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INTRODUCTION: Reflux disease has become endemic in the Western world. High quality hiatal reconstruction and fundoplication has a paramount importance in its therapy. While the primary goal of surgery is reducing reflux-associated disease burden, the evaluation and follow-up of disease-associated quality of life is essential. OBJECTIVE: In this study, we aimed to measure and evaluate the pre- and post-operative reflux-associated quality of life of patients undergoing surgery between 01. 12. 2015 and 31. 12. 2020 at a tertiary care hospital. METHOD: We utilized a health-related quality of life questionnaire both pre- and post-operatively. The main outcome measures were: patient-assessed heartburn, dysphagia, regurgitation, chest pain, nausea and vomiting. We also measured acid secretory medication use and patient satisfaction. RESULTS: We have assessed the pre- and post-operative questionnaries of 65 patients. All the symptoms above have decreased after surgery, and the changes were statistically significant (except for dysphagia). There was a tendency for minor weight loss after surgery. The use of acid secretion inhibitor medications decreased significantly. DISCUSSION: Our results are comparable to the outcomes of other tertiary care centers. Our workgroup has successfully adopted the diagnostic and therapeutic algorithms of the surgical care of reflux disease. CONCLUSION: If the proper indications for surgery are met, laparoscopic hiatoplasty and Toupet fundoplication are capable tools in decreasing reflux-associated symptoms and improving reflux-associated quality of life. Orv Hetil. 2023; 164(2): 57-63.
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Trastornos de Deglución , Reflujo Gastroesofágico , Laparoscopía , Humanos , Trastornos de Deglución/etiología , Calidad de Vida , Resultado del Tratamiento , Reflujo Gastroesofágico/complicaciones , Reflujo Gastroesofágico/cirugía , Fundoplicación/métodos , Laparoscopía/métodosRESUMEN
During the examination of patients, the probability of the occurrence of a secondary tumour is 15.2%, while that of a tertiary tumour is 1.3% [1]. The aim of this article is to draw attention to the fact that the surgical treatment of synchronous tumours in one session, if proper professional background is ensured, provides definite benefits for the patients. No protocols for the treatment of multiple tumours can be found in the relevant literature; mostly descriptions of cases are available to give orientation. The preoperative stage of the diseases, the examination protocol, the surgical procedure and the biopsy results are detailed in the study. In the article, the treatment of a triplex tumour - vulva, rectum and sigma tumour -, a large colon tumour and an endometrial adenocarcinoma with open surgery is described as well as the minimally invasive surgery of a rectal and synchronous endometrial adenocarcinoma with a patient who has gone through neoadjuvant therapy are presented. The three cases presented here prove that the surgical treatment in one session was clearly beneficial for the patients, let alone cost-efficiency. The article is not about the discussion of post-surgical or adjuvant treatments; decisions about these are to be made by the multidisciplinary professional committees of the hospitals, based on the particular situations. Orv Hetil. 2023; 164(2): 70-75.
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Adenocarcinoma , Neoplasias Primarias Múltiples , Neoplasias del Recto , Femenino , Humanos , Neoplasias del Recto/cirugía , Estadificación de Neoplasias , Recto/cirugía , Terapia Neoadyuvante/métodos , Neoplasias Primarias Múltiples/patología , Adenocarcinoma/cirugía , Adenocarcinoma/patologíaRESUMEN
Malignant tumors were the leading cause of death in Hungary between 1990 and 2018 according to the central statistical office (www.ksh.hu). While the mortality of cerebrovascular diseases is decreasing, cancer-related mortality is getting worse, despite the improvement of both diagnostic and therapeutic opportunities. The exact number of synchronous double and triple cancers in Hungary is unknown, and their therapeutic pathways are unclear. Currently there is no data available regarding these questions in the National Cancer Registry. In this case report we present the diagnostic and therapeutic algorithm of a patient with a triple malignancy.
