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At least 1,171 records · Page 65Linked to original sources
PubMed2000

Persistent pain and faecal urgency after stapled haemorrhoidectomy.

INTRODUCTION: Haemorrhoidectomy usually cures haemorrhoids. Day surgery is feasible, and is associated with high patients' satisfaction and few complications, but patients take an average of 2 weeks off work after surgery. Stapled haemorrhoidectomy has the potential to decrease postoperative pain and time off work. However, data on long-term efficacy and function are lacking. METHODS: 22 patients underwent stapled haemorrhoidectomy: seven in a pilot study, and 15 in a randomised controlled trial to compare the new stapled operation with diathermy haemorrhoidectomy in a day-case setting. All operations were done by one consultant surgeon. RESULTS: 16 patients were followed up for longer than 6 months, five of whom (31% [95% CI 8.5-54.0%]) developed symptoms of pain and faecal urgency which persisted for up to 15 months postoperatively. The randomised trial was suspended, and patients were investigated with endoanal ultrasonography, anorectal physiology, and examination under anaesthetic. All five affected patients were reviewed by two independent surgeons experienced in the stapled operation. In one patient, a fibroepithelial polyp was found adjacent to an anodermal ulcer; in the other patients, no abnormality was found. Four of the five affected patients had some muscle incorporated into the doughnut, compared with only one of 11 of the unaffected patients (p=0.012, Fisher's exact test). No other significant differences in operative variables were identified between patients with and without symptoms. INTERPRETATION: Persistent severe pain and faecal urgency has been found in a disturbingly high proportion of patients after stapled haemorrhoidectomy. The mechanism behind this phenomenon is unclear, although muscle incorporation in the doughnut may have a role. Other groups who have studied stapled haemorrhoidectomy urgently need to audit their long-term results to assess the frequency of this problem.

Adult↗
PubMed1983

Complications of vitreous surgery for diabetic retinopathy. I. Intraoperative complications.

One hundred seventy-nine eyes were analyzed to determine the incidence of intraoperative complications during vitrectomy for proliferative diabetic retinopathy. Inadvertent corneal epithelial defects occurred in 51 eyes (28%). The lens was removed in 42 (25%) of 170 phakic eyes. This was done through a pars plana approach. Accidental mechanical lens damage occurred in one eye, and mild pharmacologic lens damage occurred in two eyes. Some bleeding from fibrovascular tissue occurred in nearly every case, but this was controlled with diathermy except in seven eyes (4%) in which severe bleeding required premature termination of the operation. Latrogenic retinal tears occurred in 36 (20%) of the 179 eyes. Fifteen (34%) of the total of 44 retinal tears were anterior to the equator, and 11 (73%) of the 15 anterior tears were located posterior to the sclerotomy through which the vitrectomy probe was introduced. Twenty-nine (66%) of the 44 retinal tears were posterior to the equator, and 19 of the 29 occurred within 15 degrees radius of the fovea.

Adult↗
PubMed1983

Laryngeal stenosis following papillomatosis--a report of three severe cases.

Three cases of severe laryngeal papillomatosis beginning in early childhood are presented. Several methods of treatment were tried, but lasting results were achieved by suction diathermy. The laryngeal lumen was totally obliterated in all cases during the course of the disease. The patients were successfully operated on by making a laryngofissure in the front part of the larynx, excising the scar and enlarging the lumen by a median incision in th back wall of the larynx. An indwelling prosthesis was placed in the larynx for several months. After removing the prosthesis, the laryngeal lumen was dilated several times by oesophageal sounds. All patients were successfully decannulated. The results of treatment are evaluated both clinically and by ventilatory function studies. Central airway obstruction persisted in two cases.

Child, Preschool↗
PubMed1976

Excision of epithelial tumors: CO2 laser versus conventional methods.

