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At least 955 records · Page 53Linked to original sources
PubMed2002

Use of FloSeal hemostatic sealant in transsphenoidal pituitary surgery: technical note.

OBJECTIVE: Bleeding during transsphenoidal pituitary surgery can lead to a variety of operative difficulties. When the endonasal transsphenoidal approach is used, even mild intraoperative hemorrhage can lessen visibility in the confined operative field of view. This technical note describes the use of a hemostatic agent we have found of benefit in obtaining prompt hemostasis during this operation. METHODS: Operative records were reviewed for an 18-month period for all patients who underwent transsphenoidal surgery since we began using FloSeal hemostatic sealant in January 2000. RESULTS: During the study period, 293 transsphenoidal operations were performed for pituitary lesions. Of these, 20 procedures involved vigorous or persistent bleeding. When the standard techniques for hemostasis failed or were inadequate, FloSeal, a sterile mixture of a gelatin matrix and thrombin component mixed at the time of use, was applied to the site of hemorrhage by use of a 14-gauge angiocatheter to reach the sella. We observed complete hemostasis immediately on application of FloSeal in all cases except one, which required a second application. Hemostasis was obtained immediately after the second application. No operations were aborted during this period as a consequence of undue bleeding. CONCLUSION: We detail the method in which we use FloSeal in transsphenoidal surgery and report our impression of its effectiveness. FloSeal has been demonstrated to be safe and biocompatible as compared with hemostatic agents currently in use.

Adolescent↗
PubMed2002

Embolization for advanced abdominal pregnancy with a retained placenta. A case report.

BACKGROUND: Abdominal pregnancy is not encountered commonly, and management of the placenta is controversial. CASE: A 33-year-old woman presented with an abdominal pregnancy at 33 weeks' gestation with fetal death. The placental vasculature was embolized preoperatively. Following operative delivery. of the fetus, the placenta was left in situ in efforts to preserve fertility given its implantation on the reproductive organs. The patient suffered prolonged postoperative ileus but otherwise did well. Placental function ceased after two months. CONCLUSION: Placental vasculature embolization is a management option for a retained placenta associated with abdominal pregnancy.

Adult↗
PubMed1976

Topical hemostatic agents to reduce bleeding from cancellous bone. A comparison of microcrystalline collagen, thrombin, and thrombin-soaked gelatin foam.

In fifty-three dogs microcrystalline collagen, thrombin-soaked gelatin foam, and thrombin powder were evaluated as hemostatic agents when applied to bleeding cancellous surfaces after osteotomy of the greater trochanter using two quantitative models: one, a single osteotomy; the other, a double osteotomy. All three agents significantly reduced bleeding compared with the controls, the microcrystalline collagen being most effective. At three months there was no evidence that microcrystalline collagen and thrombin-gelatin interfered with bone healing after the greater trochanter was reattached with two wires.

Administration, Topical↗
PubMed1998

[Collagen sponge and its hemostatic properties].

Soluble collagen was extracted from bovine tendon in acid solution. Collagen sponge hemostatics were prepared by means of lyophibization. The amino acid and UV spectrum analyses were made to confirm the composition of the soluble collagen. The results of experiments on rabbits indicated the collagen sponge prepared in the authors' lab had excellent hemostatic and adhesive properties in vivo surgical tests.

Amino Acids↗
PubMed1999

[Analyses on structural and physicochemical properties of collagen hemostatic sponge].

The ultraviolet spectrum and aminoacid content of collagen hemostatic sponge prepared from bovine tendon were analyzed, and the struture and composition of collagen spoge were confirmed. Physicochemical properties measurements showed that collagen hemostatic sponge had excellently stable quality. It was concluded that the technology for preparing collagen hemostatic sponge was reasonable and reliable.

Collagen↗
PubMed2003

A novel approach to the treatment of gunshot injuries to the sacrum.

Two patients (a 17-year-old male and a 19-year-old female) sustained single gunshot wounds to the abdomen. Given the nature of their wounds and presumed peritoneal penetration they were taken urgently to the operating room for exploratory laparotomy. Both patients sustained multiple intra-abdominal injuries including gastric and small and large bowel perforations. Given the extensive nature of these injuries both patients required bowel resections. Upon further exploration they were both noted to have significant bleeding from the bony aspect of their sacrum. A surgical hemostat (CoStasis; Cohesion Technologies, Inc., Palo Alto, CA) (4.5-9.0 cm3) was directly applied to the injured area of the sacrum in both cases after standard surgical hemostatic techniques were unsuccessful. After application no further attempts of hemostatic control by standard methods were attempted. In both cases the sacral bleeding ceased without any further surgical intervention. Postoperatively neither patient rebled from the sacral injuries. Penetrating injuries to the sacrum can be life threatening and difficult to control with standard surgical hemostatic techniques. CoStasis, a new surgical hemostat, was effective in obtaining immediate and definitive hemostatic control. Future prospective trials on the use of CoStasis in trauma patients are warranted.

Adolescent↗
PubMed2003

[Percutaneous portal vein embolization before major hepatic resection].

