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DerAnaesthesist.90480802.eng.abstr
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DerAnaesthesist.90480802.eng.abstr
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"Background : To evaluate the publication rate of abstracts presented during the German Anaesthesia Congress ( DAK ) in MEDLINE-listed journals in comparison to the publication rate of abstracts presented during the meeting of the European Society of Anaesthesiologists ( ESA ) ."
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[] |
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DerAnaesthesist.90480807.eng.abstr
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DerAnaesthesist.90480807.eng.abstr
|
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"Objective : This study was designed to investigate the differences between TIVA with propofol/remifentanil ( P/R ) and balanced anaesthesia with sevoflurane/fentanyl ( S/F ) in gynaecological laparoscopic surgery . Emphasis was put on haemodynamic reaction , recovery profile , postoperative side effects and patient satisfaction ."
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DerAnaesthesist.90480813.eng.abstr
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DerAnaesthesist.90480813.eng.abstr
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"Preoperative starvation in order to prevent pulmonary aspiration is mandatory in elective pediatric surgery . Hypoglycemia , thirst and unwellness have been reported as undesired side effects . The metabolic response towards decreasing blood-glucose concentrations in fasting children includes gluconeogenesis and production of ketone bodys to meet the energetic demand . Accumulation of -hydroxybutyrate und acetoacetate in blood can lead to ketoacidosis . We report a case of a severe intraoperative ketoacidosis in a fourteen months old child complicating 36 hours of starvation ."
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DerAnaesthesist.90480858.eng.abstr
|
DerAnaesthesist.90480858.eng.abstr
|
[
{
"id": "DerAnaesthesist.90480858.eng.abstr-passage-0",
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"text": [
"Stroke is the third leading cause of death and number one cause of disability in industrialised countries . Studies into the pathophysiology of acute ischaemic stroke have indicated that treatment options are likely to be optimized when early signs of stroke are recognized and treatment is initiated within 3 hours from symptom onset . Therefore , new conceptions heading towards early diagnosis , fast preclinical treatment , structured diagnostics , immediate initiation of acute therapy as well as early initiation of rehabilitation are required . It is well known that , for most patients , there is a long delay between the onset of symptoms and the start of therapy . Many factors are responsible for the time delay : signs and symptoms often go unrecognized and/or minimized by patients , relatives and bystanders . Unlike trauma or myocardial infarction , stroke is not given a high priority by medical staff and/or emergency medical services ( EMS ) . Although a small number of strike patients is treated as emergency and attended to by the emergency medical services within this time window , this number could easily be increased by intensified public and emergency personnel education . At present the standard of care by the EMS personnel includes adequate cerebral oxygenation , treatment of cardiac arrhythmia , management of hypertension as well as therapy of hyperglycemia and hyperthermia . For the future , we hope that emergency medical services will be able to initiate therapies which must be administered within the first few hours of acute stroke after onset of symptoms . Early notification of hospitals would enable a particular stroke team to be present at the patient's admission ."
],
"offsets": [
[
0,
1711
]
]
}
] |
[
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],
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0,
6
]
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DerAnaesthesist.90480871.eng.abstr
|
DerAnaesthesist.90480871.eng.abstr
|
[
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],
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[
0,
244
]
]
}
] |
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DerAnaesthesist.90480876.eng.abstr
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DerAnaesthesist.90480876.eng.abstr
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DerAnaesthesist.90480884.eng.abstr
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DerAnaesthesist.90480884.eng.abstr
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DerAnaesthesist.90480896.eng.abstr
|
DerAnaesthesist.90480896.eng.abstr
|
[
{
"id": "DerAnaesthesist.90480896.eng.abstr-passage-0",
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"text": [
"In a 65 years old male patient 38 cc of a 7.45% potassium chloride-solution was inadvertently infused within 3 hours into an epidural catheter on the first postoperative day . The epidural potassium chloride administration resulted in a paresis and painful paraesthesia of the patient's legs and a level of sensory blockade to TH 11. Furthermore vegetative symptoms like hypertension and tachycardia were observed . For therapy a single bolus of 40 mg dexamethasone was administered intravenously followed by an epidural infusion of sodiumchloride 0,9% 99 cc/h for several hours . About 6 hours after the start of infusion all symptoms had disappeared . It is proposed that the use of colour-coded epidural catheter devices and coloured electrolyte solutions as well as infusion-pumps with a larger reservoir that reduce the frequency of syringe changes would be helpful in avoiding such complications ."
],
"offsets": [
[
0,
903
]
]
}
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[] |
[] |
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] |
DerAnaesthesist.90480900.eng.abstr
|
DerAnaesthesist.90480900.eng.abstr
|
[
{
"id": "DerAnaesthesist.90480900.eng.abstr-passage-0",
"type": "abstract",
"text": [
"We report a complication during the insertion time of a central venous catheter in a patient with intracerebral bleeding . This complication was caused by an inadvertent dislocation of a subclavian catheter . Hydromediastinum and bilateral hydrothorax developed . There was a clear diagnosis followed by removal of the central venous catheter after radiological investigations could explain the cause of the complication and the clinical symptoms . In the course of events mediastinitis was diagnosed . The clinical condition improved under antibiotic therapy . The patient could be transferred to another clinical unit for endovascular treatment of an arterio-venous cerebral malformation ."
],
"offsets": [
[
0,
691
]
]
}
] |
[
{
"id": "DerAnaesthesist.90480900.eng.abstr-s1-t1",
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"text": [
"complication"
],
"offsets": [
[
12,
24
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0009566"
}
]
},
{
"id": "DerAnaesthesist.90480900.eng.abstr-s1-t2",
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"text": [
"time"
],
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[
46,
50
]
],
"normalized": [
{
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}
]
},
{
"id": "DerAnaesthesist.90480900.eng.abstr-s1-t3",
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"text": [
"catheter"
],
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[
71,
79
]
],
"normalized": [
{
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"db_id": "C0085590"
}
]
},
{
"id": "DerAnaesthesist.90480900.eng.abstr-s1-t4",
"type": "umlsterm",
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"patient"
],
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[
85,
92
]
],
"normalized": [
{
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},
{
"id": "DerAnaesthesist.90480900.eng.abstr-s2-t1",
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],
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128,
140
]
],
"normalized": [
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[] |
[] |
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DerChirurg.00710001.eng.abstr
|
DerChirurg.00710001.eng.abstr
|
[
{
"id": "DerChirurg.00710001.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Echinococcus multilocularis , a small tapeworm in foxes , has gained considerable public attention owing to its wide distribution in central Europe . Conversely , diagnosis and treatment of the disease have been significantly improved in recent years . Consequently , the incidence among human populations has remained stable and relatively low for many decades . In southern Germany , France ( Franche Comté and Doubs ) , Austria and Switzerland , the annual incidence ranges between 0.02 and 1.4 new cases per 100,000 inhabitants . The relevance of human AE refers to the high lethality of the untreated disease . Therapy consists predominantly of radical surgery followed by continuous , long-term chemotherapy using albendazole ( or mebendazole ) . The action of chemotherapy alone is parasitostatic rather than parasitocidal ; nevertheless , clinical improvement is observed in > 80 % of such cases , including a significantly improved prognosis . Diagnosis relies predominantly on imaging procedures and serology . Immunodiagnosis must be performed early , especially when a preclinical diagnosis is desired upon exposure to infection . Thus , in the framework of seroepidemiological studies , first-time evidence was obtained about the phenomenon of natural resistance in non-diseased persons . This raised the question of a potential immunogenetic predisposition in certain infected persons . E. granulosus ( cystic hydatid disease ) is practically non-existent as autochthonous infection in central Europe now . Most clinical cases of E. granulosus infections are thus observed among persons who have immigrated from - predominantly - the mediterranean basin ."
],
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DerChirurg.00710009.eng.abstr
|
DerChirurg.00710009.eng.abstr
|
[
{
"id": "DerChirurg.00710009.eng.abstr-passage-0",
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"text": [
"An overview is presented of the various therapy options in cystic and alveolar echinococcosis based on the recent literature and upon personal experience with chemotherapy over the last 20 years . In regions with an optimal surgical infrastructure and relatively small patient cohorts , long-term chemotherapy is practically limited to patients with inoperable echinococcosis , i . e . 10 % cystic and around 70 % alveolar echinococcosis ."
],
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0,
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}
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[] |
[] |
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DerChirurg.00710021.eng.abstr
|
DerChirurg.00710021.eng.abstr
|
[
{
"id": "DerChirurg.00710021.eng.abstr-passage-0",
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"Hydatid disease , still frequent in endemic areas , is usually localized in the liver . Despite the benign nature of the disease it is one of the problematic fields of surgery due to the high complication rate and long hospital stay . Based on our experience we recommend evacuation of the cyst and omentoplasty as the surgical method of choice , as it is associated with a relatively low incidence of complications and can be performed easily ."
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0,
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] |
[] |
[] |
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DerChirurg.00710030.eng.abstr
|
DerChirurg.00710030.eng.abstr
|
[
{
"id": "DerChirurg.00710030.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Inflammatory bowel diseases ( IBD : Crohn's disease , ulcerative colitis ) are chronic inflammatory and frequently relapsing diseases of the gut that ultimately lead to destruction of the intestinal tissue . Recent evidence suggests that a pathologic activation of the mucosal immune system in response to antigens is a key factor in the pathogenesis of IBD . Furthermore , changes in cell migration and cytokine production appear to contribute to the perpetuation of IBD and the postoperative recurrence of Crohn's disease . Based on recent advances in our understanding of the pathogenesis of IBD , several new therapeutic strategies are currently being tested in clinical practice , including recombinant anti-inflammatory cytokines ( IFN- , IL-10, IL-11) and inhibitors of cell adhesion molecules ( ICAM ) , proinflammatory cytokines ( TNF , IL-12) and their receptors ( TNF , IL-6R)."
],
"offsets": [
[
0,
888
]
]
}
] |
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] |
DerChirurg.00710043.eng.abstr
|
DerChirurg.00710043.eng.abstr
|
[
{
"id": "DerChirurg.00710043.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The widespread use of alloplastic materials as the standard procedure for hernia repair makes an evaluation of the long-term integration of these implants imperative . A total of 121 explanted meshes ( mean implantation time 23.2 & 19.7 months ) of polypropylene ( Atrium , n = 20 ; Marlex , n = 50 ; Prolene , n = 21 ) , Polyester ( Mersilene , n = 19 ) and PTFE ( Gore-Tex , n = 11 ) were analyzed in regard to the tissue and cell response within the interface mesh-fiber/tissue . The mesh samples were investigated by light and electronmicroscopy , as well as immunohistochemistry . The morphometric results confirmed a persisting inflammatory proliferative foreign-body reaction with increased cell turnover in the recipient tissues . This reaction is mainly influenced by the selected mesh modification . The consequences of the arising \" chronic wound \" are discussed in detail , in particular with regard to possible malignant transformation ."
],
"offsets": [
[
0,
950
]
]
}
] |
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"procedure"
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"hernia"
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"id": "DerChirurg.00710043.eng.abstr-s2-t3",
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"polypropylene"
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"id": "DerChirurg.00710043.eng.abstr-s2-t9",
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"turnover"
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] |
[] |
[] |
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] |
DerChirurg.00710052.eng.abstr
|
DerChirurg.00710052.eng.abstr
|
[
{
"id": "DerChirurg.00710052.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Objective : The aim of this randomized controlled study was to show whether local anesthesia ( LA ) leads to a decrease of postoperative pain in inguinal hernia repair in comparison with general anesthesia ( AA ) . Method : Sixty volunteer patients were randomly assigned into a LA group and an AA group . All patients had an unilateral primary inguinal hernia and underwent inguinal hernia repair ( Shouldice technique ) . Methods to determine pain were the visual analog scale ( VAS ) , peak flow measurement , the measurement of the FEV1 % , and analgesic consumption . Results : Up to the third postoperative day we measured a decreased pain level in the LA group . The anesthesia procedure was never changed . No essential complications occurred . Conclusion : Therefore , it was concluded that local anesthesia has more advantages than general anesthesia ."
],
"offsets": [
[
0,
862
]
]
}
] |
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] |
DerChirurg.00710058.eng.abstr
|
DerChirurg.00710058.eng.abstr
|
[
{
"id": "DerChirurg.00710058.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Introduction : The extremely rare but life-threatening hypercalcemic crisis is caused by an exacerbation of a chronic hyperparathyroidism . The etiologic reasons for this exacerbation are conditions which increase the serum calcium level in addition to the hyperparathyroidism with a complete breakdown of the calcium homeostasis , e . g . malignant tumors , primary and tertiary hyperparathyroidism , vitamin D poisoning or overdoses of calcium , vitamin D and calcium-containing ionizer in patients with renal insufficiency . Methods : We present the clinical course of five patients with an acute hypercalcemic crisis and discuss the diagnostic procedure and the principles of surgical treatment with regard to the current literature . Results : A hypercalcemic crisis develops if the total serum calcium concentration is over 4 mmol/l and parathormone over 90 pmol/l . The resulting syndrome is manifested by nausea and vomiting , polyuria and consecutive dehydration and hypotonia culminating in lethargy , hallucinations and coma . Hypercalcemia is the single most important diagnostic finding . Conclusion : The emergency therapy predominantly consists on the one hand in rehydration and parallel stimulation of diuresis . Urgent surgery is required if conservative therapy is not successful ."
],
"offsets": [
[
0,
1300
]
]
}
] |
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],
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137
]
],
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],
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{
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],
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],
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],
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[] |
[] |
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{
"id": "DerChirurg.00710058.eng.abstr-s7-r28-t7.1-t4.1",
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{
"id": "DerChirurg.00710058.eng.abstr-s8-r2-t4.1-t1.1",
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},
{
"id": "DerChirurg.00710058.eng.abstr-s8-r3-t1.1-t4.1",
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},
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"id": "DerChirurg.00710058.eng.abstr-s8-r4-t1.1-t2.1",
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"id": "DerChirurg.00710058.eng.abstr-s9-r3-t2.1-t4.1",
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},
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"id": "DerChirurg.00710058.eng.abstr-s10-r1-t2.2-t1.1",
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"id": "DerChirurg.00710058.eng.abstr-s10-r2-t2.1-t1.1",
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}
] |
DerChirurg.00710063.eng.abstr
|
DerChirurg.00710063.eng.abstr
|
[
{
"id": "DerChirurg.00710063.eng.abstr-passage-0",
"type": "abstract",
"text": [
"In the method described by Ciaglia et al. , the trachea is cannulated transcutaneously below the cricoid cartilage under bronchoscopic observation . For this purpose , a Seldinger wire with seven graduated dilatators is used for successive tracheal dilatation to 36 CH and insertion of an indwelling tracheal cannula . The disadvantage of this procedure is the time-consuming successive insertion of seven bougies and the repeated risk of injury to the dorsal tracheal wall . Percutaneous cannulization sets are expensive and cannot be re-sterilized . We developed a re-sterilizable , single-step bougienage device and tested the procedure successfully without any complications in 74 patients ."
