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At least 937 records · Page 52Linked to original sources
PubMed1994

[Reoperation for tetralogy of Fallot].

We experienced 6 cases of reoperations after the intracardiac repair of tetralogy of Fallot between Nov. 1991 and Feb. 1994. Mild to moderate left to right shunts and pulmonary stenosis were observed in all patients. Pulmonary insufficiency was detected by echocardiography in all patients but one. All diagnosed residual problems were repaired at this time of operations. Cardiac parameters such as CTR, left and right ventricular dimensions were all improved in the association of NYHA improvement. The % changes of ventricular dimensions were influenced by the severity of shunt and pressure gradient. Perioperative pressure-volume loops demonstrated that the degree of left to right shunt correlated with the % changes of stroke work and pressure-volume area, which were considered to determine the myocardial oxygen demand. Thus the repairs reduced certainly the oxygen demand of the heart. We concluded that the residual complications could be safely handled by the reoperation and the repairs were extremely meaningful for the quality of life in patients.

Adolescent↗
PubMed1994

[Reoperation for valvular heart disease: its operative procedure and result].

From April, 1983 to March, 1993, 63 patients (pts) underwent reoperations of valvular heart disease at Tokyo Medical and Dental University Hospital, of which 44 pts had undergone closed mitral commissurotomy (CMC), open aortic or mitral commissurotomy (OAC or OMC) or valvuloplasty, and 17 pts had undergone aortic or mitral valve replacement (AVR or MVR). Valve replacement was performed in 59 pts (mechanical valve replacement; 42 pts, porcine valve replacement; 12 pts), and 2 pts received OMC due to restenosis after CMC. Preoperative diagnosis included restenosis after CMC, OMC or valvuloplasty in 43 pts, bioprosthetic dysfunction after MVR in 10 pts, perivalvular leakage after AVR in 1 pt, valve detachment after AVR in 4 pts (Beçhet 3 pts, infective endocarditis 1 pts). Valve replacement or valvuloplasty was done for another valves in addition to the previously operated valve in 44 pts (72.1%), especially for tricuspid valve. Restenosis after CMC, occurred at 20.6 years after surgery, and restenosis after OMC and valvuloplasty at 13.1 years. Bioprosthetic dysfunction after MVR occurred at 8.5 years. Valve dysfunction of the mechanical valve was not observed. The early operative mortality after reoperations was 11.5% (7 pts) in this series. And 3 pts (4.9%) died in the late follow-up due to cancer in 1 pt and congestive heart failure in 2 pts. A first choice of mechanical valve for redo valve replacement for aortic/mitral valve, and modified AVR using composite graft and proximal double fixation to the fragile annulus seemed to be satisfactory to accomplish better operative results.

Adolescent↗
PubMed1997

[Evaluation of reoperation results in patients after heart valve bioprosthesis implantation failure due to degeneration].

UNLABELLED: A retrospective study was conducted on 17 patients (11 female and 6 male) who underwent re-replacement of previously implanted bioprosthesis for it's structural failure in the period from 1989 until 1997. 1 of the patients was in NYHA class II, 7 in III and 9 in IV. There were 18 mechanical prostheses and 4 bioprostheses implanted during the reoperations. On 1 patient the procedure described by Geha was performed (the leaflets of damaged valve were excised and a reversed aortic St. Jude prosthesis was implanted). In almost all cases the postoperative period was complicated. There were 2 (11%) postoperative deaths. CONCLUSIONS: 1. The dysfunction of bioprosthesis is most often caused by leaflet calcification and thickening. Degeneration is faster in prostheses implanted in the mitral position. 2. The outcomes of the re-replacements are similar to those of the patients in the corresponding NYHA class after first replacement but the postoperative period may be more complicated. 3. The low prevalence of reoperation affirms the suitability of the bioprosthesis for selected patients over 65 years and for aortic valve replacement.

Adult↗
PubMed1998

Predicting the need for reoperation for abdominal infection.

