Biomedical subjects

L Balliu

Publications and source records attributed to L Balliu.

5 recordsLinked to original sources

PubMed2005

Association of colonic atresia and Hirschsprung's disease in the newborn: report of a new case and review of the literature.

Colonic atresia (CA) is an infrequent cause of lower gastrointestinal obstruction in the neonate. Coexistence with aganglionosis of the colon (Hirschsprung's disease) has been reported but is generally not recognized in the neonatal period. We report another case and present a review of the literature. A boy with a lower gastrointestinal obstruction, caused by a CA type III, had creation of a proximal colostomy and a distal mucous fistula on the 1st day of life. In the preoperative work-up before restoring the continuity, rectal suction biopsies revealed the presence of Hirschsprung's disease. When the boy was 6 months old, a distal colectomy and reanastomosis were done. Creation of a colostomy and reanastomosis in a second procedure is recommended for treating a type III CA unless distal aganglionosis has been ruled out.

Abnormalities, Multiple↗

PubMed2005

The evaluation of pyrosis and long-term satisfaction after gastric restrictive procedures: a retrospective study.

OBJECTIVE: To compare gastric banding (GB) and vertical banded gastroplasty (VBG) with respect to the evolution of pyrosis and patient satisfaction. SUMMARY BACKGROUND DATA: Although weight loss is the most immediate end-point in the evaluation of surgical treatment of obesity, the demonstration of changes in long-term patient satisfaction and in co-morbidity, like reflux, is an essential outcome measure. MATERIAL AND METHODS: Retrospective study of 243 morbidly obese patients. All patients received a questionnaire regarding the evolution of pyrosis and their satisfaction after surgery. The evolution of pyrosis was compared between 2 patient groups who had different oesophagitis stages. Group A had oesophagitis I, or no oesophagitis, and group B had oesophagitis II, III or IV. RESULTS: In group A of the GB group 57.8% had no complaints, 11.1% had improvement and 22.2% had aggravation of the pyrosis. In group B of the GB group 50.0% had improvement. In group A of the VBG group 51.4% had no complaints, 11.1% improvement and 23.6% aggravation of the pyrosis. In group B of the VBG group 16.7% had no complaints, 66.6% had improvement and 16.7% had aggravation of the pyrosis complaints. Statistically there is no significant difference between GB and VBG. The experience after GB is good with 67.9%, mediocre with 25.0% and bad with 7.1% of the patients ; 60.7% is pleased with the weight loss. The experience after VBG is good with 47.4%, mediocre with 29.5% and bad with 23.1% of the patients. 52.6% is satisfied with the weight loss. CONCLUSION: VBG and GB have a similar effect on pyrosis. From our point of view it has been evidenced that the presence or absence of pyrosis before the operation is a possible predictor of the evolution afterwards. Long-term patient satisfaction is the same after GB and VBG. Other factors influence the satisfaction.

Adult↗

PubMed2003

A performance study comparing manual and robotically assisted laparoscopic surgery using the da Vinci system.

BACKGROUND: The objective of this study was to compare the efficacy of the da Vinci robotic system using both the three-dimensional view (3D) and two-dimensional (2D) view options with traditional manually assisted laparoscopic techniques in performing standardized exercises. METHODS: To evaluate surgical efficiency in the use of robotically assisted and manual laparoscopic surgery for standardized exercises six, last-year medical students without any surgical experience were selected. The exercises consisted of placing rings over receptacles, grasping a free hanging suture and cutting three pieces of it, running a suture, and performing a surgical knot. Each student performed the exercise twice. The median times needed for completion of the exercises and the median number of errors in performing the tasks were noted. RESULTS: The unexperienced students performed the standardized tasks significantly quicker and with fewer errors when assisted by the da Vinci robot in the 3D optical display mode, as compared with traditional manually assisted laparoscopic surgery. Even when the 2D mode was selected, a significant advantage favoring the da Vinci robotic system was seen both in time and efficacy for most exercises. When the 3D and 2D modes were compared, time differences in favor of the 3D mode remained, but a significant difference in efficacy favoring the 3D mode was seen only in one exercise (exercise 2: suture cutting). CONCLUSIONS: The da Vinci robotic system permits standardized minimal invasive surgical exercises to be performed quicker and more efficiently than traditional minimally invasive techniques. Therefore, with the aid of this robotic system, difficult laparoscopic interventions may become easier to perform, and indications for minimal invasive surgery may be expanded.

Data Display↗

PubMedDate not supplied

What have we learnt after two years working with the da Vinci robot system in digestive surgery?

Robotic- assisted surgery has been introduced recently in order to overcome some of the difficulties surgeons encounter during advanced laparoscopic surgery. Due to the 3D vision equipment, higher number of degrees of freedom in manipulating instruments and better ergonomics it is hoped that by using robot techniques the indications of minimally invasive surgery in the field of digestive surgery can be broadened or that difficult procedures will be easier to perform. Since the introduction of the system in our hospital now almost two years ago 70 procedures have been performed with the aid of the da Vinci system covering the whole spectrum of GI surgery. Conversion took place in 2.5% and peroperative morbidity related to the use of robotic techniques was 10%. Although we had the subjective feeling that the procedures were indeed easier to perform and more relaxing for the surgeon, some major problems still exist as the complete lack of tactile feedback and the cost effectiveness of these procedures. Before robotics can be introduced in the every day clinical practice of the surgeon, its true benefit still needs to be established. This can only be done by well randomised prospective studies comparing one technique with the other.

Digestive System Surgical Procedures↗

PubMedDate not supplied

Intestinal necrosis in a patient with rheumatoid arthritis receiving anti-TNF treatment.

Vasculitis leading to intestinal necrosis is a rare complication of rheumatoid arthritis. The introduction of anti-TNF treatment for methotrexate-resistant cases improved disease-control substantially in these often more aggresive forms of rheumatoid arthritis. As far as we know only two cases of severe vasculitis following anti-TNF treatment have been reported. We describe a 45-year old female patient with severe rheumatoid arthritis, who presented with an epileptic insult, renal failure and a quickly deteriorating general condition due to intestinal vasculitis, while she had been receiving anti-TNF treatment for 6 months.

Antibodies, Monoclonal↗