In a comparative experimental study, excisions of a transplanted Lewis lung carcinoma in BDF1 mice were performed by means of the CO2 laser and conventional methods, namely common scalpel and diathermy. The results showed a significant reduction in tumor recurrence and animal mortality rates (27.5% vs. 75% and 45%) after tumor excision with the laser in the early stage (5th day) of tumor development. This finding, in addition to the surgical properties of the CO2 laser, suggests that early excision using this modality is a rational treatment of this type of tumor.

Animals↗
PubMed1998

Endoresection of the iris and ciliary body in epithelial downgrowth.

We present a case of epithelial downgrowth with intractable glaucoma after multiple intraocular surgeries. The eye was successfully managed with a pars plana approach. The iris and epithelial tissue over the ciliary body were removed with intraocular scissors and a vitrector combined with unipolar diathermy and endophotocoagulation. The use of moderate hypotensive anesthesia may have helped prevent intraoperative hemorrhage. During more than 3 years of follow-up, intraocular pressure ranged from 13 to 19 mm Hg, visual acuity was 20/80 with aphakic correction with a rigid gas-permeable lens, and there was no recurrence of epithelial downgrowth.

Adolescent↗
PubMed2001

Laparoscopic supracervical hysterectomy with Filshie clips.

We conducted a retrospective study to evaluate the efficacy of Filshie clips for pedicle ligation during laparoscopic subtotal hysterectomy. The procedure was a combination of endoscopic stapling with lateral movement of the cartridge to the infundibulopelvic or ovarian ligaments, Filshie clips to uterine arteries, cutting diathermy to transect the cervix, and motorized morcellator to remove the uterine body. Two patients had postoperative spotting from the stump. Median return to home activity was 7.5 weeks (range 2-24 wks) and to work was 9.5 weeks (range 2-12 wks). Based on a questionnaire survey, all 12 women were satisfied with the operation. In those who were sexually active it was associated with improved sexual functioning in six and no change in four. (J Am Assoc Gynecol Laparosc 8(1):137-142, 2001)

Adult↗
PubMed2006

Understanding submucosal electrosurgery for the treatment of nasal turbinate enlargement.

The surgical management of inferior turbinate enlargement is controversial. Submucosal electrosurgical techniques for turbinate reduction include conventional diathermy, radiofrequency tissue reduction and coblation. All electrosurgical techniques use radiofrequency electricity to damage turbinate tissue but differ in the control and delivery of energy. This review will examine the history of submucosal electrosurgery and clarify the various techniques. This review will also examine the evidence for the efficacy and safety of electrosurgery for the treatment of nasal turbinate enlargement, and will make a case that no progress will be made in clinical trials on the safety and efficacy unless there is standardisation of equipment and techniques in nasal electrosurgery.

Diathermy↗
PubMed1977

Endoscopic choledochoduodenostomy for choledocholithiasis through choledochoduodenal fistula.

A new endoscopic method for treatment of choledocholithiasis in patients with choledochoduodenal fistula is described. In 2 patients with common bile duct stones a choledochoduodenostomy was performed by means of a diathermy snare. In both patients the calculi passed into the duodenum within some days. No complications occurred. It is concluded that the described technique may be helpful when surgery is contraindicated and when endoscopic papillotomy is difficult to perform.

Aged↗
PubMed1977

Lymphangioma of the duodenum. (Diagnosis by endoscopic resection).

Submucosal lymphangiomas of the gastrointestinal tract are extremely rare entities. A case of a lymphangioma of the duodenum in a 66-year-old woman is reported. Diagnosis was made by endoscopy and tumor excision with a diathermy snare. The patient complained of crampy upper abdominal pain which only partially was referable to an gastric ulcer and stopped after polypectomy. Endoscopically, compressibility of the tumor is a characteristic sign. Roentgenographically, it may be easily overlooked.

Aged↗
PubMed1991

Submucosal dissection of the esophagus: a case report.

