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Biomedical subjects

G M Kaiser

Publications and source records attributed to G M Kaiser.

11 recordsLinked to original sources
PubMed2006

[Surgical therapy of hilar cholangiocarcinoma].

Surgical resection provides the only chance of cure for patients suffering from hilar cholangiocarcinoma. Due to the central anatomic localization within the liver hilum, established guidelines of oncologic surgery are difficult to apply. Resection of the hilar bifurcation alone or in combination with limited hepatic resection can be performed with low morbidity and low mortality but shows a high rate of local tumor recurrence. Usually, extended resection is required to achieve adequate safety margins. Right trisectionectomy complies best with the basic rules of oncologic surgery while allowing the maximum safety margin. The 5-year survival rates reported after right trisectionectomy range between 20% and 40% and reach 59% in selected patients. The increasing experience with living donor transplantation and recent advances in neoadjuvant tumor therapy may lead to renewed discussion of liver transplantation in hilar cholangiocarcinoma.

Bile Duct Neoplasms↗
PubMed2005

Staging laparoscopy in gastric cancer.

BACKGROUND: As patients with gastric cancer are offered choices between surgical resection, neoadjuvant or palliative chemotherapy, or symptomatic relief alone, the need for accurate preoperative staging becomes apparent. Laparoscopy has been suggested as an appropriate staging modality in a variety of upper gastrointestinal malignancies. METHODOLOGY: Staging laparoscopy was performed in 45 patients with potentially resectable gastric cancer as determined by physical examination, gastroscopy, endosonography, transcutaneous ultrasonography and current generation computed tomography. Conventional clinic staging and laparoscopic staging according to the Tumor-Node-Metastases classification of the International Union against Cancer were registered separately on a database. Results were then compared to evaluate the agreement of both staging procedures. RESULTS: Compared to conventional staging, laparoscopy resulted in up staging of 23 patients (51.1%). In 10 patients of them peritoneal seeding was first found during laparoscopy, whereas additional liver metastases were detected in 3 patients and Krukenberg's tumor in one. As a consequence, the therapy planning was changed and laparotomy was avoided in 14 of these patients as the first operative procedure. Sensitivity of clinical staging was especially poor for stage IV tumors (5.3%) and for the majority of stage IIIB tumors (42.9%). Cytologic examination of peritoneal fluid had no additional information in our series. CONCLUSIONS: The value of laparoscopy in staging patients with gastric carcinoma could be demonstrated in this study. It is a safe and effective staging modality, helping to avoid unnecessary laparotomies and providing new means of directing appropriate treatment strategy.

Adult↗
PubMed2005

[Two cystic retroperitoneal lesions mimicking adrenal cysts].

Adrenal cysts are uncommon lesions and most of them are found incidentally during abdominal imaging. We report on two benign extraadrenal lesions mimicking adrenal tumors in abdominal imaging. The histopathological investigation of the lesions revealed a foregut duplication cyst of the lesser gastric curvature and an epithelial inclusion cyst (epidermoid cyst) in an intrapancreatic accessory spleen respectively.

Adrenal Gland Diseases↗
PubMed2003

[Tracheal rupture from blunt chest injury in a child].

Tracheobronchial lesions after blunt chest injury are rare. Diagnosis and therapy can prove to be challenging for the attending physician. Nonrecognition of this injury may entail severe complications. Herein we report the case of a 9-year-old girl with rupture of the trachea due to a fall against the handlebar of her kickboard. The clinical, radiological, and features of the therapy performed are discussed.

Athletic Injuries↗
PubMed2003

[Intraoperative radiotherapy in Germany].

BACKGROUND: Intraoperative radiotherapy (IORT) represents an attractive method for local tumour control after surgical resection. IORT was introduced into multimodal treatment protocols in the 1980s. Aim of this study was to analyse the actual clinical and scientific activity of IORT in Germany. METHODS: Questionnaires were sent to 102 centres in Germany. The analysis was focussed on indications in general surgery including bone tumours to evaluate the activity of IORT. The literature was analysed by a medline search for the years 1975 to 2001. RESULTS: Questionnaires were answered by 92% of the centres. 24 departments are working with IORT in Germany (16 of them are university hospitals). Main Indications for IORT treatment are rectum carcinoma and soft tissue sarcoma. Furthermore, IORT is used in patients suffering from gastric, pancreatic and bile duct malignancies. Some IORT programs are also targeting on patients with head and neck malignancies and brain tumours. German institutions published within the last 5 years about 14% of all " Medline"-listed publications concerning IORT. CONCLUSION: There is an profound activity of IORT in Germany, which is concentrated on a few centres. A need for better national and international cooperation of centres performing IORT for clinical trials and to collect significant numbers of patients seems to be evident.

