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Comparison of the efficacy of tibial transverse transfer and periosteal distraction techniques in the treatment of diabetic foot refractory ulcers. 比较胫骨横向转移和骨膜牵引技术在治疗糖尿病足难治性溃疡中的疗效。
IF 1.6 4区 医学 Q2 SURGERY Pub Date : 2024-10-03 eCollection Date: 2024-01-01 DOI: 10.3389/fsurg.2024.1396897
Yang Yang, Fang Chen, Yiguo Chen, Wei Wang

Objective: To investigate the efficacy of comparing tibia transverse transport (TTT) and periosteal distraction in treating diabetic foot ulcers.

Methods: A retrospective analysis of 19 patients with diabetic foot ulcers treated with both procedures between February 2020 and November 2022, 8 of whom were treated with the tibial transverse transfer technique (transfer group) and 11 with the osteochondral distraction technique (distraction group), was performed to compare and analyze the clinical efficacy of the two methods.

Results: All wounds were healed in both groups, and the healing time ranged from 15 to 41days with a mean of 28d. The limb preservation rate was 100%. The operative time, intraoperative bleeding, and pain score in the operative area were significantly less in the distraction group than in the removal group, with statistically significant differences (P < 0.05). Intra-group comparison between the two groups of patients after surgery revealed that the skin temperature, ABI, TcPO2, SWM and VAS of the affected limb were significantly improved compared with those before surgery, and the difference was statistically significant (P < 0.05). The expression levels of VEGF, bFGF, EGF and PDGF were significantly higher than before surgery in both groups, and the difference was statistically significant (P < 0.05). No statistically significant differences were found in skin temperature, ABI, TcPO2, SWM, VAS, VEGF, bFGF, EGF and PDGF between the two groups at the corresponding time points preoperatively and postoperatively (P > 0.05).

Conclusions: The Periosteal distraction technique can significantly promote the healing of diabetic foot ulcers. It has the same efficacy as TTT in promoting the healing of diabetic foot ulcer wounds and improving the peripheral circulation of affected limbs. In addition, the periosteal distraction technique has the advantages of small trauma, simple operation, few complications, and convenient nursing care.

目的比较胫骨横向转移术(TTT)和骨膜牵引术治疗糖尿病足溃疡的疗效:回顾性分析2020年2月至2022年11月期间接受两种手术治疗的19例糖尿病足溃疡患者,其中8例采用胫骨横向转运技术(转运组),11例采用骨软骨牵引技术(牵引组),比较分析两种方法的临床疗效:结果:两组所有伤口均愈合,愈合时间从15天到41天不等,平均为28天。保肢率为 100%。牵引组的手术时间、术中出血量和术区疼痛评分明显少于切除组,差异有统计学意义(P P P P > 0.05):结论:骨膜牵引技术能明显促进糖尿病足溃疡的愈合。结论:骨膜牵引技术可明显促进糖尿病足溃疡的愈合,在促进糖尿病足溃疡伤口愈合和改善患肢末梢循环方面与 TTT 具有相同的疗效。此外,骨膜牵引技术还具有创伤小、操作简单、并发症少、护理方便等优点。
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引用次数: 0
Detection of hand motion during cadaveric mastoidectomy dissections: a technical note. 尸体乳突切除术解剖过程中的手部运动检测:技术说明。
IF 1.6 4区 医学 Q2 SURGERY Pub Date : 2024-10-03 eCollection Date: 2024-01-01 DOI: 10.3389/fsurg.2024.1441346
Thomas J On, Yuan Xu, Nicolas I Gonzalez-Romo, Gerardo Gomez-Castro, Oscar Alcantar-Garibay, Marco Santello, Michael T Lawton, Mark C Preul

Background: Surgical approaches that access the posterior temporal bone require careful drilling motions to achieve adequate exposure while avoiding injury to critical structures.

Objective: We assessed a deep learning hand motion detector to potentially refine hand motion and precision during power drill use in a cadaveric mastoidectomy procedure.

Methods: A deep-learning hand motion detector tracked the movement of a surgeon's hands during three cadaveric mastoidectomy procedures. The model provided horizontal and vertical coordinates of 21 landmarks on both hands, which were used to create vertical and horizontal plane tracking plots. Preliminary surgical performance metrics were calculated from the motion detections.

