Biomedical subjects

A S Kasper

Publications and source records attributed to A S Kasper.

11 recordsLinked to original sources

PubMed2001

Laparoscopy-assisted aneurysm resection as a minimal invasive alternative in patients unsuitable for endovascular surgery.

OBJECTIVE: So far, endovascular surgery has been the only minimal invasive way to treat patients with abdominal aortic aneurysms (AAAs). With hand-assisted laparoscopic surgery (HALS), laparoscopic transperitoneal endoaneurysm repair can be performed through a 6-cm mini-incision only. We wanted to evaluate whether this laparoscopic technique can be offered as a minimal invasive alternative in patients unsuitable for endovascular AAA repair. MATERIAL AND METHODS: Forty patients were referred for endovascular AAA repair. Three patients had to be excluded from the study. Endovascular AAA exclusion was finally performed in 13 patients. Laparoscopic AAA resection was performed in 24 patients. Hand-assisted laparoscopic surgery with transperitoneal access and endoaneurysm repair was accomplished in all patients unsuitable for an endovascular procedure. The outcome after endovascular repair was compared with the outcome of patients who underwent laparoscopy. RESULTS: In the laparoscopic group, conversion to an open procedure was necessary in one case. One patient in this group died (4.1%) postoperatively. There were four complications in each group. In the endovascular group we had one endoleak type II and one graft thrombosis, which required a reoperation. After endovascular treatment, patients were transferred significantly less frequently to the intensive care unit, and they could resume oral feeding earlier. Mobilization and postoperative hospital stay did not differ significantly between the groups. CONCLUSION: Laparoscopic AAA resection with the use of the technique described can be routinely offered to patients unsuitable for endovascular AAA exclusion with excellent long-term results similar to open surgery. A controlled study is clearly indicated to evaluate the role of laparoscopic techniques in aneurysm surgery.

Aortic Aneurysm, Abdominal↗

PubMed1996

[History of autologous blood transfusion in the 19th century].

Autologous blood transfusion in animal experiments was performed already in the first half of the 19th century. These experiments, however, were not conducted to explore the feasibility of autologous blood transfusion in man, but provided only the experimental design for physiological investigations on the defibrination of blood. Blood withdrawn from the animals by phlebotomy in these experiments was retransfused either with or without defibrination. The idea of retransfusing the patient's own blood was mentioned for the first time by Eulenburg and Landois, when in 1866 they proposed to treat gas poisonings with a type of exchange transfusion (transfusion with simultaneous depletory bleeding). They suggested that the blood that would be withdrawn could be retransfused after the poisonous gases had been eliminated. The first who demonstrably considered the possibility of autologous blood transfusion in operative medicine was the Halle surgeon Richard von Volkmann in 1868. The first originally sourced autologous blood transfusion, however, was performed by the Kiel surgeon Friedrich von Esmarch who, in a case of exarticulation of the thigh at the hip joint, collected the blood that had been shed during the operation in a washbowl, defibrinated it, and reinjected it into the severed femoral vein. However, despite some further cases of autologous blood transfusion performed for various indications and in different countries, the method was unable to gain a foothold in the treatment of acute blood loss, and fell into oblivion until the Leipzig gynaecologist Johannes Thies revived interest in it in 1914. The authors surmise that the advantages of autologous blood transfusion had not been recognised in the 19th century.

Animals↗

PubMed1995

[An arteriovenous fistula in an unusual site].

Arteriovenous fistulas are caused by trauma as well as iatrogenic, the latter especially being facilitated by the increasing frequency of invasive diagnostic and interventional procedures. We report the case of an arterio-venous fistula between the 9th arteria intercostalis and the 9th vena intercostalis caused by computed tomography guided small needle aspiration of a pleural tumor.

Adult↗

PubMed1995

The social construction of breast loss and reconstruction.

Reconstructing the breasts of women with breast cancer is standard medical care. An exploratory, qualitative study of women with breast cancer demonstrates that breast reconstruction is not essential to the resolution of a breast cancer crisis. This article reveals that today's culture creates a social context in which breast loss appears to have dire consequences for women and then provides the medical care to redress the loss it has helped create. Interviews were held with 29 women to explore the psychosocial consequences of breast cancer on their health and lives. This study demonstrates that breast reconstruction fails to meet the expectations of these women with breast cancer because the women identify disjunctures between social expectation and their own interests in health and well-being.

Adaptation, Psychological↗

PubMed1985