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At least 163 records · Page 9Linked to original sources
PubMed2001

Laparoscopy as the primary modality for the treatment of women with endometrial carcinoma.

BACKGROUND: The current study was conducted to assess the feasibility of laparoscopy in the treatment of women with early stage endometrial carcinoma and to compare the surgical outcome, cost, and quality of life among these patients with those treated with laparotomy. METHODS: A prospective study was conducted over 2 years in which all women with early stage endometrial carcinoma who could tolerate laparoscopic surgery were treated with laparoscopically assisted vaginal hysterectomy (LAVH), bilateral salpingo-oophorectomy (BSO), and lymphadenectomy. Women with a similar disease stage who underwent similar surgical procedures through laparotomy in the previous 2 years were used as the control group. Both groups were compared with regard to their characteristics, surgical outcome, and cost and were interviewed regarding their quality of life. RESULTS: Eighty-six of 90 women with endometrial carcinoma underwent LAVH. The procedure was converted to laparotomy in 5 patients (5.8%). Laparoscopic surgery thus was successful in 90% of the women. There were no significant differences noted between those women who underwent LAVH and those who underwent total abdominal hysterectomy (TAH) (n = 57) with regard to patient characteristics, type of surgical procedure, preoperative and postoperative hematocrit, complications, patient recall of postoperative pain, and tumor recurrence. LAVH patients had significantly smaller body mass indices, a longer surgical time, more pelvic lymph nodes, a smaller decrease in postoperative hematocrit, received less pain medication, had a shorter hospital stay, an earlier return to full activity and work, and a higher level of satisfaction with their treatment, although their procedures had a higher cost compared with TAH patients. CONCLUSIONS: The majority of women with early stage endometrial carcinoma can be treated with laparoscopy with an excellent surgical outcome, shorter hospitalization, earlier recovery, and improved quality of life, but with a higher financial cost.

Adult↗
PubMedDate not supplied

Surgical ablation of atrial fibrillation: the Columbia Presbyterian experience.

BACKGROUND: The Maze III procedure is an effective surgical treatment for atrial fibrillation (AF). However, it is not widely applied due to its complexity, increased operative times, and the risk of bleeding. Various energy sources have been introduced to simplify the traditional "cut and sew" approach. METHODS: This study involves patients undergoing surgical atrial fibrillation ablation (SAFA) at a single institution from 1999 to 2005. Type of concomitant procedures, preoperative clinical characteristics, and chronicity of AF were evaluated in overall patient population. Parameters including surgical approach, lesion pattern, and energy source used were collected intraoperatively. Clinical outcomes examined were postoperative rhythm success, stroke, early mortality, and long-term survival. RESULTS: Three hundred thirty-nine patients were identified. Three hundred twenty-eight (96.8%) patients had associated cardiac disease and underwent concomitant procedures; 75.8% of patients had persistent AF. Energy sources used were microwave (49.8%), radiofrequency (42.2%), and laser (8.0%). In 41.9% of cases a pulmonary vein encircling lesion was the only lesion created. Combination lesion sets were performed in the remaining cases. Rhythm success rates at 3, 6, 12, and 24 months were 74.1%, 68.2%, 74.5%, and 71.1%, respectively. Patients who underwent surgical removal of left atrial appendage by means of stapling or simple excision had no early postoperative stroke. Early mortality was 4.9%. Postoperative survival rates at 1, 3, and 5 years were 89.6%, 83.1%, and 78.0%. CONCLUSIONS: Surgical ablation of atrial fibrillation is a safe and effective procedure in restoring sinus rhythm with excellent postoperative survival rates. Further advancements in the field will eventually result in minimally invasive procedures with higher success rates.

Aged↗
PubMed2004

Utility of axillary ultrasound examination to select breast cancer patients suited for optimal sentinel node biopsy.

BACKGROUND: Because sentinel node (SN) biopsy (SNB) is known to produce false-negative results, we examined the usefulness of axillary ultrasound (AUS) in selecting patients suitable for optimal SNB. METHODS: A positive AUS finding (positive AUS) was defined as an echo pattern of a homogeneously hypoechoic SN without an echo-rich center, indicating massive to extensive nodal involvement. The identification of SNs was performed, and complete axillary dissection was carried out. RESULTS: A total of 262 women were enrolled into the study (T1 disease = 94; T2 disease = 145; and T3 disease = 23). The incidence of positive AUS increased with increasing size of breast tumor (P <0.0001). The overall identification and false-negative rates were 88.2% and 10.8%, respectively. However, when limited to AUS-negative patients, SNs were identified in 205 of 208 patients (98.6%), and the false-negative rate was 1.7%. CONCLUSIONS: AUS should be included in the preoperative procedure for the selection of breast cancer patients suitable for SNB.

