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At least 865 records · Page 48Linked to original sources
PubMed2005

[Reoperation for postoperative constipation recurrences of Hirschsprung disease].

OBJECTIVE: To summarize the causes and treatment experiences of postoperative constipation recurrences of Hirschsprung disease. METHODS: Clinical data of 37 cases receiving operation again for postoperative constipation recurrences of Hirschsprung disease were collected. The recurrent causes, reoperation procedures and therapeutic efficacy were analyzed. RESULTS: Among 37 cases, the recurrent causes included insufficient resection of the intestine in 14 cases, co-existent intestinal neural hypogenesis in 6, gate syndrome in 5, and others in 12 cases. There was no postoperative death. Thirty-one cases (83.8%) were followed-up from 6 months to 11 years. The defecation frequency was 1-2 times per day in 15 cases, one times per two days in 7, one times per three days in 6 cases. Two cases could defecate with the help of laxative purgatives. Nobody had incontinence. CONCLUSION: The main cause of postoperative constipation recurrences of Hirschsprung disease is insufficient resection of the intestine,and reoperation can get better results.

Child↗
PubMed2006

Fate of the autograft and homograft following Ross aortic valve replacement: reoperative frequency, outcome, and management.

BACKGROUND AND AIM OF THE STUDY: The optimal hemodynamic performance and potential for growth of the pulmonary autograft has led to expanded indications for the Ross aortic valve replacement (AVR) procedure in some centers. The authors' institutional mid-term experience was reviewed to assess autograft and homograft hemodynamics, growth profile of the autograft, and reoperative frequency following Ross AVR. METHODS: Between June 1993 and June 2005, 167 consecutive patients (mean age 24.9 +/- 15.5 years; range: 1 month to 61 years) underwent Ross AVR: 48% of patients were aged < 19 years. Additional procedures (n = 78) were performed in 55 patients (33%) at the time of the Ross procedure. In total, 151 patients had isolated aortic valve disease and 16 pediatric patients had more complex, multi-level left ventricular outflow tract obstruction. RESULTS: There were two early deaths (1.2%) and one late death (0.6%) over a mean follow up of 5.1 +/- 3.0 years (range: 1 month to 11 years). Actuarial survival at 10 years was 98%. In pediatric patients with Konno procedure (n = 16), the pulmonary autograft mean annulus diameter increased from 10.2 to 19.9 mm. Twelve patients underwent 12 reoperations without mortality for autograft insufficiency or an ascending aortic aneurysm at a median interval of 5 years (range: 2 to 8 years): aortic annuloplasty and ascending aorta replacement (n = 4), composite aortic root replacement (n = 7), and repair of left ventricular pseudoaneurysm (n = 1). Freedom from replacement of the pulmonary autograft was 96% at 10 years. Five of the 164 surviving patients (3%) developed significant obstruction of the pulmonary homograft and required conduit replacement at a median of four years. CONCLUSION: The Ross AVR can be performed with good mid-term results, including the pediatric age group. The potential for development of significant autograft insufficiency and homograft stenosis warrants annual follow up through the intermediate and late terms.

Adolescent↗
PubMed1991

[The classification of cryosurgical resections of the liver in reoperated patients].

The authors present a classification of cryosurgical operations in resection of the liver in reoperated patients. The basis of this classification is different combination of usual and cryosurgical (cryoresection and cryodestruction) methods, which allow to increase the radicality of the operations. Ten kinds of cryointerventions (5 radical and 5 palliative) were established. The classification proposed allows the operative volume for resection of the liver in reoperated patients to be correctly planned.

Cryosurgery↗
PubMed1991

[Reoperations in primary hyperparathyroidism].

