SEARCH · Search PubMed

Results for “REIMPLANTATION”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

SourceResearch connectionFrom yearThrough year

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 163 records · Page 9Linked to original sources

PubMed1995

Cochlear pathology following reimplantation of a multichannel scala tympani electrode array in the macaque.

The histopathologic consequence of removing and reimplanting intracochlear electrode arrays on residual auditory nerve fibers is an important issue when evaluating the safety of cochlear prostheses. The authors have examined this issue by implanting multichannel intracochlear electrodes in macaque monkeys. Macaques were selected because of the similarity of the surgical technique used to insert electrodes into the cochlea compared to that in humans, in particular the ability to insert the arrays into the upper basal turn. Five macaques were bilaterally implanted with the Melbourne/Cochlear banded electrode array. Following a minimum implant period of 5 months, the electrode array on one side of each animal was removed and another immediately implanted. The animals were sacrificed a minimum of 5 months following the reinsertion procedure, and the cochleas prepared for histopathologic analysis. Long-term implantation of the electrode resulted in a relatively mild tissue response within the cochlea. Results also showed that inner and outer hair cell survival, although significantly reduced adjacent to the array, was normal in 8 of the 10 cochleas apicalward. Moreover, the electrode reinsertion procedure did not appear to adversely affect this apical hair cell population. Significant new bone formation was frequently observed in both control and reimplanted cochleas close to the electrode fenestration site and was associated with trauma to the endosteum and/or the introduction of bone chips into the cochlea at the time of surgery. Electrode insertion trauma, involving the osseous spiral lamina or basilar membrane, was more commonly observed in reimplanted cochleas. This damage was usually restricted to the lower basal turn and resulted in a more extensive ganglion cell loss. Finally, in a number of cochleas part of the electrode array was located within the scala media or scala vestibuli. These electrodes did not appear to evoke a more extensive tissue response or result in more extensive neural degeneration compared with electrodes located within the scala tympani. In conclusion, the present study has shown that the reimplantation of a multichannel scala, tympani electrode array can be achieved with minimal damage to the majority of cochlear structures. Increased insertion trauma, resulting in new bone formation and spiral ganglion cell loss, can occur in the lower basal turn in cases where the electrode entry point is difficult to identify due to proliferation of granulation and fibrous tissue.

Animals↗

PubMed1996

Contralateral reflux after unilateral ureteral reimplantation.

PURPOSE: We analyzed the incidence and outcome of postoperative contralateral reflux after unilateral ureteral reimplantation by the Cohen and Glenn-Anderson techniques. MATERIALS AND METHODS: We retrospectively reviewed the records of 120 patients 3 months to 21 years old in whom unilateral vesicoureteral reflux was treated by unilateral reimplantation. The incidence of postoperative contralateral reflux was documented by followup voiding cystourethrography. RESULTS: Overall 19% of patients who underwent unilateral reimplantation had contralateral vesicoureteral reflux postoperatively, including 21% after the Cohen and 17% after the Glenn-Anderson procedure. Of the cases 61% spontaneously resolved, 13% were surgically corrected and 26% continue to be followed. CONCLUSIONS: The rates of postoperative contralateral vesicoureteral reflux are not significantly different after Cohen and Glenn-Anderson repair. A majority of cases will resolve spontaneously within 2 years. The likelihood of trigonal distortion as the etiology of contralateral reflux is low given the similar incidence in cross-trigonal and ureteral advancement reimplantation.

Adolescent↗

PubMed1996

Cementless reimplantation of hydroxyapatite-coated total hips after periprosthetic infections.

From February 1991 to July 1993, 26 hydroxyapatite (HA) coated total hips were implanted in 26 patients with infected hip prostheses. Seven were done as one-stage exchange arthroplasties and the other 19 were delayed reimplantations. Successful reimplantation was defined as a functioning hip without recurrence of infection at least 2 years after reimplantation. During a follow-up period of 25 to 54 months, 24 of the reimplantations were successful. Our success rate using the HA-coated prosthesis is similar to previous reports that used antibiotic impregnated bone cement. The HA method avoids the complications encountered with bone cement.

Adult↗

PubMed1997

[Two stages reimplantation for infection after knee arthroplasty. Apropos of a series of 29 cases].

