Search results for "Cardiothoracic surgery"
showing 10 items of 146 documents
Follow-up after transanal endoscopic microsurgery or transanal excision of large benign rectal polyps
1998
Methods: Between January 1986 and December 1995, 238 patients with benign rectal polyps under-went either transanal endoscopic microsurgery (n = 226) or transanal excision (n = 12) at the Clinic of General and Abdominal Surgery, Johannes Gutenberg-University, Mainz. Results: Mean polyp size was 4.2 cm; 89.1% of polyps measured more than 2 cm in diameter. In 89.1% of cases, histological analysis revealed polyps containing tubulovillous or villous adenomas. Synchronous colonic polyps were detected in 12.5% of patients. Follow-up data are available on 222 patients (94%). At follow-up examination, 169 of the 193 surviving patients (87.6%) were recurrence free. Seven of 193 patients (3.6%) had d…
Analysis of risk factors for neurological dysfunction in patients with acute aortic dissection type A: data from the German Registry for Acute Aortic…
2012
OBJECTIVES: Acute aortic dissection type A (AADA) is associated with major adverse events, such as transient or persistent neurological dysfunction (ND), which may be patient-, disease- or surgery-related. There is a lack of consensus regarding risk factors for ND in AADA patients. The aim of this study was to analyse and identify risk factors for new postoperative ND after aortic repair for AADA. METHODS: Between July 2006 and June 2010, 2137 AADA patients were enrolled in the multi-centre, prospective German Registry of AADA (GERAADA). Perioperative data were prospectively gathered from 50 institutes in Austria, Switzerland and Germany, and multivariate logistic regression analysis was pe…
Computed tomography-based tracheobronchial image reconstruction allows selection of the individually appropriate double-lumen tube size
1999
Objectives: To determine whether individualized selection of double-lumen tubes or alternatives based on three-dimensional reconstruction of the tracheobronchial image from routine preoperative computed tomography (CT) scans leads to clinically appropriate choices. Design: Prospective observational study; comparison to historic controls. Setting: Anesthesia and radiology facilities of a university medical center. Participants: Forty-nine patients undergoing thoracic surgery requiring one-lung ventilation. Interventions: Three-dimensional image reconstruction of individual tracheobronchial anatomy was performed from routine preoperative spiral CT scans as well as from scans of five left-side…
Acute Aortic Dissection Type A : Age-related Management and Outcomes Reported in the German Registry for Acute Aortic Dissection Type A (GERAADA) of …
2013
To determine the association between age and clinical presentation, management and surgical outcomes in a large contemporary, prospective cohort of patients with acute aortic dissection type A (AADA).AADA is one of the most life-threatening cardiovascular diseases, and delayed surgery or overly conservative management can result in sudden death.The perioperative and intraoperative conditions of 2137 patients prospectively reported to the multicenter German Registry for Acute Aortic Dissection Type A were analyzed.Of all patients with AADA, 640 (30%) were 70 years or older and 160 patients (7%) were younger than 40 years. The probability of aortic dissection extension to the supra-aortic ves…
Factors Influencing Morbidity and Mortality after Pancreaticoduodenectomy: Critical Analysis of 221 Resections
1999
A critical analysis of morbidity and mortality for pancreatico-duodenectomy was performed on 221 patients. During the 1960s and 1970s, the morbidity and mortality for pancreaticoduodenectomy were so high that many thought the operative procedure ought to be abandoned. During the 1980s, however, many centers reported mortality rates around 5% and a morbidity of 25% to 35%. Others still reported a mortality of more than 10% and a morbidity of up to 65%. The reasons for these discrepancies are of major interest. In a prospective case-control study 760 patients with malignant and benign diseases of the pancreas were treated in our hospital between September 1, 1985 and April 30, 1997. In 221 ca…
