ObjectiveTo evaluate the safety and clinical effect of laparoscopic Miles and perineal anal recon-struction operation for patients with low rectal cancer. MethodsOne hundred and two patients underwent Mile's and perineal anal reconstruction operation for rectal cancer in this hospital from April 2006 to February 2010 were analyzed retrospectively, in which 58 patients underwent laparoscopic surgery (laparoscope group) and 44 patients underwent open surgery (laparotomy group).All these data such as the survival time, operative time, intraoperative blood loss, harvested lymph nodes, the first anal exhaust time and liquid diet recovery time after operation, postoperative hospitalization, and postoperative complications were collected and compared between the laparoscope group and laparotomy group. ResultsThe demography and clinicopathologic characteristics were similar between these two groups (P > 0.05).The operation was successfully performed in all the patients.There was no death associated with the operation.Compared with the laparotomy group, the intraoperative blood loss was less (P < 0.05), the first anal exhaust time and liquid diet recovery time after operation, postoperative hospitalization were shorter (P < 0.05), the harvested lymph node was more (P < 0.05) in the laparoscope group.There were no significant differences in the operative time, postoperative complications, and the survival curves between the two groups (P > 0.05). ConclusionsThe clinical effects of laparoscopic and open Miles and perineal anal reconstruction operation are similar for patients with low rectal cancer.But laparoscopic operation is a safe, feasible choice with quicker recover after the operation.
ObjectiveTo observe the in vivo three-dimensional (3-D) transient motion characteristics of the subaxial cervical spine in healthy adults. MethodsSeventeen healthy volunteers without cervical spine related diseases were recruited for this study, including 8 males and 9 females with a mean age of 26 years (range, 23-41 years). The vertebral segment motion of each subject was reconstructed with CT, and Rhinoceros 4.0 solid modeling software were used for 3-D reconstruction model of the subaxial cervical spine. In vivo cervical vertebral motion in flexionextension, left and right bending, left and right rotation was observed with dual fluoroscopic imaging system (DFIS). Coordinate systems were established at the vertebral center of C3-7 to obtain the intervertebral range of motion (ROM) and displacement at C3, 4, C4, 5, C5, 6, and C6, 7. The X-axis pointed to the left along the coronal plane, the Y-axis pointed to the back along the sagittal plane, and the Z-axis perpendicular to the X-Y plane pointed to the head. The ROM along X, Y, and Z axises were represented by rotation in flexion-extension (α), in left-right bending (β), and in left-right twisting (γ) respectively, and the displacement in left-right direction (x), in anterior-posterior direction (y), and in proximaldistal direction (z), respectively. ResultsIn flexion and extension, the displacement in anterior-posterior direction of C6, 7 was significantly less that of other segments (P<0.05), but the displacements in left-right direction and in proximaldistal direction showed no significant difference between segments (P>0.05); the ROM values in flexion-extension of C4, 5 and C5, 6 were significantly larger than those of C3, 4 and C6, 7 (P<0.05), and the ROM value in left-right twisting of C4, 5 was significantly larger than those of C5, 6 and C6, 7 (P<0.05), but the ROM value in left-right bending showed no significant difference between segments (P>0.05). In left and right bending, there was no significant difference in the displacement between other segments (P>0.05) except that the displacement in anterior-posterior direction of C3, 4 was significantly larger than that of C4, 5 (P<0.05), and that the displacement in proximal-distal direction of C6, 7 was significantly less than that of C3, 4 and C4, 5 (P<0.05); no significant difference was shown in the ROM value between segments (P>0.05), except that the ROM value in left-right twisting of C3, 4 was significantly larger than that of C5, 6 and C6, 7 (P<0.05). In left and right rotation, the ROM value in left-right twisting of C3, 4 was significantly larger than that of C4, 5 and C6, 7 (P<0.05), and the displacement and ROM value showed no significant differece between other segments (P>0.05). ConclusionThe intervertebral motions of the cervical spine show different characters at different levels. And the 6-degree-of-freedom data of the cervical vertebrae are obtained, these data may provide new information for the in vivo kinematics of the cervical spine.
ObjectiveTo explore the application of three-dimensional (3-D) printing technique in repair and reconstruction of maxillofacial bone defect. MethodsThe related literature on the recent advance in the application of 3-D printing technique for repair and reconstructing maxillofacial bone defect was reviewed and summarized in the following aspects:3-D models for teaching, preoperative planning, and practicing; surgical templates for accurate positioning during operation; individual implantable prosthetics for repair and reconstructing the maxillofacial bone defect. Results3-D printing technique is profoundly affecting the treatment level in repair and reconstruction of maxillofacial bone defect. Conclusion3-D printing technique will promote the development of the repair and reconstructing maxillofacial bone defect toward more accurate, personalized, and safer surgery.