BACKGROUND Esophageal atresia(EA)is a life-threatening congenital malformation in newborns,and the traditional repair approaches pose technical challenges and are extremely invasive.Therefore,surgeons have been active...BACKGROUND Esophageal atresia(EA)is a life-threatening congenital malformation in newborns,and the traditional repair approaches pose technical challenges and are extremely invasive.Therefore,surgeons have been actively investigating new minimally invasive techniques to address this issue.Magnetic compression anastomosis has been reported in several studies for its potential in repairing EA.In this paper,the primary repair of EA with magnetic compression anastomosis under thoracoscopy was reported.CASE SUMMARY A full-term male weighing 3500 g was diagnosed with EA gross type C.The magnetic devices used in this procedure consisted of two magnetic rings and several catheters.Tracheoesophageal fistula ligation and two purse strings were performed.The magnetic compression anastomosis was then completed thoracoscopically.After the primary repair,no additional operation was conducted.A patent anastomosis was observed on the 15th day postoperatively,and the magnets were removed on the 23rd day.No leakage existed when the transoral feeding started.CONCLUSION Thoracoscopic magnetic compression anastomosis may be a promising minimally invasive approach for repairing EA.展开更多
Although major contributions have been made in the field of reconstructive surgery,reconstructive surgery of the auricle is a daunting prospect even for the most experienced surgeons.Here,we present a case who present...Although major contributions have been made in the field of reconstructive surgery,reconstructive surgery of the auricle is a daunting prospect even for the most experienced surgeons.Here,we present a case who presented to us in the emergency surgical ward with a history of an accidental laceration of right ear.Primary repair of the ear laceration after wedge resection of the avulsed part was done.The cosmesis achieved by this technique is discussed.展开更多
Treatment of male urethral trauma is always a challenging problem.In China,as the incidence of urethral trauma keeps rising,more and more studies relating to this are being published.To compare the outcome of differen...Treatment of male urethral trauma is always a challenging problem.In China,as the incidence of urethral trauma keeps rising,more and more studies relating to this are being published.To compare the outcome of different emergency treatments in China and other countries,we searched Chinese and English literature about this topic in the past 16 years.A total of 167 studies involving 5314 patients were included,with 144 in Chinese and 23 in English.All studies were retrospective in nature.Based on the analyses,surgical methods include open realignment,endoscopic realignment and primary repair,and we summarized and compared the success rate and complications(mainly erectile dysfunction and incontinence)of each method.We found that realignment of posterior urethra has similar success rate in China and other countries,but the outcome of realignment of anterior urethra is variable.The reason remains unknown.While long abandoned in Western countries,primary repair of anterior urethra is still an option in China and has high success rate.展开更多
Aim:This paper presents the latest surgical approaches for epispadias treatment in the pediatric population,as well as those for adolescent and adult populations after initial failed repair in childhood.Methods:The re...Aim:This paper presents the latest surgical approaches for epispadias treatment in the pediatric population,as well as those for adolescent and adult populations after initial failed repair in childhood.Methods:The retrospective study was conducted between March 2005 and May 2020 and included 18 patients with the mean age of 21 months(range 11-48 months)(Group A),who underwent primary epispadias repair and 15 patients with the mean age of 18 years(range 13-29 years)(Group B),who underwent redo surgery after failed epispadias repair in childhood.In Group A,the surgery was performed as a one-stage procedure using complete penile disassembly technique,while,in Group B,the surgery was done as a two-stage procedure and included complete straightening and lengthening of the penis,followed by urethral reconstruction.Penile straightening and lengthening were achieved by tunica albuginea incision and grafting.In Group A,the urethral plate was mobilized,transposed ventrally,and tubularized and augmented with vascularized preputial skin flap where needed.In Group B,the urethra was reconstructed either using the buccal mucosa graft and genital skin flaps or with tubularization of genital skin flaps.Successful treatment was defined as a functional and esthetically acceptable penis without complications.Results:The mean follow-up was 88 months(range 15-197 months).Satisfactory results were achieved in 26/33 patients.Urethral fistula occurred in 4/18 patients from Group A and in 3/15 patients in Group B and was surgically repaired after four months.Skin dehiscence occurred in eight patients,five from Group A and three from Group B.Recurrent penile curvature was observed in 2/18 patients from Group A and required surgical correction and in 2/15 patients from Group B and was mild and did not need surgical repair.Eleven patients from Group B who filled out the International Index for Erectile Function reported satisfying erectile function,sexual desire,intercourse,and overall satisfaction.Conclusion:Primary or redo epispadias repair is challenging even for experienced reconstructive urologists.Only radical surgical approach can lead to complete correction of all deformities and provide successful outcome.展开更多
