Objective To improve the diagnosis and treatment of concealed penis in children. Methods From August 1998 to January 2004, 43 cases of concealed penis in children were treated with Huang Lugang’s procedure aging aged 2-14 years (7 years on average). Eight children are obesity. The albuginea tissue were fixed to the lateral Buck’s fascia at the base of the penis. Removal of the excessive suprapublic fat was given in 2 cases of obesity type. Results All patients were followed up from 3to 24 months. The results were satisfactory in 35 (81.4%).The penile contour were dissatisfactory in 8 patients with obesity including 2 patients given removal of the excessive suprapublic fat. Conclusion The Huang Lugang’s procedure was simple and can achieved satisfactory results, but it should be used carefully in case of obesity type.
Objective To review current status of surgical treatment for angular kyphosis in spinal tuberculosis and provide reference for clinical treatment. Methods The literature on the surgical treatment for angular kyphosis of spinal tuberculosis in recent years was extensively reviewed and summarized from the aspects of surgical indications, surgical contraindications, surgical approach, selection of osteotomy, and perioperative management. Results Angular kyphosis of spine is a common complication in patients with spinal tuberculosis. If kyphosis progresses gradually, it is easy to cause neurological damage, deterioration, and delayed paralysis, which requires surgical intervention. At present, surgical approaches for angular kyphosis of the spine include anterior approach, posterior approach, and combined anterior and posterior approaches. Anterior approach can be performed for patients with severe spinal cord compression and small kyphotic Cobb angle. Posterior approach can be used for patients with large kyphotic Cobb angle but not serious neurological impairment. A combined anterior and posterior approaches is an option for spinal canal decompression and orthosis. Osteotomy for kyphotic deformity include Smith-Peterson osteotomy (SPO), pedicle subtraction osteotomy (PSO), vertebral column resection(VCR), vertebral column decancellation (VCD), posterior vertebral column resection (PVCR), deformed complex vertebral osteotomy (DCVO), and Y-shaped osteotomy. SPO and PSO are osteotomy methods with relatively low surgical difficulty and low surgical risks, and can provide 15°-30° angular kyphosis correction effect. VCR or PVCR is a representative method of osteotomy and correction. The kyphosis correction can reach 50° and is suitable for patients with severe angular kyphosis. VCD, DCVO, and Y-shaped osteotomy are emerging surgical techniques in recent years. Compared with VCR, the surgical risks are lower and the treatment effects also improve to varying degrees. Postoperative recovery is also a very important part of the perioperative period and should be taken seriously. Conclusion There is no consensus on the choice of surgical treatment for angular kyphosis in spinal tuberculosis. Osteotomy surgery are invasive, which is a problem that colleagues have always been concerned about. It is best to choose a surgical method with less trauma while ensuring the effectiveness.
【摘要】 目的 探讨椎管内囊肿的手术治疗疗效。 方法 2006年5月-2009年12月对30例患者的临床表现、影像学和治疗情况进行回顾性分析。 结果 30例均行手术治疗，3例为椎管内单侧硬膜下髓外囊肿，3例为脑脊膜囊肿，12例为髓外硬脊膜下囊肿，9例为神经根袖套部囊肿（Tarlov囊肿），3例为脊管内肠源性囊肿。术后21例症状消失；9例好转，其中3例术后发生脑脊液漏，伤口二次缝合未成功，后经内引流后切口愈合。 结论 椎管内囊肿的临床表现及体征复杂，不典型，与椎管内肿瘤及椎间盘突出症的临床表现和体征相似；对症状及体征明显者宜施行手术治疗，手术治疗效果较满意。【Abstract】 Objective To evaluate the therapeutic effect of the surgery on intraspinal cyst. Methods A total of 30 patients from May 2006 to December 2009 were collected, and the clinical manifestations, results of examinations and therapeutic effects were retrospectively analyzed. Results All the patients underwent the surgery, inluding 3 with unilateral intraspinal subdural extramedullary cyst, 3 with meningeal cyst, 12 with subdural extramedullary cyst, 3 with nerve-root oversleeve cyst (Tarlov cyst), and 3 with intra-spinal-canal enterogenous cyst. Afterh the surgery, the symptoms disappeared in 21 patients, alleviated in 9 including 3 with postoperative cerebrospinal-fluid leakage whose wound was not sutured successfully for the second time and healed up after drainage. Conclusions The clinical manifestations of intraspinal cyst are complicated and untypical, which is similar to that of intraspinal tumor and slipped disc. The surgeries should be performed on the patients with obvious symptoms and the therapeutic effect is good.
