ABSTRACT
BACKGROUND: Laparoscopic techniques used to manage asymptomatic splenic artery aneurysms have been reported infrequently. METHODS: A laparoscopic splenic artery aneurysm resection was attempted for six consecutive patients. RESULTS: One patient underwent conversion to laparotomy because of a tear in the splenic vein. Among the five successful laparoscopic splenic artery aneurysm resections, the mean estimated blood loss was 37 +/- 12.6 ml, the mean operative time was 187.6 +/- 79.2 min, and the mean postoperative length of hospital stay was 1.8 +/- 1.3 days. The mean time to a clear liquid diet was 5.3 +/- 0.5 h, and the mean time to a regular diet was 1 +/- 0 day. The mean duration of narcotic analgesic use was 5.4 +/- 1.5 days, and the mean time to resumption of regular activities was 12.7 +/- 1.6 days. CONCLUSIONS: These cases illustrate the benefit of a laparoscopic approach with brief hospitalizations, early resumption of diet and regular activity, and minimal use of postoperative narcotic analgesics.
Subject(s)
Aneurysm/surgery , Laparoscopy/methods , Splenic Artery/surgery , Adult , Aged , Analgesics, Opioid/therapeutic use , Aneurysm/diagnostic imaging , Diet , Female , Follow-Up Studies , Humans , Intraoperative Complications/surgery , Laparoscopy/adverse effects , Laparotomy , Length of Stay , Male , Middle Aged , Pain, Postoperative/drug therapy , Postoperative Care , Postoperative Complications , Radiography , Retrospective Studies , Splenic Vein/injuries , Treatment OutcomeABSTRACT
The resting metabolic rates (RMR) of 60 lean and obese men, aged 18-82 y and weighing 60-171 kg, were measured and body compositions were determined. Body compositional variables reflecting active protoplasmic tissue were all highly interrelated. Body weight alone gave prediction values for RMR that were comparable to those of other variables of active protoplasmic tissue mass. Regional distribution of fat had no influence on the RMR and the influence of age on RMR was trivial. The classic prediction equations and tables overestimate RMR of men. The 95%-confidence limits for both lean and obese men were broad. This conclusively demonstrates that metabolic efficiency is not necessarily or exclusively related to obesity. New regression equations for predicting the RMR based on weight and fat-free mass were developed: RMR = 879 + 10.2 WT kg and RMR = 290 + 22.3 FFMD kg, where FFMD is fat-free mass from densitometry measurements.
