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At least 433 records · Page 24Linked to original sources
PubMedDate not supplied

The relationship between stapling doughnuts: characteristics and functional results after total gastrectomy.

BACKGROUND/AIMS: The objective of this study was to determine whether the thickness of the esophageal doughnut is related to postoperative results in total gastrectomy. METHODOLOGY: Thirty-eight total gastrectomy patients were studied, including 18 who underwent jejunal pouch reconstruction and 20 who did not have pouch reconstruction. We used the Proximate-ILS circular stapler, with purse-string suturing at the cut end of the esophagus performing only the mucosal layer manually in all cases. We divided the esophageal doughnuts after stapling into two groups: Group A: doughnut involving muscle tissue of 0-25% of the esophageal circumference; Group B: doughnut involved muscle tissue of 25-100% of the esophageal circumference. Reflux scores and the scintigraphic reflux index were determined. RESULTS: No significant difference was found between the two groups in reflux score or scintigraphic reflux index. CONCLUSIONS: These findings indicate that the degree of postoperative reflux esophagitis was not affected by the amount of the muscular layer included in the esophageal doughnut. Continuity, and not variability of the degree of involved muscle in the esophageal doughnut, is an important factor at the time of stapling.

Aged↗
PubMed2006

Stapled vs open hemorrhoidectomy: long-term outcome of a randomized controlled trial.

BACKGROUND AND AIMS: Stapled hemorrhoidectomy is a relatively new procedure, and studies on long-term outcomes are few. We present the results of a 5-year follow-up on patients recruited to a randomized controlled trial comparing stapled and Milligan-Morgan hemorrhoidectomy. PATIENTS AND METHODS: We performed telephone interviews and office visits between May and July 2005 on patients who had taken part in a randomized controlled trial from May 1999 to December 2000. RESULTS: Occasional pain and bleeding were referred by the patients with no difference between the two groups. The patients were also equally satisfied with both procedures. No recurrent hemorrhoidal prolapse or stenosis was detected at anorectal exploration and rigid sigmoidoscopy. CONCLUSION: Both stapled and Milligan-Morgan techniques guarantee satisfactory long-term results. Larger studies are needed to assess the durability of stapled hemorrhoidectomy.

Follow-Up Studies↗
PubMed1998

Use of the disposable stapler to insure proper fixation of a transferred muscle in treatment of facial paralysis.

The authors introduce the use of a disposable stapler to create a stable muscle end in transferring a free neurovascular muscle segment for the treatment of facial paralysis. This procedure allows the firm fixation of the fragile soft end of a muscle transferred to the nasolabial region of a paralyzed face, and avoids adhesion and tethering of the muscle end to the skin, which may result in inaccurate positioning of a newly-created nasolabial fold and an asymmetrical smile. Transection and hemostasis at both ends of the harvested muscle segment also can be achieved simultaneously. Although the disposable stapler incurs additional cost, it can greatly improve the result of a free neurovascular muscle transfer for the treatment of facial paralysis, as well as simplify harvesting of the muscle segment. No complications and problems have been encountered in stapling the muscle.

Disposable Equipment↗
PubMed1996

Humeral shaft nonunion treated by a Seidel interlocking nail with a supplementary staple.

Thirty-two adult patients with humeral shaft nonunions were treated with Seidel interlocking nails, and 6 of these 32 patients required an added staple. The indication for inserting a staple was rotational instability, despite use of a distal spreading screw. All 6 patients with nonunions were followed for at least 1 year (median, 1.5 years), and all experienced a solid union. The union period was a median of 5 months, with a range of 3 to 7 months. No complications were noted. The author believes that all humeral shaft nonunions may be treated by a Seidel interlocking nail with or without a staple supplementation and cancellous bone graft. The technique is simple, and its results are satisfactory. Predrilling the cortices of both fragments is key to successful insertion of a staple.

Adult↗
PubMed2007

All-inside meniscus repair: a systematic review.

