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Biomedical subjects

M L Obeid

Publications and source records attributed to M L Obeid.

12 recordsLinked to original sources
PubMed1998

Critical lower limb ischaemia following excision of the rectum.

Critical lower limb ischaemia can occur following rectal surgery by a number of mechanisms. Patients with aorto-iliac stenosis or occlusion may be dependent on collateral circulation to the lower limbs from the visceral arteries supplying the descending colon, sigmoid colon and the rectum. Division of these collaterals can precipitate critical ischaemia of the leg. This is an uncommon scenario but one that should be considered in arteriopaths undergoing rectal surgery. Two cases of this complication are reported and the mechanisms discussed.

Aged↗
PubMed1994

Submammary approach for the excision of mammographically localised lesions of the breast.

OBJECTIVE: To describe the results of a submammary incision for the removal of impalpable, mammographically diagnosed lesions. DESIGN: Open study. SETTING: District hospital. SUBJECTS: 8 patients with deep, impalpable, mammographically suspicious lesions. INTERVENTIONS: Excision biopsy by the submammary approach. MAIN OUTCOME MEASURES: Complete excision judged radiologically and histologically, and cosmetic result. RESULTS: All lesions were completely excised both radiologically and histologically. Three patients had ductal carcinoma in situ and five had benign microcalcification. Cosmetic results were excellent in all cases. CONCLUSION: The incision gives excellent results after excision biopsy of deep or peripheral lesions of the breast, but is contraindicated if invasive carcinoma is suspected.

Adult↗
PubMed1993

Transcaecal ileal diversion in the management of the 'at risk' distal colonic anastomosis.

Transcaecal ileal diversion has been used in association with primary resection and anastomosis to defunction an elective distal colonic anastomosis in 10 patients and to allow on-table colonic lavage with subsequent colonic defunction in 11 patients presenting as an emergency with distal colonic obstruction. Post-operative wound sepsis occurred in four patients (19%) with a clinical anastomotic leak in one patient. The median hospital stay was 14 (10-19) days. Transcaecal ileal diversion is simple to perform. It may facilitate primary resection and anastomosis in both the elective and emergency situation without increasing morbidity, mortality or the hospital stay.

Aged↗
PubMed1993

A national audit of antimicrobial prophylaxis in vascular surgery.

A standard questionnaire on antimicrobial prophylaxis for elective and emergency vascular surgery was sent to 262 practising members of the Association of Vascular Surgeons (U.K.). The response rate was 68.3%. A cephalosporin based regime was used in 61.1% of cases while penicillin was used in 39.3% and an aminoglycoside in 6.5%. More than one antibiotic was routinely used in 15.6% of cases, with specific anti-anaerobic cover in 19%. Prophylaxis was used in all cases using a prosthetic graft, but in only 76% of cases using autogenous vein (p < 0.05). A single dose regime was most commonly used for autogenous vein graft (14% vs. 4.5%, p < 0.05), whilst overall a three dose regime was most popular. Some 2.8% of respondents specified a differing regime for supra- and infrainguinal surgery whilst 4.5% modified their regime in emergency cases. Despite its theoretical limitations, a three dose cephalosporin regime is the most commonly prescribed "prophylactic" regime for all forms of vascular surgery in the U.K.

Anti-Bacterial Agents↗
PubMed1993

On-table pneumoperitoneum in the management of complicated incisional hernias.

'On-table' pneumoperitoneum before repair of 'complicated' incisional hernias has been used in eight patients considered to be at high risk of recurrence. In four patients the procedure revealed the presence of occult defects. The procedure was uncomplicated and a primary repair without the need for a prosthetic implant was possible in all cases. Six patients remain well with no sign of recurrence at a median follow-up of 96 months (range 22-120 months). Two patients died from conditions unrelated to the method of repair; acute necrotising pancreatitis on the 10th postoperative day and lobar pneumonia 2 months postoperatively. Peroperative pneumoperitoneum is a simple procedure which obviates the need for a prosthetic implant in selected patients. It is therefore particularly useful in the management of incisional hernias associated with sepsis, stomas or in patients requiring synchronous bowel resection.

Aged↗
PubMed1986

Haemorrhage and perforation of gastrointestinal neoplasms during chemotherapy.

Gastrointestinal haemorrhage and perforation are known complications of cytotoxic therapy for chemosensitive tumours involving the wall of the gut, in particular non-Hodgkin's lymphoma. These complications can be avoided by aggressive surgery before chemotherapy is started. When they do occur, early operative intervention is essential to reduce morbidity and mortality. We report 4 cases in whom delay in diagnosis and surgery led to 3 deaths and suggest a policy for the management of such cases in the future.

Adult↗
PubMed1986

Ileostomy in situ.

The technique of tube ileostomy has received little attention. It offers the advantage of complete fecal diversion without the need for subsequent operative closure. We emphasize the value of this technique and suggest an easier method for inserting the ileostomy tube.

Catheterization↗
PubMed1984

Mortality in acute pancreatitis.

The mortality from acute pancreatitis at a single centre between 1967 and 1980 is described. The overall mortality was 11% and remained at a similar level throughout the review period during which annual admission rates doubled. Two main groups of mortality were identified. In those with primary pancreatico-biliary or gastric pathology, there were less associated medical conditions and death was commonly due to abscess formation. In those without such primary pathology pre-existing poor medical condition was common and contributed to death from milder forms of pancreatitis. Our findings suggest that a decrease in the mortality of acute pancreatitis is more likely to be achieved through improved medical management than by operative intervention.

Abscess↗
PubMed1979

Long term results of autogenous vein bypass grafts in femoropopliteal arterial occlusion.

The results of 329 consecutive autogenous vein grafts carried out between January 1962 and June 1973 have been reviewed. The 5- and 10-year mortality rates were 14.6 per cent and 18.7 per cent respectively. The corresponding patency rates were 70 per cent at 5 years and 34 per cent at 10 years, the lowest patency (27.8 per cent) occurring in below-knee anastomoses with grafts of 5 mm or less in diameter. As other have noted, the state of the popliteal--tibial run-off vessels had a considerable influence on long term patency rates. In severely ischaemic limbs, the limb salvage rate following this operation was 77 per cent. An analysis of symptoms, associated disease and complications is presented and discussed. No valid conclusions could be made regarding the effect of lumbar sympathectomy and postoperative anticoagulants on long term patency. This review has confirmed the findings of earlier studies that a satisfactory 5-year patency rate and a gratifying limb salvage rate can be achieved with an extremely low operative mortality rate of 0.37 per cent. Despite the presence of widespread atherosclerotic arterial disease, the 5-year mortality rate is 14.6 per cent, indicating that an attempt at reconstructive surgery is usually well worth while.

Adult↗
PubMed1975

Wolffian duct cyst.

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Abnormalities, Multiple↗