Abstract:
UNLABELLED:It was the aim of the study to find by retrospective analysis of data from totally gastrectomized patients risk factors for the development of esophago-jejunal anastomotic leakage, that may be avoidable or influenced therapeutically. PATIENTS AND METHODS:The study design was retrospective involving 838 patients with total gastrectomy for gastric cancer from the years 1973-1993. In 134 cases leakage of the esophago-jejunostomy occurred. The relative risk for the development of leakage associated with individual parameters was determined by comparing the data from 704 patients without leakage to the data from 134 patients presenting with this complication. For a subgroup of 86 patients with anastomotic leakage microbiological data of swabs taken from the anastomoses were available, which were evaluated with respect to potentially pathogenic bacilli. RESULTS:The overall leakage rate of esophago-jejunal anastomoses was 15.9% (n = 134). The mortality rate during this time period amounted to 14.3%. Leakage was a most highly significant factor for mortality (p = 0.0001). Significant risk factors for leakage of the esophago-jejunostomy were tumors of the cardia, splenectomy, a duration of operating time of more than 5 hours and manual suture technique compared to stapler anastomoses. Tumor unrelated associated disease, tumor stage and a history of other preexisting gastric diseases were not associated with an increased relative risk. At the time of the initial clinical manifestation of leakage the following pathogenic bacilli could be isolated from leaking anastomoses with decreasing incidence: E. coli, S. aureus, Proteus mirabilis, Pseudomonas aeruginosa, Klebsiella pneumoniae a.o. The bacterial spectrum has not changed during the observation period of 20 years. SUMMARY:With the exception of the choice of suture techniques the identified clinical risk factors cannot be avoided or influenced therapeutically due to a lack of potentially curative treatment alternatives. In contrast potentially pathogenic bacilli associated with leakage can be prevented from coming in contact with anastomoses thereby preventing infection and leakage.
journal_name
Zentralbl Chirjournal_title
Zentralblatt fur Chirurgieauthors
Schardey HM,Krämling HJ,Cramer C,Kusenack U,Hadersbeck J,Schildberg FWsubject
Has Abstractpub_date
1998-01-01 00:00:00pages
46-52issue
1eissn
0044-409Xissn
1438-9592journal_volume
123pub_type
杂志文章abstract:BACKGROUND:Sacral nerve stimulation (SNS) is an effective and less invasive treatment of faecal incontinence (FI). Patient selection has evolved from strict criteria to a more liberal approach, since temporary testing reliably predicts the efficacy of permanent stimulation in FI of various aetiologies. PATIENTS AND ME...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-2008-1004737
更新日期:2008-04-01 00:00:00
abstract::In computed tomography, the mediastinum is split into ventral prevascular, middle visceral and dorsal paravertebral compartments. Each compartment contains specific tumours which will be presented and discussed briefly. The focus is on image-based analysis of morphological signs to differentiate between entities using...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/a-1171-2766
更新日期:2020-07-06 00:00:00
abstract::In 1920 Braun described a technique of skin grafting particularly designed for areas where shearing forces, high pressure and extensive secretion cause repetitive loss of conventionally transplanted skin. During the last 10 years we successfully used this technique when impaired wound healing was encountered due to va...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-2004-822649
更新日期:2004-05-01 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::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::Immediate operative reconstruction of ligament injuries of the knee joint is recommended for the performance age. The optimal operation time is within 24 hours after the accident, it should be done within 72 hours. The important advantage of this early operation in comparison to a non-operative treatment is the possib...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1977-01-01 00:00:00
abstract:INTRODUCTION:We analysed our long-term results with postoperative radiotherapy of the chest wall in male breast cancer patients with respect to local control and survival. METHODS:Twenty-five patients with 26 histological proven carcinomas of the male breast underwent postoperative radiotherapy of the chest wall with ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-2007-981268
更新日期:2007-10-01 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:UNLABELLED:With regard to the factors of graft damage the role of rapid cooling during cold in situ perfusion should not be underestimated. The aim of this study was to analyse the effect of rapid cooling on microperfusion of rat livers in an in vitro model. MATERIAL AND METHODS:During harvest of 14 rat livers the org...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1998-01-01 00:00:00
abstract::5 patients suffered from melanoblastoma or thyroid cancer were treated with irradiation and cytostatics. The results of spermiograms before, and after treatment show with regard to fertility a moderate prognosis. ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1990-01-01 00:00:00
abstract::Two different approaches can be distinguished in the surgical treatment of rectal prolapse, i. e. the transabdominal route and the perineal procedures. The following article deals with both operative options with a detailed discussion of the Delorme's operation and the perineal rectosigmoidectomy, also known as the Al...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:10.1055/s-2007-981237
更新日期:2007-08-01 00:00:00
abstract::From 1975-1989 55 patients were operated on for complicated diverticular disease at our unit. Intraoperative we found the following complications: 21 walled of perforations, 22 stenosis of the sigmoid colon combined with obstruction of the small and/or large bowel, 8 free perforations with generalized, faecal peritoni...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1991-01-01 00:00:00
abstract::35 patients (17 females, 18 males), ranging from 75 to 92 years of age, underwent nephrectomy because they suffered from renal tumours, which in 12 cases had preoperatively a total blockage of the renal artery after angiography. A total of 27 retroperitoneal and 8 transperitoneal operations were performed. Indications...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1984-01-01 00:00:00
abstract::The three original aims of pancreatic duct occlusion (PDO) were first the reduction of early complications after Whipple's operation in chronic pancreatitis and carcinoma as well as segmental pancreas transplantation, second to finish the inflammation in cases of chronic pancreatitis and third to protect the B-cell fu...
