简介：Single-portlaparoscopicsurgery(SPLS)isproposedtobeasteptowardsminimizingtheinvasivenessofsurgery,andhassincegainedpopularityinseveralsurgicalsub-specialtiesincludinghepatopancreatobiliarysurgery.SPLShassincebeenappliedtocholecystectomy,liverresectionaswellaspancreatectomyforamultitudeofpathologies.BenefitsofSPLSoverconventionalmulti-incisionlaparoscopicsurgeryincludeimprovedcosmesisandpotentiallypost-operativepainatspecifictimeperiodsandextra-umbilicalsites.However,itisalsoassociatedwithlongeroperatingtime,increasedrateofcomplications,andincreasedrateofport-sitehernia.Thereisnosignificantdifferencebetweenlengthofhospitalstay.SPLShasasignificantlearningcurvethataffectsoperatingtime,rateofconversionandrateofcomplications.Inthisarticle,wereviewtheliteratureonSPLSinhepatobiliarysurgery-cholecystectomy,hepatectomyandpancreatectomy,andoffertipsonovercomingpotentialtechnicalobstaclesandminimizingthecomplicationswhenperformingSPLS-surgeonposition,positionofportandinstruments,instrumentcrossingposition,standardhandgripvsreversehandgrip,snookercueguideposition,preventionofincisionalhernia.SPLSisapromisingdirectioninlaparoscopicsurgery,andwerecommendstep-wiseprogressionofapplicationsofSPLStovarioushepatopancreatobiliarysurgeriestoensuresafeadoptionofthesurgicaltechnique.

简介：AIM:Tocomparethesafetyandefficacyofphacoemulsificationandsmallincisioncataractsurgery(SICS)inpatientswithuveiticcataract.·METHODS:Inaprospective,randomizedmulti-centricstudy,consecutivepatientswithuveiticcataractwererandomizedtoreceivephacoemulsificationormanualSICSbyeitheroftwosurgeonswellversedwithboththetechniques.Aminimuminflammationfreeperiodof3mo(definedaslessthan5cellsperhighpowerfieldinanteriorchamber)wasapre-requisiteforeligibilityforsurgery.Superiorscleraltunnelincisionswereusedforbothtechniques.Improvementinvisualacuitypost-operativelywastheprimaryoutcomemeasureandtherateofpost-operativecomplicationsandsurgicaltimeweresecondaryoutcomemeasures,respectively.Meansofgroupswerecomparedusingt-tests.Onewayanalysisofvariance(ANOVA)wasusedwhenthereweremorethantwogroups.Chi-squaretestswereusedforproportions.KaplanMeyersurvivalanalysiswasdoneandmeansforsurvivaltimewasestimatedat95%confidenceinterval(CI).APvalueof<0.05wasconsideredstatisticallysignificant.·RESULTS:Onehundredandtwenty-sixof139patients(90.6%)completedthe6-monthfollow-up.Sevenpatientswerelostinfollowupandanothersixexcludedduetoeitherfollow-uplessthansixmonths(n=1)orinabilityimplantanintraocularlens(IOL)becauseofinsufficientcapsularsupportfollowingposteriorcapsulerupture(n=5).Therewassignificantimprovementinvisionafterboththeprocedures(pairedt-test;P<0.001).Onfirstpostoperativeday,uncorrecteddistancevisualacuity(UDVA)was20/63orbetterin31(47%)patientsinPhacogroupand26(43.3%)patientsinSICSgroup(P=0.384).Themeansurgicallyinducedastigmatism(SIA)was0.86±0.34dioptres(D)inthephacoemulsificationgroupand1.16±0.28DinSICSgroup.Thedifferencebetweenthegroupswassignificant(t-test,P=0.002).At6mo,correcteddistancevisualacuity(CDVA)was20/60orbetterin60(90.9%)patientsinPhacogroupand53

简介：Objective:Toreportthedevelopmentofatechniqueforminimallyinvasivethyroidlobectomy.Method:Theprocedurewasacceptedby200patientswithanoduleofthelobeofthethyroid.Weperformedhemithyroidectomysthrougha2-4cmlow-collarhorizontalskinincisionbyconventionalinstrumentation.Results:Therecurrentlaryngealnerveandtheparathyroidglandswereeasilyidentifiedandpreserved.Theamountofbleedingrangedfrom5to50ml(mean15ml).MeanOperationtimewas52.2minutes(ranged32to80minutes).Nocomplicationoccurred.Meanpostoperativestaywas5.5days(ranged4to7days).Theincisionprovidedexcellentcometicresultsbecausethesmallandlowerincisionswerecompletelyhiddenbyclothingcollar.Conclusion:Theabovetechniqueisfeasible,safe,minimallyinvasive,lesstimeandcostconsumingandcosmetical.

