Annales De Chirurgie Plastique Esthetique最新文献_第6页

La place de la chirurgie ganglionnaire dans le traitement du cancer du sein 淋巴结手术在乳腺癌治疗中的作用

IF 0.5 4区医学 Q4 SURGERY

Annales De Chirurgie Plastique Esthetique

Pub Date : 2025-11-01 DOI: 10.1016/j.anplas.2025.05.006

A. Fitoussi

Le cancer du sein représente environ 24 % des nouveaux cas de cancers chez les femmes dans le monde et constitue un défi majeur pour la médecine malgré les avancées en dépistage et traitement. La gestion des ganglions lymphatiques axillaires est cruciale pour le contrôle locorégional et la stadification tumorale. Historiquement, la mastectomie radicale a été introduite par William Halsted à la fin du XIX^e siècle, mais cette méthode entraînait une morbidité significative. Au fil du temps, des techniques moins invasives ont été développées, notamment la biopsie du ganglion sentinelle (BGS) dans les années 1990, qui permet d’évaluer l’état des ganglions axillaires en se basant sur le ganglion sentinelle. Si celui-ci est indemne, un curage axillaire complet peut souvent être évité, réduisant les complications. La BGS est maintenant reconnue comme le standard de soin pour les patientes atteintes d’un cancer du sein précoce sans atteinte ganglionnaire clinique, soutenue par des études comme ACOSOG Z0011 et AMAROS. Toutefois, des questions demeurent sur la meilleure approche chirurgicale pour les patientes avec des sous-types tumoraux spécifiques ou une atteinte ganglionnaire importante. Cet article propose une analyse des bases scientifiques de la chirurgie ganglionnaire, les avancées techniques, les résultats d’essais cliniques et les perspectives d’une médecine de plus en plus personnalisée.

Breast cancer accounts for approximately 24% of all new cancer cases in women worldwide and remains a major challenge for the medical community despite advances in screening and treatment. The management of axillary lymph nodes is crucial for local-regional control and tumor staging. Historically, radical mastectomy was introduced by William Halsted in the late 19th century; however, this method resulted in significant morbidity. Over time, less invasive techniques have been developed, notably sentinel lymph node biopsy (SLNB) in the 1990s, which assesses the status of axillary lymph nodes based on the sentinel node. If this node is disease-free, a complete axillary dissection can often be avoided, thereby reducing complications. SLNB is now recognized as the standard of care for patients with early-stage breast cancer without clinical nodal involvement, supported by studies such as ACOSOG Z0011 and AMAROS. However, questions remain regarding the best surgical approach for patients with specific tumor subtypes or extensive nodal involvement. This article offers an analysis of the scientific foundations of lymph node surgery, technical advancements, clinical trial outcomes, and the future prospects of increasingly personalized medicine.

乳腺癌约占全球女性新发癌症病例的24%，尽管在筛查和治疗方面取得了进展，但仍是一项重大的医学挑战。腋窝淋巴结的管理对局部区域控制和肿瘤分期至关重要。历史上,提出了激进的乳房切除术(William Halsted十九世纪后期,但这种方法导致发病率显著。随着时间的推移，侵入性较低的技术被开发出来，特别是在20世纪90年代的前哨淋巴结活检（BGS），它允许基于前哨淋巴结评估腋窝淋巴结的状况。如果没有受伤，通常可以避免完全的腋窝清扫，从而减少并发症。在ACOSOG Z0011和AMAROS等研究的支持下，BGS现在被公认为无临床淋巴结病变的早期乳腺癌患者的护理标准。然而，对于具有特定肿瘤亚型或严重神经节病变的患者，最佳的手术方法仍然存在问题。本文分析了神经节手术的科学基础、技术进步、临床试验结果和日益个性化的医疗前景。乳腺癌accounts for在24%至of women in all new巨蟹座的方格worldwide遗骨in a major challenge for the medical community despite以近筛查和治疗。腋窝淋巴结的管理对局部区域控制和肿瘤分期至关重要。从历史上看，根治性乳房切除术是由威廉·霍尔斯特德在19世纪晚期引入的；然而，这种方法导致了显著的发病率。Over time,人前have been微创技术发达,哨兵notably lymph节点(biopsy SLNB 1990年代),which the status of assesses axillary lymph基于节点的“哨兵”节点。If this is disease-free节点,a complete axillary解剖thereby can be“快乐的母亲,减少并发症。SLNB早在as the standard of care for now is with early-stage乳腺癌的患者没有临床节点参与》、《by studies such as ACOSOG Z0011 and AMAROS。然而，对于具有特定肿瘤亚型或广泛结节参与的患者，最佳手术方法仍存在问题。这篇文章分析了淋巴结手术的科学基础、技术进步、临床试验结果以及日益个性化的医学的未来前景。

