The Experts below are selected from a list of 432 Experts worldwide ranked by ideXlab platform
Sun Ho Kim - One of the best experts on this subject based on the ideXlab platform.
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prevention of cerebrospinal fluid rhinorrhea after transsphenoidal surgery by collagen fleece coated with fibrin sealant without autologous tissue graft or postoperative lumbar drainage
Neurosurgery, 2011Co-Authors: Jin Mo Cho, Jong Hee Chang, Jung Yong Ahn, Sun Ho KimAbstract:BACKGROUND: Autologous tissue grafting and postoperative lumbar cerebrospinal fluid (CSF) drainage (PLD) have been used to prevent CSF rhinorrhea after transsphenoidal surgery. OBJECTIVE: To describe the technical details and efficacy of our techniques of using collagen fleece coated with fibrin sealant (Tachocomb, Nycomed, Linz, Austria) instead of an autologous tissue graft and refraining from the use of PLD. METHODS: We retrospectively reviewed 307 consecutive patients who underwent a transsphenoidal surgery for pituitary adenoma from November 2005 to February 2008. Among them, 90 cases of intraoperative CSF leaks were repaired with Tachocomb without an autologous tissue graft or PLD. The repair procedures were tailored according to CSF leakage type, and we used only Bioglue (Cryolife Inc, Atlanta, Georgia) for sellar floor reconstruction. RESULTS: The overall rate of CSF rhinorrhea was 2.2% (2 of 90 cases). The 2 cases of CSF rhinorrhea resulted from large arachnoid defects, and there were no adverse effects from Tachocomb such as transmission of viral disease or infection. CONCLUSION: Our technique is an alternative method to the traditional autologous tissue graft technique. PLD is not an essential procedure for the prevention of CSF rhinorrhea if the intraoperative CSF leak is completely sealed off during the transsphenoidal surgery. However, in cases of large arachnoid defects, aggressive repair of the arachnoid defect and sellar floor reconstruction with bone or bony substitutes should be considered in conjunction with our methods.
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Prevention of cerebrospinal fluid rhinorrhea after transsphenoidal surgery by collagen fleece coated with fibrin sealant without autologous tissue graft or postoperative lumbar drainage.
Neurosurgery, 2011Co-Authors: Jin Mo Cho, Jong Hee Chang, Jung Yong Ahn, Sun Ho KimAbstract:Autologous tissue grafting and postoperative lumbar cerebrospinal fluid (CSF) drainage (PLD) have been used to prevent CSF rhinorrhea after transsphenoidal surgery. To describe the technical details and efficacy of our techniques of using collagen fleece coated with fibrin sealant (Tachocomb, Nycomed, Linz, Austria) instead of an autologous tissue graft and refraining from the use of PLD. We retrospectively reviewed 307 consecutive patients who underwent a transsphenoidal surgery for pituitary adenoma from November 2005 to February 2008. Among them, 90 cases of intraoperative CSF leaks were repaired with Tachocomb without an autologous tissue graft or PLD. The repair procedures were tailored according to CSF leakage type, and we used only Bioglue (Cryolife Inc, Atlanta, Georgia) for sellar floor reconstruction. The overall rate of CSF rhinorrhea was 2.2% (2 of 90 cases). The 2 cases of CSF rhinorrhea resulted from large arachnoid defects, and there were no adverse effects from Tachocomb such as transmission of viral disease or infection. Our technique is an alternative method to the traditional autologous tissue graft technique. PLD is not an essential procedure for the prevention of CSF rhinorrhea if the intraoperative CSF leak is completely sealed off during the transsphenoidal surgery. However, in cases of large arachnoid defects, aggressive repair of the arachnoid defect and sellar floor reconstruction with bone or bony substitutes should be considered in conjunction with our methods.
Walter Klepetko - One of the best experts on this subject based on the ideXlab platform.