Bile Duct Neoplasms↗
PubMed1997

Xanthomonas maltophilia endophthalmitis after cataract extraction.

PURPOSE: To report a case of Xanthomonas maltophilia endophthalmitis and to increase awareness of its potential as an intraocular pathogen. METHOD: Case report. RESULTS: A 76-year-old woman developed X maltophilia endophthalmitis after cataract extraction. To eradicate the infection, we performed two vitrectomies and treated the patient with numerous intravitreal antibiotic injections. CONCLUSIONS: X maltophilia is a potential intraocular pathogen in an immunocompetent host. If the infection takes a persistent course, persistent topical and intravitreal antibiotic treatment and possibly vitrectomy are needed to eradicate the infection.

Aged↗
PubMed1987

Diagnosis of diseases of the lumbar spine: correlation of computerized tomography with myelography and clinical findings.

Data from 339 patients referred for evaluation of suspected lumbar disease were studied retrospectively to correlate findings in the routine clinical evaluation with results of computed tomography and myelography. Clinical features from the patients' history that correlated with an abnormal CT and myelogram included age greater than or equal to 40, a history of previous surgery, and absence of a history of injury. Signs from the physical examination that correlated included reduced lumbar motion, a motor or sensory deficit, abnormal reflexes, and reduced capacity for straight leg-raising or walking. Using a clinical score incorporating these variables, we suggest a diagnostic strategy to promote more efficient and selective use of CT scans and myelograms. We project that the use of this diagnostic approach can reduce the number of myelograms ordered in a similar population by more than 50%.

Adult↗
PubMedDate not supplied

Biliodigestive anastomosis after intraoperative irradiation in swine.

A large animal model was established to investigate the feasibility and suitable dosage of intraoperative radiation therapy (IORT) to the hepatic hilum before biliary-enteric anastomosis is performed. Twenty-two Pietrain Hampshire pigs underwent gallbladder and proximal bile duct resection followed by IORT using 20-40 Gy and performing biliary-enteric anastomosis. In the follow-up period of 56 days, pigs developed dose-dependent complications like stenosis of the biliary-enteric anastomosis. Results demonstrate that IORT of the liver hilum up to 20 Gy is safe with acceptable early complications in the presented animal model. The porcine biliary-enteric anastomosis can tolerate intraoperative irradiation up to a dosage of 40 Gy without disruption.

Anastomosis, Roux-en-Y↗
PubMedDate not supplied

Feasibility of veno-venous bypass surgery using leukocyte adhesion filters during abdominal surgery in a porcine model.

During oncologic surgery, manipulation of tumour tissue is almost unpreventable; liver resection even carries a higher risk of tumour cell dissemination into venous blood. Under in vitro conditions, a tumour cell reducing effect of some leukocyte adhesion filter systems has been shown. In a preclinical porcine model, these filters were used as integrated parts of a veno-venous bypass system used for liver surgery, run by a biopump. Practicability, handling and safety aspects of the filter system were analysed; the system was easy and safe to handle, and treated animals survived without any complications. For the future, effectiveness of the tumour cell depletion has to be examined in further experimental and clinical studies.

Animals↗
PubMedDate not supplied

New surgical technique for portal venous port system in Swine.

The need for serial blood sampling and continuous infusion using the portal vein for experimental surgery and pharmacological studies is evident. As suitable animal models are rare, we established a new technique to implant a permanent vascular access device to the portal vein in swine. All operations in study animals (n=8) were technically feasible due to a regularly detected side branch of the portal vein within the inferior pancreatic region; complications did not occur. Mean operation time was 48+/-17 min. This study clearly shows that the portal venous access is feasible and can be achieved safely using the inferior pancreatic vein for a permanent vascular access port system.

Animals↗