1
|
Ouhayoun L, Madar Y, Chatel H, Benoilid M, Tresallet C, Quilichini J. Upper lateral lip flap for the coverage of large superficial labial defect. ANN CHIR PLAST ESTH 2020; 66:159-166. [PMID: 32654842 DOI: 10.1016/j.anplas.2020.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 05/16/2020] [Accepted: 05/28/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Reconstruction of large superficial defects of the upper lip is challenging, as it requires the restoration of both function and morphology. To achieve optimal results, facial features and landmarks should be preserved and similar skin should be used. Moreover, in male patients, upper lip pilosity should be restored. Although myriad of local flaps have previously been described, few address these issues. Herein, we describe our results with an upper lateral lip rotation flap for large upper lip cutaneous defects coverage. PATIENTS AND METHOD A retrospective study was performed including every patient who underwent an upper lateral lip flap between 2010 and 2017. Demographic data, defect dimensions, etiology, type of anesthesia, operative time, postoperative complications, functional and morphological outcomes were recorded. RESULTS A total of 31 patients were included. All procedures were performed under local anesthesia as outpatient procedures. The length of the operative procedure was 48minutes in average. The mean size of the superficial defect was 19mm (ranging from 6 to 30mm). All patients were fully healed after 15 days, and no flap necrosis (partial or total) was reported. No nasal or lip distortion was observed and facial hair was successfully restored in all male patients. CONCLUSION The upper lateral lip flap is a fast, safe, and reproducible procedure to cover defects of the lateral upper lip of up to 3cm. With scars hidden in natural folds and lip defects covered by lip tissues, this technique restores facial cosmetic features with very satisfying aesthetic outcome, especially in men as facial hair is restored.
Collapse
Affiliation(s)
- L Ouhayoun
- Department of plastic and reconstructive surgery, Robert-Ballanger hospital, 93600 Aulnay-sous-Bois, France.
| | - Y Madar
- Department of plastic and reconstructive surgery, Robert-Ballanger hospital, 93600 Aulnay-sous-Bois, France
| | - H Chatel
- Department of plastic and reconstructive surgery, Robert-Ballanger hospital, 93600 Aulnay-sous-Bois, France
| | - M Benoilid
- Department of plastic and reconstructive surgery, Robert-Ballanger hospital, 93600 Aulnay-sous-Bois, France
| | - C Tresallet
- Paris XIII university, Avicenne hospital, university hospital Paris Seine Saint Denis (HUPSSD), Assistance publique-Hôpitaux de Paris (AP-HP), 125, boulevard de Stalingrad, 93000 Bobigny, France; Faculté de médecine Paris XIII, université Sorbonne Paris Nord, Bobigny, France
| | - J Quilichini
- Department of plastic and reconstructive surgery, Robert-Ballanger hospital, 93600 Aulnay-sous-Bois, France; Paris XIII university, Avicenne hospital, university hospital Paris Seine Saint Denis (HUPSSD), Assistance publique-Hôpitaux de Paris (AP-HP), 125, boulevard de Stalingrad, 93000 Bobigny, France; Faculté de médecine Paris XIII, université Sorbonne Paris Nord, Bobigny, France.
| |
Collapse
|
2
|
Cohen R, Preta LH, Joste V, Curis E, Huillard O, Jouinot A, Narjoz C, Thomas-Schoemann A, Bellesoeur A, Tiako Meyo M, Quilichini J, Desaulle D, Nicolis I, Cessot A, Vidal M, Goldwasser F, Alexandre J, Blanchet B. Determinants of the interindividual variability in serum cytidine deaminase activity of patients with solid tumours. Br J Clin Pharmacol 2019; 85:1227-1238. [PMID: 30701582 DOI: 10.1111/bcp.13849] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 10/23/2018] [Accepted: 12/14/2018] [Indexed: 01/30/2023] Open
Abstract
AIMS Cytidine deaminase (CDA) activity in cancer patients' serum has been proposed as a predictive biomarker for efficacy and toxicity of nucleoside analogues. However, discrepant results about its predictive value have been reported due to the high interindividual variability in CDA activity. This study aimed at identifying determinants of this interindividual variability. METHODS From December 2014 to November 2015, 183 patients were prospectively included. Serum CDA activity, biological and clinical characteristics as well as five common single nucleotide polymorphisms (SNPs) in the CDA gene (c.-451C > T, c.-92A > G, c.-33_-31delC, c.79A > C, c.435 T > C) were analysed. Associations between clinical characteristics, pharmacogenetic variants and CDA activity were univariately tested. P < 0.1-candidate variables were analysed through a multivariate analysis. The association between CDA activity and toxicity was assessed for the 56 gemcitabine-treated patients. Intraindividual variability in CDA activity was explored in six pancreatic cancer patients treated with gemcitabine. RESULTS Median CDA activity was 3.97 U mg-1 (range 1.53-15.49 U mg-1 ). A univariate analysis showed that CDA activity was statistically associated with Eastern Cooperative Oncology Group performance status, mild or severe malnutrition, inflammatory syndrome, leucocyte count, neutrophil count, albumin, C-reactive protein and -c.-33_-31delC single nucleotide polymorphism. A multivariate analysis identified that only neutrophil count (P < 0.0001) and severe malnutrition (P = 0.0278) were independently associated with CDA activity. Low CDA activity (<2 U mg-1 ) was not statistically associated with severe gemcitabine-related toxicities (P = 0.16). A decrease in CDA activity was observed during the longitudinal follow-up of six pancreatic cancer patients treated with gemcitabine (P = 0.03). CONCLUSIONS These results suggest that neutrophil count and malnutrition should be considered for the interpretation of pretherapeutic CDA activity.
