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At least 1,099 records · Page 61Linked to original sources
PubMed2002

Early increase of lower oesophageal sphincter pressure after band ligation of oesophageal varices in cirrhotics: an intriguing phenomenon.

AIM: We conducted a prospective, randomized comparison of endoscopic variceal ligation, sclerotherapy and metoclopramide injection in order to evaluate their early effect on lower oesophageal sphincter pressure. METHODS: Twenty-six patients with established cirrhosis and an episode of variceal bleeding controlled by one session of endoscopic therapy were randomized to undergo an oesophageal manometry. The patients' lower oesophageal sphincter pressure was evaluated, prior to and immediately after a single session of ligation (n = 10), a single session of sclerotherapy (n = 8) or a bolus injection of 20 mg metoclopramide hydrochloride (n = 8). RESULTS: Ligation produced a higher early increase in lower oesophageal sphincter pressure (from 12.3 +/- 2.3 to 27.8 +/- 3.0 mmHg) as compared with sclerotherapy (from 13.6 +/- 2.5 to 22.4 +/- 4.5 mmHg) or metoclopramide injection (from 14.6 +/- 3.2 to 22.5 +/- 2.9 mmHg); (P = 0.0001). CONCLUSION: Our data indicate that ligation of oesophageal varices produces an early increase in lower oesophageal sphincter pressure in cirrhotic patients.

Esophageal and Gastric Varices↗
PubMed2003

Ligation of the renal vein during laparoscopic nephrectomy: an effective and reliable method to replace vascular staplers.

PURPOSE: Application of the endovascular gastrointestinal anastomosis stapler has become a standard procedure to control renal vein during laparoscopic nephrectomy. However, device malfunction resulting in significant complications has been reported. We present a safe and cost-effective technique for renal vein ligation during laparoscopic nephrectomy. MATERIALS AND METHODS: From October 2002 to April 2003 we applied our new technique of renal vein ligation in 20 cases. After renal pedicle dissection the renal artery was secured with Hem-o-lok (Weck Closure Systems, Research Triangle Park, North Carolina) clips. The renal vein was encircled with a suture, which was knotted extracorporeally and pushed down by a knot pusher to shrivel a vein of any size. Subsequently 10 mm Hem-o-lok clips were applied to the vein to occlude it completely. RESULTS: All procedures were successfully completed. The operative costs of vein ligation were decreased. There was no significant increase in mean operative time. CONCLUSIONS: Our approach is a safe, reliable, rapid and inexpensive method to ligate the renal vein during laparoscopic nephrectomy. Therefore, this technique has replaced endovascular gastrointestinal anastomosis stapler use at our center.

Humans↗
PubMed2005

Crural ligation for primary erectile dysfunction: a case series.

PURPOSE: Some men with primary erectile dysfunction (ED) have maldevelopment of the crura of the penis. We report our experience with crural ligation for primary venous leakage ED in the last 5 years. MATERIALS AND METHODS: Between December 1998 and March 2004, 11 patients with primary ED underwent crural ligation surgery for congenital venous leakage. All patients were evaluated with pertinent history and physical examinations, color duplex ultrasound, nocturnal penile tumescence study with RigiScan, cavernosometry and cavernosography. Localized crural leakage was the pathognomonic feature in these patients. Surgery involved reflection of the dorsal and cavernous arteries and nerves off of the crura, followed by ligation of the 2 crura proximal to the entrance of the cavernous artery with umbilical tapes. Followup was performed by telephone interview or personal interview at the clinic. A retrospective preoperative and postoperative questionnaire, that is the abridged 5-item version of the 15-item International Index of Erectile Function, was given at the time of the interview. Statistical analysis was performed with the paired t test. RESULTS: Median patient age at surgery was 28 years (range 22 to 39) and mean followup after surgery was 34 months (range 6 to 58). Mean International Index of Erectile Function +/- SD preoperatively and postoperatively was 8.9 +/- 4.5 and 17.5 +/- 5.0, respectively. For questions 2, 3 and 5 mean postoperative scores were significantly better than postoperative scores (p <0.05). Marked improvement in erectile function was noted in 9 of our 11 patients. CONCLUSIONS: Penile venous surgery may not have a lasting result in men in whom venous leakage is due to systemic diseases or penile smooth muscle atrophy. However, in patients with a congenital venous leak abnormality of the crura ligation of the proximal crura with umbilical tapes seems to have a satisfactory, durable result.

