ABSTRACT
Endoscopic subfascial dissection is an effective method for the interruption of incompetent perforating veins. From 15th October to 15th December of 1995 11 patients underwent endoscopic subfascial sectioning. It is the first time to apply this procedure in Hungary. A venous ulcer was found in 5 patients. Endoscopic sectioning supplemented by extensive fasciotomy, without any substantial complication. The method is recommended due to its reduced invasiveness and fair results.
Subject(s)
Leg Ulcer/etiology , Thrombophlebitis/surgery , Adult , Endoscopes , Fasciotomy , Female , Humans , Leg Ulcer/surgery , Male , Middle Aged , Minimally Invasive Surgical Procedures , Surgical Instruments , Thrombophlebitis/complicationsABSTRACT
Diffuse bleeding from parenchymatous organs at conventional surgery is eliminated with the usual methods coagulation tamponade or styches. We performed experimental series at 9 dogs. After resection of spleen, liver, pancreas and kidney, the bleeding surface was covered by collagen fleece coated with fibrin glue (TachoComb). Postoperatively 7 days, 10 days, 14 days and 28 days we made a relaparotomy. Then the results were analyzed macroscopically and microscopically. In the abdominal cavity neither significant quantity of blood nor greater adhesions were detected. At all cases the fibrin glue was found on place were it was put before. Histologically a perfect wound healing experienced. The fibrin glue (TachoComb) using at diffuse parenchymatous organs' bleeding give a very good results when the wound area is at least 1 cm beyond the immediate wound margin and the fibrin glue is applied onto the wound and pressed on it for 4-5 minutes.
Subject(s)
Aprotinin/therapeutic use , Fibrinogen/therapeutic use , Hemostasis, Surgical/methods , Thrombin/therapeutic use , Animals , Aprotinin/administration & dosage , Blood Loss, Surgical/prevention & control , Dogs , Drug Combinations , Fibrin Tissue Adhesive/administration & dosage , Fibrin Tissue Adhesive/therapeutic use , Fibrinogen/administration & dosage , Follow-Up Studies , Hemostatics/administration & dosage , Hemostatics/therapeutic use , Hepatectomy , Kidney/pathology , Laparotomy , Liver/pathology , Nephrectomy , Pancreas/pathology , Pancreatectomy , Reoperation , Spleen/pathology , Splenectomy , Suture Techniques , Thrombin/administration & dosage , Tissue Adhesions/pathology , Tissue Adhesives/therapeutic use , Wound HealingABSTRACT
Splenectomy is known to increase the risk of overwhelming bacterial infection. There is a decrease in immunoglobulin IgM and T-lymphocytes, primary antibody response to antigen challenge is impaired, altered opsonic function an Tuftsin deficiency are noted. Splenic autotransplantation has been suggested as a method of preserving function and this concept is supported by experiments in animals. Prior to operation on humans the technique was thoroughly elaborated and practised in animal experiments (dogs). After splenectomy, 6-8 thin segments (Furka's "spleen chip") are placed in between the plates of the major omentum. Within the period of ten years out of 52 patients 11 children (4 girls, 7 boys) suffered from abdominal trauma underwent total splenectomy, and than autotransplantation in the Kenézy Hospital in Debrecen, Hungary. In several patients the postoperative follow-up radionuclide imaging, IgM, and Tuftsin levels, and the haematological changes (leukocytes, differential blood count, platelet count, iron level in serum) unambiguously confirmed the function of the splenic tissue.
Subject(s)
Abdominal Injuries/surgery , Spleen/transplantation , Splenectomy , Animals , Antibody Formation/immunology , Bacterial Infections , Blood Cell Count , Child , Disease Models, Animal , Dogs , Female , Follow-Up Studies , Humans , Immunoglobulin M/analysis , Iron/blood , Leukocyte Count , Lymphopenia/etiology , Male , Omentum/surgery , Platelet Count , Radionuclide Imaging , Risk Factors , Spleen/diagnostic imaging , Spleen/immunology , Splenectomy/adverse effects , T-Lymphocytes/pathology , Transplantation, Autologous , Tuftsin/analysis , Tuftsin/deficiencyABSTRACT
Splenectomy is known to increase the risk of overwhelming bacterial infection. There is a decrease in immunoglobulin IgM, T-lymphocytes, impaired primary antibody response to antigen challenge, an altered opsonic function and a tuftsin deficiency. Splenic autotransplantation has been suggested as a method of preserving function and this concept is supported by experiments in animals (dogs). The study describes autotransplantation of the traumatized spleen in human beings for the preservation of splenic function. Eleven patients operated on for abdominal trauma in the Kenézy Hospital in Debrecen, required total splenectomy, than splenic autotransplantation. In these patients splenic slides were implanted in between two layers of omental pouch (Furka's "spleen chip"). In 10 patients the follow-up radionuclid imaging, the IgM level, and the tuftsin level unambiguously confirmed the functioning of the splenic tissue.