Collapse
Affiliation(s)
- R Cohen
- Department of Medical Oncology, Cochin Hospital, Paris Descartes University, CARPEM, AP-HP, Paris, France
| | - L H Preta
- Pharmacokinetics and Pharmacochemistry Unit, Cochin Hospital, Paris Descartes University, CARPEM, AP-HP, Paris, France
| | - V Joste
- Biochemistry Unit, Georges Pompidou European Hospital, Paris Descartes University, AP-HP, Paris, France
| | - E Curis
- Laboratory of biomathematics, plateau iB2, Pharmacy Faculty, University of Paris Descartes, Paris, France
| | - O Huillard
- Department of Medical Oncology, Cochin Hospital, Paris Descartes University, CARPEM, AP-HP, Paris, France
| | - A Jouinot
- Department of Medical Oncology, Cochin Hospital, Paris Descartes University, CARPEM, AP-HP, Paris, France
| | - C Narjoz
- Biochemistry Unit, Georges Pompidou European Hospital, Paris Descartes University, AP-HP, Paris, France
| | - A Thomas-Schoemann
- UMR8638 CNRS, Paris Descartes University, Pharmacy Faculty, University of Paris Descartes, Paris, France.,Multidisciplinary risk assessment and Drug Monitoring, Cochin Hospital, AP-HP, Paris
| | - A Bellesoeur
- Multidisciplinary risk assessment and Drug Monitoring, Cochin Hospital, AP-HP, Paris
| | - M Tiako Meyo
- Pharmacokinetics and Pharmacochemistry Unit, Cochin Hospital, Paris Descartes University, CARPEM, AP-HP, Paris, France
| | - J Quilichini
- Pharmacokinetics and Pharmacochemistry Unit, Cochin Hospital, Paris Descartes University, CARPEM, AP-HP, Paris, France
| | - D Desaulle
- Laboratory of biomathematics, EA 4064 Environmental epidemiology and impact of pollution on health, Pharmacy Faculty, University of Paris Descartes, Paris, France
| | - I Nicolis
- Laboratory of biomathematics, EA 4064 Environmental epidemiology and impact of pollution on health, Pharmacy Faculty, University of Paris Descartes, Paris, France
| | - A Cessot
- Department of Medical Oncology, Cochin Hospital, Paris Descartes University, CARPEM, AP-HP, Paris, France
| | - M Vidal
- Pharmacokinetics and Pharmacochemistry Unit, Cochin Hospital, Paris Descartes University, CARPEM, AP-HP, Paris, France.,UMR8638 CNRS, Paris Descartes University, Pharmacy Faculty, University of Paris Descartes, Paris, France
| | - F Goldwasser
- Department of Medical Oncology, Cochin Hospital, Paris Descartes University, CARPEM, AP-HP, Paris, France
| | - J Alexandre
- Department of Medical Oncology, Cochin Hospital, Paris Descartes University, CARPEM, AP-HP, Paris, France
| | - B Blanchet
- Pharmacokinetics and Pharmacochemistry Unit, Cochin Hospital, Paris Descartes University, CARPEM, AP-HP, Paris, France.,UMR8638 CNRS, Paris Descartes University, Pharmacy Faculty, University of Paris Descartes, Paris, France
| |
Collapse
|
3
|
Ganry L, Hersant B, Bosc R, Leyder P, Quilichini J, Meningaud J. Study of medical education in 3D surgical modeling by surgeons with free open-source software: Example of mandibular reconstruction with fibula free flap and creation of its surgical guides. Journal of Stomatology, Oral and Maxillofacial Surgery 2018; 119:262-267. [DOI: 10.1016/j.jormas.2018.02.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 01/15/2018] [Accepted: 02/21/2018] [Indexed: 11/29/2022]
|
4
|
Ganry L, Quilichini J, Bandini C, Leyder P, Hersant B, Meningaud J. Three-dimensional surgical modelling with an open-source software protocol: study of precision and reproducibility in mandibular reconstruction with the fibula free flap. Int J Oral Maxillofac Surg 2017; 46:946-957. [DOI: 10.1016/j.ijom.2017.02.1276] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Revised: 01/09/2017] [Accepted: 02/28/2017] [Indexed: 11/29/2022]
|
5
|
