0000000000202157
AUTHOR
G. Buess
Elevated plasma histamine concentration as a sensitive real-time parameter for distinct phases of surgical trauma: a tool for technology assessment.
High technology plays an important role in surgery, either to expand surgical procedures or to reduce tissue trauma, which is a main goal of minimum invasive surgery. Due to the tremendous increase of costs the problem of technology assessment will not only be solved by statistical methods, but also by biomedical considerations and laboratory tests. Histamine release could be an indication for tissue trauma, which is caused directly by tissue damage or indirectly by infection or hypoxia. Therefore histamine release was investigated during different phases of operation in two clinically very important and complex situations: resection of liver metastases of colorectal carcinoma and resection…
A modified prosthesis for the treatment of malignant esophagotracheal fistula
Esophagotracheal fistula is usually a sequela of irradiation or laser treatment of advanced carcinoma of the esophagus or the tracheobronchial tree. Resection of the tumor in these cases is not possible, and palliative bypass surgery is highly risky. The peroral placement of a prosthesis is less invasive, but conventional prostheses often fail to occlude the fistula. The authors regularly use an endoscopic multiple-diameter bougie for dilation. After dilation, a specially designed prosthesis is pushed through the tumor stenosis to block the fistula. This procedure can be done without general anesthesia. The funnels of conventional prostheses cannot cover the fistula when there is either a w…