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Biomedical subjects

D Mutter

Publications and source records attributed to D Mutter.

83 records · Page 5Linked to original sources
PubMed1991

Prevention of anastomosis leakage: an artificial connective tissue.

Anastomosis leakage still causes considerable morbidity and mortality after digestive tract surgery. We report here our experience of the use of reconstituted connective tissue created from elastin, fibronectin and collagen in preventing anastomosis leakage and closing intestinal fistulas. In animal studies (56 rats), this connective tissue was used as a patch applied with fibrin sealant to the edges of a 1 cm diameter colonic defect. In a clinical evaluation, eight patients had an intestinal fistula closed by a simple sewn suture reinforced by a sealed patch and seven patients had a high risk anastomosis reinforced by a sealed patch, in most cases as an alternative to staged surgery. In animal studies, complete reconstitution of the three colonic layers was obtained without retraction and without inflammatory reaction within 40 days, while the patch was slowly resorbed. In clinical trials all 15 defects and anastomoses healed without complication. Three patients died from other causes and, at autopsy, the patch was found to have remained in place covering the suture line. If these results are confirmed by a prospective clinical trial, such biomaterial offers the possibility of reducing the occurrence of anastomosis leakage, especially in high risk circumstances.

Adult↗
PubMedDate not supplied

Cellular and vascular reactions in the liver to radio-frequency thermo-ablation with wet needle applicators. Study on juvenile domestic pigs.

UNLABELLED: The aim of this animal experiment was to investigate the cellular and vascular reactions in the liver of juvenile domestic pigs produced by a radio-frequency thermoablation (RFTA) applicator perfused with saline solution. METHODS: A total of 13 coagulation necroses were produced in the liver of 3 anesthetized domestic pigs using RFTA. The pigs were dissected and the coagulations examined. RESULTS: The mean macroscopical length and width of the coagulation zones with a hemorrhagic marginal zone after a 5-minute application time were 34.1 +/- 8 mm (22-46 mm) and 20.8 +/- 4 mm (12 +/- 28 mm) respectively. The sonographically determined diameters correlated significantly (r(length) = 0.741 and r(width) = 0.923). Three areas in the coagulation zones could be histologically distinguished: (1) central necrosis zone, (2) hemorrhagic marginal zone, (3) sublethal damage zone. Large vessels did not show any substantial changes after RFTA. Venous vessels less than 1 mm were completely thermally denatured or destroyed. CONCLUSIONS: Tumors in close proximity to large blood vessels can be treated by RFTA with 'wet electrodes'.

Animals↗
PubMedDate not supplied

[A benign retroperitoneal schwannoma with vertebral lysis. A case report].

A case of a benign retroperitoneal schwannoma invading vertebral body is reported. Clinical manifestations are not specific. Imaging studies (U.S., NMR) provide detailed information with regard to its anatomical relations. The treatment of choice for this lesion, regarding its slow growth and exceptional malignancy, is a large removal of the tumour respecting major truncal nerves.

Adult↗
PubMedDate not supplied

[A promising alternative for the treatment of type I diabetes. The implantable insulin pump].

Recent improvements in miniaturization of implantable pumps and the ability of their control by tele transmission allowed implantation of autonomous pumps which administer insulin into the peritoneal cavity. Fifty-six patients with diabetes mellitus underwent implantation of 66 pumps with a mean function life of 21.8 months per patient. No patient died to this day. Tolerance of implanted components was good. Morbidity was limited to local events, in this series 4 cutaneous erosions, two of them dictating final pump explantation. Dosages of mean global blood-sugar, pre- and post-prandial blood-sugar, and glycosylated hemoglobin were all lower versus dosages before implantation. Statistically significant difference was demonstrated regarding mean global blood-sugar. Frequency of sever hypoglycemia incidents (4 in our series) and of biological hypoglycemia (blood-sugar < 65 mg/100 ml) was decreased, representing major benefit of the technique. The patients well-being and quality of life were notably amended. Implantable insulin-pump may be offered as a treatment alternative to conventional insulin-therapy, especially in cases of diabetes which are difficult to balance and particularly in cases with frequent hypoglycemic malaise.

Adult↗
PubMedDate not supplied

[Fundoplication by the Nissen-Rosetti technique using celioscopy. 10 cases].

Ten patients presenting with hiatus hernia and gastro-oesophageal reflux underwent laparoscopic Nissen-Rossetti fundoplication. All patients had either medical treatment failure or invalidating reflux. At present, complete fundoplication is the most effective surgical treatment of gastro-oesophageal reflux. The laparoscopic procedure was rigorously identical with the habitually used "open" procedure, the only difference being the abdominal access. No laparotomy was necessary in our patients, and no major complication was observed. The follow-up showed good clinical results. Laparoscopy has been reported to decrease postoperative pain and ventilatory disorders. Morover, this minimally invasive surgical technique enables rapid resumption of social and professional activities.

Adult↗
PubMedDate not supplied

[Celioscopic digestive surgery: from the explosion to a critical reflexion].

A critical review of laparoscopic digestive surgery indications is proposed. Patient's benefit by laparoscopy is to undergo the same procedure as by open surgery with identical security conditions but with less postoperative pain and an earlier recovery. Today laparoscopy in digestive surgery is mainly indicated in the fields of functional and benign diseases. Oncology seems for our team to stay a relative contra-indication as yet. Taken into account the future technical progresses, this 1996 state of the art is obviously only a temporary view of the technique before expected mutations.

Cholecystectomy, Laparoscopic↗
PubMedDate not supplied

[Duodenal lipoma causing intestinal subocclusion. Case report].

Duodenum is a rare position for gastrointestinal lipoma which sometimes may lead to severe complications. Authors report the case of a 60-year old woman treated with a transduodenotomic excision through a midline laparotomy. At admission the patient presented epigastric pain for 1 month. Physical examination was negative except for a modest epigastric sensitivity. CT scan showed image with regular features and fat density, and permitted the exact preoperative diagnosis. Final histopathological examination confirmed the diagnosis.

Duodenal Diseases↗