A 38-year-old male was admitted to our hospital complaining of dysphagia, sore throat and fever. An upper GI series revealed a "double-barrelled" esophagus. Endoscopic examination of the esophagus showed multiple ulcers and mucosal bridges resulting from laceration of the submucosal layer. An acute ulcer of the stomach was also found. Fasting and total parenteral nutrition for several weeks failed to bring about any changes in the endoscopic findings. As treatment, the mucosal bridges throughout the esophagus were divided with a diathermy knife under endoscopic control. Soon after the procedure, the patient's symptoms disappeared completely, and the massive dissection of the esophagus had improved except for slight depressions.

Adult↗
PubMed1990

[How can hyperreflexia rhinopathy be modified surgically? I. Literature review].

A review of the literature on the surgery of vasomotor rhinitis revealed only a few studies with information by which to judge the value of a special surgical method, especially concerning its long-term results. The following modalities of treatment were reviewed: submucous resection of the septum (Killian), Vidian neurectomy, conchal surgery (diathermy, partial and total turbinectomy, cryosurgery, laser-surgery). As far as information is available, advantages and shortcomings of individual methods are listed in tables. Partial turbinectomy seems to be most effective in reducing nasal obstruction without damaging nasal functions. Nasal hypersecretion is not sufficiently influenced by the cited surgical methods. In the authors' hospital, conchal surgery is performed in about sixty percent of all nasal operations. Gray's method of anterior turbinoplasty of the inferior turbinate is used.

Cryosurgery↗
PubMed1981

[Hemangiomas of the fundus: clinical picture and treatment (author's transl)].

Hemangiomas of the fundus of the eye are rare. Nevertheless it is of great importance to know them, because some of them may lead to blindness or are part of a syndrome in which other organs of the body are involved. In this case the life of the patient may be in danger. Therefore, the clinical picture and treatment of the most important hemangiomas, such as the hemangioma of the choroid, the arteriovenous hemangioma of the retina, Leber's miliary aneurysms, Coats' disease and von Hippel's disease are discussed. The last three respond very well to treatment, but only when it is started early in the disease. Most suitable are the different coagulation methods, such as photocoagulation, (xenon, laser), cryocoagulation and diathermy.

Cryosurgery↗
PubMed1993

Electrode burns during local hyperthermia.

A patient presenting with carcinoma of the breast was treated with local hyperthermia by short wave diathermy. During the procedure she suffered severe burns at the site of the ECG electrodes as a result of concentration of the induced current.

Aged↗
PubMed2000

Evaluation of the relative cost-effectiveness of treatments for infertility in the UK.

This paper aims to complement existing clinical guidelines by providing evidence of the relative cost-effectiveness of treatments for infertility in the UK. A series of decision-analytical models have been developed to reflect current diagnostic and treatment pathways for the five main causes of infertility. Data to populate the models are derived from a systematic review and routine National Health Service activity data, and are augmented with expert opinion. Costs are derived from an analysis of extra-contractual referral tariffs and private sector data. Sensitivity analysis has been carried out to take account of the uncertainty of model parameters and to allow results to be interpreted in the light of local circumstances. Results of the modelling exercise suggest in-vitro fertilization is the most cost-effective treatment option for severe tubal factors and endometriosis, with surgery the most cost-effective in the case of mild or moderate disease. Ovulatory factors should be treated medically with the addition of laparoscopic ovarian diathermy in the presence of polycystic ovarian syndrome. For other causes, stimulated intrauterine insemination (unexplained and moderate male factor) and stimulated donor intrauterine insemination (severe male) are cost-effective.

Cost-Benefit Analysis↗
PubMedDate not supplied

Laparoscopic myolysis.

This review will focus on the different techniques and the long-term effects of the technique called myolysis on myoma growth. Indications for myolysis are essentially pelvic pain, compression symptoms and global uterine volume in order to avoid hysterectomy. In the late 1980s, myolysis was performed laparoscopically with the help of the neodynium: yttrium aluminium garnet (Nd:YAG) laser. Later, bipolar needles were developed as an alternative to the Nd:YAG laser. Diathermy and cryomyolysis were also proposed but series are small in the literature. Very recently, myoma interstitial thermo-therapy (MITT) was performed using the diode laser and a specific optical light diffuser that is designed to transmit laser light in all directions. Laparoscopic myolysis was proved to be effective in provoking myoma shrinkage, with a dramatic decrease in size and a marked devascularization of the myoma and this technique can be proposed as an alternative to myomectomy in selected patients: only those aged >40 years or those not desiring to bear any more children.

