Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “REIMPLANTATION”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 325 records · Page 18Linked to original sources
PubMed2003

Is common sheath extravesical reimplantation an effective technique to correct reflux in duplicated collecting systems?

PURPOSE: We evaluate the outcome vesicoureteral reflux (VUR) in duplicated collecting systems compared to single collecting systems corrected using an extravesical detrusorrhaphy approach. MATERIALS AND METHODS: We reviewed the records of 266 patients (422 ureters) treated for VUR using an extravesical approach between 1991 and 2001. Inclusion criteria were primary reflux in single (201 patients, 125 bilateral) or duplicated collecting systems (65, 31 bilateral) in patients not undergoing other concomitant surgery with at least 1 year of postoperative followup. The indication for surgical intervention was unresolved reflux (greater than 4 years) in more than 70% of patients. Postoperative evaluation included a voiding cystourethrogram at 3 months and 12 months if reflux was unresolved at 3 months. Also ultrasound was performed at 6 weeks or earlier if clinically indicated and 12 months. RESULTS: Group 1 (duplicated collecting systems) and group 2 (single collecting systems) were comparable for age, sex distribution and reflux grade distribution. Overall success rate at 3 and 12 months was 94.7% and 98.9% for group 1, and 95.1% and 98.5% for group 2, respectively. The difference in success rate at 3 and 12 months was not statistically significant (p >0.05). Of note in both groups postoperative VUR was contralateral in more than 40% of cases. Postoperative hydronephrosis (Society for Fetal Urology grade 1, 2 or 1 increment in grade from preoperative status) was observed in 5.3% and 7.3% of ureteral units at 6 weeks in groups 1 and 2, respectively (p >0.05). At 12 months less than 1% of ureteral units exhibited low grade residual hydronephrosis. No high grade postoperative hydronephrosis was observed in either group, and there were no intraoperative complications. Postoperative urinary retention occurred in 4.7% and 4% of patients in groups 1 and 2, respectively (p >0.05). CONCLUSIONS: Common sheath extravesical reimplantation is highly effective in treating VUR. The common sheath extravesical reimplantation for duplicated collecting systems is as effective in nonduplicated systems and is associated with minimal perioperative morbidity.

Child↗
PubMed2005

Bilateral extravesical ureteral reimplantation in toilet trained children: Is 1-day hospitalization without urinary retention possible?

PURPOSE: Bilateral extravesical ureteral reimplantation has been associated with urinary retention. We developed a critical pathway and modification of surgical technique to determine whether the bilateral extravesical procedure could be performed in toilet trained children with patients discharged home after a 1-day hospitalization and without urinary retention. MATERIALS AND METHODS: A total of 50 consecutive toilet trained children were evaluated after undergoing bilateral extravesical ureteral reimplantation using a modified technique that limits ureteral dissection, ureteral mobilization and detrusor dissection to as distally as possible so that a 5:1 ratio of tunnel length to ureteral diameter can be accomplished. No surgical dissection occurs in proximity to the obliterated umbilical artery, nor is the artery ligated. Patients follow a strict postoperative critical pathway, and parents receive extensive preoperative and postoperative education. A child is required to fulfill 5 strict criteria to be discharged from the hospital. RESULTS: Patient age ranged from 1.9 to 12.8 years (mean 4.9), with 37 girls and 13 boys participating. All patients were discharged home on postoperative day 1. All patients were able to void postoperatively without any instances of urinary retention. None of the children had acute urinary tract infections or required rehospitalization. All patients had radiographic resolution of the vesicoureteral reflux on postoperative voiding cystourethrogram. CONCLUSIONS: To our knowledge this is the first study to demonstrate that bilateral extravesical ureteroneocystostomy can be performed in selected patients without postoperative urinary retention and with uniform hospital discharge in 1 day. The critical pathway and limited dissection extravesical approach are essential for this success.

Child↗
PubMed2004

Results of the ureteral reimplantation with serous-lined extramural tunnel in orthotopic ileal W-neobladder.

