Objective To evaluate the clinical effect of the eyelid reconstruction using hard palate mucosa graft after resection of malignant tumor of eyelid. Methods From January 1998 to October2003, 18 cases of malignant tumor of eyelid underwent the eyelid reconstruction with local flap grafting and hard palate mucosa autotransplantation. Of 18 cases, there were 10 males and 8 females, aging from 35 to 67 years. The defect was caused by basal cell carcinoma of eyelid in 10 cases, by carcinoma of meibomian glands in 6 cases and by squamous cell carcinoma of eyelid in 2 cases, including 12 cases of complete eyelid defect and 6 cases of 2/3 eyelid defect. Results The appearance and function of the eyelid in all cases were almost normal after the eyelid reconstruction with hard palate mucosa autotransplantation in replacing posterior layer of eyelid. The complete eyelid closure and no entropion were observed in all cases. The infection and contracture of the graft, immunologic rejection were not observed in allcases during the followup period of 6 to 48 months. Conclusion The eyelid reconstruction using autotransplantation with hard palate mucosa in replacing posterior layer of eyelid was easy-to-operate and has satisfactory clinical effect. The hard palate mucosa as substitute of tarsus is superior to the traditional substitute.
Objective To establish dog model of testicular autotransplantation with a modified technique.Methods Testicular autotransplantations were performed on the right side of 30 male dogs, whose ages ranged from 1.5 to 2.0 years old and weights ranged from 14 to 17 kg. After the spermatic artery with a cuff of abdominal aorta and spermatic vein and with a cuff of inferior vena cava were detached, the testis was perfused and kept at icing temperature. An end-to-side anastomosis of the spermatic vessels to the external iliac vessels was conducted subsequently. The survival conditions of the auografts were assessed by digital subtraction arteriography (DSA). Histological examination and detection on the serum levels of follicle stimulating hormone (FSH), luteotrophic hormone (LH), and testosterone (T) were made at two weeks intervals. Results Of the 30 testicular autotransplantations performed, 27 cases were successful. The success rate was 90%. The time of heat ischemia, cold ischemia, anastomosis of spermatic vessels, and total operation was 4.5±0.9 minutes, 50.0±10.0 minutes, 35.5±5.5 minutes, and 3.5±0.5 hours respectively. DSA proved that the testis survived well. No morphological abnormality was found at different stages of the spermatogenic cells. The LH level was higherthan that before operation, being statistically different (Plt;0.05);however, the levels of FSH and T did not changed significantly (Pgt;0.05). Conclusion A stable and feasible model of testicular autotransplantation is established and it provides a reliable experimental platform for human testicular transplantation.
Objective To explore the correlations between the time of tracheal extubation and the intraoperative basic factors of ex vivo liver resection followed by autotransplantation in patients with advanced hepatic alveolar echinococcosis (HAE), and analyze the change trend of blood gas analysis during operation. Methods The data of 24 patients with advanced HAE who underwent ex vivo liver resection followed by autotransplantation in West China Hospital of Sichuan University between February 2014 and August 2017 were retrospectively analyzed. Results There were significant correlations between the extubation time and the duration of anesthesia (r=0.472, P=0.031), the amount of bleeding (r=0.524, P=0.015), the amount of erythrocyte suspensions infusion (r=0.627, P=0.002), and the amount of plasma infusion (r=0.617, P=0.003). There was no statistical difference in extubation time between patients with and without pulmonary complications in 3 months postoperatively [(23.74±15.84), (15.52±19.40) h, P=0.327]. Compared with those arterial blood gas results before the interruption, the pH value, blood glucose, lactic acid and base excess were statistically significantly different (P<0.05) at each time point after the interruption. Blood potassium increased at the end of operation compared with that before interruption (P<0.05); and the free calcium after blocking and opening increased with a temporary decrease (P<0.05); the hemoglobin decreased significantly after interruption and clamping (P<0.05). Conclusions Anesthesia length and bleeding should be reduced in ex vivo liver resection followed by autotransplantation, thus the extubation time would be shortened and the prognosis of the patients might be improved. Because of the longer anhepatic phase, the blood gas analysis varies largely. During operation, blood gas analysis and monitoring should be strengthened, and the acid-base balance and electrolytes should be maintained in time.