New Surgical Technique For Correction Research Articles

Subadventitial dismembered pyeloureteroplasty – new surgical technique for correction of uretero-pelvic junction stenosis

Objective: Open or laparoscopic dismembered pyeloplasty has been the gold standard for the correction of ureteropelvic junction obstruction (UPJO) with a success rate of about 90%. Main insufficient feature of dismembered pyeloureteroplasty is interfering ureteral blood supply, which creates the prerequisites for the deterioration of the regeneration of the ureter and the possibility of developing restenosis. Methods: We offered and applied the new method – subadventitial resection of ureteropelvic junction (UPJ) to prevent damage to vessels of the distal part of pelvis and proximal part of the ureter. The protection of blood supply in this area should improve anastomosis regeneration and prevent fibrotic changes for long time, simultaneously providing better condition for the kinetic ability of the ureter. Results: Retrospective analysis of 106 patients with hydronephrosis, whom performed 108 open dismembered pyeloplasty (two patients were operated bilaterally) with subadventitial resection of UPJ from 1998-2020 years with a mean follow-up of 36 month shows that this technique has advantages over analogues. Conclusion: Our 22 years of experience shows that the technique of subadventitial resection of the ureter, allows us to save the ureteral blood circulation and thus creates conditions for better regeneration of the anastomosis and prevent later complications of dismembered pyelouretereroplasty.

Complications in Mandibular Midline Distraction.

Mandibular midline distraction (MMD) is a relatively new surgical technique for correction of transverse discrepancies of the mandible. This study assesses the amount and burden of complications in MMD. A retrospective cohort study was performed on patients who underwent MMD between 2002 and 2014. Patients with congenital deformities or a history of radiation therapy in the area of interest were excluded. Patient records were obtained and individually assessed for any complications. Complications were graded using the Clavien-Dindo classification system (CDS). Seventy-three patients were included of which 33 were males and 40 were females. The mean follow-up was 2.1 years. Twenty-nine patients had minor complications, grades I and II. Two patients had a grade IIIa and three patients had a grade IIIb complication. Common complications were pressure ulcers, dehiscence, and (transient) sensory disturbances of the mental nerve. This study shows that although MMD is a relatively safe method, complications can occur. Mostly the complications are mild, transient, and manageable without the need for any reoperation.

Anatomic correction of polysyndactyly of the fifth toe fused with the fourth toe

A new surgical technique for correction of polysyndactyly with the fifth toe fused with the fourth toe was devised. The technique consists of the creation of a dorsal rectangular flap on the dorsum of the syndactyly web for the new fourth web, making a medially based plantar rectangular flap on the plantar surface of the fifth toe, and a sixth toe-tip-based rectangular hinge flap to reconstruct the lateral side of the fourth toe and medial side of the new fifth toe, respectively. All suture lines are intended to be located in the transition of the plantar and dorsal surfaces of the web and digit. This technique is characterised by accurate anatomic reconstruction, which produces better aesthetic results with no wasting of any skin components.

右肺静脈上大静脈還流異常症の新しい術式

右肺静脈上大静脈還流異常症の新しい術式