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Background: We reported favorable short-term results of laparoscopic surgery in a randomized study comparing open and laparoscopic surgery for elderly patients with colorectal cancer (CRC). The purpose of this study is to clarify the long-term outcomes of the laparoscopic surgery for elderly patients with CRC. Methods: The inclusion criteria were ≥ 75 years, adenocarcinoma, ≤ T4a, M0 and elective surgery. The patients were randomly allocated to open or laparoscopic surgery according to the tumor location. The survival rates, recurrence and reasons for death were compared. Result: One hundred patients (right colon 43, left colon 28, rectum 29) were included in each group. Eight patients who underwent open surgery and 2 patients who underwent laparoscopic surgery were excluded from the analysis because of metastatic diseases and other malignancies found during the operations. One hundred ninety patients (98 open, 98 laparoscopic) were analyzed. There was no difference in the backgrounds excluding more patients with vascular invasion in the laparoscopic rectal cancer. There were no differences in the 5-year overall survival rate (open vs. laparoscopic; 78.9% vs. 82.1%, p = 0.638), 5-year disease-free survival rate (70.5% vs. 62.8%, p = 0.276), 5-year recurrence-free survival rate (76.1% vs. 72.1%, p = 0.419), or 5-year cancer-specific survival rate (86.1% vs. 80.5%, p = 0.208). No differences in survival were detected in the analyses of stage and tumor location. There was no significant difference in the overall recurrence rate or recurrence site. However, distant lymph node metastases and local recurrences were more common after laparoscopic surgery than after open surgery. There was no difference in the cause of death. More than half of the patients died from other diseases in both groups (57.9% vs. 52.6%, p = 0.765). Conclusion: Laparoscopic surgery showed similar long-term results compared to open surgery in elderly patients with CRC. Laparoscopic surgery is an effective surgical procedure for elderly patients with CRC. [ABSTRACT FROM AUTHOR]

We report the long-term clinical outcome of an 8-month-old infant who underwent tricuspid reconstruction using fresh autologous pericardium for severe tricuspid regurgitation due to defects in the leaflets of the tricuspid valve after ventricular septal defect closure and ablation. Ten years after surgery, the tricuspid function is good with mild regurgitation and mild stenosis. From the age of 8 months to 11 years, the patient's body weight and height increased fourfold and twofold, respectively. Thus, a fresh autologous pericardial patch could be the material of choice for tricuspid leaflet repair in pediatric patients. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was (1) to compare the clinical and radiological outcomes of robotic and conventional total knee arthroplasty with a minimum follow-up of ten years, (2) to evaluate the survival rate, (3) and to estimate the accuracy of the two techniques by analyzing the outliers of the total knee arthroplasty (TKA) patients.Methods: We evaluated 351 patients (390 knees), 155 patients undergoing robotic TKA, and 196 patients treated with conventional TKA with a mean follow-up of 11.0 years. HSS, KSS, WOMAC, and SF-12 questionnaires were used for clinical evaluation. Mechanical alignment, implant radiological measurements, and outliers were analyzed for radiological results. Kaplan-Meier survival analysis was performed for survival rate.Results: All clinical assessments showed excellent improvements in both groups (all p < 0.05), without any significant difference between the groups (p > 0.05). The conventional TKA group showed a significantly higher number of outliers compared with the robotic TKA group (0 < 0.05). The cumulative survival rate was 98.8% in the robotic TKA group and 98.5% in the conventional TKA group with excellent survival (p = 0.563).Conclusion: Our study showed excellent survival with both robotic and conventional TKA and similar clinical outcomes at long-term follow-up. And, in terms of radiological outcome, robotic TKA showed better accuracy and consistency with fewer outliers compared with conventional TKA. With longer follow-up and larger cohort, the accuracy and effectiveness of robotic TKA on implant survival rate can be elucidated in the future. [ABSTRACT FROM AUTHOR]

Purpose: We investigated the late outcomes of patients who underwent manual aspiration thrombectomy for acute massive pulmonary thromboembolism. Materials and methods: Fifteen patients underwent manual aspiration thrombectomy between December 1995 and June 2002. All patients were discharged after the procedure. Patients' statuses were checked by medical record examinations and telephone interviews. The median follow-up was 162 months (116–208 months). Results: Five patients died during follow-up; two for malignancy, one for septic shock, one for cerebral infarction, and in one patient the cause of death was unknown. There were no pulmonary thromboembolism-related deaths during the period and no recurrence. The 1-year survival rate was 100%, the 5-year survival rate was 75.0 ± 12.5%, and the 10-year survival rate was 75.0 ± 12.5%. Conclusion: Patients who undergo manual aspiration thrombectomy for acute massive pulmonary thromboembolism show acceptable outcomes. [ABSTRACT FROM AUTHOR]

