Biomedical subjects

L Avtan

Publications and source records attributed to L Avtan.

4 recordsLinked to original sources

PubMed1992

[Distal arterial bypass surgery for lower limb salvage].

From 1988 to 1990, 34 operations for distal arterial revascularization aimed at lower limb salvage were carried out in 29 patients with arteritis lesions at stage IV with distal necrosis (52%), severe stage III arteritis (10%), severe acute or subacute ischemia (38%). The indications and therapeutic modalities are described and discussed. The results are compared with the data found in the literature. This is an availability and emergency surgery, the last means to avoid life-saving amputation. The rate of patent revascularization after one year can be as high as 85 to 90%. Almost 9 extremities out of 10 can be saved.

Adult↗

PubMed1992

[Treatment of spontaneous pneumothorax under videosurgery, 32 cases (with videofilm presentation)].

From September, 1991, to June, 1992, 32 cases of pneumothorax were operated with thoracoscopy (video surgery). The indication was established for second recurrence in 6 cases, first recurrence in 14 cases, a persistent bulla or a lung failing to return to the wall after a first pneumothorax in 5 cases, and in the presence of a large pulmonary bulla on radiographs or CT scans during an initial episode in the last 7 cases. Thoracic CT was performed in 18 cases and demonstrated a system of bullae in 14 (13 in the apical segment and 1 in the segmentum apicale). The procedure included exeresis of the bullae on endo-GIA with apical and posterolateral parietal pleurectomy. In two cases, conversion into axillary thoracotomy was required because of extensive pleural adhesion in one case and of a technical problem in the other. The average duration of surgery was 72 mn. The thoracic drains were removed on the 2nd and 3rd postoperative days. Partial pleural detachment occurred in two cases, one on the 4th day and the other on the 5th day after surgery, with spontaneous return to the wall on the 8th day in both cases. The average stay in hospital was of 6 days. All patients were examined 15 days after discharge with a control radiograph, which was normal in all cases. No patient complained of parietal pain when no conversion into thoracotomy was made.

Adolescent↗

PubMed1992

[Colonic perforation during colonoscopy. 100 cases].

The analysis of 100 cases of colon perforation during colposcopic examinations highly demonstrates such a statement. The perforation risk during colposcopies is generally of the order of 0.2% for a diagnosis coloscopy. According to the statistic data used, it can reach 0.5 to 3% in therapy coloscopy. This is a risk inherent to the technique used. It is thus required to analyse the causes and take the appropriate measures to reduce it to a minimum. Mortality due to such a complication remains high (14%), i.e about 0.015 to 0.1% (#2/10000) of all colposcopies. In 11% of the patients, serious sequelae are to be observed. This demonstrates the significance of the medico-legal problem set by these perforations during colposcopies. The whole personnel responsibility can be involved: colposcopist, surgeon, anesthetist and hospital unit.

Adult↗

PubMed1991

[Reconstruction of the hypopharynx and cervical esophagus with free jejunal graft with double pedicle].

Free jejunal graft autotransplantation for reconstruction of pharyngoesophageal defects was performed in 27 cases between 1983 and 1990. Of 27 cases, 26 patients who had carcinoma of hypopharynx underwent pharyngo-laryngo-cervical esophagectomy and interposition of free jejunal autograft. In one case who had a small and early-staged carcinoma of the cervical esophagus underwent resection of the cervical esophagus without laryngectomy and free jejunal autotransplantation in order to preserve the continuity of the alimentary tract. In the first 5 cases, the autografts interpositioned in the neck had single pedicle and were revascularized by one artery and vein, like the applications in the literature. Two fistulas and one necrosis were observed in these patients. In the following 22 patients a new model of free graft was applied. Jejunal graft prepared with double pedicles in abdomen was interpositioned in the neck with the microvascular anastomosis of the 4 vessels (two arteries and two veins) belonging to both pedicles. It was observed that the blood supply and vitality of the double pedicled jejunal graft was better comparing to the jejunal graft with single pedicle. Also, the feasibility of +4 degrees C continuous perfusion from the second pedicle protected the grafts from warm ischaemia. Only one case developed a fistula and no necrosis was observed in the 22 cases with double pedicled free jejunal autografts. These results suggested that application of double pedicled jejunal grafts reduces the risk of fistula and necrosis, despite the total operation time is 45-60 minutes longer.

Adult↗