],
"offsets": [
[
0,
695
]
]
}
] |
[
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],
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13
]
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}
]
},
{
"id": "DerChirurg.00710063.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"trachea"
],
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[
48,
55
]
],
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{
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"db_id": "C0040578"
}
]
},
{
"id": "DerChirurg.00710063.eng.abstr-s1-t3",
"type": "umlsterm",
"text": [
"cartilage"
],
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[
105,
114
]
],
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{
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}
]
},
{
"id": "DerChirurg.00710063.eng.abstr-s1-t4",
"type": "umlsterm",
"text": [
"observation"
],
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[
135,
146
]
],
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{
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"db_id": "C0302523"
}
]
},
{
"id": "DerChirurg.00710063.eng.abstr-s1-t5",
"type": "umlsterm",
"text": [
"cricoid cartilage"
],
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[
97,
114
]
],
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{
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"db_id": "C0010323"
}
]
},
{
"id": "DerChirurg.00710063.eng.abstr-s2-t1",
"type": "umlsterm",
"text": [
"Seldinger"
],
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[
170,
179
]
],
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{
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"db_id": "C0230779"
}
]
},
{
"id": "DerChirurg.00710063.eng.abstr-s2-t2",
"type": "umlsterm",
"text": [
"wire"
],
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[
180,
184
]
],
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{
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"db_id": "C0005978"
}
]
},
{
"id": "DerChirurg.00710063.eng.abstr-s2-t3",
"type": "umlsterm",
"text": [
"dilatation"
],
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[
249,
259
]
],
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{
"db_name": "UMLS",
"db_id": "C0012356"
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{
"db_name": "UMLS",
"db_id": "C0012359"
}
]
},
{
"id": "DerChirurg.00710063.eng.abstr-s2-t4",
"type": "umlsterm",
"text": [
"cannula"
],
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[
309,
316
]
],
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{
"db_name": "UMLS",
"db_id": "C0520453"
}
]
},
{
"id": "DerChirurg.00710063.eng.abstr-s3-t1",
"type": "umlsterm",
"text": [
"procedure"
],
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[
344,
353
]
],
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{
"db_name": "UMLS",
"db_id": "C0184661"
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}
]
},
{
"id": "DerChirurg.00710063.eng.abstr-s3-t2",
"type": "umlsterm",
"text": [
"risk"
],
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[
431,
435
]
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}
]
},
{
"id": "DerChirurg.00710063.eng.abstr-s3-t3",
"type": "umlsterm",
"text": [
"injury"
],
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[
439,
445
]
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{
"db_name": "UMLS",
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},
{
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"db_id": "C0021501"
}
]
},
{
"id": "DerChirurg.00710063.eng.abstr-s3-t4",
"type": "umlsterm",
"text": [
"risk of"
],
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[
431,
438
]
],
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{
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}
]
},
{
"id": "DerChirurg.00710063.eng.abstr-s4-t1",
"type": "umlsterm",
"text": [
"sets"
],
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[
503,
507
]
],
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{
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"db_id": "C0036849"
}
]
},
{
"id": "DerChirurg.00710063.eng.abstr-s5-t1",
"type": "umlsterm",
"text": [
"single-step"
],
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[
585,
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]
],
"normalized": [
{
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}
]
},
{
"id": "DerChirurg.00710063.eng.abstr-s5-t2",
"type": "umlsterm",
"text": [
"device"
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[
608,
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],
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]
},
{
"id": "DerChirurg.00710063.eng.abstr-s5-t3",
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],
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[
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}
]
},
{
"id": "DerChirurg.00710063.eng.abstr-s5-t4",
"type": "umlsterm",
"text": [
"complications"
],
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[
665,
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]
],
"normalized": [
{
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"db_id": "C0009566"
}
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},
{
"id": "DerChirurg.00710063.eng.abstr-s5-t5",
"type": "umlsterm",
"text": [
"patients"
],
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[
685,
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]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0030705"
}
]
}
] |
[] |
[] |
[
{
"id": "DerChirurg.00710063.eng.abstr-s1-r1-t3.1-t5.1",
"type": "developmental_form_of",
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"arg2_id": "DerChirurg.00710063.eng.abstr-s5-t5",
"normalized": []
},
{
"id": "DerChirurg.00710063.eng.abstr-s1-r2-t3.1-t1.2",
"type": "developmental_form_of",
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"arg2_id": "DerChirurg.00710063.eng.abstr-s3-t1",
"normalized": []
},
{
"id": "DerChirurg.00710063.eng.abstr-s1-r3-t1.2-t3.1",
"type": "surrounds",
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"arg2_id": "DerChirurg.00710063.eng.abstr-s5-t3",
"normalized": []
},
{
"id": "DerChirurg.00710063.eng.abstr-s1-r4-t5.1-t3.1",
"type": "surrounds",
"arg1_id": "DerChirurg.00710063.eng.abstr-s5-t5",
"arg2_id": "DerChirurg.00710063.eng.abstr-s5-t3",
"normalized": []
},
{
"id": "DerChirurg.00710063.eng.abstr-s1-r5-t4.1-t1.1",
"type": "measures",
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"arg2_id": "DerChirurg.00710063.eng.abstr-s5-t1",
"normalized": []
},
{
"id": "DerChirurg.00710063.eng.abstr-s2-r1-t2.1-t3.2",
"type": "treats",
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},
{
"id": "DerChirurg.00710063.eng.abstr-s2-r2-t1.1-t3.2",
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},
{
"id": "DerChirurg.00710063.eng.abstr-s2-r3-t1.1-t3.1",
"type": "location_of",
"arg1_id": "DerChirurg.00710063.eng.abstr-s5-t1",
"arg2_id": "DerChirurg.00710063.eng.abstr-s5-t3",
"normalized": []
},
{
"id": "DerChirurg.00710063.eng.abstr-s2-r5-t4.1-t3.2",
"type": "treats",
"arg1_id": "DerChirurg.00710063.eng.abstr-s5-t4",
"arg2_id": "DerChirurg.00710063.eng.abstr-s5-t3",
"normalized": []
},
{
"id": "DerChirurg.00710063.eng.abstr-s2-r6-t3.1-t4.1",
"type": "uses",
"arg1_id": "DerChirurg.00710063.eng.abstr-s5-t3",
"arg2_id": "DerChirurg.00710063.eng.abstr-s5-t4",
"normalized": []
},
{
"id": "DerChirurg.00710063.eng.abstr-s2-r7-t3.1-t2.1",
"type": "uses",
"arg1_id": "DerChirurg.00710063.eng.abstr-s5-t3",
"arg2_id": "DerChirurg.00710063.eng.abstr-s5-t2",
"normalized": []
},
{
"id": "DerChirurg.00710063.eng.abstr-s5-r1-t4.1-t1.1",
"type": "occurs_in",
"arg1_id": "DerChirurg.00710063.eng.abstr-s5-t4",
"arg2_id": "DerChirurg.00710063.eng.abstr-s5-t1",
"normalized": []
},
{
"id": "DerChirurg.00710063.eng.abstr-s5-r2-t2.1-t4.1",
"type": "causes",
"arg1_id": "DerChirurg.00710063.eng.abstr-s5-t2",
"arg2_id": "DerChirurg.00710063.eng.abstr-s5-t4",
"normalized": []
},
{
"id": "DerChirurg.00710063.eng.abstr-s5-r3-t2.1-t1.1",
"type": "causes",
"arg1_id": "DerChirurg.00710063.eng.abstr-s5-t2",
"arg2_id": "DerChirurg.00710063.eng.abstr-s5-t1",
"normalized": []
},
{
"id": "DerChirurg.00710063.eng.abstr-s5-r4-t4.1-t1.1",
"type": "associated_with",
"arg1_id": "DerChirurg.00710063.eng.abstr-s5-t4",
"arg2_id": "DerChirurg.00710063.eng.abstr-s5-t1",
"normalized": []
},
{
"id": "DerChirurg.00710063.eng.abstr-s5-r5-t1.1-t3.2",
"type": "uses",
"arg1_id": "DerChirurg.00710063.eng.abstr-s5-t1",
"arg2_id": "DerChirurg.00710063.eng.abstr-s5-t3",
"normalized": []
},
{
"id": "DerChirurg.00710063.eng.abstr-s5-r6-t1.1-t4.1",
"type": "associated_with",
"arg1_id": "DerChirurg.00710063.eng.abstr-s5-t1",
"arg2_id": "DerChirurg.00710063.eng.abstr-s5-t4",
"normalized": []
},
{
"id": "DerChirurg.00710063.eng.abstr-s5-r7-t1.1-t4.1",
"type": "causes",
"arg1_id": "DerChirurg.00710063.eng.abstr-s5-t1",
"arg2_id": "DerChirurg.00710063.eng.abstr-s5-t4",
"normalized": []
},
{
"id": "DerChirurg.00710063.eng.abstr-s5-r8-t1.1-t2.1",
"type": "uses",
"arg1_id": "DerChirurg.00710063.eng.abstr-s5-t1",
"arg2_id": "DerChirurg.00710063.eng.abstr-s5-t2",
"normalized": []
}
] |
DerChirurg.00710066.eng.abstr
|
DerChirurg.00710066.eng.abstr
|
[
{
"id": "DerChirurg.00710066.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Introduction : About 90 % of the patients have abdominal surgery develop adhesions afterward . Studies analyzing complications and follow-up even in emergency cases are rare . Methods : Intra- and postoperative findings and complications and follow-up were analyzed in a prospective trial between January 1994 and June 1998. Results : We performed laparoscopic procedures in 56 patients with complaints of obstructing adhesive bands or adhesions . Ninety-six percent of the patients have had abdominal surgery ; 51.8 % were treated as emergency cases with acute pain , 48.2 % with chronic abdominal pain . Intraoperatively , 37.5 % of the patients showed single adhesive bands ; 62.5 % showed adhesions . Mean operation time was 60 min , conversion rate : 5.4 % . Complications were recorded according to the \" Cologne classification \" : class I : 78.6 % , class II : 8.9 % , class III : 1.8 % , class IV : 10.8 % , class V : 0 % . The postoperative hospital stay was 6 days on average . Conclusion : Our study suggests that laparoscopic adhesiolysis can be done safely in emergency cases and in patients with extensive adhesions as well ."
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DerChirurg.00710080.eng.abstr
|
DerChirurg.00710080.eng.abstr
|
[
{
"id": "DerChirurg.00710080.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Introduction : Diagnosis of extraluminal recurrent rectal cancer may be difficult . Currently the diagnosis is based on routine imaging procedures . Diagnosis often remains unverified until histological proof can be acquired by transcutaneous biopsy or operative exploration . The diagnostic value of positron emission tomography ( PET ) in recurrent rectal cancer was evaluated in a prospective study at the Department of Surgery of the RWTH Aachen University Hospital . The aim of the study was to assess the sensitivity of PET in the detection of recurrent rectal cancer in comparison with conventional procedures . Furthermore , the valency of PET in the diagnosis of the local expansion and metastasis was evaluated . Methods : Since June 1997 , PET has been performed in all patients with suspected recurrent rectal cancer . The examined area reaches from the neck to the symphysis . Visual assessment follows transversal , frontal and sagittal sector scans . Enhanced focal FDG uptake over the physiological enrichment of the environment ( e.g. , urinary tract ) was defined as a criterion of malignancy . The findings were compared with the results of routine diagnosis and histological examinations . Results : Up to now , 23 patients have been subjected to a PET examination . In 17 cases , a local recurrence could be proved . An intrahepatic metastasis was found in 11 patients , pulmonary metastasis in 3 patients , lymph-node metastasis in 5 patients , and a peritoneal carcinomatosis was found in 4 patients . All these findings were confirmed by histological examinations after biopsy and operation or by other imaging procedures and the clinical follow-up . Conclusions : The controlled results show that PET can detect recurrent rectal cancer and its metastasis with great precision . PET seems to be a useful additional examination in the diagnosis of extraluminal recurrent rectal cancer ."
],
"offsets": [
[
0,
1909
]
]
}
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DerChirurg.00710089.eng.abstr
|
DerChirurg.00710089.eng.abstr
|
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"Deciduosis of the appendix is a rare cause of acute appendicitis in pregnancy . Ectopic decidual cells localized in the submesothelial stroma may represent a physiologic reaction of the pluripotent stromal cells to progestational hormonal stimulation . Less frequently , deciduosis is based on a preexisting extragenital endometriosis , visible in a localization other than strictly submesothelial , in residuals of cyclic proliferation and bleeding , and in endometrial glandular formations embedded in the decidual cells ."
],
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] |
[] |
[] |
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DerChirurg.00710093.eng.abstr
|
DerChirurg.00710093.eng.abstr
|
[
{
"id": "DerChirurg.00710093.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Introduction : Abdominal actinomycosis is an uncommon disease . Nevertheless it should be considered in case of unclear tumor-like abdominal masses . Methods : We report a case of a 49-year-old patient with an intrauterine device . The patient was submitted with a solid and painful tumor in the upper abdomen . After sonography , computerized tomography , gastroduodenoscopy and colonoscopy the preoperative presumptive diagnosis was a carcinoma of the transvers colon invading the abdominal wall . Pathological examination after a right hemicolectomy surprisingly revealed an actinomycosis . Results : Based on this case diagnostic tools and therapeutic options of actinomycosis of the colon are discussed . Conclusions : This case illustrates the importance to consider the possibility of actinomycosis when finding an unclear abdominal mass . After a surgical excision an abdominal actinomycosis requires antibiotic therapy ."
],
"offsets": [
[
0,
929
]
]
}
] |
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{
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}
] |
[] |
[] |
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"id": "DerChirurg.00710093.eng.abstr-s9-r1-t4.1-t3.1",
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{
"id": "DerChirurg.00710093.eng.abstr-s9-r3-t3.1-t1.1",
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"id": "DerChirurg.00710093.eng.abstr-s9-r4-t1.1-t4.1",
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}
] |
DerChirurg.00710098.eng.abstr
|
DerChirurg.00710098.eng.abstr
|
[
{
"id": "DerChirurg.00710098.eng.abstr-passage-0",
"type": "abstract",
"text": [
"A case report demonstrates the complication of pericardial tamponade during the installation of a central venous catheter via the subclavian vein . To reduce the high mortality of this rare complication , quickly applicable diagnostic measures and adequate therapy of pericardiocentesis are indicated . Prompt recognition and treatment of pericardial tamponade are imperative if a disastrous outcome is to be prevented ."
