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PubMed2001

[Esthetic and functional results of the transperitoneal laparoscopic approach in nephrectomy].

OBJECTIVE: To evaluate the aesthetic and functional sequelae of laparoscopic transperitoneal nephrectomy. MATERIAL AND METHODS: Twenty-one laparoscopic transperitoneal nephrectomies were performed between 1996 and 1999. Four trocars were used in 9 patients and 3 trocars were used in 12 patients. In all patients of the series, nephrectomy was performed without manual assistance and the kidney was extracted from the iliac fossa after enlarging a trocar orifice. A questionnaire evaluating the aesthetic sequelae of the operation, resumption of everyday activities and the patient's general satisfaction was sent to each patient by mail. RESULTS: 17 patients completed the questionnaire after a mean follow-up of 12.2 months (range: 2 to 33 months). Scars were cosmetically satisfactory in 100% of cases, painless in 100% of cases and were considered to be invisible in 58.8% of cases. All patients were satisfied with the operation, but only 70.6% would have recommended this procedure to a friend or relative. 57.1% of the patients hospitalised for less than 5 days considered the hospital stay to be too brief and 42.9% considered it to be barely sufficient. Time to resumption of everyday activity varied considerably (7 to 70 days) with a mean of 32 days and was not correlated with operative complications. CONCLUSION: Laparoscopic transperitoneal nephrectomy achieves good aesthetic and functional results, but patients are not satisfied with the short hospital stay. Resumption of everyday activity does not appear to depend on the postoperative course.

Adult↗
PubMed2002

Nasolabial esthetics after Le Fort I osteotomy and V-Y closure: a statistical evaluation.

The Le Fort I osteotomy results in predictable long-term effects. The soft tissues, however, can be difficult to control because of considerable variation in their adaptation. Several adverse reactions can take place, including thinning and lateral retraction of the lip, accentuation of the nasolabial groove, reduced vermilion exposure, and increase of the nasolabial angle. In this study on 51 selected patients, the V-shaped wound in the vestibule of the maxilla after the Le Fort I osteotomy was closed with a "Y," with the bast of the "Y" in the midline of the upper lip (V-Y closure). Forward multiple regression analysis was calculated for each bony landmark. Regression equations were formulated if P < .05. The equation with the bony point with the highest r2 value was considered the most important independent variable. The selected independent variables were used to form 4 subgroups with identical vectors of movements: impaction, advancement, impaction and advancement, and dorsal impaction. In these 4 subgroups, forward multiple regression analysis was used to select equations with the highest r2 value (P < .05). The selected equations demonstrated that a V-Y plasty as single soft tissue procedure suffices only in advancement cases, and only if the nose does not need additional upward rotation. In the other 3 subgroups, additional procedures are necessary, such as alar cinch suture, reduction of the anterior nasal spine, or grinding of the paranasal area in order to prevent the above-mentioned adverse soft tissue changes.

Adolescent↗