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Biomedical subjects

T Diamantis

Publications and source records attributed to T Diamantis.

11 recordsLinked to original sources
PubMed2005

Laparoscopic liver resection using radio frequency ablation in a porcine model.

BACKGROUND: The aim of this study was to assess the feasibility, efficacy, and safety of laparoscopic left lateral lobe resection, using radiofrequency ablation (RFA) with internally cooled tip electrodes, in a porcine model. METHODS: Eight domestic pigs underwent left lateral hepatic lobectomy. RFA was the sole hemostatic method applied throughout the entire operation. After 0, 7, 30, or 120 days the animals were killed in order to study the macroscopic and microscopic findings on the liver edge. RESULTS: An average of 90 min was enough for the entire operation. No signs of blood loss or infection were observed up to 4 months postoperatively. There was no mortality either during or after surgery. The pathology of the liver revealed the three zone lesions. CONCLUSION: Our study demonstrates that laparoscopic left lateral lobectomy using RFA is technically feasible hi the porcine model and is proved to be highly effective and safe hemostatic method.

Animals↗
PubMed2005

Acute appendicitis: the reliability of diagnosis by clinical assessment alone.

BACKGROUND AND AIMS: This prospective study aimed to review the trustworthiness of the initial clinical assessment in acute appendicitis without employment of imaging modalities, laparoscopy or any other adjunct diagnostic test. PATIENTS AND METHODS: 717 patients were operated on for appendicitis by six different surgeons. Initial clinical and laboratory examination were evaluated in relation to the intraoperative and the pathological appreciation of the appendiceal inflammation. RESULTS: 598 patients were found to have appendicitis, 34 a different condition, 41 had both appendicitis and an additional condition and 44 no pathology. 6% of the laparotomies and 11% of the appendectomies were unnecessary. The severity of the inflammation correlated significantly with periumbilical pain, pain migrating to right lower quadrant, loss of appetite, fever, rebound tenderness, local rigidity, polymorphonuclear predominance on deferential, polymorhonucleosis and leukocytosis. Leukocytosis was less frequent in aged patients. All the six surgeons were found to be equally reliable, although they all underestimated the setting compared to the pathologists. Patients with a long duration of symptoms had milder forms of inflammation and increased percentage of unanticipated abdominal conditions. CONCLUSIONS: Appendicitis can be reliably diagnosed clinically without employment of adjunct tests. These can be reserved for equivocal cases.

Acute Disease↗
PubMed2004

Video-assisted transcervical thymectomy.

BACKGROUND: The optimal surgical approach for complete removal of the thymus gland has long been debated. In this report, the excision of the entire gland through a transcervical incision using video-assisted techniques is described. METHODS: Ten patients, including one with thymoma and myasthenia gravis, underwent surgery via the transcervical approach. After standard dissection up to the level of the innominate vein and ligation of the thymic vessels, a laparoscope was inserted into the mediastinum. In the patient with thymoma, the operation was completed by a small incision in the third intercostal space. RESULTS: No perioperative mortality or long-term morbitity was observed. The mean hospital stay was 69.6 h. After a mean follow-up period of 63.8 months, eight patients displayed complete remission, whereas one continued to receive minimal medication. The patient with thymoma showed considerable improvement, but remained on same medical regimen No complications were seen throughout the study. CONCLUSION: Video-assisted thymectomy improves effectiveness of the transcervical approach for thymectomy with a minimum of trauma and excellent results.

Adult↗
PubMed2004

Does octreotide impair anastomotic healing after small bowel resection?

Seventy two rats underwent small bowel resection followed by end-to-end anastomosis. The octreotide group consisted of 36 rats treated with octreotide (subcutaneously, 7 microg/kg/day, in two equal doses), and the control group consisted of 36 rats treated with the same volume saline. Twelve animals from each group were re-explored on the 4th, 8th and 15th postoperative day. Leakages, adhesions, obstructions were the clinical postoperative findings identified and recorded. Anastomotic bursting pressures were measured. Histochemical studies included haematoxylin-eosin and Van Gieson staining techniques and focused on the microscopic characterization of the healing process. Adhesions, leakages and obstructions were not different between octreotide and control groups. Anastomoses of the octreotide group had increased bursting pressures on the 8th and the 15th day (p < .05 , p < .05, respectively). Regarding the histogical results, on the 8th day the octreotide group compared to the control group, showed healing in more layers (p < .05), increased bright red collagen fibers and quantity of fibroblasts (p < .05), and on the 15th day, the octreotide group showed fewer gaps (p < .05), increased bright red collagen fibers and quantity of fibroblasts (p < .05). In this experimental model, it appeared that octreotide does not impair healing of small bowel anastomoses, but in contrast, there is some evidence that it enhances healing on the 8th and the 15th postoperative day.

Anastomosis, Surgical↗
PubMed1997

Secondary aortoduodenal fistulae.

