摘要:

SummaryAutotransfusion is being increasingly used to avoid the complications of homologous blood transfusion. In abdominal trauma, however, the collected blood may be contaminated by intestinal contents when digestive or urinary lesions are present. In such situations, the reinfusion of blood is contraindicated. We present our experience with autotransfusion of blood collected by laparoscopy from the abdominal cavity of 21 trauma patients. Laparoscopy allowed the aspiration of blood and, at the same time, permitted diagnosis of visceral lesions, avoiding reinfusion of contaminated blood. No complications occurred, and hematocrit values were significantly elevated. This procedure may represent the only possible method of blood transfusion in Jehovah's Witnesses, as with one patient in our series.

ISSN:1051-7200    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

SummaryThe purpose of this review is to outline our experience with a completely thoracoscopic approach to major pulmonary resection (lobectomy). There were 23 patients in this study selected by the usual criteria of resectability. The preoperative workup included chest x-ray, pulmonary function studies, computed tomography (CT) of the chest and abdomen, bronchoscopy, mediastinoscopy, and brain and bone scans in the majority of patients. ATL was attempted in 23 patients. In four patients the procedure was converted to the “open” approach for the following reasons: inability to identify the location of the primary lesion (two patients), obscurative bleeding (one patient), and inability to diagnose the pathology (one patient). The underlying pathology of the ATL group was as follows: bronchiolitis obliterans-organizing pneumonia = 1, granuloma = 2, non-small cell lung cancer = 14, solitary colonic metastases = 2. The breakdown by site of the 19 ATL resections is as follows: right upper lobe = 5, right middle lobe = 1, right lower lobe = 1, right upper and right middle lobes = 1, left upper lobe = 6, left lower lobe = 5. Group A patients (n = 11) were those who had no postoperative complications. Length of stay was short, ranging from 4 to 8 days, median 5 days. Group B patients (n = 8) had complications (prolonged air leak = 4, supplemental postoperative oxygen requirement = 3, pain control = 1) and stayed longer (range 10–21 days, median 13). There were no deaths, no blood transfusions, no chest tube reinsertions and no reoperations. The most significant complication in the ATL group was prolonged air leak in one patient (21 days). Conclusions: (a) ATL without minithoracotomy is feasible; (b) ATL has potential benefits in terms of reduction of pain and hospital stay; (c) ATL had better cosmetic and functional results.

ISSN:1051-7200    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

SummaryLaparoscopic cholecystectomy is a safe and feasible surgical treatment for children with symptomatic cholelithiasis. We describe the laparoscopic management of choledocholithiasis and biliary pancreatitis, two unusual but complicated pediatric biliary tract diseases. The operative techniques described were safe and effective and permitted early discharge with rapid return to diet, school, and full activity.

ISSN:1051-7200    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

SummaryLaparoscopic cholecystectomy has been associated with an increased incidence of bile duct injury compared to conventional open cholecystectomy. Injuries are frequently related to surgical inexperience and biliary tract anatomical variations which may be difficult to identify during laparoscopic surgery. A case is reported in which endoscopic retrograde cholangiopancreatography (ERCP) failed to define and resolve a postoperative bile leak that originated from a right anterior hepatic duct. The initial operative report as well as retrograde cholangiograms obtained percutaneously and during restorative surgery localized the site of bile leak to the right anterior hepatic duct which had inserted directly into the gallbladder. Anomalous hepatic ducts require astute surgical intraoperative evaluation to prevent surgical transection, and must be considered if ERCP fails to identify or resolve a continued biliary leak.

ISSN:1051-7200    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

SummaryThe development of laparoscopic surgery has suggested new technical procedures for the treatment of several pathologies. Herein we report a case of laparoscopic excision of a posterior gastric wall leiomyoma. The technique reproduces that used in conventional surgery but with a transgastric approach, and the advantages of minimally invasive surgery are maintained. This laparoscopic approach may be considered an alternative strategy for surgical treatment of benign tumors of the stomach.

ISSN:1051-7200    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

SummaryWe present a case report of a 69-year-old man with multiple medical problems who presented to the Veterans Hospital in Tucson, Arizona, with recurrent upper gastrointestinal bleeding following multiple upper endoscopic attempts at chemical injection and thermal coagulation of several vascular malformations of the duodenum. Intraoperative endoscopy was employed to identify the location of three small mucosal lesions. By employing transmural endoscopic illumination and direct endoscopic visualization we identified all arteriovenous malformations and then ligated them with silk ligatures from the bowel wall exterior during surgical exploration, avoiding duodenotomy and duodenectomy. The patient has had an uneventful recovery with no evidence of recurrent bleeding at a 1-year follow-up.

ISSN:1051-7200    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:1051-7200    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

SummaryIntestinal malrotation is rarely diagnosed beyond the neonatal period. Detailed gastrointestinal contrast studies are required in establishing the diagnosis. The treatment is surgical and involves lysis of adhesions and bands with or without cecopexy. Here we describe the first laparoscopic procedure for the treatment of malrotation.

ISSN:1051-7200    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

SummaryA slightly modified Roeder loop for extra-abdominal knot tying during laparoscopic operations is presented. This easy and reliable method can be used to ligate the cystic duct or the vermiform appendix.

ISSN:1051-7200    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:1051-7200    

出版商:OVID    

年代:1996

数据来源: OVID