Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Reoperation”

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 505 records · Page 28Linked to original sources
PubMed1998

[Myocardial protection for cardiac reoperations in patients with valvular disease].

In cardiac reoperations, the less dissection needed, the less potential blood loss from divided epicardial adhesions and the less trauma to the heart. However, minimal cardiac dissection may result in inadequate topical cooling. Therefore the optimal delivery of cardiac solution has a great influence upon postoperative myocardial function in cardiac reoperations. We have examined the effect of the modified Buckberg's method compared to that of simple cold blood cardioplegia in valvular reoperations. In the cases of redo aortic valve procedures, antegrade-retrograde delivery of cardioplegic solution was done in the modified Buckberg's method. It was superior to simple cold blood cardioplegia in terms of the doses of dopamine needed when weaning from cardiopulmonary bypass and the ratio of spontaneous beating after aortic declamping. Nevertheless, myocardial protection measures for hypertrophied myocardium have not yet been established. In particular, reoperations for hypertrophied hearts pose many problems for cardiac surgeons. To achieve better cardiac function postoperatively, further investigations of hypertrophied myocardium are needed at the cellular or molecular level.

Cardioplegic Solutions↗
PubMed1998

[Reoperation after repair of complete transposition of the great arteries].

Atrial switch operation (Mustard operation, Senning operation). Rastelli operation, and arterial switch operation (Jatene operation) have been performed as definitive methods for the repair of complete transportation of the great arteries (TGA). Obstruction of the superior vena cavae and the pulmonary venous tract are common reasons for reoperation after the atrial switch operation. Stenosis of the extracardiac conduit is inevitable after the Rastelli operation is performed. Reconstruction of the right ventricular outflow tract using Danielson's procedures may eliminate the need for reoperation. The REV procedure at the time of initial operation may decrease the incidence of reoperation after the repair of TGA with a ventricular septal defect and left ventricular outflow tract obstruction. Pulmonary stenosis is the most common reason for reoperation after the arterial switch operation. Reconstruction of the pulmonary artery using pacifico's method or the single pantaloon patch technique with autologous pericardium is expected to reduce the occurrence rate of postoperative pulmonary stenosis. Postoperative aortic regurgitation is uncommon and is usually mild in grade. However, because the pulmonary sinus is shallow and fragile compared with the aortic sinus of Valsalva, the durability of neoaortic valves remains to be elucidated during long-term follow-up.

Aortic Valve Insufficiency↗
PubMed1998

[Main causes of reoperation in patients with thyroid cancer].

Under analysis there were 163 reoperations of patients with carcinoma of the thyroid gland. It was established that the most frequent cause of reoperations was the first intervention being inadequate to the kind of the tumor and to the degree of the tumor spread (92 cases). Recurrences and metastases after adequate operations were noted in 29 patients only. The reoperations were complex and included resection of the organs and tissues surrounding the thyroid gland. The hormonal and X-ray treatment was used. Five and more years after the reoperations 110 patients (72.4%) out of 152 followed-up patients were alive.

Adenocarcinoma, Follicular↗
PubMed1997

[Reoperations on the biliary system].

Reoperations of the biliary apparatus is a branch of biliary surgery still not well enough clarified and difficult to cope with. A total of 169 patients are subjected to operation and investigation in the clinic of abdominal surgery. In 71 of them reoperation is undertaken over the period 1952-1973, and in 97--in the period 1974 through 1993, representing 8.7 per cent of all biliary operations done for benign diseases of the biliary apparatus. In 95 per cent of cases the primary operation is related to cholelithiasis (ChL). One-hundred fifty-five cases (92.6 per cent) are reoperated once, nine (5.3 per cent)--twice, and four (0.7 per cent)--three, four and five times. What is more, 56 of the patients are operated in the clinic of abdominal surgery, and 112--elsewhere in surgical units and departments throughout the country. The severer clinical picture, prolonged postoperative period, increased operative risk and worsened prognosis in the latter group are underscored. The underlying causes necessitating secondary corrective intervention are analyzed--76 per cent are conditioned by ChL, and 24 per cent--by the primary operation. The indications for reoperation are classified in three groups: a) failure to remove or partially removed gallbladder, b) in case of preexisting primary, or secondary postoperative development of various forms of cholelithiasis, c) in surgery induced morbid conditions. A table is presented illustrating the character of secondary operations, performed in the series of 168 patients under study, namely: in 20 per cent the gallbladder is operated on, and in 80 per cent--the extrahepatic bile ducts. Postoperative morbidity is higher as compared to the one in primary operations and not infrequently it is conditioned by preexisting complications. Postoperative mortality rate amounts to 10 per cent.