文摘BACKGROUND Esophageal atresia(EA)is a life-threatening congenital malformation in newborns,and the traditional repair approaches pose technical challenges and are extremely invasive.Therefore,surgeons have been actively investigating new minimally invasive techniques to address this issue.Magnetic compression anastomosis has been reported in several studies for its potential in repairing EA.In this paper,the primary repair of EA with magnetic compression anastomosis under thoracoscopy was reported.CASE SUMMARY A full-term male weighing 3500 g was diagnosed with EA gross type C.The magnetic devices used in this procedure consisted of two magnetic rings and several catheters.Tracheoesophageal fistula ligation and two purse strings were performed.The magnetic compression anastomosis was then completed thoracoscopically.After the primary repair,no additional operation was conducted.A patent anastomosis was observed on the 15th day postoperatively,and the magnets were removed on the 23rd day.No leakage existed when the transoral feeding started.CONCLUSION Thoracoscopic magnetic compression anastomosis may be a promising minimally invasive approach for repairing EA.
文摘Although major contributions have been made in the field of reconstructive surgery,reconstructive surgery of the auricle is a daunting prospect even for the most experienced surgeons.Here,we present a case who presented to us in the emergency surgical ward with a history of an accidental laceration of right ear.Primary repair of the ear laceration after wedge resection of the avulsed part was done.The cosmesis achieved by this technique is discussed.
文摘Treatment of male urethral trauma is always a challenging problem.In China,as the incidence of urethral trauma keeps rising,more and more studies relating to this are being published.To compare the outcome of different emergency treatments in China and other countries,we searched Chinese and English literature about this topic in the past 16 years.A total of 167 studies involving 5314 patients were included,with 144 in Chinese and 23 in English.All studies were retrospective in nature.Based on the analyses,surgical methods include open realignment,endoscopic realignment and primary repair,and we summarized and compared the success rate and complications(mainly erectile dysfunction and incontinence)of each method.We found that realignment of posterior urethra has similar success rate in China and other countries,but the outcome of realignment of anterior urethra is variable.The reason remains unknown.While long abandoned in Western countries,primary repair of anterior urethra is still an option in China and has high success rate.
文摘Aim:This paper presents the latest surgical approaches for epispadias treatment in the pediatric population,as well as those for adolescent and adult populations after initial failed repair in childhood.Methods:The retrospective study was conducted between March 2005 and May 2020 and included 18 patients with the mean age of 21 months(range 11-48 months)(Group A),who underwent primary epispadias repair and 15 patients with the mean age of 18 years(range 13-29 years)(Group B),who underwent redo surgery after failed epispadias repair in childhood.In Group A,the surgery was performed as a one-stage procedure using complete penile disassembly technique,while,in Group B,the surgery was done as a two-stage procedure and included complete straightening and lengthening of the penis,followed by urethral reconstruction.Penile straightening and lengthening were achieved by tunica albuginea incision and grafting.In Group A,the urethral plate was mobilized,transposed ventrally,and tubularized and augmented with vascularized preputial skin flap where needed.In Group B,the urethra was reconstructed either using the buccal mucosa graft and genital skin flaps or with tubularization of genital skin flaps.Successful treatment was defined as a functional and esthetically acceptable penis without complications.Results:The mean follow-up was 88 months(range 15-197 months).Satisfactory results were achieved in 26/33 patients.Urethral fistula occurred in 4/18 patients from Group A and in 3/15 patients in Group B and was surgically repaired after four months.Skin dehiscence occurred in eight patients,five from Group A and three from Group B.Recurrent penile curvature was observed in 2/18 patients from Group A and required surgical correction and in 2/15 patients from Group B and was mild and did not need surgical repair.Eleven patients from Group B who filled out the International Index for Erectile Function reported satisfying erectile function,sexual desire,intercourse,and overall satisfaction.Conclusion:Primary or redo epispadias repair is challenging even for experienced reconstructive urologists.Only radical surgical approach can lead to complete correction of all deformities and provide successful outcome.