{"title":"La place de la chirurgie ganglionnaire dans le traitement du cancer du sein","authors":"A. Fitoussi","doi":"10.1016/j.anplas.2025.05.006","DOIUrl":"10.1016/j.anplas.2025.05.006","url":null,"abstract":"<div><div>Le cancer du sein représente environ 24 % des nouveaux cas de cancers chez les femmes dans le monde et constitue un défi majeur pour la médecine malgré les avancées en dépistage et traitement. La gestion des ganglions lymphatiques axillaires est cruciale pour le contrôle locorégional et la stadification tumorale. Historiquement, la mastectomie radicale a été introduite par William Halsted à la fin du XIX<sup>e</sup> siècle, mais cette méthode entraînait une morbidité significative. Au fil du temps, des techniques moins invasives ont été développées, notamment la biopsie du ganglion sentinelle (BGS) dans les années 1990, qui permet d’évaluer l’état des ganglions axillaires en se basant sur le ganglion sentinelle. Si celui-ci est indemne, un curage axillaire complet peut souvent être évité, réduisant les complications. La BGS est maintenant reconnue comme le standard de soin pour les patientes atteintes d’un cancer du sein précoce sans atteinte ganglionnaire clinique, soutenue par des études comme ACOSOG Z0011 et AMAROS. Toutefois, des questions demeurent sur la meilleure approche chirurgicale pour les patientes avec des sous-types tumoraux spécifiques ou une atteinte ganglionnaire importante. Cet article propose une analyse des bases scientifiques de la chirurgie ganglionnaire, les avancées techniques, les résultats d’essais cliniques et les perspectives d’une médecine de plus en plus personnalisée.</div></div><div><div>Breast cancer accounts for approximately 24% of all new cancer cases in women worldwide and remains a major challenge for the medical community despite advances in screening and treatment. The management of axillary lymph nodes is crucial for local-regional control and tumor staging. Historically, radical mastectomy was introduced by William Halsted in the late 19th century; however, this method resulted in significant morbidity. Over time, less invasive techniques have been developed, notably sentinel lymph node biopsy (SLNB) in the 1990s, which assesses the status of axillary lymph nodes based on the sentinel node. If this node is disease-free, a complete axillary dissection can often be avoided, thereby reducing complications. SLNB is now recognized as the standard of care for patients with early-stage breast cancer without clinical nodal involvement, supported by studies such as ACOSOG Z0011 and AMAROS. However, questions remain regarding the best surgical approach for patients with specific tumor subtypes or extensive nodal involvement. This article offers an analysis of the scientific foundations of lymph node surgery, technical advancements, clinical trial outcomes, and the future prospects of increasingly personalized medicine.</div></div>","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":"70 6","pages":"Pages 551-555"},"PeriodicalIF":0.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145486208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Mélanome : traitements systémiques (partie 2) 黑色素瘤：全身治疗（第二部分）

IF 0.5 4区医学 Q4 SURGERY

Annales De Chirurgie Plastique Esthetique

Pub Date : 2025-11-01 DOI: 10.1016/j.anplas.2025.05.004

N. Kramkimel

Depuis les années 2010, la prise en charge du mélanome localement avancé et métastatique a complètement été modifiée avec l’utilisation d’inhibiteurs de check-point immunitaires et de thérapies ciblées anti-BRAF/anti-MEK. Ces traitements sont également récemment utilisés en néoadjuvant et en adjuvant dans certaines indications de mélanome à haut risque de récidive (stade IIB à stade IIID).

Since the 2010s, the management of locally advanced and metastatic melanoma has been completely transformed by the use of immune checkpoint inhibitors and anti-BRAF/anti-MEK targeted therapies. These therapies have also recently been used as neoadjuvant and adjuvant treatments in certain high-risk melanoma indications (stage IIB to stage IIID).

自2010年代以来，局部晚期和转移性黑色素瘤的管理已经完全改变，使用免疫检查点抑制剂和靶向治疗抗braf /抗mek。这些治疗方法最近也被用作新佐剂和佐剂，用于复发高风险黑色素瘤的某些适应症（IIB期至IIID期）。自2010年以来，通过使用免疫检查点抑制剂和抗braf /抗mek靶向疗法，局部晚期和转移性黑色素瘤的管理已经完全改变。这些治疗方法最近也被用于某些高风险黑色素瘤适应症（IIB期至IIID期）的新佐剂和辅助治疗。

引用次数: 0

Carcinomes annexiels

IF 0.5 4区医学 Q4 SURGERY

Annales De Chirurgie Plastique Esthetique

Pub Date : 2025-11-01 DOI: 10.1016/j.anplas.2025.05.021

K. Souaid

Les carcinomes annexiels sont des tumeurs malignes cutanées rares dérivant des annexes de la peau. La biopsie cutanée est indispensable pour poser le diagnostic et permet de classifier le carcinome en groupes et sous-groupes précis. Le pronostic et le bilan d’extension initial vont dépendre du sous-type histologique de la tumeur. Il n’existe pas de consensus sur le traitement des carcinomes annexiels. La chirurgie large est le traitement de référence pour les tumeurs localisées. La radiothérapie ainsi que certains traitements systémiques peuvent être proposés pour les lésions inopérables ou métastatiques.

