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At least 1,297 records · Page 72Linked to original sources
PubMed1996

Embolization of pulmonary catheter-induced pulmonary artery pseudoaneurysms.

STUDY OBJECTIVES: To determine the outcome of patients with pulmonary catheter-induced pulmonary artery pseudoansurysms (PSAs) treated with embolization. DESIGN: Retrospective outcomes review. SETTING: Large urban tertiary-care hospital. PATIENTS: All patients who presented to diagnostic angiography for ruptured pulmonary artery PSA caused by pulmonary artery catheters (PACs) from November 1990 to September 1995. A total of six patients were examined. INTERVENTIONS: Transcatheter embolotherapy with coils, absorbable gelatin sponges (Gelfoam), and suture material. RESULTS: These procedures were technically successful in all patients, and none had recurrent hemoptysis. Four of the six patients were discharged from the hospital. CONCLUSION: Embolotherapy is a useful alternative to surgery for some patients with PAC-induced pulmonary PSA.

Aged↗
PubMedDate not supplied

[Epiperineural nerve sutures and neurilemmatic sutures. Comparative clinical results about 109 cases (author's transl)].

During the last ten years, 109 medical cases of traumatic hand nerve lesions have been observed, implicating 78 big nerves (median 35, cubital 42, radial 1) and 37 little nerves (median 35, cubital 42, radial 1) and 37 little nerves (interosseous, collateral, digital). 81 "mixte" epiperineural sutures have been realized (according to a technical proceeding purposed by one of the authors since 1970, and practised with the only aid of a simple optical increase by dissection's magnifying-glasses) : In the same time, 38 neurilemmatic sutures have been seen at second hand and their clinical results noted. 64+ of the global results are very good or "good" concerning the "mixte" epiperineural sutures against 34% for the neurilemmatic sutures. To note : the best quality of the results for the median nerve as well for the primitive sutures, and unfavourable influence of the associated lesions.

Hand↗
PubMedDate not supplied

Influence of suture material and technique on end-to-end reconstruction in tracheal surgery: an experimental study in sheep.

Resection and end-to-end anastomosis of the trachea represent the preferred treatment for various benign and malignant diseases involving the trachea. Various studies have reported conflicting results with alternative techniques and suture materials for tracheal anastomosis. Our objective was to evaluate three frequently used techniques concerning stenosis rate and histological reaction in a large-animal species. Tracheal resection of 3 cm and end-to-end anastomosis were performed in 15 sheep with the use of three different techniques. In the first group, an interrupted suture with polyglactin, in the second group an interrupted suture with polydioxanone, and in the last group a continuous suture with polypropylene were used. The animals were killed 1, 2, 4, 8, and 24 weeks postoperatively. The luminal stenosis was determined by means of computerized planimetry. All three techniques appeared to be appropriate for tracheal anastomosis. The luminal stenosis developed within the first 8 weeks after surgery. A cross-sectional area of approximately 40-70% was finally achieved. Differences dependent on the suture material are less important than the technical details of the operation.

Anastomosis, Surgical↗
PubMed1986

[Clinical experiences with a single layer uterine suture in cesarean section].

In this analysis 536 caesarean sections with a single layer uterine suture were compared to 256 sections with two layer closure. Their relations with regard to indications of operative delivery, complications during the puerperium and their courses in subsequent vaginal deliveries were taken into consideration. - The significant lower rate of pyrexia and shorter hospital stay of the patients may be a result of quicker and better healing of the single layer suture. The increased rate of complications in the puerperium is partially due to changes in the registry of dates. Absent disturbances during the placental period and the occurrence of only one uterine rupture, in the course of vaginal delivery in a patient with a previous single layer caesarean section suture, demonstrates the functional sufficiency of this technic.

Cesarean Section↗
PubMed1977

[Suturing of the resected renal parenchyma].

A historical and technical survey of the indication and application of people resection is presented. A new method is described to ensure rapid haemostasis, reduced parenchymal loss and early mobilization of the patient. The records of 29 patients operated upon in this way are reported.

Adult↗
PubMed2006

Avoiding complications after laparoscopic esophago-gastric banding: experience with 400 consecutive patients.

BACKGROUND: Among bariatric operations, laparoscopic adjustable gastric banding (LAGB) has been the preferred one in Europe and Australia, and has become recently popular in the USA. Like every surgical procedure, however, it is not devoid of specific complications, like slippage, band erosion, outlet obstruction and port problems. Assuming that the absence of the pouch may avoid postoperative slippage, we introduced the technique of esophago-gastric placement, instead of the original gastric banding technique. A further technical variant, introduced in June 2002, consists of suturing the gastric fundus to the left hemidiaphragm, using two non-resorbable sutures and pledgets. METHODS: Between January 1999 and July 2005, 400 LAGBs have been placed in 90 males and 310 females, with the technical variants above. Mean age was 42 (range 17-69 years), and mean BMI was 44.8 kg/m(2) (range 33-67). RESULTS: Mean hospital stay was 2.5 days (range 1-17). Mortality has been zero. Major complications included: 16 slippages (after a range of 6-45 months), 5 outlet obstructions (immediately after the operation), and one intragastric migration (after 2 years). Minor complications included 18 port problems. Since the introduction of gastric fundus fixation to the diaphragm in 2002, gastric slippage has decreased from 8% to 0.9%. BMI has decreased from 44.8 to 32 kg/m(2) at 60 months. CONCLUSIONS: The technique herein presented is effective and useful to prevent postoperative gastric slippage. It does not induce pseudo-achalasia, if strictly controlled. In fact, it is avoided by the patient due to the immediate appearance of dysphagia, in the case of wrong food ingestion. Long-term clinico-radiological follow-up confirms that the technique is safe and effective in motivated patients with good compliance and willing to undergo periodic studies.