目的：探讨宫颈残端肿瘤的外科治疗方法及手术技巧，提高外科治疗水平。方法：回顾性分析我院自2005年5月至2007年11月手术治疗的宫颈残端肿瘤22例。结果：全组病例行不同程度的残余宫颈切除术，16例辅以不同程度的放疗或化疗，全切率100%，无手术相关死亡，3例并发膀胱损伤，术后恢复良好。结论：根治性手术风险高，难度大，只有根据病情采取合理的术式，掌握手术技巧，宫颈残端肿瘤才望获得较好的疗效。
目的 全面介绍先天性囊性腺瘤样畸形(CCAM)其可能的病因，临床、病理特点及诊断手段，循证探讨针对CCAM的治疗方法及预后。 方法 对我院2011年11月收治的1例罕见的CCAM患者的临床资料进行分析，并对相关文献进行复习。 结果 患者数次误诊后最终诊断为CCAM，予手术治疗后痊愈，随访1年无复发。 结论 CCAM是一种少见的、非遗传性的、错构瘤样的肺发育异常，为一种良性的肺部畸形，其特点是局部肺终末呼吸性细支气管过度生长。CCAM多通过产前影像学检查、活组织检查或术后病检诊断。手术为治愈该病的最根本、最重要措施。
To cure patients suffering from atlanto-axial instability following old fracture of odontoid process concomitant with stenosis of lower end of cervical spinal canal, a new operative method was designed. It included atlanto-axial fusion by Gallie technique and resection of right half of the laminae of C3-C7 spine at one stage. A female of 63 years old was treated. She was admitted with neck pain and numbness of the upper and lower limbs. A history of neck injury was noted in enquiry. In physical examination showed the sensation of pain of the upper limbs was decreased and the muscle power of the upper and lower limbs ranged from III degree to IV degree. The X-ray film and MRI suggested that there was instability of the atlanto-axial joint with stenosis of 4th-6th cervical spinal canal. The operation was satisfactory. After operation, the patient was followed up for 11 months. The physical examination indicated that sensation of the upper limbs had recovered to normal and the muscle power of the upper limbs reached IV degree and that the lower limbs reached V degree and X-ray showed bony fusion of the atlanto-axial joint. The conclusions were: 1. The stability of atlanto-axial joint was reconstructed with expanding of the spinal canal at the same time. 2. The duration, risk and cost of the therapy were reduced, and maintenance of the stability of the cervical spine throughout whole period of treatment was recommended.
慢性胰腺炎是胰腺进行性炎症性疾病，以胰腺实质持续性破坏和纤维化等不可逆性的形态改变为其特征，并引起顽固性疼痛和(或)永久性功能丧失。迄今，其发病机理、病理生理和疾病过程仍不十分清楚，各种治疗也仅限于疾病的并发症。
目的:探讨平阳霉素/博来霉素联合顺铂(BP方案)、5氟尿嘧啶+异环磷酰胺联合顺铂(FIP方案)在宫颈癌新辅助化疗(Neoadjuvant Chemotherapy, NACT)的疗效及临床意义。方法:2004～2008年我院收治的Ib2-IIb期巨块型宫颈癌共62例,其中36例行BP或FIP方案化疗1～2个疗程后行根治性手术,为研究组;另26例直接行根治性手术,为对照组;术前评价NACT的疗效,并比较两组术中出血量、术后病理特征及并发症。结果:研究组36例患者术前进行NACT有效率为86％;术后病理检查示淋巴结阳性率,阴道切缘阳性率及宫旁累及率均较对照组低,差异有显著性。结论:利用BP,FIP方案对宫颈癌患者进行新辅助化疗有效、安全、经济,可缩小癌肿体积,增加手术切除率。