PURPOSE OF THE STUDY: The purpose of this work was to precise diagnosis and treatment of infected total knee arthroplasty with two stage reimplantation. MATERIAL: 29 infected total knee arthroplasties were operated between 1984 and 1994 and included in this study (mean F.U. 3.5 Y). There were 20 females and 9 males, mean age 70 (46-83). The original arthroplasty was done for OA in 28 patients, RA in one. The arthroplasties were: UHK 2, Bicompartmental 2, Tricompartmental 19. 20 TKA were cementless. 14 patients showed one or several risk factors. Infection was diagnosed in 1 of 2 ways: preoperative aspiration or culture of surgical specimen. There were 12 staphylococcus epidermidis, 8 staphylococcus aureus, streptococcus (n = 2) acinetobacter (n = 2), peptococcus (n = 1) pseudomonas (n = 1), gemella morbidellum (n = 1). 6 were non identified. METHOD: The protocol for two stage reimplantation began with components and cement removal. A synovectomy was performed. The knee cavity was filled with antibiotic cement spacer and the wound was closed. The leg was placed in a splint. All patients underwend a continued antibiotic therapy, specific in 20 cases with isolated organisms. A total knee arthroplasty was performed, using a total posterior cruciate substituting prosthesis, 6 to 8 weeks after components removal (2-24). All patients received parenteral antibiotics after reimplantation for not less than 2 months (2-6). RESULTS: Infection was eradicated in 24 cases, 22 in one time, 2 bad second debridement. At last follow-up the average Hungerford score was 75.6/100, the average Knee society knee score was 80 and the average functional score was 70. Mean range of flexion was 95 degrees. 6 patients had recurrent infection and poor result. They underwent arthrodesis. 5 of the 6 patients had solid mature fusion at last follow-up. DISCUSSION: The results of two stage reimplantation for infected total knee replacement showed that this is the method of choice for infection treatment and acceptable function restoration. As other authors, we get a good success rate (82 per cent). Functional result was better with identified microorganisms, but we did not find any correlation with organisms type or infection length. Punction and bone scanning are of great help for diagnosis in difficult chronical cases. Organism identification is fundamental for infection duration. Staphylococcus epidermidis was the most frequent identified organism. New procedures using articulated cement spacer may improve functional results.

Aged↗

PubMed1998

Voiding dysfunction after bilateral extravesical ureteral reimplantation.

PURPOSE: Voiding dysfunction has been reported after bilateral extravesical ureteral reimplantation. We evaluate the incidence and duration of voiding dysfunction, and the effects of minimizing surgical dissection in a cohort of children after bilateral extravesical reimplantation. MATERIALS AND METHODS: A retrospective chart review was performed on 33 consecutive children who underwent bilateral extravesical ureteral reimplantation for reflux. Preoperative and postoperative radiological studies, and postoperative post-void residuals were reviewed. Of the 33 patients 11 underwent ureteroneocystostomy using a modified Lich-Gregoir technique with ureteral advancement and 22 underwent a modified procedure in which the detrusor dissection was minimized and the obliterated umbilical artery was preserved. Both groups had similar preoperative characteristics. Postoperative surgical success and signs of voiding dysfunction were evaluated and compared between groups. RESULTS: The average length of time until patients were able to void at least half of the bladder volume was 5.9 +/- 3.1 days. The average length of time until successful postoperative Foley catheter or suprapubic tube removal was 7.4 +/- 4.2 days. All children were able to void adequately eventually. Postoperative voiding cystourethrogram demonstrated that reflux was cured in 97% of the ureters. There was no postoperative vesicoureteral obstruction. There was no significant difference in length of time necessary to void, the duration of catheterization or operative success between the children who underwent standard versus limited detrusor dissection procedures. CONCLUSIONS: Extravesical ureteral reimplantation is an effective method for repairing reflux without ureteral obstruction but it can also result in a high rate of transient postoperative urinary retention even when detrusor dissection is minimized.

Adolescent↗

PubMedDate not supplied

[Vesicoureteral reimplantation in infants].

OBJECTIVE: To describe the results and follow-up of 34 vesico-ureteral reimplantations in infants. METHODS: From 1985 to 1994, 34 vesico-ureteral reimplantations (Cohen transtrigonal technique) were performed in 20 infants aged 1-13 months. The indications for surgery were high grade congenital vesico-ureteral reflux and breakthrough pyelonephritis that had presented in some cases despite prophylactic measures. RESULTS: At 4 years mean follow-up, all reimplanted ureters showed no reflux. One case with bilateral reimplantation was lost to follow-up. CONCLUSIONS: Many of the infants with vesico-ureteral reflux can be managed medically and the reflux will cease in some cases. But a few of them with difficult to control infections, can benefit from early surgery.

