Annales de chirurgie
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Annales de chirurgie · Jan 1997
Review[Contribution of laparoscopy in the management of abdominal stab wounds].
Laparotomy is useless in 5 to 39% of patients suffering from penetrating abdominal trauma. The objective of this study is to try to determine the value of laparoscopy in the management of such patients. Thirteen patients underwent laparoscopy for abdominal wound. 11 of these patients had a penetrating abdominal trauma and only 4 of them suffered from lesions requiring surgical treatment (2 intestinal wounds, 1 gastric wound and 1 coeliac artery disruption). ⋯ Laparoscopy avoided useless laparotomy in 9 out of 13 patients. This suggests that laparoscopy is a reliable method in the management of patients suffering from abdominal wounds, allowing a very sensitive and specific diagnosis of penetration and visceral injuries. In some cases, is allows laparoscopic treatment of the visceral injury.
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Postoperative pain is a subjective experience involving sensations and perceptions, which may be the result of tissue damage after surgery. Various analgesic drugs and techniques can be used to relief postoperative pain. ⋯ Moreover, adequate management of postoperative pain need to be organized. This include medical attitudes, clinical orientations, disciplinary involvements, consultative protocols and program education.
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Annales de chirurgie · Jan 1997
[Cyclosporine A prevents ischemia-reperfusion induced myocardial dysfunction in the isolated heart of the rat].
Cyclosporin A (CyA) has been shown to prevent mitochondrial injury following ischemia-reperfusion injury. Therefore, the present study was designed to investigate the effect of CyA on ischemia-reperfusion injury in the isolated rat heart preparation. Hearts from Sprague-Dawley rats were perfused in the Langerdorffmode at constant pressure (80 cm H2O) and paced (270 beats/min). ⋯ Oxygen debt was decreased at 30 minutes of reperfusion in the CyA-treated hearts: 0.06 x 10(-2) +/- 0.23 x 10(-2) cc/min/g compared to Cr-treated hearts: 0.61 x 10(-2) +/- 0.37 x 10(-2) cc/min/g (p = 0.05). The coronary endothelial dependent and independent responses were similarly decreased in both groups during reperfusion. Thus, in the isolated rat heart preparation, CyA preserves myocardial function (hemodynamic variables) and oxygen consumption without affecting the coronary vascular function during ischemia-reperfusion injury.