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At least 253 records · Page 14Linked to original sources
PubMed1984

Prophylactic parenteral cephalosporins in surgery. Are the newer agents better?

Parenteral prophylactic cephalosporins used in surgery were compared in 17 published studies. Examination of these studies reveals little justification for preference of one cephalosporin over another. For gastrointestinal, obstetrical-gynecologic, or cardiac operations, newer cephalosporins did not result in substantial decreases in adverse postoperative clinical events (eg, wound infections, intra-abdominal and pelvic infections, and endocarditis) when compared with older cephalosporins. There is no evidence that second- or third-generation cephalosporins result in postoperative infection rates lower than with first-generation cephalosporins.

Cardiac Surgical Procedures↗
PubMedDate not supplied

Evaluation of new cephalosporins for prophylaxis of surgical infection.

The appropriate use of recently marketed cephalosporins for antimicrobial prophylaxis during surgery is discussed. New cephalosporins (cefamandole, cefoxitin, cefotaxime, moxalactam, and cefoperazone) are often substituted in situations where older, "first-generation" cephalosporins or other antimicrobials traditionally have been used. Adoption of these newer agents for routine use in prophylaxis of surgical infection has led to concerns of substantially increased costs as well as development of bacterial resistance. To date, some of the newer cephalosporins have been investigated for prophylaxis of postoperative infection in cesarean section, vaginal hysterectomy, gastrointestinal surgery, open-heart surgery, and total-hip replacement. Assessment of new cephalosporins for surgical prophylaxis should include: (1) the nature of infection with each specific type of procedure, (2) the effect of antimicrobials on prevention of infection with specific procedures, and (3) factors related to the institutional environment. For the surgical procedures listed above, newer cephalosporins either have not been studied or studies have not demonstrated a reduction in postoperative infection rates in comparisons with "first-generation" cephalosporins. Valid prophylactic uses for the newer agents may arise if comparative studies demonstrate postoperative infection rates lower than with regimens using the older cephalosporins or with other established regimens. Currently, none of the newer cephalosporins can be recommended for routine use in the prophylaxis of surgical infection.

Cardiac Surgical Procedures↗
PubMed1980

Directions in radionuclide hepatobiliary imaging.

The 99mTc iminodiacetic acid analogues are a group of radiopharmaceuticals which are rapidly metabolized by the hepatocytes and excreted into the biliary tract. In essence, they function as bile markers and are therefore used to trace bile flow pathways by external imaging. There are various facets of liver and biliary tract disorders which can now be investigated with these new agents at a greater confidence level than heretofore possible with the older test agent, 131I-rose bengal. These include determination of cystic duct patency, assessment of the integrity of surgically altered biliary and gastrointestinal anatomy, disclosure of biliary gastric reflux, and distinction between medical and surgical jaundice.

Biliary Dyskinesia↗
PubMed1983

[Postoperative cholecystitis. Apropos of 9 cases (3 lithiasic and 6 alithiasic)].

Postoperative cholecystitis (three cases with and six cases without associated stones) was found following 25.00 operations performed over a period of 8 years. Analysis of these cases and a literature review suggest that the onset of a postoperative lithiasic cholecystitis is probably only the result of coincidence, where as alithiasic cholecystitis is a definite postoperative complication, these affections having to be considered within the more general framework of post-aggression cholecystitis.

Acute Disease↗
PubMed1993

Intrahepatic lithiasis above a bilio-digestive anastomosis.

The authors review their experience of twenty-five cases of intrahepatic lithiasis proximal to a bilio-digestive anastomotic stricture. Patients were operated on between 1970 and 1990, with a later follow-up in 1993. The pathogenesis of stone formation, in these cases, was relatable to multiple factors: biliary infection, presence of lithogenic nuclei (e.g. foreign bodies such as suture stitches), biliary stasis due to the stenosis. Management of this peculiar disease must take into account both surgical options and percutaneous as well as endoscopic methods. Our approach is the reconstruction of the stenotic anastomosis at its highest point, associated with intraoperative lithotomy followed by post-operative lithotomy and lithotripsy (if necessary) using PTCS (percutaneous transhepatic cholangioscopy). The best results are achieved with cooperation between surgeon, radiologist and endoscopist, aimed at preventing post-operative complications and severe consequences for the patient.

Anastomosis, Surgical↗
PubMed2000

[Day surgery for anal disease].

Historically, patients with anal diseases treated on a day surgery basis had inadequate cure rates and a high complication rate. After World War II, modern treatment methods were learned from the UK and USA and improved in Japan. However, the improved radical methods were so complex that approximately 2 weeks' hospitalization was needed. Recently, day surgery for various diseases including hemorrhoids has been recommended by the Japanese ministry of Health and Welfare. However, the characteristics of anal anatomy and physiology make the smooth healing of wounds difficult and tend to cause postoperative pain, bleeding, infection, prolonged healing time, etc. To prevent such difficulties, care must be well planned following the critical path of informed consent, careful surgery, postoperative observation, and management at home. However, hospital staff in charge of such surgery are under so much stress that only patients with less severe anal disease without local or systemic complications should be selected for day surgery.

Ambulatory Surgical Procedures↗
PubMed1999

[Foreign bodies of gastrointestinal tract].

153 patients with swallowed foreign bodies in gastrointestinal tract (GIT) were treated for the last 10 years (1988-1997). In 85 (55.5%) cases foreign bodies (FB) were swallowed by psychopathic persons, in 45 (29.4%)--with the aim of mutilation, in 23 (15.0%)--due to carelessness. In 105 (68.63%) patients the foreign bodies were single, in 48 (31.37%) there were multiple foreign bodies of GIT. In 73 (47.71%) cases FB were found in the stomach. Clinical picture in patients with swallowed FB was variable. Dynamic roentgenological examination together with thorough anamnesis is the most important diagnostic tool in this pathology. The indications for urgent surgical treatment were sticking of the FB, peritonitis, gastro-duodenal bleeding, gastrointestinal obstruction. Elective surgery was used in patients with sticked F.B., with multiple FB, which formed conglomerates, as well as in single FB. with the length over 12-15 cm. Active expectant policy is valid FB of GIT with tendency for passage, due to conservative treatment.

Adolescent↗