Search results for "APAR"

Clinical update: bariatric surgery.

2007

Video-assisted surgery: suggestions for failure prevention in laparoscopic cholecystectomy

2014

Background: Surgery differs from other medical specialties in its execution. It is often complex and includes considerable individual variations. Observing problems in operating theatres (OT) allows for the identification of system failures which should be defined for learning purposes to increase patient safety and enhance general safety culture within hospital organizations. This study evaluates a common video-assisted surgical procedure, laparoscopic cholecystectomy (LC) through failure analysis. The profile of the LC procedure and failure sources is presented. Methods: Data consisted video-observations and interviews concerning twelve LC operations performed at a day surgery unit. All o…

Minimally invasive mitral valve surgery: State-of-the-art and our experience

2015

The minimally invasive approach is becoming the standard-of-care for surgery of the mitral valve. As any less invasive strategy, it entails an increased surgical complexity. Standard-of-care mitral repair using the totally videoscopic approach is indeed reproducible; however, few specific data on patients with complex mitral valve disease are available in the published literature. The purpose of the present paper is to provide an overview of the current state-of-the-art in minimally invasive cardiac surgery, and a summary of recent evidence on the topic, with particular regard to the surgical techniques and comparisons with conventional surgery. The experience of the GVM Care and Research n…

Sclerosing Angiomatoid Nodular Transformation: Laparoscopic Splenectomy as Therapeutic and Diagnostic Approach at the Same Time

2018

Introduction. Sclerosing angiomatoid nodular transformation (SANT) of the spleen is a rare benign vascular lesion with unknown etiopathogenesis and with definite features of imaging, histopathology, and immunohistochemistry. It was first described by Martel et al. in 2004, and to date, only 151 cases have been reported.Case Description. We report a case of SANT of the spleen detected in a 66-year-old Caucasian, without comorbidities, presented to our department with epigastric pain. We, also, presented a review of the literature.Conclusions. SANT is a benign incidentally vascular condition in the majority of cases. The wide age and gender distribution in our review is in accordance with tha…

Achalasia Secondary to Submucosal Invasion by Poorly Differentiated Adenocarcinoma of the Cardia, Siewert II: Consideration on Preoperative Workup.

2014

Secondary achalasia due to submucosal invasion of cardia by gastric cancer is a rare condition. We report a case of pseudoachalasia, secondary to the involvement of gastroesophageal junction by poorly differentiated gastric cancer, initially mistaken as idiopathic form. We focus on the difficulty to establish differential diagnosis only on the basis of routine exams and we stress the necessity of “second level” instrumental exams; EUS in routine workup in selected patients should be considered. We support that routine workup based on history, clinical presentation, radiological and endoscopic findings, and certainly manometry could be insufficient for a correct differential diagnosis betwee…

Anticoagulation in a Neurosurgical Patient with Heparin-Induced Thrombocytopenia Type II with Argatroban and Fondaparinux after Clipping of an Intrac…

2009

Background: Therapeutic anticoagulation in patients after a major neurosurgical procedure remains critical because of the risk of a major intracranial bleed. Novel drugs could play

Laparoscopic Treatment of Intussusception

2021

Most cases of ileocolic intussusception are reduced by imaging-guided air or fluid enema. If unsuccessful, operative intervention is necessary. The laparoscopic approach allows inspection of the bowel, identification of intraabdominal pathology, and achieves reduction of the intussuscepted bowel in most cases. The procedure requires the combination of slow and gradual traction as well as “rolling” the cecum distally. If unsuccessful, the bowel can be delivered through an extended umbilical incision for extracorporeal manipulation, or resection if this should be necessary.

Prognostisch relevante Faktoren bei der intraabdominalen infektion

1992

From 1.1.1982-30.9.1989 280 patients were treated for intraabdominal infection at the clinic for general and abdominal surgery. With regard to their prognostic significance, the extent and localization of the peritonitis, abscess formation, the number of failed organ system, patients' age, total protein, thrombocytes and leucocytes were examined in these patients. The most unfavorable prognosis showed diffuse peritonitis with a mortality rate of 47.2%. Subsequent abscessing worsened the prognosis of the illness. There was a close correlation between the number of failed organ systems at the time of hospitalization and mortality. Low total protein content or more so a necessary substitution …

Sekundäre Achalasie bei niedrigmalignem Non-Hodgkin-Lymphom und Leiomyomatose der Kardia

2008

A 28-year-old man had been dysphagic for 9 months with a weight loss of 4 kg. A preliminary diagnosis of primary achalasia was made on the basis of typical radiological and manometric findings. Despite balloon dilatation of the cardia the symptoms did not improve and further diagnostic tests were performed. Ultrasound demonstrated a 4 cm tumour below the cardia. But its type and possible malignancy remained uncertain even at laparotomy. But as a malignant tumour was suspected a gastrectomy and omentectomy with removal of the local and regional lymph nodes were performed. After this the symptoms regressed and postoperative food intake was without problem. Histological examination of the surg…

Sentinel-node biopsy in early stage ovarian cancer: a prospective multicentre study (SELLY)

2019

BackgroundSystematic para-aortic and bilateral pelvic lymphadenectomy is included in the standard comprehensive surgical staging in presumed early epithelial ovarian cancer. No prospective randomized evidence suggests it has potential therapeutic value, and related morbidity is not negligible.Primary Objective(s)To assess sensitivity, safety, and feasibility of the sentinel lymph node technique in identifying the presence of lymph node metastases in patients with early stage epithelial ovarian cancer.Study HypothesisSentinel lymph node detection with indocyanine green can accurately predict nodal status in a cohort of women with early stage epithelial ovarian cancer.Trial DesignThe SELLY tr…