Biomedical subjects

Karl J Sweeney

Publications and source records attributed to Karl J Sweeney.

3 recordsLinked to original sources

PubMed2006

Training in laparoscopic appendectomy.

BACKGROUND: The role of laparoscopic appendectomy (LA) in surgical training is unclear. Although LA as a therapeutic modality is potentially superior to open surgery, it has failed to become established as standard in training hospitals. The aim of the present study was to evaluate the outcome of LA performed by inexperienced surgeons in a training environment. MATERIALS AND METHODS: A retrospective analysis of all attempted LA performed over a 12-month period was undertaken. Data collected included operator grade (experienced and inexperienced), conversion rate and duration of surgery, complications, and postoperative stay. RESULTS: During the study period, 169 appendectomies were performed. The conversion rate to open surgery declined significantly from 28% in the first quarter to 9% in the last quarter, with no difference in the conversion rate between experienced and inexperienced surgeons. Operative time shortened significantly in the inexperienced group. Postoperative complications occurred in 8% of patients, independent of operative grade. CONCLUSIONS: Our findings demonstrate that LA may be safely introduced as a teaching procedure. Time-to-train should not preclude institutions from adopting the laparoscopic approach in the treatment of acute appendicitis.

Adult↗

PubMed2005

Inflammatory myofibroblastic tumor with ALK/TPM3 fusion presenting as ileocolic intussusception: an unusual presentation of an unusual neoplasm.

Inflammatory myofibroblastic tumor is a rare spindle cell lesion of indeterminate malignant potential occurring in both pulmonary and extrapulmonary tissues. This report describes an unusual presentation of an unusual tumor at an unusual location: an intramural ileal case of inflammatory myofibroblastic tumor presenting with intussusception in a 29-year-old woman. We characterize this tumor through microscopic and ultrastructural analysis, extensive immunohistochemical analysis, ploidy analysis, and Epstein-Barr virus in situ hybridization, and we report the finding of an ALK/TPM3 fusion using fluorescence in situ hybridization.

Adult↗

PubMed2004

Peroral and transgastric esophageal anastomosis with flexible shaft remote-control stapler (SurgASSIST).

Stapled cervical esophageal anastomoses are technically challenging and are associated with relatively high complication rates, particularly in leaks and anastomotic strictures. We describe the use of a flexible shaft, remote-control, circular stapling device in forming high esophageal anastomoses in 2 patients. Retrograde transgastric and prograde peroral approaches are evaluated comparing ease of technical application and outcomes. Both procedures were performed after total esophagectomy for cancer in a 72-year-old male patient with preoperative down-staging and a 78-year-old female who proceeded directly to surgery. The introduction of rigid staplers in the esophagus by either route can be difficult and technical pointers and the potential applications of the flexible SurgASSIST device are discussed. Potential benefits include shorter time for constructing the anastomosis and a wider lumen resulting in possible cost benefit. Both patients had uneventful technical construction of stapled anastomoses, and the only complication in the female was a leak in the gastric close-off at the site of introduction of the flexshaft. Both are alive and well without recurrence at 2 years and 22 months.

Adenocarcinoma↗