简介：BackgroundProstheticmitralvalvereplacementisacommonsurgicaltreatmentofmitralvalvedisease.Completevideo-assistedmitralvalvereplacementrepresentsthecontemporaryminimallyinvasivecardiacsurgeryinvalvediseasesurgicaltherapy.Inthefieldofminimallyinvasivecardiacsurgery,thesuccessoftheoperationislargelydependingonsurgicalincision,italsoreflectsthesurgeon'stechniquelevel.MethodFromFebruary2010toFebruary2013,80casesofcardiacpatientswithmitralvalvepathologicalchangesinourdepartmentwhohadreceivedsurgicaltreatmentofcompletevideo-assistedmitralvalvereplacementwererecruited,theyweredividedintotwogroupsaccordingtothesurgicalincision:midclaviculargroup(Mgroup,n=50)andparasternalgroup(Pgroup,n=30).Theclinicaldatawererecordedincluding:cardiopulmonarybypasstime,aorticclampingtime,volumeofthoracicdrainageafteroperation,ICUtrachealintubationtime,postoperativedaysofhospitalstayandtimeforobservingthepostoperativecomplications.Thecomparisonbetweentwogroupswasperformedusingt-testanalysis.ResultBothMGroupandPGrouphadfavorablesurgicalview,therewerenoemergencysituationofredomediansternotomyduringinitialoperativeperiodorintraoperativedeath,nopericardialtamponade,noinfection,andnootherseriouspostoperativecomplications.Whereas,therewere2casesofredooperationforstanchbleedinginMGroupand1caseofperivalvularleakageinPGroup.Nevertheless,3monthslater,theresultofreexamineshowedthattheperivalvularleakagehadvanished.Theclinicaldatawasshownasfollow(MGroupvs.PGroup):cardiopulmonarybypasstime(90.2±28.7vs.87.3±24.5min,P>0.05),aorticclampingtime(65.2±17.4vs.68.6±21.9min,P>0.05),1stdayvolumeofthoracicdrainageafteroperation1(75.8±35.6vs.53.2±25.6mL,P>0.05),ICUtrachealintubationtime(9.6±3.4vs.8.4±4.5hours,P>0.05),postoperativedaysofhospitalstay(7.3±2.2v

简介：Objective:Tointroducethetechniqueofsubciliaryincisionandlateralcantholysiswithtri-dimensionreductionandrigidinternalfixationtotreatzygomaticcomplexfractures.Methods:Thesubciliaryincisionandlateralcantholysiscombinedwithtri-dimensionreductionandrigidinternalfixationofzygomaticcomplexfractureswithtitaniummicroplateswereappliedin56patientswithzygomaticcomplexfractures.Anotherlateraleyebrowincisionorsublabialincisionwasusedtosimplifytheoperation.Results:Thepostoperativefollow-upperiodrangedfrom6monthsto5years.Duringthefollow-upperiod,allthepatientshadsatisfyingpostoperativeresults.Allclinicalsymptomsdisappearedexceptthenumbnessintheinfraorbitalregionin2patients.In94.6%patientsnocomplicationssuchasobviousscar,ectropion,entropionorblepharoedemawerefound,only5.4%ofthepatientshadslightectropion6monthsafteroperation.Conclusions:Thesubciliaryincisionandlateralcantholysishavemanyadvantagessuchasinvisiblescar,sufficientexposure,minimalinjury,andfewcomplicationsandcombinedwithrigidinternalfixationwithtitaniummicroplatesthistechniquecouldbeusedasoneoftheroutineoperationmethodstotreatzygomaticcomplexfractures.

简介：AbstractPurpose:The most popular surgical approach to manage Lisfranc fracture-dislocations is the double-incision approach, which frequently causes a variety of complications, such as skin necrosis, rotational malreduction of the first tarsometatarsal joint (TMTJ) and lateral column dorsoplantar malreduction of the TMTJ. We introduce a three-incision approach to treat Lisfranc fracture-dislocations with only minor postoperative complications and good foot function.Methods:We prospectively selected 30 previously healthy patients, ranging from 18 to 60 years of age, but only 23 patients completed the follow-up and thus were finally included, with an average age of 38.1 ± 12.9 years. All patients have sustained Lisfranc fracture-dislocations involving all three-column; 13.0% (3/23) were Myerson classification type A (medial), 47.8% (11/23) were type A (lateral), and 39.1% (9/23) were type C2. All patients were treated via a three-incision approach: a long incision made along the lateral border of the second ray was used as a working incision to visualize and reduce the first three TMTJs, as well as to apply internal fixation instrumentation; a 2 cm medial incision was made at the medial side of the first TMTJ as an inspecting incision, ensuring good reduction of the first TMTJ in medial and plantar view; another 1 cm inspecting incision was made at the dorsal side of the fourth/fifth TMTJ to prevent sagittal subluxation of the lateral column. Mean ± SD was used for quantitative data such as operation time, follow-up time and foot function scores. Postoperative complications were documented, and foot function was evaluated using the American orthopaedic foot & ankle society score, foot function index and Maryland foot score at follow-up. The foot function of the injured foot and contralateral foot of the same patient was at the end of follow-up, and independent sample t-test was used for statistical analysis.Results:The median operation time was 117.9 ± 14.6 min (range 93 - 142 min). All complications occurred within three months after the operation, and included delayed wound healing (17.4%), superficial infection (8.7%), complex regional pain syndrome (4.3%) and neuroma (4.3%). There was no case of postoperative skin necrosis or malreduction. At the end of follow-up of 14.1 ± 1.2 months (range 12-16 months), the median American orthopaedic foot & ankle society score of the operated foot was 89.7 ± 5.7, the median foot function index was 21.7 ± 9.9, and the median Maryland foot score was 88.7 ± 4.8. There were no significant differences between the operated and contralateral sides, in terms of foot function, at the end of followup (p > 0.05).Conclusion:The three-incision approach can provide adequate visualization of all TMTJs to ensure anatomical reduction and offer sufficient working space to apply internal fixation instrumentation, which is effective in treating three-column Lisfranc fracture-dislocations with minor soft tissue complications and satisfactory functional recovery.

