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Mark G Davies - One of the best experts on this subject based on the ideXlab platform.

  • endovascular versus open mesenteric revascularization immediate benefits do not equate with short term functional outcomes
    Journal of The American College of Surgeons, 2006
    Co-Authors: Nayan Sivamurthy, Jeffrey M Rhodes, David L Waldman, Richard M Green, Mark G Davies
    Abstract:

    Background Percutaneous therapy for symptomatic visceral occlusive disease is rapidly gaining popularity in many centers. This study evaluates the anatomic and functional outcomes of open and endovascular therapy for chronic mesenteric ischemia at an academic medical center. Study design We performed a retrospective review of patients who underwent endovascular or open mesenteric arterial revascularization for chronic mesenteric ischemia between January 1989 and September 2003. Indications for revascularization included postprandial abdominal pain (92%) or weight loss (54%). All had atherosclerotic visceral occlusive disease with a median of 2 vessels with more than 50% stenosis or occlusion on angiography. Sixty patients (44 women, mean age 66 years) underwent 67 interventions (43 vessels bypassed, 23 vessel endarterectomies, 22 vessel angioplasty and stents). The median numbers of vessels revascularized were two in the open group and one in the endovascular group. Results Thirty-day mortality and cumulative survival at 3 years were similar (open, 15% and 62% ± 9%; endovascular, 21% and 63%±14%, respectively; p=NS). Cumulative patencies at 6 months were 83%±7% and 68%±14% in the open and endovascular groups, respectively (p=NS). Major morbidity, median postoperative length of stay, and cumulative freedom from recurrent symptoms at 6 months were significantly greater in the open group (open, 46%, 23 days, and 71%±7%, respectively; endovascular, 19%, 1 day, and 34%±10%, respectively; p Conclusions Endovascular revascularization is attractive because it carries equivalent patency to open revascularization. Symptomatic benefit of endovascular revascularization is not achieved, probably as a result of incomplete revascularization. Despite incomplete revascularization, endovascular therapy has equivalent survival and lower morbidity compared with open revascularization. Complete endovascular revascularization needs further evaluation to determine if it is superior to open revascularization. In the interim, endovascular therapy should be reserved for the patient unable to undergo open revascularization.

H Shipkov - One of the best experts on this subject based on the ideXlab platform.

  • abdominoplasty with simultaneous laparoscopic umbilical hernia repair a practical approach to preserve the umbilical vascularization
    Annales De Chirurgie Plastique Esthetique, 2019
    Co-Authors: A Lari, P Curings, H Person, H Demian, F Braye, J Mabrut, Ali Mojallal, H Shipkov
    Abstract:

    Summary Background Umbilical necrosis is a well-known complication of abdominoplasty, the risk of this complication can be increased when an associated umbilical hernia requires further dissection in peri-umbilical region, potentially leading to umbilical devascularisation. Multiple minimally invasive open techniques were described to avoid this problem. The combined approach of abdominoplasty with laparoscopic umbilical hernia repair is one promising solution to avoid devascularising the umbilicus. Methods A retrospective evaluation of patients who underwent concomitant abdominoplasty with laparoscopic umbilical hernia repair from 2007 to 2017 was carried out. All patients were followed up and evaluated for complications, including the incidence of umbilical skin necrosis. Results A total of 47 patients were included in this study. The average operative duration was 3.3 hours with an average hospital stay of 2.5 days. No cases of postoperative umbilical necrosis were encountered. A mean follow-up period was 2.4 years showed no cases of hernia or rectus abdominis diastasis recurrence. Minor complications included 4 cases of dehiscence, one hematoma. There was no major complications. Conclusion The concomitant use of laparoscopic umbilical hernia repair and abdominoplasty is a feasible approach to reduce the risks of umbilical Devascularization. Especially in larger hernias and in patients with higher risk of recurrence.

