Abstract:
:Most patients with Crohn's disease have to be operated on. Necessity to loose some amount of the intestine and time-point of the surgical intervention may be derived from the irreversible cascade of the inflammatory process and the limitations of the conservative treatment. In ileocecal disease indications for surgery are represented by stenotic and/or penetrating complications of the inflamed bowel, whereas in Crohn's colitis acute or terminal medical refractority is predominating. Standard-procedures result from constantly definable patterns of the disease manifestation: ileocecal resection and colectomy/-proctocolectomy. In segmental colitis sometimes "resections within Crohn's" may be adequate in a first attempt to avoid anticipating the natural course by surgical means. In these cases the further prognosis depends on the treatment possibilities of the remaining colon. In contrast, true recurrence is a new inflammation of the neoterminal ileum and may indicate repeated resections. The frequence decreases with the number of resections. Nevertheless nutritional status is restored even by multiple resections, whereas specific functional sequelae of the resection--distal resection- and dehydration syndromes--are well treatable mostly. In the case of appropriate timing of the operation and the reoperation operative morbidity and mortality are remarkable low today resulting in an almost normal life expectancy. Most important as negative prognostic factor remains sepsis resulting from pre-existing or postoperative infectious complications. Keeping this in mind experimental pharmaco-therapy to delay the operation and not profoundly substantiated tendencies to minimize surgery are to be considered only with critical scepticism. At the moment, future research is thought to be more successful in focussing prophylaxis of ileal recurrence than avoiding surgery.
journal_name
Zentralbl Chirjournal_title
Zentralblatt fur Chirurgieauthors
Ecker KW,Hultén Lsubject
Has Abstractpub_date
1998-01-01 00:00:00pages
331-7issue
4eissn
0044-409Xissn
1438-9592journal_volume
123pub_type
杂志文章,评审abstract::The ligament augmentation device (Kennedy-LAD) is used to protect tendon grafts during the posttransplantation decrease in strength in anterior cruciate ligament (acl) reconstructions. The augmentation with the LAD is based on the concept of load sharing. Since 1983 we used the LAD in acl-reconstructions in 856 patien...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1998-01-01 00:00:00
abstract::Between 1969 and 1982, 38 out of 121 patients with oesophageal carcinoma underwent palliative surgery. Operatively in 22 patients a Celestin- or Häring-tube was inserted, gastrostomy was performed 10 times, palliative resection two times. Four times the obstruction was bypassed. 17 patient achieved additional radiatio...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1985-01-01 00:00:00
abstract:OBJECTIVE:The transpalpebral resection of the corrugator and depressor supercilii muscles is a new treatment option for migraine headaches. Hyperactive contractility of these muscles can provoke the peripheral compression of the supratrochlear nerve and induce a neurogenic inflammation triggering the symptoms of migrai...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-2005-836786
更新日期:2005-08-01 00:00:00
abstract::A statewide report card system for cholecystectomy as a surgical tracer has been established in Westfalia-Lippe as part of a program of external quality assurance. 74,400 data between 1993 and 1997 were analyzed. Pathologic findings in preoperative diagnostics (sonography, elevated bilirubin) do not lead to therapeuti...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:2000-01-01 00:00:00
abstract::The hormonally induced changes in the breast during pregnancy make the diagnosis of breast cancer difficult. Furthermore, examinations during pregnancy tend to concentrate only on the pregnancy itself. In this report the clinical, pathological and immunohistochemical results from 7 patients with breast cancer during p...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1992-01-01 00:00:00
abstract::Since 1984 we have been using the opportunity to registrate the dissected lymph nodes at different locations of the lymph nodes and the carcinoma in case of D-2 dissection by means of a lymph node dissection protocol. The total rate of lymph nodes by the several patients is an indirect sign for the quality of the lymp...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:2000-01-01 00:00:00
abstract::The implementation of robot-assisted surgery requires a multi disciplinary approach with appropriate training and cooperation of surgical, anesthetic and technical staff. Besides acquiring the technical skills and getting used to complex technique, patient selection and an appropriate frequency of procedures are requi...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-0042-104068