Adult↗
PubMed1998

Macroscopic aspects of cloth-covered Starr-Edwards prostheses at reoperation: what the precursory valve teaches us.

BACKGROUND AND AIMS OF THE STUDY: Cloth-covered Starr-Edwards ball valves were the first choice in prosthetic substitution at the authors' institution between June 1968 and March 1977. This study investigated, retrospectively, macroscopic aspects of the prostheses at reoperation. METHODS: Among 59 survivors who underwent isolated aortic or mitral valve replacement, 12 required reoperation for valve dysfunction (five aortic valve replacements, seven mitral valve replacements). Reoperation was necessitated by valvular endocarditis, paravalvular leak, hemolysis, thromboembolism, orifice stenosis attributable to pannus, and inappropriate sizing related to growth and thrombus. The mean time to reoperation was 11.7 +/- 6.2 years after initial surgery (range: 2 years 4 months to 21 years 8 months). RESULTS: Marked cloth wear was observed in all aortic prostheses, but only slight wear in mitral valves. Pannus formation was observed around the orifice in both aortic and mitral prostheses, but strut cloth was not extensively covered by autologous tissue. In mitral valves, strut cloth was only slightly worn and less loose than that of the aortic valve. These changes notably affected prosthetic valve function, the most significant problem in mitral prostheses being thrombus (four of seven valves). CONCLUSIONS: Pannus formation and thrombus caused by the reaction of the patient's tissues remain major problems in the use of artificial valves, and require further work for their improvement.

Adolescent↗
PubMed1998

Primary and reoperative parathyroid operations in hyperparathyroidism of multiple endocrine neoplasia type 1.

BACKGROUND: Operation and reoperation for hyperparathyroidism in multiple endocrine neoplasia type 1 (MEN 1) is controversial regarding surgical strategy, preoperative localization, and biochemical indexes of recurrence. METHODS: Fifty patients with MEN 1 with hyperparathyroidism were followed up 2 to 27 years after subtotal (SPX; n = 35) or total parathyroidectomy with forearm autografiing (TPX; n = 15), including 24 who underwent 28 reoperations because of persistent or recurrent hyperparathyroidism. RESULTS: Persistent or recurrent hyperparathyroidism was seen in 66% and 20% of patients after SPX involving extirpation of at least 3 glands and TPX, respectively, and 100% after single-gland excision as a primary procedure. After reoperation, hypercalcemia was reversed in 33% of patients by SPX and 61% by intended TPX procedures. All patients received vitamin D substitution after TPX, but restricted thyroid function allowed withdrawal in all but 10 patients (36%). Intact serum parathyroid hormone levels in nongrafted and grafted arms rose with time, but only exceptional ratios localized graft recurrence. Localization of recurrent hyperparathyroidism was achieved with 11C-labeled methionine positron emission tomography. CONCLUSION: MEN 1 hyperparathyroidism has a high risk of recurrence, and operation may include primarily SPX of at least 3 glands or TPX, although the latter includes a higher risk of long-term hypoparathyroidism. Reoperation should involve TPX with recognition of the enhanced recurrence rate in individuals with postoperative hyperparathyroidism.

Adolescent↗
PubMed1976

[Reoperation in bronchial carcinoma (author's transl)].

