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At least 1,477 records · Page 82Linked to original sources
PubMed1995

Laparoscopic ureteral anti-reflux plasty reimplantation. First clinical experience.

Several animal studies have demonstrated that antireflux surgery by means of laparoscopy is technically feasible, but clinical experience is as yet lacking. Six girls aged between 6 and 10 years underwent laparoscopic Lich-Gregoir anti-reflux surgery for vesicoureteral reflux and recurrent urinary infections. Three unilateral and three bilateral procedures were performed. No ureteral stents were used. One girl was operated on via an extraperitoneal approach. A mild unilateral stenosis was observed in one child, which, however, subsided after stenting for six weeks. A borderline compensated pyeloureteral stenosis decompensated shortly after the operation. Another child had an uncomplicated urinary tract infection. No other complications were seen. The laparoscopic Lich-Gregoir antireflux procedure is a complicated operation, which offers no advantage over the conventional procedure.

Arteries↗
PubMed1994

[Liver transplantation with preservation of the inferior vena cava and "piggyback" reimplantation of the liver].

A modified technique of orthotopic hepatic transplantation with inferior vena caval preservation and piggy-back procedure is described. This procedure, used in 14 patients, avoided the need for temporary vena cava clamping in nine cases and reduced the need for venous bypass during orthotopic liver transplantation. The indications, results and advantages of this procedure are described.

Adult↗
PubMed1994

Long-term follow-up after total parathyroidectomy without parathyroid reimplantation in chronic renal failure.

Forty-three patients with secondary or autonomous hyperparathyroidism complicating chronic renal failure (CRF) underwent total parathyroidectomy (PTX) (follow-up 2-18 years, mean 8.7 years). Five were on conservative treatment for CRF, 35 on regular dialysis, and only three had a functioning allograft. At PTX, the most frequent findings were uncontrollable hypercalcaemia, musculo-skeletal pain, radiographic changes in the phalanges, and raised plasma parathyroid hormone (PTH) concentration. Pre-operatively, all patients were loaded with dihydrotachysterol or 1-alpha-OH cholecalciferol. Postoperatively, they were maintained on tapering doses of the same drugs and, briefly, oral calcium supplements. Five glands were identified and removed in two patients, four in 35 patients, three in three patients and only two in one patient. All had changes of hyperplasia and adenoma formation, except for one with a parathyroid carcinoma. Prompt symptomatic and radiographic improvement occurred, with normalization of plasma calcium and alkaline phosphatase. Postoperative PTH levels were available in 33 patients (23 by intact PTH assay): they were persistently high in 10/33 (2/23 intact); normal in seven (6 intact); low in 11 (3 intact), and undetectable in four (3 intact). Thus, PTX was incomplete in the majority of patients. Following transplantation, 3/20 (3/18 intact) patients still had detectable PTH. Only one patient developed symptomatic recurrent parathyroid disease requiring re-operation, and complications were few. Small dosages of vitamin D continue to be required, but not calcium supplementation, and no clinical effects of possible adynamic bone have been noted. At later renal transplantation in 27 patients, an easily treatable, uncomplicated hypocalcaemia was noted in 33%.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenoma↗
PubMed1993

Composite aortic valve replacement and graft replacement of the ascending aorta plus coronary ostial reimplantation: how I do it.

Aortic root replacement in the patient with Marfan syndrome is indicated in the presence of aortic root dilatation more than 6 cm, ascending aortic dissection, or 3 to 4+ aortic valve insufficiency. The objective of operation is to prevent catastrophic aortic rupture or dissection and to treat or prevent aortic insufficiency with consequent left ventricular dysfunction. In over 170 patients undergoing aortic root replacement, operative mortality has been 1%. At mean follow-up of 5 years, the survival rate was 75%. The most frequent serious late postoperative complication has been graft endocarditis (4%). The technique described above carries a low operative risk and late complication rate. We believe it is an important surgical arm in the treatment of cardiovascular complications of the Marfan syndrome.

Aortic Dissection↗