PubMed Health⌕ Search

Biomedical subjects

R M Hirata

Publications and source records attributed to R M Hirata.

9 recordsLinked to original sources
PubMed1991

Percutaneous endoscopic gastrostomy in patients with head and neck malignancies.

One hundred thirty-six percutaneous endoscopic gastrostomies (PEGs) were placed in 126 patients with head and neck malignancies. PEG was performed by the "push" technique described by Russell. There were 140 PEG attempts, with 136 successful placements (97%). Seven complications occurred related to tube placement (5% of placements). Complications encountered were prolonged ileus in one patient (1%), local skin wound infection in one patient (1%), and early tube dislodgment in five patients (4%). Three patients required laparotomy (2%). There were no episodes of aspiration and no deaths. Patients were followed up for an average of 11 months, with a mean duration of PEG tube placement of 6 1/2 months. Patients continued PEG feedings throughout the postoperative radiotherapy period and until oral intake was satisfactory. Acceptance of PEG feedings has been high. No patient required rehospitalization for nutritional support.

Enteral Nutrition↗
PubMed1990

Definitive mandibular replacement using reconstruction plates.

Mandibular defects following radical cancer surgery continue to provide challenges to head and neck surgeons. Twenty-seven patients with advanced oral cancer underwent primary mandibular replacement with metal reconstruction plates without the use of bone. Twenty-one patients (78%) had successful reconstruction with primary soft tissue healing. Six patients required removal of the plate in the postoperative period. Two of these patients had their reconstruction plates replaced as a secondary procedure following soft tissue healing. Thus, 23 of 27 patients (85%) had final mandibular reconstruction and were followed for an average of 19 months. Functional and cosmetic results were satisfactory. For patients with advanced disease, this technique compares favorably with microvascular transfer in terms of operating time and donor defect. Despite problems with plate exposure, the initial and overall success rates of 78% and 85%, respectively, make the use of these plates a reasonable choice for immediate reconstructive needs in patients with difficult tumors.

Adult↗
PubMed1986

Salivary glands.

A review of the more common inflammatory and neoplastic conditions affecting salivary glands has been presented. The use of hydration, massage, antibiotics, and steroids is effective initial treatment for suppurative sialadenitis and usually negates the need for surgical drainage. Total excision of the salivary gland and its duct is necessary in procedures for recurrent infection. Our technique for closure of the floor of the mouth after excision of the submandibular gland and Wharton's duct is described. Salivary neoplasms involving the parotid gland, the submandibular gland, and the minor salivary glands are treated on the basis of their histologic and local findings. Stepwise illustrations of our technique of parotidectomy and surgical considerations, including the counseling of a patient with a parotid mass, are presented to assist surgeons who care for patients with salivary disorders.

Adenocarcinoma↗
PubMed1976

Surgical considerations in hyperparathyroidism: reappraisal of the need for multigland biopsy.

Sixty-seven cases of neck exploration for suspected hyperparathyroidism were reviewed. Thirty-nine patients underwent removal of an adenoma with biopsy of one or more other parathyroid glands. In another group, nine patients underwent removal of the adenoma only. Both groups have had no recurrences of hyperparathyroidism in follow-up periods of two months to twelve years. The data presented indicate that removal of a parathyroid adenoma alone, without biopsy of other tissue, represents satisfactory treatment. Experience with hyperplastic glands is also reviewed. Subtotal parathyroidectomy was effective treatment in all patients, but a 30 per cent incidence of hypocalcemia was noted after this operation.

Adenoma↗
PubMed1975

Carcinoma of the oral cavity. An analysis of 478 cases.

Evaluation and analysis of 478 cases of carcinoma of the oral cavity treated from 1947 through 1970 shows a significant improvement in radiotherapy in the supervoltage (Co60) era. Survival in the early stages of disease (I and II) improved in the supervoltage era but not in the later stages of disease (III and IV). Results with combined therapy for advanced disease showed no significant difference from that of single mode therapy, whether with radiotherapy or with surgery in the supervoltage era.

Humans↗
PubMed1975

Chylothorax complicating radical neck dissection.

The third reported instance of chylothorax occurring after left radical neck dissection is presented and the literature reviewed. The pathogenesis appears to be lymphatic leakage in the neck with accumulation of chyle in the pleural space in spite of the absence of pneumothorax. The means for entry across an intact pleura is uncertain. The condition can be managed by conservative means consisting of adequate neck drainage and thoracentesis or chest tube drainage. A favorable outcome can be expected.

Carcinoma, Squamous Cell↗
PubMedDate not supplied

Blindness following bilateral radical neck dissection.

Blindness after bilateral radical neck dissection is a rare complication. A recent patient, who suffered total blindness after simultaneous bilateral radical neck dissection, is the fifth case reported. It is, however, the first with pathological study of the optic tracts. Detailed microscopic examination revealed bilateral intraorbital hemorrhagic optic nerve infarction without evidence of embolization or ophthalmic artery occlusion. The probable etiology of this event is an episode of prolonged hypotension. An additional etiologic factor may be increased resistance to blood flow caused by venous hypertension, resulting from bilateral internal jugular vein ligation.

Aged↗