Objective To detect the operative technique and aesthetic problem of reconstruction to deformity of bilateral cleft lip． Methods From March 2003 to December 2004, 26 patients with bilateral cleft lip were treated, aged 10 months to 11 years. Of 26 patients, there were 13 bilateral complete cleft lip and palate, 9 bilateral incomplete cleft lip and 4 mixed cleft lip with unilateral complete cleft palate. The chief design principle was keeping the length of prolabium. During operation, sufficient dissociation was made in the base of the ala base and orbicularis oris muscle to reconstruct these structures．The circle suture was made for the bilateral orbicularis oris muscle. The shape of vermilion was achieved by lateral red lip muscle flap and simultaneous simple rhinoplasty was performed. Results Primary healing of the incisions was achieved in all cases. After the 10 days-3 months follow-up, the results were satisfactory in thewidth and chubbiness of the nose bottom,the shapes of nostril and Cupid’s bow were good without whistle deformity. Theapperance of upper lip was good in either dynamic or static state． Conclusion Excellent shapes and function of the nose and lip， and opportunity for twostage repair could be obtained with this method，which being believed important methods for the primary repair of bilateral cleft lip．
ObjectiveTo investigate the effectiveness of double buried suture method for correction of secondary mild unilateral cleft lip nose deformity. MethodsBetween June 2010 and June 2012, 20 patients with secondary mild unilateral cleft lip nose deformity were treated with double buried suture method. Among 20 patients, 12 were male and 8 were female, with an average age of 21 years (range, 14-44 years). All patients had unilateral cleft lip nose deformity after unilateral cleft lip repair, including 9 cases of left deformity and 11 cases of right deformity. The time between first repair and double buried suture was 11-42 years (mean, 19 years). ResultsIncisions healed by first intention, and no related complication occurred. The patients were followed up 6-12 months (mean, 8 months). All patients were satisfied with the nasal contour, symmetrical projection of the alar dome, a central columella, symmetry of nasal floor, and no obvious scar. No recurrence was observed during follow-up. ConclusionDouble buried suture method not only can correct secondary mild unilateral cleft lip nose deformity completely, but also can avoid obvious scarring and recurrence of nose deformity.
ObjectiveTo investigate the clinical application of the modified Zitelli bilobed flaps in repairing soft tissue defect of lower one-third nose. MethodsBetween February 2009 and February 2014, 26 patients with soft tissue defect of lower one-third nose after resection of basal cell carcinoma underwent reconstruction using modified Zitelli bilobed flaps. There were 15 males and 11 females, aged 48-65 years (mean, 56 years). Tumor involved the skin layer in all patients. According to TNM staging, 19 cases were rated as TisN0M0 and 7 cases as T1N0M0. The disease duration was 1-5 years (mean, 3 years). The mass size ranged from 1.0 cm×0.5 cm to 1.5 cm×1.0 cm. The defect size ranged from 1.5 cm×1.0 cm to 2.0 cm×1.5 cm after resection of basal cell carcinoma. The modified ipsilateral Zitelli bilobde flaps were designed and harvested for one-stage repair of defect, and the double-leaf flap size ranged from 2.5 cm×2.0 cm to 3.0 cm×2.5 cm and 1.5 cm×1.0 cm to 2.0 cm×1.5 cm. The donor site defects were sultured directly. ResultsTwenty-six flaps survived and incision healed primarily. No postoperative complications of hematoma, infection, and necrosis of skin flap occurred. No stretching deformation of local organs, the shape of the nose and face was symmetric. Twenty-six patients were followed up 3-24 months (mean, 13 months). Nasal and facial appearance was good and had no obvious scar formation, and patients were satisfied with the appearance. There was no tumor recurrence during follow-up. ConclusionThe modified Zitelli bilobed flap to repair soft tissue defect of lower one-third nose (the defect diameter within 2.0 cm) can obtain satisfactory effectiveness in appearance.
ObjectiveTo explore the feasibility of CORFLO feeding tube in enternal nutrition after video-assisted thoracoscopic Ivor Lewis esophagogastrectomy for esophageal cancer and cardiac adenocarcinoma. MethodsA total of 107 patients with esophageal cancer and cardiac adenocarcinoma undergoing video-assisted thoracoscopic Ivor Lewis esophagectomy or resection of cardiac adenocarcinoma in our department between October 2014 and January 2016 were enrolled, among whom 10 patients received jejunostomy and 97 patients (60 males, 37 females, median age of 66 years, range, 47-75 years) received the insertion of CORFLO feeding tubes. ResultsIn 97 cases with insertion of feeding tubes, median insertion time was 7 (3-11) min and median depth was 83 (75-90) cm. The first-attempt success rate during the operation was 77.3% (75/97), and the second attempt at the bedside postoperatively was successful in 8 cases. The overall success rate was 85.6% (83/97). Insertion was successful in 77 esophageal cancer patients and 6 cardiac adenocarcinoma patients. Conclusion Blind insertion of CORFLO feeding tube in video-assisted thoracoscopic Ivor Lewis esophagogastrectomy for esophageal cancer and cardiac adenocarcinoma is feasible and safe. This noninvasive method is simple, effective and repeatable.