Axilla↗
PubMed2005

Laparoscopic appendectomy in pregnancy.

BACKGROUND: Laparoscopic appendectomy (LA) is a safe, effective, and beneficial procedure for the treatment of acute appendicitis. However, limited data are available regarding the safety and feasibility of LA during pregnancy. METHODS: Between January 2001 and August 2004, 1235 patients with clinically suspected appendicitis underwent laparoscopic surgery at our hospital. Eleven patients (0.9%) were pregnant women (mean age, 25 years; age range, 19-37 years; range of gestational age, 4-30 weeks). Clinical data collected retrospectively included demographic information; preoperative, procedural, and postoperative information; and outcome of the pregnancy. RESULTS: All 11 pregnant women underwent laparoscopic surgery without need of conversion. Ten patients underwent LA and were found to have acute appendicitis on histologic analysis. One patient had torsion of the right fallopian tube and a healthy-looking appendix; she underwent detorsion of the fallopian tube and incidental appendectomy. Mean operative time was 50.5 minutes (range, 20-135 minutes). Length of postoperative hospital stay averaged 4.2 days (range, 1-11 days). One patient had a surgical wound infection, which was managed conservatively. Mean follow-up period was 14 months (range, 2-46 months). Seven pregnant women delivered healthy term infants, 2 had planned abortions, and 1 experienced fetal loss due to uterine infection and premature contractions 1 month after LA. Another patient had normal results at prenatal examination. CONCLUSION: Our data support the accumulating evidence that LA is a safe and feasible procedure for the treatment of acute appendicitis in all trimesters of pregnancy. Close maternal and fetal monitoring is essential during and after the operation.

Adult↗
PubMedDate not supplied

Factors predictive of LASIK flap thickness with the Hansatome zero compression microkeratome.

PURPOSE: To determine the explanatory power of preoperative variables and comeal flap thickness in laser in situ keratomileusis (LASIK) using the Hansatome zero compression microkeratome (Bausch & Lomb, Rochester, NY). METHODS: A prospective, nonrandomized, comparative interventional case study was performed on 250 eyes of 129 consecutive patients who underwent LASIK surgery using the Hansatome zero compression microkeratome. A 160-microm or 180-microm microkeratome head and an 8.5- or 9.5-mm suction ring were used in the procedures. Preoperative measurements included refraction, spherical equivalent, keratometry, intraocular pressure, corneal white-to-white, anterior chamber depth, and corneal eccentricity. Corneal thickness was measured intraoperatively using ultrasonic pachymetry before and after flap creation, and the difference was taken as flap thickness. Flap diameter was measured with a corneal gauge. Data were analyzed using simple, multiple, stepwise linear and non-linear regression analyses and two-tailed t tests. RESULTS: The mean flap thickness was 124 +/- 17 microm with the nominal 160-microm head and 142 +/- 20 microm with the nominal 180-microm head. One third (33%) of the total variation in flap thickness could be accounted for by three preoperative variables: average corneal thickness, spherical equivalent refraction, and choice of 160- or 180-microm microkeratome head. A simple correlation of 0.114 was noted between corneal eccentricity and flap thickness, but this variable did not add significant explanatory power on multiple regression analysis. Linear regression analysis allowed determination of a flap thickness nomogram with a standard error of the estimate of 16.9 microm and a 95% confidence interval of +/- 33.1. CONCLUSIONS: Comeal thickness is the most systematic predictor of corneal flap thickness using the Hansatome microkeratome. Because three preoperative variables account for only 33% of the range in flap thickness, future studies should focus on variations in blade extension and corneal biomechanical factors, which may also play an important role in determining flap thickness.

Adult↗
PubMed2004

Cataract surgical outcome at the Vancouver Eye Care Centre: can it be predicted using current data?

