[Practical and theoretical aspects of cost-benefit relations in viscerosynthesis].

Abstract:

:The necessity of limiting health care costs requires adequate service recording and quality control even in visceral surgery. In this field, the safety of the anastomoses is of greatest importance. Anastomoses at risk are esophageal connections to jejunum or colon and deep rectal anastomoses. At these locations expensive suture devices, such as stapling instruments, can be used in a cost saving aspect, if they help to increase anastomotic safety, time saving and expansion of surgical indication. Manual sutures thus represent the cheapest anastomotic technique as continuous sutures would cost between DM 10.- to 20.- and single stitch sutures between DM 60.- and 100.-. A surgical school should prevalently aim at training manual anastomoses, while special anastomotic techniques should only complete the skill for selected indications. The overall staff expenditure for extended operations amounts around DM 600.- per hour respectively DM 10.- per minute. Time for surgery might be shortened by auxiliary tools as much as to perform an additional operation. However, a circular stapler anastomosis that costs between DM 650.- to 850.- is twice as expensive as manual sutures notwithstanding the double time needed. In the past years, the necessity for a rational use of different anastomotic techniques has shown to be mandatory since, increasingly, financial aspects of health economy require cost benefit calculations in visceral surgery.

journal_name

Zentralbl Chir

authors

Fuchs KH,Heimbucher J,Geiger D,Thiede A

subject

Has Abstract

pub_date

1997-01-01 00:00:00

pages

9-13

issue

1

eissn

0044-409X

issn

1438-9592

journal_volume

122

pub_type

杂志文章
  • [Controlled reperfusion of ischemic extremity musculature to prevent free radical induced lesions].

    abstract::Tissue injury following reperfusion represents an essential problem of reconstructive vascular surgery. Pathogenetically toxic oxygen radicals are considered to play a pivotal role. Pharmacotherapeutical approaches are based particularly on antioxidants and vasodilators. However, a standardized regimen is not yet clin...

    journal_title:Zentralblatt fur Chirurgie

    pub_type: 杂志文章

    doi:

    authors: Luther B,Lehmann C,Grune T,Meyer R,Schwenke G,Beutel H,Bürger K

    更新日期:1999-01-01 00:00:00

  • [Maggot therapy for treatment of severe infections in trauma surgery: "back to the future!"].

    abstract::The ancient method of larval therapy for treatment of acute and chronic infections has become a revival and a new dimension with introduction of the Biobag (Vitapad). With use of this therapy trauma patients suffering infectious complications can be treated very effective, which can reduce the overall time needed for ...

    journal_title:Zentralblatt fur Chirurgie

    pub_type: 杂志文章

    doi:10.1055/s-2006-921510

    authors: Jukema GN,Steenvoorde P,Wong CY,Bernards AT,van Dissel JT

    更新日期:2006-04-01 00:00:00

  • [Simulation of a hypophyseal tumor in carotid-ophthalmic aneurysms].

    abstract::Case report. A 59 year old woman was thought to suffer from a neoplasm of the hypophysis. This "tumour" was simulated by a giant aneurysm of the infraorbital segment of the left carotid artery. For technical reasons the left carotid artery had not been demonstrated in the angiogram. For final clarification CT as well ...

    journal_title:Zentralblatt fur Chirurgie

    pub_type: 杂志文章

    doi:

    authors: Assmann H,Basche S,Pothe H,Dietrich J

    更新日期:1983-01-01 00:00:00

  • [What Must the (Abdominal) Surgeon Know about Experimental Medicine (?) - Translational Research in General (Abdominal) Surgery(Viszeral-)Chirurg & experimentelle Medizin].

    abstract::Experimental medicine has evolved tremendously in the last few years. In particular, the introduction of novel techniques, in-vitro models, knock-out/transgenic animals and high-through put analytical methodologies have resulted in a deeper understanding of cellular pathophysiology and diseases. The daily clinical man...

    journal_title:Zentralblatt fur Chirurgie

    pub_type: 杂志文章,评审

    doi:10.1055/s-0032-1328101

    authors: Wex T,Kuester D,Meyer F

    更新日期:2015-08-01 00:00:00

  • [Is surgical treatment of fresh, closed humeral fractures justifiable as a routine procedure?].

    abstract::Excellent results were found to be achievable from conservative functional treatment of upper arm fractures. A critical appraisal is made in this paper of the authors' own cases and of literature published over the past 25 years for comparison of the above results with surgical therapy. The conservative functional app...

    journal_title:Zentralblatt fur Chirurgie

    pub_type: 杂志文章

    doi:

    authors: Ekkernkamp A,Muhr G

    更新日期:1987-01-01 00:00:00

  • [Effects of roentgen contrast media containing barium sulfate on enterocutaneous fistulas].