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efficacy and safety of topical application of human fibrinogen thrombin coated collagen patch Tachocomb for treatment of air leakage after standard lobectomy
European Journal of Cardio-Thoracic Surgery, 2004Co-Authors: Gyorgy Lang, Gabriel Mihai Marta, Attila Csekeo, Georgios Stamatis, Ludwig Lampl, Leif Hagman, Michael Rolf Mueller, Walter KlepetkoAbstract:Objective: Persisting air leakage after pulmonary resection remains a significant problem. The aim of the study was to evaluate the incidence of air leakage after standard lobectomy and test the efficacy and safety of Tachocomb (TC). Methods: A total of 189 patients undergoing lobectomy were enrolled in a multi-centre, open, randomised, and prospective study to test the efficacy and safety of Tachocomb (TC) for air leakage treatment. Air leakage was assessed by water submersion test, and scored as grades 0 if no, 1 if countable, 2 if a stream of and 3 if coalescent bubbles have been observed. Any sites with grade 3 air leakage received further stapling or limited suturing until grade 0, 1 or 2 was obtained. Treatment of air leakage was done with TC or suturing according to randomisation. Air leakage was assessed by further submersion tests. Postoperative air leakage was assessed using the Pleur-Evac system. Results: Overall incidence of air leakage 48 ^ 6h after surgery was 34% for TC and 37% for standard treatment ðP ¼ 0:76Þ: The reduction of intra-operative air leak intensity in the subgroup with grades 1 ‐2 was significantly higher for the TC group ðP ¼ 0:015Þ: Postoperative air leakage intensity in the subgroup with air leakage grades 1 ‐ 2 was lower for TC than standard treatment ðP ¼ 0:047Þ: The mean duration of postoperative air leakage in the subgroup with grades 1 ‐ 2 was shorter for the TC group than for standard treatment, i.e. 1.9 ^ 1.4 vs. 2.7 ^ 2.2 days ðP ¼ 0:015Þ: Conclusions: TC could be proven as well-tolerated and safe. In the subgroup of patients with established air leakage, TC showed superior potential in reduction of intra-operative air leakage as well as in reduction of intensity and duration of postoperative air leakage. q 2003 Elsevier B.V. All rights reserved.
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Sealing of the mediastinum with a local hemostyptic agent reduces chest tube duration after complete mediastinal lymph node dissection for stage I and II non–small cell lung carcinoma
The Annals of thoracic surgery, 2004Co-Authors: Martin Czerny, Walter Klepetko, Tatjana Fleck, Andreas Salat, Daniel Zimpfer, Ernst Wolner, Michael Rolf MuellerAbstract:Abstract Background We assessed the impact of coverage of the mediastinum with a local hemostyptic agent as well as the impact of perioperative thromboembolic prophylaxis on cumulative chest drain volume and on the duration of chest tubes after surgical resection with complete mediastinal lymph node dissection for stage I or II non–small cell lung cancer. Methods In a prospective, randomized two-by-two factorial design, 80 patients with clinical stage I or II non–small cell lung cancer were allocated to one of two surgical therapy arms (Tachocomb or conventional surgical hemostasis) and one of two anticoagulation arms (enoxaparin 4,000 IU or dalteparin 5,000 IU). Primary end point was cumulative chest drain volume; secondary end point was duration of chest tubes. Additionally clinical data were obtained. Results Comparison of the surgical arms revealed significantly lower cumulative chest drain volumes and thereby an earlier chest tube removal in the Tachocomb group ( p = 0.045). With regard to thromboembolic prophylaxis, a significantly earlier chest tube removal was found for patients treated with dalteparin ( p = 0.039). Analysis of the interaction of surgical and anticoagulation treatment revealed the combined use of Tachocomb and dalteparin was superior to other combinations (cumulative chest drain volumes 498 ± 67 mL versus 1,000 ± 88 mL, 924 ± 87 mL, and 895 ± 118 mL; p = 0.008; mean duration of chest tubes 1.78 ± 0.15 days versus 2.96 ± 0.21 days, 2.93 ± 0.17 days, and 3.06 ± 0.27 days; p = 0.019). Conclusions The combined use of a local hemostyptic agent and dalteparin seems superior as compared with other regimens of hemostasis and thromboembolic prophylaxis in patients undergoing surgical resection and complete mediastinal lymph node dissection for stage I and II non–small cell lung cancer with regard to cumulative chest drain volume as well as duration of chest tubes.