Creatinine↗

PubMed1990

Aortic reimplantation of the superior mesenteric artery for atherosclerotic lesions of the visceral arteries: sixty cases.

We report the results of a series of patients who had isolated or associated reimplantation of the superior mesenteric artery directly into the infrarenal aorta. Between 1967 and 1988, a total of 91 revascularizations for atheromatous lesions of the visceral arteries were performed in 89 patients. The superior mesenteric artery was reconstructed in 87 instances, 60 of which were direct or indirect reimplantations into the juxtarenal aorta. The procedure was isolated in 51 cases, and associated with the revascularization of another visceral artery in nine cases. These 60 patients were divided into three groups: Group A--seven patients undergoing emergency operation for acute intestinal ischemia; Group B--30 patients operated upon for chronic intestinal angina; and Group C--22 asymptomatic patients who underwent prophylactic revascularization. Two patients died in the immediate postoperative period (3.5%). Although most of the 29 late deaths were due to vascular disorders, only one was secondary to intestinal infarction. Twenty-one patients followed had good functional results; six patients had relapse of abdominal pain. Three of these underwent repeat revascularization of the superior mesenteric artery 12 days, 18 months, and 22 months, postoperatively. Follow-up ranged from six months to 18 years. Two patients were lost to follow-up. Overall actuarial survival at five years was 69.60 +/- 15%. In our experience, isolated reimplantation of the superior mesenteric artery on the anterior aspect of the infrarenal aorta is a simple and reliable technique which affords good long-term results.

Adult↗

PubMed2006

[Long-term experience with Cohen ureteral reimplantation in bilateral vesicoureteral reflux in childhood].

INTRODUCTION: In bilateral VUR, Cohen cross-trigonal ureteric reimplantation is a popular but also controversial surgical approach. We present our own experience in a retrospective analysis. PATIENTS AND METHODS: Between 1990 and 2005, 41 children (26 girls, 15 boys) with bilateral reflux [92 renal units (RU)] underwent ureteric reimplantation. The mean age was 4.5 (0.3-12) years. Eight patients had ureteral duplication (six unilateral, two bilateral); 12 of 41 patients had no intraoperative ureteral stenting. Seven patients had prior surgery for VUR. A successful result was defined as absence of VUR, significant UVJ obstruction, or voiding dysfunction throughout the follow-up. RESULTS: The mean follow-up was 7.8 (0.5-15) years. Eight patients (19.5%) had 13 complications. One patient had an intraoperative small bowel lesion (2%). Six patients (14.6%) had UTI. Four patients (9.8%) showed transient UVJ obstruction. Three required a temporary percutaneous nephrostomy. Two of these patients had no intraoperative ureteral stenting. Recurrence of VUR was found in 2 patients (4.8%) and 2/92 RU (2.2%), respectively. Complications were more frequent in high-grade VUR, ureter duplex, or unstented ureteral reimplantation. Prior surgery for VUR did not influence the postoperative outcome. Postoperative voiding disorders were not observed. CONCLUSIONS: Two unilateral recurrences of VUR were observed, requiring a reoperation in one patient. A reoperation for UVJ obstruction was not necessary. Related to 92 RU the surgical success rate was 97.8%. Intraoperative ureteral stenting has to be considered with respect to the current discussion of shortening inpatient procedures. In our experience, the perioperative risk was elevated in patients with high-grade VUR or ureteral duplication.

Child↗

PubMed2001

Transperitoneal unstented ureteral reimplantation for injuries postgynecological surgery.

Pelvic ureteral injuries represent a serious surgical accident due to the potential damage they may cause to renal function. We report here the results of 19 years of experience with reconstruction of distal ureteral injuries by transperitoneal unstented reimplantation. This was a prospective cohort study undertaken at Barão de Lucena and University Hospitals, Recife (Brazil). Forty-seven patients with ureteral obstruction postgynecological surgery were routinely operated using the initial incision. The ureter was identified, dissected, and reimplanted through the peritoneal cavity. No stent was necessary. The average surgical time was 70 min (45-180 min). A psoas hitch or a Boari-Ockenblad bladder flap was required in six (12.8%) and four (8.5%) patients, respectively. Among 32 patients without fistula, 28 (87.5%) had complete and four (12.5%) had partial hydronephrosis regression without clinical repercussions. The cure rate was 100%. There were no complications. Routine primary unstented distal ureteral reimplantation using the transperitoneal approach is an effective and safe treatment strategy for injuries following benign gynecological surgery.

