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Query: UMLS:C0030552 (paresis)
 5,831 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In most medical textbooks, a mediastinoscopy is considered an absolute contraindication for a repeat mediastinoscopy. Retrospectively, perioperative data from 101 patients were evaluated in whom repeat mediastinoscopy was performed. The complication rate was 23% in 18 patients; 10% of these were directly related to the surgery. The surgical complications observed were hemorrhage, biopsy of the esophagus, paresis of a recurrent laryngeal nerve, and pneumothorax, which were all treated successfully. The patients receiving a nondepolarizing relaxant had fewer complications than patients given only a single dose of succinylcholine. In this patient population, the mortality rate was zero. This review concludes that an earlier mediastinoscopy is not necessarily an absolute contraindication for repeat mediastinoscopy.
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PMID:Anesthesia in repeat mediastinoscopy: a retrospective study of 101 patients. 156 6

Over a five year period 41 operations for spontaneous pneumothorax were performed on 38 patients. In all cases a transaxillary thoracotomy was performed in the third, or in some cases the fourth, intercostal space. Bullae were resected and operative pleurodesis carried out by rubbing the parietal pleura with a dry sponge. The indications for operation were: 1) More than one episode of pneumothorax on the relevant side. 2) The first incidence of pneumothorax if the patient had pneumothorax on the contralateral side before. 3) Continuous leakage of air after a week of drainage. One patient had to be reoperated for recurrence of pneumothorax, and one was reoperated due to formation of a large postoperative haematoma. One patient developed paresis of the serratus anterior muscle due to lesion of the long thoracic nerve.
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PMID:[Surgical pleurodesis in spontaneous pneumothorax]. 199 79

A new method of collagen-normalizing therapy has been worked out to prevent specific anesthesia-induced, operative and postoperative complications and to treat some symptoms in children with Ehlers-Danlos and Marfan's syndromes and with non-classified Marfan-like malformations. The technique involves a combined use of beta-adrenoblocker in the age-matched doses and vitamins C/0.03 g/(kg.day)/, B2/0.0004 g/(kg.day)/and B6/0.002 g/(kg.day)/ for 2.5 months before surgery and during the first 2 weeks of the postoperative period. The above therapy reduces the incidence of delayed recovery of the muscular tone and adequate respiration, spontaneous and recurrent pneumothorax, hemorrhagic and gastroenterologic complications, as well as the incidence and severity of intestinal paresis. The indexes of effective collagen-normalizing therapy are as follows: body weight increase, echocardiographic pattern of reduced diameter of the aorta and mitral valve prolapse, normalization of the urinary excretion of total and polypeptide-bound oxyproline. The efficacy of therapy depends on the baseline level of oxyproline excretion.
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PMID:[The effect of collagen-normalizing therapy on the incidence and severity of anesthetic and postoperative complications in children with connective tissue syndromes]. 239 60

Transhiatal esophagectomy without thoracotomy has been performed in 65 adult patients with dysphagia from benign esophageal disease: strictures (30), neuromotor dysfunction (24), acute iatrogenic perforation (five), acute caustic injury (four), and recurrent gastroesophageal reflux (two). Nearly 70% (45) had undergone at least one prior esophageal operation, and 26% (17) had a history of between two and four esophageal operations. The esophagus was replaced with stomach in 53 patients (82%), colon being used only when there was a history of either prior gastric resection or caustic injury to the stomach (10 patients). Intraoperative blood loss averaged 1,050 ml. Intraoperative complications included pneumothorax in 38 patients (58%) and a tracheal laceration in one patient. Postoperative complications included transient recurrent laryngeal nerve paresis (11 patients, 17%), chylothorax (four patients, 6%), anastomotic leak (four patients, 6%), and small bowel obstruction (two patients). There were five hospital deaths (8% mortality), none related to the technique of esophagectomy. Follow-up ranges from 1 to 84 months (average 28 months). Of 46 patients with a cervical esophagogastric anastomosis in the original esophageal bed, 42 have had an excellent functional result although 17 have required at least one postoperative esophageal dilation. Two have developed true anastomotic strictures. Clinically significant gastroesophageal reflux has not occurred. Transhiatal esophagectomy for benign disease is feasible and safe, even after multiple previous esophageal operations. The stomach appears to be a better visceral esophageal substitute than colon, because it allows an initially easier technical operation and superior long-term functional results.
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PMID:Transhiatal esophagectomy for benign disease. 405 37

Transhiatal esophagectomy (THE) without thoracotomy was performed in 100 patients with carcinoma of the thoracic esophagus (7 upper, 45 mid, and 48 lower third). The esophagus was replaced with stomach (96) or colon (4). Intraoperative complications included pneumothorax requiring a chest tube(s) (63) and membranous tracheal tear (2). Blood loss averaged 880 ml. Postoperative complications included transient recurrent laryngeal nerve paresis (31), anastomotic leak (5), and chylothorax (2). There were no intraoperative deaths or re-explorations for postoperative bleeding. Six hospital deaths resulted from aspiration pneumonia (2), retroperitoneal or mediastinal abscess (2), pulmonary embolus (1), and respiratory insufficiency (1). Postoperative hospitalization averaged 14 days. Actuarial survival among the 94 operative survivors is 82% at 6 months, 52% at 12 months, 32% at 24 months, 22% at 36 months, and 17% at 48 months. Of the operative survivors, 15% have lived 2 years or more and 10% are clinically disease free. THE is safe, associated with a low morbidity, and achieves excellent palliation and survival at least as good as that reported in many series of transthoracic esophagectomies for esophageal carcinoma.
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PMID:Transhiatal esophagectomy without thoracotomy for carcinoma of the thoracic esophagus. 646 81

