RESUMO
The main factor causing a fatal outcome as well as the serious life threatening complications is anastomotic dehiscence. On the basis of our retrospective study we will sum up the following possible factors (not in order of importance): 1. Faulty suture techniques. 2. Pelvic seroma, haematoma or abscess with breakthrough into the lumen. 3. Tension on the suture line. 4. Deficient blood supply of either the distal colon, stump or the remaining rectum. Finally we would, on the basis of our study, like to make a plea for more and better colostomies or ileostomies; preoperatively as therapy in the sick child whose condition does not improve promptly with a rectal tube and, lastly, as postoperative cover to protect whatever anastomosis has been performed.
Assuntos
Megacolo/cirurgia , Complicações Pós-Operatórias/mortalidade , Colostomia , Feminino , Humanos , Lactente , Masculino , Estudos Retrospectivos , Deiscência da Ferida Operatória/mortalidade , SuéciaRESUMO
During the years 1976-1981, 12 children with duplex kidneys and ectopic ureterocele were operated upon with heminephrectomy and ureterectomy only. This simple procedure led to cure in 10 out of 12 patients. In two of the patients it later had to be supplemented by resection of the ureterocele and reimplantation of the orthotopic ureter. Such a two-stage procedure does not seem to jeopardize the final result.
Assuntos
Nefrectomia/métodos , Ureter/cirurgia , Ureterocele/cirurgia , Adolescente , Criança , Pré-Escolar , Cistoscopia , Feminino , Humanos , Lactente , Masculino , Ureterocele/diagnóstico , Sistema Urinário/anormalidades , Urodinâmica , UrografiaRESUMO
Spinal tuberculosis with extensive abscess formation in a 5-year-old girl of Asian origin is reported. The role of CT in the preoperative visualisation of the different compartments of the lesion, including extra- and intraspinal extension, is discussed. At present, CT seems to be the method of choice in the preoperative study of infectious spinal and paraspinal processes.
Assuntos
Abscesso/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Tuberculose da Coluna Vertebral/diagnóstico por imagem , Abscesso/cirurgia , Pré-Escolar , Diagnóstico Diferencial , Feminino , Humanos , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/cirurgia , Tuberculose da Coluna Vertebral/cirurgiaRESUMO
The refinement of techniques for extremity surgery makes it urgent to get more information at cell level of the effects of tourniquet times exceeding the usually accepted 90--120 min. Therefore, in the present experiments, the cellular metabolic and functional restitution of canine skeletal muscle after 3 h of complete tourniquet ischemia was studied. During the ischemia and after recirculation, repeated skeletal muscle samples were taken for ATP, CP and lactate analyses. At the same time periods, blood from a regional vein and vena cava was drawn for pH, pyruvate and lactate analyses. Cellular function was evaluated from repeated measurements of transmembrane potentials. The tourniquet ischemia resulted in a rapid decrease of CP to 40% of the initial level within 1 h and a continuous decrease of ATP. The lactate levels increased continuously. The transmembrane potentials decreased from an initial level of --90 to --54 mV. The release of the tourniquet resulted in a hyperemic reaction and a rapid regain of tissue CP and ATP levels within 5 min of recirculation. There was a continuous washout of lactate up to about 1 h after the release and the transmembrane potentials were normalized after about the same time period. The latter parameters indicate that areas of no-reflow persisted for up to 1 h after restored circulation. The results indicate that after a 3-hour tourniquet ischema, the cellular energy metabolism as well as the membrane function are completely normalized after about 1 h of recirculation.