All-inside meniscus repairs are becoming more common with the invention of meniscal arrows, darts, screws, staples, and other suture devices. With the rising popularity of these new all-inside meniscal repair devices, it is necessary to assess the effectiveness of various all-inside surgical interventions used in the treatment of meniscal tears. We performed an evidence based review of the outcomes of all-inside meniscus repair devices. Seventy-seven percent of identified studies were case series; 10% were retrospective comparative studies; 6.5% were prospective comparative studies; and 6.5% were prospective randomized studies. The failure rates ranged from 0 to 43.5%. We found no substantial differences in the failure rates among various meniscus devices. We also found no substantial differences in failure rates with length of followup. Given the paucity of randomized controlled studies comparing different all-inside meniscal repairs, no definite conclusions can be made regarding the difference in clinical outcomes of various all-inside meniscal repair devices.

Humans↗
PubMed2000

[Staple in pericardial devascularization of upper GI bleeding due to portal hypertension: application and therapeutic effect].

OBJECTIVE: To investigate the therapeutic effect of staple in pericardial devascularization on upper GI bleeding due to portal hypertension. METHODS: From July, 1997 to July, 2000, 30 portal hypertensive patients were treated by using pericardial devascularization plus partial resection of lower part of the esophagus with staple (CDH25). The eliminating rate of varicose veins of the lower part of the esophagus and the stenosis rate of anastomosis were evaluated. The therapeutic effect of pericardial devascularization without lower part esophageal resection in 28 patient with upper GI bleeding due to portal hypertension was taken as control. RESULTS: All the patients were followed up for 23 months. There was no death due to the operation. All patients in the study group had no upper GI rebleeding during the 23-month follow-up. The rebleeding rate in the control group was 18% (5/28) (P < 0.05 vs. Study group). The varicose veins eliminating rate was 100% in the study group and 53.6% (15/28) in the control group (P < 0.01); the stenosis rate of anastomosis was 6.7% (2/30) in the study group. CONCLUSION: The therapeutic effect of pericardial devascularization could be improved by the use of staple with shorter operative time.

Adult↗
PubMedDate not supplied

Endoscopic microwave coagulation therapy of postoperative hemorrhage from a stapled anastomosis.

We experienced three cases of postoperative hemorrhage from a stapled gastrointestinal anastomosis, and established endoscopic microwave coagulation therapy (EMCT) with a cylinder-type electrode. We were able to treat postoperative hemorrhage over the entire circumference of stapled anastomosis successfully. Two patients had undergone a lower third thoracic esophagogastrectomy through a left thoraco-abdominal approach for gastric cancer in the cardia, while the other case had undergone Billroth I gastrectomy. They each had fresh bleeding from the stapled anastomosis after the operation. Emergency endoscopic examination was immediately performed. Endoscopy revealed bleeding on the suture line. We performed hemostasis endoscopically with microwave coagulation therapy safely. They were discharged from the hospital without complications such as leakage and stenosis. Since EMCT with the cylinder-type electrode can coagulate shallowly and widely, it is very effective for hemorrhage from a stapled anastomosis.

Aged↗
PubMedDate not supplied

New technique for purse string suture in stapled esophagojejunostomy using a new "needle cap" device.

Stapler anastomosis has been widely used in esophagojejunostomy following total gastrectomy. Purse string suture around the cut esophagus must be placed before stapler anastomosis. However, technical problems associated with placement of the purse string suture remain. We have designed a new reusable "needle cap" device, allowing purse string suture to be performed easily, safely, and cost-effectively. We present herein a new technique for purse string suture in stapled esophagojejunostomy using this device.

Equipment Design↗
PubMed1996

Repair of penetrating cardiac injury using skin staples.

Cardiac stapling is a highly effective technique in the management of hemorrhage from penetrating cardiac injuries. It may allow the salvage of patients with multiple cardiac lacerations who would not otherwise survive following standard suture techniques for repair. Cardiac stapling is probably not indicated in complex injury cases such as those from gunshot, and the trauma surgeon must use judgment in applying the staple technique, though its use for cardiography in the ED and the OR will minimize the risk of contamination of personnel from a needle stick from the repair portion of the surgical procedure. Staplers are readily available, easy to use and safe to surgical personnel, and they provide rapid and effective hemostasis.

Adult↗