    abstract::Fistulation in the wake of thoracic and epigastric interventions are conservatively treated, as a rule, because of the high rate of complications expected from reoperation. With properly functioning anastomotic transit, insufficiencies usually undergo spontaneous healing, within four to six weeks. Enterocutaneous fist...

    journal_title:Zentralblatt fur Chirurgie

    pub_type: 杂志文章

    doi:

    authors: Pelster FW,Reichelt S,Arndt M,Eising EG

    更新日期:1989-01-01 00:00:00

  • [Pneumothorax, what kind of therapy is necessary? A clinical overview].

    abstract::Pneumothorax is defined as the accumulation of air in the pleural space. A distinction is made between a primary (idiopathic) spontaneous pneumothorax (PSP), secondary spontaneous pneumothorax (SSP) as well as between iatrogenic pneumothorax and traumatic pneumothorax. Primary spontaneous pneumothorax (PSP) occurs mai...

    journal_title:Zentralblatt fur Chirurgie

    pub_type: 杂志文章,评审

    doi:10.1055/s-0031-1284013

    authors: Ghezel-Ahmadi D,Bölükbas S,Fischer T,Ghezel-Ahmadi V,Schirren J

    更新日期:2012-06-01 00:00:00

  • [Small Cell Lung Cancer].

    abstract::Small cell lung cancer accounts for roughly 14% of all lung cancers and is characterized by rapid progression, early distant metastasis and poor prognosis. Only a minority of patients presents with early stage disease upon initial diagnosis where surgical resection may be discussed. In addition, various treatment moda...

    journal_title:Zentralblatt fur Chirurgie

    pub_type: 杂志文章,评审

    doi:10.1055/s-0043-110185

    authors: Reinmuth N,Hoffmann H

    更新日期:2018-02-01 00:00:00

  • [Surgical therapy of complicated diverticular disease].

    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:

    authors: Huber MA,Woisetschläger R,Sulzbacher H,Wayand W

    更新日期:1991-01-01 00:00:00

  • [Management of large abdominal wall hernias with foreign implant materials (Gore-Tex patch)].

    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:

    authors: Trupka AW,Schweiberer L,Hallfeldt K,Waldner H

    更新日期:1997-01-01 00:00:00

  • [Fractures of the patella, conservative treatment (author's transl)].

    abstract::56 conservatively treated fractures of the patella with small dislocation are analysed. In comparison with plaster cast immobilisation early functional treatment yields the best results. ...

    journal_title:Zentralblatt fur Chirurgie

    pub_type: 杂志文章

    doi:

    authors: Senst W,Nowak W

    更新日期:1977-01-01 00:00:00

  • [Clinical results and color-coded duplex ultrasound findings 4 years after conditioned TRAM flap-plasty].

    abstract::Presented is a new technique in preoperative conditioning of the pedicled TRAM-flap employing an interventional-radiologic procedure, selective embolization of the deep inferior epigastric artery (DIEA). During a four year period in 40 patients with a mean age of 48.4 (31-66) years breast reconstruction was performed ...

    journal_title:Zentralblatt fur Chirurgie

    pub_type: 杂志文章

    doi:

    authors: Scheufler O,Andresen R,Kirsch A,Banzer D,Vaubel E

    更新日期:2000-01-01 00:00:00

  • [Alcohol intoxication and its differential diagnosis (author's transl)].

    abstract::Acute alcohol intoxication causes a lot of diagnostic problems. Every doctor should be well informed about its differential diagnostic aspects. Carelessness concerning diagnosis can be detrimental to the patient and the physician as well. ...

    journal_title:Zentralblatt fur Chirurgie

    pub_type: 杂志文章

    doi:

    authors: Kürzinger R

    更新日期:1979-01-01 00:00:00

  • Evaluation of toupet antireflux operation, by means of gastroesophageal scintiscan.

    abstract::The Toupet operation (270 degrees posterior fundoplication) has been performed in 99 patients suffering from symptoms of gastro-oesophageal reflux secondary to a hiatal hernia. To assess the effects of the Toupet antireflux procedure, we performed in 20 cases oesophageal manometry, intraoperatively and gastro-oesophag...

    journal_title:Zentralblatt fur Chirurgie

    pub_type: 杂志文章

    doi:

    authors: Vara-Thorbeck R,Morales OI,Guerrero JA,Ruiz-Morales M,Salvi M,Vara C

    更新日期:1989-01-01 00:00:00

  • [Cholesteatosis of gallbladder (author's transl)].

    abstract::741 cholecystektomies were examined for cholesterosis. In 92% gallstones were present and in 8% there were no stones. Cholesterosis of the gallbladder was found in 0,9% of 4417 autopsies. It was combined with gallstones in 25% and in 75% it was not. There was no difference concerning the clinical symptoms between chol...