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Neoplasias de la Vulva , Femenino , Humanos , Hungría , Sistema de Registros , Neoplasias de la Vulva/cirugíaRESUMEN
Összefoglaló. Bevezetés: A hiatus hernia egy anatómiai betegség; gyakoribb elofordulása idosebbeknél jelezheti, hogy a betegség idovel elorehalad, súlyosbodik. Elhanyagolt esetben szövodmények alakulhatnak ki, melyek növelhetik a perioperatív mortalitást. Célkituzés: A laparoszkópos hiatusrekonstrukciók sebészetében szerzett mutéti tapasztalataink ismertetése mellett igyekeztünk statisztikailag alátámasztható korrelációt találni a rekeszizom-defektus anatómiai paraméterei, valamint a betegek életkora között. Módszer: Retrospektív tanulmányunk keretében elemeztük azon betegeinket, akik laparoszkópos hiatus hernia mutéten estek át egy 58 hónapos (2016. január-2020. október) vizsgálati periódus során. A rekeszi defektus méreteit endoszkópos vonalzóval a mutét közben megmértük, a hiatus oesophagei felszínét standard matematikai formula segítségével számoltuk ki. A sürgosséggel mutétre kerülo betegeink adatait külön elemeztük. Statisztikai analízis: A defektus mérete és a betegek életkora és magassága közötti korrelációt a Spearman-féle ró (ρ)-korreláció segítségével állapítottuk meg. A szignifikanciaszint p≤0,05 volt. Eredmények: Az elektív csoportban 142 operált páciensbol 47 beteg mérési adatai feleltek meg a kritériumoknak. Az átlagéletkor 64,7 ± 12,7 év volt, 33 páciens volt no (70,2%), az átlagos testtömegindex 28,8 ± 5,5 kg/m2 volt. A defektus haránt átméroje és felszíne szignifikáns pozitív korrelációt mutatott a betegek életkorával (p≤0,05). Akut indikációval 5 beteg került mutétre; a defektus méretét illetoen hasonló eredményeket tapasztaltunk, mint az elektív csoportnál, 2 esetben azonban súlyos szövodmények alakultak ki. Következtetés: A betegség mögött húzódó anatómiai okok jobb megértése és a megfigyeléseink alapján módosított sebésztechnika reményeink szerint csökkentheti a hosszú távú kiújulások számát a jövoben. Az idoben elvégzett elektív beavatkozás alacsonyabb mortalitással, kevesebb szövodménnyel és rövidebb hospitalizációval jár együtt. Orv Hetil. 2021; 162(19): 754-759. INTRODUCTION: Hiatal hernia is an anatomical disease, and the higher incidence for elderly patients suggests that it is progressing over time. Neglected cases can cause serious complications, raising perioperative mortality. OBJECTIVE: We are presenting our experience in laparoscopic hiatal reconstructions. Our main goal is to find a statistical correlation between the anatomical parameters of the hiatal defect and the patients age. METHOD: Surgical data were reviewed retrospectively for patients who underwent laparoscopic hiatal hernia repair between January 2016 and October 2020. Dimensions of the hiatal defect were measured intraoperatively with an endoscopic ruler. The defect size was calculated using a standard formula. The acute surgeries were analyzed as a separate arm of the study. STATISTICAL ANALYSIS: The correlation between the patients age and the size of the defect were calculated using Spearman's rho (ρ) correlation. The level of significance was p≤0.05. RESULT: In the elective group, out of 142 patients 47 met the inclusion criteria. The mean age was 64.7 ± 12.7 years, 33 patients were women, and the mean BMI was 28.8 ± 5.5 kg/m2. Patient age showed significant positive correlation with the transverse dimension and the size of the hiatal defect. 5 patients underwent surgery due to acute indications. We found similarities in the size of the defects; at 2 patients we documented severe complications. CONCLUSIONS: A better understanding of the underlying anatomical disorders and the consecutively modified surgical technique will hopefully reduce the long-term recurrencies in the future. The elective surgery performed in the right time results in lower mortality, less complications and shorter hospitalization time. Orv Hetil. 2021; 162(19): 754-759.
