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Biomedical subjects

A Biterman

Publications and source records attributed to A Biterman.

2 recordsLinked to original sources

[Hemorrhoidectomy using a circular stapler].

We compared traditional local excision of hemorrhoids in 40 patients (group A) with excision using the CDH-33 surgical stapler designed for bowel anastomosis, in 41 (group B). In this technique a purse-string suture is prepared 3 cm above the dentate line, and the stapler is inserted and used to form a mucosa-mucosal anastomosis. This technique is less time-consuming than the traditional technique. Data were collected from patients' medical files and from detailed questionnaires in which symptoms prior to and after operation were reported. Mean ages were 53.0 and 51.5 years and male/female ratios were 1.0:1.2 and 1.0:1.1 respectively, neither significant. The most common complaints in both groups were pain and rectal bleeding. All patients had a lower-GI investigation prior to operation to exclude other causes of rectal bleeding. Recovery averaged 2 months in both groups. Patient satisfaction was assessed by decrease or absence of symptoms on return to normal daily activities. Satisfaction tended to be greater in group B. More patients in group A complained of tightness and discomfort at the operative site, but this was not significant. We are extending our study to a larger number of patients to determine if there are statistically significant differences between the results of the 2 methods.

Adult↗

[Percutaneous drainage of splenic abscesses under ultrasound].

A splenic abscess is considered life-threatening. Traditionally the treatment of choice has been splenectomy, which has relatively high morbidity and mortality and results in increased susceptibility to infection. Percutaneous drainage can be an alternative treatment for splenic abscesses and might avoid splenectomy. 2 cases of splenic abscess are presented: 1 had typhoid fever and the other had had a left hemicolectomy. In both cases external aspiration was performed twice and a catheter was left in the drained cavity after the second aspiration. There was no clinical improvement in the patient with typhoid fever and splenectomy had to be performed. In the other drainage was followed by marked regression of symptoms. We suggest that percutaneous drainage can be safely used for splenic abscesses. Splenectomy should be reserved for those in whom drainage does not lead to improvement.

Abscess↗