Surgery today
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Comparative Study
Transanal laser Doppler flowmetry to assess microcirculation in the upper rectum during abdominal aortic aneurysmectomy.
Fatal ischemic colitis can develop after abdominal aortic aneurysmectomy. We investigated the effectiveness of transanal laser Doppler flowmetry (LDF) for assessing microcirculation in the rectal mucosa during aneurysm repair. ⋯ Transanal rectal LDF is useful for continuously assessing microcirculation in the rectal mucosa during abdominal aneurysmectomy, and the data obtained with this method may reflect whether a collateral pathway to the upper rectum exists.
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Postoperative vital capacity (VC) and the 6-min walking (6MW) test were used to compare the differences in impairment of the pulmonary function and walking capacity in patients undergoing a lobectomy by video-assisted thoracoscopic surgery (VATS), an anterior limited thoracotomy (ALT), an anteroaxillary thoracotomy (AAT), or a posterolateral thoracotomy without muscle sparing (PLT). ⋯ The PLT without a muscle sparing procedure therefore cannot be recommended for general lung cancer surgery because of the impairment of both walking capacity and pulmonary function which continues long after surgery. VATS and ALT are better procedures than AAT regarding the recovery of walking capacity early after surgery. VATS and ALT are similar to each other regarding the impairment of pulmonary function and walking capacity after surgery.
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Intestinal perforation due to blunt abdominal trauma is rarely seen in children and delayed diagnosis is a major concern. Because the potential risk factors affecting morbidity are not well known, we evaluated whether diagnostic delay increases morbidity in gastrointestinal perforation from blunt abdominal trauma in children. ⋯ These findings suggest that rapid diagnosis and treatment is important for preventing complications in patients with intestinal perforation caused by blunt abdominal trauma. A delay exceeding 8 h and an ISS score exceeding 15 were related to significant septic complications, and falls from flat-roofed houses are an important public safety risk in Turkey.
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We report a case of severe corrosive gastritis caused by alkali ingestion, which was successfully treated by laparoscopic gastrectomy. A 38-year-old Japanese woman attempted suicide by ingesting Drano. ⋯ The patient had an uneventful postoperative course and was discharged on the 13th day after her operation. She was subsequently able to tolerate a normal diet, gained weight, and is now emotionally stable.
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Case Reports
Rupture of the descending thoracic aorta caused by blunt chest trauma: report of a case.
A 66-year-old man fell from a tree and was diagnosed to have multiple fractured ribs and hemopneumothorax based upon the chest roentgenogram findings. He underwent chest tube drainage and evacuation using video-assisted thoracic surgery. ⋯ We performed a direct closure of the penetrated portion of the descending thoracic aorta. The patient has remained well for 1 year following the second operation.