Ganry L, Hersant B, Quilichini J, Leyder P, Meningaud JP. Use of the 3D surgical modelling technique with open-source software for mandibular fibula free flap reconstruction and its surgical guides. J Stomatol Oral Maxillofac Surg 2017; 118:197-202. [PMID: 28365396 DOI: 10.1016/j.jormas.2017.03.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Revised: 12/25/2016] [Accepted: 03/16/2017] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Tridimensional (3D) surgical modelling is a necessary step to create 3D-printed surgical tools, and expensive professional software is generally needed. Open-source software are functional, reliable, updated, may be downloaded for free and used to produce 3D models. Few surgical teams have used free solutions for mastering 3D surgical modelling for reconstructive surgery with osseous free flaps. We described an Open-source software 3D surgical modelling protocol to perform a fast and nearly free mandibular reconstruction with microvascular fibula free flap and its surgical guides, with no need for engineering support. PROCEDURE Four successive specialised Open-source software were used to perform our 3D modelling: OsiriX®, Meshlab®, Netfabb® and Blender®. Digital Imaging and Communications in Medicine (DICOM) data on patient skull and fibula, obtained with a computerised tomography (CT) scan, were needed. The 3D modelling of the reconstructed mandible and its surgical guides were created. CONCLUSIONS This new strategy may improve surgical management in Oral and Craniomaxillofacial surgery. Further clinical studies are needed to demonstrate the feasibility, reproducibility, transfer of know how and benefits of this technique.
Collapse
Affiliation(s)
- L Ganry
- Department of Maxillofacial, Plastic, Reconstructive and aesthetic Surgery, Henri Mondor Hospital, 51, avenue du Maréchal de Lattre de Tassigny, 94010 Créteil, France.
| | - B Hersant
- Department of Maxillofacial, Plastic, Reconstructive and aesthetic Surgery, Henri Mondor Hospital, 51, avenue du Maréchal de Lattre de Tassigny, 94010 Créteil, France
| | - J Quilichini
- Department of Plastic & Maxillo-facial Surgery, Robert-Ballanger Hospital, Boulevard Robert Ballanger, 93600 Aulnay-sous-Bois, France; Department of Plastic Surgery, Avicenne Hospital, 125, rue de Stalingrad, 93000 Bobigny, France
| | - P Leyder
- Department of Plastic & Maxillo-facial Surgery, Robert-Ballanger Hospital, Boulevard Robert Ballanger, 93600 Aulnay-sous-Bois, France; Department of Plastic Surgery, Avicenne Hospital, 125, rue de Stalingrad, 93000 Bobigny, France
| | - J P Meningaud
- Department of Maxillofacial, Plastic, Reconstructive and aesthetic Surgery, Henri Mondor Hospital, 51, avenue du Maréchal de Lattre de Tassigny, 94010 Créteil, France
| |
Collapse
|
6
|
Madar Y, Chatel H, Leyder P, Quilichini J. [The "two positions" lipoabdominoplasty]. ANN CHIR PLAST ESTH 2015; 60:268-75. [PMID: 25937127 DOI: 10.1016/j.anplas.2015.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2015] [Accepted: 04/07/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUNDS Lipoabdominoplasty is a way to improve morphological outcomes by treating the areas not accessible to resection during classical abdominoplasty, especially hips. However, patients can present a lateral and posterior fat extension, not accessible to an anterior liposuction. This situation is managed by a first step with liposuction in the prone position. The aim of this study was to determine whether lipoabdominoplasty performed in two positions increases morbidity compared with lipoabdominoplasty in supine position only. METHODS This was a retrospective study of 137 patients who underwent lipoabdominoplasty between 2009 to 2013. Eighty-five patients underwent a one position lipoabdomynoplasty and 52 a two positions lipoabdomynoplasty. Medical records were reviewed to collect data regarding patient demographics, operative technique, volume of liposuction and complications. RESULTS The posterior liposuction has significantly increased the length of procedure (mean: 43.3 minutes). The volume of liposuction was significantly higher when the procedure was performed with prone and supine position (2789.6 mL versus 1373.8 mL, P<0.001). There was no significant difference between the two groups regarding complications and blood loss. CONCLUSION Lipoabdominoplasty in two positions is an effective technique with the same morbidity as a lipoabdominoplasty in supine position only. The procedure finds its indication, between classic abdominoplasty and bodylift, for patients with lateral and posterior fat extension without posterior skin excess.
