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Biomedical subjects

P Labas

Publications and source records attributed to P Labas.

At least 37 records · Page 2Linked to original sources
PubMed1997

[Transverse laparotomy closed with continuous absorbable loop sutures].

The authors emphasize the advantages of a transverse incision which are beyond doubt, because they provide the surgeon not only with an excellent bilateral view of the operated area, but what is most important, they have the significantly least negative effect on respiratory functions and the composition of blood gases, which is of major importance in patients with chronic respiratory failure. Due to the much smaller retraction forces the incidence of postoperative dehiscences and hernias is smaller. It is an incision which interferes least with the innervation of the abdominal wall and thus is not only less painful but has also better healing parameters. Its closure by a continuous, absorbable, loop-on mucosa double suture is not only simple, but what is most important, it is reliable and associated with a minimum of postoperative complications.

Absorption↗
PubMed1997

[One day surgery--personal experience].

The authors present their own experience with surgery carried out in the out-patient department in 1985-1996. It is a modern, effective, reliable and above all economical therapeutic method, because it maintains the standard of surgery while saving the costs of hospitalisation. It is a very attractive method for patients who want to return to work as soon as possible. As many as 87% patients were satisfied with surgical treatment of the anus and rectum.

Adult↗
PubMed1997

Urgent proctocolectomy in ulcerative colitis.

UC being a typical medical disease is encountered by the surgeon only in the stage of toxic megacolon or in case of severe complication during conservative treatment such as perforation, haemorrhage, obstruction or malignity. The authors operated urgently 6 young women with all these complications performing total proctocolectomy, constructing ileal pouch with complete stapling technique. In spite of high rate of complications the results are promising. The best prevention of malignant change and complication is the earlier indication for operative treatment which offers the ideal treatment for patients with UC.

Adolescent↗
PubMed1997

[Long-term results of anti-reflux surgery of the popliteal vein].

The pathophysiological cause of chronic venous insufficiency with trophic dermal changes is a valvular lesion in the deep and perforating venous system which develops in as many as 72% during recanalization of thrombi. The reduction of reflux by valvuloplasty in the popliteal section with discontinuation of the insufficient perforating vessels (sclerotization) leads promptly not only to marked subjective relief, but on a long-term basis it improves the trophic state of the skin and healing of refractory ulcerations. The technique of valvuloplasty by invagination of the venous wall after its prolongation by the axillary vein with a functional valve rules out venotomy and the use of alien material for suture which would damage the intima, and thus reduces to a minimum the possibility of postoperative thrombosis.

Adult↗
PubMed1996

[Sclerosing agents in clinical practice].

BACKGROUND: The objective of all forms of sclerotization by substances irritating the endothelium is the production of a permanent fibrous venous occlusion and reflux points controlling the abnormal flow of venous blood. The high percentage of relapses after surgery-as high as 65% within five years after surgery was the authors' motivation for the evaluation of results of two sclerotization technique: Sigg's Swiss method using Aethoxysclerol as the sclerotizing substance and Fegan's English method using S.T.D. substance. METHODS AND RESULTS: In 1974 to 1994 the authors sclerotized a total of 3161 patients, 84% women (mean age 43.7 years-range 15 to 78) and 16% men (men age 47.3 years-range 17 to 73). In 1973 to 1983 they used Sigg's technique with Aethoxysclerol (0.5 to 4% concentration). This group comprised 1325 patients. In 1983 to 1994 they used only the English technique described by Fegan, using S.T.D. The latter group comprised 1836 patients. In patients where there were doubts about the condition of the deep and perforating venous system they used as a diagnostic method aimed phlebography under sciascopic control (134 patients-4.2%) and as to non-invasive examination methods duplex sonography (235 patients-7.45%) and light reflex rheography (50 patients-1.5%). Comparison of the results did not reveal any statistically significant differences. The best effect was achieved with rapid and complete healing of ulcerations in chronic venous insufficiency in as many as 93/92%. More complications were recorded when using S.T.D., such as necroses at the site of administration, temporary teleangiectasias and hyperpigmentations, the statistical significance being p < 0.05. The most frequent complication when using Aethoxysclerol were collapses in hypotensive patients, the statistical significance being similar. CONCLUSIONS: The authors evaluate the two techniques as simple, effective and safe. They can be used as alternatives of surgical treatment. The advantage is that treatment is ambulatory, it leaves the vena saphena intact in situ and does not involve anaesthetic and surgical risks.

Adolescent↗
PubMed1996

[Comprehensive prevention of postoperative thrombosis].

