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Biomedical subjects

H Bünte

Publications and source records attributed to H Bünte.

At least 55 records · Page 3Linked to original sources
PubMed1985

[Perioperative staging and the Münster TNM classification in ampullary and pancreatic cancer].

From 1974 to 1982 607 patients with diseases of the pancreas were treated at the Surgical University Clinic of Münster/West Germany. 256 of those suffered from pancreatic and 42 from ampullary cancer. All patients were grouped according to a TNM-System for pancreatic cancer developed for that particular purpose. Of the curative resections performed (n = 73) with a resection rate of 78.6% for ampullary and 15.6% for pancreatic cancer, a distinct preponderance of early stages (T1N0M0/T2N0M0 greater than 60%) was noticed for the first, of late stages for the latter (T1N0M0/T2N0M0 = 25%). The frequencies of distant metastases for all operations also differed significantly, being 9.5% respectively 43.4% at the time of operation (p less than 0.05). At the low mean survival time for palliative operations an mean survival time of 40.3 months for the Whipple operation was evaluated, of 28.0 months for total pancreatectomy. At the stage T1N0M0/T2N0M0 the mean survival time was greater than 63 months.

Ampulla of Vater↗
PubMed1985

[Prognosis of cardia cancer].

224 of 853 gastric carcinomata in the years 1974-1984 were located in the cardia. Here early stages of carcinoma were less frequent in comparison to the other gastric carcinomas. 46.4% were resectable. Proximal resection was performed in 88 patients, total gastrectomy in 16. Recurrent carcinoma was seen in 27.3%. The 5-year-survival time in all treated patients was 15%, in all resected cases 26%, in all fully resected cases 35%. Stage I showed a five-year-survival time of 42%, stage II of 22%, in stage III and IV no survivors. A generally applicable suggestion as to the radicality of operation can at present not be given. Too many prognostic factors in carcinoma of the cardia cannot be properly assessed.

Adenocarcinoma↗
PubMed1985

Adrenalectomy in adrenal hypertension.

Between 1965 and 1983, a total of 138 patients with endocrine hypertension were treated at the Münster Surgical Clinic. 71 catecholamine-producing tumors were removed in 56 patients, 60 patients had primary aldosteronism; 32 patients with Cushing's syndrome received uni- or bilateral adrenalectomy. The operative access to the adrenals was by anterior abdominal incision which we consider superior to lateral or transthoracic approaches. 35 complications occurred. The operative management of these forms of secondary hypertension, with its low overall rate of complications, is currently seen as the most successful therapeutic approach.

Adenoma↗
PubMed1985

[Complications following duodenohemipancreatectomy. Results of 112 patients 1974-1983].

From 1974 to 1983, 112 patients were treated at the Chirurgische Universitätsklinik Münster according to the procedure first published by Whipple in 1935. 40 patients (35.7%) were operated for chronic pancreatitis, 39 for (34.8%) ampullary cancer and 33 (29.5%) for pancreatic cancer. As to operative mortality which amounted to 10.7% (12/112) for all patients, figures of 10.0% (4/40) could be found for relapsing pancreatitis and 7.7% or 15.2% respectively for cancer patients. The underlying cause was circulatory arrest in 6 cases, anastomotic leakage in 4 cases, liver failure and gas gangrene in 1 case each. Altogether eight relaparotomies were performed (7.1%). As non-letal complications, pancreatic fistula, rise of liver enzymes, wound healing disturbances, and pleural effusion were the most frequent non-letal complications. By using the Ethibloc for pancreatic duct occlusion the rate of complications could be lowered. Hardly ever, glucose-metabolism was markedly affected by this extensive procedure.

Adult↗
PubMed1984

Clinical efficacy of low molecular weight heparin in postoperative thrombosis prophylaxis.

In a randomized controlled clinical trial, the efficacy and safety of two low molecular weight heparin ( LMWH ) fractions in the prophylaxis of deep vein thrombosis (DVT) were assessed. One hundred twenty-six patients undergoing major abdominal surgery received alternatively 2,500 APTT units b.i.d. of two LMWH fractions or 5,000 APTT units b.i.d. of an unfractionated sodium mucosal heparin ( UFH ). LMWH 2 differed from LMWH 1 by presenting a lower mean molecular weight and a higher anti-Xa/APTT ratio in vitro. Patients were randomly allocated to the three groups, and the development of DVT was studied with the 125I-fibrinogen uptake test ( RFUT ). The study was interrupted and the code broken prematurely because of otherwise unexplainable bleeding events. While no thrombosis and no severe bleeding were detected in the UFH group, three (7%) RFUT -positive DVT and two (5%) hemorrhagic complications occurred in the LMWH 1 group. No thrombosis and nine (22%) cases of severe bleeding were observed in the LMWH 2 group. Thus, the latter group differed significantly from the control group with regard to subjective and objective criteria for postoperative bleeding. Although these results do not allow general conclusions as to the value of LMWH fractions in the prevention of DVT, they indicate that these preparations just as ordinary heparin have a limited therapeutic range.