Background: Laparoscopic sleeve gastrectomy (LSG) is considered a primary bariatric surgery and is increasingly being performed worldwide; however, long-term data regarding the durability of this procedure are inadequate. Here, we report the long-term results of LSGs in comparison to those of gastric bypass surgeries. Methods: A prospectively collected bariatric database from Ming-Shen General Hospital was retrospectively studied. Five hundred nineteen morbidly obese patients (mean age 36.0 ± 9.1 years old (14-71), 74.6 % female, mean body mass index (BMI) 37.5 ± 6.1 kg/m) underwent LSG as a primary bariatric procedure from 2006 to 2012 at our institute. The operative parameters, weight loss, laboratory data, and quality of life were followed. Another two matched groups of laparoscopic Roux-en-Y gastric bypass (RYGB) and laparoscopic single anastomosis (mini-) gastric bypass (SAGB) patients who were matched in terms of age, sex, and BMI were recruited for comparisons. Results: The mean surgical time for LSG was 113.5 ± 31.3 min, and the mean blood loss was 49.1 + 100.9 ml. The rate of major complications was 1.6 %, and the average length of the postoperative stay was 3.0 ± 1.7 days. The operation times of the RYGB patients were longer than those of both the LSG and SAGB patients. The RYGB and SAGB patients experienced higher major complication rate than the LSG patients. The weight loss of the LSG patient at 5 years was 28.3 + 8.9 %, and the mean BMI was 27.1 + 4.3. The RYGB patients exhibited a 5-year weight loss similar to the LSG patients, and the SAGB patients exhibited greater weight loss than both of the other groups. Both the RYGB and SAGB patients exhibited significantly better glycemic control and lower blood lipids than the LSG patients, but the LSG patients exhibited a lesser micronutrient deficiency than the RYGB and SAGB groups. All three of the groups exhibited improved quality of life at 5 years after surgery, and there was no significant between-group difference in this measure. Conclusions: LSG appears to be an ideal bariatric surgery, and the efficacy of this surgery is not inferior to that of gastric bypass. [ABSTRACT FROM AUTHOR]

Purpose: It has been reported that even one year after total knee arthroplasty (TKA), a relevant percentage of patients does not attain complete recovery and indicate unfavourable long-term pain outcome. We compared the clinical outcome of 33 patients undergoing TKA randomly assigned to the control or the pulsed electromagnetic field group (I-ONE therapy). Methods: I-ONE therapy was administered postoperatively four hours per day for 60 days. Patients were assessed before surgery and then at one, two and six months postoperatively using international scores. Results: One month after TKA, pain, knee swelling and functional score were significantly better in the treated compared with the control group. Pain was still significantly lower in the treated group at the six month follow-up. Three years after surgery, severe pain and occasional walking limitations were reported in a significantly lower number of patients in the treated group. Conclusions: Advantages deriving from early control of joint inflammation may explain the maintenance of results at follow-up. I-ONE therapy should be considered an effective completion of the TKA procedure. [ABSTRACT FROM AUTHOR]

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Copyright of Obere Extremitat is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Despite it being a benign disease, a choledochal cyst must be removed with the gallbladder (GB) due to the risk of cancer in the biliary tract. Most patients are young females or children, all of whom express strong interest in the cosmetic results in addition to the complete resolution of their medical problems. Here, we introduce a laparoscopic management technique for a choledochal cyst. Methods: Between 2003 and 2011, we performed a laparoscopic choledochal cyst excision procedure on 82 patients using a four-hole method. There were three open-conversion cases, one case involving robotic surgery, and one case involving combined laparoscopic liver resection because the cyst had affected the liver. Excision of the cyst and anastomosis were performed laparoscopically. We will present our method with a video. Results: The mean operation time was 230 min. The estimated blood loss was 197 ml. The average hospital stay was 8.6 days. The most common complications were minor bile leakage (7 %) and fluid collection (2.5 %), both of which were managed conservatively. Conclusions: Laparoscopic management can be a treatment of choice for the most instances of choledochal cyst considering its good cosmetic results and its feasible level of operative safety. [ABSTRACT FROM AUTHOR]

