Tehnika splenektomije

Splenectomy has been performed in trauma in a number of benign lesions of the spleen and in a certain haematological diseases. When performed for trauma a luxation technique of splenectomy is applied since it allows quick haemostasis. When performed in other indications, the spleen is usually enlarged. In those patients "splenectomy in situ" is recommended. That means, first, division of the short gastric vessels and gastrosplenic ligament, second, ligation of the splenic artery and finally division of the hilar vessels after which the spleen may be simply removed. Details of operative technique, management of accessory spleens and prevention of operative complications are described.

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Massive splenic infarction in a patient with pneumococcal septic shock and unknown celiac disease

Italian Journal of Medicine ◽

10.4081/itjm.2017.908 ◽

2017 ◽

Vol 11 (4) ◽

pp. 407 ◽

Cited By ~ 1

Author(s):

Alessandro Graziani ◽

Pierpaolo Casalini ◽

Federica Mirici Cappa ◽

Francesco Albertini ◽

Erica Fiorini ◽

...

Keyword(s):

Septic Shock ◽

Celiac Disease ◽

Splenic Artery ◽

Rare Event ◽

Abdominal Ultrasound ◽

Splenic Infarction ◽

Healthy Patient ◽

Pneumococcal Sepsis

Splenic infarction (SI) is a rare event occurring when the splenic artery or its branches become occluded by embolus or by in situ thrombosis. Many SI events are a result of embolic sources either cardiac or aortic. Massive splenic infarction (MSI) results from compromised blood flow to more than half of the spleen. In this paper we describe a case of a previously healthy patient who presented with pneumococcal sepsis who, upon investigation, revealed an unknown celiac disease and a MSI. Abdominal ultrasound with contrast agent was a useful tool for a diagnosis and follow up of this patient.

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Contact endoscopy as a novel technique in the detection and diagnosis of oral cavity and oropharyngeal mucosal lesions in the head and neck

The Journal of Laryngology & Otology ◽

10.1017/s0022215113003332 ◽

2014 ◽

Vol 128 (2) ◽

pp. 147-152 ◽

Cited By ~ 3

Author(s):

S Dowthwaite ◽

C Szeto ◽

B Wehrli ◽

T Daley ◽

F Whelan ◽

...

Keyword(s):

Sensitivity And Specificity ◽

High Sensitivity ◽

Video Data ◽

Initial Contact ◽

Benign Lesions ◽

Video Images ◽

Malignant Lesions ◽

Mucosal Lesions ◽

Detection And Diagnosis

AbstractObjective:We aimed to investigate the diagnostic accuracy of contact endoscopy in evaluating oral and oropharyngeal mucosal lesions.Methods:Between January 2010 and December 2011, 34 patients with lesions of the oral and oropharyngeal mucosa were enrolled in the study. Comparison between initial contact endoscopy results and ‘gold standard’ tissue biopsy was undertaken.Results:Nine patients had histologically confirmed squamous cell carcinoma, 2 had carcinoma in situ, 3 had dysplastic lesions and 20 patients had various benign lesions. Contact endoscopy demonstrated sensitivity and specificity of 89 and 100 per cent respectively in the evaluation of malignant lesions. Benign lesions were correctly categorised in 50 per cent of cases (10/20). The video images from contact endoscopy could not be interpreted in six cases.Conclusions:Contact endoscopy demonstrates high sensitivity and specificity in the imaging of malignant lesions with reduced reliability in the evaluation of benign lesions. Significant shortcomings also exist in the design of current technology that we believe represent a significant barrier to the reliable collection of useful video data.

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Immunohistochemical localisation of pS2 protein in ductal carcinoma in situ and benign lesions of the breast

British Journal of Cancer ◽

10.1038/bjc.1993.136 ◽

1993 ◽

Vol 67 (4) ◽

pp. 749-753 ◽

Cited By ~ 18

Author(s):

YA Luqmani ◽

T Campbell ◽

S Soomro ◽

S Shousha ◽

MC Rio ◽

...

Keyword(s):

Ductal Carcinoma In Situ ◽

Carcinoma In Situ ◽

Ductal Carcinoma ◽

Benign Lesions ◽

Ps2 Protein

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Rapid Rhino versus Merocel nasal packs in septal surgery

The Journal of Laryngology & Otology ◽

10.1017/s0022215111002179 ◽

2011 ◽

Vol 125 (12) ◽

pp. 1244-1246 ◽

Cited By ~ 16

Author(s):

A Hesham ◽

A Ghali

Keyword(s):