We report on 14 patients suffering from persistent (n = 13) and truly recurrent (n = 1) primary hyperparathyroidism. Reoperations were successful in 13 cases. Cervical reexploration was only required for 5 patients who had previous operations by unexperienced surgeons in other clinics. In 5 out of 7 patients operated by us, the causes of the persistent primary hyperparathyroidism were 4 adenomas and one hyperplastic gland in the mediastinum found by median sternotomy. The remaining cases were a rare ectopic location of the inferior glands and an inadequate resection in four-gland-hyperplasia. Preoperative localization procedures were carried out for most patients. 201-Tl/99m-Tc-subtraction scintigraphy has proved for localization in both the cervical region and the mediastinum to be a highly sensitive method. Reoperative parathyroid surgery can be reduced with thorough initial cervical exploration by experienced surgeons in specialized clinics.

Adenoma↗
PubMed1991

Morbidity and mortality of reoperation for coronary artery bypass grafting: significance of atheromatous vein grafts.

Reoperation ('redo') for coronary artery disease shows a significant increase in morbidity and mortality compared to primary surgery. Some technical approaches have been advocated to decrease myocardial injury, presumably due to coronary artery embolization from atheromatous vein grafts. From 1984 to 1989, 321 'redo' operations were performed at the Montreal Heart Institute. Patients with patent and atherosclerotic vein grafts at preoperative coronary angiography (239 patients) were compared to those with normal or occluded grafts (82 patients). Perioperative myocardial infarction and death rates were 19% and 13%, respectively. They were particularly high among patients with three or more patent and atherosclerotic vein grafts at reoperation (32% and 29%, respectively). Among the 239 patients with patent atherosclerotic grafts, the results of three different surgical techniques were studied retrospectively. A first group of 66 patients had early ligation of patent atheromatous grafts before cardioplegia was administered by antegrade infusion during single aortic clamping for coronary anastomoses, and maintained for the confection of aortic anastomoses. In a second group of 35 patients, early ligation of diseased graft, antegrade cardioplegic delivery, and partial aortic cross clamping for aortic anastomoses of vein grafts was done. In the third group of 138 patients, venous grafts were not interrupted before antegrade cardioplegic infusion and partial aortic cross clamping for aortic anastomoses of vein grafts was used. No significant difference in hospital mortality or perioperative myocardial infarction rate was observed between the three groups of patients. Thus, the modified techniques so far recommended for repeat coronary artery bypass grafting, such as early ligation of patent atherosclerotic grafts, have failed to improve the early results of 'redo' operations.

Adult↗
PubMed1991

[Reoperations after the treatment of retinal detachment].

Presented is an analysis of the clinical material comprising 100 patients in whom in the period of 1980-1989 one performed reoperations of retinal detachment. It was established that the most frequent causes--as well surgical failures as recurrences--were the vitreo-retinal proliferations and the insufficient closing of the holes. Reattachment of the retina after the second operation was attained in 42 p.c. of the eyes and after the third one in additionally 7 p.c. In cases with a reattached retina a very good visual acuity for far was found in 1/4 and for near in 1/2 of operated eyes. The results obtained are encouraging enough for the performance of reoperations.

Adolescent↗
PubMed1991

[Two reoperative cases of annuloaortic ectasia with Cabrol's method].

Two reoperative cases of annuloaortic ectasia are reported. Since they have problems such as adhesion and friability of tissues, bleeding from each anastomosed sites must be watched carefully. Especially, anastomoses of aortic annulus and the composite graft, coronary ostia and the interposed conduit are important. Appropriate anastomosis of aortic annulus needs flexibility at the proximal edge of the composite graft. It can be achieved by sewing Björk-Shiley prosthetic valve about 5 mm distant from the proximal edge of the composite graft. Cabrol's method is good for anastomoses of coronary ostia because easily visualized and less stressed anastomoses can be performed. Therefore Cabrol's method with flexible edge of the composite graft at the proximal site is a useful technique in the reoperation of annuloaortic ectasia.

Anastomosis, Surgical↗
PubMedDate not supplied

[Reoperation following failure of anti-reflux surgery].

Reoperation is the treatment of choice of failed antireflux procedures. Preoperative full-scale evaluation of both residual anatomy and function of the upper digestive tract is mandatory. Conservative surgery is almost always feasible. Success rate of reoperations is high with experienced teams.

Gastroesophageal Reflux↗
PubMed1990

[Early reoperation for infection in orthopedic surgery of the leg (arthroplasties and hip surgical procedures excluded)].