Adnexal carcinomas are rare cutaneous malignancies arising from the skin's appendages. Skin biopsy is essential for making the diagnosis, and enables the carcinoma to be classified into precise groups and subgroups. Prognosis and initial extension will depend on the histological subtype of the tumor. There is no consensus on the treatment of adnexal carcinomas: large-scale surgery is the standard treatment for localized tumors. Radiotherapy and certain systemic treatments may be proposed for inoperable or metastatic lesions.

附属物癌是一种罕见的皮肤恶性肿瘤，起源于皮肤的附属物。皮肤活检对诊断至关重要，可以将癌症划分为特定的组和亚组。预后和初始扩张的平衡将取决于肿瘤的组织学亚型。对于附属癌的治疗没有共识。大手术是局部肿瘤的参考治疗。对于不能手术或转移的病变，可以提供放射治疗和某些全身治疗。附属物癌是一种罕见的皮肤恶性肿瘤，起源于皮肤的附属物。皮肤活检对诊断至关重要，并使癌症能够被划分为精确的组和亚组。预后和最初的延伸将取决于肿瘤的组织亚型。关于附加癌的治疗没有共识：大范围手术是局部肿瘤的标准治疗。对于不能手术或转移性病变，可提供放射治疗和某些全身治疗。

引用次数: 0

Fibroxanthome atypique Fibroxanthome典型数据

IF 0.5 4区医学 Q4 SURGERY

Annales De Chirurgie Plastique Esthetique

Pub Date : 2025-11-01 DOI: 10.1016/j.anplas.2025.05.007

S. Aractingi

Le fibroxanthome atypique est une tumeur cutanée rare et maligne, touchant principalement les hommes âgés photoexposés. Il représente moins de 0,2 % des cancers cutanés et se manifeste sous forme d’un nodule érythémateux ou chair, souvent sur la tête et le cou. Son diagnostic repose sur l’analyse anatomopathologique, nécessitant des immunomarquages pour exclure son principal diagnostic différentiel, le sarcome dermique pléiomorphe. Le bilan d’extension doit comporter une échographie des aires ganglionnaires de drainage. Le traitement repose sur la chirurgie, avec deux options : excision large avec marges de 2 cm, ou chirurgie micrographique de Mohs, qui réduit les récidives. Les récidives surviennent généralement dans les deux premières années, nécessitant un suivi régulier. La radiothérapie est déconseillée. Malgré son potentiel métastatique, un traitement chirurgical adapté assure habituellement un bon pronostic.

Atypical fibroxanthoma is a rare, malignant skin tumor, mainly affecting elderly, photoexposed men. It accounts for less than 0.2% of skin cancers, and manifests as an erythematous or fleshy nodule, often on the head and neck. Diagnosis is based on anatomopathological analysis, requiring immunostaining to exclude its main differential diagnosis, pleomorphic dermal sarcoma. Extension workup should include ultrasound of lymph node drainage areas. Treatment is based on surgery, with two options: wide excision with 2 cm margins, or Mohs micrographic surgery, which reduces recurrence. Recurrences generally occur within the first two years, requiring regular follow-up. Radiotherapy is not recommended. Despite its metastatic potential, appropriate surgical treatment usually ensures a good prognosis.

非典型纤维黄斑瘤是一种罕见的恶性皮肤癌，主要影响老年男性。它只占所有皮肤癌的不到0.2%，表现为红斑或肉瘤，通常出现在头部和颈部。它的诊断是基于解剖病理学分析，需要免疫标记，以排除其主要的鉴别诊断，多形性真皮肉瘤。扩展检查应包括对引流神经节区域的超声检查。治疗以手术为基础，有两种选择：边缘为2厘米的宽切除，或减少复发的莫氏显微手术。复发通常发生在头两年，需要定期监测。不建议使用放射治疗。尽管有转移的潜力，适当的手术治疗通常可以确保良好的预后。非典型纤维黄斑瘤是一种罕见的恶性皮肤癌，主要影响老年、光照暴露的男性。它只占皮肤癌的不到0.2%，并表现为红斑或松弛的结节，通常在头部和颈部。诊断基于解剖病理学分析，需要免疫抑制，以排除其主要的鉴别诊断，多形性皮炎。研究应包括对淋巴结引流区域的超声检查。治疗以手术为基础，有两种选择：边缘2厘米的宽切除，或莫氏显微手术，以减少复发。推荐通常发生在头两年，需要定期跟进。不推荐放射治疗。尽管它有转移的潜力，适当的手术治疗通常可以确保良好的预后。

