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 by a superiorly pedicled TRAM-flap following preoperative conditioning. 30 of 40 patients were eligible for follow-up one to five years postoperatively. The mean interval between embolization and surgery amounted to 3.6 months. In 25 of 30 cases embolization of the DIEA was performed bilaterally, in 5 of 30 cases unilaterally. 14 of 30 patients underwent preoperative radiotherapy for breast cancer. Applying CCDS the peak flow values were determined in the superior epigastric arteries (TRAM/contralateral side). Pre-embolization values (54.9 cm/s/55.8 cm/s), post-embolization values (57.2 cm/s/57.9 cm/s) and late postoperative values (61.0 cm/s/61.6 cm/s) proved a statistically significant effect of selective embolization on peak flow without relevant difference between TRAM and contralateral side (p < 0.05). Postoperative flap complications consisted of partial necrosis in 2 of 30, fat necrosis in 1 of 30, impaired would healing in 5 of 30 and postoperative bleeding in 2 of 30 cases. Abdominal would healing complications occurred in 5 of 30 cases, abdominal wall weakness was found in 8 of 30 and hernia formation in 4 of 30 cases. Corrective surgery was performed at the breast (TRAM-flap) in 22 of 30 and at the abdomen (donor site) in 9 of 30 cases. Patient acceptance concerning selective embolization and TRAM-flap surgery was very high. 29 of 30 patients confirmed that they would again choose this type of breast reconstruction. The pedicled TRAM-flap following preoperative conditioning by selective embolization of the DIEA constitutes a safe and reliable method of breast reconstruction with autogenous tissue. It is superior to the pedicled TRAM-flap without delay and offers definite advantages compared to alternative techniques of enhanced flap vascularization.
journal_name
Zentralbl Chirjournal_title
Zentralblatt fur Chirurgieauthors
Scheufler O,Andresen R,Kirsch A,Banzer D,Vaubel Esubject
Has Abstractpub_date
2000-01-01 00:00:00pages
60-7issue
1eissn
0044-409Xissn
1438-9592journal_volume
125pub_type
杂志文章abstract：:At present the technique of selective proximal vagotomy (SVP) seems to be standardized. Nevertheless, the surgical procedure is practiced by many authors in a different way concerning the proximal and distal borderline of denervation. In our opinion pylorplasty should only be performed in those patients suffering from...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章,评审
doi：
更新日期：1979-01-01 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：:The authors report on their experience concerning myocardial protection during open heart surgery making use of hypothermic cardioplegia. From September 1977 to April 1980 they operated on 637 patients applying this method. 155 cases were evaluated. Hypothermic cardioplegia extends the tolerance of the myocardium to i...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：
更新日期：1982-01-01 00:00:00
abstract：:From 1971 through 1996, 16 patients were operated on for atypical aortic coarctation. Three of them (two women, 18 and 27 years old, one boy, 13 years old) had typical signs of neurofibromatosis type I (NF1). All had renovascular hypertension due to suprarenal and/or interrenal aortic stenosis. Two had additional bila...
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 present study shows the comparison of function and subjective judgement between two pouch-constructions after TME as treatment for rectal cancer. In 61 cases we constructed a J-Pouch, in 25 cases a transverse coloplasty pouch (TCP). The sex distribution was nearly the same. The influence of additional treatment li...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：10.1055/s-2002-33958
更新日期：2002-09-01 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：: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
abstract：:The development of anaesthesiology has brought about a great variety of problems e.g. unforeseen capacities, money, vacancies and equipment. The patients welfare, of course necessitates the establishment of anaesthesiological departments wherever operations are being performed. We believe that in hospitals without ana...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：
更新日期：1978-01-01 00:00:00
abstract：:Femorodistal bypass using exclusively PTFE is known to have a poor prognosis, mostly because of the development of myointimal hyperplasia (MIH). Several vein patch techniques are established but the role of hemodynamics within the anastomotic site has only been explained insufficiently and is hardly considered clinica...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：10.1055/s-2001-12419
更新日期：2001-02-01 00:00:00
abstract：UNLABELLED:Over a long time laparascopy for pancreatic diseases was performed only as staging laparoscopy in order to find hidden metastasis. The laparoscopic pyloric preserving duodeno-pancreatectomy showed many problems and could not establish. Laparoscopic distal resection of pancreas is much more feasible due to la...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：10.1055/s-2006-947366
更新日期：2006-08-01 00:00:00
abstract：BACKGROUND:In spite of dynamic development of modern diagnostic and therapeutic methods, the long-term results of surgical therapy in pancreatic cancer are still unsatisfying. The aim of this study was to analyse long-term results of surgical palliation for pancreatic cancer in a pancreatic surgery centre. METHODS:We ...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：10.1055/s-2002-35760
更新日期：2002-11-01 00:00:00
abstract：:The treatment and outcome of the respiratory failure decisively depend on its pathophysiological background. Besides simple blood gas analysis the investigation of the respiratory mechanics, interstitial lung water and the monitoring of the pulmonary pressure are necessary for an exact diagnosis. As a scoring method o...