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Efficacy and safety of topical application of human fibrinogen/thrombin-coated collagen patch (Tachocomb) for treatment of air leakage after standard lobectomy.
European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, 2004Co-Authors: Gyorgy Lang, Gabriel Mihai Marta, Attila Csekeo, Georgios Stamatis, Ludwig Lampl, Leif Hagman, Michael Rolf Mueller, Walter KlepetkoAbstract:Objective: Persisting air leakage after pulmonary resection remains a significant problem. The aim of the study was to evaluate the incidence of air leakage after standard lobectomy and test the efficacy and safety of Tachocomb (TC). Methods: A total of 189 patients undergoing lobectomy were enrolled in a multi-centre, open, randomised, and prospective study to test the efficacy and safety of Tachocomb (TC) for air leakage treatment. Air leakage was assessed by water submersion test, and scored as grades 0 if no, 1 if countable, 2 if a stream of and 3 if coalescent bubbles have been observed. Any sites with grade 3 air leakage received further stapling or limited suturing until grade 0, 1 or 2 was obtained. Treatment of air leakage was done with TC or suturing according to randomisation. Air leakage was assessed by further submersion tests. Postoperative air leakage was assessed using the Pleur-Evac system. Results: Overall incidence of air leakage 48 ^ 6h after surgery was 34% for TC and 37% for standard treatment ðP ¼ 0:76Þ: The reduction of intra-operative air leak intensity in the subgroup with grades 1 ‐2 was significantly higher for the TC group ðP ¼ 0:015Þ: Postoperative air leakage intensity in the subgroup with air leakage grades 1 ‐ 2 was lower for TC than standard treatment ðP ¼ 0:047Þ: The mean duration of postoperative air leakage in the subgroup with grades 1 ‐ 2 was shorter for the TC group than for standard treatment, i.e. 1.9 ^ 1.4 vs. 2.7 ^ 2.2 days ðP ¼ 0:015Þ: Conclusions: TC could be proven as well-tolerated and safe. In the subgroup of patients with established air leakage, TC showed superior potential in reduction of intra-operative air leakage as well as in reduction of intensity and duration of postoperative air leakage. q 2003 Elsevier B.V. All rights reserved.
V. Bahal - One of the best experts on this subject based on the ideXlab platform.
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randomised controlled trial to evaluate the efficacy of Tachocomb h patches in controlling ptfe suture hole bleeding
European Journal of Vascular and Endovascular Surgery, 2004Co-Authors: T. Joseph, A. Adeosun, T. Paes, V. BahalAbstract:Abstract Objective. Suture–hole bleeding is a considerable problem in vascular procedures using polytetrafluoroethylene (PTFE) grafts. This study aimed to study the efficacy of Tachocomb ® H patches in controlling suture–hole bleeding. Design. Prospective randomised controlled trial. Materials and methods. Patients undergoing femoral anastomosis and femoral or carotid patch angioplasty with PTFE grafts were prospectively randomised to Tachocomb ® H patches or standard compression with surgical swabs. Results. Twenty four patients were randomised (12 patients in each treatment group). The median time to haemostasis was 300 (range 180–600) s in patients treated with Tachocomb ® H and 660 (range 180–1200) s in the control group. The log rank test of equality over treatments based on the 22 patients with assessment of time to haemostasis showed statistical significance ( p =0.0134). There were no serious complications associated with use of Tachocomb ® H patches. Conclusion. Tachocomb ® H patches were found to be safe and effective for the control of suture–hole bleeding in patients undergoing vascular reconstruction with PTFE grafts.