{"title":"Fibroxanthome atypique","authors":"S. Aractingi","doi":"10.1016/j.anplas.2025.05.007","DOIUrl":"10.1016/j.anplas.2025.05.007","url":null,"abstract":"<div><div>Le fibroxanthome atypique est une tumeur cutanée rare et maligne, touchant principalement les hommes âgés photoexposés. Il représente moins de 0,2 % des cancers cutanés et se manifeste sous forme d’un nodule érythémateux ou chair, souvent sur la tête et le cou. Son diagnostic repose sur l’analyse anatomopathologique, nécessitant des immunomarquages pour exclure son principal diagnostic différentiel, le sarcome dermique pléiomorphe. Le bilan d’extension doit comporter une échographie des aires ganglionnaires de drainage. Le traitement repose sur la chirurgie, avec deux options : excision large avec marges de 2cm, ou chirurgie micrographique de Mohs, qui réduit les récidives. Les récidives surviennent généralement dans les deux premières années, nécessitant un suivi régulier. La radiothérapie est déconseillée. Malgré son potentiel métastatique, un traitement chirurgical adapté assure habituellement un bon pronostic.</div></div><div><div>Atypical fibroxanthoma is a rare, malignant skin tumor, mainly affecting elderly, photoexposed men. It accounts for less than 0.2% of skin cancers, and manifests as an erythematous or fleshy nodule, often on the head and neck. Diagnosis is based on anatomopathological analysis, requiring immunostaining to exclude its main differential diagnosis, pleomorphic dermal sarcoma. Extension workup should include ultrasound of lymph node drainage areas. Treatment is based on surgery, with two options: wide excision with 2cm margins, or Mohs micrographic surgery, which reduces recurrence. Recurrences generally occur within the first two years, requiring regular follow-up. Radiotherapy is not recommended. Despite its metastatic potential, appropriate surgical treatment usually ensures a good prognosis.</div></div>","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":"70 6","pages":"Pages 484-486"},"PeriodicalIF":0.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145486104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Chirurgie oncoplastique des cancers du sein 乳腺癌肿瘤整形手术

IF 0.5 4区医学 Q4 SURGERY

Annales De Chirurgie Plastique Esthetique

Pub Date : 2025-11-01 DOI: 10.1016/j.anplas.2025.06.018

J.-C. Millochau, C. Nos, B. Couturaud, I. Sarfati, K.B. Clough

La chirurgie oncoplastique du sein associe exérèse carcinologique et techniques de chirurgie plastique pour réduire les séquelles iatrogènes du traitement du cancer du sein et étendre les indications de la chirurgie conservatrice. En France, le traitement conservateur (tumorectomie et radiothérapie) est réalisé dans 70 % des cas, avec des taux de survie similaires à ceux obtenus par mastectomie. Près de 20 % de ces patientes développent des séquelles esthétiques. L’oncoplastie permet de réduire ces séquelles mais aussi d’étendre les possibilités de conservation mammaire à des tumeurs volumineuses. L’oncoplastie est classée en deux niveaux : (1) niveau I : résections < 20 % du volume mammaire avec transfert glandulaire, sans résection cutanée et (2) niveau II : résections > 20 %, nécessitant des techniques de plastie mammaire de réduction avec réduction de l’étui cutané. La technique de plastie mammaire varie selon la localisation tumorale (« atlas quadrant par quadrant »). Pour les résections des tumeurs externes et inférieures, on peut également réaliser des lambeaux perforants basés sur des perforantes intercostales (LICAP, AICAP), ou des branches terminales des vaisseaux axillaires (LTPA, TDAP).

Conclusion

L’oncoplastie a transformé la prise en charge du cancer du sein, en optimisant à la fois la sécurité oncologique et la qualité de vie des patientes.

Oncoplastic breast surgery combines carcinological excision and plastic surgery techniques to reduce the iatrogenic sequelae of breast cancer treatment and extend the indications for conservative surgery. In France, conservative treatment (lumpectomy and radiotherapy) is performed in 70% of cases, with survival rates similar to those obtained with mastectomy. Nearly 20% of these patients develop aesthetic after-effects. Oncoplasty not only reduces these after-effects but also extends the possibilities of breast conservation to larger tumors. Oncoplasty is classified into two levels: (1) level I: resections < 20% of breast volume with glandular transfer, without skin resection and (2) level II: resections > 20%, requiring breast reduction techniques with reduction of the skin sheath. Mammoplasty techniques vary according to tumour location (“atlas quadrant by quadrant”). For resections of external and inferior tumors, perforator flaps based on intercostal perforators (LICAP, AICAP), or terminal branches of axillary vessels (LTPA, TDAP) can also be used.