Adult↗

PubMed2006

The effect of surgeon volume and hospital characteristics on in-hospital outcome after ureteral reimplantation in children.

The aim of this study was to examine the association between surgeon and hospital characteristics on in-hospital outcome after ureteral reimplantation in children. Patients<18 years undergoing vesicoureteral reimplantation (n=3,109) were identified in Kids' Inpatient Database, an administrative database containing discharge records from 27 states during 2000 in the US. Based on patient volume in 2000, surgeons were designated as low volume (<11 procedures), medium volume (11-20 procedures) and high volume (>20 procedures) surgeons. Length of stay and hospital charges were analyzed using multivariate linear regression analysis. A significant association between shorter length of stay and higher surgeon volume (p=0.02) was observed that was independent of children's hospital status, hospital volume and other hospital characteristics. Length of stay was 20% shorter when the procedure was performed by the highest volume surgeons compared to when performed by the lowest. No significant effect of surgeon volume on hospital charges, however, was observed. Higher surgeon volume was associated with shorter length of stay but no difference in hospital charges among children undergoing vesicoureteral reimplantation.

Child↗

PubMed2002

Reimplantation of extracorporeal irradiated bone segments in musculoskeletal tumor surgery: clinical experience in eight patients and review of the literature.

BACKGROUND: Two methods are available for extracorporeally devitalizing resected tumor-bearing bone specimens, the simpler of which, autoclaving, has substantial disadvantages. We present our experience with the alternative reconstruction technique of reimplantating extracorporeally irradiated specimens (IEIR) PATIENTS AND METHODS: Eight patients who had primary malignant bone tumors of the long bones were managed with wide en bloc resection and IEIR. The segments were fixed by either plate osteosynthesis, knee arthrodesis rod, or intramedullary nailing. All seven patients with high-grade tumors received chemotherapy. RESULTS: After a median follow-up of 66 months (40-76) five of eight patients were continuously free of disease. One man with a chondroblastic osteosarcoma developed pulmonary metastases which were resected. One woman with teleangiectatic osteosarcoma developed a local recurrence in the soft tissue without contact to the irradiated reimplant. At the latest follow-up, 58 months after resection of the pulmonary metastases and 28 months after resection of the locally recurrent tumor, there was no evidence of disease in either patient. Another woman 67 months after IEIR for an osteosarcoma of the distal femur developed a subcutaneous metastasis of the scalp and the thoracic wall and an ossifying pulmonary metastasis. At the time of writing she is receiving chemotherapy. After a median duration of 4.3 months (2.3-25.2) all graft-host junctions had healed. The functional result was good in four patients and excellent in the other four. CONCLUSIONS: Limb salvage using reimplantation of extracorporeally irradiated tumor-bearing bone segments for reconstruction offers an excellent reconstruction method in appropriately selected patients compared with other options of management.

Adolescent↗

PubMed1985

Reimplantation of the ampulla of Vater.

Injury to the common bile duct and the pancreatic duct during duodenal ulcer or tumor surgery is exceedingly rare. In the past 50 years, only eight case reports have dealt with reimplantation of the ampulla of Vater. Reimplantation sites have included the stomach, duodenum, and jejunum. Herein we described a new technique that uses the gallbladder for reimplantation of the ampulla of Vater.

Adenocarcinoma↗

PubMed1992

Anomalous left coronary artery from the pulmonary artery: results of isolated aortic reimplantation.

Thirty-one consecutive children with anomalous left coronary artery underwent direct aortic reimplantation of the anomalous artery without an associated procedure. There were five deaths (16%; 70% confidence limits, 9% to 26%), three in the hospital and two early (within 3 months). The severity of preoperative left ventricular dysfunction was the only incremental risk factor for mortality: 31% mortality rate among patients with left ventricular shortening fraction of less than 0.20 versus 0% among patients with a left ventricular shortening fraction of 0.20 or more (p = 0.03). There were no late deaths up to 6 years, a survival rate of 84% +/- 7%. Late results were studied in 23 survivors having a follow-up of longer than 12 months. Ninety-six percent were free of symptoms; left ventricular function recovered to normal in all patients; moderate to severe mitral regurgitation decreased to minimal or no regurgitation in most patients (5/7); and the reimplanted anomalous left coronary artery was patent in each patient. Based on this study, we reached five conclusions. (1) Direct aortic reimplantation is technically feasible in most patients with anomalous left coronary artery and yields a high rate of late patency. (2) Left ventricular resection is unnecessary. (3) The mitral valve should not be interfered with at the initial operation, but mitral regurgitation may persist in a few patients and necessitate later operation. (4) In patients with moderate left ventricular dysfunction, the operative risk is low and early operation indicated. (5) In patients with severe left ventricular dysfunction, the operative risk is high; heart transplantation may be suggested, but our current approach favors an immediate corrective procedure.

