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At least 19 recordsLinked to original sources
PubMed1998

Re-operative surgery for recurrent or persistent primary hyperparathyroidism.

BACKGROUND: While initial surgery for primary hyperparathyroidism, in experienced hands, will result in a cure in 98% of cases, re-operative surgery remains a significant challenge. Because attitudes as to who should perform initial exploration for hyperparathyroidism are significantly different around the world, the approach to re-operative surgery may also vary. The aim of the present study was to examine a local experience of re-operative surgery for recurrent or persistent primary hyperparathyroidism. METHODS: Information on indications for surgery, the procedure performed, pathology and complications of all re-operative procedures for primary hyperparathyroidism in the period January 1962 to December 1996 were obtained from a prospective database. RESULTS: Sixteen patients with persistent (n = 12) or recurrent (n = 4) primary hyperparathyroidism were treated in the unit over the study period. Eight patients had their initial operation within the unit at Royal North Shore Hospital and eight were referred from elsewhere for re-operation. Nine of the 12 patients with persistent hyperparathyroidism were cured by re-operation with failures due to spillage at first operation (n = 1) or failure to find any additional pathology (n = 2). All four patients with recurrent hyperparathyroidism were cured. All the failures occurred early in the learning phase of the unit, with a 100% cure rate for re-operative procedures performed in the last 15 years. The most common finding in patients referred from elsewhere with a failed initial operation was a missed inferior adenoma in association with the thymus. Localization studies had a variable sensitivity, with sestamibi scintigraphy, selective venous sampling and ultrasonography providing the most reliable information. CONCLUSIONS: Re-operative surgery for persistent or recurrent hyperparathyroidism is an uncommon procedure in Australia when compared to major centres in the USA. Successful surgery depends upon experience and an accurate knowledge of the embryology and anatomy of the parathyroid glands.

Adenoma↗
PubMed2003

[Elective laparoscopic surgery in diverticular disease. A comparative study with conventional operative surgery ].

BACKGROUND: Elective surgery in diverticular disease (DD) consists classically in performing an open sigmoidectomy. Laparoscopic surgery of the colon can have results that are comparable to those of open surgery. AIM: To compare the results of laparoscopic and conventional surgery for DD. MATERIALS AND METHODS: Retrospective review of preoperative, operative and postoperative variables of patients operated by laparoscopic surgery between the years 2000 and 20002. These results were compared with those of patients treated with conventional surgery in the same period. RESULTS: Thirty nine patients, mean age 59 years old, were operated via laparotomy and 18 patients, mean age 47 years old, were treated with laparoscopic surgery. Both groups were comparable in gender, amount of previous laparotomies, type of surgery performed and American Society of Anestesiologists classification. The operative time was significantly higher in the laparoscopic surgery group (230 v/s 130 min), but the opioid requirements, stay in an intensive surgical care ward, postoperative ileus and hospital stay were significantly shorter in the laparoscopic group. Eleven percent of the patients included in the laparoscopic group and 31% of the patients treated with operative surgery had complications (p = 0.07). The length of the excised colon, the degree of inflammation and treatment costs were comparable. CONCLUSIONS: Laparoscopic surgery in DD is feasible, safe, requires less analgesia and allows a faster recovery of post-operative ileus and a lower hospital stay.

Adult↗
PubMed1995

The predictive value of troponin T in patients who underwent an extracardiac surgery operation.

UNLABELLED: Purpose of the study is the research of the diagnostic value of the determination of Troponin T in relation with the other cardiac enzymes in patients who underwent extracardiac surgery operation. METHODS: 42 pts (M = 24, F = 18, mean age 51.7 +/- 17 years) who underwent a surgery operation were studies. For all pts serum enzyme CPK, CPK MB, SGOT and Troponin T was determined 24 hours before and after the operation. RESULTS: increased value of CPK was observed in all patients. In 14.3% of pts was found abnormal value of CPK. In 1 pt CPK MB was found increased. In no one of the above pts was observed an increased value of Tr-T. No one of the pts had ECG changes and clinical symptoms indicative of ischemic heart disease. CONCLUSIONS: these results suggest that the determination of Tr-T in serum is more useful diagnostic index for myocardial cell injury in pts who underwent an extracardiac surgery because is not detected in skeletal muscle injury.

Aspartate Aminotransferases↗