Conclusion

Oncoplasty has transformed breast cancer management, optimizing both oncological safety and patient quality of life.

肿瘤整形手术结合了癌症运动和整形手术技术，以减少乳腺癌治疗的缺氧后遗症，并扩大保守手术的适应症。在法国，70%的病例进行了保守治疗（肿瘤切除和放疗），生存率与乳房切除术相似。近20%的患者会出现美容后遗症。肿瘤成形术不仅可以减少这些后遗症，还可以将乳房保存的可能性扩大到大肿瘤。肿瘤成形术分为两个级别：(1)I级：切除20%的乳房体积，通过腺体转移，但不进行皮肤切除；(2)II级：切除20%，需要缩小乳房成形术技术，减少皮肤覆盖。乳房成形术的技术因肿瘤的位置而异（“一个象限一个象限图集”）。对于外侧和下部肿瘤的切除，也可以使用岸间穿刺（LICAP， AICAP）或腋窝血管末端分支（LTPA， TDAP）进行穿刺。结论：肿瘤成形术改变了乳腺癌的管理，优化了肿瘤的安全性和患者的生活质量。肿瘤成形术结合了肿瘤切除和整形手术技术，减少了乳腺癌治疗的医源性皮疹，并扩展了保守手术的指导率。在英国，70%的病例进行了保守治疗（腰椎切除术和放疗），生存率与乳房切除术相似。近20%的患者出现了美容后遗症。肿瘤成形术不仅减少了这些后遗症，而且还扩大了乳房保存到更大肿瘤的可能性。肿瘤成形术分为两个级别：(1)I级：切除20%的乳房体积，进行腺转移，不进行皮肤切除；(2)II级：切除20%，需要使用减少皮肤皮的缩胸技术。乳房成形术技术因肿瘤位置而异（“象限图集”）。对于外侧和下部肿瘤的切除，也可以使用基于肋间穿孔（LICAP， AICAP）或腋窝末端支的穿孔片（LTPA， TDAP）。肿瘤成形术已经改变了乳腺癌的管理，优化了肿瘤安全和患者的生活质量。

{"title":"Chirurgie oncoplastique des cancers du sein","authors":"J.-C. Millochau, C. Nos, B. Couturaud, I. Sarfati, K.B. Clough","doi":"10.1016/j.anplas.2025.06.018","DOIUrl":"10.1016/j.anplas.2025.06.018","url":null,"abstract":"<div><div>La chirurgie oncoplastique du sein associe exérèse carcinologique et techniques de chirurgie plastique pour réduire les séquelles iatrogènes du traitement du cancer du sein et étendre les indications de la chirurgie conservatrice. En France, le traitement conservateur (tumorectomie et radiothérapie) est réalisé dans 70 % des cas, avec des taux de survie similaires à ceux obtenus par mastectomie. Près de 20 % de ces patientes développent des séquelles esthétiques. L’oncoplastie permet de réduire ces séquelles mais aussi d’étendre les possibilités de conservation mammaire à des tumeurs volumineuses. L’oncoplastie est classée en deux niveaux : (1) niveau I : résections<20 % du volume mammaire avec transfert glandulaire, sans résection cutanée et (2) niveau II : résections>20 %, nécessitant des techniques de plastie mammaire de réduction avec réduction de l’étui cutané. La technique de plastie mammaire varie selon la localisation tumorale (« atlas quadrant par quadrant »). Pour les résections des tumeurs externes et inférieures, on peut également réaliser des lambeaux perforants basés sur des perforantes intercostales (LICAP, AICAP), ou des branches terminales des vaisseaux axillaires (LTPA, TDAP).</div></div><div><h3>Conclusion</h3><div>L’oncoplastie a transformé la prise en charge du cancer du sein, en optimisant à la fois la sécurité oncologique et la qualité de vie des patientes.</div></div><div><div>Oncoplastic breast surgery combines carcinological excision and plastic surgery techniques to reduce the iatrogenic sequelae of breast cancer treatment and extend the indications for conservative surgery. In France, conservative treatment (lumpectomy and radiotherapy) is performed in 70% of cases, with survival rates similar to those obtained with mastectomy. Nearly 20% of these patients develop aesthetic after-effects. Oncoplasty not only reduces these after-effects but also extends the possibilities of breast conservation to larger tumors. Oncoplasty is classified into two levels: (1) level I: resections<20% of breast volume with glandular transfer, without skin resection and (2) level II: resections>20%, requiring breast reduction techniques with reduction of the skin sheath. Mammoplasty techniques vary according to tumour location (“atlas quadrant by quadrant”). For resections of external and inferior tumors, perforator flaps based on intercostal perforators (LICAP, AICAP), or terminal branches of axillary vessels (LTPA, TDAP) can also be used.</div></div><div><h3>Conclusion</h3><div>Oncoplasty has transformed breast cancer management, optimizing both oncological safety and patient quality of life.</div></div>","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":"70 6","pages":"Pages 528-538"},"PeriodicalIF":0.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145486206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Intermediate butterfly osteotomy with rigid external distraction in Crouzon syndromes]. [中间蝶形截骨术+刚性外牵张治疗Crouzon综合征]。