BACKGROUND: Patients selected for cataract surgery have an increasingly wider range of coexisting ocular and systemic diseases. The aim of this study was to determine whether preoperative patient characteristics can assist surgeons in identifying patients who are at increased risk of having little or no improvement in visual outcome after cataract surgery. METHODS: We prospectively studied a randomly selected subset (20%) of patients with cataract undergoing cataract extraction at a tertiary centre in Vancouver. There were no patient exclusion criteria. Pre-, intra- and postoperative clinical data were collected from medical records. RESULTS: We studied 1329 cataract surgical procedures from March 1999 to December 2000. Of the 1329, 851 had complete pre- and postoperative visual acuity data. The mean age of the 851 patients was 73.2 (standard deviation 10.6) years, 575 (67.6%) were women, and 472 procedures (55.5%) were first-eye procedures. Preoperatively, the best-corrected visual acuity was 20/40 or better in 146 eyes (17.2%), 20/50 in 173 (20.3%), 20/60 to 20/70 in 248 (29.1%), and 20/80 or worse in 284 (33.4%). Almost half of the patients (419 [49.2%]) had at least one coexisting eye disease in the operated eye. At about 3 months postoperatively, the best-corrected visual acuity had improved in 786 eyes (92.4%), remained the same in 42 (4.9%) and had worsened in 23 (2.7%). Of the 23 eyes with worse visual acuity, half had preoperative visual acuity of 20/40 or better; most of the remaining eyes had preoperative vision of 20/50 to 20/70. Of the 42 eyes with unchanged vision, 22 (52%) had preoperative visual acuity worse than 20/100; the remaining eyes were distributed across the visual acuity range. An increase of 1 year of age increased the odds of having a poor visual acuity outcome by 2% to 4%. Worse preoperative visual acuity predicted an increased likelihood of a poor outcome; this effect increased sharply for eyes with preoperative visual acuity of 20/80 or worse. After adjustment for age and preoperative visual acuity, patients with three or more coexisting eye diseases in the operated eye were 10 to 24 times more likely to have the worst postoperative visual acuity. INTERPRETATION: The presence and number of coexisting ocular diseases, increased age and poor preoperative visual acuity predicted an unchanged or worse visual acuity after cataract surgery.

Aged↗
PubMed1989

[The value of high-resolution computerized tomography in abnormalities of the middle ear].

Middle ear malformations are common congenital disorders of the head and neck area. Recent advances in plastic and middle ear surgery have improved the prognosis of patients suffering from congenital hearing disorders. However, sophisticated preoperative procedures are mandatory. The development of HR-CT has improved the radiologic possibilities to evaluate middle ear disorders significantly. In the present study we examined by means of HR-CT twenty patients with congenital middle ear malformation. Our findings include different sizes of the middle ear as well as dysplastic alterations of the malleus and incus. The inner ear was normal in almost all cases. Our results indicate that preoperative HR-CT is a reliable diagnostic method to demonstrate middle ear disorders.

Ear Ossicles↗
PubMed1994

Evaluation and treatment of patients receiving radiation for cancer of the rectum or sigmoid colon in the United States: results of the 1988-1989 Patterns of Care Study process survey.

PURPOSE: For the first time, a Patterns of Care Study (PCS) was conducted in 1989 to determine the national practice standards of radiation oncologists in evaluating and treating adenocarcinoma of the rectum and sigmoid colon. MATERIALS AND METHODS: A national survey of 73 institutions using two-stage cluster sampling was conducted, and specific information on 408 patients from 69 facilities with adenocarcinoma of the rectum and sigmoid colon who received radiation as part of definitive or adjuvant management was collected. RESULTS: Using the modified Astler-Coller (MAC) pathologic staging system, the stage distribution was as follows: A, 0.5%; B1, 4.4%; B2, 23.5%; B3, 5.1%; C1, 8.9%; C2, 30.2%; and C3, 6.6%. Preoperative radiation was used in 29% of patients, but the total dose was greater than 40 Gy in only 20%. Seventy-three percent of patients received postoperative radiation, with approximately 4% receiving combined preoperative and postoperative radiation. Chemotherapy was administered to 44% of patients overall, representing 55% of patients with disease through the bowel wall and/or involving lymph nodes. Only 37% of all patients received chemotherapy concurrent with radiation. An abdominoperineal resection was used in 43%; a low anterior resection was used in 43% as well, while 5% underwent other types of bowel resection. Approximately 8% of patients were treated with a local curative procedure less than bowel resection (eg, local excision, endoscopic resection, fulguration, or contact radiation). At least one third of patients had interruption in their pelvic irradiation of greater than 3 days. There was no statistically significant difference in the frequency of treatment interruptions by dose per fraction or whether chemotherapy was given concurrent with radiation. There was no significant difference in total dose delivered to patients staged B2 and higher treated without chemotherapy compared with concurrent chemotherapy and radiation. Also, there was no significant difference in total dose delivered to patients with B1 and B2, or C1 and C2 versus B3 or C3 cancer. CONCLUSION: This study was conducted on patients treated just before the 1990 National Institutes of Health consensus guidelines issued on the management of colon and rectal cancer. This study indicates that the minority of patients treated with radiation in 1988 and 1989 received concurrent chemoradiation, as currently recommended. Additionally, insofar as present studies are investigating important issues such as the use of sphincter-sparing procedures, preoperative radiation and chemotherapy, and the importance of radiation dose and scheduling with chemotherapy, the information provided by this study will serve as a useful baseline to track future changes in rectal cancer evaluation and management.

