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https://www.readbyqxmd.com/read/29280707/successful-conservative-treatment-of-enterocutaneous-fistula-with-cyanoacrylate-surgical-sealant-case-report
#1
N Musa, F Aquilino, P Panzera, G Martines
AIM: Enterocutaneous (EC) fistula is an abnormal communication between the gastrointestinal tract and the skin. The majority of EC fistulas result from surgery. Only 15-25% of EC fistulas are spontaneous and they often result from underlying diseases such as Crohn's disease, radiation and chemotherapy. CASE REPORT: A 62-year old woman who, in 2012, underwent Pylorus-preserving cephalic pancreaticoduodenectomy (PPPD sec. Traverso-Longmire), due to an advanced pancreatic ductal adenocarcinoma (pT3N1M1)...
September 2017: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29224839/intraoperative-costs-of-video-assisted-thoracoscopic-lobectomy-can-be-dramatically-reduced-without-compromising-outcomes
#2
Michael T Richardson, Leah M Backhus, Mark F Berry, Daniel G Vail, Kelsey C Ayers, Jalen A Benson, Prasha Bhandari, Mehran Teymourtash, Joseph B Shrager
OBJECTIVE: To determine whether surgeon selection of instrumentation and other supplies during video-assisted thoracoscopic lobectomy (VATSL) can safely reduce intraoperative costs. METHODS: In this retrospective, cost-focused review of all video-assisted thoracoscopic surgery anatomic lung resections performed by 2 surgeons at a single institution between 2010 and 2014, we compared VATSL hospital costs and perioperative outcomes between the surgeons, as well as costs of VATSL compared with thoracotomy lobectomy (THORL)...
November 13, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29221335/chylothorax-after-mediastinal-ganglioneuroma-resection-treated-with-fibrin-sealant-patch-a-case-report
#3
Marco Chiarelli, Pietro Achilli, Angelo Guttadauro, Giuseppe Vertemati, Sabina Terragni, Matilde De Simone, Ugo Cioffi
Chylothorax is a severe condition resulting from the accumulation of chyle into the pleural space. We report the treatment of postoperative chylothorax after resection of mediastinal ganglioneuroma in a 17-year-old boy. Since conservative measures were not effective, we performed direct ligation of lymphatic vessels and pleurodesis. At subsequent surgical re-exploration for persisting chylothorax, accurate inspection of pleural cavity revealed residual chyle leakage. Fibrin sealant patches (TachoSil®) were placed over the source of leak with complete resolution of chylous effusion...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29212712/a-reversible-thermoresponsive-sealant-for-temporary-closure-of-ocular-trauma
#4
Niki Bayat, Yi Zhang, Paulo Falabella, Roby Menefee, John J Whalen, Mark S Humayun, Mark E Thompson
Open globe injuries are full-thickness injuries sustained to the eye wall (cornea or sclera), which cause immediate drops in intraocular pressure that may lead to retinal detachment and permanent vision loss if not treated rapidly after injury. The current standard of care for open globe injuries consists of suturing the margins closed, but the technique can be time-consuming, requires specialized training and equipment, and can lead to patient discomfort, abrasion, and infection from eye rubbing. We engineered an injectable, thermoresponsive sealant (TRS) and a custom tool to occlude open globe injuries...
December 6, 2017: Science Translational Medicine
https://www.readbyqxmd.com/read/29178347/tissuepatch-is-biocompatible-and-seals-iatrogenic-membrane-defects-in-a-rabbit-model
#5
Alexander C Engels, Luc Joyeux, Johannes Van der Merwe, Julio Jimenez, Savitree Prapanus, David W Barrett, Che Connon, Tina T Chowdhury, Anna L David, Jan Deprest
OBJECTIVE: To evaluate novel sealing techniques for their biocompatibility and sealing capacity of iatrogenic fetal membrane defects in a pregnant rabbit model. METHOD: At day 23 of gestation (term=d31), a standardized fetoscopy was performed through a 14G cannula. The resulting fetal membrane defect was closed with either condensed collagen, collagen with fibrinogen, Tissuepatch®, Duraseal®, or a conventional collagen plug (Lyostypt®) as reference. At d30 the fetuses were harvested and full thickness fetal membrane samples were analyzed...
