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PubMedDate not supplied

[Haemorrhoidectomy according to Ferguson in day-surgery. Experience and results].

AIM OF THE STUDY: To evaluate of results of 1511 surgical haemorrhoidectomies performed in day-surgery setting (7-24 hours hospital stay) with improvement of both cost effectiveness and patient comfort. MATERIAL AND METHODS: From January 1980 to December 2002, 1511 patients underwent haemorrhoidectomy according to Ferguson, 1011 patients for grade III-IV haemorrhoids 10% of them for recurrence and 5% previous treated by cryotherapy or elastic ligature, 500 patients for grade II haemorrhoids 25% of them previous treated by cryotherapy or elastic ligature and 7% for recurrence. 97.6% of patients were operated on with loco-regional anaesthesia; the others with narcosis and peripheral anaesthesia. The hospital-stay was 24 hours in 34% of patients, while the remaining 66% operated on under loco-regional anaesthesia were hospitalised for 7-10 hours. Twenty-seven patients (1.8%) have had postoperative haemorrhage, only three patients (0.2%) underwent reoperation under general anaesthesia with a hospital stay of 7 days. In 52% of patients clinical recovery was observed at first follow-up (7 days); 48% had recovered at the second follow-up (14 days). RESULTS: In 1286 patients (98% of patients came back to control) anatomical recovery was observed at the follow-up three months after surgery. Patients satisfaction 6 months after operation was high in 73%; good in 26%; low in 1%. CONCLUSIONS: These results seems confirm the feasibility of haemorrhoidectomy in day-surgery in almost all patients, with both a considerably cost reduction and enhanced patient comfort and compliance.

Adult↗
PubMed1991

[Biliodigestive anastomoses using mechanical sutures].

The authors provide information concerning an experimental model of a suturing instrument for the formation of linear biliodigestive anastomoses, by means off which the communications are created in different parts of the ducts, even the intrahepatic ducts, 5 mm or more in diameter. The instrument was used in operations on 29 patients who had cicatricial stenosis of the major duodenal papilla, carcinoma of the pancreas or ducts in the region of the porta hepatis. The instrument is universal in range and can be used for the creation of various types of biliodigestive anastomoses, it makes the operative techniques simpler and more reliable. Complications associated with the use of the instrument did not occur.

Aged↗
PubMed1990

Antimicrobial prophylaxis in upper gastrointestinal, biliary, stomach and oesophageal surgery.

Start, duration and type of antimicrobial effect are decisive factor in prophylaxis in elective gastrointestinal surgery. Using a single dose regimen of 400 mg doxycycline and 1,600 mg tinidazole immediately prior to surgery a highly significant reduction of postoperative infectious complications was achieved in colorectal, gastric, small bowel and biliary surgery. Even after 10 years of regular use, no signs of clinical resistance have emerged with a wound infection rate of 1.2%. In Norway there is today no reason to introduce cephalosporins, penems or quinolones in prophylaxis of gastrointestinal surgery.

Anti-Infective Agents↗
PubMed1989

[The removal of foreign bodies in different birds].

Following problems are shown using slides: --ingrown rings and their removal with follow-up treatment, --the removal of fishhooks, especially in swans, --the removal of projectiles from the bird's body, --the removal of lead slivers from the digestive tract of parrots as well as the follow-up treatment, --the removal of gold chains, plastic tubing and other "toys" from the intestine. Gastrotomy in the parrot is described.

Animals↗
PubMed1988

Combining abdominal aortic aneurysmectomy with gastrointestinal or biliary surgery.

A retrospective study was undertaken to compare the morbidity and mortality of patients who had simultaneous abdominal aortic aneurysm (AAA) resection and gastrointestinal (GI) or biliary surgery with patients who had AAA resection alone. This series consisted of 89 patients who underwent surgery over a 6-year period (January, 1980 through December, 1985) at St. Elizabeth Hospital Medical Center. The patients were separated into three groups: group 1 had elective AAA resection; group 2 had AAA resection and a GI or biliary procedure simultaneously; and group 3 had resection of a ruptured AAA. The patients in groups 1 and 2 were similar with respect to sex, age, surgeons, estimated blood loss, operative time, preoperative risk factors and hospital stay. The patients in group 3 had shorter preoperative and longer postoperative hospital stays, were older, and had greater preoperative risk. The morbidity and mortality of the patients in group 2 were consistently the same or less than that of patients in group 1, even when individual surgeons and preoperative risk factors were compared. The patients in group 3 had a significantly higher morbidity and mortality. This article reviews the literature on management of patients with simultaneous AAA and other intraabdominal pathology and presents a suggested approach to treatment.

Aged↗
PubMed1986

[Clinical experience with fibrin gluing in general and thoracic surgery].

Fibrin sealing was applied in 615 cases to patients in the Surgery I Department of Salzburg County Hospitals, between April 1st, 1978 and April 30th, 1985. Fibrin glue Tissucol (Immuno, Vienna) was used in all cases. Need for additional sealing of sutures and anastomoses (n = 331), haemostasis and wound dressing on parenchymatous organs (n = 125), and glueing of skin grafts (n = 97) were the most common indications. Postoperative complications occurred to eight cases (6.4 per cent) in the wake of haemostatic glueing of parenchymatous organs, with lethality being 1.6 per cent (n = 2). One of the patients had to be relaparotomised. Fistulation, following additional sealing of anastomoses and sutures, was recorded from 4.9 per cent of the patients, with the rate of lethality being 0.6 per cent. Inadequate healing of skin grafts was observed in eleven per cent of all cases. Side effects of the fibrin sealant, say, hepatitis, were not observed at all.

Abdomen↗
PubMed1977

A 14-month study of severe non-wound infectious complications in general surgery.

A retrospective study of serious non-wound infectious complications in general surgery during at 14-month period is reported. A prospective study on wound infections in available from the same institution and period. Septicemia, intraabdominal and intrathoracal abscesses and rare cases of osteomyelitis occurred in 1.3% of all treated patients, whereas postoperative wound infection developed in 7.5% of primarily non-infected patients. Mortality was significantly higher among patients with serious infections than in all patients nursed during the same period. Severe postoperative infectious complications was in fact the third most common cause of death and accounted for 14% of the mortality of the clinic. This rate rises to close to 50% when death from incurable disease is excluded. Septicemia carried a significantly higher mortality rate than intraabdominal abscesses. The risk of a serious infection developing was significantly higher in operations on the small or large intestine than after appendectomies or biliary operations. Gram negative bacteria dominated, especially in cases with a fatal outcome. Contributing factors such as malignancy, preoperative infection or macroscopic peroperative wound soiling, were more common in patients where a serious infectious complication developed postoperatively.

Abscess↗