Abstract:
INTRODUCTION:In the last few years the use of intraoperative electrophysiological monitoring of the recurrent laryngeal nerve (RLN) in thyroid gland surgery has become more and more important. PATIENTS AND METHOD:In a prospective study 223 nerves at risk in 116 patients were monitored with the Neurosign(R)100 (Fa. Magstim Ltd., UK). We used intramuscular needle electrodes inserted into the vocal muscle through the conic ligament. Practicability, complications, acceptance and predictive value of the method were documented. Recurrent nerve palsy rate and complications were compared with a control group operated upon without monitoring. RESULTS:The intraoperative delay using this method was on average 8.9 minutes. There were problems with monitoring equipment avoiding use in 6.4 %. In 2 cases (1.7 %) an accidental lesion of endotracheal tube cuff was found related to malpositioning of the needle and in 7.7 % a hematoma of the vocal cords was observed. 73.3 % of the surgeons accepted the method to identify and control the nerve integrity. False-positive and false-negative signals may occur. In cases of a final real stimulus response a regular vocal cord motility was found in 95 %. If a nerve conduction block was noted an immobility of ipsilateral vocal cord was diagnosed postoperatively in 50 %. There was no decrease in transient recurrent palsy rate using monitoring (10.7 % vs. 9.6 % without monitoring) but in permanent paralysis (1.8 % vs. 3.0 %). CONCLUSIONS:It may be concluded that intraoperative electrophysiological monitoring of the RLN is a simple and accepted method with low complications reducing the incidence of permanent RLN palsy rate. We found the monitoring especially useful for operations of recurrent goiter and carcinomas of the thyroid gland as well as for learning thyroid gland surgery.
journal_name
Zentralbl Chirjournal_title
Zentralblatt fur Chirurgieauthors
Friedrich T,Staemmler A,Hänsch U,Würl P,Steinert M,Eichfeld Udoi
10.1055/s-2002-31983subject
Has Abstractpub_date
2002-05-01 00:00:00pages
414-20issue
5eissn
0044-409Xissn
1438-9592journal_volume
127pub_type
临床试验,杂志文章abstract:UNLABELLED:This randomized controlled trial aims to evaluate the influence of preoperative relaxation techniques on postoperative outcomes. From January 1997 to June 1998 208 patients were operated on for primary inguinal hernia or goiter. The patients were randomized into two groups: Group A (n = 103) underwent the su...
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:2000-01-01 00:00:00
abstract::Multiple factors such as tumour initiating, tumour promoting, tumour inhibiting are known to be involved in the aetiological process of most colon tumours. Dominant factors are associated with life style habits. Yet in spite of many experimental and epidemiological data it has not been possible, hitherto to give convi...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1985-01-01 00:00:00
abstract::Stapled transanal rectal resection (STARR) has become a well-evaluated surgical procedure for the treatment of outlet obstruction in the context of conservative refractory obstructed defaecation syndrome (ODS). The diagnosis of ODS needs to be objectified which can be best ensured by clinical scoring systems. Besides ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:10.1055/s-0032-1315124
更新日期:2012-08-01 00:00:00
abstract::The shortage of surgeons in the operative disciplines field has in recent years further increased. The training of a surgeon and the required lifestyle combined with the work-life balance of the surgeons are perceived as being less attractive, so that young doctors after finishing medical school rarely decide for surg...
journal_title:Zentralblatt fur Chirurgie
pub_type:
doi:10.1055/s-0029-1224764
更新日期:2010-02-01 00:00:00
abstract::The combined lesion of the anterior cruciate ligament (ACL) with simultaneous or secondary meniscal tears has severe consequences for the knee joint. By a synopsis of the literature and own experimental investigations in sheep it can be shown that in ACL deficient knees secondary meniscal lesions occur, what finally e...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:
更新日期:1999-01-01 00:00:00
abstract::The emergency room functions as a junction between preclinical and early clinical treatment of patients with multiple trauma and should have defined technical and room possibilities. The personal staff should continue resuscitation measures and perform clinical and technical diagnostic procedures according to trained ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1996-01-01 00:00:00
abstract::Hepatocellular carcinoma (HCC) is one of the most frequent malignancies worldwide. A variety of pharmacological strategies has been evaluated in the treatment of HCC: classical chemotherapy, tamoxifen, octreotide, thymostimulin, pravastatin, (131)I-lipiodol as well as transarterial chemoperfusion (TAC) and chemoemboli...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:10.1055/s-2003-44797
更新日期:2003-11-01 00:00:00
abstract:OBJECTIVE:To review the endogenous alterations generating critical illness in bowel obstruction. DATA SOURCES:Own experimental and clinical investigations and relevant articles published in international literature. DATA SYNTHESIS AND CONCLUSIONS:Large bowel obstruction is mostly confined to the colon. Passive dilata...