更新日期:2016-04-01 00:00:00
abstract::Background: Since 2006 the practical year in the Mannheim Reformed Curriculum Medicine (MaReCuM) is divided into four quarters: the two required subjects (surgery and internal medicine), one elective and one of four offered fields in ambulatory medicine. Therefore students can more intensively focus on their preferenc...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-0035-1546248
更新日期:2017-02-01 00:00:00
abstract:BACKGROUND:In Germany, more than one million people use benzodiazepines on a regular basis. The majority of them is older than 60 years and take low-dose benzodiazepines for sleep disorders. This does not necessarily induce tolerance, but may result in problems such as falling, seizures or delirium if benzodiazepines a...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:10.1055/s-0041-107198
更新日期:2016-02-01 00:00:00
abstract:INTRODUCTION:The aim of the study was to evaluate the efficiency of the endovenous use of laser for treatment of varicose veins. In particular the influence of laser energy on the perivenous temperature, the postoperative clinical and duplex ultrasound course was taken into account. METHOD:The patients were divided in...
journal_title:Zentralblatt fur Chirurgie
pub_type: 临床试验,杂志文章
doi:10.1055/s-2006-921389
更新日期:2006-02-01 00:00:00
abstract::The aim of this study was to determine whether arterial reconstructions in old age carry an acceptable risk and are reasonable as far as long term results are concerned. The operative mortality was 3,4% for reconstructions distal to the inguinal ligament and 20.5% for reconstructions in the aorto-iliac region. Limb am...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1980-01-01 00:00:00
abstract::Widely normal stability of the vertebral column with adequate load-bearing capacity should be achieved, following osseous reconstruction of a defect area from which benign tumours or tumour-like lesions had been removed by radical surgery. In malignant processes, surgical tumour removal may add to the effectiveness of...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1987-01-01 00:00:00
abstract::Reported are 135 cases of hepatectomy. Eight patients died, including seven who died of coma due to liver failure. Preoperative misjudgement of the functional reserve of the liver is, admittedly, an unsolved problem. A two-session approach, following chemotherapeutic tumour reduction, might be an alternative, when it ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1986-01-01 00:00:00
abstract::On the basis of 341 liver biopsies routinely taken during cholecystectomies using Menghini's technique the pathological changes of the liver in comparison to the degree of cholecystitis were studied. Because of the frequency of morphological changes detected in the liver tissue, the low risk of the procedure and the p...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1982-01-01 00:00:00
abstract::Therapeutic bronchoscopy is widely used in the treatment of airway stenosis, fistula, and pulmonary bleeding. Recanalisation of tracheobronchial stenoses can be treated by Nd: YAG-laser or stent implantation. While the use of laser irradiation is limited to intraluminal obstruction, stenting is also effective in steno...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:
更新日期:1998-01-01 00:00:00
abstract:UNLABELLED:Modified radical mastectomy remains the standard for treatment of breast cancer. Women faced with the diagnosis of breast cancer often find it difficult to cope with the arousing emotions. Fear of death or cancer recurrence and a perceived loss of femininity often coexists with the desire for a return to nor...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1998-01-01 00:00:00
abstract::Normal ranges, which were set up for quality control, serve to define an acceptable qualitative niveau of treatment. To establish such criteria, it is important to consider group-specific characteristics during investigations. Results of clinical trials are the basics to determine the normal range of parameters of qua...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:2000-01-01 00:00:00
abstract::A rare case of a retroperitoneal cyst of Echinococcus granulosus in a male adult is presented. Due to its extension and infiltration of important anatomical structures the hydatid cyst could not be completely removed by operation. Therefore the patient was treated with albendazole for 10 months after surgery. The effi...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1995-01-01 00:00:00