],
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[
0,
420
]
]
}
] |
[
{
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"complication"
],
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31,
43
]
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{
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"db_id": "C0009566"
}
]
},
{
"id": "DerChirurg.00710098.eng.abstr-s1-t2",
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"catheter"
],
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113,
121
]
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"db_name": "UMLS",
"db_id": "C0085590"
}
]
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{
"id": "DerChirurg.00710098.eng.abstr-s1-t3",
"type": "umlsterm",
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"vein"
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141,
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}
]
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{
"id": "DerChirurg.00710098.eng.abstr-s1-t4",
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"case report"
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2,
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]
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"db_id": "C0007320"
}
]
},
{
"id": "DerChirurg.00710098.eng.abstr-s1-t5",
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"pericardial tamponade"
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47,
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{
"id": "DerChirurg.00710098.eng.abstr-s1-t6",
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"subclavian vein"
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130,
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}
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"id": "DerChirurg.00710098.eng.abstr-s2-t1",
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"mortality"
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}
]
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{
"id": "DerChirurg.00710098.eng.abstr-s2-t2",
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{
"id": "DerChirurg.00710098.eng.abstr-s2-t4",
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"measures"
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235,
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{
"db_name": "UMLS",
"db_id": "C0079809"
}
]
},
{
"id": "DerChirurg.00710098.eng.abstr-s2-t5",
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"therapy"
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}
]
},
{
"id": "DerChirurg.00710098.eng.abstr-s2-t6",
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}
]
},
{
"id": "DerChirurg.00710098.eng.abstr-s3-t3",
"type": "umlsterm",
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339,
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]
],
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{
"db_name": "UMLS",
"db_id": "C0007177"
}
]
}
] |
[] |
[] |
[
{
"id": "DerChirurg.00710098.eng.abstr-s1-r1-t1.1-t4.1",
"type": "treats",
"arg1_id": "DerChirurg.00710098.eng.abstr-s3-t1",
"arg2_id": "DerChirurg.00710098.eng.abstr-s2-t4",
"normalized": []
},
{
"id": "DerChirurg.00710098.eng.abstr-s1-r2-t6.1-t4.1",
"type": "location_of",
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{
"id": "DerChirurg.00710098.eng.abstr-s1-r3-t2.1-t4.1",
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},
{
"id": "DerChirurg.00710098.eng.abstr-s1-r4-t6.1-t1.1",
"type": "location_of",
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"arg2_id": "DerChirurg.00710098.eng.abstr-s3-t1",
"normalized": []
},
{
"id": "DerChirurg.00710098.eng.abstr-s1-r5-t2.1-t1.1",
"type": "treats",
"arg1_id": "DerChirurg.00710098.eng.abstr-s3-t2",
"arg2_id": "DerChirurg.00710098.eng.abstr-s3-t1",
"normalized": []
},
{
"id": "DerChirurg.00710098.eng.abstr-s1-r6-t1.1-t4.1",
"type": "degree_of",
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"arg2_id": "DerChirurg.00710098.eng.abstr-s2-t4",
"normalized": []
},
{
"id": "DerChirurg.00710098.eng.abstr-s1-r7-t4.1-t1.1",
"type": "degree_of",
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"arg2_id": "DerChirurg.00710098.eng.abstr-s3-t1",
"normalized": []
},
{
"id": "DerChirurg.00710098.eng.abstr-s1-r8-t1.1-t4.1",
"type": "location_of",
"arg1_id": "DerChirurg.00710098.eng.abstr-s3-t1",
"arg2_id": "DerChirurg.00710098.eng.abstr-s2-t4",
"normalized": []
},
{
"id": "DerChirurg.00710098.eng.abstr-s2-r1-t4.1-t5.1",
"type": "conceptual_part_of",
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{
"id": "DerChirurg.00710098.eng.abstr-s2-r2-t2.1-t5.1",
"type": "associated_with",
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},
{
"id": "DerChirurg.00710098.eng.abstr-s2-r3-t1.1-t2.1",
"type": "conceptual_part_of",
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},
{
"id": "DerChirurg.00710098.eng.abstr-s2-r4-t2.1-t5.1",
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"normalized": []
},
{
"id": "DerChirurg.00710098.eng.abstr-s2-r5-t1.1-t5.1",
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"normalized": []
},
{
"id": "DerChirurg.00710098.eng.abstr-s2-r6-t5.1-t2.1",
"type": "associated_with",
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"arg2_id": "DerChirurg.00710098.eng.abstr-s3-t2",
"normalized": []
},
{
"id": "DerChirurg.00710098.eng.abstr-s2-r7-t4.1-t2.1",
"type": "conceptual_part_of",
"arg1_id": "DerChirurg.00710098.eng.abstr-s2-t4",
"arg2_id": "DerChirurg.00710098.eng.abstr-s3-t2",
"normalized": []
},
{
"id": "DerChirurg.00710098.eng.abstr-s3-r1-t2.1-t1.1",
"type": "result_of",
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"arg2_id": "DerChirurg.00710098.eng.abstr-s3-t1",
"normalized": []
},
{
"id": "DerChirurg.00710098.eng.abstr-s3-r2-t1.1-t2.1",
"type": "result_of",
"arg1_id": "DerChirurg.00710098.eng.abstr-s3-t1",
"arg2_id": "DerChirurg.00710098.eng.abstr-s3-t2",
"normalized": []
},
{
"id": "DerChirurg.00710098.eng.abstr-s3-r3-t2.2-t1.1",
"type": "result_of",
"arg1_id": "DerChirurg.00710098.eng.abstr-s3-t2",
"arg2_id": "DerChirurg.00710098.eng.abstr-s3-t1",
"normalized": []
},
{
"id": "DerChirurg.00710098.eng.abstr-s3-r4-t2.1-t1.1",
"type": "affects",
"arg1_id": "DerChirurg.00710098.eng.abstr-s3-t2",
"arg2_id": "DerChirurg.00710098.eng.abstr-s3-t1",
"normalized": []
}
] |
DerChirurg.00710101.eng.abstr
|
DerChirurg.00710101.eng.abstr
|
[
{
"id": "DerChirurg.00710101.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Introduction : Undifferentiated , embryonal sarcoma is a rare malignant tumour of the liver , the incidence of which is highest in children between 6 and 10 years of age ( 14.1 % ) . Among the primary tumours of the liver in childhood it ranks in third place after hepatocellular carcinoma and focal nodular hyperplasia . Embryonal sarcoma is much rarer in adults . To our knowledge , only 18 cases have been published in the last 50 years . Methods and results : We now present the case of a 29-year-old woman with spontaneous rupture of the liver caused by an undifferentiated sarcoma . Conclusion : This case report illustrates the possibility of an embryonal sarcoma being the reason for spontaneous rupture of the liver . The management of this case comprised primary tamponade , interventional embolisation of the feeding artery , and secondary resection under stable conditions ."
],
"offsets": [
[
0,
886
]
]
}
] |
[
{
"id": "DerChirurg.00710101.eng.abstr-s1-t1",
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"sarcoma"
],
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]
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},
{
"id": "DerChirurg.00710101.eng.abstr-s1-t2",
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"text": [
"malignant"
],
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62,
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],
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"db_id": "C0006826"
}
]
},
{
"id": "DerChirurg.00710101.eng.abstr-s1-t3",
"type": "umlsterm",
"text": [
"tumour"
],
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"db_name": "UMLS",
"db_id": "C0027651"
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},
{
"id": "DerChirurg.00710101.eng.abstr-s1-t4",
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},
{
"id": "DerChirurg.00710101.eng.abstr-s1-t5",
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}
]
},
{
"id": "DerChirurg.00710101.eng.abstr-s1-t6",
"type": "umlsterm",
"text": [
"children"
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},
{
"id": "DerChirurg.00710101.eng.abstr-s1-t7",
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]
},
{
"id": "DerChirurg.00710101.eng.abstr-s1-t8",
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},
{
"id": "DerChirurg.00710101.eng.abstr-s2-t1",
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"id": "DerChirurg.00710101.eng.abstr-s2-t2",
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}
]
},
{
"id": "DerChirurg.00710101.eng.abstr-s2-t3",
"type": "umlsterm",
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}
]
},
{
"id": "DerChirurg.00710101.eng.abstr-s2-t4",
"type": "umlsterm",
"text": [
"hyperplasia"
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},
{
"id": "DerChirurg.00710101.eng.abstr-s2-t5",
"type": "umlsterm",
"text": [
"hepatocellular carcinoma"
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265,
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"db_id": "C0019204"
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]
},
{
"id": "DerChirurg.00710101.eng.abstr-s2-t6",
"type": "umlsterm",
"text": [
"focal nodular hyperplasia"
],
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[
294,
319
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],
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"db_id": "C0333980"
}
]
},
{
"id": "DerChirurg.00710101.eng.abstr-s3-t1",
"type": "umlsterm",
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"sarcoma"
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332,
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]
},
{
"id": "DerChirurg.00710101.eng.abstr-s3-t2",
"type": "umlsterm",
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},
{
"id": "DerChirurg.00710101.eng.abstr-s4-t1",
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{
"id": "DerChirurg.00710101.eng.abstr-s5-t1",
"type": "umlsterm",
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"Methods"
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]
},
{
"id": "DerChirurg.00710101.eng.abstr-s5-t2",
"type": "umlsterm",
"text": [
"woman"
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]
},
{
"id": "DerChirurg.00710101.eng.abstr-s5-t3",
"type": "umlsterm",
"text": [
"rupture"
],
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]
},
{
"id": "DerChirurg.00710101.eng.abstr-s5-t4",
"type": "umlsterm",
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"liver"
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]
},
{
"id": "DerChirurg.00710101.eng.abstr-s5-t5",
"type": "umlsterm",
"text": [
"sarcoma"
],
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[
579,
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"db_name": "UMLS",
"db_id": "C0036210"
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]
},
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[] |
[] |
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},
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}
] |
DerChirurg.00710106.eng.abstr
|
DerChirurg.00710106.eng.abstr
|
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{
"id": "DerChirurg.00710106.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The academic title \" Privatdozent \" , unique to the German speaking countries , is awarded after the \" Habilitation \" , a qualification to teach and perform research on a high level and independent of supervision by a professor . A few years after the \" Habilitation \" , committees of medical faculties decide whether the title \" ausserplanmaessiger Professor \" can be awarded . This is an academic title independent of a specific university or extramural position . The rules of all German medical faculties were evaluated with regard to when and by what criteria the faculties decide . There were major differences , e . g . the minimum time after the \" Habilitation \" ( 4 years n = 9 ; 5 years n = 14 ; 6 years n = 7 ) , the numbers and quality of published papers and abstracts , the amount and quality of teaching and the number and qualification of external reviewers . For applications for university positions , but even more for leading positions in hospitals and industry , the title of \" apl . Prof. \" is still of major relevance . Therefore a certain degree of standardization but still leaving space for special criteria in different faculties , is proposed ."
],
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}
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}
] |
[] |
[] |
[
{
"id": "DerChirurg.00710106.eng.abstr-s1-r1-t1.1-t3.1",
"type": "isa",
"arg1_id": "DerChirurg.00710106.eng.abstr-s10-t1",
"arg2_id": "DerChirurg.00710106.eng.abstr-s10-t3",
"normalized": []
},
{
"id": "DerChirurg.00710106.eng.abstr-s2-r1-t3.1-t1.1",
"type": "performs",
"arg1_id": "DerChirurg.00710106.eng.abstr-s10-t3",
"arg2_id": "DerChirurg.00710106.eng.abstr-s10-t1",
"normalized": []
},
{
"id": "DerChirurg.00710106.eng.abstr-s7-r1-t2.1-t4.1",
"type": "isa",
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},
{
"id": "DerChirurg.00710106.eng.abstr-s7-r2-t4.1-t2.1",
"type": "uses",
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"arg2_id": "DerChirurg.00710106.eng.abstr-s10-t2",
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},
{
"id": "DerChirurg.00710106.eng.abstr-s8-r1-t2.1-t1.1",
"type": "isa",
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},
{
"id": "DerChirurg.00710106.eng.abstr-s8-r2-t2.1-t3.1",
"type": "carries_out",
"arg1_id": "DerChirurg.00710106.eng.abstr-s10-t2",
"arg2_id": "DerChirurg.00710106.eng.abstr-s10-t3",
"normalized": []
},
{
"id": "DerChirurg.00710106.eng.abstr-s8-r3-t1.1-t3.1",
"type": "carries_out",
"arg1_id": "DerChirurg.00710106.eng.abstr-s10-t1",
"arg2_id": "DerChirurg.00710106.eng.abstr-s10-t3",
"normalized": []
},
{
"id": "DerChirurg.00710106.eng.abstr-s10-r1-t2.1-t1.1",
"type": "evaluation_of",
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"arg2_id": "DerChirurg.00710106.eng.abstr-s10-t1",
"normalized": []
}
] |
DerChirurg.00710109.eng.abstr
|
DerChirurg.00710109.eng.abstr
|
[
{
"id": "DerChirurg.00710109.eng.abstr-passage-0",
"type": "abstract",
"text": [
"On the basis of the claims data of the statutory health insurance funds , surgery rates and small-area variations within the catchment area of the AOK Magdeburg were examined for the year 1997. Substantial variation can be constantly seen . The extremal quotient at the 30 most frequent ICPM groups ranged from 2 to 5. Generally , the extent of the variation was larger with elective procedures than with acute . Correlation analyses do not show clear associations with hospital bed supply and physician density in primary sectors . The extent of the small-area variation requires further research to evaluate possible determinants of surgery rates . Criteria for hospital admission and indications for surgery should be made explicit ."
],
"offsets": [
[
0,
736
]
]
}
] |
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"id": "DerChirurg.00710109.eng.abstr-s1-t1",
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"health"
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"normalized": [
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}
]
},
{
"id": "DerChirurg.00710109.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"insurance"
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},
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"id": "DerChirurg.00710109.eng.abstr-s1-t3",
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"text": [
"funds"
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]
},
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"id": "DerChirurg.00710109.eng.abstr-s1-t4",
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"id": "DerChirurg.00710109.eng.abstr-s3-t5",
"type": "umlsterm",
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DerChirurg.00710129.eng.abstr
|
DerChirurg.00710129.eng.abstr
|
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"Abstract . The widely propagated morbidity and mortality risks of obesity appear somewhat exaggerated , except for morbid obesity ( BMI > 40 kg/m2) and for high-risk obese subgroups concerning diabetes mellitus , hypertension , metabolic syndrome and obstructive sleep apnea syndrome . Non-medical reasons represent a major component of the social pressure that is presently experienced by obese persons in our society . Weight reduction represents the primary therapeutic approach in overweight patients with type 2 diabetes , hypertension , metabolic syndrome and obstructive sleep apnea , and it may be recommended in high-risk individuals for primary prevention of these diseases . Massive obesity is associated with excess mortality , especially in younger , physically inactive men with upper-body-segment obesity . It is widely assumed that weight reduction will lead to a reduction of excess mortality in these individuals ; so far , however , there is no proof for this assumption . Non-medicamentous conservative therapeutic approaches to weight reduction have the advantage of safety , even though their long-term efficacy is generally disappointing . There are no randomized , controlled trials to prove a reduction of morbidity or mortality risks and of therapeutic safety for pharmacological , invasive or surgical methods to treat obesity ."
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[] |
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] |
DerChirurg.00710134.eng.abstr
|
DerChirurg.00710134.eng.abstr
|
[
{
"id": "DerChirurg.00710134.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Abstract . The jejunoileostomy was a frequently used surgical procedure to treat morbid obese patients ( obesity grade III ) from 1970 to 1980. The observed weight loss was very good , 50-60 kg during the first 18 months after operation ( n = 288 ) . Even obesity-induced side effects were improved significantly . However , negativ consequences and complications were seen all too often : chronic loss of electrolytes , protein and vitamins and diarrhea with perianal skin problems . Reoperations were often necessary due to renal stone formation , cholecystolithiasis or blind loop syndrome . Therefore this procedure was abandoned in favor of operations such as vertical banded gastroplasty or the adjustable gastric band . However , in special cases similar operations may be helpful if gastric restriction has failed ."
],
"offsets": [
[
0,
823
]
]
}
] |
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[] |
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DerChirurg.00710159.eng.abstr
|
DerChirurg.00710159.eng.abstr
|
[
{
"id": "DerChirurg.00710159.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Abstract . In vitro functions of stimulated peripheral T cells and monocytes were investigated in patients experiencing sepsis following major visceral surgery . Cell culture supernatants were analyzed by ELISA for IL-2, IFN- , IL-4, IL-10, TNF- , IL-1, and IL-12 p40. In addition , monocyte HLA class II expression was determined by flow cytometry . T cell secretion of IL-2, TNF- , and in part IFN- ( but not IL-4) was significantly diminished in non-survivors throughout the entire course of sepsis , compared to controls and sepsis survivors . Production of IL-1 and IL-12 p40 by monocytes was strongly reduced in both survivors and non-survivors at the onset of sepsis . Persistence of depressed monocyte cytokine secretion correlated with lethality . Thus , overall suppression of cytokine production by T cells and monocytes was already observed at the beginning of postoperative sepsis . HLA class II expression by monocytes exhibited a strong and sustained down-regulation with no significant differences between sepsis survivors and non-survivors . In summary , suppression of both T cell and monocyte functions develops early during postoperative sepsis . Recovery of immune functions and severity of immune defects are associated with outcome ."
],
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DerChirurg.00710166.eng.abstr
|
DerChirurg.00710166.eng.abstr
|
[
{
"id": "DerChirurg.00710166.eng.abstr-passage-0",
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"text": [
"Abstract . Iatrogenic bile duct lesions are serious complications during laparoscopic cholecystectomy and include biliary leakage and major bile duct injury . The incidence of biliary lesions following laparoscopic cholecystectomy is up to threefold higher than that of the open procedure . A total of 108 patients with bile duct lesions after laparoscopic cholecystectomy were treated at our institution . Endoscopic treatment was successful in 68 cases , 6 patients were treated by external drainage , and 34 patients required surgical therapy . Selection criteria for the type of treatment included the etiology , anatomical situation , and diagnostic interval of the biliary lesion . We suggest a classification of bile duct injury and a proposal for diagnosis and treatment of these complications ."