Results: 1,948,837 landmark detections were collected, with an overall 85.9% performance. There was similar detection of the dominant hand (48.2%) compared to the non-dominant hand (51.7%). A loss of tracking occurred due to the increased brightness caused by the microscope light at the center of the field and by movements of the hand outside the field of view of the camera. The mean (SD) time spent (seconds) during instrument changes was 21.5 (12.4) and 4.4 (5.7) during adjustments of the microscope.

Conclusion: A deep-learning hand motion detector can measure surgical motion without physical sensors attached to the hands during mastoidectomy simulations on cadavers. While preliminary metrics were developed to assess hand motion during mastoidectomy, further studies are needed to expand and validate these metrics for potential use in guiding and evaluating surgical training.

背景:进入颞骨后部的手术方法需要谨慎的钻孔动作,以实现充分暴露,同时避免损伤关键结构:我们对深度学习手部运动检测器进行了评估,以改进在尸体乳突切除术中使用电钻时的手部运动和精确度:深度学习手部运动检测器跟踪了外科医生在三次乳突切除术中的手部运动。该模型提供了双手 21 个地标的水平和垂直坐标,用于绘制垂直和水平平面追踪图。根据运动检测结果计算出初步的手术性能指标:共收集到 1,948,837 次地标检测,总体性能达到 85.9%。优势手(48.2%)与非优势手(51.7%)的检测结果相似。由于视野中心的显微镜光线导致亮度增加,以及手在摄像机视野外的移动,出现了跟踪损失。仪器更换时的平均(标清)耗时(秒)为 21.5(12.4),显微镜调整时的平均(标清)耗时(秒)为 4.4(5.7):结论:在尸体上模拟乳突切除术时,深度学习手部运动检测器可以测量手术运动,而无需在手上安装物理传感器。虽然已开发出初步指标来评估乳突切除术中的手部运动,但还需要进一步研究来扩展和验证这些指标,以便用于指导和评估手术培训。
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引用次数: 0
Mediastinal drainage combined with upper mediastinal re-tunneling vs. mediastinal drainage alone in McKeown esophagectomy of esophageal cancer: a retrospective study. 食管癌麦氏食管切除术中纵隔引流术联合上纵隔再隧道术与单纯纵隔引流术的对比:一项回顾性研究。
IF 1.6 4区 医学 Q2 SURGERY Pub Date : 2024-10-02 eCollection Date: 2024-01-01 DOI: 10.3389/fsurg.2024.1436176
Lei Dai, Xiang Tan, Mingwu Chen, Huajian Peng, Yongyong Wang

Background: Although mediastinal drainage may lower the risk of anastomotic leakage, the incident rate of anastomotic leakage is still high. The current study aimed to compare the effects of mediastinal drainage combined with upper mediastinal re-tunneling with mediastinal drainage only on anastomotic leakage after McKeown esophagectomy for esophageal cancer.

Methods: From October 2018 to March 2021, 52 patients diagnosed as esophageal carcinoma were included in the study. 21 patients received mediastinal drainage combined with upper mediastinal re-tunneling (re-tunneling group) and 31 received mediastinal drainage only (standard group) after McKeown esophagectomy. The incidence rate of anastomotic leakage, mediastinal infection, chylothorax, thoracic infection, the peak value of leukocyte count and the mortality related to anastomotic leakage were compared between the two groups.

Results: One (4.8%) patient in the re-tunneling group developed anastomotic leakage, and no patient experienced mediastinal infection or thoracic infection. Four (12.9%) patients in the standard group developed anastomotic leakage, and all these patients experienced mediastinal infection and thoracic infection (p < 0.05). The drainage volumes of patients in the re-tunneling group and the standard group were (170 ± 60) ml and (155 ± 45) ml, respectively, with no significant difference between the two groups (p > 0.05). The peak values of leukocyte count and temperature in the re-tunneling group were (14.28 ± 1.12) × 109/L and (38.6 ± 1.1) °C, both lower than that of the standard group[ (16.48 ± 1.15) × 109/L and (38.9 ± 1.2) °C, respectively]. But the difference was not statistically significant (p > 0.05). No anastomotic leakage related death occurred in both groups.

