Abstract:
BACKGROUND:Coral reef aorta (CRA) is described as rock-hard calcifications in the visceral part of the aorta. These heavily calcified plaques grow into the lumen and can cause significant stenoses, leading to malperfusion of the lower limbs, visceral ischaemia or hypertension due to renal ischaemia. PATIENTS/METHODS:From 1/1984 to 11/2008, 80 patients (26 m, 54 f, mean age 61.6, range 14 to 86 years) underwent treatment in the Department of Vascular Surgery and Kidney Transplantation, Heinrich-Heine-University Hospital for CRA. The present study is based on a review of patient records and prospective follow-up in our outpatient clinic. RESULTS:The most frequent finding was renovascular hypertension (n=33, 41.3%) causing headache, vertigo and visual symptoms. Intermittent claudication due to peripheral arterial occlusive disease was found in 35 cases (43.8%). 15 patients (18.8%) presented with chronic visceral ischaemia causing diarrhoea, weight loss and abdominal pain. 79 patients (98.7%) underwent surgery; in 73 (93.7%) aortic reconstruction was achieved with thromboendarterectomy, on an isolated suprarenal segment in 7 (9.3%), an infrarenal segment in 21 (26.6%), and the supra- and infrarenal aorta in 45 cases (60%). Desobliteration of renal arteries was performed in 47 (one-sided n=8, 10.1%; both arteries n=39, 49.4%); the aortic bifurcation was desobliterated in 37 (46.8%), extension into iliac arteries was necessary in 29 cases (one-sided n=4, 5.1%; both arteries n=25, 31.6%). The coeliac trunk was desobliterated in 43% (n=34), the superior mesenteric artery in 44.3% (n=35) and the inferior mesenteric artery in 20.3% (n=16). In 15 cases additional revascularisation (bypass, transposition, graft interposition) was necessary. Surgical access was via a left-sided thoracoabdominal incision in 56.4% (n=45) and via laparotomy in 41.8% (n=33). The 30-day lethality was 8.7% (n=7). Postoperative complications requiring corrective surgery occurred in 11 patients (13.9%). Almost ⅓ of the patients (n=19, 27.5%) returned for follow-up after a mean of 52.6 months (range 3 to 215 months). Of these, there was significant clinical and diagnostic improvement in 16 (84.2%) and 3 (15.8%) were unchanged. Impairment was not observed. CONCLUSION:In spite of the existing and improving surgical techniques for the treatment of CRA, procedures are challenging and should be performed in centres with expertise.
journal_name
Zentralbl Chirjournal_title
Zentralblatt fur Chirurgieauthors
Sagban AT,Grotemeyer D,Rehbein H,Sandmann W,Duran M,Balzer KM,Grabitz Kdoi
10.1055/s-0030-1247382subject
Has Abstractpub_date
2010-10-01 00:00:00pages
438-44issue
5eissn
0044-409Xissn
1438-9592journal_volume
135pub_type
杂志文章abstract::Laparoscopic total gastrectomy for early and advanced gastric cancer is an exacting procedure which is increasingly performed in specialised institutions. Not only gastric resection and extended lymphadenectomy but especially the reconstruction by oesophagojejunostomy is a technically demanding and vulnerable operativ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-0033-1360122
更新日期:2014-02-01 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::Allogenic saphena magna and umbilical vein grafts can be successfully used for vessel replacement and dialysis shunts. The chemical preservation with 4% buffered formalin is to be recommended as a preservation procedure, since the preparation of the vein grafts can take place aseptically and without the occurrence of ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1978-01-01 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::By checking the list of local anaesthetics produced in the GDR containing vasoconstrictor drugs it could be proved that there exist disproportions concerning maximum concentrations and maximum doses of the local anaesthetic on the one hand and epinephrine as well as norepinnephrine concentration on the other. This dan...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1979-01-01 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:OBJECTIVE:The carbohydrate balance and nutritive efficacy of a completed nutritional solution with maltose were compared to an isocaloric completed nutritional solution with glucose by means of a hypocaloric parenteral nutrition after colorectal resections. METHODS:Prospective, randomised, double blind phase II trial ...
