Biomedical subjects

R B Sawyer

Publications and source records attributed to R B Sawyer.

At least 19 recordsLinked to original sources

PubMed1995

General surgeons in the world of gatekeepers.

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Economics, Medical↗

PubMed1981

Intimal breakdown causing failure of human umbilical vein graft.

Early graft failure secondary to intimal breakdown with subsequent hemorrhage into and dissection of the wall of a modified human umbilical cord vein allograft occurred. Early recognition and immediate graft replacement will undoubtedly minimize further morbidity to the patient. To our knowledge, this is the first case of early graft failure from this cause described in the literature.

Arterial Occlusive Diseases↗

PubMed1979

Obstructive complications of the Nissen fundoplication.

The obstructive complications of the Nissen fundoplication can be devastating. They are much more easily prevented than treated. The technical considerations in avoiding these complications are conceptually simple. The fundoplication should be done over a large intraesophageal stent. A no. 50 or 60 French dilator is appropriate and, in addition, the fundoplication should be left loose. If the fundoplication is to be left in the chest, the hiatus must be widely enlarged so that there is not the slightest hint of obstruction at the level of the diagphragm. Care must be taken in this case to approximate stomach to diaphragm. The Nissen fundoplication should be carried out using heavy sutures with generous bites of the stomach on both sides as well as bites of the esophageal wall and perhaps also the proximal stomach. If careful attention is paid to these technical details, the obstructive complications of the Nissen fundoplication should be eliminated.

Adult↗

PubMed1976

Community experience with small bowel bypass for morbid obesity.

A comparison of small bowel bypass performed at university centers and by private practitioners in a large metropolitan area demonstrates definite stmilarities in terms of patient selection, mortality and morbidity, and weight loss results. The only aspect of small bowel bypass in the private sector that could be criticized would be the adequacy of follow-up. An operation with as many known and probably other unknown long-term complications as jejunoileal bypass necessitates prolonged careful patient follow-up. We belive the person most qualified to provide such follow-up is the surgeon who performed by bypass procedure.

Adolescent↗

PubMed1975

Repair of peristomal colostomy hernias.

Peristomal herniation represents the second most common late complication of abdominal wall enterostomy. Early herniation results from the creation of too large of a fascial defect. Late herniation is caused by a gradual enlargement of the fascial defect because of a poor selection of the colostomy site or an intrinsic weakness of the fascia due to the patient's age or general condition. Once peristomal herniation occurs, operative repair should be considered in an otherwise healthy person. Previous reports advocate primary repair of the herniation. In the present series of nine patients, three patients developed recurrence of the hernia six to eight months after primary repair. Six patients had colostomy hernia repairs that involved moving the site of the original stoma. All of these repairs remain intact at an average of two years, nine months (range, four months to six years). We therefore believe that the solution to the problem of recurrent colostomy herniation lies in the transposition of the site of the original colostomy.

Aged↗

PubMed1974