BACKGROUND: Our experience in uretero-ileal anastomosis using the serous-lined extramural tunnel in orthotopic ileal W-neobladder is presented. METHODS: Between June 1998 and November 2001, 42 patients (40 men and two women) underwent radical cystectomy and orthotopic ileal neobladder for invasive bladder cancer. The ureters were reimplanted into serous-lined extramural tunnels as described by Abol-Enein and Ghoneim. However, we made minor modifications during the ureteral reimplantation in cases that necessitated distal ureteral excision and with grossly dilated ureters. Evaluation included clinical and radiographic studies to determine functional and oncological outcomes. RESULTS: There was no operative mortality. The mean follow-up period was 28 months (range 12-52). Early complications occurred in four patients (9.5%). An endarterectomy for acute popliteal arterial embolism, the excision of the pouchointestinal fistula and a temporary colostomy were performed in two of these four patients. The other two patients were treated conservatively. Late complications occurred in eight patients (19%). Reflux was observed in three renal units (3.7%), ureterointestinal strictures in another three renal units (3.7%) and urethroileal stenosis in two patients (4.8%). In all cases, stabilization or improvement of renal function was achieved. No metabolic complications were observed. CONCLUSIONS: Ileal W-neobladder with a serous-lined extramural tunnel is a safe, reliable form of lower urinary tract reconstruction. The method can be carried out with equal ease in grossly dilated ureters and in cases that necessitate distal ureteral excision.

Adult↗
PubMed1985

Unilateral ureteric reimplantation for primary vesicoureteric reflux in children. A policy re-evaluated.

Fifty-one children had unilateral ureteric reimplants for primary vesicoureteric reflux over an 11-year period. Reflux was abolished in 50 patients but in 8 (15.7%) it developed or became worse on the contralateral side. An isotope renal scan (99mTc DMSA) was carried out in 15 of the 18 patients who had grossly scarred or dysplastic kidneys. Thirteen of these had less than 22% of total function coming from the affected kidney and seven had less than 10% of their total GFR coming from the kidney whose ureter had previously been reimplanted. Five of these children have undergone nephrectomy and it is felt that this would have been a better initial procedure. No patient was hypertensive at the conclusion of the study.

Child↗
PubMed1992

Pulmonary artery sling with severe tracheobronchial stenosis: repair in infancy by tracheal resection and pulmonary artery reimplantation.

Pulmonary artery sling is an unusual anomaly. The results of surgical therapy have been unsatisfactory in the past because of poor long-term left pulmonary artery patency and failure to address concomitant primary tracheobronchial stenoses. Refinement of suture materials and microsurgical techniques have allowed earlier surgical treatment of tracheal stenosis and have led to improved pulmonary artery patency rates. Intermediate results of primary one-stage repair with tracheal resection and left pulmonary artery reimplantation or translocation in early childhood have been promising. It remains to be seen whether late anastomotic tracheal stenosis will be a problem. This constitutes the first report of a case of one-stage repair with tracheal resection and left pulmonary artery reimplantation in an infant.

Anastomosis, Surgical↗
PubMed1990

Effect of topical application of doxycycline on pulp revascularization and periodontal healing in reimplanted monkey incisors.

Maxillary incisors in 47 monkeys, 54 in the experimental group (I) and 117 in the control group (II), were extracted and reimplanted, either immediately or after 30 or 60 min wet or dry storage. Incisors in the experimental group I were additionally kept 5 min in a suspension of 1 mg doxycycline in 20 ml physiologic saline, freshly prepared for each of the 15 animals before reimplantation. The observation time varied from 6 to 8 weeks. The teeth were removed in tissue blocks, histologically processed and evaluated for occurrence of complete pulp revascularization (CPR), presence of the micro-organisms in the pulpal lumen and ankylosis or inflammatory root resorption. Then the results were statistically evaluated, using log-linear analyses and chi-square tests (SAS, 1985) for the comparisons between group I and group II. These analyses revealed that topical application of doxycycline increased the frequency of complete pulp revascularization (P less than 0.002) and decreased the frequency of micro-organisms in the pulpal lumen (P less than 0.001). Furthermore, the frequencies of ankylosis (P less than 0.05) and inflammatory root resorption (P less than 0.001) were also decreased compared with the control group of teeth. It was concluded that the effect of topical treatment with doxycycline was most probably exerted on the micro-organisms that contaminated root surface during the extra-alveolar time; contamination of necrotic pulp tissue from the mechanical damage in the cervical part of the root surface was not affected.

Animals↗
PubMed1991

Analysis of left ventricular wall movement before and after reimplantation of anomalous left coronary artery in infancy.

