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Biomedical subjects

D Kupczyk-Joeris

Publications and source records attributed to D Kupczyk-Joeris.

17 recordsLinked to original sources
PubMed1993

[Inguinal hernia repair with local anesthesia--a comparative analysis].

Since February 1992 local anaesthesia has been routinely used for repair of inguinal hernias at the Surgical Department of the RWTU Aachen. All 607 patients undergoing Shouldice repair of primary inguinal hernia between January 1990 and March 1993 were retrospectively analysed with reference to need for analgesics, length of stay in hospital, and rate of complications. In addition, 50 patients treated with local anaesthesia and 50 patients treated under general anaesthesia underwent prospective pain analysis using a visual analogue scale and spirometric tests. Following local anaesthesia we found fewer need of analgesics, shorter stays in hospital, and less complications. The pain level was lower and ventilatory function was better. Repair of inguinal hernia with local anaesthesia is a safe method of lowering the risks involved in the operation and improving patient comfort without increasing complications.

Adolescent↗
PubMed1992

[Spontaneous pneumothorax. Graduated concept of surgical therapy].

The clinical course of 83 patients suffering from spontaneous pneumothorax lead to a modified surgical therapy according to the development of the underlying disease. The indication for non operative therapy, thoracic tube drainage, thoracic endoscopic methods and treatment by thoracotomy are defined and change of treatment from non-invasive procedures described in detail.

Adolescent↗
PubMed1992

[Clinical aspects and surgery of complicated and uncomplicated Meckel's diverticulum].

Our series of 43 complicated and 35 uncomplicated cases of Meckel's diverticula is reviewed. The complicated courses displayed the typical symptoms, e.g. ileus, hemorrhage, inflammation, perforation with peritonitis. Indication and tactics and techniques of surgical intervention are based on the individual course. Incidental diagnosis of Meckel's diverticulum during coeliotomy indicates resection, because diverticula of normal gross appearance present with microscopic alterations in 29% which could evoke major complications.

Adolescent↗
PubMed1991

[Controlled study of cremaster resection in Shouldice repair of primary inguinal hernia].

237 Shouldice operations with resection of the cremaster muscle from the Department of Surgery of the RWT University of Aachen were compared with 153 Shouldice repairs without resection of the cremaster muscle from the Department of Surgery of the Elizabeth Hospital in Essen. The aim of this prospective controlled trial was to determine the value of the resection of the cremaster muscle in Shouldice's hernia repair. A comparable follow-up of 12 to 26 months in both groups revealed no significant differences in early-postoperative complications. In the group without resection of the cremaster muscle the incidence of chronic inguinal pain was reduced. However, avoidance of the cremaster resection is not advisable because it leads to atypical indirect recurrences and totally higher recurrence rate (2.6%), so four indirect recurrent hernias were diagnosed. In the group with resection of the cremaster muscle no indirect recurrent hernia was detected, only one direct recurrent hernia was documentated. The significantly elevated rate of recurrent hernias (p less than 0.05) and the occurrence of atypical indirect recurrent hernias in the group without resection of the cremaster muscle demonstrates the important influence on the technique of repair. Based on our results the resection of the cremaster muscle is an essential part of Shouldice's hernia repair.

Adult↗
PubMed1990

[Incisional hernia. Causes and principles of repair].

Up to 11% of all coeliotomies result in incisional hernias, their repair is followed by recurrences in up to 46%. To control the incidence of these complications transverse and oblique incisions with a skin incision of sufficient length should be prefered. At the first operation the abdominal wall should be closed by a single continuous suture with an absorbable material. Non-absorbable materials should be used for hernia repair. The doubling of the facial structures gives no advantage. Alloplastic materials are restricted to problem hernias.

Abdominal Muscles↗
PubMed1990

[Cremaster resection in Shouldice repair. A prospective controlled bicenter study].

The aim of this prospective controlled trial was to determine the value of the resection of the cremaster muscle in Shouldice's hernia repair. 237 Shouldice operations with resection of the cremaster muscle of the Department of Surgery of the RWTH of Aachen were compared with 153 Shouldice repairs without resection of the cremaster muscle of the Department of Surgery of the Elisabeth Hospital in Essen. A comparable follow-up of 12 to 26 months in both groups revealed no significant differences in postoperative complications. In the group without resection of the cremaster muscle four indirect recurrent hernias were diagnosed. In the group with resection of the cremaster muscle no indirect recurrent hernia was detected, only one direct recurrent hernia was documented. The significantly elevated rate of recurrent hernias (p less than 0.05) and the occurrence of atypical indirect recurrent hernias in the group without resection of the cremaster muscle demonstrate the important influence on the technique of repair. Based on our results the resection of the cremaster muscle in an essential part of Shouldice's hernia repair.

Female↗
PubMed1990

[Repair of recurrent inguinal hernia. Tactics, technic and results].

Based on 301 surgical repairs of recurrent groin hernias perioperative management and recommended techniques for preparation and repair of various kinds of recurrent hernias are presented. Follow-up examinations could be performed on 175 patients, representing 88.8% of 197 patients who underwent surgery for recurrent hernias. Shouldice's technique for hernia repair proved to be the treatment of choice for recurrent groin hernias with a recurrence rate of 2.9% (5/175). Early postoperative complications occurred up to the 14th day following surgery. Frequently they could not be documented due to an average postoperative hospitalization period of 6.2 days only. The rates of postoperative complications were 8.1% prior dismission and 12.6% within two weeks after the operation respectively.

Adolescent↗
PubMed1990

[Hypothermia and polytrauma. A case report (28 degrees C)].

In a 29-year-old polytraumatised motorbike driver, massive blood transfusion led to a decrease of the body temperature to 28.1 degrees C rectal on the second day after admission. We could rewarm the patient using only a Clinitron bed, although he had persisting blood loss due to an intravasal coagulopathy. This method has proven to be noninvasive, effective and without any side effects.

Adult↗
PubMed1989

[Doppler sonography of testicular circulation following reconstruction of inguinal hernia].

The use of pre- and postoperative testicular Doppler ultrasound examination in groin hernia repair is evaluated in 50 patients operated by the technique of Shouldice. The etiological differentiation between ischemic orchitis and testicular necrosis is based on the monitoring of testicular perfusion. The technique is presented in detail. Preoperatively the arterial supply could be examined in 45 of 50 patients and the venous flow in 41 patients. The postoperative arterial flow was found in all and the venous flow in 47 patients. Our results revealed the Doppler sonography as a suitable technique for postoperative semiquantitative examination of testicular perfusion. It should be employed in all cases of postoperative testicular pain. A mandatory use of the Doppler technique to obtain an indication for operative revision has still to be discussed.

Adult↗
PubMed1985

[Traumatic duodenal rupture].

Traumatic duodenal perforation has an incidence of 1%-17% (blunt injury) or 1.7%-5% (penetrating injury). Its prognosis correlates to the kind of injury, associated injuries, size of perforation and delayed diagnosis. Mortality in cases of delayed repair is 65% compared with 5% mortality in early repaired perforation. In cases of delayed diagnosis, we recommend drainage of the perforation, naso-duodenal suction tube, parenteral alimentation. 5 patients where diagnosis was delayed for 8 days or longer were treated in this way and the duodenal wound healed completely without any complications within 22-44 days.

Drainage↗