A case of congenital paresis of the supranuclear facial nerve on the left side in a newborn is presented. His mother has also congenital central facial nerve paresis and for this reason the same anomaly in the newborn was considered to be due to a genetic defect in the intrauterine development. No other lesions in the pyramidal tract were observed. At the infant's birth, a mild form was found of the partial pneumothorax which spontaneously disappeared. The authors suggest a multidisciplinary approach in the study of congenital facial nerve lesions.
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PMID:[Congenital central paralysis of the facial nerve in a newborn infant]. 664 16

Esophagectomy without opening the thoracic cavity--transhiatal esophagectomy--(THE) were performed in 47 patients with malignant tumors localized at various levels of the esophagus. Pulmonary function studies were performed in all patients and they are categorized as low, moderate, or high risk for probable postoperative pulmonary complications according to the risk category system. Nine of these patients were classified as high risk, seven as moderate risk, and the rest as low risk. In all patients but four, reconstruction was accomplished by using their stomachs as a substitute. In the remaining patient, intestinal continuity was established by a left and right colonic interposition. Three patients were lost in the early postoperative period. Two patients categorized as low risk died from pulmonary thromboembolism and cardiac failure, respectively. One patient categorized in the high risk group died of coronary thrombosis. Postoperative complications included transient hoarseness due to recurrent laryngeal nerve paresis in one patient, right pleural effusion in one patient, pneumothorax in two patients, and thrombophlebitis in one patient. In the high risk patient group, there were no pulmonary complications. This clinical study demonstrated the protective effect of THE in patients with serious pulmonary problems.
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PMID:Transhiatal esophagectomy for esophageal carcinoma in Turkey: with special reference to respiratory function. 829 63

The retrospective analysis of 489 cases of substernal and intrathoracic goiters among 4122 patients undergoing surgical treatment between 1984 and 1996 due to various thyroid gland diseases including clinical data, surgical technics and early postoperative complications was performed. The surgical procedures of substernal and intrathoracic goiter amounted to 11.9% of all thyroid gland surgery. In 468 (95.5%) patients goiter was situated substernally, in 22 (4.5%) intrathoracicaly. The mean age and time of goiter growth in that location exceeded over 10 years the location of goiter within the neck. In preoperative examination the X-ray of chest and trachea were essential. Routine ultrasonography and thyroid gland scyntigraphy were scarcely helpful as the retrosternal and mediastinal region were often omitted. The jugular access was dominant (98.6%), sternotomy was performed in 1.4% of cases due to big disproportion between size of the goiter and size of the upper inlet into the chest. The surgical complications, similarly as in goiter within the neck (no cases of pneumothorax were observed), included the single-side paresis of recurrent laryngeal nerve in 3.7% of patients, in 0.2% hypoparathyroidism, in 1% bleeding requiring reoperation and in 0.2% esophageal fistula (self-healed). The surgical treatment of retrosternal and intramediastineal goiter was safe and a total number of complications was comparable to that one in a group of patients under-going surgery due to goiter within the neck. Most of surgical procedures was possible to perform using the jugular access. In a small number of cases because of difficulties related to the anatomical conditions the access was reached through the oblong sternotomy.
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PMID:[Treatment approach for substernal and intrathoracic goiter. Personal experience]. 1037 45

Four newborn boys developed respiratory insufficiency and pneumothorax, pneumomediastinum or subcutaneous emphysema as the result of a laryngeal or tracheal rupture. These ruptures were due to birth injuries after difficult labour resulting from shoulder dystocia or a large lymphangioma and to a birth weight of at least 4500 g. The three children with shoulder dystocia also had a clavicular fracture, a Horner's syndrome, Erb paralysis or phrenic nerve paresis. Treatment consisted of surgical repair followed by a few days' intubation. The children with a shoulder dystocia recovered well, although in one of them a tracheal stenosis had to be resected a few months later. The child with the lymphangioma died from a bifurcation embolus. In newborns with respiratory insufficiency and pneumomediastinum or subcutaneous emphysema after a difficult delivery an emergency laryngotracheoscopy has to be performed to exclude rupture of larynx or trachea.
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PMID:[Rupture of larynx or trachea resulting from injuries sustained at birth]. 1044 82

A 16 patients with 20 vascular TOS have been evaluated at the our Institute. Fourteen of them were female, and 2 male patients, with average age of 33.1 (18-44) years. 19 of them had congenital, and one acquired TOS after trauma at neck-shoulder region. 13 cases had arterial, and 7 venous TOS. In 10 cases a cause of TOS was cervical rib, in one scar tissue after clavicle fracture, while in 9 soft tissue anomalies. Eight cases with arterial TOS had a hand ischemia, one TIA and 5 periodical symptoms only during the arm hyperabduction. Two cases with venous TOS also had symptoms and signs during arm hyperabducrtion only, while five patients had axillary-subclavian deep venous thrombosis (DVT). All patients underwent CW-Doppler, Duplex-ultrasonographic and angiographic examination in normal position of the arm and during the hyperabduction. The four aneurysms of the subclavian artery, two poststenotic dilatation of the subclavian artery were found as well as one thrombosis of the axillary artery and 8 brachial artery embolism. The operative treatment consists from decompression and vascular procedure. A decompression procedure include 10 resections of the cervical rib, three transaxilary and 6 supraclavcular resection of the first rib, as well as one scalenectomy. A vascular procedures included 8 transbrachial thrombembolectomy and 4 resection and replacement of subclavian artery aneurysms. Four early complications were noticed: two partial pneumothorax, and two transiet medianus nerve paresis. The follow-up period was between one and six years (mean 3 years). In this period one (12.5%) late arterial occlusion was found. The vascular TOS is more rare than neurogenic, however in mostly cases requires surgical management.
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PMID:[The upper thoracic outlet vascular syndrome]. 1143 50


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