ANZ journal of surgery
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ANZ journal of surgery · Mar 2008
Laparoscopic anterior 90 degree fundoplication for reflux or large hiatus hernia.
Anterior 90 degree partial fundoplication has been proposed as technique to minimize the risk of side-effects following surgery for gastro-oesophageal reflux. We have applied this approach for the treatment of gastro-oesophageal reflux and/or large hiatus hernias. Previous studies have shown that this type of procedure can achieve good control of reflux, with fewer side-effects. ⋯ More than 80% of the patients were able to belch normally at all time points after surgery and most were highly satisfied with the overall outcome. Satisfaction scores were higher following repair of a large hiatus hernia. The clinical results of laparoscopic anterior 90 degree fundoplication for either reflux or as part of repair of a large hiatus hernia are encouraging, although longer-term follow up is required to confirm durability of reflux control.
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Despite design and manufacturing improvements in contemporary metal-on-metal hip replacements, the problem of wear particles persists. The local and systemic biological consequences of this ionic debris have been the subject of much investigation and it has become clear that cell-mediated delayed-type hypersensitivity reactions are a discrete mode of osteolysis in susceptible patients. ⋯ We report a prevalence of 2.6% of patients displaying femoral osteolysis associated with characteristic clinical and histological findings.