Adult↗
PubMed2004

Does the early ligation of the splenic artery reduce hemorrhage during laparoscopic splenectomy?

The aim of this study was to investigate whether early ligation of the splenic artery before splenic lysis has an effect on the amount of intraoperative bleeding and conversion rate during laparoscopic splenectomy. Laparoscopic splenectomy was performed in 34 patients with hematological diseases or splenic cysts between January 1993 and January 2003. The splenic artery was ligated before manipulation of the spleen in 22 patients (group 1) and laparoscopic splenectomy was performed with no previous ligation of the splenic artery in 12 patients (group 2). Prospective data was collected and the groups compared regarding intraoperative blood loss, platelet count, operative time, hospital stay, and conversion rate. Laparoscopic splenectomy was successfully completed in 30 (88%) patients. One patient in group 1 (5%) and 3 patients in group 2 (25%) required conversion due to bleeding. Estimated average blood loss was 161 mL (range 70-450 mL) in group 1, and 292 mL (range 100-700 mL) in group 2 (P < 0.001). The average operative time was 140 minutes (range 80-240) in group 1, and 155 minutes (range 80-200) in group 2 (P > 0.05). There were no statistically significant differences between the two groups comparing splenic size, conversion rate, hospital length of stay and platelet count. Early ligation of the splenic artery is feasible, safe and effective and may provide easy dissection and manipulation of the spleen during laparoscopic splenectomy with decreased intraoperative blood loss and no extension of the operative time.

Adolescent↗
PubMed1993

Dominant maxillary artery as a cause of failure in maxillary artery ligation for posterior epistaxis.

Ligation of the maxillary artery is a logical and effective method for the arrest of severe uncontrollable posterior epistaxis. The failure rates for arrest of haemorrhage are given in the literature as 10-13%. In our centre, over the last 9 years, 23 patients have undergone maxillary artery ligation to control epistaxis without a failure. Bilateral maxillary artery ligation was carried out whenever the maxillary artery of the bleeding side was found to be of small diameter. To investigate whether there is an asymmetry in the size of the maxillary arteries we performed 13 cadaveric dissections. In 6 of the cadavers one maxillary artery was significantly larger than the other. This fact has hitherto not been observed by otolaryngologists or anatomists. Failure to arrest haemorrhage may have resulted from ligation of the non-dominant maxillary artery with consequent opening of cross-anastomoses from the dominant side.

Adult↗
PubMed1992

Efficacy of varicocele embolization versus ligation of the left internal spermatic vein for improvement of sperm quality.

Efficacy of surgical varicocelectomy versus embolization of the spermatic vein was studied in 137 men diagnosed as suffering from left varicocele. The men were divided randomly into three groups according to the methods of treatment: A--embolization of the internal spermatic vein (51 men); B--Ivanissevich technique of high ligation of the spermatic veins (43 men); and C--Bernardi technique of high ligation (43 men). The groups were similar in terms of age, duration of infertility and possessed semen characterized as oligoteratoasthenozoospermia. The fertility of the female partners was evaluated carefully and they were found to be potentially fertile. Varicocele was diagnosed by at least two of the following methods: physical palpation during valsalva manoeuvre, venography, or scrotal scanning using the technetium pertechnetate radioactive method. Semen quality was assessed before treatment and at 3, 6 and 9 months post-treatment. Fecundity was followed-up for 18 months. The major results were: (i) Shrinkage of the varicocele was found in all three groups studied. The same rate of recurrence was recorded in the three groups (24%, 37% and 35% in groups A, B and C, respectively). (ii) Improvement of sperm quality was significant in groups A and B, with better results in group B. (iii) The pregnancy rate was significantly higher in group B, compared with A (38.2% vs. 20.6%; P less than 0.05). Thus, high ligation of the internal spermatic vein yields better results than low ligation or embolization as far as semen quality and pregnancy is concerned.

Embolization, Therapeutic↗
PubMedDate not supplied

Acrylamide-induced ascending degeneration of ligated peripheral nerve: effect of ligature location.

Acrylamide was administered to rats for 10 days (50 mg/kg/day) after ligation of either proximal (sciatic) or distal (posterior tibial) nerves. Morphologic evaluation of the nerves revealed severe degeneration 0.5 cm proximal to the ligature, with progressively less pronounced change at successively higher levels above the ligature, when compared with ligated non-treated controls. Although severe degeneration of the nerves was observed in both proximal- and distal-ligated groups of animals, the distal-ligated group showed slightly more change (at 0.5 cm above the ligature), suggesting a minor effect of distance of the site of nerve injury from the nerve cell body.