Five infants who underwent direct reimplantation or redirection of an anomalous left coronary artery from the pulmonary artery to the aorta were studied. There were no deaths from the procedure. Anastomoses were patent at a mean follow up of 33 months. Left ventricular angiograms before and after operation were digitised frame by frame. Analysis of wall motion showed considerable generalised hypokinesia with no change in cavity shape before operation. After reimplantation there was a significant improvement of global ventricular function as assessed by ejection fraction and end diastolic shape index. There was also a tendency for the shape index change to increase; this was compatible with better global systolic function. Three of the four patients who were restudied showed normal isometric and contour wall motion plots. One child, the oldest at the time of operation, still showed asynchronous onset of contraction and isovolumic relaxation. The procedure offers a low risk of mortality and a high rate of patency of the anastomosis. Improvement of ventricular function can be remarkable and its extent cannot be assessed simply by ejection fraction measurements.

Anastomosis, Surgical↗
PubMed2001

Myocardial blood flow and flow reserve after coronary reimplantation in patients after arterial switch and ross operation.

BACKGROUND: Coronary reimplantation is used in therapy for congenital heart disease, such as in the arterial switch (ASO) and Ross operations. The adequacy of myocardial perfusion may remain a matter of concern. The aim of the present study was to stratify the effect of coronary reimplantation on myocardial perfusion and to highlight the clinical relevance of any attenuation in myocardial perfusion. METHODS AND RESULTS: A total of 21 children with transposition of the great arteries at a mean interval of 11.2+/-2.9 years after ASO and 9 adolescents at a mean interval of 4.2+/-2.1 years after the Ross procedure were investigated. All patients were asymptomatic and had a normal exercise capacity. On stress echocardiography, 2 of the ASO patients had dyskinetic areas within the left ventricular myocardium, and 5 had adenosine-induced perfusion defects on positron emission tomography. No coronary obstruction was detected on coronary angiography in any patient, but a common finding was right coronary dominance and a small caliber of the distal part of the left anterior descending artery. Coronary flow reserve (CFR) was significantly reduced in all patients after ASO when compared with 10 normal healthy volunteers (age, 25.6+/-5.3 years). CFR was normal in the 9 patients who had the Ross operation (age, 19.2+/-7.6 years); exercise-induced perfusion defects were not detected in the Ross patients. CONCLUSIONS: Children after ASO are asymptomatic, without clinical signs of coronary dysfunction. In contrast to patients who had the Ross operation, stress-induced perfusion defects and an attenuated CFR were documented. The prognostic implications of these findings and the clinical consequences are unclear; nevertheless, close clinical follow-up of ASO patients is mandatory.

Adolescent↗
PubMed2005

Decade of aortic valve sparing reimplantation: are we pushing the limits too far?

BACKGROUND: This single center study assesses the outcome of aortic valve sparing reimplantation (AVS) in 284 consecutive patients who were operated on for various indications during the last 11 years. METHODS AND RESULTS: From July, 1993, to July, 2004, 284 patients underwent AVS. Mean age was 53+/-16 (range 8 to 84) years. Of the 284 patients, 184 were male (64.8%) and 54 (19%) experienced Marfan's syndrome. Acute aortic dissection Stanford type A was present in 53 patients (19%) and a bicuspid aortic valve was present in 17 patients (6%). Concomitant arch replacement was necessary in 120 patients (42%). Additional procedures were performed in 66 patients (23.2%). Mean follow-up time was 41+/-32 (range 0 to 130) months. The 30-day mortality was 3.2% overall, 11.3% in emergency patients, and 1.3% in elective patients. Mean bypass time was 174+/-48 (range 90 to 440) minutes and aortic cross clamp time was 132+/-33 (range 64 to 283) minutes. In patients undergoing arch replacement, circulatory arrest was 25+/-17 (range 7 to 99) minutes. Rethoracotomy for bleeding was required in 4.6% of patients. During follow-up, there were 20 (7.3%) late deaths. Reoperation of the reconstructed valve was required in 15 patients (5.3%); underlying reasons were endocarditis (n=4) and aortic insufficiency (n=11) requiring aortic valve replacement. Average grade of aortic insufficiency increased significantly from 0.23+/-0.46 postoperatively to 0.34+/-0.59 at latest evaluation (P=0.026). Two patients experienced a transient ischemic attack early postoperatively; no further thromboembolic complications were noticed. The majority of patients (96%) presented with a favorable exercise tolerance at last contact. CONCLUSIONS: The aortic valve reimplantation technique leads to excellent clinical outcome in patients with various pathologies. Lack of anticoagulation and favorable durability should encourage the extension of indications for this technique.

Adolescent↗
PubMed1992

One-stage reimplantation for infected total knee arthroplasty.

