PubMed Health⌕ Search

Biomedical subjects

A J Voitk

Publications and source records attributed to A J Voitk.

At least 37 records · Page 2Linked to original sources
PubMed1976

Double barrelled common bile duct: a threat to biliary surgery.

The frequency of cholecystectomies has given the surgeon familiarity and confidence when dealing with biliary anomalies. Internal anomalies are not equally recognized, for they play little role in cholecystectomy. Recognition of internal anomalies is of prime importance, however, when the biliary tree is drained through the gallbladder. Radiographic confirmation of a patent drainage system, avoiding spillage of contrast material, should be routinely employed in these situations to obviate potentially lethal complications due to technical error.

Adolescent↗
PubMed1975

Alternate technic for operative cholangiography.

Occasionally the cystic duct cannot be cannulated for cholangiography. A technic of cholangiography via a fine needle is described that allows similar injection of dye. The needle must be secured to prevent dislodgement during the procedure.

Cholangiography↗
PubMed1975

The ability of an elemental diet to support nutrition and adaptation in the short gut syndrome.

85% enterectomy or jejunal biopsy was randomly carried out on 80 male Sprague-Dawley rats, 300-350 gm. After recovery, rats in each group were randomly fed either elemental diet (ED) or rat chow. All rats were sacrificed 8 weeks postoperatively. Biopsied rats gained more weight with ED than chow (22% vs. 18%; p less than .01). Resection produced greater weight loss than biopsy (p less than .01) and slower gain (p less than .01). The failure to gain was most marked in ED rats, significantly less than in the chow group (p less than .05) by week two. A fall in hemoglobin, protein and albumin was seen: neither the fall nor difference between the groups was significant (p greater than .05). Enterectomized chow rats ate 22% more than their controls (p greater than .05). Increase in bowel length after resection, equally divided between jejunum and ileum, was 21% with ED and 26% with chow. Gut diameter after resection increased 104% and 98% with chow and ED, respectively. Villus height increased 65% in the jejunum of both enterectomized groups and 85% and 78% with chow and ED, respectively, in the ileum. Changes in gut length, diameter and villus height are significant in each group (p less than .01) but not between groups (p greater than .05).

Adaptation, Physiological↗
PubMed1975

Effect of nutrition, diet and suture material on long term wound healing.

Although it is known that malnutrition hinders early wound healing, it has not been determined whether this occurs because of formation of a poor scar or a slow rate of normal healing; the ultimate fate of the malnourished wound is unknown. Malnutrition was produced in rats by short gut syndrome. Elemental diet was compared to rat chow and silk was compared with polyglycolic acid suture. Nutritional deficiency was seen in short gut rats for two weeks postoperatively. Thereafter adaptation allowed partial recovery, but relative deficiency persisted. Morbidity and mortality of short gut rats doubled that of controls and all wound complications were limited to this group, occurring within the first two weeks. Malnourished animals surviving for 60 days had wound strength equal to the control rats as determined by gut anastomosis bursting strength, skin wound breaking strength and wound hydroxyproline content. Neither diet nor suture material altered ultimate wound strength. Improved nutrition allowed more animals and wound to survive, but ultimate healing survivors was indistinguishable from that of normal controls. Thus early weakness probably results from slow healing rather than formation of poor scar. Nutrition plays an important role in early strength and survival, but not in ultimate wound healing.

Abdomen↗
PubMed1974

Abdominoperineal resection for carcinoma in the community hospital.

All abdominoperineal resections for carcinoma of the rectum carried out 1963-1972 in two small community hospitals are reviewed. Seventy-six patients were found: males slightly outnumbered females; the average age was 61. There were 67 adenocarcinomas, 7 squamous cell carcinomas and one each of villous adenoma and carcinoid. Distribution of Dukes' classification was: A-20, B-26, C-21, D-9. In an average case the operative time was 3 hours, 25 minutes, 4 units of blood were used, and postoperative hospital stay was 30 days. Postoperative complications were recorded in over 50% of the patients with reoperation needed in 26% of all patients and delayed complications occurred in 41%. The operative mortality was 1.3%. Five year followup was possible in 40 of 43 patients; survival according to Dukes' classification was A-80%, B-53%, C-9% and D-25% with overall survival 45%.

Abdomen↗
PubMed1972

Clinical uses of an elemental diet: preliminary studies.

Preliminary experience with elemental diet therapy in 30 patients is presented. Positive nitrogen balance and nutritional recovery can be achieved in patients with fistulas, inflammatory bowel disease and pancreatitis, and after extensive resection of the small bowel (short gut syndrome). The mode of administration and rare complications are described.

Adult↗
PubMedDate not supplied

Outpatient treatment of spontaneous pneumothorax in a community hospital using a Heimlich flutter valve: a case series.

This is a case series of 14 consecutive patients treated as outpatients for spontaneous pneumothorax (SP) (1 January 1992 to 31 December 1995) by one surgeon in a community hospital setting. The purpose of this study was to examine the appropriateness and financial implications of routine outpatient management of SP with closed tube thoracostomy and the Heimlich valve. All 14 patients reviewed were successfully managed as outpatients, although 3 required an overnight admission because of anxiety, pain, or vasovagal reaction. The routine outpatient treatment of all cases of SP not requiring definitive surgical intervention may have saved more than $16,000.00 for the hospital and an estimated $500,000.00 for the province of Ontario during the 1993-1994 fiscal year. Our findings suggest that the Heimlich valve is an appropriate alternative for the management of SP in a nonteaching community hospital setting, with benefits to the patient and to the health care system.

Adolescent↗
PubMedDate not supplied

Is outpatient surgery safe for the higher risk patient?

The trend toward outpatient surgery led to this study to determine the safety of elective outpatient laparoscopic surgery for the higher risk patient. One hundred consecutive higher risk patients from all patients scheduled for elective outpatient laparoscopic surgery were studied prospectively in a 256-bed community hospital. Seventeen percent of patients required admission. In each instance the need was readily evident in the perioperative observation period. Eighty-three percent of patients were stable and were successfully treated as outpatients. No patient who remained stable decompensated later, and none required readmission to treat complications resulting from outpatient status. The 2% readmission rate (for unrelated reasons) was comparable to the 2% readmission rate for low-risk patients. It was concluded that routine outpatient laparoscopic surgery is safe for elective higher risk patients. Problems requiring admission are readily evident during the period of observation and no patient who remains stable decompensates later.

Adult↗