After lung resections in bronchial carcinoma, reoperation for recurrences, metastases, or secondary primary tumors is rarely possible. The possibility depneds on the extent of the primary resection, the physiological state of the patient, and the spread of the primary or secondary tumor. From 1950 to 1975 1628 lung resections were performed in Düsseldorf, with reoperation in 26 cases (1.6%). n Bremen (1964-1974) 915 lung resections were performed, with 20 reoperations (2.2%). Survival times recorded in Bremen and Düsseldorf and in the literature justify reoperation in individual cases.

Adult↗
PubMed1982

Reoperative surgery in cholelithiasis.

From 1965 to 1980, reoperations for residual or recurrent stones were performed on 78 out of 962 Japanese patients with cholelithiasis. The majority of patients who required reoperation had intrahepatic stones. Most of the causes of reoperation were residual stones due to incomplete removal or the non-detection of intrahepatic stones at the previous surgery. Very careful examination of the intrahepatic biliary trees should be done in patients with biliary tract diseases, because in many, the first operation was done during their youth. To remove the intrahepatic calculi completely, hepatic lobectomy should be considered as a final procedure. The causes of reoperation of common duct stones were residual in 60 per cent and recurrent in 40 per cent. Definitive surgery should be done at the first or at least the second operation to avoid irreversible hepatic disorders which have untoward effects on the prognosis. It is important not only to remove the stones but also to relieve the bile stasis in the biliary tract.

Aged↗
PubMed2005

[Reoperation for primary hyperparathyroidism].

While the initial treatment for primary hyperparathyroidism (pHPT), if managed by an experienced surgeon, is almost always successful, reoperations are challenging. Patients are at high risk for complications and the rates of success are plainly below those of primary cervical explorations. In this paper the reasons for failure during initial procedures are reviewed, as are the most important localization procedures and the prerequisites with regard to technical infrastructure as well as personnel, when planning repeat operations for a missed parathyroid adenoma. Provided that a standardized diagnostic and surgical approach is used, the surgeon is experienced, and up-to-date technical equipment is available, permanent normocalcemia following reoperations in pHPT is more frequently achieved than it used to be. The best option to avoid reoperations and associated complications is a successful initial intervention by an experienced surgeon. However, reoperations should always be performed by an experienced surgeon.

Adenoma↗
PubMed1976

Internal mammary artery bypass graft in reoperative myocardioal revascularization.

Thirty-two consecutive patients who earlier received indirect or direct myocardial revascularization underwent reoperation with one or more internal mammary artery grafts either alone or in combination with saphenous vein grafts. The main indication for reoperation was graft closure or progression of coronary atherosclerosis in nongrafted vessels, or both. Graft construction was performed under normothermic perfusion and anoxic arrest with interrupted suture technique. No intraoperative infarctions or hospital deaths occurred. All patients are alive after an average follow-up period of 20 months, and two thirds are asymptomatic. Arteriography after reoperation in nine patients revealed patency of eight of nine internal mammary artery and five of five secondary vein grafts. When angiographic and symptomatic indications for reoperation exist, the internal mammary artery bypass graft has become a valuable alternative, particularly for patients with small coronary vessels or previous vein graft failure.

Adult↗
PubMed2002

Outcomes after minimally invasive reoperation for gastroesophageal reflux disease.

BACKGROUND: Reoperative antireflux surgery is complex and traditionally performed by open methods. Increasingly, surgeons are performing minimally invasive reoperations. This report summarizes our experience with laparoscopic reoperative antireflux surgery (LRAS). METHODS: A retrospective review (1996 to 2001) identified 80 LRAS cases. Median age was 49 (22 to 80) years with 52 females and 28 males. Primary symptoms included heartburn (53%), regurgitation (22%), and dysphagia (25%). Detailed outcomes recorded at follow-up included heartburn severity using the Gastroesophageal Reflux Disease-Health Related Quality of Life scale (HRQOL) and SF36 physical (PCS) and mental (MCS) component summary scores. RESULTS: LRAS was completed in 97.5% of cases (two conversions). The most common problems identified were mediastinal migration of the wrap in 48 (60%) and misplaced wrap in 11 (13.8%). LRAS operations included Collis-Nissen (42), Nissen (26), Toupet (six), and six others. Pyloroplasty was required in nine (11%). Complications occurred in 16 patients. These included nine minor gastric perforations (all repaired intraoperatively) and two reoperations for complications (1 patient with a bile leak and the second with a pyloroplasty site leak). Median length of stay was 2.5 days. Median follow-up was 18 (1 to 52) months; 18 (23%) required proton-pump inhibitors. Detailed outcomes were available in 50 patients. Mean PCS and MCS scores were 42 and 47, respectively (normals = 50). HRQOL scores were excellent in 35 (65%), satisfactory in 9 (17%), and poor in 10 (18%). Ten patients (18%) reported that they were dissatisfied. CONCLUSIONS: LRAS can be performed safely with complication and success rates similar to open operations in a center with extensive laparoscopic experience.