journal_title:Zentralblatt fur Chirurgie
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1990-01-01 00:00:00
abstract::The use of Hemostypic agents like oxised regenerated cellulose and collagen sponge is widespread in cases with severe hemorrhage that cannot be treated by conservative measure. With these materials however one cannot bring compression to the source of bleeding. We therefore have been using absorbable mesh (Vicryl, Dex...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1991-01-01 00:00:00
abstract::The authors discuss indications for using different temporary skin substitutes in local burn therapy. The clinical philosophy is based on an experience of 15 years. The advantages of those biological materials containing epidermis are stressed. Experimental results obtained in laboratory pigs show the importance of lo...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1981-01-01 00:00:00
abstract:OBJECTIVE:The use of a limited incision for abdominal aortic aneurysm (AAA) repair was evaluated, and its outcome was analyzed in comparison to standard open repair. PATIENTS AND METHODS:Between February 2000 and August 2001, 20 patients with an AAA underwent minimal incision repair (MINI) for tube graft implantation....
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-2002-33948
更新日期:2002-09-01 00:00:00
abstract:OBJECTIVE:Incisional hernia repair with conventional techniques (simple closure, Mayo) is associated with high recurrence rates in the range of 30-50%. Surgical repair using different prosthetic biomaterials gains more and more acceptance. Therefore we wanted to evaluate our own results of hernia repair and analyze the...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1997-01-01 00:00:00
abstract::The physiological significance of the residual distal stomach after proximal gastrectomy (PG) was evaluated in dogs from the view-point of serum gastrin. The fasting gastrin levels in both (1/2 and 2/3) PG groups were high, especially in the 1/2 PG group. The serum gastrin levels did not decrease with time after test ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1985-01-01 00:00:00
abstract::Treatment was applied to 181 patients for acute pancreatitis at the Surgical Department of Friedrichshain Local Hospital, between December 1, 1985 and October 30, 1987. Ninety-two of these patients were in Stage I according to Kümmerle-Hollender, 62 in Stage II, and 27 in Stage III. Operations were performed on 57 pat...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1988-01-01 00:00:00
abstract::The repair of multiple recurrences of inguinal hernias remains a surgical challenge. In 38 patients with a problematic recurrent inguinal hernia we implanted a polypropylene mesh (Prolene) in order to reinforce the transversalis fascia and to repair the inguinal hernia. 20 of these were medial and 14 lateral hernias; ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
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::Visceral aneurysms are very rare (0.1% in autopsy-statistics). In our own review of literature we have found only 9 described cases of an aneurysm of the gastroepiploic artery. In the presented case an aneurysm was found when the patient developed an acute upper gastrointestinal bleeding. Due to the high risk of ruptu...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1993-01-01 00:00:00
abstract::The growing clinical impact of radiofrequency ablation of liver lesions is reflected by a rapidly increasing number of published papers. Experimental work focuses on factors that reduce the variability of the ablation zone. The Pringle-maneuver plays a key role in this question from a surgeon's perspective. Large sing...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:10.1055/s-2007-981198
更新日期:2007-08-01 00:00:00
abstract::In a ten years period 186 extravesical antireflux operations (Lich-Gregoir) were performed in 145 children. Indications, surgical technique, postoperative complications, reflux recurrence, and pyelonephritis are described and discussed with regard to the literature. In 66 children followed up for more than 4 years the...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1985-01-01 00:00:00
abstract:INTRODUCTION:An adequate approach to surgically induced sepsis needs an early and targeted antibiotic therapy in addition to focus sanitation. The PCR-based LightCycler Septifast test can detect 90 % of the sepsis-associated microoganisms (e. g., Gram-positive, Gram-negative bacteria, fungi) within only a few hours. P...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-0028-1098776
更新日期:2009-06-01 00:00:00
abstract::We report on a 31-year-old man with a 29 x 15 x 15 cm large abdominal tumor who came to surgery under suspicion of echinococcus cyst of the liver. Histologically, the neoplasm could identified as multicystic peritoneal mesothelioma (synonyma: benign cystic mesothelioma). Additionally some cysts were located in the gre...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1996-01-01 00:00:00
abstract::Intractable pain is an important indication for stereotactic operations in deep structures of the brain. The targets are situated in primary and secondary sensomotoric regions of the thalamus, dependent or independent on cortical areas. In clinical practice it is necessary to combine two or three targets in the thalam...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1979-01-01 00:00:00
abstract::89 preschool children, 2-4 years old, treated under the diagnosis of appendicitis were analyzed, 46 of them were operated. In 40% of those children the diagnosis of an acute nonperforated appendicitis could have been ensured, in 40% the diagnosis of a perforated appendicitis was found, in 20% the laparotomy was negati...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1998-01-01 00:00:00
abstract::Sequestration is defined as an area of abnormal pulmonary tissue not connected with the bronchial tree, supplied by an aberrant systemic artery and without a normal pulmonary function. Extralobar (ELS) and intralobar (ILS) forms are distinguished. During the year 2002 the authors diagnosed and operated upon two cases ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-2003-44806
更新日期:2003-11-01 00:00:00