One-stage reimplantation for the salvage of infected total knee arthroplasty in 18 patients was reviewed at an average follow-up of five years. There had been one recurrence and one new infection, both in rheumatoid patients with another focus of infection. In four other patients the clinical result was impaired by pain after walking (2) and limited flexion (2). Our results suggest that one-stage reimplantation is a reasonably reliable procedure for the management of a loose infected prosthesis.

Adult↗
PubMed1991

Glutathione decreases the pulmonary reimplantation response in canine lung autotransplants.

The pulmonary reimplantation response (PRR) is a form of membrane permeability pulmonary edema occurring in lung transplants. The severity of the PRR reflects the quality and duration of lung graft preservation. Free radicals formed during ischemia with reperfusion in the autotransplanted dog lung may play a role in producing PRR. We hypothesized that the addition of reduced glutathione (GSH) to the preservative solution could decrease PRR if hydroperoxides are being formed. Six dogs underwent left lung autotransplantation after the lung was flushed with Euro-Collins solution (EC). These dogs demonstrated radiographic and histopathologic evidence of bilateral pulmonary edema, greatest in the transplanted left lung. They also had increases in lung wet to dry weight (W/D) ratios in both lungs (left, 12.0 +/- 0.9; right, 10.1 +/- 0.8) as compared with a group of five unmanipulated control animals (left, 6.0 +/- 0.5; right, 7.0 +/- 0.4). Malondialdehyde (MDA) concentrations were significantly increased in the transplanted left lungs (14 +/- 4) from this group as compared with the controls (5 +/- 7). Five additional dogs underwent left lung autotransplantation with GSH added to the EC cryopreservation fluid. These animals did not develop histologic or radiographic evidence of pulmonary edema, and W/D ratios as well as MDA concentrations were not different from those in controls. To evaluate the effect of ischemia alone on changes in lung GSH concentrations, ten additional dogs underwent left pneumonectomy. Left lungs were cryopreserved in EC + GSH. In five of the animals, the right lung was removed and preserved in EC alone. In the other five animals, the right lung remained in vivo for 3 h and was then removed. Lung GSH concentrations were doubled after 3 h of ischemia when incubated in EC + GSH compared to in vivo controls and to EC-treated lungs. These data suggest that GSH added to the preservation fluid prevents PRR following transplantation and that lung GSH concentrations actually increase during preservation prior to reimplantation and reperfusion if the lung graft is exposed to GSH in the preservation fluid.

Animals↗
PubMed2000

Femoral venoarterial extracorporeal membrane oxygenation for severe reimplantation response after lung transplantation.

Severe pulmonary reimplantation response after lung transplantation is not very common, although the mortality can be high. We present a patient who developed an extremely severe reperfusion injury after bilateral lung transplantation. Because of severe hypoxia and hemodynamic instability, despite aggressive ventilator settings, venoarterial extracorporeal membrane oxygenation (ECMO) was instituted using the femoral approach at the bedside. During ECMO, the patient developed a thoracic wall hematoma that was treated with transfusion alone. After 50 h of ECMO, his chest radiograph had dramatically improved, his oxygen need had been reduced to 50%, and he was successfully weaned from ECMO. Two years later, he is doing extremely well. Therefore, institution of ECMO using the femoral approach can be performed safely at the bedside in the ICU, and can be lifesaving in the context of a very severe reimplantation response after lung transplantation.

Catheters, Indwelling↗
PubMed1996

Value of the staged segmental crossclamp to the aorta technique and reimplantation of intercostal arteries for the prevention of spinal complications associated with surgery for descending and thoraco-abdominal aortic aneurysms.

Spinal complication associated with descending and thoracoabdominal aortic aneurysm surgery is most serious. This report deals with the value of the segmental crossclamp technique and/or reimplantation of intercostal arteries for the prevention of this serious complication. The subjects were 107 patients, 87 with descending thoracic and 21 with thoracoabdominal aortic aneurysm who were operated on from May 1987 to March 1992 at the National Cardiovascular Center in Osaka. The staged segmental crossclamp technique was applied in 24, while the reconstruction of intercostal arteries was undertaken in 25 patients. Thirteen patients received both procedures simultaneously. The surgical and hospital mortality rates were 1.8% and 8.4%, respectively. Spinal complications were encountered in 11 patients (8.3%), paraplegia in 2 (1.8%) and paralysis in 7 (6.5%). The incidence of paraplegia or paralysis did not decrease under the crossclamp technique and/or reimplantation of intercostal arteries, although no spinal complication was observed in the last consecutive 33 cases. It was speculated that although advances in surgical techniques in dealing with these lesions have been obtained, these two procedures did not completely prevent spinal ischemia/complication during surgical intervention.

