Articles: sutures.
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Eur J Cardiothorac Surg · Mar 2000
Comparative StudyMitral-valve repair without annuloplasty rings: results after repair of anterior leaflet versus posterior-leaflet defects using polytetrafluoroethylene sutures for chordal replacement.
Defects of the anterior mitral leaflet (AML), including ruptured chordae, are often regarded as difficult or even impossible to repair. Chordal replacement may also be an option in extensive disease of the posterior mitral leaflet (PML). It has not yet been clearly defined whether the repair of either mitral leaflet using chordal-replacement techniques is as safe as the standard repair of the mitral valve (MV) including quadrangular resection and ring reduction alone. ⋯ We were unable to find statistically significant differences concerning mortality, freedom from recurrent MR and MV reoperation between the AML and PML groups. Extensive prolapse or chordal pathology of the anterior and PML can be corrected by chordal replacement. Using these techniques, stable repair can be achieved in more than 90% of patients at mid-term follow-up. Long-term observations are necessary to confirm the durability of this type of MV repair.
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J. Thorac. Cardiovasc. Surg. · Feb 2000
Comparative StudyEliminating the cervical esophagogastric anastomotic leak with a side-to-side stapled anastomosis.
Although the acute postoperative complications of a cervical esophagogastric anastomosis are less than those with an intrathoracic esophageal anastomosis, the long-term sequelae of a cervical anastomotic leak are not as minor as initially reported. Nearly 50% of cervical anastomotic leaks result in an anastomotic stricture, and the subsequent need for chronic dilatations negates the merits of an operation intended to restore comfortable swallowing. ⋯ Construction of the cervical esophagogastric anastomosis with a side-to-side stapled anastomosis greatly reduces the frequency of anastomotic leaks and later strictures. The side-to-side stapled anastomosis is a major technical advance in the progression of refinements of transhiatal esophagectomy and a cervical esophagogastric anastomosis.
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Vestn. Khir. Im. I. I. Grek. · Jan 2000
Comparative Study[Removable draining aponeurotic and muscular-aponeurotic sutures in the prevention of suppuration of laparotomy wounds].
Clinico-instrumental investigations and experimental studying of the regeneration of laparotomy wounds sutured by removable draining aponeurotic and muscular-aponeurotic sutures have shown less pronounced course of aseptic inflammation in the wounds. It has been established that the removable aponeurotic sutures substantially decrease the frequency of postoperative suppurations of laparotomy wounds in patients operated on the colon mainly for colorectal carcinoma. The original authors' sutures provide the formation of a cicatrix of the laparotomy wound by the 20th day of the postoperative period and completely prevent the appearance of ligature fistulas.
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Breast-conserving therapy in early breast cancer is equally effective as mastectomy, with advantages of cosmesis and quality of life over mastectomy. Local control is improved when entire breast irradiation is combined with a radiation boost to the tumour bed. ⋯ A boost planned by scar dimensions can miss a substantial portion of the tumour bed, compromising local control. On the other hand, a substantial amount of breast tissue beyond the tumour bed can be unnecessarily irradiated, compromising cosmetic treatment results. Thus, the scar provides an inadequate landmark for radiation boost planning in breast-conserving therapy.