],
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DerChirurg.00710174.eng.abstr
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DerChirurg.00710174.eng.abstr
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"Abstract . Introduction : Bile duct complications after laparoscopic cholecystectomy occur twice to three times more frequently than after an open procedure . Four different types of lesions may be differentiated by the Siewert classification : postoperative bile fistulas ( type I ) , late strictures ( type II ) , tangential injuries of the bile duct ( type III ) and defect lesions ( type IV ) . The diagnostic and therapeutic management is demonstrated in relation to our own experience and the literature . Methods : Eleven patients ( median age 43.8 +/- 17.2 ) with bile duct complications after laparoscopic cholecystectomy were operatively treated between November 1993 and December 1998. Nine patients ( four type-II lesions , five type-IV lesions ) were referred from another hospital ; 2 defect lesions out of 410 laparoscopic cholecystectomies ( 0.5 % ) were documented in our own patient group . Results : Four patients with late strictures were operatively treated with a hepaticocholedochostomy ( n = 2 ) or hepaticojejunostomy ( n = 2 ) after 14.3 +/- 8.4 months and were discharged from hospital after 10.6 +/- 3.8 days . In both cases with type-IV lesion and a short defect , an end-to-end anastomosis was successful ( hospital stay 11.6 +/- 1.0 days ) . However , a retrocolic Roux-Y end-to-side hepaticojejunostomy was perfomed in all cases with a larger defect ( n = 5 ; hospital stay 14.8 +/- 2.0 days ) . The two defect lesions in our own group were detected by intraoperative cholangiography and immediately treated after conversion either with hepaticocholedocho-stomy or hepaticojejunostomy ( hospital stay 11.2 +/- 0.6 days ) . Conclusions : The incidence of bile duct complications after laparoscopic cholecystectomy might be kept down by anatomic preparation , selective intraoperative cholangiography and early consideration of conversion to open procedure . The clinical course after biliary tract injury can be positively influenced only by a standard diagnostic and operative procedure and by an early transfer to a specialized center ."
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[] |
[] |
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DerChirurg.00710182.eng.abstr
|
DerChirurg.00710182.eng.abstr
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"Abstract . Introduction : High benign biliary stenoses , which can occur as a complication of disease or surgery , may be difficult to correct by open surgery and may also carry a high risk . An alternative to surgery is the percutaneous implantation of a flexible metallic stent or silicon prosthesis at the affected site . Methods : Twelve patients with benign biliary stenoses have been operated on in our department since March 1992 , and the therapeutic success was reviewed in this study . Results : Six received a Palmaz stent and six a silicon prosthesis , with a follow-up after completion of treatment of more than 7 years and more than 3 years , respectively . Fifty percent of the patients with a stent experienced no problems and 66 % of the stents remained patent ( including one requiring operative intervention to restore patency ) . No further surgery was necessary in any of the patients with a silicon prosthesis . Conclusion : When the advantages and disadvantages of the various procedures are considered , long-term splinting with a wide-lumened silicon prosthesis ( Yamakava ) appears to be a promising alternative to surgery for the treatment of benign biliary stenosis ."
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[] |
[] |
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DerChirurg.00710189.eng.abstr
|
DerChirurg.00710189.eng.abstr
|
[
{
"id": "DerChirurg.00710189.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Abstract . Introduction : To compare treatment results an international established classification is necessary . In 1997 the TNM classification of 1992 was modified . Methods : Between 1983 and 1997 , 159 patients with a ductal carcinoma of the pancreas underwent resection . All data of the resected specimens were documented in standardized manner prospectively in a protocol that offered ready transfer of the collected data to a new classification . The TNM categories and stage groupings were transferred to the new UICC classification of 1997 and analyzed in comparison to the classification of 1992. Results : The inclusion of a pT4 category equivalent to the other GI tumors made a new stage grouping necessary . Also division into pN1 a and pN1 b was established . According to the clinical experience only few tumors in early stages ( pT1/2 and stage I ) were observed in the new classification . There was a significant improval in the patient's distribution to the new stage grouping because of the homogeneous groups . In comparison to the 1992 classification the new stage II shows a relevant prognostic value and a significant difference to stage III . Conclusion : We conclude that the new UICC classification relates to prognosis better than the old classification ."
],
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]
}
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[] |
[] |
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DerChirurg.00710196.eng.abstr
|
DerChirurg.00710196.eng.abstr
|
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{
"id": "DerChirurg.00710196.eng.abstr-passage-0",
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"text": [
"Abstract . Introduction : The most common benign ampullary tumors are adenomas ( 80 % ) . They are considered as premalignant lesions with a transformation rate to carcinoma of up to 30 % . Methods : From 1 January 1997 to 28 February 1999 we treated 11 patients with adenoma of the ampulla of Vater . An ampullectomy was performed in 10 cases . One poor-risk patient could not be operated on . Results : No operative mortality occurred . In two patients a pT1 adenocarcinoma was diagnosed postoperatively . One of the two patients with a high-risk carcinoma underwent a second operation , a Whipple pancreatoduodenectomy . Nine of 10 patients had no recurrence with a median follow-up of 12 months . Conclusion : One patient died of glioblastoma . We would therefore recommend ampullectomy as the first-line treatment for benign tumors of the ampulla of Vater . In low-risk pT1 carcinoma ( G1/G2, L0) and R0 resection , local excision is acceptable . In high-risk pT1 carcinoma ( G3 and/or L1) Whipple pancreatoduodenectomy is mandatory ."
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[] |
[] |
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DerChirurg.00710202.eng.abstr
|
DerChirurg.00710202.eng.abstr
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"Abstract . Introduction : The aim of the study was to evaluate the modern principles of surgery in diverticulitis , e . g . early elective resection and primary anastomosis . Methods : The data of 445 consecutive patients were retrospectively analysed after classifying all cases in four subgroups according to a modified Hinchey classification ( stages 0-III ) . Results : Within our study group the morbidity was 26.5 % ( n = 118 ) and the mortality was 1.6 % ( n = 7 ) . In 96 % ( n = 425 ) of all cases and in 64 % ( 21/33 ) of patients with perforated diverticulitis and peritonitis ( stage III ) , a primary anastomosis was performed . Four patients of the study group showed insufficient anastomosis ( 0.9 % ) . No leakage was observed from any of the anastomoses performed in stage III diverticulitis . Stage of inflammation and age of patient correlate with morbidity and mortality . Some 53 % ( 94/177 ) of the patients in stage II and 67 % ( 22/33 ) of the patients in stage III had never showed symptoms of diverticulitis before . Conclusion : Prophylactic surgery to avoid life-threatening situations , including abscess formation or perforation , is not possible in many cases . However , especially patients at risk ( age , coexisting illness ) should undergo early surgery . Primary anastomosis can be performed safely even at an advanced stage ."
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DerChirurg.00710209.eng.abstr
|
DerChirurg.00710209.eng.abstr
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[
{
"id": "DerChirurg.00710209.eng.abstr-passage-0",
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"Abstract . Aim of the study : About 30 % of the patients with acute aortic dissection suffer from organ or limb ischemia . We analyzed the influence of ischemic localization and method of operative treatment ( aortic fenestration or extraanatomic bypass revascularization ) on morbidity and mortality . Patients and methods : From 1 May 1987 to 31 December 1998 21 patients with 24 vascular complications such as renal or intestinal ischemia , lower extremity ischemia and paraplegia following acute aortic dissection were treated at our institution . Recruitment was retrospective in 16 and prospective in 5 patients . In 5 patients ( 24 % ) the complication was associated with Stanford A , in 16 ( 76 % ) with Stanford B dissection . Ten patients ( 48 % ) complained of malperfusion of only one region , whereas 11 patients ( 52 % ) suffered from ischemia of two or three different regions . Aortic fenestration and resection of the dissected membrane was performed in nine cases ( 37 % ) . Fifteen patients ( 63 % ) were treated with extraanatomic bypass techniques . Results : One third of the patients died , four of them due to aortic penetration or perforation and two due to visceral ischemia . During follow-up of 32 ( 1-110 ) months two patients developed aortic complications . One died of aortic perforation , while the other developed a thoracoabdominal aneurysm and had to be treated by a tube graft replacement . Conclusions : Outcome depended more on the spontaneous course of aortic dissection and on prompt diagnosis and therapy of the complications than on the different operative techniques ."
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[] |
[] |
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DerChirurg.00710215.eng.abstr
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DerChirurg.00710215.eng.abstr
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"Abstract . Introduction : Postoperative delirium is a common psychic disturbance occurring acutely after various surgical procedures and typically presenting with a fluctuating course . These patients ' recovery takes longer . In this study we analyze the incidence of postoperative delirium in patients undergoing vascular surgery and try to identify risk factors for its development . Methods : Patients undergoing elective arterial operations were included . Their medical history , the specific vascular diagnosis and operation performed , the medication and laboratory data were monitored . Additionally the patients were preoperatively interviewed by a psychiatrist . Intraoperatively the drugs , infusions , possible transfusions , blood gases and pressures were monitored , as were the times of surgery and anesthesia . Postoperatively patients were seen daily by the psychiatrist and the surgeon for at least 7 days . Postoperative delirium was diagnosed according to DSM IV criteria , and mild , moderate and severe delirium were distinguished . Results : Fifty-four patients entered the study . Twenty-one ( 38.9 % ) developed postoperative delirium ( 11 mild , 2 moderate , 8 severe ) . Patients with aortic operations developed delirium more frequently than those with non-aortic procedures ( 55.5 vs 22.2 % , n = 27 each ) . Some preexisting diseases ( hearing disturbance ) increased the probability of postoperative delirium , while age was not identified as a risk factor . General psychopathological and depressive disturbances increased the likelihood of postoperative delirium . Patients who had a severe intraoperative course developed postoperative delirium more frequently . This was not seen in the absolute time of surgery or anesthesia nor in the intraoperative development of blood pressure or intraarterial gases , which did not differ between patients with and without postoperative delirium . More reliable parameters were an increased intraoperative need for crystalloid volume , intra - or postoperatively decreased hemoglobin values ( Hb 10 g/dl ) and the development of acidosis that had to be treated . Patients with delirium had serious complications more often ( 8/21 = 38.1 % vs 6/33 = 18.2 % ) and needed Intensive Care treatment longer ( 2.7 vs 2.1 days , only aortic surgery 3.2 vs 2.4 days ) . Conclusions : Postoperative delirium after vascular surgery is frequent . Patients undergoing aortic surgery , with specific concomittant medical disease , psychopathological disturbances and a severe intraoperative course , are at risk of developing postoperative delirium ."
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[] |
[] |
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DerChirurg.00710228.eng.abstr
|
DerChirurg.00710228.eng.abstr
|
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"Abstract . Abdominal organs such as the rectum and urinary bladder are rarely involved in Klippel-Trénaunay syndrome , but may occasionally be the source of severe blood loss . Since frequently no isolated source of bleeding is identified , severe blood loss can result in a critical condition . This article describes an unusual multimodal treatment concept for a patient with Klippel-Trénaunay syndrome associated with severe recurrent rectal bleeding . We present the case of a 39-year-old patient with Klippel-Trénaunay syndrome and a history of rectal bleeding since childhood requiring multiple blood transfusions over the years . He was referred to our department in a state of continuous rectal bleeding . Preoperative work-up revealed a complete alteration of the rectum and the distal parts of the sigmoid/colon by hemangiomas , with diffuse bleeding from the destroyed rectal mucosa . Preoperatively the superior rectal artery was embolized . After a 48-h interval , sphincter-preserving complete rectal excision including the sigmoid/colon was performed followed by a colon pouch anal anastomosis and protective loop ileostomy ."
],
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1140
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] |
[] |
[] |
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] |
DerChirurg.00710234.eng.abstr
|
DerChirurg.00710234.eng.abstr
|
[
{
"id": "DerChirurg.00710234.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Abstract . Usually postoperative wounds are kept dry until the stitches are removed . In a prospective randomized study early water contact was allowed in order to test postoperative wound healing in 817 patients operated on for varicose veins . Regardless of whether the wounds were kept dry or had water contact with or without shower foam from the second postoperative day , no infection was registered ."
],
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[
0,
407
]
]
}
] |
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{
"id": "DerChirurg.00710234.eng.abstr-s2-t3",
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"dry"
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{
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"id": "DerChirurg.00710234.eng.abstr-s4-t3",
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"id": "DerChirurg.00710234.eng.abstr-s4-t5",
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}
] |
[] |
[] |
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DerChirurg.00710249.eng.abstr
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DerChirurg.00710249.eng.abstr
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"Abstract . It is difficult to provide valid data with regard to changes in incidence and prevalence of acute pancreatitis in Germany . The lack of information is due to strict legal regulations to protect personal data , a certain lack of interest in epidemiological research and the lack of exact statistics of diseases treated in hospitals . The incidence of acute pancreatitis in other industrialized Western countries is about 10 new cases per year and 100,000 inhabitants . The increase of alcohol consumption over the last 30 years is associated with an increase of ethanol-induced pancreatitis . One may speculate that due to improved diagnostic possibilities , such as CT scan , cases where acute pancreatitis is diagnosed at autopsy are rare . Due to the increase in alcohol consumption it can be assume that the incidence and prevalence of chronic pancreatitis have increased in Germany similar to well-documented data from Denmark . Since alcohol consumption is slightly decreasing in Germany it is likely that the present incidence of about 10 cases of chronic pancreatitis per 100,000 inhabitants will also decrease ."
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[] |
[] |
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DerChirurg.00710253.eng.abstr
|
DerChirurg.00710253.eng.abstr
|
[
{
"id": "DerChirurg.00710253.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Abstract . Induction of acute pancreatitis follows a uniform mechanism independent of the different etiologic factors such as gallstones , alcohol , ischemia , hyperlipidemia , hypercalcemia , hereditary and others . Each cause seems to affect primarily the acinar cell , resulting in premature intracellular activation of trypsinogen and other digestive enzymes . Activated enzymes and oxygen free radicals injure the acinar cell and cause a release of cytokines and vasoactive mediators , attract inflammatory cells and activate the vascular endothelium as well as the expression of adhesion molecules . The disturbance of the pancreatic microcirculation induces a progression from edematous to necrotizing pancreatitis independent of the early intracellular events , including protease activation . Specific therapy must be directed towards microperfusion failure as a secondary pathogenetic step , since the initial enzyme activation and cytokine release is irreversible by the time of clinical presentation . In experimental designs comparable to the clinical situation the following therapeutic principles have proven beneficial : increase of blood fluidity by dextran , inhibition of leukocyte-endothelium interaction by ICAM-1 antibodies , and blockade of local vasoconstriction by endothelin-receptor antagonists ."
],
"offsets": [
[
0,
1323
]
]
}
] |
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]
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{
"id": "DerChirurg.00710253.eng.abstr-s2-t1",
"type": "umlsterm",
"text": [
"pancreatitis"
],
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[
30,
42
]
],
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"db_id": "C0030305"
}
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},
{
"id": "DerChirurg.00710253.eng.abstr-s2-t2",
"type": "umlsterm",
"text": [
"gallstones"
],
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[
126,
136
]
],
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"db_id": "C0242216"
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{
"id": "DerChirurg.00710253.eng.abstr-s2-t3",
"type": "umlsterm",
"text": [
"alcohol"
],
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139,
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]
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"text": [
"ischemia"
],
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157
]
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]
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"id": "DerChirurg.00710253.eng.abstr-s2-t5",
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"text": [
"hyperlipidemia"
],
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[
160,
174
]
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"id": "DerChirurg.00710253.eng.abstr-s3-t1",
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}
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{
"id": "DerChirurg.00710253.eng.abstr-s3-t2",
"type": "umlsterm",
"text": [
"cell"
],
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[] |
[] |
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DerChirurg.00710265.eng.abstr
|
DerChirurg.00710265.eng.abstr
|
[
{
"id": "DerChirurg.00710265.eng.abstr-passage-0",
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"text": [
"Abstract . Early endoscopic intervention is required in the treatment of biliary pancreatitis in the presence of cholangitis or jaundice , possibly with dilated common bile duct . Also patients with predicted severe disease , lack of spontaneous clinical improvement or progressive jaundice might benefit from endoscopic retrograde cholangiopancreatography ( ERCP ) with sphincterotomy . If endoscopy is indicated , it should be performed as soon as possible . Injection of contrast medium into a dilated bile duct is accompanied by the risk of cholangitis . Therefore therapeutic decompression by sphincterotomy and stone extraction is necessary , or , if this is not possible , insertion of a naso-biliary tube for drainage . Prophylactic use of antibiotics is recommended periinterventionally . Early endoscopic intervention is not necessary in patients with mild biliary pancreatitis and spontaneous clinical improvement . Here , ERCP can be performed later , if indicated ."
