Abstract:
BACKGROUND:In the management of gastrointestinal tumour lesions, palliative treatment has attained an increasing role. As also in curative treatment, an interdisciplinary cooperation between gastroenterologists and surgeons has to be aimed for. AIM:The aim of this study is to illustrate the diagnostic and therapeutic management of frequently occurring diseases in palliative medicine from a gastroenterological point of view. METHODS:Complementary short overviews on clinical experience and selectively searched references from the current scientific literature were evaluated. RESULTS:The symptomatic complex is very heterogeneous and requires an adequate approach taking into account the differential diagnosis. The palliative gastroenterological approach is characterised by the competent care on ascites, management of "malignant intestinal obstruction and obstipation" (MIO) as well as appropriate nutrition and analgetic therapy. The surgical approach is indicated after sequential exhaustion of medical, interventional endoscopic and (eventually) image-guided radiological measures; it comprises creation of a peritoneovenous shunt (ascites), bypass procedures (gastroenteral, biliodigestive, enteroenteral) as well as, in extraordinary cases, resection in addition to the implantation of an i. v. port-a-cath or surgical revision of a PEG / stent complication; in particular, in case of recurrent and massive haemorrhage and perforation (absolute indication), surgery becomes necessary. DISCUSSION:A lack of appropriate studies, absence of adequate study results including the difficult initiation of medical studies with palliative intention aggravate a competent evidence-based approach. Therefore, the management is considerably affected by clinical experience. CONCLUSION:Efficacious care in palliative visceral medicine requires relevant clinical expertise and interdisciplinary action because of the occurrence of clinical cases in gastroenterology at the border to surgery.
journal_name
Zentralbl Chirjournal_title
Zentralblatt fur Chirurgieauthors
Schütte K,Weigt J,Meyer F,Malfertheiner Pdoi
10.1055/s-0030-1262702subject
Has Abstractpub_date
2010-12-01 00:00:00pages
528-34issue
6eissn
0044-409Xissn
1438-9592journal_volume
135pub_type
杂志文章,评审abstract::The aim of this study was to determine the pressure conditions in the tissue beneath and on the surface of wounds. This was done in vitro both on a plain surface and on a bovine muscle. In comparison we measured the pressure of the anterior tibial muscle of a patient with compartment syndrome. Besides, we applied nega...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-2004-822650
更新日期:2004-05-01 00:00:00
abstract::Like other industrial countries Germany experiences a significant increase of cancer prevalence. Recent advances in the treatment of various types of cancer resulted in prolonged survivaltimes of patients. Cancer--especially in advanced incurable stages--often is accompanied by severe pain. Therefore, the need for suf...
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:BACKGROUND:Carcinoma of ampulla of Vater are rare tumours of the GI-tract with an improved prognosis compared to other periampullary tumours. Analysis of survival and prognostic factors are limited due to the low incidence of the carcinoma. The intention of this study in patients with papillary carcinoma was to evaluat...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-0034-1383412
更新日期:2016-06-01 00:00:00
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:
更新日期:2000-01-01 00:00:00
abstract::Laparoscopic colorectal surgery has become increasingly more common since first being described in a publication in 1990. Despite a multitude of studies about the learning curve in laparoscopic colon surgery, there are almost no such studies with regard to laparoscopic rectum surgery. This paper aims to describe a sur...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-0030-1262684
更新日期:2011-06-01 00:00:00
abstract::Occurrence of postoperative wound dehiscence with fistulae in stomach and small intestine is considered to be a severe surgical complication. The question has been raised, if the problem should be therapeutically tackled by means of surgery or medication in the context of intensive care. Retrospective and prospective ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1988-01-01 00:00:00
abstract::Lokal recidivation rate in carcinoma of the female breast represents besides the 5- to 10-years survival rate an important parameter for primary surgical treatment. At the Chirurgische Universitätsklinik Tübingen radical mastectomy in the Rotter-Halsted technique as well as extended radical mastectomy were abandoned b...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1977-01-01 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:The pancreatic anastomosis may be the Achilles heel in pancreatic surgery. When a postoperative pancreatic fistula develops, be it mild or severe, in some cases life-threatening, POPF-associated complications can occur. OBJECTIVES:Possibilities for the prophylaxis, diagnosis and therapy of POPF and POPF-ass...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:10.1055/s-0043-119896
更新日期:2018-06-01 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::Traffic accidents are among the most important causes of child death. It is sometimes quite difficult to diagnose blunt abdominal traumata due to traffic accidents. 35 blunt hepatic and splenic injuries treated in our clinic during the period of 1971 to 1976 have been evaluated and pertinent references reviewed. ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1978-01-01 00:00:00
abstract::Since November 2001 all patients with postoperative sternum bone infections were treated with V.A.C. therapy. The mean length of stay at intensive care unit was reduced from 9 to 1 day and reduces costs for 33 714.- USD per patient. Additionally patients who had to be closed with pectoralis muscle flap had significant...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-2006-921492
更新日期:2006-04-01 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
abstract::An experimental study is reported on different injections of barium sulfate into peritoneal cavity of 10 dogs and intravasal. All experimental animals died. The experiments show that barium sulfate causes not only local reaction but the most important is it's general deleterious effect. There results macro- and microe...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1976-01-01 00:00:00