    journal_title:Zentralblatt fur Chirurgie

    pub_type: 杂志文章

    doi:

    authors: Lehmann L,Kraus K

    更新日期:1976-01-01 00:00:00

  • [Clinical diagnosis of fresh injuries of the knee joint].

    abstract::Clinical diagnosis has to registrate fresh injuries. These have to undergo immediate operation or further instrumental or radiological procedures respectively. This may be effected in almost all cases by systematic evaluation of informations on the anamnesis and general or special clinical diagnosis. Main symptom of t...

    journal_title:Zentralblatt fur Chirurgie

    pub_type: 杂志文章,评审

    doi:

    authors: Senst W,Zeumer B

    更新日期:1989-01-01 00:00:00

  • [New Applications and Indications for Contrast-Enhanced Sonography in Endovascular Aortic Repair].

    abstract::After edovascular repair of infrarenal aortic aneurysms (EVAR) endoleaks may occur necessitating further therapy. Therefore a reliable method for follow-up imaging after EVAR for detection and control of endoleaks is of high importance. Contrast-enhanced sonography (CEUS) does not require the application of nephrotoxi...

    journal_title:Zentralblatt fur Chirurgie

    pub_type: 杂志文章,评审

    doi:10.1055/s-0035-1546147

    authors: Zimmermann H,Reiser M,Meimarakis G,Paprottka P,Clevert DA

    更新日期:2015-10-01 00:00:00

  • [Liver parameters in intensive care medicine].

    abstract::Elevated liver function tests in ICU-bound patients are associated with a greater risk of mor-tality. Chronic liver diseases as well as acute events and complications of therapy are among the causes. The disorder could further be investigated by assessment of liver cell integrity markers (AST, ALT and GLDH), cholestas...

    journal_title:Zentralblatt fur Chirurgie

    pub_type: 杂志文章,评审

    doi:10.1055/s-0031-1271601

    authors: Penndorf V,Saner F,Gerken G,Canbay A

    更新日期:2013-12-01 00:00:00

  • [Monteggia injuries. Therapy and late results in 204 cases].

    abstract::A follow-up check of 204 Monteggia fracture-dislocation in two clinics showed that in 84% of the cases an operative treatment led to good functional late results. In 65% of the patients treated conservatively, the mobility of the elbow was evidently limited. Plate fixation has been proved to stabilize ulna fractures, ...

    journal_title:Zentralblatt fur Chirurgie

    pub_type: 杂志文章

    doi:

    authors: Hennig FF,von Kroge H

    更新日期:1991-01-01 00:00:00

  • [Extended resections in bronchial cancer: complications and late results].

    abstract::From 1982 through April 1992, 192 patients underwent extended resection for non-small cell carcinoma of the lung (NSCLC) invading the chest wall (n = 52) or the mediastinum (n = 140). Complete resection of the tumor was possible in 81 (58%) patients with invasion of mediastinum and in 34 (65%) patients with invasion o...

    journal_title:Zentralblatt fur Chirurgie

    pub_type: 杂志文章

    doi:

    authors: Dienemann H,Hoffmann H,Mewes A,Müller C,Schildberg FW

    更新日期:1993-01-01 00:00:00

  • [Decubital ulcer--causes, surgical therapy and prognosis].

    abstract::7.6 % (n = 134/1 769) of all inpatients in Leuven, but 30.1 % of risk patients suffer of pressure sores (Norton Scale 10.4 points). Predisposed are geriatric patients or those of intensive care units. While fasciocutaneous flap likewise the superior gluteal artery perforator flap are more resistant to mechanical force...

    journal_title:Zentralblatt fur Chirurgie

    pub_type: 杂志文章

    doi:10.1055/s-2002-32619

    authors: Brenner P,Krause-Bergmann A

    更新日期:2002-06-01 00:00:00

  • [Surgical treatment of acquired, benign esophago-respiratory fistulas].

    abstract:BACKGROUND:Acquired, benign esophago-respiratory fistula occurs as a rare complication of different disorders. STUDY DESIGN:Over a period of 30 years, 37 patients with acquired, benign esophago-respiratory fistulas were treated at the authors' institutions. 35 of the 37 patients were operated upon. Acute operation inv...

    journal_title:Zentralblatt fur Chirurgie

    pub_type: 杂志文章

    doi:10.1055/s-2004-816284

    authors: Csikos M,Horváth O,Petri A,Szendrényi V,Oláh T

    更新日期:2004-04-01 00:00:00

  • [Prophylaxis of gallstone formation (author's transl)].

