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Biomedical subjects

A Tittel

Publications and source records attributed to A Tittel.

17 recordsLinked to original sources
PubMed1998

Laparoscopy versus laparotomy: comparison of adhesion-formation after bowel resection in a canine model.

AIM: The purpose of the study was to compare adhesions following laparoscopic and conventional operations. METHODS: In 14 dogs cecal resection and a deserosation of the abdominal wall were performed laparoscopically (n = 7) or by laparotomy (n = 7). After 8 days all dogs were reexamined and the adhesions were quantified by computer-aided measurements. The significance of any differences were tested using Student's t test. RESULTS: The extent of adhesions after laparoscopy (630 +/- 360 mm2) and after laparotomy (3,300 +/- 1,007 mm2) differed significantly (p < 0.0001). Extensive adhesions to the abdominal incision and interenteric adhesions were found after conventional operations. Identical manipulations, such as cecal resection or deserosation of the lateral wall, led to the same frequency and extent of adhesions in both operation groups. CONCLUSION: Laparoscopic procedures are associated with significantly less adhesions in comparison to conventional operations. Therefore the risk of adhesion-related complications should be reduced after laparoscopic operations.

Abdominal Muscles↗
PubMed1996

Memory deficits in subsyndromes of chronic schizophrenia.

Recent psychopathological studies consistently identified a delusional, a negative, and a disorganized subsyndrome in chronic schizophrenia. The aim of the present study was to investigate these subsyndromes with respect to declarative, procedural and working memory deficits. While the delusional subsyndrome was associated with an impaired delayed recognition, the negative subsyndrome showed a marked deficit in delayed recall. In addition, the delusional and the negative subsyndrome shared procedural memory changes. The disorganized subsyndrome was associated with neurological soft signs and a poor working memory performance. These results do not seem to be effected by severity of illness, degree of chronicity, nor attentional deficits. Our findings support the differentiation of three subsyndromes in chronic schizophrenia and suggest that memory impairment in schizophrenia may reflect the involvement of different memory systems rather than an unspecific, global deficit.

Adult↗
PubMed1996

[Minor abdominal trauma by laparoscopic surgery? Comparison of adhesion formation and intestinal motility after laparoscopic and conventional operations in the dog].

Early postoperative intestinal motility after conventional and laparoscopic cholecystectomy was registered in dogs (n = 10) by implanted serosal electrodes to compare the abdominal trauma. In addition postoperative adhesions after laparoscopic and conventional resection of the cecum were measured in dogs (n = 14). A significantly shortened postoperative atony occurred after laparoscopic cholecystectomy compared with the conventional operations. Laparoscopic operations caused significantly less adhesions. After conventional operations extensive adhesions to the abdominal wall and interenteric adhesions were found. The shortened postoperative atony and the reduced adhesions document the minor abdominal trauma of laparoscopic surgery.

Abdominal Muscles↗
PubMed1996

[Gastroesophageal reflux--surgical indications, laparoscopic surgical technique, results].

OBJECTIVE: To investigate criteria for indication to surgery and results of laparoscopic fundoplication. BACKGROUND: Gastroesophageal reflux is a common problem in well developed countries. Beside clinical symptoms of heartburn and regurgitation complications may occur like esophagitis, bleeding, ulceration, mucosal metaplasia and loss of motility. A connection of reflux disease, Barrett's esophagus and adenocarcinoma of motility. A connection of reflux disease, Barrett's esophagus and adenocarcinoma of the esophagogastric junction is discussed. In some patients medical treatment is complicated by relapse, persistent or progressive disease. For these patients laparoscopic antireflux surgery may be an effective alternative. PATIENTS: 22 patients with chronic gastroesophageal reflux disease. METHODS: Since 9-2-1922 patients with gastroesophageal reflux disease were prospectively evaluated and treated by laparoscopic Nissen fundoplication. RESULTS: 11 patients had frequent recurrent disease, 9 persistent reflux and 2 a stricture while on medical treatment. All had pathologic reflux on 24 hour pH monitoring and defective sphincter on standard manometry. Beside an intraoperative pneumothorax there was no intraoperative complication. Postoperative 2 patients had a temporary and 1 mild persisted dysphagia. None had recurrent reflux. 10 patients were reevaluated one year after surgery. None had an esophagitis, abnormal reflux or an insufficient or hypercontinent sphincter. CONCLUSIONS: Patients with recurrent or persistent reflux while on medical treatment with abnormal reflux on pH monitoring and defective sphincter on manometry can be treated by laparoscopic Nissen fundoplication with good results.

Adult↗
PubMed1995

Intraabdominal humidity and electromyographic activity of the gastrointestinal tract. Laparoscopy versus laparotomy.

The purpose of this study was to observe electromyographic activity of stomach, small bowel, and colon during and early after identical laparoscopic and conventional operations to compare the operative trauma. In nine dogs a cholecystectomy was performed laparoscopically (n = 5) or by laparotomy (n = 4). Analysis of electromyographic activity focused on rhythm, frequency, and amplitudes of slow waves. Furthermore, oxygenation of blood and tissue, intestinal impedance, intraabdominal humidity, and temperature were documented to investigate their influence on slow waves. Open cholecystectomy caused an evident decrease of frequency and amplitude of colonic slow waves in comparison to laparoscopic cholecystectomy. Arrhythmic slow waves were observed only in the stomach during conventional cholecystectomy. Stomach and small intestine showed no significant difference of frequency and amplitude of slow waves in both operation groups. Intraabdominal humidity and intestinal impedance differed significantly in laparoscopy and laparotomy. Laparoscopic cholecystectomy proceeded with a minor abdominal trauma documented by smaller alterations of slow waves. This may be caused by reduced peritoneal desiccation.