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::Treatment of distal fractures of the radius has undergone considerable change during recent years. The cause for this lies primarily in the poor results of conservative treatments. In addition to osseous instability, the fractures of the radius are frequently combined with ligamentary instability as well, thereby exce...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:
更新日期:1994-01-01 00:00:00
abstract::Ureterosigmoidostomy was the method of choice for continent urinary diversion in cases of bladder exstrophy. The development of colonic cancer at the ureterocolic junction is one of the major complications in the late course of this procedure. The risk of large bowel carcinoma is increased 150-500-fold compared to the...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1998-01-01 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::Two-third gastrectomy or supplementary gastrectomy was performed on 13 patients, between July 2, 1986 and September 30, 1988. Continuity of the gastro-intestinal tract was restored by end-to-side gastrojejunostomy according to Roux-en-Y. An antireflux valve according to Rumpf was inserted 15 cm below the gastroenteroa...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1990-01-01 00:00:00
abstract:BACKGROUND:Sacral nerve stimulation (SNS) is an effective and less invasive treatment of faecal incontinence (FI). Patient selection has evolved from strict criteria to a more liberal approach, since temporary testing reliably predicts the efficacy of permanent stimulation in FI of various aetiologies. PATIENTS AND ME...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-2008-1004737
更新日期:2008-04-01 00:00:00
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...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/a-0713-0457
更新日期:2018-10-01 00:00:00
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:
更新日期:1979-01-01 00:00:00
abstract::Visceral aneurysms are very rare (0.1% in autopsy-statistics). In our own review of literature we have found only 9 described cases of an aneurysm of the gastroepiploic artery. In the presented case an aneurysm was found when the patient developed an acute upper gastrointestinal bleeding. Due to the high risk of ruptu...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1993-01-01 00:00:00
abstract::Electromyography (EMG) of the pelvic floor musculature is only carried out as a routine method in few clinics. There is a lack of standard patient groups and, correspondingly, standardized values do not exist. Close cooperation between proctologists and neurologists is the exception. Some surgeons use the EMG to evalu...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:
更新日期:1996-01-01 00:00:00
abstract::Injuries, burns, and surgical intervention may lead to temporary depression of immune defence. Today, life-threatening infections may be caused by bacteria, such as pseudomonas, bacteroids, serratia as well as by viruses, including cytomegaly virus, and yeasts. Severe infections of that kind may be countered by adequa...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:
更新日期:1987-01-01 00:00:00
abstract::Although the term hierarchy isn't in keeping with the times for secular spheres, the identical term ranking omnipresent and indispensable in a political way. Without ranking there ist no final but only a general responsibility. Ranking is based on authority--to be distinguished between professional competence an offic...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1999-01-01 00:00:00
abstract::Isolated hypoxic perfusion (IHP) is a commonly used technique in the treatment of abdominal malignancies. During a phase II-study the pathophysiology of this technique was explored in patients with advanced pancreatic cancer. Twenty perfusions of the abdomen were performed in 17 patients. Under general anesthesia, fem...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1999-01-01 00:00:00
abstract::Objective This video is a step-by-step illustration of the laparoscopic-assisted mobilisation and resection of a sacrococcygeal teratoma Altman type III. Indication Laparoscopic supralevatory tumour mobilisation is an established method in selected centres and can be the initial step in approaching sacrococcygeal tera...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-0043-100015
更新日期:2017-06-01 00:00:00
abstract::Autologous blood procurement remains in evolution. Interest in preoperative autologous blood donation (PAD) increased substantially in the 1980's due to the recognition that HIV was transmissible by blood. Concomitant with increased blood safety, however, PAD activity has declined approximately 40% since 1992. Reasons...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-2003-40618
更新日期:2003-06-01 00:00:00
abstract::Anomalous pulmonary venous drainage of the right lung into the inferior vena cava is an uncommon congenital defect. In 440 patients suffering from atrial septal defect (with or without anomalous pulmonary venous drainage) we could demonstrate the Scimitar-Syndrome in five cases. The described side-to-side-anastomosis ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1983-01-01 00:00:00
abstract::The case history of a 75 year old man is demonstrated, who developed an abscess in the scar after B-II-resection 30 years ago. In this abscess S. typhi murium was detected. Diabetes mellitus was an additional risk factor. A review of the literature is given concerning extraintestinal manifestations of salmonellosis wi...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1994-01-01 00:00:00
abstract::Continuous arteriovenous hemofiltration is the treatment of choice for postoperative acute renal failure (ARF). The clinical value of two different treatment modalities (spontaneous vs. pump-driven hemofiltration PDHF) were compared in two groups of patients with postoperative ARF. There were no differences in both gr...
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:1991-01-01 00:00:00
abstract::5.3% of all ruptures of the Achilles tendon occurring during alpin skiing are accompanied by an eversion fracture of the inner malleolus. The frequency of this type of combined trauma has not changed in the last fifteen years. A typical eversion trauma resulting in the inner malleolus being torn off, but not involving...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1977-01-01 00:00:00
abstract::Diabetic foot syndrome represents a challenge for every practicing physician. The multifactorial genesis requires a broad therapeutic approach. ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1999-01-01 00:00:00
abstract::We recommend explorative laparotomy with splenectomy in the field of Hodgkin's lymphoma even in childhood. Operation is an early therapeutic and diagnostic method enabling further treatment to be made in relation to the stages of the disease. A chance of better survival seems to exist in children with Hodgkin's diseas...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1977-01-01 00:00:00
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:
更新日期:1989-01-01 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