Adult↗
PubMed1976

Reoperation for recurrent thoracic outlet syndrome.

Recurrent thoracic outlet syndrome that requires reoperation accounts for 1% of first rib resections. Symptoms in a series of 30 patients were mainly neurological and consisted of pain and paresthesia involving the neck, shoulder, arm, and hand and were severe and unrelenting. Recurrence of symptoms ensued from one month to seven years following initial rib resection, with the majority appearing within the first three months. Nerve conduction velocities were diminished to an average of 51 m per second, well below the normal of 72 m per second. Reoperation was required after a period of extensive physiotherapy and muscle relaxants. The high posterior thoracoplasty approach is recommended for all reoperations, as it gives better exposure to achieve safe neurolysis of the plexus and complete excision of the regenerated periosteum and posterior rib remnant, which were present in almost all patients. Results of reoperation were gratifying, and postoperative nerve conduction velocities were improved to an everage of 66 m per second.

Adult↗
PubMed1998

An algorithm for preoperative prediction of reoperation risk after internal fixation of femoral neck fractures.

An algorithm was designed for preoperative prediction of the risk for reoperation, and the mortality risk, after internal fixation of femoral neck fractures. Out of 51 reviewed studies of femoral neck fractures, eight met specified inclusion criteria such as low dropout rates, a minimum of ten surgeons performing the surgery, a minimum of 2 years follow-up, and a standard age, sex, and Garden class distribution. Five of these studies were used for the construction of the algorithm, and the remaining three for testing the specificity and sensitivity of the algorithm. A separate analysis of the influence of age on the reoperation rate was also performed. In the analysis of 399 reviewed cases of femoral neck fractures, the specificity for the algorithm in predicting the risk for reoperation was 96%, and the sensitivity was 51%. The positive predictive value for the algorithm in predicting the risk for reoperation was 77%, which was three times higher compared to the commonly used predictors age and Garden class (positive predictive value 25%). For prediction of the mortality risk the positive predictive value for-the algorithm was 57%.

Aged↗
PubMed1999

Vascular surgical society of great britain and ireland: Re-evaluation of criteria for reoperation in carotid endarterectomy using intraoperative duplex imaging

BACKGROUND: The aim of this study was to compare data obtained during surgery with data collected at 6 weeks after operation to evaluate appropriate criteria for reoperation. METHODS: One hundred and twenty consecutive patients undergoing carotid endarterectomy had duplex scans at operation and 6 weeks later. Neurological evaluation was also documented. RESULTS: Of 96 patients who had a normal intraoperative duplex scan by standard criteria, 91 had normal scans at 6 weeks. One occluded an internal carotid artery (ICA) at 6 weeks with no symptoms. Four had kinks or high-grade contralateral lesions leading to velocity enhancement but no filling defect. All were asymptomatic. Twenty-four patients had abnormal intraoperative scans. Thirteen patients had visible kinking of the ICA or reperfusion hyperaemia; 12 of these patients had normal 6-week scans and one had a mild residual kink but no symptoms. Eleven patients had visible colour-filling defects and significant velocity enhancement. Nine of these were reopened and refashioned. Subsequent duplex imaging was satisfactory in all cases and 6-week scans were normal. One patient had an occluded ICA at operation and developed a dense stroke after operation. Another had residual raised velocities distally which remained at 6 weeks. This patient had no symptoms. CONCLUSION: Intraoperative velocity measurements alone cannot be relied upon as an indication for reoperation. Significant velocity enhancement combined with a visible filling defect appears to represent a satisfactory criterion for reoperation. There were no complications as a result of reoperation. There was no early restenosis in the whole group and there were no neurological sequelae in any patient with a satisfactory scan using the above criteria.