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Hernia Hiatal , Laparoscopía , Anciano , Femenino , Hernia Hiatal/cirugía , Humanos , Masculino , Persona de Mediana Edad , Estudios RetrospectivosRESUMEN
BACKGROUND: Macro, and microcirculatory effects of crystalloids and colloids are difficult to compare, because interventions to achieve haemodynamic stability seldom follow similar criteria. OBJECTIVES: Our aim was to compare the effects of crystalloids and colloids on the microcirculation during free flap surgery when management was guided by detailed haemodynamic assessment. DESIGN: A randomised, controlled clinical trial. SETTINGS: The investigation was performed at the University of Szeged, Hungary. PATIENTS: Patients undergoing maxillofacial tumour resection and free flap reconstruction were randomised into groups treated with either intra-operative crystalloid (Ringerfundin, nâ=â15) or colloid (6% hydroxyethyl starch, HES, nâ=â15) solutions. INTERVENTIONS: Macrohaemodynamics were monitored by a noncalibrated device (PulsioFlex-PULSION). Central venous oxygen saturation, venous-to-arterial PCO2-gap, lactate levels and urine output were measured hourly. Maintenance fluid was Ringerfundin (1âmlâkgâh), and a multimodal, individualised, approach-based algorithm was applied to guide haemodynamic support. Hypovolaemia was treated with Ringerfundin or HES fluid boluses, respectively. The microcirculatory effects were assessed by laser-Doppler flowmetry (PeriFlux 5000 LDPM), with the probe placed on the flap and on a control area. Measurements were performed after the flap was prepared, then 1 and 12âh later. MAIN OUTCOME MEASURES: The primary end-point was microcirculatory perfusion as determined by laser-Doppler flowmetry. RESULTS: There was no difference between the groups regarding patient characteristics. Both groups remained haemodynamically stable throughout due to the use of approximately a 1.5 times higher total fluid volume in the Ringerfundin group than in the HES group: meanâ±âSD: 2581â±â986 and 1803â±â497) ml, respectively, (Pâ=â0.011). There was no significant difference in the microcirculatory blood flow between the groups. CONCLUSION: Our results showed that when fluid management was guided by detailed haemodynamic assessment, more crystalloid than colloid was needed to maintain haemodynamic stability, but there was no difference between the effects of crystalloids and colloids on the microcirculation. TRIAL REGISTRATION: ClinicalTrials.gov NCT03288051.
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Fluidoterapia/métodos , Cuidados Intraoperatorios/métodos , Complicaciones Intraoperatorias/prevención & control , Microcirculación/efectos de los fármacos , Procedimientos de Cirugía Plástica/efectos adversos , Anciano , Coloides/administración & dosificación , Soluciones Cristaloides/administración & dosificación , Neoplasias Faciales/cirugía , Femenino , Colgajos Tisulares Libres/trasplante , Monitorización Hemodinámica/métodos , Hemodinámica/efectos de los fármacos , Humanos , Complicaciones Intraoperatorias/diagnóstico , Complicaciones Intraoperatorias/etiología , Flujometría por Láser-Doppler , Masculino , Neoplasias Maxilares/cirugía , Microcirculación/fisiología , Persona de Mediana Edad , Monitoreo Intraoperatorio , Procedimientos de Cirugía Plástica/métodosRESUMEN
INTRODUCTION: The incidence of acute mesenteric ischemia (AMI) appears to be increasing due to aging in the population with increasing prevalence of comorbidities. Despite the wide-scale availability of diagnostic technologies, the timely detection and correct treatment are not ensured. This is due to the fact that the required CT angiography is not immediately performed and that vascular surgical reconstruction can be performed within the short ischemic tolerance window of the bowels amounting 4-6 hours. METHOD: In our case report, we retrospectively analysed the time of the operation after the onset of the complaint, the types of occlusions, the surgical interventions that could be performed and the progress of the disease. RESULTS: Case 1: In the case of superior mesenteric artery (SMA) emboli, without bowel necrosis and ischemia, embolectomy is the treatment. Case 2: In the case of complete superior mesenteric artery occlusion, proper bowel circulation will not restore despite the delayed arterial reconstruction, as a result, the patient will not survive. Case 3: In the case of incomplete SMA occlusion, even if the diagnosis is confirmed several days after the onset of complaints and the patient has an acute abdomen, extensive bowel necrosis will not evolve in every case. Case 4: Acute complete occlusion on chronic mesenteric ischemia. The bowels were found macroscopically healthy during the operation. We performed vascular reconstruction. CONCLUSION: Acute mesenteric ischemia is a rare disease, which is recognised and treated mostly late. A proportion of patients can be saved, if vascular reconstruction and bowel resection can be performed at the same time at the first operation.