],
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0,
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]
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] |
DerChirurg.00710269.eng.abstr
|
DerChirurg.00710269.eng.abstr
|
[
{
"id": "DerChirurg.00710269.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Abstract . In the present review we describe our experience with debridement in necrotizing pancreatitis , with particular emphasis on the indications for surgery and the outcome in patients with infected and sterile necrosis . Within 7 years 64 patients with necrotizing pancreatitis underwent surgery with a median preoperative APACHE II score of 9. The indications for surgery were either proven infection or persistence of symptoms . Thirty-six patients were found to have infected necrosis , while 28 patients had sterile necrosis . There was no significant difference between the two groups regarding pre- and postoperative parameters . The surgical technique involved a blunt necrosectomy followed by closed packing with Penrose drains . This technique produced the lowest reported mortality of 6.2 % with a reoperation rate of only 17 % , demonstrating that even with sterile necrosis surgical management can be carried out safely ."
],
"offsets": [
[
0,
940
]
]
}
] |
[
{
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DerChirurg.00710274.eng.abstr
|
DerChirurg.00710274.eng.abstr
|
[
{
"id": "DerChirurg.00710274.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Necrotizing pancreatitis is still associated with considerable morbidity and mortality . Formerly , surgical treatment with early and extensive pancreatic resection has been the standard . Improvements in our understanding of the pathogenesis of the disease and progress in the field of intensive care therapy have made conservative therapy the initial standard in the treatment of necrotizing pancreatitis . A considerable percentage of patients with sterile necrosis can be managed with low morbidity and mortality by conservative treatment without operation . Nevertheless , surgical treatment is indicated in patients with infected necrosis and in sterile necrosis if multiorgan failure persists over a limited period of time despite maximum intensive care therapy . Pancreatic resection should be abandoned for surgical treatment of pancreatic necrosis , as results with regard to morbidity , mortality and long-term outcome are unsatisfactory . Today the surgical standard is careful digital necrosectomy , which must be followed by either postoperatve drainage , repeated open lavage or continuous closed lavage . In experienced hands , all three procedures provide similar results with regard to morbidity and mortality ."
],
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0,
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]
}
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[] |
[] |
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DerChirurg.00710281.eng.abstr
|
DerChirurg.00710281.eng.abstr
|
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"Abstract . Surgical hospitals can be seen as operational or even industrial production systems . Doctors have a major impact on both medical performance and costs . For active participation in the management process , knowledge of industrial controlling mechanisms is required . German hospitals currently receive no procedure-related financial revenues , such as prices or tariffs for defined medical treatment activities . Maximum clinical revenues are , furthermore , limited by principles of planned economy and can be increased only slightly by greater medical performance . Costs are the only target that can be autonomously influenced by the management . Operative controlling in hospitals aims at horizontal and vertical coordination of subunits and decentralisation of process regulations . Hospital medical performance is not clearly defined , its quantitative measurement very problematic . Process-orientated clinical activities are not taken into account . A high percentage of hospital costs are fixed and can be influenced only by major structural interventions in the long term . Variable costs are primarily dependent on the quantity of clinical activities , but also heavily influenced by patient structure ( comorbidity and risk profile ) . The various forms of industrial cost calculations , such as internal budgeting , internal markets or flexible plan-cost balancing , cannot be directly applied in hospital management . Based on these analyses , current operational concepts and strategic trends are listed to describe cost-management options in hospitals with focus on the German health reforms ."
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[] |
[] |
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] |
DerChirurg.00710300.eng.abstr
|
DerChirurg.00710300.eng.abstr
|
[
{
"id": "DerChirurg.00710300.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Abstract . The aetiology of varicosis is still unclear . Investigation of changes in normal veins which result in the formation of varicosis led to examination of elastic properties and histomorphological alterations in the region of the extracellular matrix in the vessel wall of the long saphenous vein in normal and varicose veins . The rigidity of varicose veins was higher than that of normal veins ; there was no difference between the varicose vein above a competent valve and the \" normal \" vein below this competent valve . The matrix proteins demonstrated an increase in total fibres , whereas the elastic fibres were reduced and fragmented , explained the rigidity of varices . These results suggest that the role of the venous valves in the development of varicose veins is secondary to changes of the vein wall ."
],
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[
0,
825
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]
}
] |
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"id": "DerChirurg.00710300.eng.abstr-s3-t2",
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{
"id": "DerChirurg.00710300.eng.abstr-s5-t2",
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"id": "DerChirurg.00710300.eng.abstr-s6-t4",
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"secondary"
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{
"id": "DerChirurg.00710300.eng.abstr-s6-t5",
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"vein"
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{
"id": "DerChirurg.00710300.eng.abstr-s6-t6",
"type": "umlsterm",
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] |
[] |
[] |
[
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"type": "disrupts",
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{
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DerChirurg.00710311.eng.abstr
|
DerChirurg.00710311.eng.abstr
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"Abstract . Introduction : The treatment of soft tissue defects of the foot and ankle region remains a challenge , because special anatomical and physiological properties have to be considered . Patients and methods : The data of 52 patients , who were treated between 1994 and 1998 , were analyzed . 48 % were posttraumatic defects and were located in the weight bearing zone in 37 % . Results : Fifty-nine procedures were used , including skin transplantation in 16 patients , local flaps in 3 cases , regional flaps in 14 cases , and microvascular procedures in 17 cases . Amputation was required in 4 patients . The overall success rate was 92 % . Complications occurred in 18 patients . Conclusions : Using these data and evaluation of the actual literature lead to the development of an algorithm for the treatment of defects in this area . The modern armamentarium of plastic surgery offers the possible different treatment modalities ."
],
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DerChirurg.00710319.eng.abstr
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DerChirurg.00710319.eng.abstr
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"Abstract . Introduction : The aim of the following article is to summarize our experience in the treatment of osteiod osteomas , with special emphasis on diagnostic and therapeutic pitfalls . Patients and methods : A consecutive series of 14 patients with osteoid osteomas was treated surgically between 1985 and 1996. All tumors but one were located in the lower limb . The main symptom was pain , being worse at night and being responsive to oral salicylates ( 10/14 patients ) . As reported in other studies , the duration of symptoms was unacceptably long ( mean 24 months ) . The classical pathognomonic symptoms were misinterpreted in many cases , leading to frustrating conservative and even operative therapies . Results : Open biopsy prior to surgical excision is not indicated because of the typical clinical and roentgenographic imaging of these lesions . Surgical excision of the nidus is the treatment of choice and gives immediate pain relief . If the characteristic morphology is not evident in plain roentgenograms , conventional tomograms , radionuclide scans and computerized tomography are reliable tools . All patients were free of disease at a mean of 6.6 years after operation . Conclusion : In symptomatic patients with osteoid osteomas the excision of the nidus is the established diagnostic/therapeutic modality . Minimally invasive procedures seem to be alternatives to classical surgery ."
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[] |
[] |
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DerChirurg.00710326.eng.abstr
|
DerChirurg.00710326.eng.abstr
|
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"Abstract . Dislocated metacarpal V fractures , fixed by percutaneous Kirschner wires or other implants near the metacarpophalangeal joint , often show impaired movement despite excellent radiologic findings . We therefore chose an alternative method using intramedullary Kirschner wire osteosynthesis according to Foucher . Twenty-five patients were operated on in a 3-year period and movement of the fingers and complications were examined . Six weeks after operation all fractures were consolidated in anatomical reduction . One patient suffering from an early stage of Sudeck's dystrophy was healed , and no other complications appeared . Three months after treatment all patients achieved free movement of the fingers with anatomical alignment . We therefore recommend intramedullary Kirschner wire osteosynthesis in distal metacarpal V fractures ."
],
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0,
852
]
]
}
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] |
[] |
[] |
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DerChirurg.00710331.eng.abstr
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DerChirurg.00710331.eng.abstr
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"The treatment of choice in retroperitoneal liposarcoma is curative R0 resection . However , there are high rates of reoperation due to recurrence . Our present case report shows difficulties in detecting recurrence due to atypical configuration . Eventually a huge diverticulum of the duodenum combined with leiomyoma in its neck area was histopathologically identified as a recurrent liposarcoma ."
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[] |
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DerChirurg.00710334.eng.abstr
|
DerChirurg.00710334.eng.abstr
|
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{
"id": "DerChirurg.00710334.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Abstract . Introduction : Primary liposarcoma of the stomach wall is rare . Only eight cases have been described so far . Material and method : Here we report the ninth case , occurring in a 74-year-old woman who presented with weight loss and a therapy-resistant ulcer of the stomach wall . Results : Pre- and perioperative findings suggested a benign lipoma of the stomach wall . The patient was treated with subtotal gastrectomy . On microscopic examination the tumor showed features of a benign lipoma but for a distinctive capillary net . Immunohistochemically the S-100 reaction was positive . Less than 1 % of Ki67-positive cells could be found , thus suggesting a highly differentiated primary liposarcoma of the stomach wall . Conclusion : In situations where the benign or malignant nature of a submucosal lesion cannot be diagnosed with certainty a mesenchymal tumor of the stomach wall has to be included in the differential diagnosis . Here the indication for complete surgical excision and histological workup has to be set widely ."
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DerChirurg.00710337.eng.abstr
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DerChirurg.00710337.eng.abstr
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"Abstract . Surgery of the great veins inevitably began with the surgical treatment of injuries , often involving the femoral vein . Because of the famous case presented by Roux in 1813 , the prevailing opinion until almost the end of the nineteenth century was that ligation of the vein made death inevitable , but that the only way to control severe hemorrhaging from a vein was to ligate the femoral artery . Zaufal's principle ( 1880 ) consisted in the ligation and resection of great veins of the body and limbs in order to prevent sepsis in suppurative processes . This surgical method was still being used in the first half of the twentieth century in patients with perforated appendicitis or puerperal fever . In the limb , the congestion induced in the vein had a positve effect on the healing process . The surgical treatment of leg and pelvic deep vein thrombosis was initially ( 1931 ) aimed at achieving decompression in compartment syndromas . The first thrombectomy was performed in 1937 , but several operations with a successful outcome were reported at the 61st annual meeting of the German Society of Surgery in the following year ."
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[] |
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DerChirurg.00710355.eng.abstr
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DerChirurg.00710355.eng.abstr
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"Abstract . Abnormal surgical bleeding may be caused by congenital or acquired plasmatic and/or thrombocytic coagulation disorders . They may be known at the time of operation , or they may occur during the perioperative course for the first time . A detailed identification of haemostatic defects can be performed by a diagnostic spectrum of multiple tests . However , in clinical practice global screening tests are used first . In diagnostic routine three groups of patients have to be considered : ( 1 ) patients with no personal or family history of bleeding and no operative bleeding risk ; ( 2 ) patients with no history , but increased bleeding risk by the planned procedure ; ( 3 ) patients with a known haemorrhagic diathesis in their own history . In all difficult situations a specialist in haemostasiology should be consulted , because only rational diagnosis and therapeutic monitoring achieve an optimal and cost-effective operative result . The surgeon should always be aware that surgical bleeding from an operative cause must be considered in the differential diagnosis ."
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[] |
[] |
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DerChirurg.00710369.eng.abstr
|
DerChirurg.00710369.eng.abstr
|
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"Abstract . Across centers , transfusion can vary eightfold for the same mediastinal drainage after adult cardiac operations . Excessive blood drainage resulting in increased transfusions occurs in 29 % of patients . Various strategies have been proposed to decrease bleeding and allogenic transfusion requirements in the perioperative period of heart surgery . Blood conservation methods were reviewed critically . Avoidance of preoperative anemia , tolerance of low hemoglobin concentrations , the use of autologous blood , and adherence to a strict transfusion protocol will reduce the use of allogenic transfusions . Perioperatively , maintenance of normothermia contributes to improved hemostasis ."
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[] |
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DerChirurg.00710374.eng.abstr
|
DerChirurg.00710374.eng.abstr
|
[
{
"id": "DerChirurg.00710374.eng.abstr-passage-0",
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"Abstract . Viral hepatitis is one of the most important infectious diseases worldwide . It is frequent in tropical and subtropical areas , but also plays still a significant role in the industrialized countries of Northern and Western Europe and the USA . In Germany more than 100 000 people are infected by viral hepatitis each year . Whereas hepatitis A and E are transmitted fecal-orally , hepatitis B , C and D are transmitted by the parenteral route . Most hepatitis A infections seen in Germany are acquired abroad . Hepatitis B is still a nosocomial disease ; the majority of infections in Germany , however , seems to be transmitted sexually . For the serological diagnosis of viral hepatitis a battery of sensitive tests for specific antibodies and antigens is available ; usually testing of one serum sample allows an unambiguous diagnosis . Prophylaxis of hepatitis A and B is possible using safe and efficient vaccines ."
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[] |
[] |
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DerChirurg.00710389.eng.abstr
|
DerChirurg.00710389.eng.abstr
|
[
{
"id": "DerChirurg.00710389.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Abstract . This report analyzes 46 cases of personnel-to-patient transmissions of hepatitis B ( HB ) , hepatitis C ( HC ) and HIV in health care settings . Similar circumstances were found for transmission of HB ( 40 cases , 404 infected patients ) , HC ( 4 cases , 224 infected patients ) and HIV ( 2 cases , 7 infected patients ) . Cases with the highest number of transmissions ( one anesthesiologist with 217 HC transmissions , and one EEG technologist with 75 HB transmissions ) were attributed to poor infection control practices . As long as infected health care workers ( HCW ) adhere to general infection control measures , a risk for transmission to patients exists only from infected surgeons who perform'xposure-prone invasive procedures ' . Whether changes in duties of infected HCW are necessary should be decided on an individual basis . Often , the infected personnel were assumed to have acquired the disease occupationally . Medical practices and devices bearing a risk of infection should constantly be reviewed with regard to risk for patients and personnel ."
],
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0,
1079
]
]
}
] |
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DerChirurg.00710396.eng.abstr
|
DerChirurg.00710396.eng.abstr
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"Abstract . In the United States of America ( 1991 ) , in Canada ( 1998 ) , in the UK ( 1993 , 1994 ) and in Germany ( 1999 ) recommendations have been published concerning performance of \" exposure-prone procedures \" ( EPP ) by persons infected with Hepatitis-B virus ( HBV ) , Hepatitis-C virus ( HCV ) or HIV . This review summarises the definition of EPP , methods to reduce the transmission of blood-borne pathogens , immunisation and screening policies , constitution of an advisory panel and the question of trace-back investigations described in these regulations ."
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[] |
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] |
DerChirurg.00710404.eng.abstr
|
DerChirurg.00710404.eng.abstr
|
[
{
"id": "DerChirurg.00710404.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Chronic hepatic dysfunction and acute liver failure due to viral hepatitis represent the most frequent indications for liver transplantation . Liver grafting is the only available life-saving intervention for most of these patients . Reinfection of the graft is still a central problem . In hepatitis B , reinfection frequently leads to cirrhosis with subsequent dysfunction of the graft . Prophylaxis of HBV reinfection with polyclonal human antibodies against HBsAg alone or in combination with the nucleoside analogue lamivudine is effective but costly . Reinfection in hepatitis C is a regular event in all patients and has a far better prognosis than HBV reinfection of the graft . Effective prophylaxis of HCV reinfection has still not been established and requires further studies . After HCV reinfection the prognosis of allograft survival is negatively affected ; however , the 5-year survival rate in patients who have undergone liver transplantation for HCV-related liver disease is not lower than for other non-viral benign indications ."
],
"offsets": [
[
0,
1049
]
]
}
] |
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DerChirurg.00710410.eng.abstr
|
DerChirurg.00710410.eng.abstr
|
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"text": [
"Abstract . The 5-year survival of patients with colorectal cancer UICC stage I and II ranges from 70 % to 80 % . Therefore , at least 20 % to 30 % of these patients develop recurrent disease , caused by hematogenic or lymphogenic tumor cell dissemination . Using immunohistochemical or molecular biological methods , disseminated tumor cells can be detected in lymph nodes in a high proportion of patients in UICC stage I or II . The detection of disseminated tumor cells could help to identify a subgroup of patients at risk for disease relapse who could benefit from adjuvant therapy . Lymphogenic tumor cell dissemination seems to be a very common event in early colorectal cancer , preceding hematogenic tumor cell dissemination . Although these observations appear to confirm the therapeutic importance of meticulous lymph node dissection , their prognostic relevance has yet to be determined in prospective studies ."
