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Khirurgiia (Mosk). 2000;(10):16-9.
[Use of regulated silicone bandage in horizontal gastroplasty in patients with morbid obesity]
[Article in Russian]
Kuzin NM, Dadvani SA, Kashevarov SB, Leont'eva MS, Koroleva IM, Gorbunov AS, Guznov IG, Zainiddinov FA.
From 1984 in N.N. Burdenko Surgical clinic of I.M. Sechenov MMA more than 500 horizontal gastroplasties (HGP) were performed for the treatment of patients with extreme degree of alimentary-constitutional obesity. In 1996 for the first time in our country HGP was performed, including laparoscopic method, with use of regulated silicon bandage "Lap-Band" (LB) made by "Bioenterics", USA. Laparoscopic HGP was performed in 29 patients (7 males, 22 females), aged from 23 to 60 years, mean age was 34.2 +/- 10 years. Minimal body weight was 85 kg, maximal--180 kg, mean--131 +/- 27.2 kg. Mean body mass index was 47 +/- 9.9 kg/m2. Open operations were performed in 14 cases, laparoscopic operations--in 15 cases. 11 laparoscopies were performed in initial stages in very stout patients and in the absence of laparoscopic equipment. In 3 cases the conversion from laparoscopic to open operation was necessary: in 1st case because of hemorrhage from lesser omentum's vessels, when hemostasis cannot be performed by laparoscopy; in 2nd case as a result of bronchospasm associated with tense pneumoperitoneum in the patient with bronchial asthma; in 3rd case because of significant enlargement and rigidity of liver left lobe, which didn't permit to create the space for manipulations in cardial portion of the stomach. The mean bed day turnover after traditional HGP with LB and after laparoscopic HGP was 12.2 and 5.4 respectively. Intraoperative complication was observed in one case--hemorrhage from lesser omentum's vessels. One complication was observed in immediate postoperative period, on the 6th day after traditional HGP: the eventration as a result of hard diarrhea due to antibacterial treatment was diagnosed. One more complication was observed in a year after traditional HGP: small stomach evacuatory function disorders as a result of its significant dilatation. These disorders occurred because of gastric mucosa inflammatory edema, decrease of anastomosis diameter and frequent vomiting due to aspirin taking. In this case the repeated operation--bandage's reposition was performed. There were no other complications. The rate of repeated operations was 4% which agrees with literature data.
Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11070665&dopt=Abstract hemorrhage
Khirurgiia (Mosk). 2000;(10):35-40.
[Injury of large intestine in urgent surgery]
[Article in Russian]
Aliev SA.
The results of examination and surgical treatment of 108 patients (93 males, 15 females), aged from 19 to 73 years, with large intestine injuries of different origin are presented. Large intestine injuries as a result of stab-incised abdominal wounds was in 58 patients, gunshot wounds--in 29, blunt trauma--in 21. The diagnosis of large intestine injuries was based on clinico-laboratory, X-ray and instrumental examinations. The injury of blind intestine was revealed in 8 patients, ascending colon--in 11, transverse colon--in 39, descending colon--in 5, sigmoid colon--in 45. All the patients were operated. The method of choice in the surgical treatment of these injuries was suturing of damaged portion of large intestine, which was performed in 72 patients. In 14 patients the suturing was complemented by decompressive colostomy, in 3--by extraperitonisation of the damaged site, in 4--by extraperitonisation and decompressive colostomy, in 2--by terminal ileostomy. Resection of damaged intestinal segment with primary anastomosis was performed in 4 patients, right-side hemicolectomy--in 7, Hartmann's operation--in 17, resection of large intestine with bitrunk colostoma creation--in 3, transfer of damaged segment of large intestine--in 5. Repeated operations for intestine integrity repair and fistula closure were performed in 47 patients. 18 (16.7%) patients died after operation as a result of peritonitis (7), shock and acute hemorrhage (10), denutrition due to intestinal fistula (1).
Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11070670&dopt=Abstract hemorrhage
Arch Gynecol Obstet. 2002 Dec;267(2):90-4.
Corticosteroid treatment for prevention of prematurity complications.
Celik C, Acar A, Cicek N, Koc H, Ak D, Akyurek C.