Collapse
Affiliation(s)
- Y Madar
- Service de chirurgie plastique, reconstructrice et esthétique, centre hospitalier Robert-Ballanger, boulevard Robert-Ballanger, 93600 Aulnay-sous-Bois, France.
| | - H Chatel
- Service de chirurgie plastique, reconstructrice et esthétique, centre hospitalier Robert-Ballanger, boulevard Robert-Ballanger, 93600 Aulnay-sous-Bois, France
| | - P Leyder
- Service de chirurgie plastique, reconstructrice et esthétique, centre hospitalier Robert-Ballanger, boulevard Robert-Ballanger, 93600 Aulnay-sous-Bois, France
| | - J Quilichini
- Service de chirurgie plastique, reconstructrice et esthétique, centre hospitalier Robert-Ballanger, boulevard Robert-Ballanger, 93600 Aulnay-sous-Bois, France; Groupe hospitalo-universitaire Avicenne - Jean-Verdier, université Paris Nord, 93000 Bobigny, France
| |
Collapse
|
7
|
Lize F, Leyder P, Quilichini J. [Horizontal V-Y advancement flap for lower eyelid reconstruction in young patients]. J Fr Ophtalmol 2014; 38:7-12. [PMID: 25542445 DOI: 10.1016/j.jfo.2014.07.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2014] [Revised: 07/03/2014] [Accepted: 07/07/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE The reconstruction of lower eyelid defects is a complex issue because of the thinness of eyelid tissues and the need for protection of the globe. The surgery must address two requirements: a functional goal, avoiding eyelid malposition, and a cosmetic goal, limiting aesthetic compromises. In young patients, direct closure is rarely possible if the defect is superior to 1cm. The horizontal V-Y advancement flap is a simple and reliable method but is hardly ever reported. The purpose of this study is to review the surgical technique and report our experience with this flap in the reconstruction of younger patients. PATIENTS AND METHODS Nine patients, 5 men and 4 women, with a mean age of 54 years, underwent a lower eyelid reconstruction by horizontal V-Y advancement flap between 2011 and 2014. In every case, the initial pathology was a basal cell carcinoma and the surgical margins were uninvolved. The mean diameter of the surgical defect was 1.9 centimeters and the average procedure duration was 40 minutes. RESULTS All patients were managed as outpatients. Functional and aesthetic results were judged satisfactory or very satisfactory by all the patients and their surgeon. No flap necrosis and no ectropion or scleral show were reported. In one patient, lower lid edema lasted until the third postoperative month. CONCLUSION The horizontal V-Y advancement flap enables to repair lower eyelid defects using nearby skin of similar characteristics. Aesthetic results are very satisfactory, and scars, concealed in the eyelid creases, are nearly invisible in the long term. The lack of tension on the eyelid margin limits the risk of eyelid position. This simple and reliable one-step procedure, possible under local anesthesia, is appropriate for young, active patients, limiting the cosmetic sequelae and social ramifications.
