Articles: postoperative-complications.
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Chronic pain following an amputation may involve the stump, the phantom limb, or both. Operations such as rhizotomy, cordotomy, stump revision, and dorsal column stimulation have been unsuccessful in treating this condition. This study evaluates the effectiveness of dorsal root entry zone (DREZ) coagulation for this pain problem. ⋯ However, good results were obtained in six (67%) of nine patients with phantom pain alone, and in five (83%) of six patients with traumatic amputations associated with root avulsion. Poor results were obtained in patients with both phantom and stump pain, or stump pain alone. The DREZ procedure has a limited, but definite, place in the treatment of post-amputation pain.
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Anterior mandibulectomy can precipitate the development of sleep apnea. All head and neck tumor patients having had extensive composite anterior oral cavity resections should be evaluated for sleep apnea before decannulation of their tracheostomy tube. Subsequent flap and/or rigid reconstruction of the lower jaw appears to prevent the development of sleep apnea. Fascial sling suspension of the lower lip does not appear to prevent sleep apnea.
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Fertility and sterility · Nov 1984
Tubal patency and pelvic adhesions at early second-look laparoscopy following intraabdominal use of the carbon dioxide laser: initial report of the intraabdominal laser study group.
It has been suggested that the carbon dioxide (CO2) laser, by virtue of its hypothetical capabilities for precise incisions, minimization of tissue handling and bleeding, and shortened operating time, may improve the success rate of gynecologic infertility surgery. To assess this hypothesis, a multicenter prospective study was performed to assess tubal patency and adhesion formation at early second-look laparoscopy after intraabdominal laser surgery. Procedures performed included salpingoneostomy, fimbrioplasty, lysis of adhesions, vaporization of endometriosis, and ovarian wedge resection. ⋯ Adhesions present at the time of the second-look procedure were reduced from initial presentation at most sites; however, nonlaser infertility surgery appeared to have equal or greater efficacy in the prevention of adhesion formation at most sites. Thus, the CO2 laser does not appear to be a panacea for the treatment of tuboperitoneal causes of infertility. Pregnancy rates following intraabdominal use of the CO2 laser remain to be established.
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J Bone Joint Surg Am · Oct 1984
Case ReportsHyperalimentation for superior mesenteric-artery (cast) syndrome following correction of spinal deformity.
The cast syndrome, recently called the superior mesenteric-artery syndrome, is a well recognized complication that can occur after a body cast has been applied. We are reporting the cases of three patients who had this syndrome following surgical correction of spinal deformity. The complication failed to resolve with the usual non-operative measures but did resolve with treatment by total parenteral nutrition.