The concept of tissue engineered small-caliber vascular grafts (TE-SCVGs) is theoretically ideal. In this study, we evaluated the long-term (more than 1 year) course of TE-SCVGs using a rat carotid arterial replacement model. We fabricated a TE-SCVG scaffold (0.7 mm in diameter) with electrospun nano-scale fibers. Poly-ε-caprolactone was used as a biodegradable polymer. These artificial vessels were then used in carotid arterial replacement performed on Sprague-Dawley rats. The implanted grafts were removed at an early phase (1, 2, 6 weeks), middle phase (12, 24 weeks), and late phase (48, 72 weeks) after implantation. Twenty-nine patent grafts from among the 40 implanted grafts (patency 72.5 %) could be evaluated. No aneurysm formation was observed during the follow-up period. Endothelial cells positive for immunostaining with von Willebrand factor were found to be already attached to the inner surface of the TE-SCVGs in the early phase. The percentage of smooth muscle cell specific marker (α-smooth muscle actin and calponin with fluorescent immunostaining) positive cells, which seemed to be mesenchymal cells in the graft wall, increased with time, while, in contrast, the scaffold material decreased. Even after 72 weeks, however, although the scaffold material had degraded, it had not disappeared completely. These results show that the novel TE-SCVGs we developed were still functioning in the rat carotid arterial circulation after more than 1 year. However, further investigations will be required with regard to regeneration of the SMC layer and the complete degradation of graft materials. [ABSTRACT FROM AUTHOR]

The aim of this study was to determine the long-term prognoses for conservatively treated fractures of the scapula. Ascertainment of functional long-term results in 50 patients treated for a total of 51 scapular fractures in a retrospective cohort study with an average follow-up period of 65 months. The breakdown of these scapular fractures was as follows: simple (22%) and fragmented (51%) fractures of the scapular body, fractures through the scapular neck (41%), fractures of the coracoid process, spine and acromion of the scapula (10%) and glenoid fractures (8%). In 17 of these cases of scapular fracture two or more types were present. At the follow-up examination a restricted range of movement was found in all directions. In abduction, flexion and external rotation the range of motion on the affected as against the unaffected side was significantly restricted, but the observed restriction did not substantially affect the functional results. The Constant score on the affected side was 79 points, with 23% very good, 51% good, 20% satisfactory and 6% poor results. Isokinetic testing carried out on both sides for comparison revealed lower peak torque values and lower mean power output in all planes of movement, and lower speeds on the affected side. There was a correlation between extent of restriction on movement and diminution of isokinetic muscular strength. Determination of the external rotation is recommended as a clinical test value, as it highlights significant deficits both in restriction of range of motion and in isokinetic test measurements. The outcome of treatment was not influenced by fracture type, associated injuries or handedness. After conservative treatment, scapular fractures heal with a good functional result despite measurable restrictions. [ABSTRACT FROM AUTHOR]

The depth of tumor penetration is a crucial factor in determining the prognosis of patients with esophageal carcinoma. Patients with superficial esophageal carcinoma (SEC) have a far more favorable clinical course compared with those with advanced cancers. The outcome for patients with mucosal cancer is excellent with a 5-year survival rate exceeding 80%. On the other hand, submucosal cancer often metastasizes to regional and/or distant lymph nodes or other organs, and the prognosis of these patients are far from satisfactory. Among 334 patients with esophageal cancer who underwent surgery between December 1980 and December 2006, 100 patients (30%) had SEC confined to the epithelium, lamina propria mucosa, or submucosa. Patient and tumor characteristics of those 100 patients were studied. The prevalence of SEC has increased from 13% (8 of 61) in the initial 5-year period (1985–1989) to 44% (41 of 93) in the recent 7-year period (2000–2006). Subjective symptoms were present in 7 (14%) of 51 mucosal cancers and in 13 (27%) of 49 submucosal cancers. The remaining 80 patients (80%) had no subjective symptoms. Ninety-one patients (91%) were diagnosed to have the lesions by endoscopy at the time of screening for gastric problems, and only nine were detected by gastrointestinal series. Four of 51 patients with mucosal cancer had venous or lymph vessel invasion, and among those, only one (2%) had a solitary perigastric lymph node metastasis. In 49 patients with submucosal cancer, 35 (71%) had lymph vessel invasion, 28 (57%) had venous invasion, and 16 (33%) had lymph node metastases. In particular, 15 of 35 patients with positive lymph vessel invasion had lymph node metastasis, whereas only 1 of 14 with negative lymph vessel invasion had lymph node metastasis ( P < .05). Among 17 patients with nodal involvement, 4 patients with upper thoracic SEC had upper mediastinum and/or cervical nodal metastases, 11 patients with middle thoracic SEC had widespread upper and lower mediastinal and abdominal metastases, and 2 patients with lower thoracic SEC had lower and abdominal lymph node metastases. Seventy-nine patients were alive without recurrence at last follow-up. Five of 49 patients with submucosal cancer died of recurrent disease, and 4 of these developed regional nodal recurrence around the bilateral laryngeal recurrent nerves. Forty-two patients (42%) developed double cancers during the follow-up period, and 5 died of a second cancer. The 3- and 5-year survival rates of all 100 patients were 85% and 73%, and those disease-specific survival rates were 96% and 93%, respectively. The 3- and 5-year survival rates for patients with mucosal cancer were 89% and 83%, and those for submucosal cancer were 80%, and 64%, respectively. Esophagectomy with extensive lymphadenectomy should be carried out particularly for upper thoracic submucosal cancer, whereas esophagectomy with moderate lymphadenectomy may be preferred for mucosal cancer. Patients with SEC should be examined for another primary cancer preoperatively and periodically during follow-up. [ABSTRACT FROM AUTHOR]