Collapse
Affiliation(s)
- F Lize
- Service de chirurgie plastique, reconstructrice et esthétique, centre hospitalier Robert-Ballanger, boulevard Robert-Ballanger, 93600 Aulnay-sous-Bois, France
| | - P Leyder
- Service de chirurgie plastique, reconstructrice et esthétique, centre hospitalier Robert-Ballanger, boulevard Robert-Ballanger, 93600 Aulnay-sous-Bois, France
| | - J Quilichini
- Service de chirurgie plastique, reconstructrice et esthétique, centre hospitalier Robert-Ballanger, boulevard Robert-Ballanger, 93600 Aulnay-sous-Bois, France; Service de chirurgie, groupe hospitalier Avicenne-Jean-Verdier, université Paris Nord, 125, route de Stalingrad, 93000 Bobigny, France.
| |
Collapse
|
8
|
Leyder P, Wycisk G, Quilichini J. [An adjustable distractor for transverse maxillary distraction osteogenesis]. ACTA ACUST UNITED AC 2013; 114:170-4. [PMID: 23827271 DOI: 10.1016/j.revsto.2013.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2012] [Revised: 11/18/2012] [Accepted: 03/25/2013] [Indexed: 10/26/2022]
Abstract
INTRODUCTION The posterior skeletal widening in conventional distractions (Surgical Assisted Rapid Maxillary Expansion) is often modest, in contrast with a predominant anterior expansion. Until recently, it was not possible to consider transverse palatal distraction osteogenesis and Le Fort I impaction or advancement in the same procedure, as the osteosynthesis plates impeded maxillary anterior opening. We developed new sliding osteosynthesis plates allowing to perform an advancement or impaction Le Fort I osteotomy associated with a low-resistance bipartite palatal distraction osteogenesis. We had for aim to describe the device and to determine its clinical applications. MATERIAL This new palatal distractor is made up of two independent stainless steel jacks allowing for an adjustable distraction in the anterior or posterior area as needed. Bone-borne and tooth-borne versions are available. DISCUSSION This new distractor can be adjusted sagittally. The distraction can be angular or parallel, and the distraction mode can be modified during post-operative distraction. This device should be adapted to all clinical presentations. It can be used in combination with sliding osteosynthesis to perform a Le Fort 1 osteotomy and at the same time a complete correction of vertical, horizontal, and sagittal deficiencies.
Collapse
Affiliation(s)
- P Leyder
- Chirurgie maxillo-faciale et stomatologie, service de chirurgie plastique, reconstructrice et esthétique, centre hospitalier Robert-Ballanger, boulevard Robert-Ballanger, 93602 Aulnay-sous-Bois cedex, France
| | | | | |
Collapse
|
9
|
Leyder P, Wycisk G, Quilichini J. [Sliding osteosynthesis: a new technique for transverse palatal distraction osteogenesis associated with advancement and/or impaction Le Fort I osteotomy]. ACTA ACUST UNITED AC 2013; 114:19-23. [PMID: 23711212 DOI: 10.1016/j.revsto.2012.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2011] [Revised: 06/02/2012] [Accepted: 12/16/2012] [Indexed: 10/26/2022]
Abstract
BACKGROUND The orthopedic and surgically assisted maxillary expansion is often followed by maxillary advancement osteotomy. The posterior width gain is often small. The expansion is often more extended anteriorly. It impairs posterior correction. The authors describe a new device, ensuring both transversal and sagittal maxillary correction in a single procedure. MATERIAL AND SURGICAL TECHNIQUE The sliding internal fixation device is in titanium, 0.8mm thick. It is made up of two plates (Deltex(®), Paris cedex 15, France): an inferior plate with a 45°-angulated slide, a superior plate with a spur. The surgical technique is a Le Fort 1 segmented osteotomy. The distractor is activated between the fifth and 10th postoperative day. Contention is maintained for 1 year after the end of activation. DISCUSSION This sliding osteosynthesis technique allows stabilizing the advancement and/or impaction as well as transversal expansion for large transversal deficits in adult patients. This technique avoids performing a second procedure.