November 25, 2017: Prenatal Diagnosis
https://www.readbyqxmd.com/read/29156887/technical-aspects-of-pancreaticoduodenectomy-and-their-outcomes
#6
Katherine Giuliano, Aslam Ejaz, Jin He
Pancreatic cancer is the fourth leading cause of cancer-related death in the Unites States and is rising in incidence. For the 15-25% of patients who do not have either metastatic or locally advanced disease, surgical resection with pancreaticoduodenectomy is the standard of care and results in improved 5-year survival of 15-25%. While mortality at high-volume centers is less than 5%, morbidity remains high at approximately 30-45%. This paper reviews technical aspects of pancreaticoduodenectomy and their outcomes...
September 26, 2017: Chinese Clinical Oncology
https://www.readbyqxmd.com/read/29145993/an-absorbable-hydrogel-spray-reduces-postoperative-mediastinal-adhesions-after-congenital-heart-surgery
#7
Nahidh Hasaniya, Anees Razzouk, Jennifer Newcombe, Dana Hassneiah, Jessica Heimes, Joshua Gysbers, Timothy Martens, Leonard Bailey
BACKGROUND: Adhesions encountered during reoperative cardiac surgery can prolong operative time and increase operative risk. The purpose of this clinical study was to investigate the antiadhesion property of a synthetic bioabsorbable polymer spray after cardiac reoperations in infants. METHODS: A prospective randomized double-blinded study was designed. Forty infants requiring staged cardiac operations were randomly allocated to a study group (n = 20) or a control group (n = 20)...
November 14, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29110769/impaired-cerebrospinal-fluid-pressure
#8
Jan Hoffmann
Abnormalities of cerebrospinal fluid (CSF) pressure are relatively common and may lead to a variety of symptoms, with headache usually being the most prominent one. The clinical presentation of alterations in CSF pressure may vary significantly and show a striking similitude to several primary headache syndromes. While an increase in CSF pressure may be of primary or secondary origin, a pathologic decrease of CSF pressure is usually the result of a meningeal rupture with a resulting leakage of CSF. The pathophysiologic mechanisms of idiopathic intracranial hypertension (IIH) remain largely unknown...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/29064875/perioperative-patient-blood-management-to-improve-outcomes
#9
Neel Desai, Nick Schofield, Toby Richards
Anemia is common in elective surgery and is an independent risk factor for morbidity and mortality. Historical management of anemia has focused on the use of allogeneic blood transfusion but this in itself is not without risk. It too has been independently associated with morbidity and mortality, let alone the costs and relative shortage of this resource. In recognition of this, patient blood management (PBM) shifts the focus from the product to the patient and views the patient's own blood as a resource that should be conserved and managed appropriately as a standard of care...
October 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29058505/a-case-series-of-anophthalmic-socket-cysts-excised-utilising-fibrin-sealant
#10
Yun Wong, Lucy Clarke, Gordon Lau
Anophthalmic socket cysts are challenging to remove and incomplete excision has been shown to increase the risk of recurrence. This case series describes a novel technique utilising the fibrin sealant Tisseel (Baxter AG, Vienna, Austria) to retain the socket cyst integrity during surgical removal to facilitate its complete excision. Five patients were included and followed up for a minimum of 1 year, and there were no signs of recurrence in any of the cases. The surgical technique is described and illustrated...
October 23, 2017: Orbit
https://www.readbyqxmd.com/read/29036794/assessing-the-effect-of-different-operation-techniques-on-postoperative-duplex-ultrasound-quality-after-carotid-endarterectomy
#11
E Grambow, T Heller, P Wieneke, C Weiß, E Klar, M Weinrich
BACKGROUND: Duplex ultrasound is the first choice in diagnostics and surveillance of stenoses of the internal carotid arteries before and even after surgery. Therefore, the quality of duplex ultrasound is crucial to investigate these vascular pathologies. OBJECTIVE: Aim of this study was the evaluation whether different surgical techniques affect the postoperative quality of duplex ultrasound. METHODS: In a time period from January to May 2015 duplex ultrasound of the cervical vessels was performed in 75 patients after unilateral endarterectomy of the internal carotid artery at our department between 2006 and 2012...