abstract:BACKGROUND:Bile duct anastomoses are still associated with a high failure rate. Although following iatrogenic bile duct transection only a positive selected group of patients get a primary end-to-end reconstruction, long-term results demonstrate an incidence of postoperative strictures up to 78%. Also in orthotopic liv...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-2000-10077
更新日期:2000-01-01 00:00:00
abstract::The transplantation of marginal organs or those meeting the so-called extended donor criteria (EDC) is today a significant option to alleviate the low availability or organs and to increase the number of transplantation which in turn is -accompanied by a lower mortality among wait-ing-list patients. However such an ex...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:10.1055/s-0028-1098880
更新日期:2009-04-01 00:00:00
abstract::26 children with extrophy of the bladder were treated surgically during a period of 23 years. In all cases a ureterosigmoidostomy was performed with a follow up of 1-22 years in 15 of 26 cases. In 9 children the clinical, radiological, and biochemical findings were good in 4 satisfying and 2 bad due to hydronephrosis ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1979-01-01 00:00:00
abstract::Various forms of compartment syndrome can now be distinguished. Acute compartment syndrome is the result of a discrepancy between the volume of the compartment and its contents. This leads to increased pressure at rest and during load, which cuts off the micro-circulation and hence destroys the intracompartmental stru...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-2001-14770
更新日期:2001-06-01 00:00:00
abstract::Since 1982 a total number of 1062 patients underwent surgical treatment of bronchogenic carcinoma. There were 972 men and 89 women, with a mean age of 62.5 years. In 484 cases a squamous cell carcinoma was diagnosed and in 416 patients an adenocarcinoma. An alveolar cell carcinoma was found in 54 and a polymorphocellu...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1996-01-01 00:00:00
abstract::Idiopathic varicocele is quite common even among children and adolescents. Irreversible testicular damage may occur before adult age. Diagnosis and therapy for the purpose of preventing infertility constitute a challenge to youth health organisations and paediatric surgeons. Surgery according to Bernardt or Ivanissevi...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1986-01-01 00:00:00
abstract:INTRODUCTION:Tension-free incisional hernia repair using alloplastic material increasingly replaces conventional repair techniques. The aim of the present study was to evaluate the early and long-term complications as well as patients' satisfaction. METHODS:Laparoscopic hernia repair with intraperitoneal mesh implanta...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-2005-836526
更新日期:2005-06-01 00:00:00
abstract::We report the case of a 32-year-old woman presenting with acute extremity ischemia due to thrombosis of a previously undetected popliteal artery aneurysm. The popliteal artery aneurysm was revealed by PST which was indicated for the treatment of thrombosis of the superficial femoral artery. PST was complicated by a pe...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:2000-01-01 00:00:00
abstract::From 1968 to 1978 more than 500 patients suffering from histologically verified malignant melanoma were seen. Only in 12 cases (appr. 2%) the tumour was situated on the tip of the fingers and toes. In such cases nowadays amputation and exarticulation of the whole extremity is no longer practiced. It is sufficient only...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1979-01-01 00:00:00
abstract::Currently, there is no structured training plan to become a transplant surgeon in Germany. Similar to the Anglo-Saxonian educational system we have implemented a 3-year fellowship in transplant and hepatic-, pancreatic-, biliary (HPB) surgery. The educational curriculum is based on the guidelines of the European Board...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-0032-1328738
更新日期:2014-06-01 00:00:00
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:
更新日期:1976-01-01 00:00:00
abstract::This manuscript gives a review about important studies addressing problems in intensive care medicine that have been published in journals focussing on critical care medicine and surgery in 2004. Only clinical studies are included in this review, mostly metaanalyses, randomized controlled trials and a few important or...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:10.1055/s-2005-836561
更新日期:2005-06-01 00:00:00
abstract:BACKGROUND:To be able to evaluate properly a vascular problem, basic concepts of vascular physiology need to be considered, as they have been taught in physiology for a long time. This article deals with selected definitions and laws of passive vascular mechanics, subdivided into parameters of vascular filling and para...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:10.1055/s-0032-1327967
更新日期:2014-10-01 00:00:00
abstract::Recurrent duodenal ulceration after highly selective vagotomy is best managed by antral gastric resection and gastroduodenostomy (BI). In cases of gastral localisation of the recurrent ulcer and in cases with high postoperative acidity a 2/3 partial gastrectomy (BI) should be performed. Revagotomy after highly selecti...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1985-01-01 00:00:00
abstract::Demographic developments have led to an exponential increase of cardiovascular illness. Additionally, the technical development of conservative and invasive treatment modalities has added to an increase of differentiated therapy. The development of vascular centres led to optimised processes in diagnostic and therapy ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:10.1055/s-0031-1271602
更新日期:2013-10-01 00:00:00
abstract::Interruption of the inferior vena cava by an umbrella-filter, clip or Green-field-filter has been performed in more than 400 patients during the past 14 years. Overall hospital mortality was 1% by clip application and 7% by Mobin-Uddin-umbrella. The indication for this method is limited to those patients suffering fro...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1985-01-01 00:00:00