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At least 217 records · Page 12Linked to original sources
PubMed2000

[Comparative efficacy of low molecular heparin (fraxiparine), non-fractionized heparin and anti-aggregate therapy in the prophylaxis complex for thromboembolic complications after surgical interventions performed for oncological disease].

Thromboembolism is one of the most frequent postoperative complications, which lead to exitus letalis in many of the patients. The thromboembolism occurrence is the most frequent in oncological diseases. Anticoagulants of direct action the nonfractionized heparin and low molecular weight heparins are applied for prophylaxis of thromboembolic complications. Their usage in combination with antiaggregative preparations is undesirable because of the bleeding occurrence threat. Comparative studying of prophylactic action and the haemorrhagic complications frequency under the usage of heparin, fraxiparin and antiaggregative preparations was performed in 462 patients. Maximal activity of low molecular weight heparins vs such of nonfractionized heparin and antiaggregative preparations was proved. The trustworthy enhancement of the bleeding frequency and of the blood coagulating system was not noted in the combined application of fraxiparin and antiaggregative preparations.

Adult↗
PubMedDate not supplied

Surgical treatment of hepatocellular carcinoma with direct removal of the tumor thrombus in the main portal vein.

BACKGROUND/AIMS: Hepatocellular carcinoma with tumor thrombus in the main portal vein is generally associated with a poor prognosis. If the liver function tolerated the hepatic resection, we aggressively selected surgical treatment. METHODOLOGY: We performed surgical treatment in 18 of 72 patients with hepatocellular carcinoma with tumor thrombus in the main portal vein. We analyzed the prognostic factors and survival rate of the surgical treatment group. RESULTS: The overall cumulative survival rates following the operation at 1 and 2 years were 48% and 34%, respectively. No patients died within 30 days of the operation. An univariate survival analysis revealed that intrahepatic metastases (P = 0.013), tumor differentiation (P = 0.011) and operative curability (P = 0.0058) had significant effects on survival. For the 6 patients with a complete resection, the cumulative survival rates at 1 and 2 years were 75% and 75%, respectively. In the 3 of 5 patients who died within 90 postoperative days, incomplete removal of the tumor thrombus in the portal vein or hepatic vein caused early recurrence and death. CONCLUSIONS: If the liver function tolerates the hepatic resection, hepatectomy of the main tumor combined with removal of tumor thrombus in the main portal vein is an effective treatment. This is especially true in patients where a long life is made possible by a complete resection of the main tumor, intrahepatic metastases and tumor thrombus. An important feature of this operation is to attempt complete removal of the tumor thrombus so as to prevent early recurrence and death.

Carcinoma, Hepatocellular↗
PubMed2004

[Methods in draining surgical procedures performed on the thoracic lymphatic duct in liver cirrhosis].

During the period from 1980 till 2000 212 operations were performed on the thoracic lymphatic duct (TLD). Different modifications of the lympho-venous anastomosis were used in 160 (75.4%) of them, direct external drainage of TLD in 41 (20%) patients, ductolysis of TLD in 11 (5%) patients. In order to get lymph from TLD and for the following lymphosorption two kinds of operations were used: direct external drainage of TLD or of one of its branches and the formation of lymphovenous anastomosis (most frequently anastomosis of TLD with the external jugular vein) in combination with lymphaticostomy. A technique of chronic catheterization of TLD is proposed which allows performing external drainage of the duct for the following courses of lymphosorption in activation of cirrhosis without reoperations. When withdrawing the catheter from TLD the author recommends to make a relaxation suture tied during elimination of the drainage. It prevents lymphedema of the tissues and the formation of lymphatic fistulas.

Chronic Disease↗
PubMed1991

[Studies on right ventricular performance in surgical treatment for primary lung cancer--especially in changes of right ventricular ejection fraction in acute phase].

In surgical treatment for lung cancer, increase of right ventricular afterload associated with decrease of pulmonary vascular bed after lung resection is serious problem in acute phase. Intensive care is necessary for the patients having major surgery, especially in aged. Until now, we have studied on pre and post operative extravascular lung water (EVLW) in addition to measurement of conventional hemodynamic changes on right ventricular afterload. And then, we have discussed when we should start to care intensively for degradation of compensatory hyperdynamic change. According to percent exchanges (delta %) between pre and post operative measurement, we established following criterion 1) delta %HR greater than 150% 2) delta SVI less than 60% 3) delta % PARI greater than 200% 4) observed postoperative EVLW greater than predicted postoperative EVLW. Furthermore, we investigated the correlation with these criterion and RVEF in 14 patients using a rapid computerized thermodilution method on right cardiac function in acute phase. We found that 1) changes of RVEF seem to depend on endsystolic volume 2) RVEF decreased just after operation and then slowly increased until 48 hours 3) PARI elevated to 194 +/- 117% in average at 6 to 24 hours showing significant inversed linear correlation to changes of RVEF (R = -0.54). The patients having prolonged elevation of PARI showed degradation of cardiac output and RVEF. RVSWI showed compensative acceleration gradually with increased right ventricular afterload.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1989

Investigation of the relationship between volume and mortality for surgical procedures performed in New York State hospitals.

Recent studies have demonstrated that the number of times a hospital or surgeon performs certain procedures annually has an inverse relationship with in-hospital mortality rates for patients undergoing the procedures. This study uses an improved measure of physician volume to test the combined relationship of hospital and physician volume with in-hospital mortality rates and to explore the existence of threshold volumes that optimally discriminate high- and low-volume providers. Five procedure groups have significant volume-mortality relationships. For total cholecystectomies, hospital volume is the more significant volume measure, but physician volume is marginally related to mortality rate. For coronary artery bypass surgeries, resection of abdominal aortic aneurysms, partial gastrectomies, and colectomies, physician volume is more significant than hospital volume, but hospital volume is marginally significant. Annual hospital volume thresholds for these data appear to exist at approximately 5 procedures for partial gastrectomies, 40 procedures for colectomies, and 170 procedures for total cholecystectomies.

Age Factors↗