Your email was sent successfully. Check your inbox.

An error occurred while sending the email. Please try again.

Proceed reservation?

Export
Filter
Collection
Publisher
Years
  • 1
    Electronic Resource
    Electronic Resource
    Springer
    World journal of surgery 9 (1985), S. 391-397 
    ISSN: 1432-2323
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé En raison de l'augmentation du risque d'infection après splénectomie les auteurs ont tenté la splénorraphie, dans la mesure du possible, chez les victimes d'un traumatisme abdominal. Sur 75 blessés qui présentaient une blessure splénique, 44 (58.7%) ont été traités par splénorraphie. Ces blessés étaient dans un état grave et présentaient souvent des lésions traumatiques associées. Les auteurs considèrent que la splénorraphie peut être pratiquée avec une perte minime de sang et sans augmentation de la durée de l'opération, ceci à moins que des conditions physiologiques ou anatomiques particulières s'opposent à cette attitude thérapeutique. La majorité des blessés (63.6%) ainsi traités présentaient une simple lacération, lésion qui fut contrôlée soit par l'application locale d'agents hémostatiques, soit à l'aide de sutures résorbables. La mortalité opératoire et les complications postopératoires furent identiques pour la splénorraphie et pour la splénectomie. Un blessé traité par splénorraphie dut être réopéré pour hémorragie. Une hémorragie tardive ou une rupture capsulaire de la rate ne fut jamais constatée. Les auteurs concluent que la splénorraphie est une intervention licite et sûre et qu'elle peut remplacer la splénectomie dans certaines circonstances. La conservation de la rate est bénéfique car elle réduit les risques d'infection secondaire à la splénectomie.
    Abstract: Resumen En vista de la mayor conciencia sobre el riesgo de sepsis masiva después de esplenectomía, hemos intentado la esplenorrafia en los casos de trauma en que ha sido posible. De 75 pacientes con lesión esplénica, 44 (58.7%) fueron tratados con esplenorrafia. Estos pacientes se encontraban en estado crítico y con frecuencia tenían múltiples lesiones asociadas. Encontramos que a menos que consideraciones fisiológicas o anatómicas lo impidan, la esplenorrafia puede ser realizada fácilmente con mínima pérdida de sangre y sin prolongación del tiempo operatorio. La mayoría de los pacientes que fueron sometidos a reparación esplénica (63.6%) presentaban laceraciones simples que pudieron ser controladas bien con agentes hemostásicos tópicos o con suturas absorbibles. Las tasas de complicaciones y mortalidad tempranas fueron similares para la esplenorrafia y para la esplenectomía. Un paciente sometido a esplenorrafia requirió reoperación por hemorragia. No se observaron episodios de hemorragia tardía o de rotura capsular. Hemos concluído que la esplenorrafia es una alternativa viable y segura bajo ciertas circunstancias, y que puede ser beneficiosa al reducir el riesgo de sepsis masiva subsiguiente a la esplenectomía.
    Notes: Abstract Because of the increased awareness of the risk of over-whelming sepsis following splenectomy, we have attempted splenorrhaphy in trauma victims whenever possible. Among 75 patients with splenic injuries, 44 (58.7%) were treated with splenorrhaphy. These patients were critically ill, and frequently had multiple associated injuries. We found that unless physiologic or anatomic considerations precluded its use, splenorrhaphy could be performed readily with minimal blood loss and no increase in operating time. The majority of patients undergoing repair (63.6%) had simple lacerations which were controlled either with topical hemostatic agents or repaired with absorbable sutures. The early complication and operative mortality rates for splenorrhaphy and splenectomy were similar. One patient undergoing splenorrhaphy required reoperation for bleeding. There were no episodes of delayed hemorrhage or capsular disruption. We conclude that splenorrhaphy is a viable and safe alternative to splenectomy under certain circumstances, and may be beneficial by reducing the risk of subsequent overwhelming postsplenectomy sepsis.
    Type of Medium: Electronic Resource
    Signatur Availability
    BibTip Others were also interested in ...
  • 2
    ISSN: 1615-5947
    Keywords: Chylous ascites ; ascites ; abdominal aortic operations
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Three patients, two women, one man (mean age 74 years), who had abdominal aortic aneurysms (2) or aortobifemoral surgery (1), developed chylous ascites postoperatively. They were studied to determine their clinical course and develop a plan for management of this complication. In each patient, the ascites was not manifest until abdominal swelling developed two weeks after operation, and the problem was confirmed by the finding of milky fluid on paracentesis. A low serum albumin (mean 2.6 gm) was also characteristic. The ascites was not altered by parenteral nutrition or reduction of dietary fat and ingestion of medium chain triglycerides. In one patient (man, age 93) the ascites resolved spontaneously two months after abdominal aortic aneurysm surgery. Another (woman, age 70) was cured following operative ligation of a lymphatic fistula identified at operation five weeks after abdominal aortic aneurysm repair. In the third (woman, age 60), the ascites resolved immediately following placement of a peritoneal venous shunt six weeks after an aortobifemoral bypass. Chylous ascites is rare after aortic surgery and manifests itself about two weeks after operation, at times after discharge from hospital. It has an indolent course, but may resolve spontaneously up to two months after operation. Its course appears not to be foreshortened by diet, including omission of fat, but can be successfully treated surgically with a shunt or fistula ligation. If done early a protracted hospital course may be avoided.
    Type of Medium: Electronic Resource
    Signatur Availability
    BibTip Others were also interested in ...
Close ⊗
This website uses cookies and the analysis tool Matomo. More information can be found here...