A New Method of Costal Cartilage Harvest for Total Auricular Reconstruction: Part I. Avoidance and Prevention of Intraoperative and Postoperative Complications and Problems

Objective Frontonasal dysplasia (FND) is a rare congenital condition. Its major features include hypertelorism, a large and bifid nasal tip, and a broad nasal root. We present our technique of septal L-strut reconstruction using costal cartilage. Design Retrospective review from June 2008 and August 2017. Methods Under general anesthesia, 6 patients with FND underwent septal reconstruction using costal cartilage via open rhinoplasty. We reconstructed the nasal and septal cartilaginous framework by placing columellar struts and cantilever-type grafts. Results The patients ranged in age from 6 to 13 years old. All were female. The follow-up period ranged from 8 months to 2 years; we encountered no postoperative complications (infection, nasal obstruction, or recurrence). All patients were satisfied with their nasal appearance. Conclusions Although the results were not entirely satisfactory from an esthetic point of view, we found that FND can be treated via septal reconstruction with costal cartilage and that the clinical outcomes are reliable and satisfactory. Our approach is a useful option for FND patients.

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Retrospective Analysis of Complication Rates Associated With Auricular Reconstruction After Skin Cancer Surgery

Journal of Cutaneous Medicine and Surgery ◽

10.1177/1203475419890841 ◽

2019 ◽

Vol 24 (2) ◽

pp. 137-143

Author(s):

Diana Crișan ◽

Horațiu Alexandru Colosi ◽

Avram Manea ◽

Sabine Kastler ◽

Anna Lipke ◽

...

Keyword(s):

Postoperative Complications ◽

Postoperative Infection ◽

Tumor Resection ◽

Case Series ◽

Skin Tumor ◽

Complication Rates ◽

Ear Reconstruction ◽

Retrospective Case ◽

Auricular Reconstruction ◽

Early Postoperative Complications

Background There is limited data regarding postoperative complications after microtia surgery or tympanoplasty; however, complication rates after pinna reconstruction following tumor resection and comorbidities associated with suboptimal outcomes have not been investigated so far. Objective To examine the incidence of postoperative complications after auricular reconstruction surgery following tumor resection and determine the association between postoperative complications and defect size, patients’ comorbidities, and reconstruction type. Methods and Materials In a retrospective case series ( n = 146, January 2014 to October 2018), we examined the surgical outcome and amount of postoperative complications following auricular surgery as well as the association with different comorbidities. SPSS 16.0 was used for statistical analyses. Results The following early postoperative complications were identified: pain (29.5%), hematoma (4.1%), flap congestion (4.8%), infection (3.4%), and flap/graft necrosis (2.7%). Late complications including cartilage step-offs, helical rim sulcus alteration, granulomas, or ear deformities occurred only in 3.6% of subjects. Reconstructions of large defects (>1 cm2) were associated with a higher incidence of early postoperative complications compared to small defects (<1 cm2) ( P < .001). Neither the presence of smoking or diabetes nor immunosuppression was significantly linked to an increased incidence of early complications. Immunosuppression, however, was associated with a higher incidence of postoperative infection ( P < .001) Conclusion The incidence of early and late postoperative complications after skin tumor resection and external ear reconstruction is low. The occurrence of postoperative infection was not linked with smoking or the presence of diabetes, but strongly associated with a state of immunosuppression, which is why a perioperative antibiotic prophylaxis in immune-compromised patients may be considered.

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Safety of double and a half-layered esophagojejunal anastomosis in total gastrectomy with gastric cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.e16563 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. e16563-e16563

Author(s):

Pengfei Ma ◽

Yuzhou Zhao ◽

Xijie Zhang

Keyword(s):