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简介：AIMTo在intraocularscattering.METHODSSixty上在小切口的lenticule抽取(微笑)和它的效果以后调查帽子形态学--经历微笑的33个病人的五只眼睛被注册。除了常规评估，Fourier域光连贯断层摄影术被用来在1d调查帽子厚度，1wk，1并且3mo手术后地。散布的光优秀包括调整转移函数截止频率，Strehl比率，光优秀分析系统(OQAS)值，和目的索引(OSI)，用OQAS.RESULTSCap厚度被评估从1d减少了到1wk(P<0.001)，但是仍然保持比120的打算的厚度高

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简介：AbstractPurpose:To assess the clinical efficacy of converting partial articular supraspinatus tendon avulsion (PASTA) lesions to full-thickness tears through a small local incision of the bursal-side supraspinatus tendon followed by repair.Methods:We retrospectively analyzed 41 patients with Ellman grade 3 PASTA lesions and an average age of (54.7 ± 11.4) years from March 2013 to July 2017. Patients without regular conservative treatment and concomitant with other shoulder pathologies or previous shoulder surgery were excluded from the study. The tears were confirmed via arthroscopy, and a polydioxanone suture was placed to indicate the position of each tear. A small incision of approximately 6 mm was made using a plasma scalpel on the bursal-side supraspinatus tendon around the positioned suture to convert the partial tear into a full-thickness tear. The torn rotator cuff was sutured through the full thickness using a suture passer after inserting a 4.5-mm double-loaded suture anchor. Data were analyzed using a paired Student’s t-test with statistical significance defined as p <0.05.Results:At the final follow-up of 2 years, the pain-free shoulder joint range of motion and visual analog scale score were significantly improved compared to those before surgery (p < 0.001). The postoperative American Shoulder and Elbow Surgeons shoulder score was (90.6 ± 6.2), which was significantly higher than the preoperative score of (47.9 ± 8.3) (p < 0.001). The University of California at Los Angeles shoulder rating scale score increased from (14.7 ± 4.1) prior to surgery to (32.6 ± 3.4) points after surgery (p < 0.001). No patient had joint stiffness.Conclusion:This modified tear completion repair, by conversion to full-thickness tears through a small incision, has less damage to the supraspinatus tendon on the side of the bursa compared to traditional tear completion repair in the treatment of PASTA lesions. This surgical method is a simple and effective treatment that can effectively alleviate pain and improve shoulder joint function.

简介：AIMTo在小切口lenticule抽取(微笑)和在situkeratomileusis(FS-LASIK)帮助激光的femtosecond以后估计角膜的敏感和干燥眼睛的发生.METHODSThe元分析用RevMan5.3被执行。我们从开始在PubMed上寻找了到2016年3月。概括加权的吝啬的差别(WMD)和95%信心间隔(CI)被用来分析资料。随机效果或改正效果模型被选择直到在学习之间异质。主要结果由眼睛的表面疾病索引(OSDI)分数，眼泪电影分散时间(TBUT)，Schirmer测试和角膜的sensitivity.RESULTSEight组成包括772只眼睛的合格研究(386在微笑组织，386在FS-LASIK组织)被识别。参数没外科手术前地有在微笑和FS-LASIK组之间的significiant差别异质。手术后地手术后地在在一个和三个月点的OSDI分数的二个组之间有重要差别，在在一个和三个月点的TBUT，在在一个星期，大约一个月和三个月的角膜的敏感手术后地。然而，没有重要差别，在后续periods.CONCLUSIONCompare在Schirmer测试观察到FS-LASIK，干燥眼睛和角膜的敏感在SMILE组更好恢复，在在外科以后的开始的三个月内。