Standard Deviation ◽

Pain Score ◽

Visual Analogue Score ◽

Nasal Packing ◽

The Other ◽

Septal Surgery ◽

Patient Tolerance ◽

Operative Complications ◽

The Mean

AbstractObjective:To compare Rapid Rhino and Merocel packs for nasal packing after septoplasty, in terms of patient tolerance (both with the pack in place and during removal) and post-operative complications.Materials and methods:Thirty patients (aged 18–40 years) scheduled for septoplasty were included. Following surgery, one nasal cavity was packed with Rapid Rhino and the other one with Merocel. Patients were asked to record pain levels on a visual analogue score, on both sides, with the packs in situ and during their removal the next day. After pack removal, bleeding was compared on both sides.Results:The mean ± standard deviation pain score for the Rapid Rhino pack in situ (4.17 ± 1.78) was less than that for the Merocel pack (4.73 ± 2.05), but not significantly so (p = 0.314). The mean pain score for Rapid Rhino pack removal (4.13 ± 1.76) was significantly less that that for Merocel (6.90 ± 1.67; p = 0.001). Bleeding after pack removal was significantly less for the Rapid Rhino sides compared with the Merocel sides (p <0.05).Conclusion:Rapid Rhino nasal packs are less painful and cause less bleeding, compared with Merocel packs, with no side effects. Thus, their use for nasal packing after septal surgery is recommended.

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IMPALEMENT OF AN UNUSUAL FOREIGN BODY IN THE LEG – A CASE REPORT

10.36106/ijsr/1202520 ◽

2021 ◽

pp. 77-79

Author(s):

Surya Rao Rao Venkata Mahipathy ◽

Alagar Raja Durairaj ◽

Narayanamurthy Sundaramurthy ◽

Anand Prasath Jayachandiran ◽

Suresh Rajendran

Keyword(s):

Case Report ◽

Foreign Body ◽

Body Part ◽

The Body ◽

Parenteral Antibiotic ◽

Unusual Foreign Body ◽

Operative Complications ◽

Thorough Debridement ◽

Antibiotic Cover

Foreign body penetration is not uncommon and may be glass, shrapnel, needles, etc. and may occur in almost any part of the body. Impalement injury is when a blunt force causes a long object to penetrate a body part resulting in retention of the object in situ. The management following foreign body penetration includes tetanus prophylaxis, parenteral antibiotic cover and removal of the foreign body in the theatre with exploration for neurovascular injury, thorough debridement and repair of any damaged tissue. Here, we report a case of an industrial foreign body that impaled a middle aged male while at work in the left leg which was carefully removed under anaesthesia with no post-operative complications.

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An alternative experimental model for training in microsurgery

Revista do Colégio Brasileiro de Cirurgiões ◽

10.1590/s0100-69912014000100014 ◽

2014 ◽

Vol 41 (1) ◽

pp. 72-74 ◽

Cited By ~ 8

Author(s):

Ivan Maluf Junior ◽

Alfredo Benjamin Duarte Da Silva ◽

Anne Karoline Groth ◽

Marlon Augusto Camara Lopes ◽

Adriana Sayuri Kurogi ◽

...

Keyword(s):

Animal Model ◽

Undergraduate Students ◽

Operative Technique ◽

Splenic Artery ◽

Low Cost ◽

Microvascular Surgery ◽

Vascular Pedicle ◽

Real Model ◽

Initial Learning ◽

The Sacrifice

OBJECTIVE: to describe a new model of training in microsurgery with pig spleen after splenectomy performed by undergraduate students of the Discipline of Operative Technique of the UFPR Medical School. METHODS: after the completion of splenectomy we performed dissection of the vascular pedicle, distal and proximal to the ligation performed for removal of the spleen. After complete dissection of the splenic artery and vein with microscope, clamps were placed and the vessels were cut. We then made the anastomosis of the vessels with 9.0 nylon. RESULT: the microsurgical training with a well-defined routine, qualified supervision and using low cost experimental materials proved to be effective in the practice of initial microvascular surgery. CONCLUSION: the use of pig spleen, which would be discarded after splenectomy, is an excellent model for microsurgical training, since besides having the consistency and sensitivity of a real model, it saves the sacrifice of a new animal model in the initial learning phase of this technique.

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Comparative study of uterine repair during caesarean section: exteriorization repair versus in-situ repair

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20171403 ◽

2017 ◽

Vol 6 (4) ◽

pp. 1426

Author(s):

Lakshmi Priya ◽

Reddi Rani P. ◽

Lopamudra B

Keyword(s):