Thromboembolic disease with its high mortality and morbidity is currently one of the most serious postoperative complications. Its occurrence in high-risk patients in surgical wards is 25-50%. Since 1979, the authors have examined 160 risk patients in whom no prevention had been performed. In this group of patients they detected the occurrence of profound venous thrombosis by means of the accumulation fibrinogen test, targeted phlebography under skiascopic control. At the same time the clinical symptomatology was followed in detail. Since the thrombosis is a multifactorial process, the effective preventive measure must affect and normalize as many disturbed homeostatic processes as possible. Into the group of 176 high-risk patients, the authors introduced a complex prevention into surgical routine residing in classical low-dose heparinization by 5000 u.s.c. with the first dose administered 1 hours prior to surgery, preoperational haemodilution with the administration of minimally 500 ml of Dextran and in preoperation administration of antiaggregants (Acylpyrin). by means of this tactic, the greatest antithrombotic effect is brought about preoperatively and in the first postoperative hours while the patient is protected minimally 5 to 7 postoperative days. Both preoperative and postoperative procedures are monitored by means of a complex haemocoagulation examination of the basic 10 haemocoagulation factors. The occurrence of thrombosis in patients without prevention with minimally 5 thrombogenetic risk factors during the control by means of the accumulation fibrinogen test was 32.4% and during the control by means of targeted phlebography is 24%. The differences are not statistically significant. In the group of patients with prevention the occurrence is 5.6%. In this group the screening is represented by the accumulation fibrinogen test and its positivity is verified by its localization by means of selective phlebography. The occurrence of deep vein thrombosis in the group with prevention and in the control groups statistically highly significant p > 0.0005. Haemocoagulation examination is aimed at the determination of the normalization impact of prevention on the state of hypercoagulation ability associated with the depression of spontaneous fibrinolysis in patients without prevention. The thrombi detected in patients with prevention are localized in short segments of crural veins. Clinically more significant bleeding in the group of patients with prevention occurred only in 2 patients, i.e. in 1%. Complex multifactorial prevention is not only simple and safe for patients, but also highly effective in the group of patients with high risk of postoperative thrombosis. The clinical diagnosis is unreliable and misleading with low sensitivity and specificity. (Tab. 2, Fig. 2, Ref. 28.).

Anticoagulants↗
PubMed1996

[Intracavitary thrombosis--unusual complications in ulcerative colitis].

The statement of echocardiographic differential diagnosis of intracavitary masses is not simple even for an experienced echocardiographist. It is mainly caused by the resemblance in echo-densities of thrombi and myxoma. Atypical localization of masses makes the differential diagnosis even more difficult. Authors report a case of a 30 year-old man with the history of ulcerative colitis, in whom sepsis occurred as a complication of an inflammatory bowel disease. They report the diagnosis of thrombus in the right atrium, probably of infectious genesis, formed on the endocardium which had been damaged by a catheter tip and potentiated by activated coagulatory system. In the documented period, histological examinations of colonoscopic and peroperative biopsies were performed repetitively. Neither these examinations answered the question of differential diagnosis between ulcerative colitis and Crohn's disease. The authors report an echocardiographic diagnosis and they follow-up the genesis and subsequent disappearance of the pathological mass in the right atrium which was finally diagnosed as a thrombus. The final diagnosis was based on the clinical follow-up and disappearance of the mass. (Fig. 3, Ref. 7.).

Adult↗
PubMed1995

[Advantages of continuous resorbable mattress sutures in closing extensive laparotomies].

In a group of 170 patients the mean time taken to close the abdominal cavity was 10 minutes, suppuration and fistulation resp. was observed in 2% of patients after 6 weeks. In 1.1% dehiscence occurred and in 3.5% hernia in the scar. All this applies to patients with severe malignity and hypoproteinaemia. Smead Jones technique of a continuous absorbable suture without knots is not only quick, safe, effective, cheap but also reliable in risk patients and obese patients with impaired healing, but only when its basic principles are respected: reliable anchoring and termination in fasciae, regularly alternating distances of stitches.

Absorption↗
PubMed1995

[Vulvar varices].

The authors treated in 1983-1993 72 patients with vulvar varicosities who suffered particularly during pregnancy. Typical symptoms are pruritus, pain caused by pressure in the vulvar area and the sensation of prolapse. According to the authors surgical treatment is unnecessary and involves risk. They recommend compressive sclerotherapy as described by Fegan, using sodium tetradecyl sulphate S.T.D. Hegefort England not only in case of a marked clinical symptomatology but also as prevention of dangerous haemorrhage during delivery.

Adult↗
PubMed1995

[Mechanical anastomoses in gastrointestinal surgery].

The authors present an account of possibilities to use a mechanical anastomosis by means of staplers in gastrointestinal surgery and the advantages of this procedure. It is a rapid, simple, and above all, reliable technique with a minimal percentage of postoperative complications. Despite the relatively high cost its importance is invaluable in particular in surgery of the oesophagus, cardia and in low resections of the rectum where it is possible to fix a reliable anastomosis up to 2 cm from the linea dentata. The authors evaluate 95 mechanical anastomoses, incl. three where during the postoperative period dehiscence occurred.

Adult↗
PubMed1995

[Surgical treatment of ulcerous colitis].

Ulcerative colitis, being a typical medical disease, is encountered by the surgeon only in the stage of toxic megacolon or in case of sever complications during conservative treatment such as perforation, haemorrhage or obstruction. The authors operated six young women where they performed as the only choice total proctocolectomy with formation of an ileal reservoir which was sutured to the rectum stripped of the mucosa. Despite the serious condition at the time of operation, the patients survive the operation, although the percentage of postoperative complications is high, with the exception of one patient who died on the 126th day after operation. The remainder survive in a fair condition with complete and continence.

Adolescent↗