Journal Article↗
PubMedDate not supplied

Reoperation rate following lumbar discectomy. An analysis of 662 lumbar discectomies.

A retrospective study of 560 patients having a first lumbar discectomy performed by one surgeon in his first ten years of practice was carried out. Sixty-three repeat operations were carried out on these patients and 39 were carried out on patients originally operated upon by other surgeons. These 662 operations were analyzed. Factors possibly associated with recurrent episodes of back and leg pain or reoperations were studied. Significant associations were found between these episodes and year of operation, level and type of operation, and the presence or absence of compensation. The overall reoperation rate was 11.8%. Increased operator experience resulted in fewer reoperations. The results of reoperation were comparable to the results of the original surgery. Complications were minor and the rate was 2%.

Adolescent↗
PubMed1980

Reoperation for bronchial carcinoma.

After a primary operation for bronchial carcinoma, 17 patients underwent reoperation for local recurrence or intrathoracic metastasis (nine squamous cell, five alveolar cell, and three adenocarcinomas). The average interval between the first and second operation was 23 months (range: six to 48 months). Twelve patients had a pneumonectomy after an initial ipsilateral lobectomy. Five patients underwent contralateral wedge excision after initial lobectomy or wedge excision. Three patients died within 30 days of the reoperation. Eight of the remaining 14 patients died subsequently, the time of survival averaging 18 months (range: three to 54 months). Six patients are still alive, two having survived their reoperation for more than five years. Reoperation for recurrent bronchial carcinoma is rarely performed, but it should be considered in all cases where patients survive operation for lung cancer if the primary operation was thought to be radical.

Adenocarcinoma↗
PubMed1998

Evidence-based review of the role of reoperation in the management of malignant glioma.

Using an evidence-based approach to available clinical studies, the authors examined the role of reoperation in the management of malignant glioma. A review of 1270 Medline-referenced articles spanning the period from 1966 through March 1998 was undertaken using the key words "glioblastoma" and "astrocytoma." Using an evidence-based four-tiered grading system, the authors found only 14 articles that met their inclusion criteria. Of these, 11 were graded as Class III (retrospective case series) and three as Class II (prospective nonrandomized studies). There were no Class I reports (randomized clinical trials), and all Class IV reports (opinion reports) were excluded. The authors of 10 Class III and one Class II articles supported the role of reoperation in increasing survival time or quality of life in selected patients; however, the results of multivariate analysis in two Class II and one Class III article did not support prolonged survival. The authors conclude that there was insufficient evidence to support either a standard or a guideline for reoperation in malignant glioma given the current status of the literature. Selection bias was a major factor in these studies. With continued interest in clinical trials for recurrent malignant glioma, the role of reoperation needs to be addressed in case-controlled or randomized fashion to establish either standards or guidelines on this commonly debated issue.

Journal Article↗
PubMed1986

Reoperation for stenotic saphenous vein bypass grafts without cardiopulmonary bypass or shunt.

From October 1982 through February 1985, six patients have undergone seven reoperative revascularization procedures for stenosis of coronary artery vein bypass grafts without the use of cardiopulmonary bypass or intraoperative shunt. All patients had prior coronary artery saphenous vein bypasses, ranging from 2 months to 5 years preoperatively. All patients survived reoperation and there was no morbidity. Patients have been followed-up to 26 months. One patient underwent postoperative cardiac catheterization at 1 year, which revealed a patent interposition graft, and one patient had a second operation for restenosis of a vein graft. To decrease the risk of morbidity and mortality in reoperative procedures for saphenous vein graft stenosis, a technique is described that avoids the use of cardiopulmonary bypass or intraoperative shunt. This technique has been used successfully for seven reoperative revascularization procedures and is recommended for selected cases.

Journal Article↗