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Procedimientos Endovasculares/métodos , Isquemia Mesentérica/cirugía , Oclusión Vascular Mesentérica/cirugía , Enfermedad Aguda , Anciano de 80 o más Años , Procedimientos Endovasculares/efectos adversos , Femenino , Humanos , Masculino , Arteria Mesentérica Superior/cirugía , Isquemia Mesentérica/diagnóstico , Isquemia Mesentérica/etiología , Oclusión Vascular Mesentérica/complicaciones , Oclusión Vascular Mesentérica/diagnóstico , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Tiempo de Tratamiento , Resultado del TratamientoRESUMEN
OBJECTIVES: Nonreinforced tensile repair of giant hiatal hernias is susceptible to recurrence, and the role of mesh graft implantation remains controversial. Creating a new and viable choice without the use of high-cost biological allografts is desirable. This study presents the application of dermis graft reinforcement, a cost-efficient, easily adaptable alternative, in graft reinforcement of giant hiatal hernia repairs. METHODS: A 62-year-old female patient with recurrent giant hiatal hernia (9 × 11 cm) and upside down stomach, immediately following the Belsey repair done in another department, was selected for the pilot procedure. The standard three-stitch nonabsorbable reconstruction of diaphragmatic crura was undertaken via laparoscopic approach. A 12 × 6 cm dermis autograft was harvested from the loose abdominal skin. "U" figure onlay reinforcement of diaphragm closure was secured with titanium staples. The procedure was completed with a standard Dor fundoplication. One- and seven-month follow-ups were conducted. RESULTS: No short-term postoperative complications were observed. One-month follow-up showed normal anatomical location of abdominal viscera on computed tomography imaging. High-resolution manometry showed normal lower esophageal sphincter pressure. Preoperative abdominal complaints were resolved. Procedural costs were lower than the average cost following mesh graft reinforcement. CONCLUSION: Dermis graft reinforcement is a cheap, easily adaptable procedure in the repair of giant hiatal hernias, even in the setting of laparoscopic reoperative procedure.
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BACKGROUND: The surgical management of malignant tumors in the head and neck region often leads to functional and esthetic defects that impair the quality of life of the patients. Reconstruction can be solved with prostheses in these cases, but various types of microsurgical free flaps can provide a better clinical outcome. CASE PRESENTATION: In this case report, the tumor and parts of the involved facial muscles and nerve were excised surgically from a 42-year-old patient after a third relapse of basal cell carcinoma in the left midface. The tissue defect was reconstructed with an anterolateral thigh chimeric type I fascio-myocutaneous flap, where the facial palsy was restored with a segmental branch of the femoral nerve and the involved mouth corner elevator muscles for the segmented vastus lateralis muscle. The 6-month follow-up revealed a good esthetic outcome, the soft tissue defect reconstruction with good functional activity of the reconstructed facial nerve and with acceptable mimic movements. There has been no subsequent recurrence. CONCLUSIONS: It is concluded that the chimeric type I anterolateral fascio-myocutaneous free flap can offer a good option for the esthetic and functional reconstruction of an extensive tissue defect in the maxillofacial region.