Caesarean Section ◽

Cesarean Section ◽

Comparative Study ◽

P Value ◽

Surgical Methods ◽

Significant Difference ◽

Operative Complications ◽

In Situ Repair ◽

Post Operative Complications

Background: Cesarean section is one of the most common major obstetrical operation performed worldwide and the rates of cesarean section are increasing. It is associated with both intra-operative and post-operative complications. Many variations in surgical methods have been devised to decrease the adverse effects and morbidity. One such method is technique of uterine repair after delivery of the fetus and placenta by exteriorizing the uterus or in-situ repair.Methods: A prospective comparative study was conducted in the department of Obstetrics and Gynecology at MGMCRI Pondicherry over 18 months from March 2015 to August 2016. Two hundred women undergoing caesarean section were assigned to 2 groups. Group 1 (Exteriorization) 100 women and Group 2 (In-situ repair) 100 women. Intra-op and post-operative complications were assessed in both groups and compared.Results: There was no significant difference between the two groups with regard to age, parity, gestational age and type of cesarean section. There was no significant difference between two groups with regard to fall in Hb, operating time, mean drop in pulse rate and blood pressure, nausea, vomiting and intra-op pain. There was significant difference in blood loss during surgery in in-situ repair, P value was <0.001 highly significant and also statistically significant increase in transfusion rates in in-situ group with a p value of 0.038. Postoperative complications like febrile morbidity was significantly more in in-situ repair P=0.046. There was no significant difference in other variables like urinary tract infection, surgical site infection, endometritis and hospital stay.Conclusions: Both techniques are accepted methods of uterine repair. Technique of repair depends on surgeon’s choice and clinical situation. Exteriorization repair is a valid option with no significant increase in morbidity compared to In-situ repair especially in cases where exposure of lower uterine segment is difficult, there is extension of incision and difficulty in achieving hemostasis.

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Follow-up interval for probably benign breast lesions on screening ultrasound in women at average risk for breast cancer with dense breasts

Acta Radiologica ◽

10.1177/0284185117745906 ◽

2017 ◽

Vol 59 (9) ◽

pp. 1045-1050 ◽

Cited By ~ 3

Author(s):

Hee Jung Moon ◽

Min Jung Kim ◽

Jung Hyun Yoon ◽

Eun-Kyung Kim

Keyword(s):

Breast Cancer ◽

Ductal Carcinoma ◽

Risk Groups ◽

Average Risk ◽

Benign Lesions ◽

Dense Breasts ◽

Screening Ultrasound ◽

Biopsy Rate

Background Women at high risk for breast cancer and women at average risk have different pretest probabilities. Probably benign lesions on screening ultrasound (US) should be assessed and managed differently for these two risk groups. Purpose To evaluate the effectiveness of short-term follow-up for probably benign lesions on screening US in women at average risk for breast cancer with dense breasts. Material and Methods A total of 445 women at average risk for breast cancer with probably benign lesions on screening US, dense breasts, and negative or benign mammography results were included. Women were classified into the six-month group (n = 345) or 12-month group (n = 100) according to when the first follow-up was performed (3–9 months or 9–15 months). The cancer detection rate, frequencies of newly developed lesions and progressed lesions, and biopsy rate were compared. Results There were no malignancies from three to 15 months. Three cancers newly developed after 15 months. One was a 3-mm ductal carcinoma in situ and two were 10-mm and 18-mm invasive ductal carcinoma without lymph node metastasis. The frequency of newly developed lesions and progressed lesions and biopsy rate were not significantly different between the six-month and 12-month groups ( P = 0.320, 0.621, and >0.999). Conclusion A follow-up at 12 months can be considered for probably benign lesions on screening US in women at average risk for breast cancer with dense breasts. However, a large series prospective study is needed before clinical application.

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Histological and biological evolution of human premalignant breast disease.

Endocrine Related Cancer ◽

10.1677/erc.0.0080047 ◽

2001 ◽

pp. 47-61 ◽

Cited By ~ 239

Author(s):

D C Allred ◽

S K Mohsin ◽

S A Fuqua

Keyword(s):

Biological Evolution ◽

Breast Disease ◽

Premalignant Lesions ◽

Breast Cancers ◽

Benign Lesions ◽

Evolutionary Pathway ◽

Scientific Investigations ◽

Genetic Mechanisms ◽

The Many

Most human invasive breast cancers (IBCs) appear to develop over long periods of time from certain pre-existing benign lesions. Of the many types of benign lesions in the human breast, only a few appear to have significant premalignant potential. The best characterized of these include atypical hyperplasias and in situ carcinomas and both categories are probably well on along the evolutionary pathway to IBC. Very little is known about earlier premalignant alterations. All types of premalignant breast lesions are relatively common but only a small proportion appear to progress to IBC. They are currently defined by their histological features and their prognosis is imprecisely estimated from indirect epidemiological evidence. Although lesions within specific categories look alike, they must possess underlying biological differences causing some to remain stable and others to progress. Recent studies suggest that they evolve by highly diverse genetic mechanisms and research into these altered pathways may identify specific early defects that can be targeted to prevent premalignant lesions from developing or becoming cancerous. It is far more rational to think that breast cancer can be prevented than cured once it has developed fully. This review discusses histological models of human premalignant breast disease that provide the framework for scientific investigations into the biological alterations behind them and examples of specific biological alterations that appear to be particularly important.

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