Adolescent↗
PubMed2003

Suture anchor repair of ulnar-sided triangular fibrocartilage complex tears.

Traditional open repair of traumatic triangular fibrocartilage complex (TFCC) tears requires a relatively extensive exposure, and arthroscopic repair, though conceptually simple, can be technically demanding. We describe a mini-open suture anchor technique that, while minimally invasive, is easier to perform than previously described open or arthroscopic techniques. Results achieved using this technique in eight cases compare favourably with those reported for other techniques.

Adult↗
PubMed2001

[Meniscus reconstruction. Established and innovative methods].

After the first description of meniscus repairs in the literature it took nearly a century until they were routinely performed in orthopaedic surgery. The scientific basis for meniscus reconstruction needed to be elaborated, including the study of the anatomy, and for instance the vascularisation and the function of the meniscus. After the first experiences with open repair, several arthroscopic techniques have been developed. It has been shown that several factors could influence the healing rate of meniscus lesions. One of the major factors is knee stability. Meniscus repairs performed in conjunction with reconstruction of the anterior cruciate ligament (ACL) have shown higher healing rates (generally > 75%) than isolated repairs, either in stable (50-75% healing rate) or in unstable knees (< 50% in some studies). The localization of the tear is probably the most important factor influencing the healing rate of meniscus repairs. Peripheral tears which are located in the vascular zone of the meniscus heal better than centrally located tears in the avascular area. Many efforts have been provided to enhance the vascularity in this part of the meniscus. None of the proposed techniques have been proven to be definitively effective, or they are too demanding for routine use. Conventional meniscus suture techniques are time-consuming, technically demanding and necessitate incisions at risk for neurovascular structures. In order to simplify meniscus repair several new implants have been developed. They have different forms and are made of different materials among which some are biodegradable. The first clinical results with these techniques are encouraging. However, some new complications have been described. Their incidence and the fate of intraarticular biodegradable devices still has to be defined, especially in the long-term. The present study describes the actual knowledge of meniscus repair and presents the new techniques. It also shows that several questions concerning meniscus repair still need to be answered, and points out the need for further controlled studies.

Anterior Cruciate Ligament↗
PubMed1979

Why Marshall-Marchetti operation works . . . or does not.

Vesicourethral suspension operations fail (1) when preoperative evaluation is insuffcient, leading to improper selection of patients; and (2) for technical reasons when anatomy is uncorrected (suture malplacement, suture breakage, and failure to release adhesions) or when anatomy is corrected (periurethral fibrosis, fistula, stone or granuloma formation on nonabsorbable suture, and overcorrection). Vesicourethral suspension operations work by changing urethrotrigonal anatomy, creating a new equilibrium of forces acting on the bladder neck and urethra.

Female↗
PubMed2003

A new approach for proximal anastomosis in type "A" acute aortic dissection: prosthesis eversion.

One of the crucial aspects of surgical repair of type A aortic dissection is to achieve hemostasis of the anastomosis. Furthermore, the possibility of improving the suture with additional stitches is often technically demanding. We, therefore, describe a new surgical technique for the proximal anastomosis, positioning the prosthesis within the left ventricle. We present our series of 6 patients treated with this new technique. The immediate results confirmed the efficacy, speed, and simplicity of the technique. During long-term follow-up no patient showed significant residual aortic valve incompetence.

Acute Disease↗
PubMed1980

Anatomical correction of transposition of the great arteries.

This method of true anatomical repair of transposition of the great arteries (TGA) avoids the transection and suture of the coronary arteries and does not require any tubes of foreign material. Because the transection goes through the infundibulum under the aortic annulus, the complete aortic root together with the coronary arteries and a muscular subvalvular rim can be sutured to the pulmonary annulus. The technical simplicity of this procedure allows its application in TGA with intact ventricular septum in the newborn when the left ventricular pressure is still high or after the left ventricle has been "prepared" by previous banding of the main pulmonary artery.

Aorta↗
PubMedDate not supplied

Double-bundle anatomic anterior cruciate ligament reconstruction using bone-hamstring-bone composite graft.