The long-term results of pilon fractures are rarely documented. The present study evaluated the long-term results related to each fracture pattern of a pilon fracture treated with open reduction and plating. One hundred and twenty-eight pilon fractures with a mean 10-year follow-up were divided into three groups, based on the Ruedi-Allgower classification. Group A was composed of 39 patients with Ruedi-Allgower type I fractures; group B comprised 62 patients with type II fractures; and group C included 27 patients with type III fractures. The radiographs were reviewed for adequacy of fracture reduction and posttraumatic arthrosis. At the end of follow-up, the clinical results were evaluated using a rating scale. Group C had significantly lower excellent and good reduction rates than group A or B ( P < 0.05). Groups B and C had progressively increased ankle arthrosis with time ( P = 0.043, P = 0.049, respectively). Group C had more unsatisfactory clinical outcomes than group A or B ( P < 0.05). Operative concurrent fixation of the fractured fibula resulted in a better outcome than non-operative treatment ( P < 0.05). Open fractures had significantly lower satisfactory outcomes than closed fractures (60.5% versus 78.9%, P < 0.05). Open reduction with plating was a reasonably effective procedure for the treatment of Ruedi type I pilon fractures. The long-term outcome of pilon fractures was affected by fracture patterns, fibular length restoration, quality of reduction, and severity of soft tissue injury. Posttraumatic arthrosis affecting the ankle after a severe pilon fracture (Ruedi type II or III) was a progressive disease, and required long-term follow-up. [ABSTRACT FROM AUTHOR]

Objective: This paper describes the long-term results of endoluminal grafting (EG) for the treatment of descending thoracic aortic aneurysms (dTAA). Methods: Until July 2004, EG for dTAA has been applied in 45 cases (male/female, 29/16, 49–86 years old, mean age 67 years old). Locations included the proximal dTAA in 24 cases, and middle or distal dTAA in 21 cases. The stent-grafts (SGs) were constructed of Gianturco Z-stents covered with woven polyester grafts. Results: Deployment of the SGs was successful in 43 of 45 cases (96%) and complete thrombosis of the aneurysm was achieved in 39 cases (87%). Six minor endoleaks (13%), one migration (2%) and one conversion to surgery (2%) occurred. There was no instance of paraplegia nor hospital death. Over a mean 48 month follow-up (range 3 to 90), there were three persistent endoleaks (6%), four secondary endoleaks (8%), one breakage of wire frame (2%). Four cases were converted to open surgery due to secondary endoleak. There were two aneurysmal ruptures at the site where EG was not performed. The cumulative survival rate was 95.6±4.4% at 12 months, 85.7±5.4% at 24 months, and 82.4±6.1% at 36 and 60 months. Conclusion: These results demonstrated that EG is safe and effective in selected dTAA patients. Improvements in patients selection, surgical techniques and equipment will reduce EG related complications and conversion to open repair over the course of the evaluation. [ABSTRACT FROM AUTHOR]