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Carcinoma Basocelular/cirugía , Neoplasias Faciales/cirugía , Parálisis Facial/cirugía , Colgajos Tisulares Libres/trasplante , Procedimientos de Cirugía Plástica/métodos , Adulto , Carcinoma Basocelular/patología , Estética , Neoplasias Faciales/patología , Nervio Femoral/trasplante , Humanos , Masculino , Colgajo Miocutáneo/trasplante , Recurrencia Local de Neoplasia/parasitología , Recurrencia Local de Neoplasia/cirugía , Reoperación/métodos , Medición de Riesgo , Neoplasias Cutáneas/patología , Neoplasias Cutáneas/cirugía , Cicatrización de Heridas/fisiologíaRESUMEN
BACKGROUND: The only definitive treatment of chronic axillar hidradenitis suppurativa (HS) that prevents relapses is 'in toto' excision of the infected glandular tissue. This way a deficiency emerges, which needs to be restored. Reconstruction with split skin graft (SSG) is a most common way of recovery, but thoracodorsal artery perforator (TDAP) fasciocutneous flap delivers better functional and aesthetic results. METHOD: Between May 2014 and July 2016, 14 patients underwent reconstructive surgery after excision of axillary HS, 2 of them had bilateral lesion. In 15 cases TDAP was used, in 1 case we used thoracodorsal artery capillar perforator flap (TAPcp). RESULTS: In all but 2 cases 1 dominant perforator was found. 1 flap had 2 dominant perforators and 1 flap was supplied by capillary perforators. Size of the flaps spread between 6 × 8 and 10 × 15 cm. 15 reconstructions were successful, 1 flap necrotised because of the lack of compliance of the patient. CONCLUSION: As a result of the glandular tissue excision carried out because of a chronic HS, a deficiency emerges. TDAP flap is an ideal solution for surgical reconstruction of axillar deficiencies, and a great alternative to SSG.
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Arterias/cirugía , Axila/irrigación sanguínea , Axila/cirugía , Hidradenitis Supurativa/cirugía , Colgajo Perforante/irrigación sanguínea , Procedimientos de Cirugía Plástica/métodos , Procedimientos Quirúrgicos Vasculares/métodos , Enfermedad Crónica , Hidradenitis Supurativa/clasificación , Humanos , Colgajos QuirúrgicosRESUMEN
Progressive hemifacial atrophy (PHA) is a rare disorder characterized by slow, unilateral atrophy of the soft tissues and bones of the craniofacial region. The defect becomes more pronounced with age, leading to esthetic and functional deficits. However, the proper timing and method of surgical reconstruction are still debated. The correction of this defect markedly influencing the quality of life of the patient can be achieved with less invasive to more invasive surgical approaches. A 21-year-old female patient with hemifacial atrophy and extensive alopecia presented to our clinic. Considering the body type and the expectations of the patient, a profunda artery perforator flap was applied for the reconstruction and esthetic improvement of the facial region. The facial asymmetry attenuated after the reconvalescence period. This case shows that in the up-to-date surgical treatment of severe PHA, the use of microvascular free flaps may provide a better approach when trying to achieve an acceptable esthetic result. This is the first time that a profunda artery perforator flap was used to restore facial asymmetry caused by PHA.