],
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922
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DerChirurg.00710417.eng.abstr
|
DerChirurg.00710417.eng.abstr
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"Abstract . The health reform 2000 in Germany has little impact on the structural deficits of the German health service . The monopolies of hospitals for inpatient and of contract doctors for outpatient care are not changed . The budgeting of hospitals remains . In future there will be a catalog of operations that may only be carried out on an outpatient basis . The duty for quality assurance is specified and intensified . Implementation of innovative medical treatments in hospital will to be done only under strict control of a new countrywide committee . A new DRG-based price system for hospitals will be established ."
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DerChirurg.00710424.eng.abstr
|
DerChirurg.00710424.eng.abstr
|
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"id": "DerChirurg.00710424.eng.abstr-passage-0",
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"Abstract . Introduction : Serous cystadenomas of the pancreas are rare tumors and thought to be almost always benign . Methods : We report our experience in the diagnosis and surgical treatment of 12 patients with these tumors . Results : Between October 1993 and December 1998 , 41 patients with cystic tumors of the pancreas underwent surgical resection ; in 12 cases ( 11 women , 1 man ) a serous cystadenoma ( 10 micrcocystic , 2 oligomacrocystic ) was found . Only 6 ( 50 % ) patients had symptoms . The mean tumor size was 4.8 ( 2.7-10) cm . Ultrasound , CT and MRT usually could detect the mass , but differentiation with other cystic lesions was not reliable . All tumors were resected : 4 Whipple procedures , 7 distal pancreatectomies and 1 segmental resection were performed . No patient died after surgery and none had to be reoperated on . Conclusions : Because of the difficulty in reliably differentiating benign and malignant lesions of the pancreas , we believe that cystic tumors of the pancreas should be resected ."
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[] |
[] |
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] |
DerChirurg.00710436.eng.abstr
|
DerChirurg.00710436.eng.abstr
|
[
{
"id": "DerChirurg.00710436.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Abstract . Introduction : Endovascular therapy of aortic aneurysms is an attractive alternative to conventional aortic surgery . A number of patients , however , will fail endovascular therapy and require open surgical repair . Methods : We report our experience with conversion to open aortic repair . Of 306 patients given endovascular therapy for an infrarenal aortic aneurysm , 30 ( 9.8 % ) required conversion to conventional repair . Results : Thirteen patients ( 43.3 % ) suffered complications , 3 ( 10 % ) of which were fatal . Conversion to open aortic repair after endovascular therapy is technically more demanding than primary open repair , particularly because of clamp techniques and stent-extraction . Conclusions : Emergent conversion operations , especially when preceded by significant retroperitoneal bleeding from vascular tears due to endovascular manipulations are complicated by significant morbidity and mortality ."
],
"offsets": [
[
0,
940
]
]
}
] |
[
{
"id": "DerChirurg.00710436.eng.abstr-s1-t1",
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"Abstract"
],
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[
0,
8
]
],
"normalized": [
{
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}
]
},
{
"id": "DerChirurg.00710436.eng.abstr-s2-t1",
"type": "umlsterm",
"text": [
"therapy"
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DerChirurg.00710444.eng.abstr
|
DerChirurg.00710444.eng.abstr
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"id": "DerChirurg.00710444.eng.abstr-passage-0",
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"Abstract . Epidemiologic data suggest that an underlying genetic disposition can be detected in up to 10 % of all colorectal cancer patients and autosomal dominantly inherited hereditary non-polyposis colorectal cancer ( HNPCC ) is the entity most frequently identified . It was described first by A. Warthin in 1895 in \" Family G \" and is characterized by a predisposition to an early onset of colorectal cancer and other intestinal or genitourinary tumors . We report the case of a 61-year-old woman with five different cancers . Although the strict Amsterdam Criteria were not fulfilled , molecular analysis revealed HNPCC ; further genetic testing in the family confirmed that the 36-year-old and so far healthy son had inherited the germline mutation of his affected mother . Genetic testing in clinically suspected HNPCC cases is recommended for patients with colorectal cancer meeting the Amsterdam Criteria . In patients meeting one of Bethesda Criteria 2-7 without meeting the Amsterdam Criteria , germline mutation analysis is recommended only in MSI-positive tumors ."
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[] |
[] |
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DerChirurg.00710448.eng.abstr
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DerChirurg.00710448.eng.abstr
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"Abstract . Morbid obesity ( body mass index > 40 kg/m2) is a risk factor for cardiovascular , pulmonary , metabolic , neoplastic , and psychologic sequelae . In the present prospective clinical study 65 patients ( 11 men , 54 women ) underwent vertical banded gastroplasty ( Mason procedure ) from June 1994 to October 1997. The median age was 41 +/- 5.3 years ( range 18-69 ; n = 65 ) . Preoperative body weight was 135 +/- 23 kg ( 96-229 ; n = 65 ) , excess body weight in kg was 75 +/- 6.9 ( 44-155 ; n = 65 ) or in % 126 +/- 10 ( 78-223 ; n = 65 ) and BMI was 49 +/- 7.4 kg/m2 ( 39-69 ; n = 65 ) . Mean hospital stay was 9.7 +/- 2.4 days ( 6-18 ; n = 65 ) . Hospital mortality was 0 % ( 0/65 ) . Early complications were vomiting ( 30 % ) and problems in wound healing ( 15 % ; n = 65 ) . Late complications ( > 30 days ) were incisional hernias ( 13.8 % ) and staple-line disruptions ( 12.3 % ; n = 65 ) with a reoperation rate of 23 % ( 15/65 ) . Median follow-up was 15.0 +/- 5.2 months ( 2-42 ) with a follow up rate of 100 % . Mean weight loss after 12 months was 38.5 +/- 17 kg ( 30-98 ; n = 34 ) ( P 0.0001 ) and loss of excessive body weight 65 +/- 10 % ( 57-86 ; n = 34 ) , respectively ( P 0.0001 ) . Cardiovascular risk factors ( hypertension , diabetes , hyperlipidemia ) were significantly improved within 12 months ( n = 34 ) . Vertical banded gastroplasty ( Mason procedure ) - well established for 20 years - is a good , safe therapy for morbid obesity if strict indications for operation are observed and if there is multidisciplinary long-term follow-up . Co-morbid risk factors are considerably reduced and a long-term weight loss of more than 50 % can be achieved without the risk of pathological metabolic changes ."
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[] |
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DerChirurg.00710458.eng.abstr
|
DerChirurg.00710458.eng.abstr
|
[
{
"id": "DerChirurg.00710458.eng.abstr-passage-0",
"type": "abstract",
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"Abstract . We report the case of a 27-year-old female patient with a symptomatic Bochdalek hernia operated on laparoscopically . We discuss the diagnostic strategy and options in therapy ."
],
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[
0,
188
]
]
}
] |
[
{
"id": "DerChirurg.00710458.eng.abstr-s1-t1",
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"Abstract"
],
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0,
8
]
],
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}
]
},
{
"id": "DerChirurg.00710458.eng.abstr-s2-t1",
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47,
53
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{
"id": "DerChirurg.00710458.eng.abstr-s2-t2",
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],
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[
54,
61
]
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]
},
{
"id": "DerChirurg.00710458.eng.abstr-s2-t3",
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"hernia"
],
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[
91,
97
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]
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{
"id": "DerChirurg.00710458.eng.abstr-s3-t1",
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{
"id": "DerChirurg.00710458.eng.abstr-s3-t2",
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"db_id": "C0087111"
},
{
"db_name": "UMLS",
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}
]
}
] |
[] |
[] |
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DerChirurg.00710462.eng.abstr
|
DerChirurg.00710462.eng.abstr
|
[
{
"id": "DerChirurg.00710462.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Abstract . Budd-Chiari syndrome is a rare manifestation of hereditary or acquired thrombophilia . We saw a case of Budd-Chiari syndrome in a 30-year-old woman leading to initial diagnostic difficulties . She underwent surgical side-to-side shunt and 9 weeks later an almost normal liver could be demonstrated on computerized tomography . Budd-Chiari syndrome should be considered if the Chiari triad with abdominal pain , hepatomegaly and ascites occurs in a patient . If necessary , invasive diagnostic procedures ( e.g. angiography ) must be performed . Therapeutic options are anticoagulative therapy and porto-systemic shunt , either as a TIPS or a surgical shunt . If severe liver failure occurs or liver cirrhosis is present , orthotopic liver transplantation is an additional option which also cures hereditary thrombophilia ."
],
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[
0,
833
]
]
}
] |
[
{
"id": "DerChirurg.00710462.eng.abstr-s1-t1",
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],
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31
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},
{
"id": "DerChirurg.00710462.eng.abstr-s2-t2",
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"thrombophilia"
],
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{
"id": "DerChirurg.00710462.eng.abstr-s2-t3",
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[] |
[] |
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DerChirurg.00710466.eng.abstr
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DerChirurg.00710466.eng.abstr
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[] |
[] |
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DerChirurg.00710469.eng.abstr
|
DerChirurg.00710469.eng.abstr
|
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"id": "DerChirurg.00710469.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Abstract . Arterial injuries following arthroscopic procedures are extremely rare , but may have dramatic consequences without early diagnosis and appropriate treatment . We report a case of popliteal artery pseudoaneurysma following arthroscopic meniscectomy in a child . Noninvasive diagnostic workup included Doppler flow color imaging and computed tomography with contrast and 3D workup . The arterial lesion was repaired surgically by an posterior approach using a vein patch plasty . The popliteal artery is in close relationship to the posterior capsule of the knee joint . During knee flexion the vessel is positioned forward and placed even closer to the horn of the lateral meniscus . For this reason arthroscopic surgical manipulation in the posterior aspects of the knee joint must be performed under direct visualization . Indistinct swelling in the popliteal fossa and calf following arthroscopic surgery should arouse suspicion of an arterial injury ."
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}
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DerChirurg.00710472.eng.abstr
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DerChirurg.00710472.eng.abstr
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"Abstract . An increasing number of surgical departments is creating its own homepage in the World Wide Web ( WWW ) . We investigated 184 presentations concerning their quality in content and technical realization . Our research revealed that most presentations regard patients as their main target group in order to meet the patients ' demand for information and transparency . However , universities are especially concentrating on scientific development and neglecting the patients . Only a few presentations contain means for web-based training . In general , technical realization seems to be much better than the content itself . As patients tend to appear as customers who will choose the hospital they feel comfortable with , every clinical department that is a competitor should create a communication and information base for their customers . Thus , they will be able to keep in touch , present their treatment types and to enable patients to compare a multitude of surgical departments . The usefulness for colleagues or cooperating institutions must be improved . The WWW has become an important center of information in surgery ."
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[] |
[] |
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DerChirurg.00710503.eng.abstr
|
DerChirurg.00710503.eng.abstr
|
[
{
"id": "DerChirurg.00710503.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Abstract . In obstructed small bowel the number of stercoral bacteria increases due to stasis , inducing a liberation of mediators that are leading to ileus disease with facultative sepsis and breakdown of the circulatory system . The therapeutic procedures have to cure the stasis . In the case of mechanical obstruction cure is achieved by operation , while functional ileus may be healed by conservative treatment . Implantation of a gastric tube or Dennis ' tube can evacuate the small intestine . Several peristalsis-inducing drugs are in use , although their clinical relevance remaines to be demonstrated . Clinical examination and anamnesis offer initial information ; X-ray of the abdomen confirms the diagnosis of ileus and is the baseline examination . Addition of oral contrast medium , ultrasonography , CT and endoscopy may help to evaluate the underlying cause of small-bowel paralysis ."
],
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[
0,
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}
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DerChirurg.00710510.eng.abstr
|
DerChirurg.00710510.eng.abstr
|
[
{
"id": "DerChirurg.00710510.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Abstract . For more than a century peritoneal adhesions are being recognized as frequent sequelae following abdominal surgery . Intraoperative lesions of the mesothelial lining by abrasion , ischemia , dissication , and foreign bodies result in complaints , intestinal obstruction , female infertility , and problems during reoperations . The global increase of life expectancy and surgical procedures are leading to rising incidences of adhesion-related complications and subsequent socio-economic implications . As of today , there is no safe and efficient prophylaxis available . Scientific efforts should be aimed at a liquid substance for single intraperitoneal application which significantly reduces postoperative adhesions at reasonable cost without adverse effects on blood coagulation and wound healing ."
],
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[
0,
814
]
]
}
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DerChirurg.00710518.eng.abstr
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DerChirurg.00710518.eng.abstr
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"Abstract . Today laparoscopic procedures are routinely performed in patients with intestinal adhesions from previous abdominal surgery . Does laparoscopy have a potential benefit in acute small-bowel obstruction ? Theoretically , a lower rate of wound complications and incisional hernias , as well as less subsequent adhesions with a lower incidence of recurrent intestinal obstruction , can be expected . However , laparoscopy is successful in only 50-70 % of selected patients , thereby representing the highest rate of conversion in minimally invasive surgery . Laparoscopic management of severe abdominal distension with massively dilated and fragile small-bowel or dense adhesions is extremely difficult even when performed by experienced surgeons . Significantly prolonged operating time , the high risk of bowel injury ( > 6-10 % ) and an increased frequency of early reoperations jeopardize the patient's safe outcome . However , in strictly selected patients the laparoscopic approach may be promising . In acute intestinal obstruction without a history of previous abdominal surgery , laparoscopy is - in the absence of adhesions - an excellent diagnostic tool and may also be a successful therapeutic modality in a variety of bowel-obstruction etiologies . Furthermore , the laparoscopic option should be considered in patients who previously had undergone small laparotomies ( e.g. , appendectomy ) or laparoscopic surgery . We recommend \" postlaparoscopic \" intestinal obstruction as the ideal case for laparoscopic reexploration . Incarcerated hernias at the site of trocar insertion or adhesions due to peritoneal tears are easily identified as the cause of obstruction and successfully cured with the laparoscope . In conclusion , we advocate the laparoscopic approach in acute small-bowel obstruction exclusively for selected patients . Clinical studies are required to define appropriate surgical indications objectively ."
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DerChirurg.00710524.eng.abstr
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DerChirurg.00710524.eng.abstr
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] |
DerChirurg.00710539.eng.abstr
|
DerChirurg.00710539.eng.abstr
|
[
{
"id": "DerChirurg.00710539.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Abstract . Introduction : Vocal cord paralysis is a important complication in thyroid gland surgery . A prospective study was conducted ascertain the frequency of laryngeal nerve palsy not caused by surgical trauma . Patients and Methods : Two hundred and ten patients were investigated laryngoscopically pre- and postoperatively after short-term intubation in the course of operations far removed from thorax or neck region . We noted the inner diameter of the tube , intubation problems , the qualification of the anaesthesiologist and the positioning of the patient . Results : Preoperatively we found previously unknown unilateral laryngeal nerve palsy in 1.9 % of cases . Postoperatively there were pathological findings of vocal cords in 13 patients ( 6.2 % ) . In 10 patients a direct lesion ( oedema , rubor , haematoma , granuloma ) was established . Three patients ( 1.4 % ) were found to have a movement disorder caused by a neural lesion without morphological findings , leading to restitutio ad integrum in two of three cases after 6 months . Conclusion : The frequency of intubation-related recurrent nerve palsy is 1.4 % transiently and 0.5 % permanently . The reasons are discussed . Preoperative laryngoscopic investigation of vocal cords should be carried out before intubation ."