Secondary aortoenteric fistula (SAF) is a rare but fatal complication of reconstructive aortoiliac surgery. The prevention, diagnosis and treatment of this complication remains a challenging problem in everyday practice. Nine cases of secondary aortoduodenal fistulae during the period of 1980 to 1992 are presented. Their main symptom was bleeding of the upper gastrointestinal tract. The mean time interval since the aortic surgical procedure was 32 months. Removal of the old graft and closure of the duodenal defect was the first stage of the operative procedure. One patient underwent replacement of the old graft, with a new graft, while in the remaining three patients extranatomical bypass was not necessary because of satisfactory circulation in the lower extremities. In five patients extranatomical revascularization of the lower limbs was performed postoperatively at various intervals. Three patients died postoperatively. Follow-up of the remaining patients ranged from one month to 8 years. Bleeding of the upper gastrointestinal tract in patients with a history of intrabdominal reconstructive vascular surgery must raise severe suspicion as to the certainty of existance of SAF unless the diagnostic procedure, mainly exploratory laparotomy, excludes this possibility.

Aged↗
PubMed1992

Sucralfate and ranitidine twice daily in the treatment of gastric ulcer. A multicenter randomized double-blind study.

Sucralfate and ranitidine were compared in the treatment of gastric ulcer (GU) in this multicenter randomized double-blind study. Sixty-four patients with endoscopically diagnosed GU initially included in the trial were randomly assigned to treatment with sucralfate, 2 g b.i.d. (morning and evening on an empty stomach), or ranitidine, 150 mg b.i.d. Nine patients were subsequently excluded for various reasons. The remaining 55 were examined endoscopically after 4 and, if unhealed, 8 weeks. At 4 weeks, 54.2% (13 of 24) of the sucralfate group had a healed ulcer, in comparison to 45.2% (14 of 31) of the ranitidine group (NS). At 8 weeks, cumulative healing rates were 87.5% (21 of 24) and 84% (26 of 31), respectively (NS). No differences were found in the healing effects of the drugs on smokers and nonsmokers or in side effects. These results suggest that both drugs are equally effective in the short-term treatment of GU.

Adult↗
PubMed1991

Comparison of sucralfate and ranitidine twice daily in duodenal ulcer treatment: a multicenter randomized double-blind study.

Sucralfate and ranitidine were compared in the treatment of duodenal ulcer in this multicenter, randomized, double-blind study. A total of 165 patients with endoscopically proven duodenal ulceration were included in the trial and randomized to treatment with sucralfate, 2 g b.i.d. (morning and evening with an empty stomach), or ranitidine, 150 mg twice daily. All patients were endoscopically examined after 4 and, if unhealed, 8 weeks. Of the patients considered suitable for analysis at 4 weeks, 73.5% (61 of 83) of the sucralfate group demonstrated healing of the ulcer in comparison with 63.3% (50 of 79) of the ranitidine group. At 8 weeks cumulative healing rates were 89% (74 of 83) and 84.8% (67 of 79), respectively. When smokers were considered separately, healing rates at 4 weeks were 69.2% (36 of 52) for sucralfate and 53.3% (24 of 45) for ranitidine. At 8 weeks cumulative healing rates were 92.3% (48 of 52) and 77.7% (35 of 45), respectively (p less than 0.05). Overall, there was no difference in the two groups regarding symptom relief and side effects. These results suggest that these drugs are equally effective in the short-term treatment of duodenal ulcer, although in smokers sucralfate appears to be more effective than ranitidine.

Adult↗
PubMed1986

Axillary intercostal drain in traumatic haemopneumothorax.

During an 8-month period, 242 patients with thoracic injuries were admitted to one of the general surgical units at Baragwanath Hospital. Of these, 7.4% required surgical exploration, while 92.6% had pneumothorax treated conservatively by insertion of a single drain at the mid-axillary line in the 5th intercostal space. Of patients managed conservatively 76 had pneumothorax and 148 haemopneumothorax. There were no deaths in this series. All patients explored recovered well from the operation and were discharged after a mean period of 6 days. Of those with a pneumothorax managed conservatively full expansion of the lung was obtained in 98.7%. In 80% of the patients with haemopneumothorax, axillary intercostal drainage proved adequate treatment and resulted in prompt re-expansion of the lung. However, 6.8% of the patients in this group required further needle aspiration of the pleural cavity and in 2.7% a second drain was inserted for evacuation of residual blood. Eight (5.4%) patients were discharged with a small and insignificant residual haemothorax.

Adult↗
PubMedDate not supplied

Six-month maintenance treatment of duodenal ulcer with sucralfate: influence on antral gastritis and Helicobacter pylori antral colonization--a prospective uncontrolled study.

Fifty-four patients (41 men, 13 women), aged 17 to 78 years (mean +/- SD, 48.13 +/- 13.5 years), with endoscopically confirmed healing of their duodenal ulcer after treatment with sucralfate (2 gm BID for 4 to 8 weeks) were recruited for this study. They were started on a 6-month maintenance treatment with sucralfate 1 gm BID. Endoscopy was done at the end of the 6-month period or whenever there was any evidence of ulcer relapse. Helicobacter pylori antral colonization (CLO test) and antral gastritis were estimated from biopsy samples taken before, and at the end of, the healing treatment, as well as at the end of the maintenance treatment. Cumulative relapse rate after 6 months was 15% (8 of 54). No patient discontinued treatment because of side effects. No influence of sucralfate on H pylori antral colonization or antral gastritis was observed after the healing or maintenance treatment. It is concluded that sucralfate 1 gm BID for 6 months is an effective maintenance treatment for duodenal ulcer, but has no beneficial effect on either H pylori antral colonization or antral gastritis.

Adolescent↗