PubMed Health⌕ Search

Biomedical subjects

G Kubo

Publications and source records attributed to G Kubo.

At least 19 recordsLinked to original sources

[Rectusbanding by polypropylene-mesh--a new method for incisional hernia repair].

We report on a new method of incisional hernia repair applicable to any size. With exception of an area 1 cm medial of the m. rectus abdominis where the strip penetrates the anterior wall of the rectus sheath for a better fixation, the muscle ist looped in a loose way with a 2 cm wide band of polypropylene (Prolene(R)) on both sides at a distance of 2 cm depending on the size of the hernial opening. Different models of strips were used in 27 % of the cases adapted to anatomical particularities of the hernial opening. Anterior and posterior wall of the rectus sheath are closed by a continuous panacryl suture which covers the strip. Because of the wide subcutaneous excavation extending to the lateral margin of the rectus sheath an extensive drainage by Redon-Drainages as well as compression bandages are important therapeutical procedures until formation of seromas has finished. For perioperative antibiotic prophylaxis we used Cefuroxime (3 x 1,5 i. v.). From 07/1999 until 10/2001 75 patients underwent an operation in our department. The direct postoperative complications observed were: Seroma formation up to 300 ml after discharge in 5 patients (6,6 %) and wound infections in 2 patients (2,8 %). In none of the cases the mesh had to be removed. In a follow-up period of 6 to 24 months we found 2 recurrences in 60 patients (3,3 %). These were related to technical failures of the beginning. 64.9 % of the patients were free of complaints after 6 months and almost 96 % after one year. Only 3 patients (4 %) had to take analgetic drugs occasionally. With regard to the mobility of the abdominal wall we found no measurable limitation. The method of Rectusbanding is easy to learn for every surgeon and with little material the mesh-strip can be fixed safely. It can be cut to individual sizes and shapes adapted to the fascial proportions of the hernial opening.

Adult↗

[Laparoscopic versus conventional appendectomy].

From 1/1995 to 8/1997 857 appendectomies were observed in a prospective study. From then on in our clinic has done more laparoscopic then conventional operations, and has developed in the years before a permanent laparoscopic team. For all operations resterilized MIC-instruments are used. Preparation is done with bipolaric instruments and scissor, the appendix stump is supplied a with Röder-sling. The expensive Endo-GIA was used only 3x, if the coecumpole was also inflamed. Because of the fantastic intraabdominal view additional findings quickly be recognized through the laparoscopic method. It was then possible, to plan the therapeutic management exactly. Also variations of the appendix-position are seen clearly and can be operated on without other incisions. There is no significant difference in time between the two methods as we have seen here in practice (35.3 minutes for the conventional and 43.8 for the laparoscopic operation)--they will assimilate, when the surgeon is routine. Fat and muscular patients profit definitely. The problems of wound infection have been rarely observed by the laparoscopic operation. The rate of intraabdominal abscesses was 1.9% and therefore higher as by the conventional method (0.2%). This could be reduced during the period of the study, because we now often lavage and drain. We think that there are no surgical opponent indication to the laparoscopic appendectomy. The reliable conventional technique has to be an obligate technique also in future.

Adolescent↗

[Results of treatment of acute cholecystitis following conservative therapy, interval operation and early operation].

The results achieved by conservative treatment interval operation and early operation in 981 patients suffering from acute cholecystitis were compared in a retrospective study by means of electronic data processing (EDP). There is no difference in length of operating time, intra- and postoperative complications and mortality rate between operation at an interval and early operation. By introducing the early operation the total mortality rate of all patients suffering from acute cholecystitis decreased from 7% to an average of 2.5%.

Acute Disease↗

[Rationalization and limits of diagnostic and operative measures in invasive cholestasis diagnosis (percutaneous transhepatic cholangiography) in primary medical care].

In a case of jaundice PTC enables the surgeon to detect its mechanical cause without further delay. This method is especially helpful in smaller hospitals without CT or even sonographic equipment. Explorative laparotomy is no longer necessary. An immediate decision can be made whether to perform a palliative or curative procedure or only to install a percutaneous bile drainage.

Biliary Tract Neoplasms↗

[Cholestasis syndrome in acute cholecystitis].

A slight rise in bilirubin values and rises of the serum transaminases belong to the symptoms of acute cholecystitis and do not necessarily stand for an occlusion of the bile duct, i.e. for a cholestase. They admit conclusions as to the seriousness of the inflammation and especially the alkaline phosphatase gives clear indication of additional choledocholithiasis. Even with a general attitude in favour of early surgery, there should be undertaken a comprehensive laboratory diagnostic prior to surgery.

Acute Disease↗

[Monday to Friday-clinic (author's transl)].

On a Monday to Friday ward with 21 beds in 1 1/2 years 1149 patients underwent the following operations: appendectomy 23%, hernioplasty (femoral and inguinal) 20,5%, phimoses 14,4%, cryptorchidism 9,7%, anal fistula and fissure 7,8%, hydrocelectomy 2,9%, saphenectomy 2,7%, haemorrhoidectomy 2,9%, excisions of Dupuytren's contracture 1,0%, varicocelectomy 0,4% pacemaker implantations 2,7%, other operations and patients for diagnostics 8,5%. The standardised diagnostic procedure is performed during the prehospital time. On Monday all patients were operated upon and dismissed on Friday. The operative results are good. The in-patient time is 4,5 days. - The advantage of this system is: increase of scheduled in-patient surgery, short stay, prophylaxis of noso - comial infections, more efficiency.

Berlin↗