abstract:BACKGROUND:Complete mesocolic excision (CME) and central vascular ligation (CVL) for right-sided colon cancer may be superior to standard hemicolectomy in terms of oncological results. This hypothesis is currently being investigated in a large multicentre trial conducted by the authors of this paper (Resektatstudie). B...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,多中心研究
doi:10.1055/s-0034-1383133
更新日期:2015-08-01 00:00:00
abstract::Experiments in rats and dogs showed that bleeding of parenchymal organs can be stopped quickly and reliable by using a recently developed infrared contact coagulator (ICC). Haemostasis of liver parenchyma was established in a shorter time than by usual diathermo-coagulation. Due to this reduced time of coagulation sma...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1980-01-01 00:00:00
abstract::The alterations in diagnosis and therapy of intussusception in infants is described in 155 cases from 1978-1989. The primary diagnostic procedure is the abdominal sonography. It is followed to 1988 the attempt of hydrostatic reduction by barium enema and now the pneumatic reduction. The rate of success with conservati...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1990-01-01 00:00:00
abstract::Currently available replacement therapies for the treatment of acute renal failure are reviewed. Particular interest is focused on their application in intensive care, especially in septic patients. Underlying principles and mechanisms of action are explained. The continuous "High flux-dialysis" is shown to be a parti...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:
更新日期:1997-01-01 00:00:00
abstract:INTRODUCTION:The resection of pulmonary metastases can extend life of patients, even offering the possibility of cure. A risk analysis of the surgical procedure under the current practice of the thoracic surgery has been performed in this study. MATERIALS AND METHODS:Using a prolective method, data from 199 patients w...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-2005-918183
更新日期:2005-12-01 00:00:00
abstract::Regional chemotherapy offers a means to enhance the local efficacy of an otherwise ineffective systemic chemotherapy. The regional concentration advantage of a drug is proportional to its total body clearance and inversely proportional to the blood flow through the organ. Regional infusion of adriamycin, cisplatin, me...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:
更新日期:1995-01-01 00:00:00
abstract::A highly evacuated wound drainage system according to Redon (980 mbar) was applied to 100 women who had undergone laparotomy. No change of bottles was necessary up to removal of the system in 96 cases. Bacteriological tests were applied to various points of the Redon system and revealed only minimum colonisation with ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1987-01-01 00:00:00
abstract::The surgical approach to malignant hepatoma in cirrhotic liver has continued to be an unresolved problem. Early diagnosis, differentiated indication, and surgical techniques need further improvement, before adjuvant therapy can be discussed. All surgeons are called upon to verify experience of the past and to integrat...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:
更新日期:1989-01-01 00:00:00
abstract:AIM OF THE STUDY:The surgical technique of transoral diverticulostomy by a modified Endo-GIAtrade mark Stapler (Multifire Endo GIA, Tyco Healthcare) is described. Experiences of this procedure in 31 patients are analysed and compared with different endoscopic and conventional surgical therapies of Zenker's diverticula,...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-2007-981312
更新日期:2007-10-01 00:00:00
abstract::2 cases of peritonitis fibroplastica with obscure genesis and atypical complaints were operated on. Pseudomembranes were carefully cleared away from the intestine. The first patient has been cured after two years, the other died of another disease. ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1978-01-01 00:00:00
abstract::Laparoscopic common bile duct exploration offers the possibility of complete minimal invasive therapy of biliary stone disease with respect to the anatomical structures of the papilla Vateri. In spite of generously indicated preoperative ERC, we found in 23 of 376 laparoscopic cholecystectomies unsuspected common bile...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1993-01-01 00:00:00
abstract::With 44.9 % trauma is the main cause of death in men under 40 years. From September 3(rd) 1997 to June 30(th) 1998 174 patients with severe injuries or polytrauma were treated in our hospital. The mean ISS was 29 (18-75). 15 (8.75 %) patients died within the first 24 hours. The mean age was 34.5 (2-85) years. The mean...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-2001-19658
更新日期:2001-12-01 00:00:00