Abstract:
INTRODUCTION:Aortoesophageal fistula (AEF) following open or endovascular operations of the thoracoabdominal aorta is a rare, yet life-threatening condition. In this case, the whole thoracic aorta has to be replaced using a "clamshell approach" because of an AEF following open repair of the ascending aorta after type A dissection and a thoracic endovascular aortic repair (TEVAR). CASE REPORT:In 2015 a 43-year old woman suffered a type A dissection and underwent open supracoronary ascending aortic replacement including the proximal aortic arch. In 2016, she developed severe haemoptysis. An AEF could be detected and TEVAR was performed as emergency treatment. The further steps of the repair included oesophagectomy and repair of the whole thoracic aorta using a transverse thoracotomy - a clamshell approach. CONCLUSION:The curative treatment of AEF, which is based on radical, open repair of the oesophagus and the involved aortic segments, is challenging. A clamshell approach is a feasible option when replacement of the whole thoracic aorta is required. EINLEITUNG:Aortoösophageale Fisteln infolge offener und endovaskulärer Operationen der thorakoabdominellen Aorta sind seltene und lebensbedrohliche Erkrankungen. Im vorliegenden Fall war durch die infektiöse Mitbeteiligung einer einliegenden Ascendens-Bogenprothese sowie einer thorakalen Endoprothese im Bereich der Aorta descendens der vollständige Ersatz der thorakalen Aorta über einen sog. „clamshell“-Zugang notwendig. KASUISTIK:Bei einer Aortendissektion Typ A nach Stanford erfolgte bei einer 43-jährigen Patientin 2015 ein suprakoronarer Aortenersatz. 2016 wurde bei aortoösophagealer Fistel mit schweren Hämoptysen notfallmäßig eine thorakale Stentprothese (TEVAR) implantiert. Zur definitiven Versorgung mit Entfernung des infizierten Prothesenmaterials erfolgte ein vollständiger Ersatz der thorakalen Aorta im Rahmen einer queren Thorakotomie als Teil eines multimodalen Therapiekonzeptes. Bereits vorab war eine Ösophagektomie erfolgt; abschließend wurde die Passage mittels eines sekundären antesternalen Magenhochzugs rekonstruiert. SCHLUSSFOLGERUNG:Aortoösophageale Fisteln stellen eine therapeutische Herausforderung dar, die in Referenzzentren durch ein interdisziplinäres Team behandelt werden sollten. Der „clamshell“-Zugang mittels querer Thorakotomie ermöglichte im vorliegenden Fall den Ersatz der gesamten thorakalen Aorta.
journal_name
Zentralbl Chirjournal_title
Zentralblatt fur Chirurgieauthors
Gombert A,Grommes J,Kotelis D,Jacobs MJdoi
10.1055/a-0713-0457subject
Has Abstractpub_date
2018-10-01 00:00:00pages
475-479issue
5eissn
0044-409Xissn
1438-9592journal_volume
143pub_type
杂志文章abstract::The indication for replantation of traumatised limbs cannot be forced into any scheme. Each single case has to be critically considered as individual problem with main reference to age, sex, general condition, profession and motivation of patient and personal competence and qualification. A factor of central importanc...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1979-01-01 00:00:00
abstract::In a 19 year old man with a single kidney the development of a large Douglas' abscess was followed by anuria; The various causes are discussed. It is resonable to assume, that the obstruction resulted from longitudinal tension of the ureter over the iliace vessels (iliac sign). ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1976-01-01 00:00:00
abstract:INTRODUCTION:A multimodal perioperative therapy strategy (fast-track) decreases the morbidity of general thoracic interventions and increases postoperative reconvalescence after lung resections. Thoracic surgery is associated with relevant pain and sufficient pain relief is essential for postoperative recovery. Epidura...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-2008-1076975
更新日期:2008-09-01 00:00:00
abstract::Intraabdominal abscesses are life-threatening complications of inflammatory processes or major surgery. Ultrasonography, computed tomography, magnetic resonance, and scintigraphy are the diagnostic methods of choice. The sole diagnosis intraabdominal abcess" is insufficient to recommend a specific therapeutic strategy...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:
更新日期:1993-01-01 00:00:00
abstract::Breast cancer is the most common malignancy among women. Genetic predisposition is considered to account for 5-10% of all cases while the majority of these cancers are sporadic and caused by complex interactions of exogenous and endogenous factors. The inherited predisposition can be due to germline mutations in one o...
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::The surgical management of defects in the pelvic region is a great surgical challenge. Primary tumor recurrences have to be addressed and local infections require appropriate therapy such as rigorous debridement and antibiotic therapy. Plastic surgery provides tissue reconstruction by well perfused flaps and also rees...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-2006-955456
更新日期:2006-12-01 00:00:00
abstract:INTRODUCTION:We report on our results of MIVAT operations. METHOD:Nineteen Patients including 15 females and 4 males were operated with MIVAT, corresponding to 11 % of all patients undergoing an operation for benign goitre in our hospital. A single node of the thyroid gland within 30 mm and enlargement of a thyroid lo...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-2003-41392
更新日期:2003-08-01 00:00:00
abstract::After operation of uncomplicated forms of appendicitis in children postoperative complications characterised by sudden vehement stomach-ache, quickly increasing tension of the abdominal wall, rise of temperature, pulse and white blood cells as well as vomitus, mostly on the fifth post-operative day could be observed. ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1978-01-01 00:00:00
abstract::After excision of pilonidal sinus treatment consists either in open procedure or primary closure. We present the results of 45 consecutive patients (male 29, female 16, age 32 +/- 13 years), who underwent surgery between September 2001 and December 2002. Fourteen patients had simple fistula without infection, 18 had f...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-2004-822742
更新日期:2004-06-01 00:00:00
abstract::Motor vehicle accidents may cause apart from physical also psychological aftermath. Despite of posttraumatic psychologic symptoms may remit after 2-3 months, 10-20% of the injured persons will develop sustainable psychopathological symptoms. This report aims at an overview on possible psychopathological disturbances a...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:10.1055/s-2000-10676
更新日期:2000-01-01 00:00:00
abstract::For therapeutic recommendations three different kinds of scores are essential: 1. The severity scores for trauma; 2. Severity scores for mangled extremities; 3. Intensive care scores. The severity of polytrauma patients is measurable by the AIS, ISS, RTS, PTS and TRISS which is a combination of RTS, ISS, age, and mech...