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Hemiatrofia Facial/cirugía , Colgajo Perforante/irrigación sanguínea , Procedimientos de Cirugía Plástica/métodos , Estética , Hemiatrofia Facial/diagnóstico por imagen , Femenino , Humanos , Radiografía Panorámica , Adulto JovenRESUMEN
INTRODUCTION: Handling problems in the head and neck region often requires a close cooperation between allied professions, just as in the challenging cases presented by us. Cases and methodology: With the first patient, we performed a radical surgery on the left side of the face due to recidivious basal cell carcinoma, followed by reconstruction using a Type I chimeric anterolateral thigh flap (ALT), while in the case of the second patient, we carried out a radical surgery on the right side of the face due to epithelial carcinoma and reconstruction with a Type I chimeric thoracodorsal flap. With our third patient, a reconstructive operation was performed due to left-sided congenital hemifacial microsomia, using a profunda artery perforator (PAP) flap. The fourth patient, due to the loss of the right hemi mandible as a result of an injury, went through a reconstructive procedure designed with Computer-Aided Design and Computer-Aided Manufacturing (CAD-CAM) technology, using a fibula free flap. RESULTS: All chosen reconstructive methods proved to be efficient and safe solutions in handling the problems. CONCLUSION: Through the cases presented, we intend to raise awareness of the importance of cooperation between maxillofacial and plastic surgery as well as of the ever-growing range of reconstructive opportunities through the flaps used.
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Neoplasias de Cabeza y Cuello/cirugía , Cabeza/cirugía , Cuello/cirugía , Procedimientos de Cirugía Plástica/métodos , Cirugía Plástica/métodos , Colgajos Quirúrgicos , Muslo/irrigación sanguínea , Carcinoma/cirugía , Conducta Cooperativa , Femenino , Arteria Femoral/cirugía , Humanos , Hungría , Comunicación Interdisciplinaria , Masculino , Persona de Mediana Edad , Muslo/cirugía , Resultado del TratamientoRESUMEN
BACKGROUND: Despite the well-known high donor site morbidity of the radial forarm flap, it has still remained the first option for the reconstruction of the tongue and the floor of mouth. However, a desire for an alternative, thin fasciocutaneous flap has led to the use of the median sural artery perforator flap. METHODS: Three patients had reconstructive surgery used MSAP flaps, after radical tumor excision. RESULTS: The flap was based in all cases on a dominant perforator vessel. The size of the skin paddles ranged between 20-32 cm2, and the length of the vascular pedicle between 8.2-11 cm. The mean thickness of the flap was 6.5 mm. CONCLUSION: MSAP flap is an ideal solution for surgical reconstruction in the oral cavity.
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Pierna , Suelo de la Boca/irrigación sanguínea , Suelo de la Boca/cirugía , Procedimientos de Cirugía Plástica/métodos , Colgajos Quirúrgicos/irrigación sanguínea , Neoplasias de la Lengua/cirugía , Sitio Donante de Trasplante/irrigación sanguínea , Adulto , Anciano , Arterias/trasplante , Femenino , Antebrazo , Humanos , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/prevención & control , Procedimientos de Cirugía Plástica/efectos adversos , Neoplasias de la Lengua/irrigación sanguínea , Resultado del TratamientoAsunto(s)
Absceso/cirugía , Enfermedades de la Mama/cirugía , Mamoplastia/métodos , Pezones/cirugía , Colgajos Quirúrgicos , Estética , Femenino , Humanos , RecurrenciaRESUMEN
Perineal wound healing problems following extended abdomino-perineal resection of ano-rectal cancer represent a great challenge to the surgeon. Perineal soft-tissue reconstruction with a myocutan flap was thought to reduce surgical wound healing complications. A review of the relevant literature was carried out on perineal soft-tissue reconstruction with rectus abdominis myocutan (VRAM) flap following extended abdomino-perineal rectal resection for cancer. The more commonly used neoadjuvant chemo- and radiotherapy as well as extended surgical radicality resulted in increased perioperative risks, therefore combined procedures between the colorectal and plastic surgical teams are inevitable. This case report illustrates the above trend.
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Adenocarcinoma/cirugía , Perineo/cirugía , Procedimientos de Cirugía Plástica/métodos , Neoplasias del Recto/cirugía , Recto del Abdomen/trasplante , Colgajos Quirúrgicos , Neoplasias del Ano/cirugía , Colostomía , Procedimientos Quirúrgicos del Sistema Digestivo/métodos , Humanos , Resultado del TratamientoRESUMEN
DIEP flap is a reliable option for autologous breast reconstruction after mastectomy. Previously performed lower median laparotomy can cause some difficulties in cases when more volume is needed than the DIEP flap harvested from one side can provide. We performed breast reconstruction using double hemi-DIEP flaps in three of the cases discussed. All patients recovered without complications and had a good aesthetic outcome. This method offers a safe opportunity and broadens the spectrum of breast reconstruction.