  • Abdominoplasty with simultaneous laparoscopic umbilical hernia repair: A practical approach to preserve the umbilical vascularization
    Ann. Chir. Plast. Esthet., 2019
    Co-Authors: A Lari, P Curings, H Person, H Demian, F Braye, J Mabrut, Ali Mojallal, H Shipkov
    Abstract:

    Background. - Umbilical necrosis is a well-known complication of abdominoplasty, the risk of this complication can be increased when an associated umbilical hernia requires further dissection in peri-umbilical region, potentially leading to umbilical devascularisation. Multiple minimally invasive open techniques were described to avoid this problem. The combined approach of abdominoplasty with laparoscopic umbilical hernia repair is one promising solution to avoid devascularising the umbilicus. Methods. - A retrospective evaluation of patients who underwent concomitant abdominoplasty with laparoscopic umbilical hernia repair from 2007 to 2017 was carried out. All patients were followed up and evaluated for complications, including the incidence of umbilical skin necrosis. Results. - A total of 47 patients were included in this study. The average operative duration was 3.3 hours with an average hospital stay of 2.5 days. No cases of postoperative umbilical necrosis were encountered. A mean follow-up period was 2.4 years showed no cases of hernia or rectus abdominis diastasis recurrence. Minor complications included 4 cases of dehiscence, one hematoma. There was no major complications. Conclusion. - The concomitant use of laparoscopic umbilical hernia repair and abdominoplasty is a feasible approach to reduce the risks of umbilical Devascularization. Especially in larger hernias and in patients with higher risk of recurrence. (C) 2018 Elsevier Masson SAS. All rights reserved.

Zheng Shuguo - One of the best experts on this subject based on the ideXlab platform.

L. Nolan - One of the best experts on this subject based on the ideXlab platform.

  • Short-term response of epiphyseal plate cell populations following selective Devascularization and microsurgical revascularization.
    Microsurgery, 1994
    Co-Authors: C V A Bowen, J. D. Fowler, Peter W Bray, Martin I Boyer, L. Nolan
    Abstract:

    The distal femoral epiphyseal plates of 21 8-week-old New Zealand white rabbits were totally or partially (nutrient artery only) devascularized, or devascularized and then microsurgically revascularized. Sacrifice was at 24, 48 or 72 hours postoperatively. The heights of the proliferative and hypertrophic zones of the epiphyseal plates operated upon were compared with the contralateral control epiphyseal plates for both the central and the peripheral regions of the epiphyseal plate. Neither extent of Devascularization nor revascularization had a significant effect on the height of the proliferative zone of chondrocytes at any of the follow-up intervals. Selective Devascularization of the nutrient artery led to a significant increase in height of the central region of the hypertrophic zone of chondrocytes at 48 and 72 hours. Microsurgical revascularization did not lead to a significant change in the height of either the central or the peripheral regions of the hypertrophic zone of chondrocytes at any of the follow-up intervals. This study is another ‘building block’ experiment toward vascularized epiphyseal plate transplantation in humans. © 1994 Wiley-Liss, Inc.

Edward H. Oldfield - One of the best experts on this subject based on the ideXlab platform.

  • Tumor Devascularization by intratumoral ethanol injection during surgery: Technical note
    Journal of neurosurgery, 1998
    Co-Authors: Russell R. Lonser, John D. Heiss, Edward H. Oldfield
    Abstract:

    Preoperative reduction in tumor vascularity has been accomplished previously by selective catheterization of tumor vessels and delivery of occlusive materials. The results of percutaneous infusion of vertebral hemangiomas and other vascular lesions led the authors to speculate that rapid Devascularization of tumors by direct injection of ethanol (ETOH) could be used to reduce bleeding and facilitate resection during surgery. Thus, the use of intratumoral injection of ETOH and its effects on tumor hemostasis and resectability were examined. Four patients received direct injection of ETOH into either a spinal epidural (two renal cell carcinomas and one rhabdomyosarcoma) or a large cerebellar neoplasm (hemangioblastoma). Intraoperative perfusion of the tumors with ETOH produced immediate blanching and Devascularization and enhanced visualization and resection. Incremental tumor Devascularization is achieved by careful injection of small amounts of ETOH directly into the lesion, producing immediate and complete regional tumor Devascularization. Use of this technique reduces intratumoral bleeding and enhances the ease and effectiveness of resection.