Conclusion: Mediastinal drainage combined with upper mediastinal re-tunneling after McKeown esophagectomy for esophageal cancer may decrease the risk of anastomotic leakage, mediastinal and thoracic infection, reduce the inflammatory response of patients, but did not increase the mortality related to anastomotic leakage.

Trial registration: The study was retrospectively registered.

背景:尽管纵隔引流可降低吻合口漏的风险,但吻合口漏的发生率仍然很高。本研究旨在比较纵隔引流联合上纵隔再通术与单纯纵隔引流对食管癌麦氏食管切除术后吻合口漏的影响:2018年10月至2021年3月,52例确诊为食管癌的患者纳入研究。21例患者在麦氏食管切除术后接受纵隔引流联合上纵隔再通(再通组),31例患者仅接受纵隔引流(标准组)。比较了两组吻合口漏、纵隔感染、乳糜胸、胸腔感染的发生率、白细胞计数峰值以及与吻合口漏相关的死亡率:结果:再通组有一名(4.8%)患者出现吻合口漏,没有患者出现纵隔感染或胸腔感染。标准组有四名患者(12.9%)出现吻合口漏,所有这些患者都出现了纵隔感染和胸腔感染(P P > 0.05)。再通组的白细胞计数和体温峰值分别为(14.28 ± 1.12)×109/L 和(38.6 ± 1.1)℃,均低于标准组[分别为(16.48 ± 1.15)×109/L 和(38.9 ± 1.2)℃]。但差异无统计学意义(P > 0.05)。两组患者均未发生与吻合口漏相关的死亡:结论:食管癌麦氏食管切除术后纵隔引流联合上纵隔再通术可降低吻合口漏、纵隔和胸腔感染的风险,减轻患者的炎症反应,但不会增加与吻合口漏相关的死亡率:该研究为回顾性注册。
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引用次数: 0
A comparative study of single-stage bilateral vs. unilateral medial unicompartmental knee arthroplasty on complications, clinical outcomes, and costs. 单阶段双侧与单侧内侧单室膝关节置换术在并发症、临床效果和成本方面的比较研究。
IF 1.6 4区 医学 Q2 SURGERY Pub Date : 2024-10-02 eCollection Date: 2024-01-01 DOI: 10.3389/fsurg.2024.1470421
Kao-Chang Tu, Han-Ting Shih, Shun-Ping Wang, Kun-Hui Chen

Background: This retrospective study aimed to evaluate the short-term recovery and cost-effectiveness of bilateral unicompartmental knee arthroplasty (UKA) compared to staged unilateral UKA. The study analyzed postoperative pain scores, medical costs, and complications in patients with knee osteoarthritis who underwent these procedures.

Methods: A total of 226 patients who received either unilateral UKA (Group A, n = 170) or bilateral UKA (Group B, n = 56) using the mobile-bearing UKA were included in the study. Patient demographics, surgical details, postoperative pain scores, knee range of motion, length of hospital stay, self-controlled analgesic use, total medical costs, and complications were retrospectively collected from medical records.

Results: The demographic characteristics were comparable between the groups. Group B had a longer surgical time and higher medical costs than Group A. However, there were no significant differences in hospital stay, pain scores, or knee range of motion between the two groups. Complications were infrequent and not significantly different. Insert dislocation and loosening were the most common complications. Patient-controlled analgesia effectively reduced pain scores in Group A but not in Group B.

Conclusion: Bilateral UKA does not significantly affect hospital stay, postoperative pain, or complications compared to unilateral UKA. Although bilateral UKA requires longer surgical time and incurs higher costs, it offers the potential benefit of reducing anesthesia-related complications and overall health insurance expenditures. This study recommends bilateral UKA as a suitable option for patients with bilateral knee osteoarthritis, given its comparable short-term outcomes and potential cost-saving advantages.

Level of evidence: III.