Abdominal infection complicating abdominal operation is a serious clinical problem that is subject to diagnostic delay, which is a risk factor for adverse outcomes. Clinical examination and laboratory and imaging modalities become more accurate at achieving a diagnosis once the patient becomes sicker from infection but cannot reliably predict the need for reoperation early in the postoperative course. The Abdominal Reoperation Predictive Index scoring system synthesizes common sense and objective measurements in an attempt to predict the need for reintervention before it is too late. We encourage other centers to test this predictor in their own patient populations.

Abdomen↗
PubMed1998

[The effect of the primary operation on reoperations on the thyroid gland].

The authors analyze the possibility to reduce the number of reoperations of the thyroid gland, based on a group of thyroid operations performed at the Surgical Clinic of the Second Medical Faculty Charles University and Faculty Hospital Motol during the 22-year period from 1975-1997. 507 reoperations from a total number of 4501 thyroid operations amount to 11.3%. In the authors opinion correct indication of the operation is most important as well as the correct extent and technique of the primary operation. The achieved results are except for unilateral temporary lesions of the NLR comparable with primary operations.

Adolescent↗
PubMed1976

Results of reoperation for failed aortocoronary bypass grafts.

Thirty-one patients underwent reoperation for failure of one or more previous aortocoronary bypass grafts. Thirty-nine grafts were replaced. Twenty-four grafts were constructed to vessels not thought to be significantly diseased at initial operation. There were no early or late deaths. Postoperative morbidity was comparable to initial prodecures. Of 24 patients followed up for more than six months., 62% clearly experienced improvement without evidence of perioperative or postoperative infarction. Reoperation for failed aortocoronary bypass grafts can be achieved without excess risk, but with long-term results less optimistic than initial procedures.

Arm↗
PubMed1976

[Reoperation in recurrence of carcinoma of the esophagus, Cardia and stomach (author's transl)].

Reoperative surgery is performed with the object of restoring gastrointestinal passage or of pain relief and only rarely, for example in recurrence of an early carcinoma, with the object of curative resection. Out of 31 reoperations for such a purpose, a second resection (total or extended gastrectomy) was possible in 9 cases, gastric bypass or some other palliative operation in 12; in 10 cases, only a laparotomy was possible. The interval between the 1st and 2nd operations was 29 months in the resectable group and 17 months in the nonresectable group, the survival times 11 and 3.3 months respectively. Indications have to be considered separately for each patient.

Adult↗
PubMed1978

Reoperation after initial treatment of endometriosis with conservative surgery.

One hundred and fifty-three patients with pelvic endometriosis met the study criteria of inferility, tissue diagnosis, treatment with conservative surgery, and adequate follow-up. The extent of disease was classified according to Acosta and and associates. Pregnancy rates were 10 to 100% in various subclassifications of patients; these pregnancy rates were related to the extent of disease and the existence of concurrent inferitility factors. One hundred and seventeen patients were followed up for three years. Reoperation in this group was carried out in 28 patients for recurrent pain and/or persistent infertility. Each patient had diagnostic laparoscopy preceding relaparotomy. The reoperation rate was 40.6% in those patients who remained infertile, whereas this rate was only 3.7% in those patients who conceived following initial operation. The incidence of conception after a second conservative procedure was 12%. However, an equal number of patients in this group required total abdominal hysterectomy as a third procedure for control of recurrent pain. Thus, repeat conservative surgery should play a secondary role in the treatment of patients with infertility and recurrent endometriosis.

Anovulation↗
PubMed1975

Reoperation after esophagomyotomy for achalasia of the esophagus.

Eleven patients who required reoperation for persistent or recurrent symptoms after esophagomyotomy are reported on. Failure of the original operation was attributed to inadequate myotomy in three, healed myotomy in four, and reflux esophagitis in four. The myotomy was extended or a new myotomy created in the first two categories of patients. Three of the four patients with reflux esophagitis were treated by antrectomy and Roux-en-Y esophagojejunostomy; one of these also required concomitant exision of the esophagogastric junction because of stricture. The fourth patient with esophagitis ultimately required colonic interposition for relief of symptoms. Ten of the eleven patients were improved after reoperation, but results were less good than those achieved by a properly performed primary esophagomyotomy. This -re-emphasizes the need for attention to the technical details of esophagomyotomy if good results are to be achieved.

Adult↗
PubMed1975

Reoperative parathyroid surgery.

