Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0243026 (sepsis)
 52,417 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

From 1973 to 1986, 160 patients with adenocarcinoma localized to the prostate were treated with radical prostatectomy and pelvic lymphadenectomy. In 78 (49%) patients more advanced stage of disease was found at surgery and they received local pelvic irradiation (RT). This consisted of 45 Gy for microscopic and 55 Gy for macroscopic residual disease. RT was given at 1.8 Gy a day, using the four-field "box" technique with the 23 MV X ray beam. Pelvic lymph node metastases were found in 28 (36%) patients who, in addition to RT, received systemic therapy: 20 with cyclophosphamide alone, 4 combined with 5-Fluorouracil, and 4 patients received DES. The 5- and 10-year overall actuarial survival was 95 and 77%, respectively, and the 5- and 10-year disease-free survival was 58 and 43%, respectively. Recurrent tumor was found in 34 (44%) patients. Of these 34 patients, 32 (94%) had distant metastatic tumor and 2 (6%) had local recurrence in the pelvis. The presence of metastatic disease in pelvic lymph nodes had clinical significance since it influenced disease-free survival and the incidence of tumor recurrence. The 10-year disease-free survival for the 50 patients with no lymph node metastases was 51%, as compared to 28% for the 28 patients with such metastases, p = 0.001. Similarly, recurrent tumor was found in 28% of the former and 68% of the latter patients, p = 0.002. Other important parameters predicting recurrence were: clinical stage, p = 0.018, histological grade, p = 0.013, and Gleason's grade, p = 0.002. This treatment program was very well tolerated and of low toxicity. There was no surgical mortality. Surgical complications were seen in 10 (13%) patients including: minor in 5 and major in 5. At 1 year, 77% of the patients remained continent, while 10% had mild stress incontinence. Of the remaining 13% only 3 (4%) patients had severe incontinence (greater than 5 pads daily). RT toxicity was mild with 38% experiencing diarrhea. Severe toxicity was seen in 2 (3%) patients who, early in the study, developed scrotal and lower extremity edema. Severe chemotherapy complications were seen in 1 (4%) patient who had severe neutropenic sepsis. Postoperative radiotherapy is a well tolerated, safe and effective treatment in patients who have microscopic or macroscopic residual tumor following radical prostatectomy.
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PMID:Radiotherapy following radical prostatectomy in patients with adenocarcinoma of the prostate. 191 24

Medium-term results are reported in 100 patients who had a Stamey operation for genuine stress incontinence. The results were good in 72, improved in 8 and 20 were failures when assessed clinically and with pad tests. Most of the failures occurred in the first post-operative year. A repeat Stamey operation was easy and the results have been good in 7 of the 8 cases. Bladder outflow obstruction, urinary infection and wound sepsis were not a problem.
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PMID:Follow-up results with the Stamey operation for stress incontinence of urine. 231 50

The aim of this prospective study was to evaluate the long-term follow-up result of Swenson's operation in the treatment of Hirschsprung's disease in Vietnamese children. The surgical intervention was performed in three stages. Swenson's operation was performed by the same surgical team. Hirschsprung's disease was confirmed by an operative rectal biopsy. Regular out-patient attendances were made for follow-up. From January 1987 to January 1990, 69 patients including 61 boys and eight girls underwent Swenson's operation at a mean age of two years and five months (range from seven months to 14 years). There were two postoperative deaths during first 48 hours due to sepsis and two other late deaths due to severe enterocolitis (four months and six months after closure of colostomy respectively). Complications such as anastomotic leakage, anastomotic stenosis, perianal abcess, pelvic abcess did not occur. A follow-up result was obtained in 54 of 65 survivors (83%) with follow-up ranging from two to five years (mean: three years and six months). 51 of 54 children (94%) had a normal evacuation. Constipation persisted in three children (6%). Fecal soiling occurred in four children (8%) and stress urinary incontinence in one child (2%). All boys (47 children) had a normal erection. 53 patients (98%) had a normal weight growth, whereas 48 patients (89%) had a normal height growth. In conclusion, the long-term follow-up result of Swenson's operation in the treatment of Hirschsprung's disease was satisfactory.
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PMID:The long-term follow-up result of Swenson's operation in the treatment of Hirschsprung's disease in Vietnamese children. 761 79

A total of 342 benign prostatic hypertrophy patients were treated at the Department of Urology, Kaohsiung Medical College Hospital from January 1972 to December 1988. Median duration of operating time was 74.4 minutes, 67 patients (20%) required a blood transfusion and the mean volume of blood per patient transfused was 1019.4 ml. Median post-operative catheter management was 7 days and the median post-operative ward time was 8.6 days. Two patients (0.5%) had a bladder lesion with peritoneal perforation and required a secondary operation for bladder suture. Secondary hemorrhaging return for treatment of clotting was seen in 11 cases (3.2%). Stress incontinence was noted in 11 cases (3.2%). Anterior urethral stricture was noted in 9 cases (2.6%), impotence occurred in only one case (0.3%) and TUR syndrome in 2 (0.6%). There were two post-operative deaths, for a mortality rate of 0.6 percent. The causes of death were sepsis in one patient and acute renal failure in the other.
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PMID:[Complications of transurethral resection of prostate]. 769 73

