Pathophysiological effects of laparoscopy: current knowledge.
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Carbon Dioxide↗
Biomedical subjects
R Z Abdel-Misih
Publications and source records attributed to R Z Abdel-Misih.
An overview of thyroid carcinoma.
Approximately, 12,000 cases of thyroid carcinoma are diagnosed each year. This disease entity accounts for 1.5 percent of all malignancies and is clinically evident in four percent to seven percent of the United States population. This paper provides an overview of thyroid carcinoma, including types, incidence, predisposing factors, evaluation, and treatment.
Adult↗
Paired temporary loop ileostomies in the localization of small bowel hemorrhage of obscure origin.
Hemorrhage from the gastrointestinal tract can be a challenging clinical problem when it persists and the source remains obscure. Intraoperative enteroscopy has been shown to be of value when standard diagnostic tests fail to localize the source of bleeding. We describe a case of small bowel hemorrhage that required multiple trips to the operating room. Paired ileostomies were fashioned, which led to the successful localization and resection of the responsible segment of the small intestine.
Endoscopy, Digestive System↗
Head and neck reconstruction using the platysma myocutaneous flap.
A retrospective analysis of our experience with 41 patients who received a platysma myocutaneous flap for reconstruction of intraoral and pharyngeal defects is presented. All patients had epidermoid carcinoma of the head and neck region, with tumor size ranging from T1 to T4. The primary sites of malignancy were the oral cavity (61%), the oropharynx (32%), and the hypopharynx (7%). Either radical or modified radical neck dissection requiring routine ligation of the facial artery was performed in all 41 patients. Adjuvant therapy included preoperative or postoperative radiotherapy (39%) and preoperative chemotherapy (73%). The mean hospital stay was 13 days. Flap-related complications occurred in eight patients (19%) only. These included partial flap necrosis involving the epithelium alone, skin necrosis of the neck suture line, and fistula formation. Most complications resolved with local care only. Minor surgical intervention was required in three patients. There were no perioperative deaths. These results indicate that the platysma myocutaneous flap is a viable alternative in head and neck reconstruction.
Adult↗
Thyroid and parathyroid surgery without drains.
The question of routine wound drainage after thyroid and parathyroid surgery remains controversial among experienced surgeons. Review of the literature failed to reveal any study that established the benefit of drainage after thyroidectomy and parathyroidectomy. A retrospective review of 139 thyroid or parathyroid procedures performed without drainage was conducted. One hundred ten thyroid operations were performed, including unilateral lobectomy with isthmusectomy [82 (74.5%)], total or bilateral subtotal thyroidectomy [26 (23.6%)], and isthmusectomy [2 (1.8%)]. Histologic examination yielded a benign diagnosis in 94 specimens (85.4%); 16 specimens (14.5%) contained thyroid carcinoma. Parathyroid explorations were performed in 29 patients (20.8%) all of whom had adenomas. Postoperatively, there were no instances of wound hematomas, infections, or rebleeding necessitating reoperation. Minor complications included asymptomatic wound seromas (4-30 mL) in five (3.6%) patients, which were aspirated 2 weeks after discharge without further recurrence. This minimal complication rate of 3.6% with undrained neck incisions suggests that routine prophylactic drainage of thyroid and parathyroid wounds is unnecessary.
Adolescent↗