背景:这项回顾性研究旨在评估双侧单室膝关节置换术(UKA)与分期单侧UKA相比的短期恢复情况和成本效益。研究分析了接受这些手术的膝关节骨性关节炎患者的术后疼痛评分、医疗费用和并发症:共有226名患者接受了单侧UKA(A组,n=170)或双侧UKA(B组,n=56)。研究人员从病历中回顾性收集了患者的人口统计学特征、手术细节、术后疼痛评分、膝关节活动范围、住院时间、自控镇痛药使用情况、医疗总费用和并发症:结果:两组的人口统计学特征相当。然而,两组在住院时间、疼痛评分和膝关节活动范围方面没有明显差异。并发症并不常见,且无明显差异。假体脱位和松动是最常见的并发症。患者自控镇痛可有效降低A组患者的疼痛评分,但B组患者的疼痛评分则没有降低:结论:与单侧UKA相比,双侧UKA对住院时间、术后疼痛或并发症没有明显影响。虽然双侧UKA需要更长的手术时间和更高的费用,但它能减少麻醉相关并发症和总体医疗保险支出。鉴于双侧UKA具有可比的短期疗效和潜在的成本节约优势,本研究建议双侧UKA作为双侧膝关节骨性关节炎患者的合适选择:证据等级:III。
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引用次数: 0
Anterolateral thigh free flap using modified turbocharging method: a case report. 使用改良涡轮增压法的大腿前外侧游离皮瓣:病例报告。
IF 1.6 4区 医学 Q2 SURGERY Pub Date : 2024-10-01 eCollection Date: 2024-01-01 DOI: 10.3389/fsurg.2024.1273843
Yooseok Ha, Donghyun Kim, Hyeokjae Kwon, Sunje Kim, Seung Han Song, Sang-Ha Oh, Joo-Hak Kim, Ho Jik Yang, Hyunwoo Kyung

The free flap is a versatile option for reconstruction of soft tissue defects around the ankle. In patients with poor lower leg circulation, arterial insufficiency is one of the complications that can occur immediately after vessel anastomosis during free flap surgery. The authors were able to improve blood circulation in the flap by using modified turbocharging method in which another perforator was anastomosed to the distal end of the main pedicle.

游离皮瓣是重建踝关节周围软组织缺损的多功能选择。对于小腿血液循环不良的患者来说,动脉供血不足是游离皮瓣手术中血管吻合后可能立即出现的并发症之一。作者采用改良的涡轮增压法,将另一条穿孔器吻合到主蒂的远端,从而改善了皮瓣的血液循环。
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引用次数: 0
Intraoperative marking of pulmonary nodules in a hybrid operating room: electromagnetic navigation bronchoscopy versus percutaneous marking. 混合手术室肺结节的术中标记:电磁导航支气管镜与经皮标记。
IF 1.6 4区 医学 Q2 SURGERY Pub Date : 2024-09-30 eCollection Date: 2024-01-01 DOI: 10.3389/fsurg.2024.1482120
María Teresa Gómez-Hernández, Cristina E Rivas Duarte, José María Fernández García-Hierro, Marta G Fuentes, Oscar Colmenares, Clara Forcada Barreda, Francisco Gómez Valle, Irene Jiménez García, Marcelo F Jiménez

Background: Intraoperative identification of subsolid or small pulmonary nodules during minimally invasive procedures is challenging. Recent localization techniques show varying success and complications. Hybrid operating rooms (HORs), equipped with radiological tools, facilitate intraoperative imaging. This study compares the accuracy and safety of marking pulmonary nodules using electromagnetic navigation bronchoscopy (ENB) combined with Cone Beam Computed Tomography (CBCT) vs. CBCT-guided percutaneous marking (PM).

Methods: This retrospective cohort study included patients with pulmonary nodules scheduled for minimally invasive resection in a HOR. Marking techniques included ENB assisted by CBCT and PM guided by CBCT. The study compared the success rate, procedure time, intraoperative complications and radiation dose of both techniques.

Results: A total of 104 patients with 114 nodules were included (October 2021-July 2024). Thirty nodules were marked using ENB, and 84 with PM. One case used both techniques due to ENB failure. No differences among groups were found in nodule characteristics. Success rates were similar (93.3% in ENB group vs. 91.7% in PM group, p = 1). Marking took significantly longer time in the ENB group (median 40 min) compared to PM group (25 min, p = 0.007). Five (6%) patients in the PM group experienced intraoperative complications compared to none in the ENB (p = 0.323). Radiation dose was significantly higher in the ENB group (p = 0.002).

Conclusions: ENB assisted by CBCT is a safe and effective technique, with success rates comparable to CBCT-guided PM, though it may result in longer procedural times and higher radiation doses.