Adenocarcinoma↗
PubMed2003

Treatment of nonunions following anterior cervical discectomy and fusion with interspinous wiring and bone grafting.

Between 1979 and 2000, 25 posterior arthrodeses were performed for repair of symptomatic nonunions following anterior discectomy and fusion. The surgical technique in all cases was an interspinous wiring with an autogenous bone graft in 20 and morselized allograft bone in five. The average follow-up was 5 years (range, 1-14 years). In all patients, the anterior pseudarthrosis progressed to a solid union as judged by an independent musculoskeletal radiologist. In 17 patients, their preoperative pain was relieved; however, of these, six developed recurrent pain caused by degeneration at an adjacent level on an average of 5 years (range, 1-14 years) after their posterior surgery. The authors propose that posterior interspinous wiring with a bone graft is a safe and efficacious method of repair of an anterior pseudarthrosis. However, patients must be cautioned that even though the pseudarthrosis can be predictably repaired by a posterior procedure, preoperative pain may not be relieved.

Bone Transplantation↗
PubMedDate not supplied

[Reoperation following failure of anti-reflux surgery].

Reoperation is the treatment of choice of failed antireflux procedures. Preoperative full-scale evaluation of both residual anatomy and function of the upper digestive tract is mandatory. Conservative surgery is almost always feasible. Success rate of reoperations is high with experienced teams.

Gastroesophageal Reflux↗
PubMed2000

Further experience with seromuscular colocystoplasty lined with urothelium.

PURPOSE: We report our continuing experience with seromuscular colocystoplasty lined with urothelium. This procedure is designed to preserve the urothelium and potentially decrease the incidence of complications associated with standard bladder augmentation. MATERIALS AND METHODS: We retrospectively reviewed the charts of 32 patients who underwent seromuscular colocystoplasty lined with urothelium between April 1994 and July 1999. Data were collected on patient demographics, surgical indications, previous and adjunctive surgical procedures, preoperative and postoperative urinary continence, upper urinary tract changes, urodynamic parameters, surgical complications and histological findings. RESULTS: Mean patient age at surgery plus or minus standard deviation was 11.1 +/- 4.8 years. Mean followup was 1.6 +/- 1 years. A mean of 1.5 +/- 0.9 years postoperatively urodynamic studies available in 28 cases showed that total and safe bladder capacity increased by 1.8 and 2.4-fold, respectively. Continence was achieved in 71% of patients after the initial procedure, increasing to 81% after secondary procedures. Hourglass deformity developed in 7 cases (22%), augmentation failed in 4 (12.5%) and there were bladder calculi in 2 (6%). New onset or increased hydronephrosis and reflux were present in 6 of 62 (10%) and 9 of 60 (15%) evaluated renal units, respectively. Of the 7 interpretable biopsies 5 revealed various degrees of repeat colonic mucosal growth. There was no bladder perforation or metabolic abnormalities, and mucous production was not clinically significant. CONCLUSIONS: Seromuscular colocystoplasty lined with urothelium is a viable alternative to standard bladder augmentation. The 2 procedures have a similar overall complication rate. Comparatively there appears to be a low incidence of bladder calculi, mucous production has not been clinically significant, metabolic disturbances have not developed and perforation has not occurred during short-term followup. We are enthusiastic about this technique and continue to apply it in select patients.

Adolescent↗
PubMed2005

Changes in the chewing path of patients in skeletal class III with and without asymmetry before and after orthognathic surgery.

