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1.
Neonatology ; 98(3): 229-31, 2010.
Article in English | MEDLINE | ID: mdl-20389127

ABSTRACT

Haemangiomas are the most common soft tissue tumours in infancy, occurring in approximately 5-10% of 1-year-old children. Current drug-based therapeutic options for large haemangiomas include corticosteroids, α-interferon and vincristin, all of which can result in harmful side effects. Recently, promising results have been reported using the non-cardio-selective ß-blocker propranolol for the treatment of cutaneous capillary haemangiomas, in which a spectacular size reduction was observed during the first 7 days of treatment. We here report a similar significant and rapid inhibitory effect of propranolol on the growth of a viscerally located congenital haemangioma.


Subject(s)
Abdominal Neoplasms/congenital , Abdominal Neoplasms/drug therapy , Hemangioma/congenital , Hemangioma/drug therapy , Propranolol/therapeutic use , Abdominal Neoplasms/pathology , Hemangioma/pathology , Humans , Infant, Newborn , Male , Umbilical Cord/drug effects , Umbilical Cord/pathology , Vascular Malformations/drug therapy , Vascular Malformations/pathology , Vasodilator Agents/therapeutic use
2.
Obes Surg ; 19(10): 1355-64, 2009 Oct.
Article in English | MEDLINE | ID: mdl-19685100

ABSTRACT

BACKGROUND: Various techniques of laparoscopic Roux-en-Y gastric bypass have been described. We completely standardized this procedure to minimize its sometimes substantial morbidity and mortality. This study describes our experience with the standardized fully stapled laparoscopic Roux-en-Y gastric bypass (FS-LRYGB) and its influence on the 30-day morbidity and mortality. METHODS: We retrospectively analyzed 2,645 patients who underwent FS-LRYGB from May 2004 to August 2008. Operative time, hospital stay and readmission, re-operation, and 30-day morbidity/mortality rates were then calculated. The 30-day follow-up data were complete for 2,606 patients (98.5%). RESULTS: There were 539 male and 2,067 female patients. Mean age was 39.2 years (range 14-73), mean BMI 41.44 kg/m(2) (range, 23-75.5). The mean hospital stay was 3.35 days (range 2-71). Mean total operative time was 63 min (range 35-150). One patient died of pneumonia within 30 days of surgery (0.04%). One hundred and fifty one (5.8%) patients had postoperative complications as follows: gastrointestinal hemorrhage (n = 89, 3.42%), intestinal obstruction (n = 9, 0.35%), anastomotic leak (n = 5, 0.19%) and others (n = 47, 1.80%). In 66 patients, the bleeding resolved without any surgical re-intervention. One hemorrhage resulted in hypovolemic shock with subsequent renal and hepatic failure. CONCLUSION: The systematic approach and the full standardization of the FS-LRYGB procedure contribute highly to the very low mortality and the low morbidity rates in our institution. Gastrointestinal bleeding appears to be the commonest complication, but is self-limiting in the majority of cases. Our approach also significantly reduces operative time and turns the technically demanding laparoscopic Roux-en-Y gastric bypass procedure into an easy reproducible operation, effective for training.


Subject(s)
Gastric Bypass , Obesity, Morbid/mortality , Obesity, Morbid/surgery , Surgical Stapling/standards , Adolescent , Adult , Aged , Body Mass Index , Clinical Competence , Female , Gastric Bypass/instrumentation , Gastric Bypass/methods , Gastric Bypass/standards , Gastrointestinal Hemorrhage/epidemiology , Gastrointestinal Hemorrhage/mortality , Humans , Length of Stay , Male , Middle Aged , Postoperative Complications/epidemiology , Postoperative Complications/mortality , Postoperative Period , Retrospective Studies , Surgical Stapling/methods , Treatment Outcome , Young Adult
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