ObjectiveTo summarize the advancement of precise diagnosis and treatment for spastic cerebral palsy in recent years.MethodsThe literature and own experiences were reviewed, and the surgical method, precise diagnosis, and personalized treatment of spastic cerebral palsy based on the classification of spastic cerebral palsy were summarized and analyzed.ResultsThe common classification of spastic cerebral palsy are gross motor function classification system (GMFCS) and manual ability classification system (MACS). The surgical methods of spastic cerebral palsy can be divided into soft tissue surgery, nerve surgery, and bone and joint surgery. The precise diagnosis of spastic cerebral palsy includes qualitative diagnosis, localization diagnosis, and quantitative diagnosis. Based on precise diagnosis and classification, one or more corresponding surgical methods are selected for treatment.ConclusionThe manifestations of spastic cerebral palsy are so diverse that it is necessary to select rational surgeries based on precise diagnosis to achieve individualized treatment.
Objective To summarize the current management of anterior cruciate ligament (ACL) injury in children and adolescents, in order to provide reference for the management of ACL injury in children and adolescents. MethodsThe relevant literature at home and abroad in recent years was extensively accessed to summarize the management status of ACL injury in children and adolescent. Results The number of ACL injury in children and adolescents is increasing every year. The diagnosis of ACL mainly depends on symptoms and signs. Rehabilitation, physeal-sparing techniques, partial transphyseal techniques, all-epiphyseal techniques, and transphyseal techniques are used to treat ACL injury in children and adolescents. Conclusion Dynamic monitoring of knee joint in children and adolescents should be strengthened. The best treatment for ACL injury in children and adolescents is selected according to the patients’ actual age, bone age, Tanner stage, and physiological conditions such as menstruation, body growth speed, and other characteristics.
Transcatheter mitral valve edge-to-edge repair (TEER) has become an essential treatment option for patients with severe mitral regurgitation at high or prohibitive surgical risk. However, the surgical devices and procedural steps of the surgery are intricate, and there is currently a lack of standardized TEER procedures in China. Based on existing evidence and the accumulated experience in clinical practice, this article briefly introduces the definition, indications, contraindications, and surgical devices of TEER. It also provides a systematic and detailed elaboration on the procedural steps, key technical points, complications, and their management measures, offering guidance for the standardized implementation and widespread adoption of TEER in clinical practice in China.
The surgical difficulty of congenital heart disease varies greatly. To ensure the safety of surgery and maximize the benefits of patients, various congenital heart surgery scoring systems have been used to evaluate the risk of different complex congenital cardiac operations. However, the complete correction of cardiac anatomical malformations is a common surgical challenge. Recent studies have shown that the correction is closely related to perioperative mortality and postoperative complications, and a new scoring system for the degree of cardiac anatomical malformations has been proposed. Therefore, this review summarizes the literature and discusses different evaluative methods of congenital heart surgery, aiming to optimize the surgical evaluation system for congenital heart surgery, enhance the quality of surgery and improve the prognosis of patients.
Objective To explore the short-term surgical outcomes of the modified surgical procedure for uniportal thoracoscopic right middle lobectomy (RML). Methods In this modified approach, the incision was created at sixth or seventh intercostal space inferior to the subscapular angle. The surgeon stood on the opposite side of the operating table. The surgery was performed by serial division of the anterior oblique fissure, the vein, bronchus, artery, and horizontal fissure following the single-direction strategy. As for patients with malignant lesions, hilar and mediastinal lymph node dissection was performed. Clinical characteristics and early surgical outcomes were collected and analyzed. Results Fifty two patients were included in this study in the Department of Thoracic Surgery, West China Hospital, Sichuan University between January 2021 and June 2023. There were 20 males and 32 females at an average age of 48.0±10.5 years. No conversion or perioperative mortality was occurred. Mean surgical time was 68.1±16.8 min, mean blood loss was 16.5±4.9 mL, median chest tube duration was 2 (2-22) d and median postoperative hospital stay was 3 (3-24) d. There was no intraoperative or postoperative complication but one patient developed postoperative prolonged air leak (>5 d). Mean postoperative visual-analog scale on postoperative day 1, day 2 and day 3 was 1.5±0.8, 1.7±0.4, 0.8±0.7, respectively. Conclusion Trans-posterior-approach uniportal thoracoscopic single-direction RML is a safe, feasible, and effective procedure, which provides an appropriate direction and angle for dissection and stapling, solving the challenge of conventional uniportal RML lobectomy.