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M Lichtinger

Publications and source records attributed to M Lichtinger.

5 recordsLinked to original sources

Gastrointestinal surgery in gynecologic oncology: evaluation of surgical techniques.

In recent years, the use of surgical staples has become popular in all subspecialties of surgery. The advantages proposed have been a decrease in operative time and morbidity. This paper reviews the University of Miami/Jackson Memorial Medical Center, Division of Gynecologic Oncology experience with the use of surgical staples in gastrointestinal surgery on patients with a diagnosis of a gynecologic malignancy. Between January 1, 1979 and July 1, 1985, a total of 152 procedures were done, 81 by stapler and 71 by suture anastomosis. Ninety-one patients had received previous radiation or chemotherapy. The average age of the patients was 52 years. The results show a decrease in operating time, blood loss, and postoperative hospital stay in those patients where the stapler anastomosis was used. The postoperative morbidity and mortality were not increased. Twenty-seven total pelvic exenterations were performed during the period of study and they were evaluated separately. The hospital stay and blood loss as well as the operative time were significantly less using staplers. This report includes a detailed evaluation of the results. From this study, we concluded that surgical staples are a safe alternative in gastrointestinal surgery in patients with a gynecologic malignancy.

Adult

Small bowel complications after supravesical urinary diversion in pelvic exenteration.

Between June, 1966, and June, 1984, 102 pelvic exenterations were performed at Jackson Memorial Hospital/University of Miami Medical Center and all patients had some type of supravesical urinary diversion. Of these patients, 23 were reexplored for a gastrointestinal complication and 15 of those had a small bowel complication. Small bowel fistula occurred in 15 instances and 9 patients were reexplored. The fistula associated mortality was 53.3%. All the fistulas occurred in previously radiated patients who had undergone an enteroenteroanastomosis. The recent use of enterocolostomies after the construction of an ileal conduit in 21 patients has not produced any postoperative small bowel fistula, while in 43 patients who underwent enteroenterostomies, 13 fistulas occurred (P less than 0.01). Patients who did not undergo pelvic floor closure had a higher incidence of fistula and small bowel obstruction, while there were no fistulas in patients with previous enterocolostomies, regardless of the pelvic closure.

Colon, Sigmoid

Major surgical procedures for gynecologic malignancy in elderly women.

We review 89 patients more than 75 years old who had major operations for various gynecologic malignancies. The recent routine use of perioperative intensive care decreased hospital mortality from 8.9% to 3.2%, and helped in decreasing and anticipating intraoperative and postoperative cardiorespiratory complications. Availability of visiting nurses since 1980 decreased the mean hospital stay from 30.2 to 24.4 days in patients who had radical vulvectomy. There were no deaths among 11 patients who subsequently had surgical reexploration for recurrent or new disease. Fifty-two of the 89 patients survived more than three years with no limitations resulting from the operations. When indicated, major surgical procedures for gynecologic malignancy in elderly women can be done safely, especially when the patient is evaluated and managed in a well staffed surgical intensive care unit.

Aged