IF 0.5 4区医学 Q4 SURGERY

Annales De Chirurgie Plastique Esthetique

Pub Date : 2025-10-22 DOI: 10.1016/j.anplas.2025.09.005

J Saboye

In Crouzon syndromes, there is an hypoplasia of the midface. An intermediate midfacial osteotomy between Lefort 2 and Lefort 3, called "butterfly osteotomy", associated wit a rigid external distraction on a Pooley helmet allows to pull the entire middle maxillary, orbital and zygomatic level in one step, and to project the tip of the nose, by a single endobuccal approach. The osteotomy concerns the entire middle level of the face while respecting the upper part of the nose. The external distractor with cranial support makes it possible to reposition the face, corrects the open bite and project the tip of the nose. This technique brings a ventilatory improvement in sleep apnea syndromes and an aesthetic improvement, beneficial on a psychological level.

在Crouzon综合征中，面部中部发育不全。在Lefort 2和Lefort 3之间的中间面中截骨术，称为“蝴蝶截骨术”，与Pooley头盔上的刚性外部牵张相结合，可以一步拉出整个上颌中部，眶和颧骨水平，并通过单次颊内入路突出鼻尖。截骨术涉及整个脸的中间部分，而尊重鼻子的上部。颅骨支撑的外部牵张器使面部重新定位、矫正开口咬合和突出鼻尖成为可能。这项技术改善了睡眠呼吸暂停综合症的通气，改善了审美，在心理层面上是有益的。

引用次数: 0

[Management of venous malformations: A prospective study of 33 cases]. 静脉畸形的治疗：33例的前瞻性研究。

IF 0.5 4区医学 Q4 SURGERY

Annales De Chirurgie Plastique Esthetique

Pub Date : 2025-10-16 DOI: 10.1016/j.anplas.2025.09.008

G Belmaati Cherkaoui, D Ar Reyouchi, I Kamaoui, A Benzirar, O El Mahi, A A Oufkir

Objective: Determine the epidemiology and frequency of complications, and compare the efficacy of different therapeutic approaches.

Methods: This prospective study included patients with venous malformation (VM) treated at the Vascular Anomalies Center between 2019 and 2023.

Results: Thirty-three patients were included in this study. The median age of the patients was 20 years, 17 patients were born with VM. 63% had symptomatic VM. The most common location was the face (42%). Aesthetic impact was significant in patients under 12 years old (P=0.01) and in the cephalic extremity (P=0.000). Treatment was initiated only in cases of symptomatic VM or with aesthetic impact. Compression garments were used in 6 patients, sclerotherapy in 14 patients, including 2 after surgery, and surgery in 16 patients, including 5 after non-successful sclerotherapy. Two patients received curative Low molecular weight heparin (LMWH) injection. Sirolimus was prescribed to 4 patients. These treatments resulted in complete regression in 10 patients and partial improvement in 12, with failure or recurrence in 7.

Conclusion: Most patients present with symptomatic VM with a functional or aesthetic impact. This study underlines the difficulty of managing VM, which must be adapted on a case-by-case basis, and confirms that medical and contention treatments can only bring about an often-transient improvement in symptoms. Only complete surgical excision can provide definitive cure.

目的：了解并发症的流行病学及发生频率，比较不同治疗方法的疗效。方法：这项前瞻性研究纳入了2019年至2023年在血管异常中心治疗的静脉畸形（VM）患者。结果：33例患者纳入本研究。患者中位年龄为20岁，17例为先天性VM。63%有症状性VM。最常见的部位是面部（42%）。12岁以下患者和头端患者的审美影响显著（P=0.01）。只有在有症状的VM或有美观影响的情况下才开始治疗。6例患者使用压缩服，14例患者使用硬化治疗，其中2例术后使用，16例患者使用手术治疗，其中5例硬化治疗不成功。2例患者接受治疗性低分子肝素（LMWH）注射。4例患者使用西罗莫司治疗。这些治疗导致10例患者完全消退，12例患者部分改善，7例患者失败或复发。结论：大多数患者表现为症状性VM，并伴有功能或美观影响。这项研究强调了管理VM的困难，必须根据具体情况进行调整，并证实医学和争论治疗只能带来通常是短暂的症状改善。只有完全的手术切除才能彻底治愈。

