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Biomedical subjects

S F Redo

Publications and source records attributed to S F Redo.

At least 19 recordsLinked to original sources
PubMed1997

Esophageal atresia and tracheoesophageal fistula: surgical experience over two decades.

BACKGROUND: Despite improvements in survival, for infants born with esophageal atresia tracheoesophageal fistula, or both, the morbidity associated with repair of these anomalies remains high. METHODS: This report retrospectively analyzes 81 patients with esophageal atresia, tracheoesophageal fistula, or both presenting to our institution between 1975 and 1995, with a focus on anastomotic complications. RESULTS: There were 46 male and 35 female patients with a mean gestational age of 37 weeks and mean birth weight of 2443 g. Forty-four patients underwent primary esophageal anastomoses, 7 underwent delayed primary anastomoses, 12 patients underwent staged repairs, and 5 underwent repair of H-type fistulas. Among 62 patients with anastomoses, complications included stricture in 25/62 patients (40%), leakage in 12/62 patients (19%), and recurrent tracheoesophageal fistulas in 6/62 patients (10%). Stricture rates for esophagoclonic anastomoses versus esophagoesophageal anastomoses were 4/8 cases (50%) versus 21/54 cases (39%). This difference was not statistically significant. All esophagoesophageal strictures were managed successfully with dilations; three of four esophagocolonic strictures required anastomotic revision. The leakage rate for esophagocolonic anastomoses versus esophagoesophageal anastomoses was 6/8 cases (75%) versus 6/54 cases (11%). This difference was statistically significant (p = 0.0003). Two patients required revision of their colon grafts secondary to necrosis. Eighteen of 81 patients (22%) died. Operative mortality was 9/74 (12%). Causes of death included associated anomalies (n = 15), recurrent aspiration and sepsis secondary to missed fistula (n = 1), and unknown (n = 2). CONCLUSIONS: Although the morbidity associated with surgical repair of these anomalies is high, this does not affect the overall survival. The high complication rate associated with colonic interposition suggests that one should preserve the native esophagus as a primary conduit whenever feasible.

Anastomosis, Surgical↗
PubMed1995

Modified catheter for prolonged central venous use.

A modification of an existing Broviac type of central venous catheter is described. The catheter has two suture fixation rings distal to the Dacron cuff, which anchor the catheter to the patient and minimize the risk of displacement or migration until tissue-cuff adherence has taken place. The technique for using the catheter is described.

Catheterization, Central Venous↗
PubMed1993

Hypertrophic pyloric stenosis in the newborn.

Hypertrophic pyloric stenosis is exceedingly rare in newborns as well as patients over 6 months of age. These cases likely represent outliers from the normal distribution of its clinical presentation. This is a report of pyloric stenosis in a newborn. A review of the literature is included.

Female↗
PubMed1993

Placement of central venous catheters by cut-down with electrocardiogram positioning.

A technique of placement of central venous catheters for hyperalimentation, long term antibiotic treatment or chemotherapy by cut-down and positioning of the catheter tip with intravascular electrocardiography is described. The method was used in 384 patients during a period of four years. The patients varied from premature newborns to adolescents. The external jugular vein was used in 218 patients, the internal jugular vein in 150, the cephalic vein in 11 and the axillary vein in five. Catheters were successfully positioned by electrocardiogram (ECG) control in 95 percent of the patients. In only 5 percent of the patients, the ECG was difficult to interpret because of interference, poor electrode contact or unsatisfactory ECG image or tracing. Roentgenograms to check catheter location did not have to be done in the operating room. Confirmation of catheter position was done in the recovery room or on return to the neonatal intensive care unit. Using the cut-down procedure described, there were no complications, such as bleeding or chest wall infections, along the course of the catheter.

Adolescent↗
PubMed1992

Ventriculoatrial shunt utilizing the azygos vein.

Long-term ventricular cerebrospinal fluid shunting can prove difficult in the neonatal population, particularly in those neonates who have had previous abdominal and vascular procedures. This article presents a technique of providing vascular access for ventriculoatrial shunting via the azygos vein for patients with limited vascular access and in whom ventriculoperitoneal shunting is not feasible.

Azygos Vein↗
PubMed1984

Intestinal decompression tube for neonates.

A modification of the Baker jejunostomy catheter for use as an intestinal decompression tube for neonates is described. This has been used safely and effectively in the management of obstructive problems of the intestinal tract of diverse cause in full term and premature infants.

Catheters, Indwelling↗
PubMed1977

Pneumoperitoneum without ruptured viscus in the neonate: a case report and review of the literature.

A premature infant with severe respiratory distress developed the clinical and radiologic signs of pneumoperitoneum. At operation, free intraperitoneal air without visceral perforation was found. This case is unique in that pneumothorax was never observed and that interstitial emphysema or ischemic gastrointestinal lesions were not present at autopsy. The patient, however, was on a positive pressure ventilator for some time because of hyaline membrane disease and early pulmonary oxygen toxicity. Reduced parenchymal compliance could predispose to alveolar rupture. Although there was no clinical or anatomic evidence to point to a source of the intraperitoneal air, an undetectable pulmonary rupture with prompt dissection into the peritoneal cavity is the most likely explanation for the pneumoperitoneum.

Emphysema↗
PubMed1977

Surgery in patients with congenital disorders of blood coagulation.

Surgical procedures on patients with congenital disorders of blood coagulation can be performed with a high degree of confidence and an acceptable incidence of complications. During the period 1960-1975, 42 patients with congenital disorders of blood coagulation underwent 94 operative procedures at the New York Hopital-Cornell Medical Center. The coagulation defect was diagnosed preoperatively, in nearly all patients. Careful hematologic management, including specific factor replacement, is essential. The importance of meticulous hemostasis at surgery and careful monitoring of blood coagulation in the postoperative period is strongly emphasized.

Adolescent↗
PubMed1975

The response of the right ventricle to experimentally induced pulmonary artery obstruction.

Banding of the main pulmonary artery was undertaken in 11 litter-mate puppies and 8 young adult beagle dogs to study the response of the right ventricle to pressure loading. Five puppies and 3 young adult dogs acted as controls, undergoing sham surgical procedures without pulmonary artery banding. In one banded puppy and one banded young adult dog, adequate banding was not achieved and each was subsequently considered with its respective control group. A trans-band gradient of 15 mm Hg or greater was deemed a successful banding procedure. Banded puppies showed an increase in the trans-band pressure gradient in the year following surgery whereas young adult dogs showed a fall in the gradient, despite satisfactory banding as shown by cardiac catheterization 14 days after surgery. Cardiac muscle analyses indicated that the right ventricle of puppies responded to pulmonary banding by an increase in total organ weight, total tissue protein, DNA and RNA without altering the protein/DNA and RNA/DNA ratios. By contrast, young adult dogs showed only slight and insignificant increases in the protein/DNA and RNA/DNA ratios. Thus the response of the right ventricle to pulmonary artery banding in puppies is hyperplastic in nature, while in young adult animals the response to a similar stress load is with mild muscular hypertrophy and dilatation. This differential cellular response to the same stimulus based on the age of the organism is another demonstration of the principle that growth responses in the young involve cellular proliferation while those in the adult consist primarily of cell enlargement. It is, therefore, perhaps erroneous to refer to cardiac enlargement in newborns and infants as cardiac hypertrophy.

Animals↗