The authors report 32 cases of post-operative infections reoperated before the first month of which 12 articular fractures of the tibia. 6 tibial osteotomies of valgisation, 6 tibial diaphyseal fractures, 2 fractures of the lower extremity of the femur, 2 bimalleolar fractures, 1 serious knee sprain, 1 patellar fracture, 1 calcaneum fracture and an arthroscopic arthrolysis of the knee. Twelve of them had an articular infection. Globally, they have obtained 22 satisfactory results (very good or good) and 10 non satisfactory results out of which 2 deaths and 1 amputation. The bad results were due either to a particularly aggressive germ (streptococcus and gas gangrene), or to an articular infection insufficiently controlled: 5 out of the 10 arthrites on infected articular fractures have had a non satisfactory result. As for metaphyseal infections, a simple cleaning has given 4 very good results out of 6, the 2 excluded being very serious and special cases. For the 6 diaphyseal leg infections after osteosynthesis, the early reoperation has not avoided a secundary graft in a picture of infected pseudoarthrosis. In view of this series, the authors propose to adapt the cleaning operation to the localisation and to the presence or not of an articular infection.

Adolescent↗
PubMed1990

[Selection of the method of reoperation after closure of perforated duodenal ulcer].

The work deals with the study of the fate of patients who underwent closure of a perforated opening in a duodenal ulcer. In 27-53% of such patients subsequent nonoperative treatment was ineffective and they were subjected to reoperation: resection of the stomach or vagotomy. After comparative evaluation of these two reoperations on the grounds of the clinical data and the secretory and evacuating function of the stomach which had been operated on, the authors give preference to selective proximal vagotomy as an operation that is more physiological and devoid of the short-comings of gastric resection.

Adult↗
PubMed1990

[Reoperation for para-esophageal hiatal hernia following fundus plication].

A paraesophageal hiatus hernia was found in 15 of 86 patients examined radiologically due to symptoms after fundoplication (Nissen-Rosetti). 7 patients were reoperated 4 months to 12 years after fundoplication. Hernia repair was achieved by narrowing of the hiatus with sutures (4), attachment of the left lobe of the liver (1) or a Gore-tex patch (1). Additional surgical measures were fundophrenicopexy (4) and ventral corpopexy (4). At follow-up 2-19 years later, 4 of 5 patients had symptomatic improvement but none was symptom free. On x-ray 2 patients had recurrent paraesophageal hernias and 1 patient a slipped fundoplication. We conclude that reoperation for paraesophageal hiatus hernia after fundoplication, with the attendant technical difficulties, is only indicated if severe symptoms are present.

Adult↗
PubMed1985

Rationale of reoperation for gastric malignancies.

The aim of this retrospective study was to elucidate the role and rationale of reoperation for tumour recurrence in 47 consecutive patients operated on for gastric cancer. The overall operative mortality was 26%, morbidity 45%, mean and median survivals 14 +/- 25 and 5 months, respectively postoperative symptom free period 8 +/- 23 months, and cumulative 5-year survival 8 +/- 3%. Bypass procedures and resection carried the lowest mortality, 7% and 20%, respectively whereas the corresponding percentages after colostomy, exploratory laparotomy and jejunostomy were 33%, 40% and 50%. Resection yielded a significantly longer mean (41 +/- 44 mos) and median (82 mos) survival than other procedures. The postoperative symptom free period after resection (34 +/- 42 mos) was significantly longer than after exploratory laparotomy and bypass procedures, whereas the difference between resection and enterostomy was insignificant. After exploratory laparotomy, colo- and jejunostomy the median survivals were under 2 months. We conclude that only resection, when possible, favourably affects survival and emphasize the importance of regular endoscopic follow-up after operation for gastric cancer. Resection and bypass procedures are most suitable for long-lasting palliation at reoperation for gastric malignancy. Unnecessary laparotomies, if the diagnosis can be confirmed by other means, and useless jejunostomies should be avoided in patients with far-advanced metastatic disease and short life expectancy.

