PubMed Health⌕ Search

Biomedical subjects

E Mühe

Publications and source records attributed to E Mühe.

At least 19 recordsLinked to original sources
PubMed1992

Long-term follow-up after laparoscopic cholecystectomy.

A five-year follow-up was performed in 93 of 94 patients who successfully underwent laparoscopic cholecystectomy between 1985 and 1987. The results were compared to those in 130 of 136 patients of a non-randomized control group who had undergone open cholecystectomy during the same period. Patients characteristics and gallbladder findings were comparable in the two groups. Postoperative complications were infrequent and not significantly different in the two groups, whereas the mean hospital stay was shorter in the laparoscopic group. During follow-up, one patient in the laparoscopically treated group had a common bile duct stone which was treated surgically since he refused to undergo ERCP; this patient died of postoperative complications. Various abdominal complaints were reported in 27% and 25% of the patients undergoing laparoscopic and open cholecystectomy, respectively; in most cases no organic causes were found. Scar problems were less frequently reported in the laparoscopically treated group (2% versus 12%). It is concluded that the long-term results of laparoscopic cholecystectomy are as good as those of open cholecystectomy, however, the hospital stay is significantly shorter and the long-term cosmetic results are considerably better in laparoscopically treated patients.

Cholecystectomy↗
PubMed1991

[Laparoscopic cholecystectomy--late results].

From September 1985 to March 1987 I carried out the first 94 laparoscopic cholecystectomies, with pneumoperitoneum, in the world. Later I preferred the better open laparoscopic cholecystectomy without pneumoperitoneum. In the same period I treated 136 patients with simple cholecystectomy by laparotomy. Five years 2% of the endoscopically operated patients mentioned slight pain in the scar, while 12% of the laparatomy group had scar problems, including four patients with hernias (p = 0.0084). One patient in the endoscopy group had complications from the biliary system because of a common duct calculus. Intraoperative cholangiography is needed to prevent residual stones and biliary lesions. The indications for the endoscopic procedure should be extended in view of the reduced operative risk and the trend to increasingly longer spontaneous courses.

Cholecystectomy↗
PubMed1984

Intermittent sequential high-pressure compression of the leg. A new method of preventing deep vein thrombosis.

The effect of sequential pneumatic leg compression on venous flow velocity was studied in 25 patients. At the usual pressures of 35 to 55 mm Hg, venous flow velocity was only 175 percent of the control value, but 366 percent when pressures were between 90 and 100 mm Hg. The incidence of post-operative thrombosis was studied in three groups of patients. In 24 patients receiving sequential compression prophylaxis of 90 to 100 mm Hg, there was one case of thrombosis, whereas there were three cases among the 25 patients with compression of 35 mm Hg and three cases among the 25 patients receiving 5,000 units of heparin three times per day. Sequential intermittent compression with high pressures, 10 compression cycles three times daily, is recommended for all patients unable to undertake physically active prophylactic measures. An absolute indication exists in those patients who cannot be mobilized and those in whom there are additional contraindications to the use of anticoagulants. Sequential compression is no alternative to antithrombosis stockings which must be worn from the day of hospitalization until discharge and also during the period of pneumatic compression.

Aged↗
PubMed1983

Urinary excretion of calcium, magnesium, oxalate and citrate in duodenal ulcer patients. Preliminary results before and up to five years after highly selective vagotomy.

The urinary excretion of calcium, oxalate, citrate and magnesium, and the relative saturation products in urine of either calcium oxalate or calcium phosphate, were determined in male duodenal ulcer (DU) patients preoperatively (n = 60), and 1 and 5 years following highly selective vagotomy (HSV), and in male healthy controls (n = 30). In DU before HSV citrate and magnesium were lowered, oxalate was in the low normal range and calcium was normal. The calcium oxalate product was lower than in controls, while the calcium phosphate product was unchanged. Within 5 years HSV normalized urinary citrate and oxalate, but not urinary magnesium, and the median urinary pH was lower than pre-operatively. There thus results a normal product for calcium oxalate, but a reduced one for calcium phosphate. It is suggested that: (1) unoperated DU patients have a urine composition similar to that exhibited in normocalciuric recurrent calcium urolithiasis; (2) this spectrum of urinary constituents may be changed by HSV.

Adult↗
PubMed1982

[Echinococcoses of the human. Diagnosis and therapy].

The clinical symptoms of hydatid disease result from the suppression and damage of the parenchyma of liver or lung. They resemble those of neoplastic diseases but show comparatively slower progression. For the diagnosis of cysts serological procedures, sonography, CT-scan and laparoscopy are discussed. One should be aware that exploratory puncture might be dangerous because of the possibility of generalized spread. Among 17 patients referred to Erlangen University Hospital with echinococcus cysticus the correct diagnosis was made in only 9 patients whereas the diagnosis on admission was correct in 8 out of 13 patients with echinococcus alveolaris. The treatment of choice is intraoperative sterilization of the cystic fluid with 0,5% silver nitrate followed by radical surgery.