Collapse
Affiliation(s)
- P Leyder
- Service de chirurgie plastique, reconstructrice et esthétique, chirurgie maxillofaciale et stomatologie, centre hospitalier Robert-Ballanger, boulevard Ballanger, 93602 Aulnay-Sous-Bois cedex, France
| | | | | |
Collapse
|
10
|
Matar N, Quilichini J, Bosc R, Benjoar MD, Lantieri. L. Reconstruction mammaire par lambeau de superior gluteal artery perforator (SGAP) sans changement d’installation. À propos de huit cas. ANN CHIR PLAST ESTH 2010; 55:539-46. [DOI: 10.1016/j.anplas.2010.09.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2010] [Accepted: 09/09/2010] [Indexed: 10/18/2022]
|
11
|
Quilichini J, Guihard T, Le Masurier P. Sauvetage de prothèses en reconstruction mammaire : à propos de sept cas consécutifs. ANN CHIR PLAST ESTH 2010; 55:578-82. [DOI: 10.1016/j.anplas.2010.07.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2009] [Accepted: 07/01/2010] [Indexed: 11/28/2022]
|
12
|
Quilichini J, Le Masurier P, Guihard T. [Increasing the reliability of SIEA flap using peroperative fluorescent angiography with indocyanine green in breast reconstruction]. ANN CHIR PLAST ESTH 2010; 55:531-8. [PMID: 20863606 DOI: 10.1016/j.anplas.2010.08.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2010] [Accepted: 08/13/2010] [Indexed: 10/19/2022]
Abstract
UNLABELLED The lower abdominal skin and fat have become a standard for breast reconstruction. For 30 years, techniques have evolved, seeking to reduce the morbidity while increasing the reliability of the flap. The Superficial Inferior Epigastric flap Artery (SIEA) spares the abdominal fascia and provides a very satisfying autologous breast reconstruction. However, the pedicle of this flap and its angiosome exhibit a considerable variability, making its use less reliable than other abdominal flaps. MATERIAL The Indocyanine green (ICG) is soluble dye. When illuminated by an near-infrared light, the ICG emits fluorescence that is not trapped by the skin. A single device (Photo Dynamic Eye(®)) provides the emission of the near-infrared light and the reception of the fluorescence. It provides therefore a simple and efficient intraoperative real-time surface angiographic imaging. SURGICAL PROTOCOL: After dissecting the superficial inferior epigastric vessels, the abdominal flap was harvested from the abdominal wall preserving one perforator arising from the deep inferior epigastric vessels. The perforator was then clamped, and the vascular territory of the SEIA artery was visualized using laser-induced fluorescence of the indocyanine green. The surgical technique was modified depending on the indication for surgery and the result of perfusion measurements. RESULTS The authors present four clinical cases of breast reconstruction with SIEA to illustrate this procedure. CONCLUSION The SIEA flap is another surgical technique to achieve autologous breast reconstruction without abdominal morbidity or muscular dissection. Intraoperative angiographic imaging with ICG makes this flap more reliable.
Collapse
Affiliation(s)
- J Quilichini
- Unité de chirurgie plastique, service de chirurgie, centre de lutte contre le cancer René-Huguenin, 35, rue Dailly, 92210 Saint-Cloud, France.
| | | | | |
Collapse
|
13
|
Cohen M, Quilichini J, Boubli L, Erny R, Bautrant E, Blanc B. [Current role of laparoscopy in the diagnosis and treatment of ovarian cysts]. Rev Fr Gynecol Obstet 1992; 87:248-52. [PMID: 1385655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Between October 1986 and March 1990, 220 patients underwent surgical treatment for ovarian cysts. 156 of these patients underwent an initial celioscopy and could potentially benefit from celiosciopic treatment. The group mean age was 33.3 years. The circumstances under which the cysts were discovered usually consisted of pelvic pain or diagnosis during a routine examination. Twenty-four patients underwent laparotomy immediately after coelioscopy either due to a suspect macroscopic diagnosis either due to technical difficulties. 84.6 percent of the patients in the group were able to undergo celioscopic treatment only, essentially consisting of intraperitoneal cystectomy. The main advantages were the reduction in adherent sequelae in these women of a sexually active age, but also some financial savings related to the reduced duration of hospitalization and of sick leave. The theoretical reservations consist of the risk of malignancy and macroscopic diagnosis following coelioscopic exploration must be very restricted, with laparotomy whenever there is any doubt. No malignant tumor was escaped detection in this group.
Collapse
Affiliation(s)
- M Cohen
- Service de Gynécologie-Obstétrique B, Hôpital de la Conception, Marseille
| | | | | | | | | | | |
Collapse
|
14
|
Cohen M, Quilichini J, Boubli L, Blanc B. [Sites of endometriosis]. Rev Prat 1990; 40:1091-6. [PMID: 2345851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Endometrious may be located in many parts of the body which are not limited to the pelvic region. While the classical theory of menstrual reflux easily accounts for the genital locations, other theories, notably metaplasia, have been propounded to explain more remote locations. Among the sites of implantation of the disease, the most common is the ovary followed, in order of frequency, by the anterior and posterior parts of the vaginal fornix, the broad ligament of the uterus and the uterosacral ligaments. Endometriosis of the digestive or urinary tract may create problems of differential diagnosis with cancer. External locations are much less frequent.
Collapse
Affiliation(s)
- M Cohen
- Service de gynécologie-obstétrique B, hôpital de la Conception, Marseille
| | | | | | | |
Collapse
|