PURPOSE: The purpose of this study was to examine the relation between changes in the condylar long axis and the chewing path before and after mandibular ramus osteotomy for patients with prognathism with and without asymmetry. PATIENTS AND METHODS: Eleven men and 16 women with mandibular prognathism were divided into groups on the basis of symmetry and osteotomy procedure. Preoperative and postoperative frontal chewing paths were recorded. The chewing path consisted of 4 components: deviated side range, undeviated side range, vertical range, and incisal path angle. The angle of the condylar long axis and the 4 components of the chewing path were compared between groups and the differences were analyzed statistically. RESULTS: No significant differences in each of the 4 chewing path components were found between groups on the basis of symmetry or osteotomy procedure. A positive correlation was found between the changes in incisal path angle when chewing on the undeviated side and condylar long axis angle on the undeviated side (P < .05). A positive correlation was also found between the changes in undeviated side range when chewing on the deviated side and condylar long axis angle on the deviated side (P < .05). CONCLUSION: This study suggests that surgically induced increase in the condylar long axis is correlated with increase in side range and incisor path angle, although surgical orthodontic treatment does not significantly change the chewing pattern.

Adult↗
PubMed2002

Benign tracheal and laryngotracheal stenosis: surgical treatment and results.

OBJECTIVES: Benign tracheal stenoses remain the most common indications for tracheal resection. We report lessons learned with surgical management of tracheal stenoses in a consecutive series of 65 patients from the beginning of our experience to date. METHODS: From December 1991 to January 2001 65 patients underwent primary tracheal and laryngotracheal resection and reconstruction for non-neoplastic stenoses. There were 39 males and 26 females with a median age of 33 years (range 14-74 years). There were 58 cases of postintubation and seven of idiopathic stenosis. A cervical approach was used in 60 patients, and a cervical incision with sternal split in four and with sternotomy in one. We performed 45 (69.2%) tracheal resections and 20 (30.8%) laryngotracheal resections. The length of resection ranged between 1.5 and 4 cm (median 2.5 cm). The range of resected rings was two to eight (median five). RESULTS: Fifty-four patients received a preoperative treatment. Preoperative procedures consisted of laser therapy (37), tracheostomy (38) and endotracheal prosthesis (16). We had major complications in eight patients (12.3%) and minor complications in 15 patients (23%). The most frequent complications were: temporary vocal cord dysfunction (eight patients), wound infection (five patients), anastomotic dehiscence (four patients), vocal cord paralysis (two patients), granulation tissue (two patients), deglutition dysfunction (one patient) and restenosis (one patient). Perioperative mortality was 1.5% (one patient). In classifying final results obtained, 54 patients achieved an excellent result, eight a good result and two satisfactory. CONCLUSIONS: The strategy for treatment of airway stenoses is now well established and leads to a high level of success with minimal or no sequelae. Meticulous preoperative assessment and preparation associated with a perfect surgical technique is mandatory to obtain good results. Preoperative treatments (laser and/or endotracheal prosthesis) could increase the extent of injury and the length of stenosis.

Adolescent↗
PubMed2003

[Preliminary results with Cuénod's osteoligamentoplasty and capsulodesis for treatment of chronic scapholunate dissociation].

Until now, the ideal treatment of scapholunate dissociation has not yet been found. Cuénod described an operation with reconstruction of the dorsal part of the scapholunate ligament using a bone-ligament-bone autograft (dorsal trapezoidometacarpal II ligament) and an additional dorsal capsulodesis using the dorsal intercarpal ligament. From December 2000 until January 2002, we operated on twelve patients with symptomatic chronic scapholunate dissociation without signs of osteoarthrosis using Cuénod's procedure. Preoperatively as well as at follow-up patients were evaluated using a traditional wrist score and a DASH-questionnaire in addition to clinical examination. X-rays of both wrists in two planes each and additional stress radiographs were done. All patients had an arthroscopy preoperatively and a CT scan before K-wire removal. The mean follow-up time was twelve months. Clinical follow-up showed good results (traditional wrist score: 77 points; DASH-score: 27 points), but with regard to the good preoperative findings (traditional wrist score: 73 points; DASH-score: 28 points) no significant improvement. Postoperative X-rays showed a correction of static instability in three cases; in four cases we found a recurrent SL gap, which was interpreted as failure of the transplanted ligament. Until now, one patient had to be reoperated by STT-fusion. In our patients, Cuénod's operation showed different results. So, further studies are necessary to find the correct indications for applying this procedure.

Adult↗
PubMedDate not supplied

Histological findings after placement of a self-expanding stent in rectal carcinoma with complete obstruction--case report.