Diagnosis, Differential↗
PubMed1982

[New method of preventing thrombosis: Intermittent sequential high-pressure leg compression (author's transl)].

The effect of sequential pneumatic leg compression on venous flow velocity was studied in 25 patients. At the usual pressures of 35-55 mm Hg, venous flow velocity was only 175% of control value, but 366% when pressures were between 90 and 100 mm Hg. The incidence of postoperative thrombosis was studied on three groups of patients. In 24 patients, receiving sequential compression prophylaxis with 90-100 mm Hg, there was one case of thrombosis, while there were three cases among the 25 patients with 35 mm Hg compression and three in the 25 receiving 5000 unit of heparin three times daily, Sequential intermittent compression with high pressures, ten compression cycles three times daily, is recommended for all patients unable to undertake active prophylactic measures. An absolute indication exists in those patients which can no be mobilised and those in whom there are additional contraindications to the use of anticoagulants. Sequential compression is no alternative to antithrombosis stockings. These must be worn from the day of hospitalisation until discharge, also during the period of pneumatic compression.

Bandages↗
PubMed1981

[Results of surgery of metastases].

We resected pulmonary metastases in 88 patients. The five-year survival rate was 42%, the ten year rate 26%. Results after resection of hepatic metastases in 52 patients were less favourable. The five year survival rate was 25%, the ten year rate 18%. The indications for surgical treatment are given and prognostic conclusions drawn.

Hepatectomy↗
PubMed1981

[Surgery of Crohn's disease: a study of 155 patients after intestinal resection (author's transl)].

Operative mortality after intestinal resection in 155 patients with Crohn's disease was 8.4%. In 12 of 13 the cause of death was septic complications, most of them related to prolonged pre-operative cortisone medication. Follow-up examination was possible in 90% of all discharges. Five-year recurrence rate was 37.6%. Recurrence was not prevented by long-term drug treatment. Purely macroscopic assessment of the resection margins would have led to excision within diseased gut: for this reason frozen sections are recommended before the anastomosis is made. Primary death-rate in 30 cases of colectomy with primary ileorectostomy was 3%. In three patients the rectum had to be excised, while in one the anastomosis had to be taken down because of recurrence. The failure rate was thus only 11%. If rectoscopy, stepwise biopsy and intra-operative frozen section indicate a normal rectum it is recommended that ileorectostomy be done rather than diversion ileostomy with occlusion of the rectum or even proctocolectomy.

Colectomy↗
PubMed1981

Are growth rates of tumors of any clinical importance?

The tumor doubling times were determined in 142 rounded pulmonary lesions of 78 patients (13 bronchial carcinomas, 7 benign pulmonary tumors, and 122 pulmonary metastases). They varied between +12 and +8863 days of tumor growth and of -1810 days of decrease in tumor mass. Forty-four percent of all pulmonary metastases doubled their volume within 60 to 250 days. The growth rates during the period of observation varied greatly in several pulmonary metastases of the same patient, even for the same solitary circular lung focus of the same person. There is no relationship between tumor doubling time and histological type of the tumor, nor between the interval between operative removal of the primary tumor and the occurrence of pulmonary metastases. In patients between the ages of 10 and 30 years only rapidly growing pulmonary metastases with a tumor doubling time of less than 60 days could be found; even though there is no proved relationship between growth rate and age. The tumor doubling time gives no useful information on the nature of a circular lung focus, and there are no clinical consequences for diagnosis.

Adenocarcinoma↗
PubMed1981

Surgical treatment of metastases to the lung and liver.

We resected 120 pulmonary metastases in 67 patients and 49 hepatic metastases in 38 patients. After surgical removal of pulmonary metastases, 14 patients survived five years; without surgical therapy, only one patient survived. As for the prognosis, as many as four resected pulmonary metastases are unimportant. In instances of several metastases, resections should be performed carefully and as rarely as possible. After lobectomy, nine patients have survived for five years; after wedge excisions, four patients have survived for five years, and after bilobectomies or pneumonectomy, one patient has survived for five years. If the lungs are the first filter of hematogen metastases, more patients survive for five years than if the liver is the first filter. With a prolonged free interval period, the prognosis is better. The tumor-doubling time must not influence indication. After resection of hepatic metastases, four patients survived for five years. The prognosis is more favorable for patients with solitary metastasis and if local resection will be sufficient. When the primary tumor and hepatic metastases are removed at the same operation, the prognosis is better than in an instance of delayed diagnosis and removal. If the liver is the first hematogen filter for cleaned off cells of the primary tumor, the survival rates are higher than when the lungs are the first filter.

Hepatectomy↗