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C R Wheeless

Publications and source records attributed to C R Wheeless.

12 recordsLinked to original sources
PubMed1992

Recent advances in surgical reconstruction of the gynecologic cancer patient.

Despite significant advances in radiation oncology and chemotherapy, radical en bloc resection of pelvic tissue remains an important part of the armamentarium of the gynecologic oncologist. Total pelvic exenteration can be the only hope of women who failed more conservative therapy. The time has come where it is appropriate to employ temporary techniques in the discipline of reconstructive surgery to restore these women to an acceptable quality of life. It may be the next challenge for the pelvic surgeon to participate in such surgical reconstruction. This challenge is becoming an active part of the oncologic surgical practice in head and neck surgery, and in breast surgery. Reconstructive surgery of the vulva has been well described in the literature with the use of cutaneous and myocutaneous flaps, and it is beyond the scope of this paper to recount them here. This paper reviews the techniques that are available for reconstruction of a functional vagina, restoration of a functional rectum with elimination of colostomy, and reconstruction of a continent urostomy that will allow better physiologic protection of the upper renal tracts and improve the aesthetics of a urine ostomy bag.

Female↗
PubMed1979

Gracilis myocutaneous flap in reconstruction of the vulva and female perineum.

For the past 2 decades there has been a definite trend among pelvic surgeons to immediately reconstruct the large defects created by deforming radical cancer surgery in the female pelvis and perineum. Extensive en bloc removal of more tissue has enhanced the probabilities of increased 5-year survival. At the same time, however, the quality of life following radical surgery has been of great concern to both patient and surgeon. Recent advances have been made in techniques for reconstruction. It is the purpose of this paper to present our experience using the gracilis myocutaneous flap for reconstruction of the vulva after radical excision of perineal tissue. The technique of the procedure is presented with the clinical results in 5 cases, and the complications noted therein.

Adult↗
PubMed1979

Avoidance of permanent colostomy in pelvic malignancy using the surgical stapler.

The potential for reducing the number of gynecologic oncology patients left with a permanent colostomy may be achieved by the use of the end-to-end anastomosis (EEA) automatic surgical stapler. This instrument allows a rectocolonic anastomosis at a very low level (below the levator muscles), which is very difficult and poorly performed by hand-suture techniques. This report presents the author's experience with 6 patients in whom a low rectocolonic anastomosis was performed with the EEA surgical stapler.

Adult↗
PubMed1978

An evaluation of prophylactic doxycycline in hysterectomy patients.

Although data now exist that the use of prophylactic antibiotics reduces postoperative febrile morbidity in hysterectomy patients, some controversy remains about this point of view. This prospective, double-blind, randomized study evaluated the use of doxycycline before and during the first three postoperative days after abdominal and vaginal hysterectomy in private patients. The results indicate a reduction in the febrile morbidity in the drug group as compared to the placebo group.

Adult↗
PubMed1976

Laparoscopy.

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Ambulatory Care↗
PubMed1975

An inexpensive laparoscopy system for female sterilization.

Laparoscopy has become an established procedure for female sterilization. The cost of the equipment remains excessively high, thereby reducing its availability to all physicians and patients who desire and need it. We have described an inexpensive--but highly effective--female sterilization system utilizing equipment that should cost in the range of $400.00.

Adult↗
PubMed1975

Abdominal hysterectomy for surgical sterilization in the mentally retarded: a review of parental opinion.

Between the years 1950 and 1973, 152 abdominal hysterectomies were performed for surgical sterilization in patients who were mentally retarded. A retrospective follow-up study was performed to ascertain the opinions of parents, guardians, and institutional care workers charged with the care and responsibility of these patients since the time of the original operation. In the categories evaluated, over 90 per cent of those charged with the care of the patient were enthusiastic for the benefits achieved by hysterectomy rather than tubal ligation for the purpose of surgical sterilization.

Adolescent↗
PubMed1975

Failures of laparoscopy sterilization.

Female sterilization by laparoscopy has become widely accepted throughout the United States and Europe. The failure rate of this procedure is still speculative. In the course of 4200 operative sterilization, 32 failures have been identified and 31 of these have been subsequently evaluated. The most common finding was inadequate or superficial fulguration and resection. Operative errors such as round ligament fulguration were also more common than expected.

Adolescent↗
PubMed1975

The Gambee intestinal anastomosis in gynecologic surgery.

The Gambee single-layer, through-and-through, catgut suture anastomosis of the gastrointestinal tract has been in use from 1969 to 1974. Sixty-four anastomoses have been performed on 56 patients with gastrointestinal involvement or pelvic malignancy. There were no operative deaths, and no patients required reoperation for correction of intestinal anastomotic leaks or rupture of the suture line. This experience suggests that the Gambee intestinal single-layer anastomosis may be useful in the management of gastrointestinal complications of pelvic surgery and malignancy.

Adult↗