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Results for “Surgically-Created Structures”

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134 records · Page 8Linked to original sources
PubMed2006

[The treatment of complex urethral stricture greater than 8 cm long].

OBJECTIVE: To evaluate the selection of different procedures and the feasibility for the treatment of long segment urethral stricture. METHODS: Seventy-six patients with complex urethral stricture greater than 8 cm long underwent different procedures of urethroplasty. Of them various mucosa grafts urethral reconstruction were adopted in 42 cases (colonic mucosal graft, n = 26; buccal mucosal graft, n = 10; bladder mucosal graft, n = 6); One-stage pedicle flaps urethroplasty in 20; two-stage urethroplasty of Johanson procedure in 12; and penile urethra-prostatic urethra anastomosis, three-stage urethroplasty in 2. RESULTS: In early followed up (within 6 months postoperatively), 67 patients (88%) voided well and complications developed in 10. Among the 70 patients who lasted more than 1 year after operation, 51 cases were followed up. Forty-four patients voided well, and complications developed in 8. Of the 8 cases urethral restructure developed in 2 (18%) for pedicle flaps urethroplasty, 2 for colonic mucosal urethroplasty (9%), 1 for buccal mucosal graft (1/7), 1 for bladder mucosal graft (1/3); penile chordee in 2 (2/5), and one of them was accompanied by hair bearing neourethra for two-stage urethroplasty of Johanson procedure. CONCLUSIONS: Colonic mucosal and buccal mucosal grafts urethroplasty are feasible procedures for the treatment of long segment urethral stricture, and Colonic mucosal graft urethroplasty may be considered when more conventional procedures fail or complicated urethral strictures greater than 10 cm long.

Adolescent↗
PubMed2006

Subcutaneous reservoir placement during penile prosthesis implantation.

Currently, the prosthesis of choice for patients undergoing penile prosthesis surgery is a three piece inflatable device, as this provides optimal inflation and deflation when compared to a one or two piece prosthesis. However, prior pelvic surgery or radiation therapy can obliterate the retropubic space and make placement of the reservoir required for a three piece prosthesis difficult. We report a novel location for reservoir placement in a man who had undergone multiple pelvic surgeries after suffering a severe pelvic crush injury.

Abdominal Wall↗
PubMed1997

[Pseudo-continent perineal colostomy. Results and techniques].

OBJECTIVE: This prospective study was conducted to assess functional results obtained after pseudo-continent perineal colostomy using the Schmidt procedure. METHODS: Functional outcome was assessed in 40 patients who had undergone amputation of the rectum for cancer and pseudo-continent perineal colostomy reconstruction between 1989 and 1995 in our institution. The cancer pathology, operative procedure and post-operative care were noted. Morbidity, functional outcome and degree of patient satisfaction were recorded. Mean follow-up was 45 months (18-87) in 100% of the patients. RESULTS: There were no operative deaths. Twenty patients had post-operative complications and 2 patients required early conversion to definitive abdominal colostomy due to severe perineal complications. Function outcome showed normal continence in 4 patients, air incontinence in 23, occasional minimal leakage in 9 and incontinence requiring iliac colostomy in 2. Eighty-six percent of the patients were highly satisfied or satisfied with their continence capacity. DISCUSSION: Pseudo-continent perineal colostomy is a reliable technique which can be proposed as an alternative to left iliac colostomy after amputation of the rectum for cancer if a rigorous procedure is applied: careful patient selection, informed consent, rigorous surgical procedure, daily life-long irrigation of the colon.

Adenocarcinoma↗
PubMedDate not supplied

Jejunal pouch with nerve preservation and interposition after total gastrectomy.

BACKGROUND/AIMS: In this paper, we describe operative technique details and our results with a modified technique for jejunal pouch formation and interposition after total gastrectomy, with an overall aim to achieve results superior to jejunal pouch and Roux-en-Y reconstruction, as reported in the literature. METHODOLOGY: Following total gastrectomy, the jejunum was divided approximately 20 cm distal to the ligament of Treitz. Marginal vessels were not divided in order to preserve the nerves in the 50 cm of distal jejunum which would be used for pouch construction. The pouch was constructed using a linear stapler (Endo GiA, United States Surgical Corp., Norwalk, Conn). A total of 15 gastric cancer patients underwent construction of a nerve-preserving jejunal pouch and interposition following total gastrectomy. RESULTS: None of the patients experienced postoperative complications due to pouch construction. Additionally, discomforts such as dumping or stagnation were not observed. Mild reflux esophagitis occurred in five of the 15 patients and was resolved by oral administration of camostat mesilate. Six months after surgery, the average patient's diet volume and body weight had gradually increased to 79% and 86%, respectively, of the presurgical levels. A dual phase, dual isotope radionucleid pouch emptying study was also performed six months after surgery. The intra-pouch RI retention rate was 47% for liquid food and 53% for solid food 120 minutes after intake. The emptying rate was slower for both solid and liquid food, as compared with healthy individuals. CONCLUSIONS: The pouch-emptying test demonstrated a satisfactory retention capacity and an acceptable emptying time as a gastric substitute. The patients who underwent gastric reconstruction with a nerve-preserving jejunal pouch with interposition have experienced a reasonably good quality of life.