The bone-hamstring-bone (BHB) composite graft is a hybrid ligament reconstruction methodology that combines the advantages but eliminates the disadvantages of the bone-patellar tendon-bone (BPTB) and tendon of semitendinosus and gracilis muscle (STG) methods. We have developed an innovative modified BHB method involving anatomic anterior cruciate ligament (ACL) reconstruction. It takes into account the 2 bundles of the ACL: the anteromedial bundle and the posterolateral bundle. The composite graft was prepared by folding the gracilis and the semitendinosus tendons twice and flanking the ends by bone blocks obtained from the tibia. One tunnel of 11-mm diameter was made in the tibia and the femur, and the top of the graft was introduced into the femoral socket; the distal end of the graft was rotated 90 degrees in the counterclockwise direction for a right knee and 90 degrees in the clockwise direction for a left knee to apply a twist to the graft, giving rise to an anteromedial bundle and a posterolateral bundle. The bone blocks attached to the graft were fixed with 2 interference screws. Modified BHB technique allows free selection of the location of the bone plug, minimizes the intra-articular length of the graft, and maintains the double-bundle structure of the original ACL.

Anterior Cruciate Ligament↗
PubMed2006

Sutureless off-pump repair of post-infarction left ventricular free wall rupture.

Left ventricular free wall rupture after myocardial infarction has a high mortality. Suturing techniques of repair may be technically difficult and require cardiopulmonary bypass. We report a case of left ventricular rupture in a 47 year old man managed off pump employing a sutureless technique with Gelatine-Resorcin-Formalin glue and bovine pericardial patches.

Adhesives↗
PubMed2006

Hepatic injury.

Hepatic trauma occurs in approximately 5% of all admissions in emergency rooms. The anatomic location and the size of the liver make the organ even more susceptible to trauma and frequently in penetrating injuries. The American Association for the Surgery of Trauma established a detailed classification system that provides for uniform comparisons of hepatic injury. Diagnosis of hepatic injury can be sometimes easy; however the use diagnostic modalities as diagnostic peritoneal lavage, ultrasound and computed tomography allow faster and more accurate diagnosis. Nonoperative management of the hemodynamically stable patient with blunt injury has become the standard of care in most trauma centers. Few penetrating abdominal lesions allow conservative management; exceptions can be some penetrating wounds to right upper abdominal quadrant. Operative treatment of minor liver injuries requires no fixation or can only be managed with eletrocautery or little sutures. Major liver injuries continue, despite technical advances, a challenge to surgeons. Many procedures can be done as direct repair, debridement associated to resections, or even in more severe lesions, packing. This constitutes a damage control which can allow time to recovery of patient and decreasing mortality shortly after trauma.

Abdominal Injuries↗
PubMedDate not supplied

Upper extremity nerve lesions (diagnosis, indications, surgical techniques).

OBJECTIVE: Revision and questioning of orthodox principles regarding the conduction of nerve impulse. DESIGN: Retrospective study with clinical analysis of results. SITE: Hospital das Clinicas (HCFMSP), public university institution with research programs and tertiary attention to health. GROUP MEMBERS: Author and a team of residents and trainees. OPERATION: Direct suture of nervous stumps utilizing auxiliary technical procedures:- joint-flexion, nerve transposition, tendon transplants, bone shortening. MEASUREMENT: Clinical evaluation and objective tests for tactile and stereognostic function recovery (Weber Test). RESULTS: Variable, depending on preoperative conditions:- type of lesion, time elapsed since injury. CONCLUSIONS: Neurorrhaphy should be the procedure of choice even for long term lesions, although the expected results may be less favourable. Periodical evaluation from 24 hs. postoperative, checking for early undefined signals of nervous function recovery. Association of specific drugs for chemical biophysics of the nerve.

Arm↗
PubMed1990

[The surgical treatment of keratoconus by intralamellar keratoplasty].

The paper describes results after clinical approbation of intralamellar keratoplasty used for treatment of 9 patients with chronic keratoconus, the follow-up period ranging from 1 to 3.5 years. The technique of the operation consists in transplantation of an implant in a form of a disc into the layers of a thinned cornea and allows to stabilize the development of chronic keratoconus, to somewhat flatten the cornea and to rise visual acuity. The operation is technically simple, avoids the using of sutures that traumatize the cornea and the implant, can be used for treatment of early stages of keratoconus when there aren't yet coarse changes in corneal stroma.

Adolescent↗
PubMed1990

[Trans-suture mechanical colorectal anastomosis using a double stapler in the anterior resection of the rectum. Technical note].

The spread of mechanical staplers now makes it possible to perform anastomoses in anterior resections of the rectum that are easier and safer than manual ones. Certain related problems are well known, particularly in patients with narrow pelvis and, in low anastomoses, the fashioning of the tobacco pouch on the distal rectal stump. The technique of transutural mechanical colorectal anastomosis with circular stapler after closure of the rectal stump with linear stapler is described in detail. Advantages of the technique are: anastomoses that are technically easier and safer because making of the tobacco pouch on the distal rectal stump is avoided; pollution of the operating field is reduced to the minimum; there are no problems related to differences in lumen of the colorectal stumps.

Anastomosis, Surgical↗