背景:在微创手术中术中识别实性下或小的肺结节具有挑战性。最新的定位技术显示出不同的成功率和并发症。配备了放射工具的混合手术室(HOR)为术中成像提供了便利。本研究比较了使用电磁导航支气管镜(ENB)结合锥形束计算机断层扫描(CBCT)与 CBCT 引导下经皮标记(PM)标记肺结节的准确性和安全性:这项回顾性队列研究纳入了计划在 HOR 进行微创切除术的肺结节患者。标记技术包括 CBCT 辅助的 ENB 和 CBCT 引导的 PM。研究比较了两种技术的成功率、手术时间、术中并发症和辐射剂量:共纳入 104 名患者,114 个结节(2021 年 10 月至 2024 年 7 月)。其中 30 个结节使用 ENB 标记,84 个使用 PM 标记。一个病例因 ENB 失败而同时使用了两种技术。各组结节特征无差异。成功率相似(ENB 组 93.3% 对 PM 组 91.7%,P = 1)。ENB 组的标记时间(中位 40 分钟)明显长于 PM 组(25 分钟,P = 0.007)。PM 组有五名(6%)患者出现术中并发症,而 ENB 组无并发症(p = 0.323)。ENB组的放射剂量明显更高(p = 0.002):由 CBCT 辅助的 ENB 是一种安全有效的技术,成功率与 CBCT 引导的 PM 相当,但可能导致手术时间延长和辐射剂量增加。
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引用次数: 0
Total hepatic inflow occlusion vs. hemihepatic inflow occlusion for laparoscopic liver resection: a systematic review and meta-analysis. 腹腔镜肝切除术中的全肝血流闭塞与半肝血流闭塞:系统回顾和荟萃分析。
IF 1.6 4区 医学 Q2 SURGERY Pub Date : 2024-09-26 eCollection Date: 2024-01-01 DOI: 10.3389/fsurg.2024.1428545
Ting An, Jie Liu, Liwei Feng

The control of bleeding during laparoscopic liver resection (LLR) is still a focus of research. However, the advantages of the main bleeding control methods, including total hepatic inflow occlusion (TIO) vs. hemihepatic inflow occlusion (HIO), during LLR remain controversial. The purpose of this meta-analysis was to compare the clinical outcomes of patients who received TIO and patients who received HIO. This meta-analysis searched the Medline, PubMed, Web of Science, Embase, Ovid, and Cochrane Library databases. The language of the studies was restricted to English, and comparative studies of patients treated with TIO and HIO during LLR were included. The primary outcome was to compare the intraoperative details, such as the operative time, occlusion time, and volume of blood loss, between the two groups. Secondary outcomes included conversion, overall complications, liver failure, biliary leakage, ascites, pleural effusion, and hospital stay. Five studies including 667 patients, 419 (62.82%) of whom received TIO and 248 (37.18%) of whom received HIO, were included in the analysis. The demographic data, including age, sex, hemoglobin, total bilirubin, albumin, and alpha-fetoprotein, were comparable. No significant differences noted in operative time, occlusion time, volume of blood loss, conversion, overall complications, liver failure, biliary leakage, hemorrhage, ascites, or pleural effusion. The hospital stay in patients who received HIO was significantly shorter than that for patients who received TIO [mean difference (MD), 0.60; 95% confidence interval (CI), 0.33-0.87; p < 0.0001; I 2 = 54%]. The blood loss of patients with liver cirrhosis in the TIO group was significantly less than that in the HIO group (MD, -107.63; 95% CI, -152.63 to -62.63; p < 0.01; I 2 = 27%). Both the TIO and HIO methods are safe and feasible for LLR. Compared with HIO, TIO seems to have less blood loss in cirrhotic patients. However, this result demands further research, especially multicenter randomized controlled trials, for verification in the future. Systematic Review Registration: https://www.crd.york.ac.uk/, Identifier PROSPERO (CRD42022382334).