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Randomised Controlled Trial to Evaluate the Efficacy of Tachocomb H Patches in Controlling PTFE Suture–hole Bleeding
European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery, 2004Co-Authors: T. Joseph, A. Adeosun, T. Paes, V. BahalAbstract:Abstract Objective. Suture–hole bleeding is a considerable problem in vascular procedures using polytetrafluoroethylene (PTFE) grafts. This study aimed to study the efficacy of Tachocomb ® H patches in controlling suture–hole bleeding. Design. Prospective randomised controlled trial. Materials and methods. Patients undergoing femoral anastomosis and femoral or carotid patch angioplasty with PTFE grafts were prospectively randomised to Tachocomb ® H patches or standard compression with surgical swabs. Results. Twenty four patients were randomised (12 patients in each treatment group). The median time to haemostasis was 300 (range 180–600) s in patients treated with Tachocomb ® H and 660 (range 180–1200) s in the control group. The log rank test of equality over treatments based on the 22 patients with assessment of time to haemostasis showed statistical significance ( p =0.0134). There were no serious complications associated with use of Tachocomb ® H patches. Conclusion. Tachocomb ® H patches were found to be safe and effective for the control of suture–hole bleeding in patients undergoing vascular reconstruction with PTFE grafts.
Jin Mo Cho - One of the best experts on this subject based on the ideXlab platform.
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prevention of cerebrospinal fluid rhinorrhea after transsphenoidal surgery by collagen fleece coated with fibrin sealant without autologous tissue graft or postoperative lumbar drainage
Neurosurgery, 2011Co-Authors: Jin Mo Cho, Jong Hee Chang, Jung Yong Ahn, Sun Ho KimAbstract:BACKGROUND: Autologous tissue grafting and postoperative lumbar cerebrospinal fluid (CSF) drainage (PLD) have been used to prevent CSF rhinorrhea after transsphenoidal surgery. OBJECTIVE: To describe the technical details and efficacy of our techniques of using collagen fleece coated with fibrin sealant (Tachocomb, Nycomed, Linz, Austria) instead of an autologous tissue graft and refraining from the use of PLD. METHODS: We retrospectively reviewed 307 consecutive patients who underwent a transsphenoidal surgery for pituitary adenoma from November 2005 to February 2008. Among them, 90 cases of intraoperative CSF leaks were repaired with Tachocomb without an autologous tissue graft or PLD. The repair procedures were tailored according to CSF leakage type, and we used only Bioglue (Cryolife Inc, Atlanta, Georgia) for sellar floor reconstruction. RESULTS: The overall rate of CSF rhinorrhea was 2.2% (2 of 90 cases). The 2 cases of CSF rhinorrhea resulted from large arachnoid defects, and there were no adverse effects from Tachocomb such as transmission of viral disease or infection. CONCLUSION: Our technique is an alternative method to the traditional autologous tissue graft technique. PLD is not an essential procedure for the prevention of CSF rhinorrhea if the intraoperative CSF leak is completely sealed off during the transsphenoidal surgery. However, in cases of large arachnoid defects, aggressive repair of the arachnoid defect and sellar floor reconstruction with bone or bony substitutes should be considered in conjunction with our methods.
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Prevention of cerebrospinal fluid rhinorrhea after transsphenoidal surgery by collagen fleece coated with fibrin sealant without autologous tissue graft or postoperative lumbar drainage.