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Arterias Epigástricas/cirugía , Colgajos Tisulares Libres , Mamoplastia/métodos , Adulto , Neoplasias de la Mama/cirugía , Estética , Femenino , Humanos , Mastectomía Radical Modificada , Persona de Mediana Edad , Satisfacción del Paciente , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
Centrally located breast cancers account for 5-20% of all breast cancer cases. Historically, patients with central breast cancers were not offered breast conservation surgery but conventional mastectomy only. The relatively frequent nipple-areola-complex involvement and consequent nipple-areolar resections with an adequate safety margin around the tumor usually result in an unacceptable cosmetic result. However, breast conservation surgery can be offered to these patients applyingoncoplastic surgical techniques. In this study, central quadrantectomy and breast reconstruction with Grisotti's dermo-glandular flap is evaluated.
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Mamoplastia , Mastectomía Segmentaria , Neoplasias de la Mama , Humanos , Mastectomía , Colgajos QuirúrgicosRESUMEN
Microsurgical transplantation of the osteo-cutaneous fibula as a free flap to reconstruct the defect following radical resection of a mouth floor's tumor is a well-known and often applied procedure. Anatomy of the vessels supplying this flap is recognized but it may have some rare and unexpected variations. In this case report we discuss the reconstruction of the middle and lateral parts of the mandible which was resected due to a T4 gingival tumor. Interestingly, the aforementioned segment of the fibula and the overlying skin island were supplied by different pedicles, both emerging from the posterior tibial vessels. Both flaps were transplanted using autologous arterial and venous grafts of the peroneal artery and vein in case of the fibula. We believe this case is worth publishing due to its relative rarity in the literature and the applied surgical method.
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Peroné/trasplante , Colgajos Tisulares Libres/irrigación sanguínea , Neoplasias Gingivales/cirugía , Mandíbula/cirugía , Suelo de la Boca/cirugía , Procedimientos de Cirugía Plástica/métodos , Trasplante de Piel/métodos , Arterias Tibiales/trasplante , Peroné/irrigación sanguínea , Humanos , Masculino , Persona de Mediana Edad , Trasplante Autólogo , Resultado del TratamientoRESUMEN
AIM: Treatment of sacral dermoid cysts (SDC) is a surgical challenge. Etiology and adequate operative technique of that are debated widely up to now, and recurrence rates remained high despite various surgical techniques applied. In cases of unsuccessfully operated and repeatedly recurrent SDC a fascio-cutaneous flap on the first perforating branch of the inferior gluteal artery (IGA) is a definitive procedure. MATERIAL AND METHOD: Following preparation and dissection of sidebranches of IGA in cadavers, a repeatedly recurrent SDC was operated. CONCLUSION: a flap harvested and transferred on the first superficial perforating branch(es) of the inferior gluteal artery offers a definitive and recurrence-free surgical solution for SDC.
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Quiste Dermoide/cirugía , Arteria Ilíaca/trasplante , Sacro , Neoplasias de la Columna Vertebral/cirugía , Colgajos Quirúrgicos/irrigación sanguínea , Adulto , Nalgas/irrigación sanguínea , Quiste Dermoide/etiología , Humanos , Masculino , Recurrencia , Neoplasias de la Columna Vertebral/etiología , Resultado del Tratamiento , Cicatrización de HeridasRESUMEN
Soft tissue defect of the sole is usually a quite challenging problem. In this case report the most frequently used reconstructive options of this problem are reviewed paying particular attention for the well applicable and reliable types. An ALT graft as a free flap to the sole offers a good possibility for coverage, which is resistant enough to mechanic strains.