It remains controversial whether biological or mechanical prostheses in the tricuspid position give better long-term results. The clinical advantage of mechanical prostheses is evaluated in this article. Our subjects were 25 consecutive patients who underwent tricuspid valve replacement (TVR) from January 1985. Five patients underwent TVR with mechanical prostheses (MP), and 20 patients had bioprostheses (BP). The mean age of the patients was 50.8 ± 15.9 years for those with MP and 50.2 ± 11.5 years old for those with BP. The preoperative New York Heart Association (NYHA) functional classification was 3.5 for those with MP and 3.1 for BP. The mean follow-up period was 5.05 ± 2.05 years for MP, ranging from 3 to 7 years, and 7.2 ± 5.6 years for BP, ranging from 1 to 12 years. No operative mortality occurred, but there was a single hospital death in a patient with BP due to sepsis after acute postoperative cholecystitis. One patient with BP suffered from neurological deficiencies. Long-term temporary cardiac pacing was required in one patient with MP and three with BP. A permanent cardiac pacemaker was implanted in one patient with BP. There was one late death in the MP group and three late deaths in the BP group. The actuarial survival rates at 5 and 7 years after surgery were 80% and 80%, respectively, for MP and 88% and 88% for BP. There was one embolic episode, a minor stroke, in the BP group. Four patients with BP had valvular dysfunction at 3, 8, 9, and 10 years after surgery, and two of these required re-TVR. Among BP patients, 93% were free from prostheses dysfunction at 5 years after surgery, and 78% were free from dysfunction after 10 years; all patients (100%) with MP were free from dysfunction at 7 years. This study suggests that TVR with MP shows no late complications and with careful anticoagulant therapy provides highly satisfactory follow-up results. [ABSTRACT FROM AUTHOR]

Background. Esophageal cancer is one of the most malignant tumors, with a dismal prognosis in spite of recent advances in early diagnosis and extended lymphadenectomy. These patients need to be stratified according to prognostic variables for precise identification of high-risk group. Material and methods. Seventy-six patients with esophageal carcinoma were uniformly treated with curative intent between 1980 and 1992 with at least 6 years follow-up. Results and prognostic factors of long-term survival were analyzed by univariate and multivariate analyses. Results. Thirty patients (39.5%) survived 6 years, and the remaining 46 patients died within 6 years: recurrent esophageal cancer in 27 and causes unrelated to esophageal cancer in 19. The 1-, 2-, 3-, and 6-year overall survival rates in all 76 patients were 77.6%, 57.9%, 53.9%, and 39.5%, respectively. The factors influencing survival rate verified by univariate analysis were Borrmann classification (0, 1 vs. 2, 3), size of tumor (≤3.0 vs. >3.0 cm), depth of invasion (T1, 2 vs. T3, 4), pN category (pN0 vs. pN1), number of lymph node metastasis (≤4vs. >4), metastatic lymph node ratio (≤0.1 vs. >0.1), time of operation (≤480 vs. >480 min), and amount of perioperative blood transfusion given (≤2 vs. >2 U). Among the significant variables independent prognostic factors for survival determined by multivariate analysis were metastatic lymph node ratio and amount of blood transfusion. Conclusions. A significant number of patients can thus apparently be cured of esophageal carcinoma by extensive resection. Patients with many metastatic lymph nodes and much blood transfusion, on the other hand, should receive appropriate treatment against such esophageal carcinoma. [ABSTRACT FROM AUTHOR]

Copyright of Arthroskopie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

From 1982 through 1992, 103 patients (mean age: 69 years) underwent an elective repair of an abdominal aortic aneurysm (AAA) at our institution. One or more postoperative complications occurred in 30 patients (29%), with a mortality rate of 1.9%. Factors which were found to be significantly associated with postoperative complications based on an univariate analysis included male sex (P = 0.0082), operation time (P = 0.0006), the size of the aneurysm ( P = 0.0045), the amount of blood loss during operation ( P = 0.0037), poor lung function ( P = 0.0155), and the platelet count (P = 0.0468),. A simple linear regression analysis showed that there were significant correlations among the AAA size, the duration of operation and the amount of blood loss. The age at operation, however, did not influence morbidity or mortality. Complete survival information was obtained in 96 (95%) patients, while the influence of preoperative risk factors on late survival was also examined by the Kaplan-Meier method. The factors influencing long-term survival were determined to be renal dysfunction and age at the time of operation. [ABSTRACT FROM AUTHOR]