Aorta↗
PubMed1992

Response to reimplanting beef steers with estradiol benzoate and progesterone: performance, implant absorption pattern, and thyroxine status.

This study determined the influence of the estrogenic ear implant Synovex-S on feedlot performance, tissue deposition, and thyroid status of growing-finishing beef steers implanted either once or reimplanted. The pattern of implant absorption was also determined. Two 112-d feeding trials were used with 48 Hereford steers per trial. Each trial was a randomized block design with eight groups (lots) of six steers each assigned to four treatments (two lots/treatment). Treatments were 1) no implant or control, 2) implanted on d 0 and reimplanted at 60 d on trial, 3) implanted at 30 d on trial, and 4) implanted on d 0 only. These implant treatments resulted in withdrawal periods before slaughter of approximately 60, 90 and 120 d for Treatments 2, 3, and 4, respectively. All steers were given ad libitum access to water and a 60% concentrate diet. Group intakes were determined daily, BW weekly, estimated body composition every 28 d, plasma thyroid hormone concentrations at 112 d and at slaughter, and carcass measurements and liver tissue deiodinase at slaughter. Approximately 25% of the original implant dose remained in the ear 60 d after implanting and this residual amount was absorbed linearly at the rate of approximately .15% of the original dose per day. Implant treatments increased (P less than .05) DMI, BW gain, feed conversion, and empty body gains for water and protein. Carcass measurements suggested a nonsignificant trend (P greater than .10) for leaner carcasses for implanted steers. An immediate shift toward greater protein and less fat deposition occurred within 28 d after initial implanting (Treatment 3).(ABSTRACT TRUNCATED AT 250 WORDS)

Absorption↗
PubMed1986

Response of fall-born calves to progesterone-estradiol benzoate implants and reimplants.

Two trials, involving 469 steer and heifer calves, were conducted to evaluate the practices of implanting or reimplanting suckling fall-born calves with progesterone-estradiol benzoate (PE) implants (100 mg of progesterone, 10 mg of estradiol benzoate). Calves having an average initial weight of 67 kg were randomly allocated within sex and location to remain either nonimplanted or to receive a PE implant in the late fall, in the spring just before green grass, or in both fall and spring. All animals grazed good- to excellent-quality native Bluestem range. Nonimplanted calves in Trial 1 gained .57 kg/d during the winter months and PE implants improved growth rate by 7% to .61 kg/d (P less than .05). Growth rate of calves on dry winter range in Trial 2 was only .20 kg/d, and was not affected by PE implants. Average daily gain of nonimplanted calves during the spring and summer months was .96 and .87 kg/d for trials 1 and 2, respectively. Performance of implanted calves during that period was improved an average of 4.3 to 10% (P less than .05) by PE implants in both trials regardless of when the calves were implanted. Growth rate of calves over the entire 8-mo trials was .66 kg/d for nonimplanted calves and was improved (P less than .01) to .70, .70 and .71 kg/d for calves on the two single-implant and reimplant schedules, respectively. Implanted calves gained an average of 10.4 kg more than nonimplanted calves during the study.

Analysis of Variance↗
PubMed1977

Reimplantation of an amputated hand. Long-term follow-up report.

A case of nearly total amputation of the right hand is described. The hand was reimplanted with initially good result. A final evaluation of the hand was attempted 6 years following the accident. It is concluded that the unsatisfactory nerve regeneration renders the final result a function failure. However, the psychological and cosmetic effect of a real hand may justify the reimplantation.

Adult↗
PubMed1982

Osteogenetic properties of reimplanted decalcified and undecalcified autologous bone in the rabbit radius.

In facial reconstructive surgery extensive studies have been performed to find substitutes to autologous vital bone as grafting material. Decalcified homologous compact bone has been found to possess a capacity of inducing new bone formation in rabbits whereas the application in man has not been successful thus far. In order to investigate the osteogenetic properties in autologous devitalized bone, the difference in bone forming capacity between decalcified and undecalcified devitalized autologous bone was studied. In rabbits, from the radius of each foreleg a piece of bone was resected, rinsed from periosteum and marrow whereupon one was decalcified in 0.6 N HCl. Both pieces were reimplanted in the radial defects 3 days later. The healing process was examined by radiography, light- and fluorescence microscopy. Decalcification seems to accelerate the osteogenetic process when bone is reimplanted to a defect in the rabbit radius.

Animals↗