Female↗
PubMed1998

Fibrin glue as a delivery vehicle for autologous urothelial cell transplantation onto a prefabricated pouch.

PURPOSE: The purpose of the study was to investigate how in vivo expanded urothelium can be transplanted onto a prefabricated capsule-pouch for urinary reconstruction. MATERIALS AND METHODS: Urothelial cells from 40 rats were harvested for culture. A tissue expander was used to induce a capsule-pouch on which the cell culture were reimplanted ten days later. As delivery vehicle we compared standard culture media and fibrin glue. RESULTS: The histology demonstrated viable, multilayered clusters of urothelium cells only in the group using the fibrin glue delivery vehicle. CONCLUSION: We conclude that cultured urothelial cells can be successfully reimplanted onto a prefabricated capsule-pouch via fibrin glue, showing potential for urinary reconstructions.

Animals↗
PubMed1997

An experimental rabbit model for jaw-bone healing.

The purpose of this investigation was to study the structural and topographical bone anatomy of the right and left edentulous areas between the incisors and molars in the rabbit maxilla with regard to the symmetry of the bone, and to assess the degree of spontaneous healing of surgical defects. Anatomical and radiographic examinations together with analysis of serial histological ground sections in ten rabbits disclosed no statistically significant differences between the two sides regarding the different bone-tissue structures, i.e. they exhibit a sufficient degree of symmetry to serve as a useful bilateral test-control model. Surgical defects were made on one side of the jaw (test side) in a group of eight rabbits. This resulted in an average loss of 17% of the total bone volume after a healing period of four weeks as compared to the untreated control side. It was concluded that surgically-created defects do not show completely spontaneous healing. From a histological section of the test side, it was possible to redraw the original bone contour by interpolation between unaffected areas of bone, coronal and apical to the defect. This means that the test side of this model can also serve as its own control with regard to the amount of regenerated tissue, given that there is unaffected bone, coronal and apical to the defect.

Animals↗
PubMed1994

Periodontal repair in dogs: space provision by reinforced ePTFE membranes enhances bone and cementum regeneration in large supraalveolar defects.

Regeneration of alveolar bone and cementum following reconstructive therapy with reinforced space providing expanded polytetrafluorethylene (ePTFE) membranes was evaluated in supraalveolar mandibular premolar periodontal defects in five beagle dogs. The surgically-created defects in contralateral jaw quadrants were randomly assigned to receive the dome-shaped membrane or serve as surgical control. Flaps were positioned to completely submerge the teeth and sutured. The dogs were sacrificed 8 weeks after surgery and tissue blocks including teeth and surrounding structures processed for histology. Membrane treated defects in two animals became exposed and infected leaving intact quadrants in three dogs for histometric analysis. Parameters evaluated included defect height, height and area of regenerated alveolar bone, height of regenerated cementum, root resorption, and ankylosis. Mean defect height approximated 4.1 mm. Mean height (+/- s.d.) of regenerated alveolar bone amounted to 2.9 +/- 0.6 and 0.6 +/- 0.2 mm for membrane and control defects, respectively (P = 0.006). Corresponding values for bone area were 1.4 +/- 0.7 and 0.4 +/- 0.4 mm2 (P = 0.02). Cementum regeneration was observed in all teeth averaging (+/- s.d.) 1.6 +/- 0.3 mm for membrane treated and 0.1 +/- 0.1 mm for control defects (P = 0.01). Small amounts of root resorption were seen in all teeth with no significant difference between treatments. Ankylosis was noticed in three membrane treated and two control teeth. The present study provides a biologic rationale for space provision for enhanced bone and cementum regeneration in periodontal defects subject to reconstructive therapy.

Alveolar Bone Loss↗