],
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0,
1297
]
]
}
] |
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] |
[] |
[] |
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DerChirurg.00710545.eng.abstr
|
DerChirurg.00710545.eng.abstr
|
[
{
"id": "DerChirurg.00710545.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Abstract . In recent years , two methods of intraoperative monitoring of the laryngeal nerve have mostly been used : evoked electromyographic responses via endscopically applied needle electrodes inserted into the adducting laryngeal muscles , and non-invasive electrodes like special tubes with integrated electrodes or separately insertable electrodes like the postcricoid electrode or disposable electrodes attached to the tube , as used in this study . The incidence of recurrent nerve paresis or paralysis during the IRM period was 1/174 nerves ( 0.6 % ) . The advantage of the IRM is the quick and certain identification of the nerve ; intraoperative monitoring cannot replace a proper surgical technique . We conclude that the IRM , using a laryngeal surface electrode attached to the tube , is a safe and reliable method ."
],
"offsets": [
[
0,
830
]
]
}
] |
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DerChirurg.00710551.eng.abstr
|
DerChirurg.00710551.eng.abstr
|
[
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"id": "DerChirurg.00710551.eng.abstr-passage-0",
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"Abstract . A new \" all in one \" sensing device was developed for continuous transtracheal intraoperative monitoring and in situ detection of the recurrent laryngeal nerve ( RLN ) during thyroid surgery . Patients and methods : The new system is based on a double-balloon endotracheal tube with integrated atraumatic stimulating and tracing electrodes . The recurrent laryngeal nerve is stimulated transtracheally and compound action potentials are recorded from the laryngeal muscles . Fifty-five patients were introduced into a phase-one clinical trial . Thirty-five patients with primary thyroid operations , 20 patients with reoperations , 10 of whom had neck dissections . All patients were evaluated laryngoscopically and phoniatrically by an ENT specialist before and after surgery . Results : Compound muscle action potentials were recorded continuously during the whole operation and responded sensitively to tension and pressure to the nerve . There were no accidental permanent RLN palsies . Conclusion : The new system offers five advantages : ( 1 ) it is atraumatic ; ( 2 ) it is easy to use ; ( 3 ) it can monitor continuously with an audio feedback to the surgeon ; ( 4 ) it works outside the operation field ; and ( 5 ) it is highly sensitive , even indicating reversible irritation to the nerve ."
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] |
[] |
[] |
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DerChirurg.00710558.eng.abstr
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DerChirurg.00710558.eng.abstr
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"id": "DerChirurg.00710558.eng.abstr-passage-0",
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[] |
[] |
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DerChirurg.00710568.eng.abstr
|
DerChirurg.00710568.eng.abstr
|
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{
"id": "DerChirurg.00710568.eng.abstr-passage-0",
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"text": [
"Abstract . Iatrogenic colonic perforation is a rare but very dangerous complication of colonoscopy . We report on eleven prospectivly recorded patients treated between 1994 and 1998. In seven cases the colonoscopy had been done for diagnostic and in four cases for therapeutic reason . Nine women and two men ( age range 56 to 92 years ) were affected . In 77 % the perforation was found in the sigmoid colon . All patients were operated on and five sutures , five resections and one colostomy were performed . No significant differences could be shown in six patients with classical perforation compared with five patients presenting with prolonged abdominal pain . Only duration of symptoms was significantly different in the two groups . Three patients ( 85 , 90 and 92 years ) died from late complications ."
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DerChirurg.00710572.eng.abstr
|
DerChirurg.00710572.eng.abstr
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"id": "DerChirurg.00710572.eng.abstr-passage-0",
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[] |
[] |
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{
"id": "DerChirurg.00710572.eng.abstr-s3-r10-t1.1-t2.1",
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}
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DerChirurg.00710575.eng.abstr
|
DerChirurg.00710575.eng.abstr
|
[
{
"id": "DerChirurg.00710575.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Abstract . Isolated pancreatic metastases from renal-cell carcinomas ( RCC ) are extremely rare . Only 96 cases of clinically diagnosed renal-cell carcinoma metastatic to the pancreas have been reported in the world literature , and 70 of the patients ( including ours ) underwent a definitive surgical resection . In many cases the time between the nephrectomy and diagnosis of metachronous metastases is reported to exceed 10 years . Therefore , the initial diagnosis may be overlooked when there is a prolonged disease-free interval . When it does occur simultaneously or metachronously , aggressive surgical resection , when possible , seems to be the most effective treatment for this metastatic lesion . Surgical resection can provide long-term survival in selected cases . We present the case of a 69-year-old woman in whom two pancreatic metastases were treated by a left-sided subtotal pancreatectomy with splenectomy , 12 years after radical nephrectomy for a RCC . The patient simultaneously presented with both a mass in the body of the pancreas and a right-sided colon cancer . Thus , the diagnosis of pancreatic metastasis of colon cancer was suspected initially . Both tumors were radically resected , and histological examination revealed two pancreatic metastases from the previous RCC . In the world literature this report represents the eighth case of multiple pancreatic metastases due to RCC . It illustrates a rare indication of pancreatic resection because of pancreatic metastasis . The need for prolonged follow-up of patients is emphasized . The few reports on surgically treated pancreatic metastases from RCC are reviewed after the presentation of this case ."
],
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0,
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}
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DerChirurg.00710580.eng.abstr
|
DerChirurg.00710580.eng.abstr
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"Abstract . The potential for improvement of the results of laparoscopic operations as well as necessity of enhanced efficiency in the health-care systems are the main reasons for development and practical use of robotic systems in the field of laparoscopic surgery . While robotic systems imitate the human camera-holder the Image Tracking System ( ImagTrac , Olympus , Tokio ) is based on another principle : A voice-activated zoom function allows change between overview and detailed view . In the zoom-in position it is possible to select four different fields of view . The results of a clinical trial with control group show that the system : 1. Makes it possible to dispense with the human camera-holder without compromising patient safety , sometimes at greater convenience to the surgeon . 2. Makes it possible for routine laparoscopic operations such as laparoscopic cholecystectomy and laparoscopic hernia repair to be performed ( as solo surgery ) by a team of a surgeon and a nurse only . 3. Is more cost-effective than robotic systems with a similar range of features ."
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[] |
[] |
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] |
DerChirurg.00710615.eng.abstr
|
DerChirurg.00710615.eng.abstr
|
[
{
"id": "DerChirurg.00710615.eng.abstr-passage-0",
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"Abstract . The employment of the optimal therapeutic option according to the best current knowledge is called evidence-based medicine ( EBM ) . Moreover , considering the cost explosion in public health systems , EBM should contribute towards economical and targeted use of the restricted resources and towards quality assurance in medicine . Obviously , this is applicable to the operative specialties and can be termed as evidence-based surgery . Surgeons have to do their \" homework \" about this subject and to perform randomized controlled trials ( the gold standard with the greatest evidence ) on a large scale , in order to come up to this expectation in future . Evidence-based therapy is essential for the preservation and especially for the further development and evolution of high-quality surgery with , at the same time , quality assurance in the new millenium . This article presents the definition of EBM and its implication in the operative fields . Fundamental principles for the practical conduct of clinical randomized controlled trials are defined and the specific problems in surgery are discussed ."
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DerChirurg.00710635.eng.abstr
|
DerChirurg.00710635.eng.abstr
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"Abstract . Introduction : The aim of this literature review is to classify current knowledge on nine questions of current interest for endocrine surgery and their classification with regard to levels of evidenced-based medicine ( EBM ) . Methods : The literature in Medline and EMBase was reviewed . Only retrospective or prospective comparative studies with statistical analysis were selected . Results : ( See Table 8. ) Conclusion : With respect to the current literature , only routine identification of the RLN and the minimally-invasive approach for adrenalectomy can be regarded as EBM . To answer the remaining questions prospective studies are needed ."
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DerChirurg.00710646.eng.abstr
|
DerChirurg.00710646.eng.abstr
|
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DerChirurg.00710658.eng.abstr
|
DerChirurg.00710658.eng.abstr
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[] |
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DerChirurg.00710682.eng.abstr
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DerChirurg.00710682.eng.abstr
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"Abstract . Surgery alone often fails to achieve local control in advanced gastrointestinal tumors . With multimodal therapy approaches , both local tumor control and long-term survival appear to be improved . Intraoperative radiation therapy ( IORT ) is an attempt to achieve higher doses of irradiation while dose-limiting structures are surgically displaced . It has been shown previously that both local tumor control and long-term survival are improved in patients undergoing surgery combined with IORT for both primary and recurrent rectal carcinoma . In advanced gastric carcinoma , IORT has achieved optimistic survival results in a few studies . In locally advanced pancreatic cancer , an apparent improvement in local control has been noted with IORT , but survival has not been prolonged because of a high incidence of both liver and peritoneal metastases . The data concerning IORT for esophageal carcinoma are not yet sufficient to allow judgement ."
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[] |
[] |
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DerChirurg.00710692.eng.abstr
|
DerChirurg.00710692.eng.abstr
|
[
{
"id": "DerChirurg.00710692.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Abstract . In order to perform resections of tumors at critical sites in the liver in young children , liver resections in cardiac arrest and deep hypothermia under cardiopulmonary bypass have been developed . We report our experience with liver resection under cardiopulmonary bypass in three children with hepatoblastoma . In the first child the operation was performed under cardiac arrest and , the other two children were operated on under \" low flow \" conditions . The periods under cardiopulmonary bypass circulation were well tolerated . Extended right liver resections with vascular reconstructions were performed . The postoperative increase of liver enzymes was moderate . The increase in GOT was between 100 and 200 U/l . In spite of the extended tumor growth , reasonable long-term results were achieved by resection in combination with chemotherapy . One child has been living 8 years and another 10 months without tumor recurrence . The third child died due to sepsis during adjuvant chemotherapy , after she had recovered well from liver resection ."
],
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0,
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DerChirurg.00710696.eng.abstr
|
DerChirurg.00710696.eng.abstr
|
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"Abstract . Gastric cysts are a rare disease and their diagnostic work-up often produces inconclusive results . We report on four gastric stromal tumors , in part huge , with cystic degeneration where the diagnosis and organ of origin remained unclear until operation . Considering these tumors as examples we discuss means and limits of differential diagnosis , taking into account further diseases with cystic formations in the gastric wall , such as other soft tissue tumors , pancreatic pseudocysts and gastric duplication cysts . In conclusion , every cystic tumor in the upper abdomen for which a diagnosis and origin cannot be established should be explored by surgery ."
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[] |
[] |
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DerChirurg.00710702.eng.abstr
|
DerChirurg.00710702.eng.abstr
|
[
{
"id": "DerChirurg.00710702.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Abstract . Introduction : Although the effectiveness of perioperative antibiotic prophylaxis is proven , it is not used adequately . The aim of this study was to evaluate whether hospital-based guidelines are useful tools to improve the management of perioperative antimicrobial prophylaxis . Material : In a retrospective study the actual quality of perioperative antibiotic prophylaxis as given by the criteria choice of drugs , dosage , timing , continuation and 2nd dose after > 3 h was evaluated . After information and establishment of adequate guidelines we started a prospective analysis to test compliance and rate of adequate prophylaxis . Differences were calculated according to the 2-test with P 0.05 significance niveau . Results : The percentage of cases in which antibiotics were indicated but not administered was reduced from 15.5 % to 8.4 % . Compared to the result of the retrospective analysis , the prospective study showed a significantly higher percentage of adequately administered antibiotics ( 35.7 % vs. 63.5 % ) . This was mainly due to the compliance with dosage recommendations and to the 2nd dose in longer surgical procedures . Discussion : Guidelines lead to a significant improvement in perioperative antibiotic prophylaxis . To increase this effect , further approaches such as integration of guidelines into computer-based systems should be evaluated ."
],
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0,
1389
]
]
}
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DerChirurg.00710707.eng.abstr
|
DerChirurg.00710707.eng.abstr
|
[
{
"id": "DerChirurg.00710707.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Abstract . Purpose : In recent years , the efficacy of laparoscopic antireflux surgery has been well-documented with quality-of-life data . The aim of the present study was to describe the efficacy of laparoscopic redo-surgery using health-related and disease-specific quality-of-life data . Methods : A sample of 30 patients with mean age of 56 years underwent laparoscopic refundoplication . In 18 patients the primary antireflux procedure was performed by the open technique . In 12 cases the primary intervention was performed laparoscopically . To evaluate quality-of-life the German SF-36 Health Survey and the Gastrointestinal Quality of Life Index ( GIQLI ) were used and given to all patients before and 3 months and 1 year after redo-surgery . Results : Before surgery , in two ( physical functioning , role physical ) out of 8 dimensions of SF-36 the values have not decreased significantly ( P 0.05 ) compared to healthy individuals . Three months after laparoscopic redo-surgery all reduced dimensions improved significantly ( P 0.05 ) . One year after surgery all dimensions are stable and comparable to a healthy population . Prior to redo-surgery , the mean GIQLI was 86.7 points and improved significantly ( P 0.05 ) to 121.6 and 123.8 points ( 3 months and 1 year after refundoplication ) and reached an equivalent level of comparable healthy individuals ( 122.6 points ) . There are no significant differences between patients with an open and laparoscopic initial antireflux procedure at all times of measurement . Postoperative data of only 28 patients were included because in two patients conversion was necessary due to operative problems . Conclusion : Because of these results laparoscopic refundoplication can be discussed as an effective method of treatment after failed primary antireflux procedure . Laparoscopic redo-surgery normalizes objective outcome criteria and also improves quality of life ."
],
"offsets": [
[
0,
1929
]
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}
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DerChirurg.00710712.eng.abstr
|
DerChirurg.00710712.eng.abstr
|
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"Abstract . A 58-year-old woman was initially externally diagnosed in 1983 with a presacral mass , which was subsequently treated as an abcess . Thereafter , the patient experienced recurrent perianal fistulas . Further diagnostic studies revealed a cystic tumor , considered to be an epidermoid cyst , which was located in the inferior pelvis and was consequently removed . Histologically , cystic scar tissue was found with a highly differentiated adenocarcinoma which measured 4 cm . Later on , the patient again experienced perianal fistulas originating from a renewed presacral mass . As a result , an abdominal-perianal rectum extirpation and a partial resection of the sacrum with placement of a descendostomy were done . Histologically , adenocarcinoma tissue was found at the base of a tail-gut cyst . One year following her operation , the patient is free from any complaints and relapses . The tail-gut cyst is a very rare entity which arises from the inadequate involution of the tail-gut during embryonal development . A malignant transformation occurs in 10 % of the cases . In the case of recurrent perianal fistulas and cystic masses between the rectum and os sacrum or os coccygeum , a tail-gut cyst should be taken into consideration , the goal being its complete removal ."
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[] |
[] |
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DerChirurg.00710743.eng.abstr
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DerChirurg.00710743.eng.abstr
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{
"id": "DerChirurg.00710743.eng.abstr-passage-0",
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"Abstract . A perspective on the newer techniques and techniques and recommendations in abdominal wall closure as described in the English-language literature is given . Primary closure of midline incision with running suture should be performed with a suture length to wound length ratio in the range of 4-5 to 1 ; this appears to be the most important step the surgeon can take to avoid dehiscence and/or hernia . The choice of suture material does not appear to be crucial with regard to the prevention of wound failure . Anecdotal experience has suggested that the specific technique of mesh placement in incisional herniorrhaphy is important to prevent recurrence . Difficult abdominal closure can be handled by one of a number of temporary abdominal closure techniques ."
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[] |
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DerChirurg.00710754.eng.abstr
|
DerChirurg.00710754.eng.abstr
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{
"id": "DerChirurg.00710754.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Abstract . Deep wound infection of the abdominal wall and postoperative abdominal wound rupture are dangerous complications of laparotomy that require emergency operative intervention . The wound infection quota after laparotomy is between 5 and 10 % . While subcutaneous infections heal without consequences after wound treatment , deep infections of incisional wounds are a problem . The cause is often an intra-abdominal infection . There are some standard operational measures : consistent debridement of the necrotic parts , careful reexploration of the intra-abdominal site and early fascial closure with special sutures . All other procedures depend on the individual case . Abdominal wall rupture only occurs in 1 % of the cases , but the mortality is high ( 15-45 % ) . Besides local wound factors and the technical aspects , there a many general causes . Abdominal wall rupture also requires emergency operation . Repeated wound closure without further steps is possible in half of the cases . The mass technique should be used . Both deep wound infections and rupture are important complications in the development of incisional hernias ."