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:1996-01-01 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::The authors report on their experiences gained by animal experiments (calf) and their attempts (human corpses) concerning adaptation of the apparatus to the human thorax. At the present time they do not see a chance for its routine clinical use. The main reason why is the impossibility to install the extrathoracic dri...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1984-01-01 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:BACKGROUND:Due to uncontrolled activation of digestive enzymes produced within the pancreas, acute pancreatitis is a disease with a great potential for complications and variable course. Since the pathophysiological steps of human pancreatitis can only be inadequately investigated, various animal models were establishe...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-0032-1328099
更新日期:2013-08-01 00:00:00
abstract::Reference is made in this paper to the role played by the CEA level as an important marker for indication of second-look and third-look operations for colorectal carcinoma. ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1986-01-01 00:00:00
abstract:AIM:The paper retrospectively evaluates a set of patients with ipsilateral fractures of the proximal femur and shaft treated with PFN-long. MATERIAL:19 patients (14 males and 5 females), aged 48 in average, were treated from 1998-2003. The fractures included 2 types: combined intraarticular femoral neck and shaft frac...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-2005-836368
更新日期:2005-04-01 00:00:00
abstract:AIM:Evaluation of the diagnostic and therapeutic management of peripheral steal syndrome after placement of an autologous arteriovenous (av-) fistula and presentation of treatment results after its surgical correction. METHODS:During a time period from 1994 to 1999, 1 253 av-fistulas for hemodialysis were placed in ou...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-2002-33705
更新日期:2002-08-01 00:00:00
abstract:BACKGROUND:Survival time is an important parameter to investigate therapeutic measures. It plays a crucial role in study concepts, data analyses as well as publications. AIM:The aim of this study was to emphasise essential points, which need to be taken into account to (i) gain resilient results of survival time analy...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:10.1055/s-0034-1383077
更新日期:2016-08-01 00:00:00
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journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:10.1055/s-2001-14799
更新日期:2001-04-01 00:00:00
abstract::Present state and own experience in surgical treatment of different fractures of the acetabulum are reported. Primary insufficient treatment of those cases and delayed treatment impair the results considerably. ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1978-01-01 00:00:00
abstract::The number of patients with a diagnosis of cancer is alarming: according to new figures from the Robert Koch Institute about 435 000 patients are diagnosed annually in Germany. 210 000 patients die annually of this diagnosis. Even if no significant progress in prevention has been achieved, in 2020 about 25 % more case...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:10.1055/s-0031-1283923
更新日期:2013-02-01 00:00:00
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journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1983-01-01 00:00:00
abstract::In spite of quite a few clinical trials the benefit of venous thrombectomy is seen controversially. The primary objectives of treating venous thrombosis are survival rate, prevention of pulmonary embolism and of postthrombotic syndrome. We report our experience with 47 patients who underwent venous thrombectomy. The m...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1999-01-01 00:00:00
abstract::After explaining the tertiary patterns of prehension the possibilities of restoring prehensile function in patients after high cervical spinal injury (C4-C6) by means of orthotics or operation are discussed. Absolute indication for the application of electrical orthotics in patients with complete spinal cord injuries ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1976-01-01 00:00:00
abstract:UNLABELLED:In 35 patients with diabetic gangrene, amputation above the ankle (n = 18) or below the ankle (n = 17) was planned by nonspecialised general surgical departments or practicing surgeons. Prior to the operation, these patients presented to a specialised diabetic foot clinic; their clinical courses were analyse...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1996-01-01 00:00:00
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journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1993-01-01 00:00:00
abstract::Background: Since 2006 the practical year in the Mannheim Reformed Curriculum Medicine (MaReCuM) is divided into four quarters: the two required subjects (surgery and internal medicine), one elective and one of four offered fields in ambulatory medicine. Therefore students can more intensively focus on their preferenc...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-0035-1546248
更新日期:2017-02-01 00:00:00
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:
更新日期:1994-01-01 00:00:00
abstract::Two questions are discussed: 1. our relation to death. Contrary to the saying "shadows of the death" and to it's modern concealment this contribution states: death gives light: it enables to be conscious of one's self and to bow to the inevitable, it shows the valuables of earthly and mortal beings, and even allows us...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:
更新日期:1999-01-01 00:00:00
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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
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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
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journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1997-01-01 00:00:00
abstract::The alterations in diagnosis and therapy of intussusception in infants is described in 155 cases from 1978-1989. The primary diagnostic procedure is the abdominal sonography. It is followed to 1988 the attempt of hydrostatic reduction by barium enema and now the pneumatic reduction. The rate of success with conservati...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1990-01-01 00:00:00