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 results of a mesh hernioplasty using an expanded polytetrafluoroethylene patch (ePTFE). PATIENTS AND METHODS:1. During the study period (1984-1992) a total of 205 hernia repairs (148 primary repairs, 57 repairs for recurrent hernia) were done in 173 patients at our institution using the following techniques: Mayo technique n = 90, simple one layer suture n = 56, absorbable mesh n = 25, ePTFE n = 17, other mesh techniques n = 17. In a retrospective study 135 of these patients (78%) could be examined clinically. The average follow up time was 44 months (10-105). 2. Since 1988 we used the ePTFE patch (Gore-tex Soft Tissue Patch) in selected cases for incisional hernia repair. In a second retrospective analysis the course of 26 patients, who were operated between 1988 and 1994, is reported. RESULTS:1. Local wound complications occurred in 3-6% with conventional techniques and in 11-13% after different types of mesh repair (n.s.). Overall recurrence rates were 30% for primary hernia repair and 38% for recurrent hernia repair without statistically different rates for the various techniques. The presence of two or more patient dependent risk factors (obesity, obstructive lung disease etc.) (p < 0.05) and hernia diameter > 5 cm (p < 0.05) were identified as risk factors for hernia recurrency. 2. In the ePTFE group one patient (4%) developed a superficial wound complication, in another three patients (12%) the patch had to be removed due to deep wound infections. All three patients had revealed septic wound complications after previous surgery. The recurrence rates (17% for primary repair and 20% for repeated repair) were clearly lower compared to conventional techniques. CONCLUSIONS:The use of prosthetic mesh should be considered for repair of large or recurrent incisional hernias, especially in high risk patients (obesity, obstructive lung disease). Beside the most often used polypropylene mesh, the ePTFE patch (Gore-tex-Soft-Tissue-Patch) represents a valuable alternative in selected cases with direct contact of the prosthesis to abdominal viscera. Any previous septic wound complication or a contaminated operating field (e.g. colostomy) seems to be a contraindication for its use.
journal_name
Zentralbl Chirjournal_title
Zentralblatt fur Chirurgieauthors
Trupka AW,Schweiberer L,Hallfeldt K,Waldner Hsubject
Has Abstractpub_date
1997-01-01 00:00:00pages
879-84issue
10eissn
0044-409Xissn
1438-9592journal_volume
122pub_type
杂志文章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::Intraabdominal cystic lymphangiomas are rare tumor-like lesions, predominantly found in the pediatric age group, but also in juveniles or young adults. Lymphangiomas are always benign and do not recur after complete excision. In this paper we report on two 4-year old children with a history of abdominal discomfort due...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1999-01-01 00:00:00
abstract::Between 1978 and 1990 98 patients with gas gangrene were treated in the departments of general surgery and traumatology of the University of Kiel. The microbiological results of tissue samples and results of animal infectious experiments were correlated to the clinical outcome. It could be shown, that gas gangrene due...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1992-01-01 00:00:00
abstract::Surgical correction of bilateral cleft lips is known to have a lot of problems. The surgical principles of treatment of bilateral cleft lips are similar to those of unilateral clefts but differ in the area of the prolabium due to specific anatomical disorders of the orbicularis oris muscle. The postoperative results o...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-2002-20235
更新日期:2002-01-01 00:00:00
abstract::For the hemodynamically unstable patient with pelvic fracture a target focussed and rapid diagnostic and therapy is mandatory. After hemorrhage control at crash site the direct transport in a trauma center follows. Primary therapy in the emergency room sometimes includes stabilization by a pelvic clamp or an external ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-2004-44882
更新日期:2004-01-01 00:00:00
abstract::From the new payment system of procedure (covering anesthesia and surgery with all personal and material costs) or case related payment (including all costs of operation and hospital stay, medical as well as room-and-care and administrative), in 1996 for all German hospitals obligatory introduced, 22 respectively 9 co...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1997-01-01 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::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::For the first time the surgical technique of right and left adrenalectomy by a posterior percutaneous retroperitoneoscopic access is described. The adrenal gland is mobilized after creation of a pneumoretroperitoneum and insertion of 3-4 trocars beneath the 12th rip. Indications for this new method are small, benign a...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1995-01-01 00:00:00
abstract::This study reports on follow-up controls of 53 children with fractures of the humerus near the elbow-joint. 31 children had supracondylar fractures, 11 condylar fractures and 11 other lesions of the lateral epicondylus. The examination was carried out with special attention to functional aspects. A new own method for ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1980-01-01 00:00:00
abstract::Due to unsatisfactory results of porto-systematic shunts in oesophageal varices as prophylaxis or as therapy in haemorrhagic states local therapeutic measures have attracted attention, especially sclerosing the wall of the oesophagus by an endoscopic technique. ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1978-01-01 00:00:00
abstract::Aorto-iliacal or aortofemoral bifurcation grafts were implanted to 351 patients for stenotic or occlusive diseases of pelvic and femoral arteries, between 1974 and 1986. The average age of patients was 62.7 years, and perioperative lethality amounted to 7.4 per cent. The average age of patients who died was 68.2 years...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1988-01-01 00:00:00
abstract::In 1973 the observation was published that in patients who had received non specific blood transfusions before kidney transplantation graft survival was improved. An immunosuppressive effect of blood transfusion was suggested. Indeed, modulation on the cellular and humoral immunologic system has been demonstrated duri...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1991-01-01 00:00:00
