benefit soft tissue and volumetric muscle loss patients providing tissue- and species-specific grafts. In this proof-of-concept study, we show the successful generation a large-scale, acellular composite tissue scaffold from a full cadaveric human upper extremity. This construct retained its morphological architecture and perfusable vascular conduits. Histological and biochemical validation confirmed the successful removal of nuclear and cellular components, and highlighted the preservation of the native extracellular matrix components. Our results indicate that perfusion decellularization can be applied to produce human composite tissue acellular scaffolds. With its preserved structure and vascular template, these biocompatible constructs, could have significant advantages over the currently implanted matrices by means of nutrient distribution, size-scalability and immunological response.
[Mh] Termos MeSH primário: Braço/cirurgia
Procedimentos Cirúrgicos Reconstrutivos/métodos
Engenharia Tecidual/métodos
Tecidos Suporte
[Mh] Termos MeSH secundário: Animais
Braço/anatomia & histologia
Braço/irrigação sanguínea
Reatores Biológicos
Cadáver
Matriz Extracelular/química
Seres Humanos
Imagem Tridimensional
Masculino
Meia-Idade
Perfusão
Ratos
Engenharia Tecidual/instrumentação
Tecidos Suporte/química
Microtomografia por Raio-X
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180121
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191497


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[PMID]:29443758
[Au] Autor:Atsumi S; Hara K; Arai Y; Yamada M; Mizoshiri N; Kamitani A; Kubo T
[Ad] Endereço:Department of Orthopedics, JCHO Kyoto Kuramaguchi Medical Center.
[Ti] Título:A novel arthroscopic all-inside suture technique using the Fast-Fix 360 system for repairing horizontal meniscal tears in young athletes: 3 case reports.
[So] Source:Medicine (Baltimore);97(7):e9888, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Considering the risk of osteoarthritis following resection of a horizontally torn meniscus of the knee, repairing and preserving the meniscus as much as possible is preferred. We report 3 cases of restoration of horizontally torn menisci using a novel arthroscopic method we have called "all-inside interleaf vertical suture" that afforded preservation. PATIENT CONCERNS: The 3 patients (aged 14, 17, and 21 years) had knee pain through sports activity. DIAGNOSES: All patients had horizontal tears in the posteromedial part of the meniscus. INTERVENTIONS: The method uses Fast-Fix, whereby a first anchor is inserted from the tibial surface of the tear's superior leaflet and a second anchor is inserted from the femoral surface of the tear's inferior leaflet, and the 2 leaflets are closed using vertical suture. In all cases, the suture knots were embedded between the superior leaflet and inferior leaflet, avoiding contact with the articular cartilage, and superior leaflet and inferior leaflet crimping was good. OUTCOMES: All 3 were able to resume competing in sport and ≥ 1 year after surgery they had no pain and their postoperative mean Lysholm scores were 99.7. There were no complications or recurrence. On magnetic resonance imaging, the signal intensity of all the horizontal tears was high before surgery but low after surgery, suggesting that the repaired tear was healing. LESSONS: The all-inside interleaf vertical suture procedure is a new surgical technique that can repair posteromedial horizontal meniscal tears of the knee of young people by easy crimping of the superior and inferior leaflets without the suture knots causing complications.
[Mh] Termos MeSH primário: Artroscopia
Traumatismos em Atletas/cirurgia
Traumatismos do Joelho/cirurgia
Complicações Pós-Operatórias/prevenção & controle
Técnicas de Sutura
Lesões do Menisco Tibial
[Mh] Termos MeSH secundário: Adolescente
Artroscopia/efeitos adversos
Artroscopia/métodos
Atletas
Traumatismos em Atletas/diagnóstico
Seres Humanos
Traumatismos do Joelho/diagnóstico
Imagem por Ressonância Magnética/métodos
Masculino
Meniscos Tibiais/diagnóstico por imagem
Complicações Pós-Operatórias/etiologia
Procedimentos Cirúrgicos Reconstrutivos/efeitos adversos
Procedimentos Cirúrgicos Reconstrutivos/métodos
Lesões do Menisco Tibial/diagnóstico
Lesões do Menisco Tibial/cirurgia
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180215
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009888


