Guneren Ethem, Canter Halil Ibrahim, Yildiz Kemalettin, Kayan Resit Burak, Ozpur Mustafa Aykut, Baygol Emre Gonenc, Sagir Haci Omer, Kuzu Ismail Melih, Akman Onur, Arslan Serap
*Department of Plastic and Reconstructive Surgery, Bezmialem Vakif University, Instanbul †Plastic and Reconstructive Surgery, Acibadem University, Istanbul ‡Plastic and Reconstructive Surgery, Government Hospital, Adiyaman §Plastic and Reconstructive Surgery, Government Hospital, Kirklareli, Turkey ||Turkiye Hospital, Instanbul.
J Craniofac Surg. 2015 Jul;26(5):e426-30. doi: 10.1097/SCS.0000000000001881.
In underdeveloped countries one-stage definitive repair of cleft lip and palate is considered for late-presenting patients.
A total of 25 patients with unoperated cleft lip and palate more than 2 years of age were enrolled in this study for one-stage simultaneous repair of cleft lip and palate. According to Veau-Wardill-Kilner push-back technique, 2 flap palatoplasties were performed for palatal repairs; all of the lips were repaired with the Millard II rotation-advancement technique.
The authors experienced no perioperative or postoperative life-threatening complications. With respect to the registered operation periods, longer times were required to perform these double operations, but this elongation is shorter than the sum of the periods if the 2 operations had been performed separately. Although the authors were unable to evaluate the late postoperative results because the authors could not follow-up the patients after they were discharged the day after surgery, the early results related to the success of the operation without any surgical complication were prone to meet the parents' and patients' expectations.
The authors presented their experiences with many volunteer cleft lip and palate trips to third world countries; however the structure of this article is not a new hypothesis and data based to support a scientific study, but observations are objective to get a conclusion. To perform one-stage definitive repair of the cleft lip and palate in late-presented patients was the reality that they had only 1 chance to undergo these operations. According to the terms and conditions of this challenging operation, one-stage simultaneous repair of cleft lip and palate is a more demanding and time-consuming procedure than is isolated cleft lip repair or cleft palate repair. Although technically challenging, single-stage repair of the whole deformity in late-presenting patients is a feasible, reliable, successful, and safe procedure in authors' experience.
在不发达国家，对于就诊较晚的唇腭裂患者可考虑进行一期根治性修复。
本研究共纳入25例年龄超过2岁的未接受过手术的唇腭裂患者，进行唇腭裂一期同期修复。根据Veau-Wardill-Kilner后推技术，采用双瓣腭成形术修复腭裂；所有唇部均采用Millard II旋转推进技术修复。
作者未遇到围手术期或术后危及生命的并发症。关于记录的手术时间，进行这些双重手术需要更长时间，但此延长时间短于分别进行这两种手术的时间总和。尽管作者无法评估术后晚期结果，因为患者在术后次日出院后无法进行随访，但与手术成功且无任何手术并发症相关的早期结果易于满足家长和患者的期望。
作者介绍了他们多次前往第三世界国家进行唇腭裂志愿手术的经历；然而，本文的结构并非基于新的假设和数据来支持一项科学研究，而是基于客观观察得出结论。对就诊较晚的患者进行唇腭裂一期根治性修复是他们仅有一次手术机会的现实情况。根据这项具有挑战性手术的条件，唇腭裂一期同期修复比单纯唇裂修复或腭裂修复要求更高且耗时更长。尽管技术上具有挑战性，但根据作者的经验，对就诊较晚的患者进行全畸形单阶段修复是一种可行、可靠、成功且安全的手术。
Zotero 插件