1,721,013 research outputs found

    Use of a disposable stapling instrument in gastrointestinal surgery

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    The authors describe the use of a disposable automatic metallic-clip instrument in gastrointestinal surger

    The anti-oedema activity of venoruton injectable in abdominal surgery

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    The anti-oedema activity of an injectable drug (HR; active principle: 0-(beta-hydroxyethyl)-rutoside) was assessed in 60 gastric extrahepatic bile duct, and large intestine surgery patients (30 being used as controls). Gastroscopy (with biopsy), gastroduodenoscopy, colonoscopy (with biopsy) and radiological examination were usually performed on the 5th and 10th post-operative days. The drug showed significant therapeutic effects: rapid resolution of oedema, especially at the sutures, leading to early cicatrisation, canalisation and the prevention of dehiscence. Finally, duration of hospitalisation was less than in the untreated cases. The gastroscopic, radiographic and biopsy findings are considered to have shown clear evidence of the drug's action against oedema formation

    Laparoscopic approach for a case of esophageal achalasia with epiphrenic diverticulum

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    We present the case of a 65-year-old woman with al lO-year history of dysphagia, regurgitation, cough, and lO-kilogram weight loss due to an epiphrenic diverticulum associated with esophageal achalasia treated by laparoscopic approach. A preoperative barium swallow showed a dilated sigmoid esophagus with a 6-cm epiphrenic diverticulum. Upper endoscopy with distal biopsies was negative for cancer, and esophageal manometry confirmed absence of peristalsis in the esophageal body. We performed a laparoscopic diverticulectomy and a 7-cm distal esophageal myotomy with a Dor fundoplication. The postoperative course was uneventful. On the third postoperative day a barium swallow showed no leak, and the patient started PO intake. She was discharged home 5 days after the operation free of symptoms and tolerating a soft diet. Twelve months postoperatively she is still asymptomatic and has gained 8 kilograms. A barium swallow showed a normal size esophagus with regular emptying. We reaffirm the feasibility, safety and efficacy of the laparoscopic diverticulectomy and distal myotomy with Dor fundoplication to treat epiphrenic diverticula due to esophageal achalasia

    A new technique in positioning of Kehr's tube in laparoscopy

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    The enlargement of the indications in the use of the laparoscopic technique puts the surgeon in front of the need to project new techniques and to improve new instruments daily. On one hand, the technique and instruments used to perform a video-laparoscopic cholecystectomy are codified. However, there is still a lot of work to do for the laparoscopic treatment of the common bile duct stones. The aim of the present scientific contribution is the exposition of an original methodology for the positioning of the T-tube in laparoscopy which would be a difficult manoeuvre otherwise

    Evolution in the treatment of esophageal achalasia.

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    Achalasia is a rare disease of the esophagus, characterized by the absence of peristalsis in the esophageal body and incomplete relaxation of a hypertensive lower esophageal sphincter. The cause of the disease is unknown; therefore, the aim of therapy is to improve esophageal emptying by eliminating the outflow resistance caused by the lower esophageal sphincter. This goal can be accomplished by either pneumatic dilatation or surgical cardiomyotomy, which are the only long term, effective therapies for the treatment of achalasia. In fact, medications such as channel blockers are ineffective, and botulinum toxin injection appears to offer only short-term relief of symptoms. Historically, pneumatic dilatation was preferred to surgery because of the morbidity associated with a thoracotomy or a laparotomy. However, with the development of minimally invasive techniques, the surgical approach has gained widespread acceptance among patients and gastroenterologists. Therefore, the role of surg..
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