Gastric Cancer ◽

Postoperative Complications ◽

Blood Loss ◽

Anastomotic Leakage ◽

Total Gastrectomy ◽

Operating Time ◽

New Method ◽

Control Group ◽

Observation Group ◽

Esophagojejunal Anastomosis

e16563 Background: Esophageal jejunal anastomotic fistula is still one of the serious postoperative complications of gastric cancer, the incidence was 1% ~ 16.5%. The aim of this study was to evaluate the safety of double and a half layered esophagojejunal anastomosis in total gastrectomy. Methods: The new method was called double and a half layered esophagojejunal anastomosis: esophagojejunal anastomosis was performed with a tubular stapler, then the anastomosis was reinforced by absorbable suture (Full-layer continuous suture, slurry muscularis embedding). The new method was used in observation group (n = 295). In the control group(n = 469),the esophagojejunal anastomosis was performed with a tubular stapler, then reinforced by intermittent suture with absorbable sutures. Data analysis including operating time, blood loss, anastomosis time, types and cases of postoperative complications, and postoperative hospitalization time. Results: The data of 764 patients who performed radical gastrectomy between May 2015 and May 2019 were analyzed retrospectively. 1.Surgery situations: The operating time (140.66±26.96 min vs 139.61±22.75min, t= 0.581, P> 0.05) blood loss (200.61±111.03ml vs214.45±114.09ml, t= -1.481, P> 0.05), anastomosis time (20.44±4.31min vs19.92±4.58min, t= 1.573, P> 0.05), postoperative hospitalization time (15.35±6.46 d vs15.89±5.58d, t= -1.229, P> 0.05) .2. Postoperative situations: the rates of anastomotic complications in observation group was 1.69% (5/295) and 4.69% (22/469) in control group, with a statistically significant difference between two groups( χ2 = 4.768, P< 0.05). The rates of anastomotic leakage in observation group was lower than that in the control group 1.02% (3/295) vs 3.41% (16/469) ( χ2 = 4.282, P< 0.05) . The severity of anastomotic leakage, anastomotic stenosis, anastomotic bleeding were no statistically significant differences between two groups( χ 2= 2.030,1.261,0.075, P> 0.05). Total postoperative complications: 101 cases (34.24%) in the observation group, 14 cases (4.75%) with severe complications, and 1 case death. 151 cases (32.2%) in the control group, 34 cases (7.25%) with serious complications, and 2 cases death ( χ2 = 0.838, Z = -1.465, P > 0.05). Conclusions: Double and a half layered esophagojejunal anastomosis is safe and feasible in total gastrectomy, which can reduce the incidence of anastomosis complications.

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A New Method of Reconstruction for Pectus Excavatum That Preserves Blood Supply and Costal Cartilage

Plastic & Reconstructive Surgery ◽

10.1097/00006534-199905060-00013 ◽

1999 ◽

Vol 103 (6) ◽

pp. 1661-1666 ◽

Cited By ~ 3

Author(s):

Hideo Nakajima ◽

Hak Chang

Keyword(s):

Blood Supply ◽

Pectus Excavatum ◽

Costal Cartilage ◽

New Method

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Comparison of the safety and efficacy of the new method of en-bloc and conventional monopolar transurethral resection in the management of primary non-muscle-invasive bladder cancer

Cancer Urology ◽

10.17650/1726-9776-2019-15-3-102-112 ◽

2019 ◽

Vol 15 (3) ◽

pp. 102-112

Author(s):

S. A. Krasny ◽

I. L. Masanskiy

Keyword(s):

Bladder Cancer ◽

Postoperative Complications ◽

New Method ◽

Invasive Bladder Cancer ◽

Muscle Invasive Bladder Cancer ◽

En Bloc ◽

Safety And Efficacy ◽

Group A ◽

Muscle Invasive

Objective: to comparе the safety and efficacy of the new method of en-bloc transurethral resection (TUR) and conventional TUR in management of primary non-muscle-invasive bladder cancer, and investigate long-term effects on tumour recurrence and progression.Materials and methods. A total of 914 patients with primary non-muscle-invasive bladder cancer were treated using TUR of bladder at the Minsk City Clinical Oncologic Dispensary in 2005 to 2016. For final analysis the data was underwent many-stage random sampling. Randomization was stratified according to sex and age, category T, tumour grade, EORTC risk groups. In total, 273 patients were selected: 136 in the new method of en-bloc TUR group (a study group) and 137 in the conventional TUR group (a control group). The new method of en-bloc TUR is based on using impulses of high-frequency current applied to the active electrode of the resectoscope. The impulse sequence and individual impulse duration within the interval from 0.1 to 1 second are controlled in the course of the operation. Five-year follow-up data of operative management were analyzed.Results. In event of the new method of en-bloc TUR there were no perioperative complications and no cases of conversion to conventional TUR. Postoperative complications were less frequently observed in the new method group compared with conventional TUR group. There were significant differences with major priority to the new method of en-bloc TUR in median time to recurrence (р = 0.032) and progression (р = 0.001), 5-year survival to recurrence (р = 0.0001) and progression (р = 0.001), 5-year cancer-specific survival (р = 0.033) and overall survival (р = 0.045) of patients.Conclusion. The new method of en-bloc TUR of non-muscle-invasive bladder cancer was more effective than conventional TUR in reducing rates of intraand postoperative complications, and at the same time was applicable in all clinical cases, regardless of the tumor location in the bladder lumen, its size, vascularization, and growth pattern. The new method of en-bloc TUR also significantly improved the long-term cancer treatment results in patients with primary non-muscle-invasive bladder cancer.

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