October 7, 2017: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/28978753/engineering-a-highly-elastic-human-protein-based-sealant-for-surgical-applications
#12
Nasim Annabi, Yi-Nan Zhang, Alexander Assmann, Ehsan Shirzaei Sani, George Cheng, Antonio D Lassaletta, Andrea Vegh, Bijan Dehghani, Guillermo U Ruiz-Esparza, Xichi Wang, Sidhu Gangadharan, Anthony S Weiss, Ali Khademhosseini
Surgical sealants have been used for sealing or reconnecting ruptured tissues but often have low adhesion, inappropriate mechanical strength, cytotoxicity concerns, and poor performance in biological environments. To address these challenges, we engineered a biocompatible and highly elastic hydrogel sealant with tunable adhesion properties by photocrosslinking the recombinant human protein tropoelastin. The subcutaneous implantation of the methacryloyl-substituted tropoelastin (MeTro) sealant in rodents demonstrated low toxicity and controlled degradation...
October 4, 2017: Science Translational Medicine
https://www.readbyqxmd.com/read/28962655/a-unique-heterologous-fibrin-sealant-hfs-as-a-candidate-biological-scaffold-for-mesenchymal-stem-cells-in-osteoporotic-rats
#13
Patrícia Rodrigues Orsi, Fernanda Cruz Landim-Alvarenga, Luis Antônio Justulin, Ramon Kaneno, Marjorie de Assis Golim, Daniela Carvalho Dos Santos, Camila Fernanda Zorzella Creste, Eunice Oba, Leandro Maia, Benedito Barraviera, Rui Seabra Ferreira
BACKGROUND: The injection of mesenchymal stem cells (MSCs) directly into the bone of osteoporotic (OP) patients for rapid recovery has been studied worldwide. Scaffolds associated with MSCs are used to maintain and avoid cell loss after application. A unique heterologous fibrin sealant (HFS) derived from snake venom was evaluated for the cytotoxicity of its main components and as a three-dimensional biological scaffold for MSCs to repair a critical femur defect in osteoporotic rats. METHODS: The cytotoxicity of HFS was assessed using a 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazoliumbromide (MTT) assay and transmission electron microscopy...
September 29, 2017: Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/28927211/a-pivotal-randomized-clinical-trial-evaluating-the-safety-and-effectiveness-of-a-novel-hydrogel-dural-sealant-as-an-adjunct-to-dural-repair
#14
Michael J Strong, G Alexander West, Henry Woo, Daniel E Couture, John A Wilson, Lorenzo F Munoz, Charles L Rosen, Jeremy D Greenlee, Harry R van Loveren, Mark Iantosca, Clinton J Baird, Mark Smith, Matt McGirt, Jonathan Parish, Anthony L Asher
BACKGROUND: A watertight dural repair is critical to minimizing the risk of postoperative complications secondary to cerebrospinal fluid (CSF) leaks. OBJECTIVE: To evaluate the safety and efficacy of a novel hydrogel, Adherus Dural Sealant, when compared with control, DuraSeal Dural Sealant System, as an adjunct to standard methods of dural repair. METHODS: In this 17-center, prospective, randomized clinical trial designed as a noninferiority, single-blinded study, 124 patients received Adherus Dural Sealant (test sealant) and 126 received DuraSeal (control)...
April 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28920559/functional-mechanics-of-a-pectin-based-pleural-sealant-after-lung-injury
#15
Andrew B Servais, Cristian D Valenzuela, Arne Kienzle, Alexandra B Ysasi, Willi L Wagner, Akira Tsuda, Maximilian Ackermann, Steven J Mentzer
Pleural injury and associated air leaks are a major influence on patient morbidity and health care costs after lung surgery. Pectin, a plant-derived heteropolysaccharide, has recently demonstrated potential as an adhesive binding to the glycocalyx of visceral mesothelium. Since bioadhesion is a process likely involving the interpenetration of the pectin-based polymer with the glycocalyx, we predicted that the pectin-based polymer may also be an effective sealant for pleural injury. To explore the potential role of an equal weight % mixture of high-methoxyl pectin and carboxymethylcellulose as a pleural sealant, we compared the yield strength of the pectin-based polymer to commonly available surgical products...