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:Etiology of osteochondral lesions of the talus remains uncertain, a myriad of treatment options exists. The purpose of this study is to evaluate the clinical and radiological results of fixation of osteochondral lesions of the talus using K-wires. An unstable osteochondral fragment or osteosclerotic change...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-2004-832393
更新日期:2004-12-01 00:00:00
abstract::Medical responsibility and hospital management, competency for resident's training and decision making in therapy are better performed in a system of hierarchy than other kinds of organisation of a surgical department. If all the duties and responsibilities are concentrated to a head of the department, it is also nece...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1999-01-01 00:00:00
abstract::A new technique for breast imaging is presented. This technique combines radiographic mammography directly with automated ultrasound. The combined examination, which is performed without decompression of the breast, yields the conventional mammography films as well as a complete set of B-mode scans and ultrasound proj...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1998-01-01 00:00:00
abstract::About 50% of relaparotomies in the early postoperative period are caused by peritonitis, the lethality ranges from 32 to 88% (average 56%). The most frequent reasons for the development of peritonitis following abdominal surgery are presented as well as the possible way to early diagnosis of this complication. In view...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1983-01-01 00:00:00
abstract::In UICC stage I a selected group of patients with T1 tumours and a low risk profile regarding simultaneous lymph node metastases can be treated by endoscopic resection alone, if the tumour is thereby completely removed. In UICC stage II an adjuvant chemotherapy (CT) should not be routinely performed. However, in high ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:10.1055/s-0031-1271562
更新日期:2011-08-01 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::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:
更新日期:1993-01-01 00:00:00
abstract::Extracorporeal membrane oxygenation (ECMO) has become a routine method in thoracic surgery. Recent developments in lung transplantation have led to its widespread acceptance. Firstly, ECMO is increasingly being used to bridge patients to transplantation. The best results in this setting have been described with "awake...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/a-0624-9612
更新日期:2019-02-01 00:00:00
abstract::By means of a case report classification, etiology and pathogenesis of benign esophageal strictures are discussed. In the presented case an endobrachyesophagus with peptic stricture of the middle third of the esophagus was found. The most common conservative treatment consists of esophageal bouginage combined with lon...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-2002-20233
更新日期:2002-01-01 00:00:00
abstract::The German Stomach Cancer TNM Study Group registered 1444 patients from 1982 to 1984 in a multicenter observational study to validate the tumor node metastasis stage groupings. The follow-up-rate in 1989 was 99.4%. Among others the pattern of lymph node metastases and the benefit of systematic lymphadenectomy (SLA) wa...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1996-01-01 00:00:00
abstract::From 1970 to 1977 we observed 35 patients with polypi of the colon and rectum, in 18 cases on the basis of heredity. We recommend total proctocolectomy and ileostomy making use of the reservoir technique after Kock. The operation should be performed not until the beginning of the third decade of life. ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1978-01-01 00:00:00
abstract::The etiology of choledochal cysts isn't yet clarified unequivocably. Numerous theories have been worked out. One of them is the 1969 by Babbitt postulated "common-channel"-theory, which is based on an anomaly of the pancreaticobiliary connection. In case of a fusion of ductus choledochus and ductus pancreaticus widely...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:
更新日期:1991-01-01 00:00:00
abstract::The special way of infection of the lymphogenic osteomyelitis caused by trivial trauma is demonstrated in 4 cases. Germ ascension is done by lymphatics or fissures in the tissue, as it is well known in the panaritium ossale. The treatment consists in removing the focus of infection, irrigation-suction drainage and spe...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1976-01-01 00:00:00
abstract::Findings on admission to hospital and after surgery recorded from 35 patients with gallbladder perforation were compared to findings obtained from 98 patients with cholecystitis, with a view to establishing determining factors in pathogenesis of gallbladder perforation and for the purpose of improving therapeutic stra...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1988-01-01 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::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::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::Different causes, for example posttraumatic and postoperative complications, can lead to an elevated intra-abdominal pressure. Increased intraabdominal pressure effects cardiovascular, pulmonary and renal systems. The abdominal compartment syndrome can be defined as organ failure caused by an increased intra-abdominal...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-2001-16568
更新日期:2001-08-01 00:00:00
abstract:AIM OF INVESTIGATION:The treatment of nonunions complicated by infection and bone loss is divided into two stages. Having calmed down the infection by stabilizing, removal of infected and necrotic tissue and local antibacterial measures, the bone loss has to be filled up. Bridging the gap by means of autogenous cancell...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1994-01-01 00:00:00