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：:Obstructive jaundice is a common clinical sign in patients with pancreatic cancer. 52% of all patients with a potentially resectable pancreatic cancer suffer from painless obstructive jaundice. There are no prospective studies showing a beneficial effect of preoperative drainage in patients with resectable pancreatic ...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：10.1055/s-2003-40037
更新日期：2003-05-01 00:00:00
abstract：:With the purpose to minimize the complications in anastomotic surgery, we have developed a new soluble device, the SBS-TUBE. This paper presents our first results in experimental and clinical surgery with this device. In experimental surgery the SBS-TUBE was applied in ten pigs (+ two controls) with transection of the...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：
更新日期：1994-01-01 00:00:00
abstract：:The aim of this study was to determine whether arterial reconstructions in old age carry an acceptable risk and are reasonable as far as long term results are concerned. The operative mortality was 3,4% for reconstructions distal to the inguinal ligament and 20.5% for reconstructions in the aorto-iliac region. Limb am...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：
更新日期：1980-01-01 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：: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：: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：:The functioning of our anti-infectious regimen now working over a period of 7 years with 4 checks per year has been controlled. The wound infection rate came up to a percentage of 1.55. Blunders concerning chemical disinfection especially could be detected in spite of check-ups made every 3 months. ...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：
更新日期：1982-01-01 00:00:00
abstract：:The coloanal anastomosis is in low rectal cancer for oncological reason the appropriate procedure, if the sphincter is not involved, but is followed often by impaired continence. For better continence a colonic-J-pouch anal anastomosis was performed in 11 consecutive operated patients after rectal resection predominan...
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：UNLABELLED:The aim of this study was to analyse the causes of death after liver transplantation in order to find and to avoid preventable fatal complications if possible. METHODS:Between September 1988 and September 1993 415 orthotopic liver transplantations in 382 patients were performed at the Rudolf Virchow Univers...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：
更新日期：1995-01-01 00:00:00
abstract：:Transverse spinal cord lesions entail severe secondary pathological alterations to the urinary tract, reducing longevity and quality of life. It is, therefore, urgently recommended to take a coherent approach to such patients throughout the GDR and to use for urine voiding intermittent catheterisation right from Phase...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：
更新日期：1986-01-01 00:00:00
abstract：:Based on the example of the sigmoid resection, we did a cost-income analysis evaluating the particular expenses and effects of the new DRG-based medical financing system. We analysed the cost of diagnostic tests, medication and nutrition, surgery, personnel and non medical expenses for 20 open and 27 laparoscopic oper...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：10.1055/s-2004-820301
更新日期：2004-08-01 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：:The change of surgical operations from inpatient to outpatient conditions as a method of lowering costs in health care has lead to a significant rise in the number of outpatient operations, especially in varicose vein surgery. Hospitalisation is still required in special cases. The criteria of 146 patients with varico...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：10.1055/s-2001-16278
更新日期：2001-07-01 00:00:00
abstract：:In the early post-operative follow-up after allogenic kidney transplantation sigmoid perforation due to diverticula is a life-threatening complication. As immunosuppression is indispensable perforation is favoured. Due to pharmacotherapy the risk of sepsis is implied because clinical symptoms might be masked. Referenc...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：
更新日期：1988-01-01 00:00:00
abstract：:Nailing has become the major method of treating lower leg fractures: though there are still different opinions how to treat lower leg fractures localized between the proximal-middle and middle-distal third as well as in the second and fifth/sixth. Following our own experiences with 192 lower leg nailings in that spher...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：
更新日期：1985-01-01 00:00:00
abstract：INTRODUCTION:An adequate approach to surgically induced sepsis needs an early and targeted antibiotic therapy in addition to focus sanitation. The PCR-based LightCycler Septifast test can detect 90 % of the sepsis-associated microoganisms (e. g., Gram-positive, Gram-negative bacteria, fungi) within only a few hours. P...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：10.1055/s-0028-1098776
更新日期：2009-06-01 00:00:00
abstract：:Intraabdominal cystic lymphangiomas are rare tumor-like lesions, predominantly found in the pediatric age group, but also in juveniles or young adults. Lymphangiomas are always benign and do not recur after complete excision. In this paper we report on two 4-year old children with a history of abdominal discomfort due...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：
更新日期：1999-01-01 00:00:00
abstract：INTRODUCTION:In a prospective trial we analysed the results and the management of complications following a combined endovascular and vascular surgical therapy of peripheral occlusive arterial disease (POAD). PATIENTS AND METHODS:From November 1998 until January 2001 a total number of 61 patients with 64 extremities w...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：10.1055/s-2002-22030
更新日期：2002-02-01 00:00:00