Adult↗
PubMed1989

The use of somatosensory evoked potential during revision or reoperation for total hip arthroplasty.

Somatosensory evoked potential (SSEP) was used to continuously monitor the sciatic nerve intraoperatively during revision or reoperation for total hip arthroplasty. Of 25 cases monitored, eight patients (32%) exhibited 12 instances of SSEP deterioration, indicating neurologic compromise. These neurologic problems were due to retraction in seven cases and limb positioning in five. No postoperative neurologic deficits were noted in this group. Two of 35 patients (5.7%) not monitored had postoperative neurologic deficits. SSEP monitoring is a useful method for minimizing the intraoperative risks of clinical neurologic deficits during revisions or difficult reoperations.

Adult↗
PubMed1989

[Malfunction of the Björk-Shiley valve prosthesis due to disc defacement--report of two cases of successful reoperation].

Derlin-disc model Björk-Shiley valve prosthesis was reoperated due to the disc defacement. One had admitted cerebral embolism which was suggested due to the prosthetic valve malfunction of aortic position and the other had congestive heart failure due to the malfunction of mitral position. These patients had implanted Derlin-disc model Björk-Shiley valve prosthesis in the aortic and mitral position 10 and 11 years ago. One's cineangiocardiography showed mild aortic regurgitation and the other showed mitral regurgitation due to the malfunction of the prosthesis. The episode of cerebral embolism in one patient was suggested due to the malfunction of aortic prosthetic valve, and congestive heart failure in the other patient was due to the malfunction of mitral prosthetic valve. These prostheses which removed at the reoperation were observed with strat shape indentation and distinct of the disc which resulted the malfunction of the prostheses. In patient who replaced with Derlin-disc model Björk-Shiley valve prosthesis should be carefully followed up.

Aortic Valve↗
PubMedDate not supplied

Reoperation in treatment of clubfoot.

We evaluated 118 operations (including 57 reoperations) on clubfeet. We concluded that relapse is most often the consequence of insufficient primary surgery, and the less sufficient the intervention, the more severe the relapse or residual deformity. The severity of deformity is determined and shown, first of all, by the position of calcaneum. In milder cases, soft tissue operation can prove useful, whereas more severe cases require bony intervention as well. The second, rarer cause of relapse was the fact that the foot was originally stiff and nonreducible. These feet may need multiple reoperations.

Arthroplasty↗
PubMed1988

[Laparostomy and planned reoperations in the complex treatment of suppurative pancreatitis].

An experience with using laparostomy and planned reoperations in 22 patients with purulent pancreatitis is presented. A method of creation of open controlled drainage cavity is described which allows to make the timely and adequate revision of the pancreato-duodenal zone and other organs of the abdominal cavity in planned relaparotomies. Criteria of choice of the optimal terms of reoperations are proposed.

Abdominal Muscles↗
PubMed1988

Bilateral renal tumours with reference to the reoperation of a solitary kidney resected for tumour.

A case of bilateral renal tumour is reviewed, where the disease was detected by sonography performed for screening. On one side, nephrectomy, while on the other, partial resection of the kidney were performed in two sessions. Due to occlusion and a resultant renal fistula produced by scar tissue following the second operation as well as to progressive azotaemia, reoperation of the solitary kidney resected for tumour became necessary. As a result of the failure of both cytostatic and radiotherapy, the authors believe that, in similar cases, every surgical method possible should be used for prolonging the patient's life. In the available literature no reference has been found on the reoperation of solitary kidney resected for malignant tumour.

Adenocarcinoma↗
PubMed1988

[Clinical anatomy of the upper part of the abdominal cavity in reoperations on the stomach after organ-sparing surgery].

Based upon intraoperative observations and analysis of anatomo-surgical findings in 50 patients subjected to reoperations after selective proximal vagotomy the authors have established 3 stages of anatomical alterations of organs of the upper part of the abdominal cavity. Performing antrumectomy is thought to be possible as reoperation in the first stage and in the less degree in the second stage. Extensive resection is indicated to patients with the third stage of the alterations.

Cicatrix↗