Actuarial Analysis↗

PubMed1991

Characteristics of periodontal mechanoreceptors supplying reimplanted canine teeth in cats.

These characteristics were investigated 12 weeks and one year after tooth reimplantation. Electrophysiological recordings were made from single mechanosensitive units dissected from the inferior alveolar nerve and each unit was characterized by applying forces to the crown of the tooth. The characteristics were compared with those of receptors innervating normal teeth. The periodontal mechanoreceptors supplying teeth reimplanted 12 weeks earlier responded to applied forces over a narrower range of directions, had higher force thresholds, lower discharge frequencies and adapted more rapidly than controls. One year after reimplantation their characteristics were nearer to normal but they remained significantly different from those of control units. It seems likely that the altered receptor characteristics could have resulted from a combination of changes in tooth mobility, disorganisation of the collagen matrix and direct injury to the nerve terminals.

Action Potentials↗

PubMed1979

Ureteral reimplantation in children with neurogenic bladder.

The treatment of urologic complications from myelomeningocele and especially of vesico-renal reflux is a controversial problem. A series of 26 reimplanted ureters in 17 children, with good results in more than 85%, is reported. Ureteroneocystostomy, carried out with a few technical innovation, may represent a useful method for the treatment of vesico-renal reflux and obstruction of the uretero-vesical junction in neurogenic bladder associated with myelomeningocele. This surgical approach leads to the disappearance of the reflux, decrease of dilatation of the upper urinary tract and preservation of renal function in most cases; moreover, infection can be more easily controlled. Ureteral reimplantation should be preceded by periodic urethral dilatation, external transurethral sphincterotomy, and pharmacologic regulation in order to attempt to decrease urethral resistance. After successful surgery, it is possible to try to reeducate the bladder. Reimplantation should be preferred to permanent urinary diversion even if there is gross reflux.

Adolescent↗

PubMed1986

The reimplanted ureter as a catheterizing stoma.

Some current trends in the management of neurogenic bladder have been toward utilization of the urinary bladder as a storage device with a continent catheterizing stoma. This study presents a procedure using the now standard Cohen ureteral reimplantation, followed some 6 weeks later by transureteroureterostomy and distal ureteral stomal formation, after the method of Mitrofanoff. This staged procedure appears to have allowed the recently reimplanted ureter to be divided and brought to the skin as a viable catheterizing stoma. We believe that this experimental study has demonstrated that the Cohen technique of ureteral reimplantation is a reasonable antecedent to the use of transureteroureterostomy and distal ureteral stoma creation for continent catheterization. Monfort has demonstrated this clinically in one patient, and we feel that this technique deserves more extensive clinical trials.

Animals↗

PubMed1977

Long-term results after intentional tooth reimplantation in monkeys.

The purpose of this study was to evaluate histologically the long-term response to intentional tooth reimplantation in six rhesus monkeys. The study revealed that cervical and apical root resorption is a universal complication after tooth reimplantation and that arrested areas of resorption will show repair by deposition of cementum. A highly cellular periodontal membrane usually will develop. Periodontal fibers will reattach to reparative bone and cementum but seldom regain functional orientation. Partial or complete ankylosis may result. A further complication is progressive undermining resorption of the ankylosed teeth. Long-term studies are mandatory to evaluate the response to intentional tooth reimplantation.

Alveolar Process↗

PubMed1983

Evaluation of osteogenesis following immediate and delayed reimplantation of frozen autogenous mandibular bone.

A follow-up study of the feasibility of delayed reimplantation of frozen autogenous mandibles after ablative surgery for oral carcinomas with mandibular involvement was performed. Fifteen young adult mongrel dogs were used and evaluated clinically, bacteriologically, radiographically, histologically, and by radionuclide imaging. The animals were divided into two groups according to whether they underwent immediate or delayed reimplantation. These were subdivided into those who received grafts with and without autogenous marrow augmentation. The results were positive and suggested clinical evaluation. Twelve patients had undergone delayed reimplantation along with marrow augmentation over the past 3 years. Again, the results are most promising and we believe that, with further refinement, this technique will offer a new and acceptable modality for facial reconstruction in the cancer patient.

Animals↗