{"title":"[Management of venous malformations: A prospective study of 33 cases].","authors":"G Belmaati Cherkaoui, D Ar Reyouchi, I Kamaoui, A Benzirar, O El Mahi, A A Oufkir","doi":"10.1016/j.anplas.2025.09.008","DOIUrl":"https://doi.org/10.1016/j.anplas.2025.09.008","url":null,"abstract":"<p><strong>Objective: </strong>Determine the epidemiology and frequency of complications, and compare the efficacy of different therapeutic approaches.</p><p><strong>Methods: </strong>This prospective study included patients with venous malformation (VM) treated at the Vascular Anomalies Center between 2019 and 2023.</p><p><strong>Results: </strong>Thirty-three patients were included in this study. The median age of the patients was 20 years, 17 patients were born with VM. 63% had symptomatic VM. The most common location was the face (42%). Aesthetic impact was significant in patients under 12 years old (P=0.01) and in the cephalic extremity (P=0.000). Treatment was initiated only in cases of symptomatic VM or with aesthetic impact. Compression garments were used in 6 patients, sclerotherapy in 14 patients, including 2 after surgery, and surgery in 16 patients, including 5 after non-successful sclerotherapy. Two patients received curative Low molecular weight heparin (LMWH) injection. Sirolimus was prescribed to 4 patients. These treatments resulted in complete regression in 10 patients and partial improvement in 12, with failure or recurrence in 7.</p><p><strong>Conclusion: </strong>Most patients present with symptomatic VM with a functional or aesthetic impact. This study underlines the difficulty of managing VM, which must be adapted on a case-by-case basis, and confirms that medical and contention treatments can only bring about an often-transient improvement in symptoms. Only complete surgical excision can provide definitive cure.</p>","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145314150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comparison of WALANT (Wide Awake Local Anesthesia Without Tourniquet) technique and infraclavicular brachial plexus block in cubital tunnel decompression surgery. 宽醒局麻无止血带技术与锁骨下臂丛阻滞在肘管减压手术中的比较。

IF 0.5 4区医学 Q4 SURGERY

Annales De Chirurgie Plastique Esthetique

Pub Date : 2025-10-03 DOI: 10.1016/j.anplas.2025.08.001

A Acar, A B Acar, N Yılmaz, Ö Torun, A B Girgin, H B Çevik

Purpose: This study aimed to compare the efficacy of the WALANT (WA) technique with the infraclavicular brachial plexus block (IBPB) in patients undergoing anterior transposition and decompression of the ulnar nerve.

Methods: A total of 46 patients were included in this bicentric retrospective study. Twenty-two were in WA, 24 were in IBPB group. WA was done by a hand surgeon and IBPB was done by an anesthesiologist under ultrasonography guidance. The two groups were compared regarding demographic data, clinical results, and radiological outcomes.

Results: Preoperative preparation time and hospital stay were shorter in the WA group. VAS values at the 1st, 6th and 72nd hours after surgery were lower in the WA group. Intraoperative VAS-A values were higher in the WALANT group. Postoperative VAS-A values at the 6th hour were lower in the WA group. Return to work time was shorter in the WA group.

Conclusion: The WA technique in CuTS surgery is a method that can be easily applied, is safe and is not inferior to IBPB in terms of clinical results. WA shortens preoperative patient preparation time, pain, host stay, operating room usage and return to work time after CuTS surgery.

目的：本研究旨在比较WALANT （WA）技术与锁骨下臂丛神经阻滞（IBPB）技术在尺神经前移位减压患者中的疗效。方法：共纳入46例患者进行双中心回顾性研究。WA组22例，IBPB组24例。WA由手外科医生完成，IBPB由麻醉师在超声指导下完成。比较两组的人口学数据、临床结果和放射学结果。结果：WA组术前准备时间短，住院时间短。WA组术后1、6、72小时VAS值较低。WALANT组术中VAS-A值较高。WA组术后第6小时VAS-A值较低。WA组的复工时间较短。结论：WA技术在切口手术中应用方便、安全，临床效果不逊于IBPB。WA缩短了术前患者准备时间、疼痛、住院时间、手术室使用时间和cut手术后重返工作岗位的时间。