Cryosurgery↗
PubMed1980

Comparison of in vivo temperatures produced by hydrotherapy, paraffin wax treatment, and Fluidotherapy.

The effectiveness of a new heat modality, Fluidotherapy, was compared with other superficial heat modalities by in vivo temperature measurements. The joint capsule and muscle temperatures in the hands and feet were measured in subjects treated with hydrotherapy, paraffin wax, and Fluidotherapy. Fluidotherapy is a dry heat modality consisting of finely divided solids suspended in an air stream. The dry heat modality, applied at 118 degrees F (47.78 degrees C), resulted in maximum joint capsule and muscle temperature rises of 16.2 degrees F (9 degrees C) and 9.5 degrees F (5.27 degrees C), respectively, compared to 13.5 degrees F (7.5 degrees C) and 8.1 degrees F (4.5 degrees C) for paraffin wax treatment and 10.8 degrees F (6.0 degrees C) and 7.7 degrees F (4.3 degrees C) for a 102 degrees F (38.89 degrees C) water bath, at a depth of about 0.5 cm beneath the skin. At depths down to 1.2 cm, superficial heat modalities are more effective than diathermy and much more effective than ultrasound in elevating temperature.

Calorimetry↗
PubMed1992

The effectiveness of manual therapy, physiotherapy, and treatment by the general practitioner for nonspecific back and neck complaints. A randomized clinical trial.

In a randomized trial, the effectiveness of manual therapy, physiotherapy, continued treatment by the general practitioner, and placebo therapy (detuned ultrasound and detuned short-wave diathermy) were compared for patients (n = 256) with nonspecific back and neck complaints lasting for at least 6 weeks. The principle outcome measures were severity of the main complaint, global perceived effect, pain, and functional status. These are presented for 3, 6, and 12 weeks follow-up. Both physiotherapy and manual therapy decreased the severity of complaints more and had a higher global perceived effect compared to continued treatment by the general practitioner. Differences in effectiveness between physiotherapy and manual therapy could not be shown. A substantial part of the effect of manual therapy and physiotherapy appeared to be due to nonspecific (placebo) effects.

Adult↗
PubMed2005

Controlled study of in-line ovine spleen transection assisted by radiofrequency ablation.

BACKGROUND: Trauma to the spleen or tumors of the spleen often require total splenectomy for control of hemorrhage. Partial splenectomy is the preferred technique because of the short- and long-term sepsis problems in asplenic patients. Multiple techniques for partial splenectomy have been tried in the past with limited success. The authors designed the in-line radiofrequency ablation (ILRFA) probe for liver surgery. It uses radiofrequency energy to make a linear coagulative plane that allows the parenchyma of solid vascular organs to be divided. In this study, for the first time, the efficiency of ILRFA was tested with the ovine spleen. METHODS: Seven sheep were used for this study. With the sheep under general anesthesia, a laparotomy was performed. The first sheep was used for a pilot study. Eight partial splenectomies were made in the remaining six sheep using ILRFA. For a control, a matching partial splenectomy was made in each sheep using diathermy and sutures. Blood loss was measured by determining the difference in the weights of dry sponges and blood-stained sponges after resection. A paired t test was used to compare the bleeding between the control and the ILRFA techniques. RESULTS: The mean blood loss was 33.14 +/- 17 g using ILRFA and 123.43 +/- 72 g in the control group. The bleeding was significantly reduced in the ILRFA group (p = 0.0056). The time required to apply ILRFA was 12 minutes. CONCLUSION: Partial splenectomy was achieved in the ovine spleen using radiofrequency energy with minimal blood loss.

Animals↗