Copyright of Langenbecks Archiv fuer Chirurgie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Choledochal cyst is generally accompanied by pancreatobiliary malunion. Pancreatic juice usually refluxes into the bile duct via the malunion, and bile juice occasionally regurgitates into the pancreatic duct. As a result, various pathological conditions occur in the biliary tract, pancreas, and liver. We have revised our classification of choledochal cyst on the basis of malunion. Abdominal mass, pain, and jaundice are regarded as the triad of choledochal cysts, but symptoms are quite non-specific. In neonates and infants less than 12 months of age, choledochal cyst is usually huge and no cylindrical dilatation is observed. Vomiting and jaundice with acholic stool are often observed. No hyperamylasemia is seen, despite the presence of a malunion. Whereas children over 13 months of age tend to show diffuse dilatation, and an abdominal mass is rarely palpable. Epigastralgia with hyperamylasemia, fever, vomiting, and slight jaundice are often observed. Cyst excision is the treatment of choice to prevent the development of ascending cholangitis and cancer in the cyst. Late complications of excisional surgery include recurrent cholangitis, pancreatitis, and rarely, biliary malignancy. These complications usually develop 5 years or more after initial surgery and become the object of reoperation. Complete removal of the extrahepatic bile duct from the hepatic hilum to the intrapancreatic duct and a hilar hepaticoenterostomy with wide anastomosis after ductoplasty, including the coexisting primary stricture, are essential at the primary surgery. Provided a large anastomosis, favorable results can be obtained with either duodenostomy or Roux-Y jejunostomy. Surgical enlargement of the hilar ducts and careful lifelong follow-up should be routine in all patients who have undergone cyst excision. When ductal stricture with intrahepatic gallstones is confirmed, reoperation at an early stage is indicated to obtain a good quality of life with short hospitalization. [ABSTRACT FROM AUTHOR]

Between March 1977 and December 1984, 103 Blalock-Taussig shunts were performed on 88 patients. Included in this study were 40 patients who underwent the modified BT shunt and 63 patients who underwent the classical BT shunt. 13 of the modified BT shunts (33 per cent) and 18 of the classical BT shunts (29 per cent) were performed during infancy and 10 of the modified BT shunts (25 per cent) were performed on patients under the age of 3 months. EPTFE grafts of varying sizes were used in the patients who underwent modified BT shunts-4 mm in 14 cases, 5 mm in 15 cases and 6 mm in 11 cases, respectively. The early mortality rate was 11 per cent (3 deaths) in the group who had modified BT shunts and 8 per cent (5 deaths) in the group who had classical BT shunts. Over a follow-up period of 6 years, 6 shunt failures were diagnosed in the modified BTS group by auscultation and/or angiographic study, and during a follow-up period of 8 years, 12 shunt failures were diagnosed in the classical BTS group. The patency rate 3 years after surgery was 88.8 per cent in the modified BTS group and 78.0 per cent in the classical BTS group. The patency rate 5 years after surgery was 88.8 per cent in the modified BTS group and 75 per cent in the classical BTS group. No significant differences were noted in the patency rates between the modified and classical BTS groups during the period of 5 years' follow-up, however, the former patency rate does appear to be slightly superior to the latter. This study confirms that where an EPTFE graft of larger than 5 mm in diameter was used, the modified BT shunt is the procedure of choice as a palliative treatment in patients with cyanotic congenital heart defects who will only be able to have corrective surgery several years later. [ABSTRACT FROM AUTHOR]

Patients who underwent gastric cancer surgery in our clinic during a 12-year period from 1960-1971 were divided into two groups. Group A is comprised of patients who were treated in the first, and group B of patients treated in the second half of this 12-year period and the short- and long-term results were evaluated and compared for both groups. We discovered that both short- and long-term results were better in group B than in group A. Group B contained more cases of histologically early cancer stages and extensive lymph node resection was performed more frequently in group B than in group A. These factors may account for the better results obtained for group B. In addition, performance of gastrectomy combined with the resection of other neighboring organs may have effected the better long-term results observed in group B. [ABSTRACT FROM AUTHOR]

We encountered two cases of ruptured anastomotic pseudoaneurysms 47 and 77 months after surgery for atherosclerotic thoracic aortic aneurysms. Autopsy was performed in one case and emergency re-operation was performed in the other case. We gained some interesting findings in the autopsy and the re-operation. The anastomotic sites were sustained by sutures only, and there was no evidence of tissue supplementation at the anastomotic sites in macroscopic observation. Microscopic findings demonstrated endothelium healing on the internal side of the prosthesis near the anastomotic site. There was no tissue connection between the prostheses and the native aortic walls, although over four or six years had passed after the previous anastomoses. Anastomotic pseudoaneurysms may occur even in a long time after surgery. Careful operative procedures and long-term computed tomography or magnetic resonance imaging follow-up are crucial. [ABSTRACT FROM AUTHOR]