Magyar sebészet
-
The healing of colonic anastomoses is determined by several factors such as microcirculation, the strength of the inflammatory response, and the time required for regeneration. We investigated the effects of pentoxifylline--a drug which improves microcirculation and modulates leukocyte functions--on the healing of experimental anastomosis on the left colon of rats. As a result of drug treatment (0.25 mg/100 g, i.p.) in Group I anastomosis bursting pressure (ABP) was by 56 +/- 17% higher at day 2 than in controls with no pentoxifylline treatment. ⋯ Pentoxifylline treatment also suppressed the peritoneal inflammatory response assessed with peritoneal reaction index (2.0 +/- 0.3 vs. 1.1 +/- 0.2, p < 0.01). The results of the present study show that pentoxifylline treatment shortens the time needed for the healing of colonic anastomosis. These observations suggest that pentoxifylline medication can prevent failure of colonic anastomoses.
-
Extended gastric and esophageal resection is still associated with high postoperative morbidity and mortality. We performed a retrospective analysis of the perioperative management of 72 patients who had undergone such operations during a one-year period. Patient and management variables were analyzed by multivariate statistical methods to identify pre-, intra-, and postoperative factors which influence the results. ⋯ Enteral nutrition was given through a jejunal tube that had been inserted intraoperatively. Calorie intake was built up step by step to a maintenance level of 31.2 kcal/day, which was administered until oral feeding could be started (mean duration 10.94 days; maximum duration: 42 days). We conclude that careful selection of patients, appropriate intra- and postoperative management, with adequate postoperative pain control can reduce postoperative morbidity and length of inpatient stay.
-
Historical Article
[Thoracic surgery and related disciplines in Hungary].
-
The authors pursue longitudinal studies since 1972 on a defined population of 106,000 relating to several questions of the aortic dissection. Till now, in 90 patients 93 cases of the aortic dissection were found. In seven patients, the aortic dissection was complicated with the clinical and pathological symptoms of surgical diseases. ⋯ In an additional patient with a chronic recurrent pancreatitis, the acute aortic dissection as an acute exacerbation of chronic pancreatitis was considered. It makes known in a short report of cases the clinicopathological features of vascular complications of the thoracoabdominal aortic dissections. Their pathomechanisms as well as the possibilities of their diagnosis and treatment are reviewing in detail.
-
The most feared complication of thoracoabdominal clamping is the paraplegia or paraparesis following ischemic injury of the spinal cord. Early intraoperative recognition of this complication has not been solved yet. In our earlier experiment we found significant alterations of CSF glucose, lactate, pCO2 and Neuron Specific Enolase (NSE) levels during 60 minutes thoracoabdominal aortic clamping in dogs. ⋯ In our present paper we studied protective effect of regional hypothermia using peridural cooling by registration of above parameters. Statistical analysis of our data showed prevention of production of anaerobe metabolites in animals with icy peridural irrigation. The biochemical approach is appropriate for monitoring effectiveness of regional hypothermia of the spinal cord during aortic surgery.