Acrylamide↗
PubMedDate not supplied

Digestibility rates of major and trace elements in pancreatic duct-ligated pigs.

Ligation of pancreatic duct in pigs leads to a severe maldigestion of calcium and magnesium. Substitution of missing enzymes results in a 'normalization' of the digestibility rates of these elements. In comparison to controls the pre-caecal phosphorus digestibility decreased, but the total digestibility rates increased, after ligation of the pancreatic duct. Furthermore, the total amount of absorbed phosphorus was significantly higher in pancreatic duct ligated pigs. Further studies have to be carried out to investigate, whether phosphorus in exocrine pancreatic insufficiency is excreted with urine, as in this study the observed Ca:P-ratio in blood was in a physiological range. Without a forced renal excretion of phosphorus, consequences and risks (e.g. secondary hyperparathyroidism) of the regulation have to be considered. Regarding the elements sodium, potassium and chloride, an increased faecal excretion could be observed in pancreatic duct ligated pigs. As a substitution with enzyme products led to digestibility rates similar to those in controls, no losses of electrolytes have to be feared. Even though pancreatic juice seems to have influences on the digestibility of investigated trace elements (copper, zinc, iron and manganese), it did not lead to severe imbalances in the corresponding mineral metabolism.

Animals↗
PubMed1994

Laparoscopic varicocelectomy: invasiveness and effectiveness compared with conventional open retroperitoneal high ligation.

The invasiveness of laparoscopic varicocelectomy and open retroperitoneal high ligation of the internal spermatic veins were compared and the surgical effects on fertility of these two procedures determined. 48 of 97 men diagnosed with varicocele testis underwent laparoscopic varicocelectomy, while the remaining 49 underwent open retroperitoneal high ligation of the internal spermatic vessels. Operating time, number of post-operative days to walking, length of hospital stay and analgesic use were measured as peri-operative indicators of invasiveness. In addition, seminal parameters were determined in order to evaluate the effects of these procedures on fertility. The operating time required for laparoscopic surgery was significantly longer than that for open surgery (96.6 vs 78.1 min., p = 0.0078). The patients in the laparoscopic surgery group began walking earlier post-operatively than did those who underwent open high ligation (0.97 vs 1.42 days, p = 0.00037). Length of hospital stay for the laparoscopic patients was shorter than for the open surgery group (7.05 vs 9.55 days, p = 0.00001). There were no statistical differences between the groups in terms of semen quality or improvement in the post-operative rate of pregnancy of partners. These findings indicate that laparoscopic varicocelectomy is associated with a shorter period of convalescence than open high ligation of the internal spermatic vessels.

Adolescent↗
PubMed2005

Evaluation of the role of varicocelectomy including external spermatic vein ligation in patients with scrotal pain.

OBJECTIVES: The aim of the present study was to assess and compare pre- and postoperative scrotal pain in patients with varicocele who underwent varicocelectomy with different approaches. METHODS: The study included 144 consecutive patients with left-sided varicocele who had left scrotal pain for more than 3 months. All patients underwent varicocele ligation using either a subinguinal or inguinal approach with or without external spermatic vein ligation. We asked the patients to complete an 'Assessment Questionnaire for Scrotal Pain' both before and after the surgery. RESULTS: The surgery was successful in 101 (83.4%) of the 121 patients available for follow up. Seventy-four (61.1%) patients reported the complete resolution of pain while 27 patients (22.3%) reported partial resolution. Symptoms worsened in a single case and pain persisted postoperatively in 19 cases (15.7%). There were no statistically significant differences in the characteristics of the pain and grade of varicocele between postoperative groups. A significant difference was observed in postoperative success between patients who had external spermatic vein ligation and those who did not, regardless of the surgical approach (inguinal or subinguinal). All patients who reported complete or partial resolution of pain stated that they would recommend surgery to relatives with the same problem. CONCLUSIONS: Varicocelectomy using either inguinal or subinguinal approaches is an effective and reasonable treatment option in this patient group and should include external spermatic vein ligation for a satisfactory outcome.

Adult↗
PubMed1993

Comparison of laparoscopic and open ligation of the testicular vein.