Major liver resection cannot be performed when the remaining liver mass is too small. Preoperative embolization of the portal vein (PVE) helps to increase the volume of the non-tumorous liver segments, and patients' liver function will remain stable postoperatively. CT, MRI, CTAP examinations help to decide about surgery. Volume measurements are performed based on data of CT scans. PVE is indicated, when the remaining, non-tumorous liver volume is too small. The procedure starts with percutaneous portal vein catheterization, then selected portal vein branches are embolized with a mixture of contrast material, antibiotics and Gelfoam particles. The patients stay in the hospital 3-5 days after the procedure. Control CT-volumetry is done after 3-6 weeks. From November 2001 to April 2002 3 patients were selected to have this procedure. PVE of the right portal branches were performed successfully in two cases. Control CT-volumetry showed significant increase of the volume of the left liver lobe. One patient underwent successful right hemihepatectomy. On the third patient we could not catheterize the portal vein. PVE is a relatively safe and tolerable procedure. The increased remaining liver volume helps in performing major liver resection.

Administration, Cutaneous↗
PubMedDate not supplied

[Effectiveness of sub-Tenon's capsule implantation of collage sponge in the treatment of glaucomatous atrophy of the optic nerve].

The surgery of "subtenon implantation of collagen sponge" is offered; its essence is in implanting a fragment of hemostatic collagen sponge for the purpose of revasculizing and improving the trophism of the retina and optic nerve. A total of 96 patients (105 eyes) with glaucomatous atrophy of the optic nerve were operated on. The reliable results of visometry as well as of kinetic and static perimetry and of rheography were obtained. The efficiency of the surgery (without any additional conservative therapy) ranged from 63.4 to 78.6% according to various examination methods. The visual functions improved within 6 to 12 months after surgery.

Aged↗
PubMed2003

Chemoembolization with cisplatin, lipiodol and Gelfoam and subsequent systemic chemotherapy with cisplatin and interferon in patients with hepatocellular carcinoma: a non-randomized prospective study.

Arterial chemoembolization with subsequent systemic chemotherapy was assessed prospectively. Of 94 consecutive patients with HCC, 31 patients were considered to have inoperable disease and were selected for chemoembolization. Twenty-two of the 31 patients underwent chemoembolization. In eight patients, technical problems with catheterization prevented the application of therapy, and one patient rejected further treatment. Regimen: Three monthly cycles of chemoembolization with cisplatin 20 mg/m(2) mixed with lipiodol delivered intraarterially with Gelfoam or collagen on day 1, followed by intravenous chemotherapy with cisplatin 60 mg/m(2) on day 2; interferon alpha-2c 30 microg (10 M IU) subcutaneously on days 2, 5, 9, and 12. Three percent of the patients (1/31) (CI 95% 0.08; 16.7) experienced a partial clinical response, in 53% alpha-fetoprotein levels decreased by more than 50%. On univariate analysis, performance status, Child score, Okuda stage, albumin levels, and lactate dehydrogenase were found to have an effect on survival. Postchemoembolization syndrome occurred in 68% of the patients, nausea/vomiting grades 3/4 (according to the World Health Organization WHO) in six patients, anemia grade 3 in three patients, leukopenia grade 3 in one patient and thrombocytopenia grade 3 in one patient. This treatment regimen is a very selective procedure. Because of the low response rate it is not recommended for routine clinical use.

Adolescent↗
PubMedDate not supplied

Transcatheter arterial embolization in hepatocellular carcinoma: a long-term follow-up.

Transcatheter arterial embolization (TAE) was performed in 1,058 cases of hepatocellular carcinoma (HCC), and the prognosis after TAE in HCC was then assessed from the long-term follow-up data. The results indicated that the prognosis was better for small tumors, and was significantly better for capsulated than noncapsulated tumors. For this reason, the prognosis of small tumors was not always better than that of large tumors. The prognosis worsened as the severity of portal obstruction increased. The prognosis improved with the use of Lipiodol (iodized oil). It was found that the use of anticancer drugs in combination with TAE, however, did not significantly affect the prognosis as compared with TAE alone. The 1-, 2-, 3-, 4-, and 5-year overall survival rates were 70%, 51%, 29%, 14%, and 5%, respectively.

Adult↗
PubMedDate not supplied

Intraarterial injection therapy of newly developed cisplatin-phosphatidyl choline-lipiodol suspension for hepatocellular carcinoma.

Twenty-seven patients with hepatocellular carcinoma were treated by intraarterial injection of a suspension of cisplatin powder and iodized oil using phosphatidyl choline as a dispersing stabilizer. A reduction in tumor size of over 25% was obtained in 23 patients (85%) and a reduction of more than 50% was obtained in 17 patients (63%). In all of 14 patients with a high serum alpha-fetoprotein level (more than 200 ng/ml), 27% to 99% reduction in the level was obtained. The one-, two-, and three-year survival rates were 74%, 50%, and 35%, respectively. As for side effects, digestive symptoms were rather frequently observed. Liver abscess and cholangitis were observed in one patient each in patients combined with embolization using gelatin sponge particles. Injection of the suspension with embolization was superior to injection only in therapeutic effect, but was associated with a higher frequency of side effects. The therapeutic effect was better in cases of higher Lipiodol retention in the tumor on follow-up CT.

Aged↗