Neurosurgery, 2011Co-Authors: Jin Mo Cho, Jong Hee Chang, Jung Yong Ahn, Sun Ho KimAbstract:Autologous tissue grafting and postoperative lumbar cerebrospinal fluid (CSF) drainage (PLD) have been used to prevent CSF rhinorrhea after transsphenoidal surgery. To describe the technical details and efficacy of our techniques of using collagen fleece coated with fibrin sealant (Tachocomb, Nycomed, Linz, Austria) instead of an autologous tissue graft and refraining from the use of PLD. We retrospectively reviewed 307 consecutive patients who underwent a transsphenoidal surgery for pituitary adenoma from November 2005 to February 2008. Among them, 90 cases of intraoperative CSF leaks were repaired with Tachocomb without an autologous tissue graft or PLD. The repair procedures were tailored according to CSF leakage type, and we used only Bioglue (Cryolife Inc, Atlanta, Georgia) for sellar floor reconstruction. The overall rate of CSF rhinorrhea was 2.2% (2 of 90 cases). The 2 cases of CSF rhinorrhea resulted from large arachnoid defects, and there were no adverse effects from Tachocomb such as transmission of viral disease or infection. Our technique is an alternative method to the traditional autologous tissue graft technique. PLD is not an essential procedure for the prevention of CSF rhinorrhea if the intraoperative CSF leak is completely sealed off during the transsphenoidal surgery. However, in cases of large arachnoid defects, aggressive repair of the arachnoid defect and sellar floor reconstruction with bone or bony substitutes should be considered in conjunction with our methods.
Michael Rolf Mueller - One of the best experts on this subject based on the ideXlab platform.
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efficacy and safety of topical application of human fibrinogen thrombin coated collagen patch Tachocomb for treatment of air leakage after standard lobectomy
European Journal of Cardio-Thoracic Surgery, 2004Co-Authors: Gyorgy Lang, Gabriel Mihai Marta, Attila Csekeo, Georgios Stamatis, Ludwig Lampl, Leif Hagman, Michael Rolf Mueller, Walter KlepetkoAbstract:Objective: Persisting air leakage after pulmonary resection remains a significant problem. The aim of the study was to evaluate the incidence of air leakage after standard lobectomy and test the efficacy and safety of Tachocomb (TC). Methods: A total of 189 patients undergoing lobectomy were enrolled in a multi-centre, open, randomised, and prospective study to test the efficacy and safety of Tachocomb (TC) for air leakage treatment. Air leakage was assessed by water submersion test, and scored as grades 0 if no, 1 if countable, 2 if a stream of and 3 if coalescent bubbles have been observed. Any sites with grade 3 air leakage received further stapling or limited suturing until grade 0, 1 or 2 was obtained. Treatment of air leakage was done with TC or suturing according to randomisation. Air leakage was assessed by further submersion tests. Postoperative air leakage was assessed using the Pleur-Evac system. Results: Overall incidence of air leakage 48 ^ 6h after surgery was 34% for TC and 37% for standard treatment ðP ¼ 0:76Þ: The reduction of intra-operative air leak intensity in the subgroup with grades 1 ‐2 was significantly higher for the TC group ðP ¼ 0:015Þ: Postoperative air leakage intensity in the subgroup with air leakage grades 1 ‐ 2 was lower for TC than standard treatment ðP ¼ 0:047Þ: The mean duration of postoperative air leakage in the subgroup with grades 1 ‐ 2 was shorter for the TC group than for standard treatment, i.e. 1.9 ^ 1.4 vs. 2.7 ^ 2.2 days ðP ¼ 0:015Þ: Conclusions: TC could be proven as well-tolerated and safe. In the subgroup of patients with established air leakage, TC showed superior potential in reduction of intra-operative air leakage as well as in reduction of intensity and duration of postoperative air leakage. q 2003 Elsevier B.V. All rights reserved.