Scrotal varicoceles undoubtedly contribute to subfertility in an as yet undefined group of patients. The best method of treatment of varicoceles, however, remains controversial. Laparoscopic testicular vein ligation has recently been offered as a new option. We examined the feasibility of laparoscopic testicular vein ligation (n = 11) compared with standard high ligation (n = 11). The mean post-operative stay in the open group was 25.6 h compared with 7.1 h in the laparoscopic group. Analgesic requirements were a mean of 4.73 Co-proxamol tablets for the open group and 0.18 tablets for the laparoscopic group. All operations were successful. Laparoscopic ligation of the testicular vein is an effective treatment of varicocele with decreased post-operative morbidity.

Adult↗
PubMed2004

Nitric oxide-induced increase of excitatory amino acid levels in the trigeminal nucleus caudalis of the rat with tactile hypersensitivity evoked by the loose-ligation of the inferior alveolar nerves.

To investigate whether or not N-methyl-D-aspartate (NMDA)/nitric oxide (NO) pathway in the trigeminal system is involved in the development and/or maintenance of such pathological pain states as the hyperalgesia and allodynia observed after dental surgery, we examined the alteration patterns of excitatory amino acid (EAA) level in the superficial layer of subnucleus caudalis of the brain-stem trigeminal sensory nuclear complex (SpVc-I,II) by in vivo microdialysis. A very high EAA release response was observed immediately after the start of the perfusion in ligated animals compared with sham-operated rats. The EAA level evoked by application of the 40-V tooth pulp-stimulation or 1% capsaicin cream was significantly higher in the ligated animals than those in the sham-operated animals. This increase of EAA level induced by capsaicin cream was inhibited by adding carboxy-PTIO (100 microM) to the perfusate. The applications of SNAP (2 mM) into the perfusate enhanced the level of EAAs in ligated animals and sham-operated animals. However, SNAP-evoked EAA levels in ligated animals were not significantly different compared with those of sham-operated animals. These results suggest that alterations in the stimulus-evoked raised EAA levels that occur in the site of the first synaptic relay of the dental pain pathway and which are expressed via endogenous NO, and which play an important role in development and/or maintenance of pathological pain states following dental peripheral nerve injury.

Animals↗
PubMed1991

The effectiveness of occipital artery ligations as a priming procedure for extensive scalp-lifting.

Extensive scalp-lifting is a relatively new cosmetic scalp procedure that involves cutting both occipital arteries, which then allows undermining of the entire donor dominant scalp down to the hairline of the nape. Because of this more extensive undermining, dramatic improvements are accomplished even with one operation. Conversely, one can develop necrosis at the nuchal ridge because of a sudden curtailment of circulation in the occipital region. In an attempt to eliminate this complication, the author experimented with "horizontal incision ligations" of the occipital arteries 4 to 8 weeks prior to the surgery which resulted in a significant reduction in the average size of necrosis (from 3.1 cm2 to 1.6 cm2; P = .036) but no significant difference in the incidence (P = .49). When these patients did develop necrosis, it always occurred below the horizontal incisions--therefore, the procedure was changed to vertical incisions, which to date have yielded a significant protective effect when compared with the previous method of "horizontal incision ligations" (P = .014), and even greater significance when compared with the original method of no previous ligations (P = .012). Vertical-incision ligation performed 4 to 8 weeks prior to surgery is an optimal method for preventing the complication of necrosis after extensive scalp-lifting surgery.

Adult↗
PubMed1986

Immunohistochemical demonstration of keratin proteins in duct-ligated salivary glands of mice and rats.

Immunohistochemical detection of keratin proteins in duct-ligated submandibular glands (SMG) was carried out in mice and rats with or without testosterone administration. Keratin staining in normal salivary glands was limited to the striated duct (SD) and excretory duct (ED) cells and was usually lacking in granular convoluted tubule (GCT) cells. Following duct-ligation, the epithelia of intercalated ducts (ICD), degranulated tubules, duct-like structures, and dilated striated and excretory ducts showed positive keratin staining, usually in their luminal aspects. The concentration of keratin was proportional to the degree of degranulation of the GCT cells. The duct-ligated SMGs in animals with testosterone treatment showed a comparatively higher number of granules located in the GCT cells, and degranulation was slight. Keratin staining in hormone-treated duct-ligated glands also occurred in ductal segments to a slight degree. Keratin was also detected in degranulated tubules, and its concentration was increased in duct-like structures, whereas staining for EGF and NGF was decreased in degranulated tubules and lacking in duct-like structures.

Animals↗
PubMed1992

Immunoreaction of keratin, actin, S-100 protein and rat-EGF in duct-ligated rat salivary glands.

