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Biomedical subjects

L B Pemberton

Publications and source records attributed to L B Pemberton.

At least 37 records · Page 2Linked to original sources
PubMed1982

Early postoperative results with EEA stapler.

This study of 106 patients who had end-to-end anastomoses (EEA) performed by 26 surgeons in 11 hospitals reports the operative and postoperative complications of using the EEA stapling device. The complications are probably exaggerated, because this study involves the initial experiences of many surgeons. The 106 patients included 78 patients with colon anastomoses, 3 with small intestinal anastomoses, and 25 with gastric anastomoses. The mortality rate included two patients (1.9%) with low rectal anastomoses who died of problems associated with the EEA stapler. The anastomotic morbidity rate included 9 operative complications (9%), which were corrected at operation, and 12 postoperative complications (11%), which included leaks (4), fistula (4), and stenosis (4). Intra-abdominal abscess occurred in 3 and wound infections in 19 patients (18%). The EEA stapler requires practice and specific skills for its safe use. The EEA stapler makes a reliable, inverted anastomosis and can be used successfully throughout the gastrointestinal tract.

Adult↗
PubMed1981

Risk factors in colostomy closure.

A retrospective study of 69 patients who underwent colostomy closure between 1973 and 1978 was conducted to evaluate three categories of risk: predisposing risk factors, preoperative interventions, and intraoperative techniques. The overall morbidity rate was 44% with no deaths. Factors associated with a greater complication rate included a divided colostomy (especially Hartmann's pouch), diverticulitis, elderly patients, and lack of preoperative oral antibiotics. Irrigation of the distal segment in divided colostomies and preoperative use of systemic antibiotics in association with oral agents, particularly neomycin-erythromycin, may be effective in decreasing morbidity. Factors that did not influence morbidity included time between colostomy and closure, wound management intraoperatively, the use of systemic antibiotics alone, and the location of loop colostomies. With careful preparation of the patient to combat the documented risk factors, colostomy closure may be safely undertaken in most patients.

Administration, Oral↗
PubMed1980

Secure closure of duodenal stump with staples.

A modification of the GIA stapler is described that allows closure of a duodenal stump with four rows of staples without any sutures. This method of closing the duodenal stump is simple, quick and secure. It has been used successfully in 12 patients with no postoperative leaks.

Duodenum↗
PubMed1977

Shock lung with massive tracheal loss of plasma.

Fulminant pulmonary edema developed in two young, healthy adults within one hour after blood loss, hypolemic shock, and an anaphylactoid reaction to intravenous pyelogram dye. Pulmonary edema developed and they subsequently passed large amounts of edema fluid through the endotracheal tube. Massive loss of plasma-like fluid from the lung required frequent evacuation of the endotracheal tube and intravenous replacement with large amounts of albumin-containing fluids. Both patients were treated with a volume respirator, positive end-expiratory pressure, 100% oxygen, corticosteroids, and tracheostomy. Both patients recovered from massive pulmonary edema with very severe hypoxemia and, three months afterwards, had normal pulmonary function, blood gas levels, and no evidence of pulmonary injury.

Adolescent↗