腹腔镜肝脏切除术(LLR)期间的出血控制仍是研究重点。然而,腹腔镜肝切除术中主要出血控制方法(包括全肝血流闭塞(TIO)与半肝血流闭塞(HIO))的优势仍存在争议。本荟萃分析旨在比较接受 TIO 和接受 HIO 患者的临床结果。该荟萃分析检索了 Medline、PubMed、Web of Science、Embase、Ovid 和 Cochrane Library 等数据库。研究语言仅限于英语,并纳入了在 LLR 期间接受 TIO 和 HIO 治疗的患者的对比研究。主要结果是比较两组患者的术中细节,如手术时间、闭塞时间和失血量。次要结果包括转归、总体并发症、肝衰竭、胆漏、腹水、胸腔积液和住院时间。五项研究共纳入了 667 名患者,其中 419 人(62.82%)接受了 TIO,248 人(37.18%)接受了 HIO。包括年龄、性别、血红蛋白、总胆红素、白蛋白和甲胎蛋白在内的人口统计学数据具有可比性。在手术时间、闭塞时间、失血量、转归、总体并发症、肝衰竭、胆漏、出血、腹水或胸腔积液等方面均无明显差异。接受 HIO 的患者的住院时间明显短于接受 TIO 的患者[平均差异 (MD),0.60;95% 置信区间 (CI),0.33-0.87;P I 2 = 54%]。TIO组肝硬化患者的失血量明显少于HIO组(MD,-107.63;95% CI,-152.63至-62.63;P I 2 = 27%)。TIO 和 HIO 方法对于 LLR 都是安全可行的。与 HIO 相比,TIO 在肝硬化患者中的失血量似乎更少。不过,这一结果还需要进一步研究,尤其是多中心随机对照试验,以便在未来进行验证。系统综述注册:https://www.crd.york.ac.uk/,标识符为 PROSPERO (CRD42022382334)。
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引用次数: 0
Types of nasal deformities in individuals seeking rhinoplasty at governmental hospital in Saudi Arabia. 沙特阿拉伯政府医院鼻整形患者的鼻畸形类型。
IF 1.6 4区 医学 Q2 SURGERY Pub Date : 2024-09-24 eCollection Date: 2024-01-01 DOI: 10.3389/fsurg.2024.1426170
Abdullah D Alotaibi, Bashayr N Alsuwayt, Rana N Raghib, Rahaf S Alsayer, Sarah M Albarrak, Abdullah N Alrasheedi, Mohd Saleem, Sheeba Afreen, Oren Friedman

Introduction: This study explores the profound impact of nasal structure on individuals' self-image and emotional well-being, emphasizing the increasing popularity of rhinoplasty in Saudi Arabia, influenced by societal beauty standards portrayed on social media. The investigation aims to unravel the complex interplay between demographic factors, such as gender and age distribution, and prevalent nasal deformities in a cohort of 293 participants.

Material and methods: This retrospective study at the University of Hail and King Khalid Hospital, Saudi Arabia, investigated nasal deformities in 293 participants aged 15-54. Ethical approval was obtained, and data, including bio-demographics and nasal deformities, were retrospectively reviewed. Statistical analyses, utilizing chi-square and Fisher exact tests, assessed associations, enhancing internal validity. The study targeted a diverse population, emphasizing ethical guidelines and systematic sampling.

Results: Our study of 293 participants revealed a prevalence of common nasal deformities. Dorsal hump deformity (59.0%) was the most prevalent, followed by external nasal deviation (54.6%). Significant gender differences were observed, with males more prone to external nasal deviation (65.6%), while decreased nasal tip rotation was more common in females (40.6%). Variations in nasal tip shape were statistically significant, with broad nasal tip shape more prevalent in females (35.2%).

Conclusion: In conclusion, our study highlights the prevalence of common nasal deformities, emphasizing significant gender variations. These findings contribute to a deeper understanding of nasal anatomy, essential for informed decision-making in rhinoplasty.