Reoperative parathyroid surgery is associated with a high mortality and morbidity. Morbidity consists of uncorrected hypercalcemia, hypoparathyroidism, and recurrent nerve injury. Initial operative failure is most frequently a result of not identifying four parathyroid glands. On reoperation, parathyroid glands are most often found in the neck and are usually hyperplastic. It is recommended that before attempting rexploration for parathyroid disease, all the patient's records especially the operative note and the previous pathology material should be reviewed. Preoperative localization by selective venous catheterization is of great use in the management of this type of patient.

Adenoma↗
PubMed1985

Extrapelvic colon--areas of failure in a reoperation series: implications for adjuvant therapy.

A total of 230 patients had planned single or multiple reoperative procedures following "curative" resection of colorectal cancer at the University of Minnesota. The site of the primary lesion was extrapelvic in 91, and later evidence of cancer was found in 58 patients (64%) at re-operation and/or other follow-up. Eight of the 58 (14%) were converted to disease-free status. Incidence and patterns of failure were correlated with initial operative-pathologic extent of disease (87 of the 91 at risk had initial tumor extension beyond the bowel wall, involved nodes or both) and comparisons were made with the previously analyzed rectal reoperation patients. While a component of local-regional failure was more common with rectal lesions (48/74 at risk, 65%), it was not uncommon with extrapelvic primaries (44/91-48%). The incidence of hematogenous metastasis (DM) was equal, but the pattern of initial DM differed (extrapelvic colon--primarily liver; rectum--liver and lung). Peritoneal seeding was a more common component of failure with the extrapelvic primaries (19/91--21% vs 3/74-4%). Since surgery alone is inadequate treatment for many patients with colon as well as rectal cancer, the rationale of adjuvant radiation and systemic therapy, alone or in combination, is discussed.

Carcinoma↗
PubMed1977

Reoperation for dysfunction of the Björk-Shiley mitral disc prosthesis: report of eight cases.

Of 193 patients with Björk-Shiley mitral valve prostheses, replacement was necessary in 8 (4.1%). The reasons for reoperation were: detachment (4), thrombosis (1), technical error (1), and late disc entrapment (2). Five of these patients died (62.5%), the death being directly related to the need for urgent operation because of low cardiac output. We recommend avoiding the use of the larger sized Björk-Shiley prostheses, since striking of the disc against the ventricle wall, probably consequent to postoperative decrease in heart size, may appear even 1 year after implantation of the prosthesis. An early diagnosis and early reoperation offer these patients a much more favorable prognosis.

Adult↗
PubMed1978

The determinants of survival following reoperation on prosthetic cardiac valves.

In an effort to identify the determinants of survival following reoperation on patients with prosthetic cardiac valves, the experience with a group of 33 patients at the University of Rochester Medical Center was reviewed. The survival rate was 58% (19/33). Survival was not related to the valve involved, the age of the patient, or the technical hazards of a second cardiac operation. Ten (77%) of the 13 patients in New York Heart Association (NYHA) Functional Class II survived compared with 8 (40%) of the 20 in Class III or IV. The survival rate for patients with a paravalvular fistula was 79% (11/14); with valve dysfunction, 50% (6/12); and with prosthetic valve infection, 29% (2/7). The determinants of survival seem to be similar to those for primary operation (i. e., NYHA patient classification and indication for operation) and less related to the potential operative complications of a reoperation.

Age Factors↗
PubMed1996

Endometrial Resection and Late Reoperation in the Treatment of Menorrhagia

We evaluated the effectiveness of transcervical resection of the endometrium (TCRE) and the indications of late reoperations in 250 women with dysfunctional bleeding. The women were questioned about symptoms and levels of satisfaction 3, 12, 24, 36, and 48 months after the procedure. Average follow-up was 24 months (range 4-48 mo). Repeat resection was performed in 8 women (3.2%) and hysterectomy in 13 (5.2%). Seven women (2.8%) had reoperation because of recurrent unacceptable vaginal bleeding. Late onset of pain occurred in 14 (5.6%). The success rate at 3 months as measured by patient satisfaction was 97% and at 4 to 45 months 91%. A definite subgroup of women developed late onset of pain with or without bleeding after endometrial resection. Results at 3 months did not necessarily correlate with longer-term outcomes. Provided that the surgeon has extensive training, few women will be dissatisfied with the procedure.