September 16, 2017: Tissue Engineering. Part A
https://www.readbyqxmd.com/read/28917398/hydrogel-ocular-sealant-for-clear-corneal-incisions-in-cataract-surgery
#16
Nambi Nallasamy, Karen E Grove, Gary L Legault, Melissa B Daluvoy, Terry Kim
PURPOSE: To assess the relationship between use of a hydrogel ocular sealant (Resure) to secure clear corneal incisions (CCIs) in cataract surgery and surgeon efficiency, patient symptomatology, and postoperative results. SETTING: Duke University Eye Center, Durham, North Carolina, USA. DESIGN: Retrospective case series. METHODS: A 1:1 matched cohort of hydrogel sealant exposure-discordant eyes of cataract surgery patients was retrospectively generated...
August 2017: Journal of Cataract and Refractive Surgery
https://www.readbyqxmd.com/read/28902719/wound-closure-and-tissue-adhesives-in-clear-corneal-incision-cataract-surgery
#17
Amy Y Tong, Preeya K Gupta, Terry Kim
PURPOSE OF REVIEW: Achieving secure wound closure in clear corneal incision cataract surgery remains highly desired for its role in reducing infection risk and leak-related complications, including hypotony, corneal edema, and lens dislocation. Although classic techniques of stromal hydration or wound suturing represent traditional approaches, the introduction of newer and more effective ocular surface adhesives has increased the options that are available. This review aims to provide an update on the peer-reviewed literature regarding wound closure and the currently available and investigational tissue adhesives used to seal clear corneal incisions in cataract surgery...
September 11, 2017: Current Opinion in Ophthalmology
https://www.readbyqxmd.com/read/28870821/self-made-cost-reducing-hemostatic-agent-for-use-in-spine-surgery
#18
Fernando Alonso, Tarush Rustagi, Joe Iwanaga, Christian Fisahn, Rod Oskouian, R Shane Tubbs, Andrew Dailey, Jens R Chapman
Operative bleeding complications can lead to patient morbidity and mortality as well as longer and increased hospitalization costs. The use of matrix hemostatic sealants are commonly used to shorten the time to hemostasis, operative times and the need for blood transfusion. Commercially available hemostatic powders are used in spine surgery due to their ability to conform to wounds and decrease bleeding in difficult to access surgical sites. Hospital costs for these agents are variable and are dependent on negotiated institutional contracted prices...
September 1, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28867760/in-vitro-study-of-serial-changes-to-carmustine-wafers-gliadel-with-mr-imaging-and-computed-tomography
#19
Satoshi Doishita, Taro Shimono, Tetsuya Yoneda, Eiji Yamada, Taro Tsukamoto, Daichi Takemori, Daisuke Kimura, Hiroyuki Tatekawa, Shinichi Sakamoto, Yukio Miki
PURPOSE: Implantation of carmustine wafers (Gliadel) in vivo is accompanied by characteristic serial changes on magnetic resonance imaging (MRI) and computed tomography (CT), such as transient hyperintensity of the wafers on T1-weighted images (T1WIs) and considerable gas accumulation in surgical resection cavities. The purpose of this study was to evaluate intrinsic imaging changes to carmustine wafers in vitro. METHODS: Three phantoms simulating a surgical resection cavity were constructed...
September 4, 2017: Magnetic Resonance in Medical Sciences: MRMS
https://www.readbyqxmd.com/read/28813710/is-endoscopic-vasectomy-just-a-dream-an-ex-vivo-study-on-feasibility-and-reliability-of-endoluminal-occlusion-of-porcine-vas-deferens
#20
Daniel Schlager, Moritz Maas, Simon Hein, Fabian Adams, Martin Schoenthaler, Bjoern Spittau, Ulrich Wetterauer, Arkadiusz Miernik
INTRODUCTION AND AIM: Surgical vasectomy remains the gold standard for fertility control in men. Endoluminal occlusion of the seminal ducts, thus avoiding an external incision, may become an appealing alternative to this approach. As our group has shown, nontraumatic endoscopic inspection of the seminal ducts is feasible in the human cadaver. We investigated the feasibility and reliability of occlusion using several commercially available medical sealing agents in the porcine vas deferens (VD)...
August 17, 2017: Urologia Internationalis
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