Duct-ligated submandibular and sublingual glands of rats were evaluated immunohistochemically for changes in keratin (MoAb 1164), actin, S-100 protein and rat-EGF (rEGF). Normal salivary glands were reactive for keratin, S-100 protein and rEGF in the granular convoluted tubule (GCT) and duct cells, and for actin in the myoepithelium. Submandibular glands showed a marked reduction of S-100 protein and rEGF staining following duct ligation, and no increased staining of proliferating epithelial cells of the late stage in duct ligated glands. Sublingual glands revealed no marked changes for actin staining in myoepithelial cells, irrespective of atrophic changes occurring in acinar and duct cells after duct ligation. Immunohistochemical patterns differed for each type of gland; changes associated with the obstructive lesion were more prominent in the submandibular gland.

Actins↗
PubMed2004

Cell death and cell proliferation in the regeneration of atrophied rat submandibular glands after duct ligation.

BACKGROUND: The present study aimed to clarify the proliferation and apoptosis of parenchymal cells during regeneration of rat submandibular glands following atrophy. METHODS: Atrophy of the right submandibular gland of rats was induced by excretory duct ligation at the hilum with metal clips, which were removed 1 week (day 0) after ligation. The right submandibular glands were collected from 0 to 14 days after removal of the clips and investigated using immunohistochemistry for proliferating cell nuclear antigen (PCNA) as a marker of proliferating cells, terminal deoxynucleotidyl transferase (TdT)-mediated dUTP-digoxigenin nick end labeling (TUNEL) as a marker of apoptotic cells, and transmission electron microscopy (TEM). RESULTS: After 1 week of ligation, there were many remaining ducts and a few acini in the atrophic glands. At day 3 after discontinuing the ligation, newly formed acini appeared and thereafter increased in number and maturity. Many residual and newly formed acinar cells showed positive reaction to PCNA especially at days 4 and 5. The PCNA-positive duct cells decreased in number with the regeneration. A few TUNEL-positive acinar and duct cells were identified during regeneration. Mitosis and apoptosis of parenchymal cells were also identified by TEM. CONCLUSIONS: During regeneration of the submandibular gland after atrophy, both residual and newly formed acinar cells proliferate actively. There is also apoptosis of parenchymal cells; however, the significance of apoptosis is low.

Animals↗
PubMed1998

Laparoscopic intra-abdominal ligation and removal of cryptorchid testes in horses.

Laparoscopic intra-abdominal ligation and removal of cryptorchid testes in horses was evaluated retrospectively in 50 horses that underwent the procedure between 1991 and 1996. Sixty-one cryptorchid testes were removed by one of the following methods; the use of 1) an endoscoping stapling and transection device, 2) an endoscopic clipping device, 3) an endoscopic ligating loop. Monopolar electrosurgery was combined with these methods to facilitate coagulation and cutting of tissue. In 8 horses, 9 testes were retained between the internal and external inguinal rings. The inguinal testes were removed by cutting the internal inguinal ring and bringing the testis back into the abdomen for removal. No attempt was made to close the internal inguinal ring. The most frequently employed and most cost effective method for laparoscopic intra-abdominal removal of cryptorchid testes in this study was the combined use of an endoscopic ligating loop and monopolar electrosurgery. One intra-operative complication (perforation of the small intestine) occurred and was dealt with successfully. One horse developed a fever attributed to upper respiratory tract infection post operatively and was treated successfully with antibiotic. Intra-abdominal ligation and transection of cryptorchid testes is an effective method for cryptorchid castration. This technique minimises the loss of insufflation, allows inspection of the cut tissue for haemorrhage and offers secure closure of the abdominal wall preventing inguinal herniation and excellent visualisation of the cryptorchid testis.

Animals↗
PubMed1974

Effect of carotid ligation on cerebral blood flow in baboons. 2. Response to hypoxia and haemorrhagic hypertension.

Cerebral blood flow (CBF) measurements were carried out in two groups of anaesthetized normocapnic baboons. In the first group of five animals the effect of hypoxia on the CBF before and after ipsilateral carotid artery ligation was studied. The results showed that, although after ipsilateral carotid ligation there was little change in the CBF at normal PaO(2), at hypoxia there was only 20% rise in the CBF as compared with an 80% rise before the carotid ligation. In the second group of 10 animals, effects of haemorrhagic hypotension on the CBF after ipsilateral carotid artery ligation were estimated. The results indicated impairment of autoregulatory response of the cerebral circulation.

Animals↗