Faculty of Medicine Department of Obstetrics and Gynecology, Selcuk University, 42080-Akyokus/Konya, Turkiye. celikceotmail.com
OBJECTIVE: To investigate of efficiency to corticosteroid treatment for prevention of respiratory distress syndrome and other prematurity complications. MATERIALS AND METHODS: One thousand and six babies born at 26-36(th) gestational age were investigated for following parameters; the development of respiratory distress syndrome, necessity of surfactant therapy, mean duration of daily ventillatory support, rates of Grade III or IV intraventricular hemorrhage, and periventricular leukomalacia, necrotizing enterocolitis, proven neonatal sepsis and neonatal death. Antenatal steroids were administered in the form of two 12-mg intramuscular doses of betamethasone 12 h apart as a total 24 mg in the 24 h and repeat courses of two 12 mg of betamethasone every 7 days after the first dose of the last course if undelivered. Babies were divided into 4 groups based on betamethasone TREATMENT: The first group or control group didn't received treatment; the second group received treatment and delivered within 12 h after first injection; the third group delivered 12-24 h after first injection; and fourth group delivered at least 24 h after first injection. The patients ongoing pregnancy at least 1 week were divided into two groups as a single dose and multiple courses in once a week. RESULTS: Significant difference for development of respiratory distress syndrome between fourth group and others was found (p=0.029). There were significant difference for respiratory distress syndrome rate in hypertensive and premature rupture of membranes groups between fourth group and control group (p=0.002, p=0.041). There weren't significant difference for RDS between repeat doses and single dose groups (p>0.05). CONCLUSION: Single dose corticosteroid is an effective treatment for the development of RDS and the prevention of other prematurity complications.
Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12439554&dopt=Abstract hemorrhage
No Shinkei Geka. 2000 Oct;28(10):891-7.
[A surgical case of growing cavernous angioma at the pontomedullary junction]
[Article in Japanese]
Okuno S, Nishi N, Hirabayashi H, Sakaki T.
Department of Neurosurgery, Nara Medical University, Japan.
We described a surgical case of growing cavernous angioma located at the pontomedullary junction. This 52-year-old woman presented with symptoms caused by a small hemorrhage in the right cerebellopontine angle. Magnetic resonance images (MRI) suggested cavernous angioma as the underlying pathology. 9 months after the first episode, the second hemorrhage occurred with a deteriorated neurological state that disappeared under conservative treatment except for right facial paresis and hearing disturbance. During careful observation for 1 year, the size of the lesion gradually increased on MRI and additional neurological deficits including left hemiparesis and right abducent nerve palsy were diagnosed. The first operation was carried out through the right lateral suboccipital approach, but only partial removal of the cavernous angioma was accomplished due to the overlying seventh and lower cranial nerves. After more than 4 months, a third hemorrhagic episode was presented with a sudden onset of right cerebellar signs and facial numbness. The cavernous angioma grew in size to reach the ventrolateral corner of the 4th ventricle with dense hemosiderin deposition around the core lesion on MRI. An enhancement inside the lesion was also demonstrated after gadolinium-diethylenetriaminepenta-acetic acid administration. The second operation through the midline suboccipital approach was selected for the complete resection of the residual cavernous angioma. The lesion was too hard to resect without internal decompression. The pontine part of the lesion was almost totally resected, but manipulation for the medullary part to create a discrete layer between the lesion and surrounding neural tissues was unsuccessful and generated severe bradycardia, so this part of the cavernous angioma had to be left. The problems for the management of cavernous angioma in the brain stem should be discussed, especially focussing on the surgical indication in reference to our experience and previous literatures.
Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11070910&dopt=Abstract hemorrhage
No Shinkei Geka. 2000 Oct;28(10):905-8.
[A case of Terson's syndrome with an interesting MRI finding]
[Article in Japanese]
Haraguchi K, Morimoto S, Tanooka A, Inoue M, Takaya S, Sakamoto Y.
Department of Neurosurgery, Kushiro City General Hospital, Hokkaido, Japan.
We report a case of a 62-year-old woman admitted to our hospital in a semicomatose state. CT scan and MRI on admission revealed a dense subarachnoid hemorrhage and intracerebral hematoma in the right frontal lobe. Digital subtraction angiography showed a saccular aneurysm located in the anterior communicating artery, so radical neck clipping of the aneurysm was performed via the right pterional approach. The operation was unevential. The patient complained of bilateral visual disturbance on the next day and FLAIR image of MRI demonstrated clearly crescent shaped and mobile high intense lesions corresponding to subhyaloid vitreous hemorrhage in both eye balls. The fundoscopic examination revealed an intravitreous hemorrhage which gradually disappeared over the next 12 days. Terson's syndrome after subarachnoid hemorrhage has been linked to an entity of poor prognosis, so it is beneficial that characteristic findings in FLAIR image of MRI can lead to correct diagnosis of Terson's syndrome earlier.
Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11070912&dopt=Abstract hemorrhage
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