Journal Article↗
PubMed1978

Leftsided thoracotomy for coronary artery reoperation.

3 cases of coronary reoperations are described in which a leftsided thoracotomy offered considerable advantages. This approach is recommended for certain types of reoperations on the left coronary system.

Coronary Artery Bypass↗
PubMed1980

Mortality patterns following internal fixation for acute femoral neck fractures in the elderly with special emphasis on potential excess mortality following reoperations.

Mortality patterns and excess mortality have been studied and quantified in 103 patients treated with internal fixation for acute, displaced femoral neck fractures with special emphasis on the potential excess mortality which may follow later operations for capital necrosis, failure of the osteosynthesis, etc. Of 103 patients studied 31 needed one or more reoperations. We have confirmed previously published reports that excess mortality is limited to the first six months after the primary operation. Quantification of the excess mortality which may follow reoperations shows that later operations are not followed by an increased death rate compared with the standard population.

Aged↗
PubMed2004

Initial experience with staged buccal graft (Bracka) hypospadias reoperations.

PURPOSE: We report outcomes from staged buccal graft urethroplasty after failed hypospadias surgery. MATERIALS AND METHODS: When the urethral plate had been excised or was visibly scarred after prior surgery patients underwent staged buccal graft repair. In the first operation persistent penile curvature was corrected, a proximal cutaneous urethrostomy was created, scarred tissues distally were excised and buccal graft was quilted into place for subsequent urethroplasty. At least 6 months later the now revascularized buccal strip was tubularized and covered with a dartos or tunica vaginalis flap. RESULTS: A total of 25 patients underwent stage 1 repair following an average of 4.4 prior hypospadias surgeries. Complete graft take occurred in 22 (88%) cases while the remaining 3 had focal scar or graft contracture that was successfully patched before tubularization. To date 20 patients have undergone the stage 2. There were no cases of meatal stenosis, neourethral stricture or diverticulum. A fistula occurred in 1 (5%) of 18 cases in which a flap barrier layer was used. Partial glans dehiscence occurred in 4 prepubertal boys with graft obtained from the cheek, and they have undergone successful reoperative glansplasty. All patients completing surgery have a vertical slit neomeatus. CONCLUSIONS: Staged buccal graft reoperation reliably creates a well vascularized substitute urethral plate for tubularization with low complication rates and good cosmetic outcomes. Inner lip, which is thinner than cheek, may be a better source of graft for the glanular urethra.

Adolescent↗
PubMed2004

Mutations in the NOD2/CARD15 gene in Crohn's disease are associated with ileocecal resection and are a risk factor for reoperation.

BACKGROUND: Mutations within the NOD2/CARD15 gene have recently been shown to be associated with Crohn's disease. AIMS: To investigate the clinical impact of the three common NOD2/CARD15 mutations in patients with Crohn's disease. METHODS: We investigated the prevalence of the three common NOD2/CARD15 mutations (Arg702Trp, Gly908Arg, 3020insC) in 180 patients with Crohn's disease, 70 patients with ulcerative colitis and 97 controls. In patients with Crohn's disease, prevalence of NOD2/CARD15 mutations were correlated to clinical and demographical parameters. RESULTS: In Crohn's disease patients, 35.6% carried at least one mutant allele of NOD2/CARD15 mutations compared with 14.3% of patients with ulcerative colitis (P = 0.006) and to 15.5% of controls (P = 0.0001). Genotype phenotype analyses revealed that NOD2/CARD15 mutations determined younger age at disease diagnosis (P = 0.03), ileal disease location (P = 0.01) and ileocecal resections (P = 0.0002). Interestingly, reoperation with resection of the anastomosis was significantly more frequent in patients with NOD2/CARD15 mutations (P = 0.01). CONCLUSIONS: Our investigations support the current hypothesis that NOD2/CARD15 mutations are associated with a phenotype of Crohn's disease with younger age at diagnosis, ileal involvement, ileocecal resections and a high risk of postoperative relapse and reoperation. NOD2/CARD15 mutations might therefore be used to identify high risk patients for relapse prevention strategies.

Adolescent↗