简介本研究探讨了鼻部结构对个人自我形象和情感幸福的深远影响,强调了在沙特阿拉伯,受社交媒体上描绘的社会审美标准的影响,鼻整形手术日益流行。调查旨在揭示人口统计学因素(如性别和年龄分布)与 293 名参与者中普遍存在的鼻部畸形之间复杂的相互作用:这项在沙特阿拉伯海尔大学和哈立德国王医院进行的回顾性研究调查了 293 名 15-54 岁参与者的鼻部畸形情况。研究获得了伦理批准,并对包括生物特征和鼻部畸形在内的数据进行了回顾性审查。利用卡方检验和费雪精确检验进行统计分析,评估了相关性,提高了内部有效性。该研究针对不同人群,强调道德准则和系统取样:我们对 293 名参与者进行的研究显示,常见鼻畸形的发病率较高。鼻背驼峰畸形(59.0%)最为普遍,其次是外鼻偏斜(54.6%)。性别差异明显,男性更容易出现外鼻偏斜(65.6%),而鼻尖旋转减少在女性中更为常见(40.6%)。鼻尖形状的变化具有统计学意义,宽鼻尖形状在女性中更常见(35.2%):总之,我们的研究强调了常见鼻部畸形的普遍性,并强调了显著的性别差异。这些发现有助于加深对鼻部解剖学的理解,对鼻整形手术的知情决策至关重要。
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引用次数: 0
Autologous fat grafting for cosmetic temporal augmentation: a systematic review. 自体脂肪移植用于颞部美容整形:系统性综述。
IF 1.6 4区 医学 Q2 SURGERY Pub Date : 2024-09-20 eCollection Date: 2024-01-01 DOI: 10.3389/fsurg.2024.1410162
Sahra Nasim, Henna Nasim, Martin Kauke, Ali-Farid Safi

Background: Autologous fat grafting for temporal augmentation is increasingly popular in aesthetic surgery. However, its high absorption rate, unpredictable volume retention rate, and potential safety risks are significant drawbacks. Evaluation methods for the fat graft survival rate, especially volume retention in the temporal area, vary widely and tend to be more subjective than objective. Therefore, this systematic review aims to analyze the unpredictable volume retention rate, associated safety concerns, and the various assessment strategies following autologous fat grafting for cosmetic temporal augmentation.

Methods: We conducted a systematic review of manuscripts listed in the MEDLINE/PubMed database on autologous fat grafting for cosmetic temporal augmentation. Articles had to be available in full text and written in English. Studies not presenting human data or not discussing cosmetic indications were excluded. We adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

Results: Eight articles were included. The average fat volume injected into each temporal region was 10.69 ml (range 6-17.5) on the right and 10.64 ml (range 5.9-17.4) on the left side. All included articles utilized photographic documentation before and after treatment, along with various questionnaires and scales (37.5% Likert Scale, 12.5% Hollowness Severity Rating Scale, 12.5% Visual Analogue Scale, 12.5% Allergan Temple Hollowing Scale). For objective assessment, one article (12.5%) used computed tomography, and another (12.5%) employed a three-dimensional scanning system to objectively evaluate fat graft survival.

Conclusion: Autologous fat grafting effectively addresses temporal hollowness, with high patient satisfaction and a favorable safety profile. However, the variability in fat retention rates highlights the need for more controlled studies to establish reliable, validated methods for evaluating fat graft survival in the temporal area, and to further assess the safety of this procedure.