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DerChirurg.00710771.eng.abstr
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"Abstract . The estimation of risk should be an essential prerequisite for the choice of the correct surgical therapy and also for assessment of the quality of surgical care . The fact is , that many people talk about \" risk \" but have the wrong idea about this remarkable concept . Too often minutely detailed enumeration of negative events ( complications ) is mistaken for risk . Risk is the probability that something negative will happen . It is also a fact that risk is always regarded as negative . Another fact is that risk in medicine mostly - or only - describes morbidity and mortality . Even though this is correct and important , it is not enough ! Today , risk must include the probability of a therapy option not working , or even the risk of perversion of the therapy intention ! Determination of a risk factor is time-consuming . It is a typical example for clinical research . Proceeding stepwise is maybe helpful . I propose seven steps : Step 1 demands that the circumstances , facts , variables like negative events , ability to cooperate , mortality , severeness of sickness , social circumstances , etc. be clarified . Step 2 means collecting and compiling these circumstances assumed to be clinically relevant All sources of information are good , but better is a prospective data collection . Step 3 defines the individual surgical situation , and from this the different circumstances , which could be risk factors . This is regarded as development of hypothesis . In step 4 the probability is determined with which a special condition or a group of circumstances could become a clinically relevant risk factor . This is done in the clinical experiment with the aid of the mathematical models known today , but also with the experience and intuition of the surgeon . In step 5 the individual clinical situation can be determined according to the significance of the risk factors ( ranking ) . Step 6 is intended for handling the known risk factors . How to proceed with the risk factor within the decision finding process at the surgical intervention ? Step 7 is the all decisive step . It should supply the unequivocal information as to whether risk analysis in toto will bring any benefit for surgery - even more importantly , for the individual patient at a certain time . There is evidence ( external ) that the correct handling of the risk analysis brings a significant effect or benefit in surgery , but it still has its limits . It is a fact that risk analysis with the methods used nowadays has an advantage for group analyses , but ist limits are tight for the individual patient . This is especially true for the scores established and used for this . With the risk analysis the decisive risk factors can be recognized and determined and put into order according to their different effect . Whether this fact has a benefit in surgery or even for the individual patient is still without unknown . There is evidence that comparing the quality of surgical treatments in individual clinics without risk analysis is almost naive ! This is the case for which risk analysis has proved to be the best ! Risk analysis is so far unable to predict the risk of a surgical therapy for an individual patient with sufficient certainty . With a value of 70 % certainty , risk analysis is as good - or as bad - as the experienced surgeon for this decisive question . Conclusion : Risk analysis has not yet given enough proof of its effectiveness . The method is time consuming and up to now only successful for assessment of groups . Comparison of surgical quality in different clinics is naive without risk analysis . Here its importance has been proved . The risk analyses practised so far have no chance when dealing with the individual patient . It can be recognized that the surgeon is a risk factor . However , in the complex system of different circumstances and mechanisms of a surgical care , he is only one factor even though an important one . Risk analysis is an aspect of clinical research and demands more consideration ."
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DerChirurg.00710787.eng.abstr
|
DerChirurg.00710787.eng.abstr
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"Abstract . Soft-tissue sarcomas are a relatively rare disease accounting for approximately 1 % of adult malignancies . Various different histological subtypes exist that behave similarly regarding their biological characteristics and response to treatment . Soft-tissue sarcomas occur in up to 50 % of cases in the extremities , followed by visceral/retroperitoneal and trunk tumors . Primary therapy is predicated on surgical resection with an adequate margin of normal tissue . Limb-sparing surgery for extremity lesions is possible in more than 90 % of patients . For high-risk patients , identified by tumor grade , size and site , local control is improved with postoperative adjuvant radiation . Local recurrence rates vary , depending on the anatomic site . In the most common extremity lesions , one-third of the patients develop locally recurrent disease with a median disease-free interval of 18 months . For visceral sarcomas recurrence rates are up to 40-50 % . Treatment results for extremity local recurrences may approach those for primary disease . Metastases of extremity sarcomas predominantly spread to the lungs where isolated metastases can be resected with 20-30 % 3-year survival rates . Patients with unresectable pulmonary metastases or extra-pulmonary metastatic sarcoma have a uniformly poor prognosis and are best treated with systemic chemotherapy . In general , optimal treatment of soft-tissue sarcoma requires individual care tailored to the single patient ."
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DerChirurg.00710795.eng.abstr
|
DerChirurg.00710795.eng.abstr
|
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"Abstract . Insular carcinoma of the thyroid is a low differentiated type constituting about 5 % of all thyroid cancers . Higher aggressiveness has been suggested as an important clinical feature . The value of preoperative fine-needle aspiration biopsy is not clearly proven for insular carcinoma . The criteria for histological diagnosis have been outlined by Carcangiu et al. . Because of its aggressiveness , radical treatment at primary surgery appears advisable . Its clear distinction from undifferentiated ( anaplastic ) and medullary ( C cell ) cancers is important , as thyroglobulin is regularly synthesized by cancer cells . Enrichment of radioactive iodine makes such treatment feasible postoperatively and at relapse . Follow-up should be performed as in highly differentiated papillary and follicular thyroid cancer . A patient series of eight cases is presented . While all cancers were advanced at the initial diagnosis , the observed disease courses were in agreement with the assumption that insular carcinoma is a more aggressive form of differentiated thyroid cancer ."
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] |
DerChirurg.00710803.eng.abstr
|
DerChirurg.00710803.eng.abstr
|
[
{
"id": "DerChirurg.00710803.eng.abstr-passage-0",
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"Abstract . Tumor invasion of the portal vein by ductal adenocarcinoma of the pancreatic head is classically known as a criterion for inoperability . Despite improvement in operation techniques for portal vein resection during Whipple's procedure and acceptable mortality and morbidity , in the case of uncertain tumor infiltration vascular resection cannot be recommended in general . The problem is the preoperative detection of tumor infiltration of the portal vein . Often the surgeon is confronted with unsuspected macroscopic portal vein infiltration or tumor adhesion during the operation . Between 1986 and 1995 105 patients underwent Whipple's procedure for ductal adenocarcinoma of the pancreatic head in our department . In eight of these cases partial portal vein resection was performed because of macroscopic tumor infiltration or tumor adhesion . In all eight cases the preoperative diagnostic procedures with CT and portography did not show any suspicion of tumor infiltration . In four of the eight cases histological tumor infiltration of all vascular layers was found . In the others we found no or only adventitial tumor invasion . The patients without tumor infiltration of the portal vein showed a survival time after surgery of 27.78 months in contrast to 6.67 months in the group with histologically proven tumor infiltration . Endovascular , intraportal ultrasound ( IPEUS ) , a new diagnostic procedure , can give helpful information regarding portal vein involvement . Although the IPEUS is not a standard diagnostic procedure it was shown to detect portal vein infiltration with high sensitivity and specificity . Our results indicate that in such cases where portal vein infiltration has been excluded by IPEUS , patients with macroscopic tumor adhesion do benefit from partial portal vein resection ."
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DerChirurg.00710808.eng.abstr
|
DerChirurg.00710808.eng.abstr
|
[
{
"id": "DerChirurg.00710808.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Abstract . Introduction : Liver transplantation is the method of choice for metabolic diseases and end-stage liver failure . Methods : At the Klinikum Grosshadern we have performed liver transplantation for inborn errors of metabolism in 24 patients ( 5.3 % of all transplantations , 16 adults , age 39 +/- 13 years ; 8 children , age 9 +/- 3 years ) ; 19 patients received a transplant for end-stage liver disease , and in 5 cases because of fulminant hepatic failure . Results : Twenty-four patients received 27 transplants . In 3 cases , a split-liver transplantation was performed ; one patient received a combined lung-liver graft . The 5-year survival rate for children is 100 % and for adults 68 % . Conclusions : Liver transplantation for inborn errors of metabolism not only replaces the diseased organ , but also leads to complete reversal of the metabolic defect ."
],
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[
0,
875
]
]
}
] |
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[] |
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"id": "DerChirurg.00710808.eng.abstr-s7-r15-t3.2-t2.3",
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] |
DerChirurg.00710820.eng.abstr
|
DerChirurg.00710820.eng.abstr
|
[
{
"id": "DerChirurg.00710820.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Abstract . A 69-year-old patient with reduced pulmonary function was diagnosed as suffering from non-small cell lung cancer of the left lung invading the main bronchus , pulmonary artery and left atrium . Staging examinations were negative . Using cardiopulmonary bypass , an extended pneumonectomy with partial resection of the left atrium was performed . The cardiac defect was closed with a pericardial patch . The lower lobe was divided ex situ from the upper lobe and reimplanted with anastomosis of the lower pulmonary vein to the left auricle . After a totally uneventful course the patient is in good condition and free of tumor recurrence 2.5 years postoperatively ."
],
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[
0,
675
]
]
}
] |
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"db_id": "C0031843"
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"id": "DerChirurg.00710820.eng.abstr-s2-t4",
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"id": "DerChirurg.00710820.eng.abstr-s2-t5",
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"id": "DerChirurg.00710820.eng.abstr-s2-t7",
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"id": "DerChirurg.00710820.eng.abstr-s2-t9",
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"id": "DerChirurg.00710820.eng.abstr-s2-t10",
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"id": "DerChirurg.00710820.eng.abstr-s4-t3",
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"id": "DerChirurg.00710820.eng.abstr-s6-t1",
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{
"id": "DerChirurg.00710820.eng.abstr-s6-t2",
"type": "umlsterm",
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"id": "DerChirurg.00710820.eng.abstr-s7-t2",
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{
"id": "DerChirurg.00710820.eng.abstr-s7-t3",
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] |
[] |
[] |
[
{
"id": "DerChirurg.00710820.eng.abstr-s2-r1-t2.1-t7.1",
"type": "adjacent_to",
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{
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{
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},
{
"id": "DerChirurg.00710820.eng.abstr-s2-r5-t9.1-t2.1",
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},
{
"id": "DerChirurg.00710820.eng.abstr-s2-r6-t2.1-t10.1",
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},
{
"id": "DerChirurg.00710820.eng.abstr-s2-r7-t9.1-t10.1",
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},
{
"id": "DerChirurg.00710820.eng.abstr-s2-r8-t9.1-t5.1",
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"arg2_id": "DerChirurg.00710820.eng.abstr-s2-t5",
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},
{
"id": "DerChirurg.00710820.eng.abstr-s2-r9-t9.1-t2.1",
"type": "affects",
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},
{
"id": "DerChirurg.00710820.eng.abstr-s2-r10-t2.1-t9.1",
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},
{
"id": "DerChirurg.00710820.eng.abstr-s2-r11-t9.1-t5.1",
"type": "affects",
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{
"id": "DerChirurg.00710820.eng.abstr-s2-r12-t2.1-t5.1",
"type": "adjacent_to",
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},
{
"id": "DerChirurg.00710820.eng.abstr-s2-r13-t9.1-t8.1",
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"arg2_id": "DerChirurg.00710820.eng.abstr-s2-t8",
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},
{
"id": "DerChirurg.00710820.eng.abstr-s2-r14-t2.1-t5.1",
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},
{
"id": "DerChirurg.00710820.eng.abstr-s2-r15-t9.1-t12.1",
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},
{
"id": "DerChirurg.00710820.eng.abstr-s2-r18-t2.1-t9.1",
"type": "adjacent_to",
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},
{
"id": "DerChirurg.00710820.eng.abstr-s2-r19-t2.1-t12.1",
"type": "adjacent_to",
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},
{
"id": "DerChirurg.00710820.eng.abstr-s2-r20-t9.1-t7.1",
"type": "disrupts",
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},
{
"id": "DerChirurg.00710820.eng.abstr-s2-r21-t2.1-t10.1",
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{
"id": "DerChirurg.00710820.eng.abstr-s2-r23-t2.1-t5.1",
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{
"id": "DerChirurg.00710820.eng.abstr-s2-r24-t2.1-t8.1",
"type": "adjacent_to",
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},
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"id": "DerChirurg.00710820.eng.abstr-s4-r1-t2.1-t1.1",
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},
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},
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{
"id": "DerChirurg.00710820.eng.abstr-s4-r4-t1.1-t2.1",
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},
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"id": "DerChirurg.00710820.eng.abstr-s4-r5-t4.1-t2.1",
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"id": "DerChirurg.00710820.eng.abstr-s4-r8-t2.1-t3.1",
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{
"id": "DerChirurg.00710820.eng.abstr-s7-r2-t2.1-t3.1",
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},
{
"id": "DerChirurg.00710820.eng.abstr-s7-r3-t3.1-t2.1",
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"arg2_id": "DerChirurg.00710820.eng.abstr-s7-t2",
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}
] |
DerChirurg.00710824.eng.abstr
|
DerChirurg.00710824.eng.abstr
|
[
{
"id": "DerChirurg.00710824.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Abstract . Introduction : Since the introduction of laparoscopic hernioplasty the TAPP procedure ( transabdominal preperitoneal approach ) has become the most widely used technique . Many surgeons have changed to the total extraperitoneal approach ( TEP ) , because they fear the consequences of a peritoneal lesion . Method : We evaluated our results with TAPP in a retrospective study , with special attention to complications caused by the approach . We operated on 460 hernias in 390 patients in a period of 5 years . Results : Complication rates and recurrence rates were similar to those after TEP . There was a marked learning curve with decrease of both rates during the evaluated years . There were no complications related to the transabdominal approach other than trocar hernias , the rate of which could be reduced by eliminating the learning curve and by using smaller trocar diameter . Conclusion : We see no reason to change from TAPP to the TEP technique ."
],
"offsets": [
[
0,
972
]
]
}
] |
[
{
"id": "DerChirurg.00710824.eng.abstr-s1-t1",
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{
"id": "DerChirurg.00710824.eng.abstr-s2-t1",
"type": "umlsterm",
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"TAPP"
],
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[
82,
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]
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"db_id": "C0163807"
}
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{
"id": "DerChirurg.00710824.eng.abstr-s2-t2",
"type": "umlsterm",
"text": [
"procedure"
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[
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"db_id": "C0184661"
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"db_name": "UMLS",
"db_id": "C0025664"
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]
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{
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[] |
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DerChirurg.00710836.eng.abstr
|
DerChirurg.00710836.eng.abstr
|
[
{
"id": "DerChirurg.00710836.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Abstract . Introduction : Sphincterotomy can be avoided in the repair of high anorectal or rectovaginal fistulas by use of rectal advancement flaps . Methods : Between 1986 and 1998 , 22 patients with high anorectal and 15 patients with rectovaginal fistulas underwent fistulectomy without sphincterotomy and consecutive transanal rectal advancement flap repair . Results : Primary healing was achieved in 81 % ( 30/37 patients ) . There was no disturbance of continence though anal resting pressures decreased postoperatively . Recurrences occurred in 4 of 12 patients with Crohn's disease ( 2 anorectal , 2 rectovaginal ) and in 1 patient with traumatic anorectal fistula . There were no recurrences in patients with cryptoglandular disease , while the operation failed in 2 patients with ergotamine-induced fistulas . Conclusions : This operative approach achieves a high primary healing rate with optimal functional outcome . Despite good results the indication should be set carefully in patients with Crohn's disease ."
],
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1024
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]
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"id": "DerChirurg.00710836.eng.abstr-s7-r19-t3.1-t1.1",
"type": "result_of",
"arg1_id": "DerChirurg.00710836.eng.abstr-s7-t3",
"arg2_id": "DerChirurg.00710836.eng.abstr-s9-t1",
"normalized": []
},
{
"id": "DerChirurg.00710836.eng.abstr-s7-r20-t3.1-t6.1",
"type": "degree_of",
"arg1_id": "DerChirurg.00710836.eng.abstr-s7-t3",
"arg2_id": "DerChirurg.00710836.eng.abstr-s7-t6",
"normalized": []
},
{
"id": "DerChirurg.00710836.eng.abstr-s9-r1-t2.1-t1.1",
"type": "occurs_in",
"arg1_id": "DerChirurg.00710836.eng.abstr-s9-t2",
"arg2_id": "DerChirurg.00710836.eng.abstr-s9-t1",
"normalized": []
}
] |
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