abstract::According to the postoperative prophylaxis of thromboembolia a review of actual publications is given. The therapeutical problems of Coumarin, Dextran, Acetylsalicylic acid and low dosis Heparin were discussed. A final answer to the various questions can not be given. Concerning the prophylaxis low dosis Heparin seems...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:
更新日期:1977-01-01 00:00:00
abstract::While classical inguinal hernia repair has recently been brought up for discussions among surgeons, at present various modified techniques are being reintroduced in general surgery. Surgical hernia repair techniques which partly are known since several decades are being carried out laparoscopically since 1989. Between...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1993-01-01 00:00:00
abstract::From 1948 to 1977 359 patients suffering from oesophageal reflux disorders or the hiatus-hernia-complex underwent surgery at the I. Surgical clinic of the Medical Faculty Palacky-Univ. in Olomouc. In the group of 50 patients with simple paraaesophageal hernias the operative mortality came up to 4.0%. The mortality rat...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1981-01-01 00:00:00
abstract::The onset of a malignant transformation in long-standing ulcerative colitis is difficult to predict. The value of the clinical and histomorphological parameters in current use is limited. It was thus aim of the present study to investigate the value of DNA-ploidy for the early detection of a malignant transformation i...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-2000-10063
更新日期:2000-01-01 00:00:00
abstract:BACKGROUND:Prevention programmes should only be recommended if they achieve what they promise to achieve. Therefore, we checked the variation and validity of recommendations for screening for colorectal cancer of nine organisations. METHODS:We analysed the information concerning recommended screening age, guaiac faeca...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:10.1055/s-0032-1328074
更新日期:2015-08-01 00:00:00
abstract:AIMS:Laparoscopic splenectomy has been established as standard procedure for elective splenectomy and is performed for a variety of haematological diseases. However, different techniques have been used and a four- to five trocar technique is applied in most instances. We report our experience with a three-trocar techni...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-2004-820359
更新日期:2004-10-01 00:00:00
abstract::By introduction of laparoscopic cholecystectomy, an increase of accidental common bile duct injuries up to 1.2% has been reported. In the present study of 325 cholecystectomies we evaluated whether mandatory intraoperative cholangiography (IOC) can reduce the rate of accidental bile duct injuries or, at least, identif...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1997-01-01 00:00:00
abstract::The value of low dosage heparin in preventing venous thromboembolism was studied in 150 patients with proximal femoral fractures. This was a prospective, randomized, clinical trial, consisting of 116 women and 34 men with a mean age of 73 years (38 to 92). 5000 units of subcutaneous heparin was given twice a day for a...
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:1980-01-01 00:00:00
abstract::The functioning of our anti-infectious regimen now working over a period of 7 years with 4 checks per year has been controlled. The wound infection rate came up to a percentage of 1.55. Blunders concerning chemical disinfection especially could be detected in spite of check-ups made every 3 months. ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1982-01-01 00:00:00
abstract::Thoracotomy and lung-resection are often followed by a decrease of the oxygenation of blood and disturbances of the acid-base-balance. Both ventilation and circulation must be restored to normal and therefore adequate levels of cardiac output, peripheral resistance, electrolytes and kidney-function are required. ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1977-01-01 00:00:00
abstract::Background An enterothorax with herniation of bowel segments through a diaphragmatic defect is a rare postoperative complication, which can occur in the early postoperative period as well as several months or even years after the primary procedure. In virtually all cases, this diagnosis requires surgical treatment wit...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:10.1055/s-0042-119304
更新日期:2017-02-01 00:00:00
abstract:INTRODUCTION:Over the last decade endovascular stenting of aortic aneurysm (EVAR) has been developed from single centre experiences to a standard procedure. With increasing clinical expertise and medical technology advances treatment of even complex aneurysms are feasible by endovascular methods. One integral part for ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-0035-1546261
更新日期:2015-10-01 00:00:00
abstract::For malignering a venous oedema of the leg can be artificially manipulated. Two cases of this kind are reported. ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1978-01-01 00:00:00
abstract::As our experimental studies demonstrate save laparoscopic tubular resection of colon and rectum is possible using linear staplers for resection and circular staplers for the anastomosis. As soon as linear endostaplers are available this technique can be applied in clinical work. Open colon resection and subsequent pur...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1992-01-01 00:00:00
abstract::Dr. Rahel Hirsch was only the second woman to attain a professional medical position at the Charité Hospital in Berlin. For more than 16 years, she worked in Clinic II Internal Medicine. In 1906, she discovered that solid particles are able to pass from the veins and arteries into urine (Hirsch-Effect). The results of...
journal_title:Zentralblatt fur Chirurgie
pub_type: 传,历史文章,杂志文章
doi:
更新日期:1999-01-01 00:00:00
abstract::Only in 2/3 out of a total of 33 patients suffering from renal artery stenosis surgery was indicated. Thrombendarterectomy and saphenous patch are the method of choice for reconstructive procedures. In 87% of successful reconstructions the functional result was satisfactory. The follow-up gave evidence of change to th...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1979-01-01 00:00:00
abstract::We report on two patients with postinterventional retrogastric abscesses, one as a postoperative complication after partial pancreatectomy, one as a complication of biliary pancreatitis. In both cases, the abscess cavity could be completely drained by EUS-guided endoscopic application of a short "Amsterdam" stent, len...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-2002-31978
更新日期:2002-05-01 00:00:00