背景:自体脂肪移植丰颞术在美容手术中越来越受欢迎。然而,自体脂肪的高吸收率、难以预测的容积保持率和潜在的安全风险是其明显的缺点。脂肪移植存活率的评估方法,尤其是颞部的容积保持率,差异很大,而且往往主观多于客观。因此,本系统性综述旨在分析自体脂肪移植用于颞部美容增大术后不可预测的容积保持率、相关的安全问题以及各种评估策略:我们对 MEDLINE/PubMed 数据库中列出的有关自体脂肪移植用于颞部整形的手稿进行了系统性回顾。文章必须为英文全文。未提供人体数据或未讨论美容适应症的研究被排除在外。我们遵循了系统综述和元分析首选报告项目(PRISMA)指南:结果:共纳入八篇文章。每侧颞部的平均脂肪注射量为右侧 10.69 毫升(范围 6-17.5),左侧 10.64 毫升(范围 5.9-17.4)。所有收录的文章都使用了治疗前后的照片记录,以及各种问卷和量表(37.5% 利克特量表、12.5% 下垂严重程度分级量表、12.5% 视觉模拟量表、12.5% Allergan 太阳穴凹陷量表)。在客观评估方面,一篇文章(12.5%)使用了计算机断层扫描,另一篇文章(12.5%)使用了三维扫描系统来客观评估脂肪移植的存活率:结论:自体脂肪移植能有效解决颞部凹陷问题,患者满意度高,安全性好。结论:自体脂肪移植可有效解决颞部凹陷问题,患者满意度高,安全性好。然而,脂肪保留率的差异突出表明,需要进行更多的对照研究,以建立可靠、有效的方法来评估颞部脂肪移植的存活率,并进一步评估该手术的安全性。
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引用次数: 0
Knowledge and perception of medical students regarding remote-access thyroidectomy in Tabuk: the effects of extensive counseling—an interventional study 医科学生对塔布克远程甲状腺切除术的了解和看法:广泛咨询的效果--一项干预性研究
IF 1.8 4区 医学 Q2 SURGERY Pub Date : 2024-09-18 DOI: 10.3389/fsurg.2024.1428046
Hyder Mirghani, Amirah Alhowiti
IntroductionRemote-access scarless thyroidectomies are relatively new surgical procedures, and their uptake for cosmetic concerns is rapidly evolving. However, demographic factors, previous thyroid surgery, and culture substantially influence the patient's choice. This is the first study to assess the extensive counseling effect on the patient's preference for remote-access thyroidectomies compared to conventional transcervical approaches. We aimed to assess the same among medical students at the University of Tabuk, Saudi Arabia.MethodsThis interventional study was conducted from December 2023 to March 2024. A structured questionnaire was used to gather information about demographic factors, knowledge, and perception of the medical students regarding remote-access thyroidectomies before and after a slide presentation.ResultsOf 394 medical students (age 22.65 ± 1.62 years), 53.8% were women. Initially, the majority of the students preferred remote-access thyroidectomy over the conventional approach (85.3% vs. 14.7%, respectively); however, a substantial change toward the cervical approach was evident after extensive counseling [odds ratio, 2.59; 95% confidence interval (CI), 1.58–4.27; and P-value &lt;0.00]. Knowledge regarding remote-access thyroidectomy was poor (26.9%). The students were anxious regarding postoperative complications (3.22 ± 1.59/5), thyroid scar appearance (3.28 ± 1.36/5), and postoperative pain (3.17 ± 1.38/5). Concerns regarding body satisfaction and cost were lower.ConclusionMedical students at the University of Tabuk, Saudi Arabia, demonstrated low knowledge. The strong preference for remote-access thyroidectomy over transcervical thyroidectomy shifted substantially toward the conventional approach after counseling. The main factors were thyroid scar appearance, pain, and complications. Further larger-scale studies involving the general public and assessing the effect of extensive counseling on surgical choice are needed.
导言:远端入路无疤痕甲状腺切除术是一种相对较新的外科手术,其在美容方面的应用正在迅速发展。然而,人口统计学因素、既往甲状腺手术经历和文化背景对患者的选择有很大影响。与传统的经颈椎入路手术相比,本研究首次评估了广泛的咨询对患者选择远程入路甲状腺切除术的影响。我们的目的是在沙特阿拉伯塔布克大学的医科学生中进行同样的评估。方法这项干预性研究于 2023 年 12 月至 2024 年 3 月进行。在幻灯片演示前后,我们使用结构化问卷收集了医学生的人口统计学因素、知识和对远端入路甲状腺切除术的看法等信息。最初,与传统方法相比,大多数学生更倾向于远端入路甲状腺切除术(分别为 85.3% 对 14.7%);然而,经过广泛的咨询后,学生们明显倾向于颈部入路甲状腺切除术[几率比 2.59;95% 置信区间 (CI),1.58-4.27;P 值 &lt;0.00]。学生对远端入路甲状腺切除术的了解较少(26.9%)。学生对术后并发症(3.22 ± 1.59/5)、甲状腺疤痕外观(3.28 ± 1.36/5)和术后疼痛(3.17 ± 1.38/5)感到焦虑。结论沙特阿拉伯塔布克大学的医学生知识水平较低。经咨询后,他们对远程入路甲状腺切除术的强烈偏好大幅转向传统方法。主要因素是甲状腺疤痕外观、疼痛和并发症。我们需要进一步开展更大规模的研究,让公众参与进来,评估广泛咨询对手术选择的影响。
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引用次数: 0
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Frontiers in Surgery
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