目的 探討手術切除聯合液氮冷凍治療結膜鱗狀細胞癌的臨床效果。 方法 分析1998年-2008年收治的21例眼瞼結膜鱗癌患者的臨床資料。對腫瘤局限在眼球結膜和部分穹窿結膜受侵犯者行單純手術切除聯合液氮冷凍治療；部分或全部結膜及眼瞼受侵犯者行局部腫瘤切除聯合眼瞼重建及液氮冷凍治療；眼瞼和球結膜廣泛受累，無法進行眼瞼重建者行眼眶內容物剜除術。 結果 21例中，7例行單純腫瘤切除合并冷凍治療，其中5例痊愈，2例復發；10例行局部腫瘤切除并進行眼瞼重建，其中7例痊愈，3例復發，復發病例作眶內容摘除；4例腫瘤侵犯范圍較寬而無法保留眼球者行眼眶內容物摘除。術手3例死于肝肺轉移。 結論 眼瞼結膜鱗狀細胞瘤的外科手術切除是唯一有效的方法，眼瞼重建視腫瘤侵犯范圍而定，冷凍治療作為輔助治療可提高疾病的治愈率。
Surgery is still the main treatment for congenital polydactyly, and the aim of surgical reconstruction is to obtain a thumb with excellent function and appearance. A systematic assessment of polydactyly is required prior to surgery, including bone stress lines, joint deviation, joint activity and joint instability, size and development of finger and nail. Bone shape, joint incongruency, and abnormal tendon insertions must be corrected completely, in order to obtain good function and to avoide secondary surgery. Bilhault-Cloquet procedure can reconstruct the size of the finger and nails. Fine manipulation can improve the postoperative nail deformity, so that the reconstructed nail reaches a satisfactory aesthetic score.
Objective To investigate the application of three-dimensional (3D) reconstruction technology in preoperative planning for anterolateral thigh flap transplantation. Methods A retrospective analysis was performed on the clinical data of 11 patients with skin and soft tissue defects treated with free anterolateral thigh flap transplantation between January 2022 and January 2024, who met the selection criteria. There were 8 males and 3 females, aged 34-70 years (mean, 50.8 years). Causes of injury included traffic accidents (4 cases), machine trauma (3 cases), heavy object crush injury (3 cases), and tumor (1 case). The time from injury to flap repair ranged from 7 to 35 days (mean, 23 days). Preoperatively, the patients’ CT angiography images were imported into Mimics21.0 software. Through the software’s segmentation, editing, and reconstruction functions, 3D visualization and measurement of the vascular pedicle, perforators, wound size, and morphology were performed to plan the flap harvest area, contour, vascular pedicle length, and anastomosis site, guiding the implementation of flap transplantation. Results The length of the vascular pedicle needed by the recipient site was (9.1±0.9) cm, and the maximum length of vascular pedicle in the donor area was (10.6±0.6) cm, with a significant difference (t=4.230, P<0.001). The operation time ranged from 220 to 600 minutes (mean, 361.9 minutes). One patient had poor wound healing at the recipient site, which healed after dressing changes. All 11 flaps survived well without necrosis. All patients were followed up 6-19 months (mean, 11 months). Four flaps showed bulkiness and underwent secondary debulking; the remaining flaps had good contour and soft texture. The donor sites healed well, with no sensory disturbance around the incision or complications such as walking impairment.ConclusionPreoperative planning using CT angiography data and 3D reconstruction software can effectively determine the flap area, contour, required vascular pedicle length, anastomosis site, and whether vascular grafting is needed, thereby guiding the successful execution of anterolateral thigh flap transplantation.