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Biomedical subjects

B A McGonagle

Publications and source records attributed to B A McGonagle.

5 recordsLinked to original sources
PubMed1987

Postoperative perineal hernia.

Eight patients (seven male and one female) with symptomatic postoperative perineal hernias treated at the Cleveland Clinic Foundation from 1975 to 1986 are reviewed. The patients ranged in age from 43 to 68 years (mean, 61 years). Seven had previous abdominoperineal resections of the rectum and one had a pelvic exenteration. The first two patients underwent repair via a perineal approach and both had recurrences of their hernias. These recurrences, as well as the presenting hernias in the six later patients, were repaired with mesh placed through an abdominal approach. Of these, there was one recurrence, which was repaired via an abdominal approach. There was no operative mortality. Based on experience, the authors believe that the best method of repair for this uncommon problem, involves placement of Marlex mesh across the pelvic inlet through an abdominal approach. This allows attachment of the mesh to the lateral musculature and posterior sacral periosteum under direct vision. The anterior borders of the mesh can be secured to the apex of the vaginal or prostatic tissue. The placement of metallic clips to the edges of the mesh allows for confirmation of the mesh position by radiographic examination during follow-up.

Aged↗
PubMed1986

The Chilaiditi syndrome and associated volvulus of the transverse colon. An indication for surgical therapy.

Hepatodiaphragmatic interposition of the colon is a rare anomaly described by Chilaiditi in 1910. Usually this syndrome presents as an asymptomatic roentgen finding, although occasionally it is associated with a broad range of gastrointestinal symptoms. The hallmark of therapy is conservative, and rarely has surgical intervention been indicated. This is the only case report of the Chilaiditi syndrome associated with colonic volvulus. It also illustrates the rare progression of colonic interposition from mild abdominal discomfort to intermittent bowel obstruction requiring surgical intervention.

Adult↗
PubMed1985

Evaluation of the Proximate-ILS circular stapler. A prospective study.

In a prospective open study of the Proximate ILS circular stapler, the results of 125 intestinal anastomoses in 119 patients were reviewed. Intraoperative leakage was observed in five instances, after intraluminal povidone instillation, necessitating suture-line reinforcement. In three instances, incomplete tissue rings (donuts) were found. Temporary fecal diversion was used in seven of 84 patients with anastomoses made to the rectum or anal canal. Roentgenographic assessment of 79 of these anastomoses using Gastrografin demonstrated a leak in three (3.8%). There was one clinical leak (0.9%) in the series. Three patients died (2.5%), none from anastomotic complications. Transient anastomotic strictures were found in three of 82 operative survivors where the anastomosis was within range of the proctoscope. There were no instances of significant hemorrhage from the anastomosis. No patient required anastomotic revision, and of the 51 survivors of cancer surgery where proctoscopy could evaluate the anastomosis, there was no evidence of local recurrence in the period of follow up (mean 16.3 months). The authors conclude: that the Proximate ILS is a safe, reliable and effective instrument for construction of intestinal anastomoses.

Aged↗
PubMed1983

The effect of hyaluronidase and dimethyl sulfoxide (DMSO) on experimental skin flap survival.

Hyaluronidase has been shown clinically and experimentally to reduce the effects of tissue ischemia in myocardial infarction and hemorrhagic shock. Dimethyl sulfoxide (DMSO) has been shown to reverse the effects of cerebral ischemia in the primate model. A caudally based dorsal skin flap in the rat was used to study the effects of these two drugs in physiological doses on skin flaps, and to investigate their mechanisms of action. This study demonstrates that both hyaluronidase and DMSO, which are nontoxic in physiological doses, can increase the surviving length of an experimental skin flap. It is hypothesized that these substances exert their effect by decreasing tissue edema and by aiding in the transport of nutritive substances to the flap during its acute phase.

Animals↗