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Query: UMLS:C0432222 (SEM)
 47,337 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The value of peritoneal closure at the time of cesarean birth was evaluated prospectively. Two hundred forty-eight women undergoing low transverse cesarean through a Pfannenstiel skin incision were assigned to one of two groups: peritoneum open (N = 127) or peritoneum closed (N = 121). The mean (+/- SEM) surgical time in the open group (48.1 +/- 1.2 minutes) was significantly less than for the closed group (53.2 +/- 1.4 minutes) (P less than .005). There were no postoperative differences between the groups in the incidence of wound infection, dehiscence, endometritis, ileus, and length of hospital stay. Our study suggests that leaving the parietal peritoneum unsutured is an acceptable way to manage patients at cesarean delivery.
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PMID:Peritoneal closure or non-closure at cesarean. 198 96

We sought to determine the influence of operation on the pattern of human duodenal myoelectric activity and to assess whether electrical pacing might correct any postoperative disturbances. Three pairs of temporary bipolar serosal electrodes were placed on the duodenums of ten patients undergoing cholecystectomy. Electrical recordings were obtained daily until the patients' discharge, at 3 to 7 days, after operation. On each postoperative day, a regular rhythmic pattern of pacesetter potentials (PPs) was detected in all patients. The PP frequency (mean +/- SEM) was greater at the proximal electrode than at the distal electrode on the first postoperative day (12.3 +/- 0.1 cpm vs 11.9 +/- 0.1 cpm, p less than 0.01) and on the day of feeding (12.0 +/- 0.2 cpm vs 11.6 +/- 0.2, p less than 0.01). Spontaneous periods when spike potentials accompanied each PP (phase III of the migrating myoelectric complex), were found in only one patient on the day after operation, while they were recorded in five patients after 3 to 7 days, when postoperative ileus had resolved (p less than 0.05). Pacing with electric pulses (50 msec, 5 to 15 mA, 11 to 13 cpm) did not alter the pattern of duodenal PPs or entrain them in the duodenum of any patient at any time after operation. In conclusion, the pattern of duodenal pacesetter potentials changed little during the period of postoperative ileus, while the incidence of phase IIIs of the migrating myoelectric complex was greatly decreased.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Human duodenal myoelectric activity after operation and with pacing. 229 59

After resection of the head of the pancreas, the distal remnant is typically telescoped into the jejunum. Recently, pancreaticogastrostomy has re-emerged as a useful alternative, as the anastomosis is easy and without tension. The results of pancreaticogastrostomy in 10 consecutive patients is reviewed, as is the literature of both the technique and the physiology of the procedure. In the current series, mean +/- SEM age was 65 +/- 2.3 years. Extended pancreaticoduodenectomy was performed in two patients, pylorus-preserving in eight. Mean tumor size was 3.9 +/- 1.1 cm (range, 1.5-7.5 cm), mean operative time was 6.5 +/- 0.5 hours. Intraoperatively, 7.6 +/- 0.8 L of fluid was given, only two patients were transfused. The mean length of stay was 9.4 +/- 1.8 days. There were no anastomotic leaks, no deaths, and two patients developed temporary gastric ileus. There are now 841 pancreaticogastrostomies reported in the literature, with a leak rate of 3.1% and a death rate of 2.6%. Pancreaticogastrostomy is easy to perform, safe, and useful even after extended Whipple.
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PMID:Use of pancreaticogastrostomy for pancreatic reconstruction after pancreaticoduodenectomy. 1091 69