Transobturator tape is an artificial tape designed for urethral suspension to treat female stress urinary incontinence. This tape has two original features: its non-woven polypropylene structure is coated with silicone on the urethral surface in order to limit retraction of polypropylene and to establish a barrier to extension of periurethral fibrosis. transmuscular insertion, through the obturator and puborectalis muscles, reproduces the natural suspension fascia of the urethra while preserving the retropubic space. A preliminary study (40 implantations) confirmed the feasibility of this operation, the low morbidity (one complication: sepsis) and the encouraging results between 3 and 12 months; in the treatment of isolated incontinence (16 patients), no postoperative dysuria has been observed; 15 patients are totally continent and 1 patient is improved; in the treatment of prolapse associated with frank or potential incontinence (24 patients), transient postoperative dysuria was observed in 4 cases, with no postoperative incontinence.
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PMID:[Transobturator urethral suspension: mini-invasive procedure in the treatment of stress urinary incontinence in women]. 1185 72

To evaluate whether the use of suction drains in the paravescical spaces is associated with the occurrence of postoperative infectious complications. Patients who underwent to a Burch colposuspension to treat urinary stress incontinence were included. Thirty-seven patients had the placement of suction drains in the paravescical spaces while 25 patients did not. Postoperative infectious morbidity was defined as the occurrence of at least one of the following events: febrile morbidity, sepsis, pelvic infections, severe wound infection and infected subfascial haematoma. Febrile morbidity was defined as two oral temperatures greater than 38 degrees C, taken at least 4 h apart, starting 24 h after the operation. The two groups were comparable in terms of demographic and clinical characteristics. The overall incidence of postoperative infectious morbidity was 22.6%. The proportion of patients with drains was higher in those groups who had postoperative complications than in patients with an uneventful postoperative period (78.6% vs 54.1%), although not statistically significant. The power to detect such a difference was only 39% (alpha=0.05). Seven patients developed a wound infection. Of these, five had the placement of suction drains. The placement of suction drains at Burch colposuspension seems to increase the risk of postoperative infectious complications. The possible benefits of suction drains must be counterbalanced with possible risks and, therefore, their routine use in Burch colposuspension is questionable.
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PMID:The use of suction drains at burch colposuspension and postoperative infectious morbidity. 1267 74

Tension-free vaginal tape (TVT) is commonly used to treat stress urinary incontinence (SUI). TVT is known for its simplicity of use and successful outcomes with low morbidity [1]. However, complications can occur. We report an abscess posterior to the rectus muscle following TVT. A 46-year-old woman underwent TVT for SUI. On postoperative day (POD) 13, she presented with an abscess of the left suprapubic incision, which was treated with antibiotics and drainage. She represented on POD 22 with multiple pulmonary emboli and sepsis, and computed tomography (CT) revealed a multiloculated abdominal-wall fluid collection deep to the rectus muscle. The mesh was removed via vaginal incision. The rectus sheath abscess was accessed through a subfascial but extraperitoneal midline incision. The abdominal-wall wound was connected to the suprapubic wound. Whereas major infectious complications of TVT are rare, when they do occur, debridement, drainage, and removal of the mesh are imperative to prevent morbidity.
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PMID:Posterior rectus abdominis sheath abscess after tension-free vaginal tape. 2243 Sep 46

A 67-year-old lady presented to the surgical outpatient clinic with a 4 month history of recurrent purulent discharge from her left buttock. Four years and 4 months prior to this she underwent a posterior intravaginal slingoplasty for vaginal prolapse and urinary stress incontinence. An MRI demonstrated a long gluteo-vaginal fistula tract from the posterior wall of the vaginal vault through the left ischiorectal fossa to the skin. An examination under anaesthesia revealed that the fistulous tract was surrounding the intact mesh used for the posterior intravaginal slingoplasty. The mesh was removed, the fistula tract excised and the perineal wound marsupialised. The patient was discharged 5 days later. The wound healed within 4 weeks and she remains sepsis free 2 years on.
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PMID:Gluteo-vaginal fistula: a long-term complication of posterior intravaginal slingplasty. 2267 11

Tension-free vaginal tape (TVT), is a commonly performed, low risk procedure for treatment of stress urinary incontinence (SUI). Severe complications are rare, but can be potentially life threatening. We present a case of 66 year old patient who sustained bladder perforation at the time of TVT procedure and subsequently developed sepsis rapidly leading to multi-organ failure and triggering sequence of serious complications. During her inpatient stay she required ITU admission, emergency laparotomy, TVT mesh removal, bowel resection due to ischemic colitis and anticoagulation for pulmonary embolism. Despite of clinical picture of sepsis her microbiology tests were almost consistently negative. This case emphasise importance of awareness and quick recognition of TVT related complications. Patient ultimately survived and recovered thanks to timely and coordinated management by the multidisciplinary team of doctors.
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PMID:Sepsis and multiorgan failure following TVT procedure. 2483 12

We report a 50-year-old woman case with an extensive necrotizing fasciitis (NF). The NF appeared 10 years after a tension free vaginal tape procedure for urinary stress incontinence. Vital prognosis was engaged due to the initial sepsis severity. This kind of complication is rare and could be under estimated. NF usually appear soon after surgery, whatever within the year following implantation. Anyway, NF are always related to a vaginal erosion of the tape.
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PMID:[Delayed necrotizing fasciitis: a complication of stress incontinence surgery by suburethral sling]. 2485 9


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