{"title":"Comparison of WALANT (Wide Awake Local Anesthesia Without Tourniquet) technique and infraclavicular brachial plexus block in cubital tunnel decompression surgery.","authors":"A Acar, A B Acar, N Yılmaz, Ö Torun, A B Girgin, H B Çevik","doi":"10.1016/j.anplas.2025.08.001","DOIUrl":"https://doi.org/10.1016/j.anplas.2025.08.001","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to compare the efficacy of the WALANT (WA) technique with the infraclavicular brachial plexus block (IBPB) in patients undergoing anterior transposition and decompression of the ulnar nerve.</p><p><strong>Methods: </strong>A total of 46 patients were included in this bicentric retrospective study. Twenty-two were in WA, 24 were in IBPB group. WA was done by a hand surgeon and IBPB was done by an anesthesiologist under ultrasonography guidance. The two groups were compared regarding demographic data, clinical results, and radiological outcomes.</p><p><strong>Results: </strong>Preoperative preparation time and hospital stay were shorter in the WA group. VAS values at the 1st, 6th and 72nd hours after surgery were lower in the WA group. Intraoperative VAS-A values were higher in the WALANT group. Postoperative VAS-A values at the 6th hour were lower in the WA group. Return to work time was shorter in the WA group.</p><p><strong>Conclusion: </strong>The WA technique in CuTS surgery is a method that can be easily applied, is safe and is not inferior to IBPB in terms of clinical results. WA shortens preoperative patient preparation time, pain, host stay, operating room usage and return to work time after CuTS surgery.</p>","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Jacques Joseph (1865-1934): The turning point. Part II: From rhinopoïesis to rhinoplasty]. 雅克·约瑟夫（1865-1934）：转折点。第二部分：从rhinopoïesis到鼻整形]。

IF 0.5 4区医学 Q4 SURGERY

Annales De Chirurgie Plastique Esthetique

Pub Date : 2025-10-01 DOI: 10.1016/j.anplas.2025.08.003

Y Jallut

A new dimension in rhinoplasty emerged at the end of the 19th century, cosmetic surgery. Some authors recognized the importance of responding to the growing demand for cosmetic surgery, particularly for the nose. Although not the first, Joseph brought a new approach to rhinoplasty by laying the foundations for a technique that would later be known as the "structural technique", involving the resection and reduction of a pre-existing structure, beginning with the dorsal hump. Throughout his career, Joseph fought hard to impose his ideas and gain recognition from his peers despite not having a university education. His surgical skill and innovative spirit earned him the admiration of all who visited him, despite his sometimes challenging personality. His dexterity with a scalpel was matched only by his skill with a pen. In a difficult political and social context, he was a prolific author who wrote well-organised texts, thus facilitating the transmission of his knowledge and immense experience. For this reason, he fully deserves the title of "Father of Modern Rhinoplasty".

鼻整形术的一个新领域出现在19世纪末，那就是整容手术。一些作者认识到应对日益增长的整容手术需求的重要性，尤其是鼻子整形手术。虽然不是第一个，但约瑟夫带来了一种新的隆鼻方法，为后来被称为“结构技术”的技术奠定了基础，包括从背峰开始切除和缩小原有结构。在他的整个职业生涯中，尽管没有受过大学教育，但约瑟夫努力将自己的想法强加于人，并获得同龄人的认可。他的手术技巧和创新精神为他赢得了所有来访者的钦佩，尽管他有时具有挑战性的个性。他使用手术刀的熟练程度只有用笔的熟练程度能与之媲美。在困难的政治和社会背景下，他是一位多产的作家，他写了组织良好的文本，从而促进了他的知识和丰富经验的传播。因此，他完全配得上“现代隆鼻术之父”的称号。

引用次数: 0

Transwomen satisfaction after nonsurgical management of large lower face with botulinum toxin injection of the masseter: A preliminary FACE-Q study. 跨性别女性使用咬肌注射肉毒杆菌毒素非手术治疗下面部后的满意度：一项初步的face - q研究。

IF 0.5 4区医学 Q4 SURGERY

Annales De Chirurgie Plastique Esthetique

Pub Date : 2025-09-29 DOI: 10.1016/j.anplas.2025.09.003

M Slimani, E Ramelli, L Azoulai, M Atlan, A G Lellouch, S Cristofari

Facial feminization can be considered as an essential element of gender-affirming care and overall well-being of transgender women. This study explores a nonsurgical approach to facial gender-affirming procedures (FGAP) by assessing the efficacy of botulinum toxin (BT) injection for lower face transversal reduction. This cosmetic procedure was evaluated by administering the FACE-Q survey to participants, both pre- and post-procedure and at the three-month follow-up visit. A significant improvement in satisfaction was observed concerning the lower face appearance after BT injection in the masseter (P<0.001). These findings raise awareness towards alternative nonsurgical options in achieving lower facial feminization.

面部女性化可以被认为是性别确认护理和跨性别女性整体福祉的基本要素。本研究通过评估肉毒杆菌毒素（BT）注射下面部横向复位的疗效，探讨了一种非手术方法进行面部性别确认手术（FGAP）。通过对参与者在手术前后和三个月的随访中进行FACE-Q调查来评估这一美容手术。在咬肌注射BT后，下面部外观满意度显著提高(P

引用次数: 0