Liu J.,Fudan University |
Liu J.,Key Laboratory of Hand Reconstruction |
Liu J.,Key Laboratory of Peripheral Nerve and Microsurgery |
Wang J.,Fudan University |
And 3 more authors.
PLoS ONE | Year: 2013
Background: Recently, vagus nerve preservation or reconstruction of vagus has received increasing attention. The present study aimed to investigate the feasibility of reconstructing the severed vagal trunk using an autologous sural nerve graft. Methods: Ten adult Beagle dogs were randomly assigned to two groups of five, the nerve grafting group (TG) and the vagal resection group (VG). The gastric secretion and emptying functions in both groups were assessed using Hollander insulin and acetaminophen tests before surgery and three months after surgery. All dogs underwent laparotomy under general anesthesia. In TG group, latency and conduction velocity of the action potential in a vagal trunk were measured, and then nerves of 4 cm long were cut from the abdominal anterior and posterior vagal trunks. Two segments of autologous sural nerve were collected for performing end-to-end anastomoses with the cut ends of vagal trunk (8-0 nylon suture, 3 sutures for each anastomosis). Dogs in VG group only underwent partial resections of the anterior and posterior vagal trunks. Laparotomy was performed in dogs of TG group, and latency and conduction velocity of the action potential in their vagal trunks were measured. The grafted nerve segment was removed, and stained with anti-neurofilament protein and toluidine blue. Results: Latency of the action potential in the vagal trunk was longer after surgery than before surgery in TG group, while the conduction velocity was lower after surgery. The gastric secretion and emptying functions were weaker after surgery in dogs of both groups, but in TG group they were significantly better than in VG group. Anti-neurofilament protein staining and toluidine blue staining showed there were nerve fibers crossing the anastomosis of the vagus and sural nerves in dogs of TG group. Conclusion: Reconstruction of the vagus nerve using the sural nerve is technically feasible. © 2013 Liu et al.
Rui J.,Fudan University |
Rui J.,Key Laboratory of Hand Reconstruction |
Guan W.,Fudan University |
Gu Y.,Fudan University |
And 3 more authors.
Oncology Letters | Year: 2016
Desmoplastic fibroma, alternatively known as aggressive fibromatosis or desmoid tumors, occurs in the form of benign locally aggressive tumors that possess a high rate of recurrence. The forearm bones are rarely involved. The current study presents a case of desmoplastic fibroma in the distal forearm of a 23-year-old man. The tumor was widely resected, and the bone defect was reconstructed using an autologous vascularized fibular graft during the resection procedure. The patient experienced recurrence three times and underwent four resections during the subsequent 3 years following the initial resection. After 10 years of follow-up, the patient's functional recovery remains positive. Despite the implication that surgical resection may be involved in the development of aggressive fibromatosis, surgical wide local excision and functional reconstruction were recommended for the treatment of the present patient. © 2016, Spandidos Publications. All rights reserved.
Zhang C.-G.,Fudan University |
Zhang C.-G.,Key Laboratory of Hand Reconstruction |
Zhang C.-G.,Shanghai Key Laboratory of Peripheral Nerve and Microsurgery |
Gu Y.-D.,Fudan University |
And 2 more authors.
Journal of Brachial Plexus and Peripheral Nerve Injury | Year: 2011
Contralateral C7 nerve transfer has been used in treating brachial plexus avulsion injury since 1986. During the past two and half decades, much has been achieved, yet more needs to be explored. In this review article, the indications, technical details, outcome and pitfalls of this technique are summarized. © 2011 Zhang and Gu; licensee BioMed Central Ltd.
Liu Y.,Fudan University |
Liu Y.,Key Laboratory of Hand Reconstruction |
Liu Y.,Shanghai Key Laboratory of Peripheral Nerve and Microsurgery |
Lao J.,Fudan University |
And 5 more authors.
Injury | Year: 2013
Background: The treatment of global brachial plexus avulsion is a demanding field of hand and upper extremity surgery. The recent development of functional and quality-of-life (QOL) assessment tools has improved quantifying these functional outcomes after surgery. Objective: We sought to combine Medical Research Council (MRC) grading with the Disability of the Arm, Shoulder, and Hand (DASH) questionnaires and Numerical Rating Scale (NRS) for pain to evaluate the functional outcome of patients who suffered complete brachial plexus avulsion before and after nerve transfers. Methods: The author carried out a retrospective review of 37 patients with global avulsion of the brachial plexus between 2000 and 2007. All of them underwent nerve transfers in Hua Shan Hospital in Shanghai. They were followed up for over 3 years for physical examination and responding to the questionnaires of DASH, NRS, as well as the satisfaction with the surgery. Results: The mean time to surgery was less than 6 months and the mean follow-up period was 4.59 years (range: 3-9 years). The effective motor recovery rate was 54%, 86%, 46% and 43%, respectively, in supraspinatus, biceps, triceps and finger flexor. Patients who underwent nerve transfers scored consistently better on the DASH score and NRS score than those before surgery. There was also a significant correlation between the change in NRS scores and patient satisfaction. Conclusion: This study validated the effect of nerve transfers for global brachial plexus avulsions from objective MRC grading combining with patients' self-assessments. Neurolysis after neurotisations correlated positively with functional outcomes. © 2012 Elsevier Ltd.
Wang L.,Fudan University |
Wang L.,Key Laboratory of Hand Reconstruction |
Wang L.,Shanghai Key Laboratory of Peripheral Nerve and Microsurgery |
Jiang Y.,Fudan University |
And 8 more authors.
Journal of Plastic, Reconstructive and Aesthetic Surgery | Year: 2014
Contralateral C7 (cC7) root transfer to reconstruct brachial plexus injury (BPI) has been widely used. A revised technique that cC7 root was transferred to lower trunk via the prespinal route with direct neurorrhaphy has been reported clinically. The aim of this experimental study was to develop an animal model of the modified surgical approach in order to obtain quantification index of postoperative nerve regeneration and muscle morphology. Sixty adult Sprague-Dawley rats randomized into experimental and control groups of 30 each. In the experimental group, after total brachial plexus injury (BPI) the cC7 root was transferred to lower trunk via the prespinal route with direct neurorrhaphy, and in the control group the brachial plexus was only exposed without intervention. Electrophysiological study, muscle tension test, neuromorphology, muscle wet weight, and muscle fiber cross-sectional area measurements were obtained 4, 8, and 12 weeks postoperatively. Median and ulnar nerve regeneration and the forearm flexor muscles functional recovery were obtained by cC7 root transfer to lower trunk via the prespinal route when measured at 12 weeks following the operation though the parameters had not recovered to normal value. We concealed the control and experimental groups from those who did the evaluations. © 2014 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.