Patients with acute obstruction due to colorectal carcinomas frequently require emergency surgery. However, such emergency procedures are associated with various complications, a high mortality rate and a poor prognosis. If the obstruction could be immediately relieved, the patient could later undergo an elective operation with a much better prognosis. Recently, expanding metallic stents have been used to treat obstruction due to colorectal carcinoma. In the case reported here, we initially inserted a colonoscopic retrograde bowel drainage tube per anus to achieve decompression. We then placed a self-expanding metallic stent, since we anticipated a prolonged preoperative period due to high fever, congestive heart failure, cerebral infarction, and persistent high blood sugar concentrations. The patient had no complications for 57 days after placement of the stent, and eventually underwent an elective operation. Histologically, the side of the cancerous lesion compressed by the stent was thin and consisted solely of a serosal layer. Implantation of a metallic stent is safe for the treatment of acute malignant obstruction. Stent placement is indicated not only as a palliative treatment for inoperable or recurrent cases, but also as a preoperative procedure before elective surgical resection.

Aged↗
PubMedDate not supplied

Preoperative embolization of arteriovenous malformations with polylene threads: techniques with wing microcatheter and pathologic results.

The technique with a wing microcatheter system and the pathologic aspects of 11 cerebral arteriovenous malformations (AVMs) surgically resected after embolization with polylene threads are reported. Embolization was performed once in eight patients and twice in three patients. Resected AVMs were submitted both to routine hematoxylineosin examination and to immunohistochemical workup in order to detect the type of immunologic response to thread emboli. In nine cases, 50% or more of the nidus was obliterated by the embolization. After embolization two patients developed reversible neurologic deficits. Pathologic specimens of resected AVMs demonstrated no vascular necrosis; however, a moderate inflammatory response could be seen, characterized by the presence of both mononuclear cells and foreign-body giant cells, associated with the absence of polymorphonuclear infiltrates. A granulomatous fibrotic process was identified that was present from the first month after embolization. Immunohistochemistry indicated that the immunologic response to thread emboli was cell-mediated, not humoral. Embolization with the wing microcatheter with the use of polylene threads proved to be a safe and efficient system of embolization, as a preoperative procedure. Polylene threads are a nontoxic and biocompatible material that can be used as an embolic agent for brain AVMs.

Adult↗
PubMedDate not supplied

Pes anserinus and iliotibial band transfer for anterior cruciate insufficiency.

Twenty-one patients with chronic anterior cruciate ligament insufficiency were treated with a combined iliotibial band (Ellison) and pes anserinus (Slocum-Larson) transfer procedure. Preoperatively, the most prominent instabilities were drawer laxity in 16 patients and anteromedial rotation in 5 patients. After a median of 34 months of followup, 15 patients were absolutely satisfied with the result, 2 were fairly satisfied, and 4 were not satisfied at all, including 2 patients who had been reoperated. All of the patients with unsatifactory results had a pivot shift and a positive Slocum test. Intraarticular derangements had no influence on the results. At followup, 14 patients demonstrated an anteromedial rotatory instability, indicating that the lateral stabilization procedure acted better than the medial one. Only a few patients returned to their preinjury levels of sports activity. Compared with other extraarticular procedures in the literature, the results were quite similar. The operative procedures used in this study cannot be recommended in cases with combined instabilities of the knee.

Adult↗
PubMed1998

Residual inflammatory process after aortoiliac reconstructive surgery.

BACKGROUND: The aim of the present study was to investigate the inflammatory reaction and its evolution in patients who underwent a prosthetic vascular procedure. Moreover the participation of this chronic process, during the follow-up, as a promoting or a consequence of vascular injury must be discussed. METHODS: Thirty-four patients were enrolled in the study. All patients had an aortic disease and underwent a prosthetic vascular procedure. Preoperative exclusion criteria were an emergency situation, diabetes, infection, chronic inflammatory disease, cancer and hemopathy. Postoperative exclusion criteria were the same together with abdominal complications and additional surgery during the follow-up. The inflammatory process was investigated with the measurement of blood acute phase proteins, haptoglobin, alpha1-glycoprotein acid, C-reactive protein and interleukin-6, before, immediately after surgery and several months after surgery. RESULTS: An increase in acute phase proteins was not observed to the same extent for all the studied patients. Before the surgical procedure, chronic inflammatory process was revealed by an increase in haptoglobin (52.9 p 100) and alpha1 glycoprotein acid (52.9 p 100) whereas increase in C-reactive protein (26.4 p 100) and interleukin-6 (92 p 100) are related to an acute process. Later after surgery, the chronic inflammatory process remained but differed from the observed process before surgery only by haptoglobin (61.7 p 100) and interleukin-6 (47 p 100). CONCLUSIONS: The presented results, observed during the follow-up of vascular surgery focused on persistent inflammatory process and the surgical procedure did not modify the time course of this process. The evolutionary disease could be considered as chronic and independent of the local effect.

Aged↗