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[PMID]:29443757
[Au] Autor:Deng C; Li H; Wei Z; Jin W; Nie K; Li S; Wu B; Wang D
[Ad] Endereço:Department of Plastic Surgery, Affiliated Hospital of Zunyi Medical College, Zunyi, Guizhou, People's Republic of China.
[Ti] Título:Various surgical techniques to create an aesthetic appearance at the donor site of anterolateral thigh free flaps based on the oblique branch: Twenty-one clinical case reports.
[So] Source:Medicine (Baltimore);97(7):e9885, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Reducing the morbidity associated with anterolateral thigh (ALT) donor sites by performing aesthetic restoration has become a popular research topic. Various surgical techniques have been developed allowing for direct closure of the donor site. However, closure techniques for ALT donor sites based on the oblique branch have not been systematically reported. PATIENT CONCERNS: Data from 21 patients (18 males, 3 females) undergoing operative reconstruction with an ALT free flap between January 2016 and December 2016. The mean age of the participants was 42 years (range, 18-60 years). DIAGNOSES: The soft-tissue defects resulted from a traffic accident in 9 patients, a fall injury in 7 patients, a machinery injury in 3 patients, an electrical injury in 1 patient, and a burn scar in 1 patient. The wound areas ranged from 6 × 3.5 to 28 cm × 10 cm. INTERVENTIONS: Several surgical techniques, including the split skin paddle technique and utilization of an adjacent perforator flap or an ipsilateral groin flap, were utilized to facilitate direct closure of the ALT flap donor site. OUTCOMES: Of the 21 patients included in the study, the donor sites were directly sutured in 14 patients (8 of which required a split skin paddle technique). Four patients required an adjacent perforator flap, and 3 patients received an ipsilateral groin flap. The size of the adjacent perforator flaps ranged from 15 × 5 to 17 × 6 cm. The groin flaps ranged from 18 × 6 to 28 × 6 cm. All the flaps had excellent appearance and texture. A linear scar in the donor area was not conspicuous and achieved an aesthetic appearance. LESSONS: The ALT flap donor site based on the oblique branch pedicle can be directly closed without skin grafts through the use of several surgical techniques.
[Mh] Termos MeSH primário: Retalhos de Tecido Biológico
Procedimentos Cirúrgicos Reconstrutivos/métodos
Transplante de Pele/métodos
Lesões dos Tecidos Moles/cirurgia
Coxa da Perna/cirurgia
Sítio Doador de Transplante/cirurgia
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Masculino
Meia-Idade
Retalho Perfurante
Cirurgia Plástica/métodos
Resultado do Tratamento
Técnicas de Fechamento de Ferimentos
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180215
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009885


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[PMID]:29443747
[Au] Autor:Pu S; Xu H; Li X
[Ad] Endereço:Department of Otolaryngology-Head and Neck Surgery, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China.
[Ti] Título:Supraglottoplasty in neonates and infants: A radiofrequency ablation approach.
[So] Source:Medicine (Baltimore);97(7):e9850, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Supraglottoplasty is the mainstay of surgical treatment for laryngomalacia. A novel supraglottoplasty surgical technique is needed to achieve better efficacy. The purpose of this study was to introduce modified microscopic radiofrequency ablation supraglottoplasty (MMRAS) for the treatment of congenital laryngomalacia and to evaluate the outcome and effectiveness of this novel approach. METHODS: Seventeen children with severe laryngomalacia who underwent MMRAS were studied retrospectively. Supraglottoplasty of type III laryngomalacia was different from classical method. All the patients were kept intubated for 5 days after surgery to achieve a better epiglottal position and to avoid reconglutination of aryepiglottic folds. The patients' demographic information, symptoms, comorbidities, type of laryngomalacia, synchronous airway lesions and final outcomes were examined. RESULTS: The median age at the time of surgery was 3.36 months (3 months 10 days). Operative indications included feeding difficulties, noisy breathing or respiratory distress (or both), and sleep-related symptoms. The MMRAS success rate was 82.4%. Most patients were extubated successfully on postoperative day 5. The major postoperative complication was pulmonary infection which occurred in 3 cases (17.6%) and required anti-infective therapy. No perioperative deaths and no long-term complications occurred. Failures were observed in 3 (17.6%) of 17 cases, 2 patients presented with a neurological disease and required tracheostomy, 1 patient relapsed because of postoperative adhesions and later underwent revision supraglottoplasty. CONCLUSIONS: From these results, we conclude that MMRAS is an effective and safe treatment for symptomatic laryngomalacia and has the potential to provide better breathing, feeding, and sleeping outcomes in children with severe laryngomalacia. Postoperative intubation for 5 days may result in better therapeutic outcomes. Multicenter cooperative studies of comparison between MMRAS and conventional approaches would lend further evidence-based support for this surgical method.
[Mh] Termos MeSH primário: Ablação por Cateter/métodos
Epiglote/cirurgia
Laringomalácia/cirurgia
Microcirurgia/métodos
Procedimentos Cirúrgicos Reconstrutivos/métodos
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Lactente
Recém-Nascido
Masculino
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180215
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009850



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