Intensive Postoperative Follow-up Research Articles

Benefits of arterial reconstruction in claudication.

We conducted a midterm follow-up of 150 claudicants who underwent surgical reconstruction by assessing cumulative patency, survival, and palliation (graft patency in live patients) rates. Eighty-nine claudicants (group I) underwent direct (in situ) proximal revascularization, 33 (group II) had indirect (ex situ) proximal revascularization, while 28 (group III) had distal revascularization. The secondary patency rates at 3 years were 97.5% in group I, 97.0% in group II, and 75.0% in group III, respectively. Only one patient with limb graft thrombosis required below-knee amputation. There were 3 perioperative deaths (2 in group I and 1 in group II). The survival rates at 3 years were 86.0% in group I, 69.5% in group II, and 95.8% in group III, respectively. The palliation rates at 3 years were 84.8% in group I, 70.0% in group II, and 77.9% in group III, respectively. These findings indicate the midterm benefits of supra- and infrainguinal arterial reconstructions, and also suggest that the preoperative assessment of risks in individual patients, the selection of the appropriate operative procedure and graft material, and intensive postoperative follow-up and management of any associated disease are all important aspects in the treatment of claudicants.

Gastroesophageal reflux

The incidence of recurrent reflux is higher than suggested by current reports and will increase when intensive postoperative follow-up becomes routine practice. The designs of all antireflux procedures need critical study and revision. The investigation and management of recurrent reflux demands far more attention than it has received in the past.

Current management of strabismus in childhood

Summary The essential points in diagnosis of strabismus have been reviewed. The reasons for early diagnosis and treatment have been stressed. Current concepts in the treatment of amblyopia are elaborated, and intensive and early therapy is recommended. In nonsurgical management the use of miotics is discussed. Preoperative orthoptics and its limitations are considered. Changing concepts in the advisability of operating during the 3–6 year age group have been reviewed. Intensive postoperative follow-up is necessary to produce functional as well as cosmetically acceptable results.