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Biomedical subjects

F Siriser

Publications and source records attributed to F Siriser.

5 recordsLinked to original sources
PubMed1995

Primary anastomosis with transverse colostomy as an alternative to Hartmann's procedure.

Hartmann's procedure remains the favoured option in patients with acute left colonic and sigmoid disease, despite the well documented morbidity and mortality associated with reversal. In 40 patients with left colonic pathology, primary anastomosis was performed; 32 had a covering transverse colostomy. There were six hospital deaths, five in the transverse colostomy group. Closure was not attempted in seven of the 27 patients surviving with a colostomy (three refused, four had disseminated malignancy). In the 20 undergoing closure, there was no morbidity or mortality. With advances in intensive care, antibiotic therapy and anaesthesia, it is reasonable to consider alternatives to Hartmann's procedure, particularly when subsequent reconstruction is envisaged.

Adult↗
PubMed1993

Gastrointestinal surgical emergencies following kidney transplantation.

This study reports major gastrointestinal complications in a group of 416 patients following kidney transplantation. Three hundred and ninety-nine patients received a cadaveric kidney while the other 17 received a living related organ. The immunosuppressive regimen changed somewhat during the course of the study but included azathioprine, prednisolone, antilymphocyte globulin, and cyclosporin. Perforations occurred in the colon (n = 6), small bowel (n = 4), duodenum (n = 2), stomach (n = 1), and esophagus (n = 1). There were five cases of acute pancreatitis, four of upper gastrointestinal and two of lower intestinal hemorrhage, two of acute appendicitis, one of acute cholecystitis, one postoperative mesenteric infarction, and two small bowel obstructions. Fifty percent of the complications occurred while patients were being given high-dose immunosuppression to manage either the early postoperative period or episodes of acute rejection. Ten percent of the complications had an iatrogenic cause. Of the 31 patients affected, 10 (30%) died as a direct result of their gastrointestinal complication. This high mortality appears to be related to the effects of the immunosuppression and the associated response to sepsis. Reduction of these complications can be achieved by improved surgical management, preventive measures, prompt diagnosis, and a reduced immunosuppressive protocol.

Adolescent↗
PubMedDate not supplied

Focal nodular hyperplasia of the liver. A retrospective review of 20 patients managed surgically.

Focal nodular hyperplasia remains a difficult diagnostic and clinical dilemma. Over a 10-year period, 20 patients with this diagnosis underwent surgery in our service. Eight of the patients had focal nodular hyperplasia discovered incidentally as part of investigation or surgery for other unrelated conditions. Seventeen of the patients were female, with 64% receiving oral contraceptives. In the 12 patients without concomitant disease all but one had upper abdominal pain. Despite the use of CT scan, isotope studies, NMR, angiography, ultrasound and biopsy, a firm preoperative diagnosis of focal nodular hyperplasia was made in only one patient. Resective surgery was performed without complication in all cases. During a mean follow-up of 42 months (range 6-128 months) one patient died from lymphoma and two patients had recurrent abdominal pain. This study highlights the difficulty in preoperative diagnosis of focal nodular hyperplasia. Conservative treatment can be considered or resective surgery safely performed for symptomatic or suspect lesions.

Adult↗