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Biomedical subjects

A Assalia

Publications and source records attributed to A Assalia.

At least 37 records · Page 2Linked to original sources
PubMed1996

Upper dorsal thoracoscopic sympathectomy for palmar hyperhidrosis: improved intermediate-term results.

PURPOSE: The purpose of this study was to examine the immediate and mid-term results of thoracoscopic upper dorsal (T2-T3) sympathectomy for primary palmar hyperhidrosis. METHODS: From June 1993 to October 1994 we performed 106 sympathectomies on 53 patients with palmar hyperhidrosis. Thirty-four female patients and 19 male patients ranging in age from 15 to 44 years, (mean 23.1 years) were studied. Both sides were operated during the same surgical procedure. The T2-T3 ganglia were resected by electrocuting with a hook and were removed for histologic examination. Follow-up for a mean of 19.25 months was obtained on 52 patients (104 operated limbs). RESULTS: All limbs were completely dry at the end of the procedure, and hyperhidrosis did not recur during the whole follow-up period. Short-term postoperative complications (mainly atelectasis, pneumonia, pneumothorax, and hemothorax) occurred in six (11.3%) patients. Long-term sequelae were observed in 43 (81.1%) patients and included Horner's syndrome (9 patients, 17.3%, one side only in each patient), neuralgia (7 patients, 13.5%), and compensatory hyperhidrosis (35 patients, 67.3%). These sequelae were not permanent in all cases, and the degree of severity was variable. Six (11.5%) patients, three of whom regretted being operated, were dissatisfied with their results: one because of Horner's syndrome, one because of persisting neuralgia, and four because of compensatory sweating. CONCLUSIONS: Despite the large number of postoperative long-term sequelae, 88.5% of patients expressed subjective satisfaction from the procedure. Obtaining 100% of dry hands on mid-term follow-up makes this approach rewarding.

Adolescent↗
PubMed1995

Is mechanical bowel preparation necessary before primary colonic anastomosis? An experimental study.

UNLABELLED: The necessity of preoperative or intraoperative mechanical bowel preparation of the colon, before primary anastomosis, has been recently challenged in clinical elective and emergency situations. PURPOSE: This experimental study in dogs investigated the safety of segmental resection and primary anastomosis in the unprepared or loaded colon. METHODS: Two segments of the descended colon were resected and anastomosed in each animal. Group I (12 anastomoses) received preoperative mechanical bowel preparation; the colon was not prepared in Group II (16 anastomoses); in Group III (12 anastomoses), a preliminary distal colonic obstruction was produced, and during the subsequent resection the colon was loaded. Postoperatively, animals were observed clinically, and anastomoses were assessed at autopsy on the ninth day. RESULTS: All animals recovered uneventfully. At autopsy there was no evidence of anastomotic leakage. CONCLUSIONS: In light of recent clinical reports and this experimental study, the ritual of mechanical bowel preparation should be further scrutinized.

Anastomosis, Surgical↗
PubMed1994

Minimal antibiotic therapy after emergency abdominal surgery: a prospective study.

The optimal duration for courses of antibiotic therapy following emergency abdominal surgery was examined. The length of postoperative administration was based on the operative findings of contamination versus infection and the degree of the latter. A total of 163 patients (mean APACHE II score 7) were stratified into four groups: group 1 (60 patients), no postoperative antibiotics; group 2 (32), antibiotic therapy for 24 h; group 3 (48), administration for 48 h; and group 4 (23), antibiotic therapy for 72 h to 5 days. Three patients (2 per cent) died. Wound infection developed in 12 patients (7 per cent) and postoperative intra-abdominal infection in two (1 per cent). Antibiotics were stopped according to the protocol in 28 patients in spite of continued fever; one developed a subhepatic abscess and three had wound infections. Distinguishing contamination from infection and operative stratification of the latter allowed a successful 'minimal' postoperative antibiotic policy to be employed.

Abdomen↗
PubMed1994

Small bowel obstruction following laparoscopic cholecystectomy: diagnosis of incisional hernia by computed tomography.

As laparoscopic cholecystectomy has become the procedure of choice for symptomatic gallstones, specific complication related to this technique have been noted. We report a case of small bowel obstruction in the trocar puncture site following uneventful laparoscopic cholecystectomy in an extremely obese woman. Diagnosis was made by computed tomography, and reduction was possible by local approach, avoiding explorative laparotomy.

Cholecystectomy, Laparoscopic↗
PubMed1994

[National survey of antibiotic use after abdominal surgery].

A postal survey of 283 members of the Israeli Association of Surgeons was conducted to determine their current practices as to duration of antibiotic therapy following emergency abdominal operations (response rate 26.5%). The maximal acceptable length of antibiotic administration after various emergency operations was based on recommendations in the recent literature. By these criteria, about half those responding were using excessive courses of post-operative antibiotics. We conclude that failure to distinguish between contamination, which requires either minimal post-operative administration of antibiotics or none at all, and infection which requires a proper postoperative course, is the main reason for unnecessarily prolonged postoperative use of antibiotics.

Abdomen↗
PubMed1994

Therapeutic effect of oral Gastrografin in adhesive, partial small-bowel obstruction: a prospective randomized trial.

BACKGROUND: Previous published clinical observations claim that Gastrografin, a hyperosmolar gastrointestinal water-soluble contrast agent, speeds the resolution of postoperative ileus, barium impaction ileus, adhesive small-bowel obstruction, and intestinal obstruction caused by parasites and bezoars. However, no objective data exist that support the therapeutic effects of Gastrografin in these situations. METHODS: A total of 107 episodes of adhesive, partial small-bowel obstruction in 99 patients were randomized into a control group (48 episodes), who were treated with conventional methods, and a trial group (59 episodes), who were treated with 100 ml of Gastrografin administered through the nasogastric tube. The following variables were examined: time to resolution of partial small-bowel obstruction, the need for operation, complications, and hospital stay. RESULTS: Mean timing of the first stool was 23.3 hours in the control group and 6.2 hours in the patients receiving Gastrografin (p < 0.00001). Ten obstructive episodes (21%) in the control group required operative treatment compared with six (10%) in the trial group (p = 0.12). Mean hospital stay for the patients who responded to conservative treatment was 4.4 days and 2.2 days in the control and trial groups, respectively (p < 0.00001). One patient in each group died after operation. No Gastrografin-related complications were observed. CONCLUSIONS: Orally administered Gastrografin is safe and has a therapeutic role in adhesive, partial small-bowel obstruction. It significantly prompts the resolution of the obstructive episodes and shortens hospital stay. However, further studies are necessary to confirm the significance of our observation that it may reduce the need for operation.

Administration, Oral↗