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Biomedical subjects

D Geipel

Publications and source records attributed to D Geipel.

6 recordsLinked to original sources

[Reoperations in primary hyperparathyroidism].

We report on 14 patients suffering from persistent (n = 13) and truly recurrent (n = 1) primary hyperparathyroidism. Reoperations were successful in 13 cases. Cervical reexploration was only required for 5 patients who had previous operations by unexperienced surgeons in other clinics. In 5 out of 7 patients operated by us, the causes of the persistent primary hyperparathyroidism were 4 adenomas and one hyperplastic gland in the mediastinum found by median sternotomy. The remaining cases were a rare ectopic location of the inferior glands and an inadequate resection in four-gland-hyperplasia. Preoperative localization procedures were carried out for most patients. 201-Tl/99m-Tc-subtraction scintigraphy has proved for localization in both the cervical region and the mediastinum to be a highly sensitive method. Reoperative parathyroid surgery can be reduced with thorough initial cervical exploration by experienced surgeons in specialized clinics.

Adenoma

Clinical aspects of surgery in primary hyperparathyroidism.

60 patients suffering from primary hyperparathyroidism were operated during the period from 1980 till september 1988. The operation was successful in 55 cases. Most patients had single adenomas of the parathyroid glands. There was only one case with a four-gland-hyperplasia and one case with a parathyroid carcinoma. Rare observations were: one woman with a truly recurrent primary hyperparathyroidism, two patients with a papillary carcinoma of the thyroid gland in addition to the hyperparathyroidism and one patient with a large cystic parathyroid adenoma. Most of the patients had severe clinical symptoms of the primary hyperparathyroidism, mainly renal stones, in some cases bone changes. Only three patients were asymptomatic.

Adenoma

[Surgical treatment in deep venous thrombosis of the legs and pelvis (author's transl)].

The only effective causal therapy in thromboses of the deep pelvic and femoral veins is fibrinolysis or operative thrombectomy. Concerning the contraindications, fibrinolysis is successful only up to the 5th day. After that time patients with deep vein thrombosis were submitted to thrombectomy and at the same time, to prevent renewed thrombosis secondary to a slowing down of the flow, a peripheral arteriovenous fistula was temporarily positioned. Between 1974 and 1976, 14 patients were treated operatively this way. In 6 cases of pulmonary embolism a vena cava umbrella filter was inserted.

Arteriovenous Shunt, Surgical