    abstract::Today we know the pathobiochemical mechanism of gallstone formation. Cholecystectomy is the therapy of choice with a mortality-rate 0,5% in uncomplicated cases. The mortality-rate increases in patients with recurrent stones in the biliary tract system after cholecystectomy. In addition the liver produces a lithogenic ...

    journal_title:Zentralblatt fur Chirurgie

    pub_type: 杂志文章

    doi:

    authors: Stremmel W

    更新日期:1980-01-01 00:00:00

  • [Preperitoneal implantation of Dacron mesh for treatment of recurrent inguinal hernia and bilateral inguinal hernia].

    abstract:UNLABELLED:The preperitoneal approach with implantation of a dacron sheet was applied in 37 patients with recurrent hernias and in 30 patients with primary bilateral hernias. In total 120 hernias were repaired. The patients were controlled prospectively for serious complications. The patients were examined every 3 mont...

    journal_title:Zentralblatt fur Chirurgie

    pub_type: 杂志文章

    doi:

    authors: Gross E,Köfüncü O

    更新日期:1994-01-01 00:00:00

  • [Clinical application of growth factors and cytokines in wound healing].

    abstract::The clinical value of growth factor treatment of chronic wounds has yet to be determined. Beneficial effects have been reported so far only from specialized wound care centers where growth factors supplemented the results achieved with good wound care. In general optimization of current methods of external wound care,...

    journal_title:Zentralblatt fur Chirurgie

    pub_type: 杂志文章,评审

    doi:

    authors: Vogt PM,Drücke D,Mühlberger T,Homann HH,Steinau HU

    更新日期:2000-01-01 00:00:00

  • [Experimental approach to left laparoscopic pancreas resection preserving the spleen].

    abstract::The pancreas has been excluded from laparoscopic surgery ever since. The technical possibilities of laparoscopic left resection of the pancreas in pigs are examined in this study. Mobilization of the left pancreatic segment up to the confluence area (splenic vein and upper mesenteric vein) was possible preserving the ...

    journal_title:Zentralblatt fur Chirurgie

    pub_type: 杂志文章

    doi:

    authors: Pistorius GA,Schüder G,Hildebrandt U,Plusczyk T

    更新日期:1995-01-01 00:00:00

  • [Minimal invasive cannulated screw osteosynthesis of Bennett's fractures].

    abstract:PURPOSE OF THE STUDY:The current study presents a new technique and results of minimal invasive screw osteosynthesis in the treatment of Bennett's fractures and discusses its advantages and disadvantages. OPERATIVE TECHNIQUE:The Bennett's fragment has to be of sufficient size (at least one quarter of the articular sur...

    journal_title:Zentralblatt fur Chirurgie

    pub_type: 杂志文章

    doi:10.1055/s-2003-40628

    authors: Meyer C,Hartmann B,Böhringer G,Horas U,Schnettler R

    更新日期:2003-06-01 00:00:00

  • [The Relevance of Surgeon-performed Ultrasound For the Detection of Acute Appendicitis: a Review of the Literature and a Practical Diagnostic Algorithm].

    abstract::Background The relevance of ultrasound (US) in diagnosing acute appendicitis is controversial. The validity of US in comparison with other imaging techniques, such as computed tomography (CT) and magnetic resonance imaging (MRI), is unclear, as is the difference between surgeon-performed ultrasound (SPUS) and radiolog...

    journal_title:Zentralblatt fur Chirurgie

    pub_type: 杂志文章,评审

    doi:10.1055/s-0043-114414

    authors: Beltzer CR,Zischek C,Schmidt R,Friemert B,Achatz G,Palm HG

    更新日期:2017-08-01 00:00:00

  • [Evaluation of postoperative pain therapy with patient-controlled analgesia from the viewpoint of the patient and nursing staff].

    abstract::Patient-controlled analgesia has been proven to be an effective technique in postoperative pain management. The aim of our study was to evaluate PCA on general surgery wards. 311 patients and their nurses were questioned about their experiences in using PCA for postoperative pain management. Satisfaction with pain rel...

    journal_title:Zentralblatt fur Chirurgie

    pub_type: 杂志文章

    doi:

    authors: Breme K,Stehr-Zirngibl S,Anthuber M,Jauch KW,Taeger K,Altmeppen J

    更新日期:1999-01-01 00:00:00

  • [Local treatment of thermal injuries in children. Results of a multicenter study].

    abstract::The study described in this paper helped to establish the present position in locally delimited treatment of children for thermic injuries. 25 hospitals or other medical institutions were involved in the inquiry programme, including 16 departments of paediatric surgery and nine departments of general surgery. Studies ...

    journal_title:Zentralblatt fur Chirurgie

    pub_type: 杂志文章

    doi:

    authors: Reuter G,Laskus S

    更新日期:1986-01-01 00:00:00