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Sealing of the mediastinum with a local hemostyptic agent reduces chest tube duration after complete mediastinal lymph node dissection for stage I and II non–small cell lung carcinoma
The Annals of thoracic surgery, 2004Co-Authors: Martin Czerny, Walter Klepetko, Tatjana Fleck, Andreas Salat, Daniel Zimpfer, Ernst Wolner, Michael Rolf MuellerAbstract:Abstract Background We assessed the impact of coverage of the mediastinum with a local hemostyptic agent as well as the impact of perioperative thromboembolic prophylaxis on cumulative chest drain volume and on the duration of chest tubes after surgical resection with complete mediastinal lymph node dissection for stage I or II non–small cell lung cancer. Methods In a prospective, randomized two-by-two factorial design, 80 patients with clinical stage I or II non–small cell lung cancer were allocated to one of two surgical therapy arms (Tachocomb or conventional surgical hemostasis) and one of two anticoagulation arms (enoxaparin 4,000 IU or dalteparin 5,000 IU). Primary end point was cumulative chest drain volume; secondary end point was duration of chest tubes. Additionally clinical data were obtained. Results Comparison of the surgical arms revealed significantly lower cumulative chest drain volumes and thereby an earlier chest tube removal in the Tachocomb group ( p = 0.045). With regard to thromboembolic prophylaxis, a significantly earlier chest tube removal was found for patients treated with dalteparin ( p = 0.039). Analysis of the interaction of surgical and anticoagulation treatment revealed the combined use of Tachocomb and dalteparin was superior to other combinations (cumulative chest drain volumes 498 ± 67 mL versus 1,000 ± 88 mL, 924 ± 87 mL, and 895 ± 118 mL; p = 0.008; mean duration of chest tubes 1.78 ± 0.15 days versus 2.96 ± 0.21 days, 2.93 ± 0.17 days, and 3.06 ± 0.27 days; p = 0.019). Conclusions The combined use of a local hemostyptic agent and dalteparin seems superior as compared with other regimens of hemostasis and thromboembolic prophylaxis in patients undergoing surgical resection and complete mediastinal lymph node dissection for stage I and II non–small cell lung cancer with regard to cumulative chest drain volume as well as duration of chest tubes.
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Efficacy and safety of topical application of human fibrinogen/thrombin-coated collagen patch (Tachocomb) for treatment of air leakage after standard lobectomy.
European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, 2004Co-Authors: Gyorgy Lang, Gabriel Mihai Marta, Attila Csekeo, Georgios Stamatis, Ludwig Lampl, Leif Hagman, Michael Rolf Mueller, Walter KlepetkoAbstract:Objective: Persisting air leakage after pulmonary resection remains a significant problem. The aim of the study was to evaluate the incidence of air leakage after standard lobectomy and test the efficacy and safety of Tachocomb (TC). Methods: A total of 189 patients undergoing lobectomy were enrolled in a multi-centre, open, randomised, and prospective study to test the efficacy and safety of Tachocomb (TC) for air leakage treatment. Air leakage was assessed by water submersion test, and scored as grades 0 if no, 1 if countable, 2 if a stream of and 3 if coalescent bubbles have been observed. Any sites with grade 3 air leakage received further stapling or limited suturing until grade 0, 1 or 2 was obtained. Treatment of air leakage was done with TC or suturing according to randomisation. Air leakage was assessed by further submersion tests. Postoperative air leakage was assessed using the Pleur-Evac system. Results: Overall incidence of air leakage 48 ^ 6h after surgery was 34% for TC and 37% for standard treatment ðP ¼ 0:76Þ: The reduction of intra-operative air leak intensity in the subgroup with grades 1 ‐2 was significantly higher for the TC group ðP ¼ 0:015Þ: Postoperative air leakage intensity in the subgroup with air leakage grades 1 ‐ 2 was lower for TC than standard treatment ðP ¼ 0:047Þ: The mean duration of postoperative air leakage in the subgroup with grades 1 ‐ 2 was shorter for the TC group than for standard treatment, i.e. 1.9 ^ 1.4 vs. 2.7 ^ 2.2 days ðP ¼ 0:015Þ: Conclusions: TC could be proven as well-tolerated and safe. In the subgroup of patients with established air leakage, TC showed superior potential in reduction of intra-operative air leakage as well as in reduction of intensity and duration of postoperative air leakage. q 2003 Elsevier B.V. All rights reserved.