Thoracic Endovascular Aortic Repair (TEVAR) for the treatment of aortic diseases: a position statement from the European Association for Cardio-Thora…
2012
Thoracic endovascular aortic repair (TEVAR) is an emerging treatment modality, which has been rapidly embraced by clinicians treating thoracic aortic disease.1–4 Fundamentally, it is a far less invasive approach than open surgery and its availability and relative ease of application has changed and extended management options in thoracic aortic disease, including in those patients deemed unfit or unsuitable for open surgery. In the operating room, this requires considerable perceptual, cognitive and psychomotor demands on the operators. The dramatic expansion of TEVAR activity has necessarily prompted a requirement to systematically consider the indications, appropriateness, limitations and…
Osteosynthesetechniken bei proximalen Humerusfrakturen
2001
Proximale Humerusfrakturen sind haufige Verletzungen. Die Frage der optimalen osteosynthetischen Behandlung instabiler und dislozierter 2- bis 4-Segmentfrakturen ist nach wie vor nicht einhellig geklart. Die operative Therapie befindet sich in der Konfliktsituation zwischen der Forderung einer anatomischen Reposition und stabilen Frakturretention auf der einen Seite und der Notwendigkeit einer maximalen intraoperativen Schonung der periglenohumeralen Weichteilstrukturen und Blutversorgung des Oberarmkopfs, mit dem Ziel das iatrogene Risiko der avascularen Kopfnekrose zu minimieren, andererseits. Wahrend Minimalosteosynthesen, bei denen die Reposition indirekt oder percutan erfolgt, Vorteile…
Wider implications of video-assisted thoracic surgery versus open approach for lung metastasectomy
2015
ABSTRACT Lung metastasectomy is considered a safe and potentially curative procedure despite there is not a strong evidence that metastasectomy prolongs long-term survival in patients with lung metastases. Moreover, the debate is open regarding the best approach for lung metastasectomy, video-assisted thoracic surgery versus open approach. A systematic review of literature to clarify what is the best approach to prolong survival in patients with lung metastases was performed. Our study confirms that overall survival is equivalent for video-assisted thoracic surgery and thoracotomy, therefore the ‘gold standard’ surgical treatment for lung metastases remains a point of debate. The choice o…
Morphometrische Untersuchungen an Darminterponaten nach totaler Gastrektomie
1982
Im Tierexperiment wurden nach totaler Gastrektomie die Bildung eines Ersatzmagens mit verschiedenen Darminterponaten sowie der Oesophago-Jejunostomie mit Roux-Y-Anastomose durchgefuhrt. Bei der Relaparotomie nach 3monatiger postoperativer Uberlebenszeit wurden die Interponate an ausgewahlten Stellen morphometrisch untersucht. Als deutlichste Veranderung fiel bei allen Dunndarmersatzmagen eine starke muskulare Wandhypertrophie auf, die vor allem die Ringmuskulatur betraf. Beim Colonersatzmagen, der physiologisch eine dickere Wandmuskulatur besitzt, war die Hypertrophie sehr viel geringer. Als pathogenetischer Faktor dieser Veranderung gilt die Volumenbelastung, der der Ersatzmagen an dieser …
Selektion von Patienten mit Rektumtumoren zur lokalen Exzision aufgrund der pr�operativen Diagnostik
2004
Ziel unserer Studie war die Erfassung der Genauigkeit der praoperativen Diagnostik (rektal-digitale Untersuchung, Biopsie und transanale Endosonographie) bei durch lokale Exzision behandelten Rektumtumoren. 552 Patienten mit Rektumkarzinom, Adenom, Karzinoiden oder seltenen benignen Tumoren wurden lokal exzidiert. Die Ergebnisse der rektal-digitalen Untersuchung, der Biopsie und der transanalen Endosonographie wurden mit dem postoperativen pathohistologischen Befund verglichen. Der praoperative histologische Nachweis des Karzinoms ist abhangig von der Tumorgrose (52% bei Karzinomen 3 cm; p=0,001) und war korrekt in 56% aller Karzinome. Die transanale Endosonographie (uT0/1) ist sensitiver (…