Animals↗
PubMed1994

[Laparoscopy versus laparotomy. An animal experiment study comparing adhesion formation in the dog].

We performed laparoscopy (n = 7) or laparotomy (n = 7) for exploration of the small intestine, cecal resection with Endo-GIA or TA-30, deserosation of 2 cm2 of the abdominal wall and resection of the omentum majus in dogs. After 8 days all dogs were re-examined and the adhesions were quantified by computer-aided measurement. Laparoscopic operations were followed by significantly (P < 0.001) fewer adhesions. After conventional operations extensive adhesions to the abdominal incision and interenteric adhesions were found, together with frequent conglomerates of adhesions, intestinal kinkings or adhesive bands. Identical manipulations, such as cecal resection or deserosation of the lateral abdominal wall, led to the same frequency and severity of adhesions in both groups. Based on our results, the risk of adhesion-related complications may be reduced by the laparoscopic approach.

Abdomen↗
PubMed1994

[Video thoracoscopic therapy of spontaneous pneumothorax. Technique and initial results].

The acceptance of operative therapy of spontaneous pneumothorax (SPT) has been tempered by the serious trauma of thoracotomy access. Development of videoequipment and miniaturized instruments allows now a thoracoscopic resection of bulla with minimal access. 25 patients with recurrent SPT (n = 15), primary resistant SPT (n = 5), and first SPT (n = 5) were treated from January 1991 thoracoscopically. Bullae resection was performed with an Roeder ligature or an Endo-GIA. Pleurodeses was induced by mechanical irritation or coagulation of the upper thoracic aperture with the argon beamer. Postoperative lung reinflation was rapid and without patchy collapse. The analgetic drug demand was dramatically reduced and patients were mobilised on the 1st postoperative day. Patients were discharged on the 4th postoperative day. Major complication were one hematothorax and one recurrence of SPT. The advantages of the thoracoscopic surgical treatment are rapid full expansion of the lung, decreased postoperative pain, short postoperative hospital stay and early return to normal activity.

Adult↗
PubMed1994

[Value of sonography in routine diagnosis of acute appendicitis. A retrospective analysis].

Our retrospective study of ultrasound examinations in 261 consecutively appendectomized patients shows a lower sensitivity in sonographic diagnosis of acute appendicitis compared to our former prospective study. One reason seems to be the different experience of the participating surgeons in ultrasound examination of acute appendicitis. Conditions of a prospective study might be another reason for our former better results. In conclusion recognition of appendicitis during ultrasound must lead to early operation, but a negative ultrasound alone is not safe enough to avoid surgical intervention in clinically supposed appendicitis. In every-day surgery clinical experience combined with additionally performed ultrasound leads to an early and safe indication for appendectomy.

Abdomen, Acute↗
PubMed1993

[Ambulatory surgery interventions in childhood in a surgical clinic].

Between Jan. 1, 1980 and Dec. 31, 1990 1 688 children underwent One-Day-Surgery at the Surgical Department of the Rhenish-Westfalian Technical University. More than 85% of the operations were inguinal hernias (n = 765), phimoses (n = 324) and umbilical hernias (n = 185). The children's age ranged from 3 months up to 14 years. 27 patients (1.6%) could not be dismissed at the same day because of early complications. Two postoperative hemorrhages after circumcision led to readmissions and reoperation. More than 90% of the parents and 85% of the pediatrists were satisfied with the One-Day-Surgery. A responsible and successful One-Day-Surgery needs qualified surgeons, a well defined organizational structure and the observance of forensic problems.

Adolescent↗
PubMed1992

[Interrupted suture versus adhesive dressing in skin closure of pediatric inguinal hernia--a controlled randomized prospective study].

The skin closure with resorbable interrupted sutures (Dexon 6x0) was compared with adhesive plasters (Leukostrip) in a randomized prospective clinical trial with 100 children with an inguinal hernia. The same operative technique was used in both groups. There were no significant differences referring to the complication rates and the cosmetic results between both groups. Skin closure with adhesive plasters significantly saved operation-time and reduced costs. It can be recommended in cases of infantile inguinal hernias.

Bandages↗
PubMed1992

[Results of surgical therapy of choledocholithiasis--a retrospective study].

A multimodal therapeutic concept of choledocholithiasis with endoscopic and surgical procedures is presented. Between January 1986 and December 1990 106 patients with choledocholithiasis were operated. These patients are retrospectively analyzed. The success rate is 95.3%, the morbidity 18.7% and the mortality 0. These results are compared with the published data of the surgical or endoscopic therapy of the choledocholithiasis.

Adolescent↗
PubMed1992

[Jejunogastric invagination--a rare complication of stomach surgery].

The jejunogastric intussusception is a rare complication of gastric surgery. An acute and a chronic form of intussusception can be distinguished. Three anatomical types of jejunogastric invagination have been classified. Endoscopy is the diagnostic procedure of choice, early operative desinvagination the therapy of choice. The effectiveness of different operative procedures to prevent reinvagination is contested.

Aged↗
PubMed1990

[Common channel syndrome--2 case reports].

The common channel syndrome is a disease mostly of young girls. To demonstrate the problems of diagnosis and therapy we report on 2 cases operated on in 1987 and 1989. The long delay of several years between the onset of symptoms and the diagnosis might be shortened by improved diagnostic possibilities (Ultrasound, ERCP). In any case of hyperamylasemia or chronic pancreatitis in childhood an obstruction of the biliary tract should be excluded. The common channel syndrome can be treated by means of sphincteroplasty or a bilidigestive anastomosis.

Amylases↗