Adult↗
PubMed1984

[Crohn disease: II. Indications for operation].

As the etiology of Crohn's disease is still unknown conservative as well as surgical treatment has to be symptomatic. Medical therapy is performed by use of prednisolone, salazosulfapyridine, metronidazole and elementary diet depending on the localisation and extension of the disease. Surgical treatment means therapy of complications like stenoses, fistulae and abscess formation. Neither after conservative nor after surgical treatment is the course of the disease predictable.

Crohn Disease↗
PubMed1984

[Somatostatin in pancreas and small intestine fistulas].

Infusing 6 mg of somatostatin continuously for 24 hours will lead to a reduction of pancreatic secretion and perfusion of the splanchnic area. Due to this mechanism, secretion is significantly reduced in case of pancreatic or small intestine fistulae. Somatostatin was applied continuously in 39 patients for a period of 7 days. This led to a healing of pancreatic fistulae in 85.7% and small intestine fistulae in 63.6% of cases.

Adult↗
PubMed1984

[Protection of sutures of the injured esophagus using polyglactin 910 (Vicryl) mesh].

Dehiscence of suture after operative treatment of esophageal rupture is a quite frequent and dangerous complication. Several methods of reinforcement of suture with autologus material have been suggested of which the use of a pleura flap was the most successful one. After experimental investigations in the Department of Surgery of the University Hospital of Münster the securing of suture was performed by using Polyglactin 910 (Vicryl) meshgrafts. In 8 patients where the mesh grafts were used, a secondary leakage could be avoided. Considering our experiences, securing of suture by the use of Polyglactin 910 mesh-grafts is a recommendable method.

Animals↗
PubMed1984

[An ischemic-septic disease picture following acute occlusion of the superior mesenteric artery].

The pattern of symptoms which evidences acute mesenterial infarction has been investigated on more than 40 pigs by applying diverse non-surgical therapeutic approaches during transarterial balloon occlusion of the A. mesenterica superior. All animals died within 38 hours, much earlier after central occlusion than after blockage of the peripheral branches of the artery. A convincing delay could only be observed in the group treated by antibiotics. In two groups of clinical patients, 20 before and 28 after the experimental study, we found a significantly better prognosis in the latter group. About 46% of them got an antibiotic treatment immediately after being admitted to hospital. However, recently the time elapsing from the vascular accident to laparotomy has been shorter than in the last two decades. This contributes to better chance of survival in mesenterial ischaemia. Thus, antibiotic protection and early surgical intervention can be considered to be crucial for survival after mesenterial infarction.

Adult↗
PubMed1984

[Papilla and pancreas cancer. An epidemiologic-clinical case control study of 298 patients].

The study is based on the case records of 816 in-patients (256 adenocarcinoma of the pancreas, 42 carcinoma of Vater's papilla and 518 controls) admitted to the Surgical Clinic of Münster University between 1974 and 1982. With respect to preliminary diseases only pancreatitis and cholecystectomy showed a significant difference between cancer group and control group. 36% of the patients with ampullary and 6.7% with pancreas cancer survived the five-year limit. Prognosis was best among patients over 60.

Adenocarcinoma↗
PubMed1984

Morphological changes in the operated stomach under the influence of duodenogastric reflux. Clinical follow-up over 20 years.

The chronic changes in the gastric mucosa arising years or even decades after surgery and interpreted as a precancerous state are causally related to the unphysiological irritation due to duodenogastric reflux. It was the objective of our study to determine whether there is an increase in alterations in the gastric mucosa of the operated stomach, as a function of postoperative interval and the particular surgical procedure performed, with consideration for the varying degrees of resultant duodenogastric reflux. Specifically, there were 320 patients and three different operative procedures studied with postoperative follow-up averaging a period of up to 20 years. The synopsis of the results shows not only a progression of the premalignancy apparent in the morphology of the mucosa, but also provides an indication of the varying intensity of duodenogastric reflux associated with each of the operative methods.

Biopsy↗
PubMed1982

[Syndromes following resection and gastrectomy].

Surgical therapy of carcinoma of the stomach has to take into consideration the individual type and localization of the tumor. Total gastrectomy as a therapeutical principle must be rejected. The syndromes after partial resection are less inconvenient than after total gastrectomy. A resection in combination with a reflux-free Roux-en-Y anastomosis should be preferred. After partial resection prophylactic therapeutic measures are not indicated. Continuous postoperative supervision is necessary however. Reoperations after a preceding partial resection are successful in many cases. The fate of the patient and the five-year survival rate depend directly on the stage of the tumor at the time of operation. Palliative operations improve expectation and comfort of life of the patient with an incurable carcinoma.

Esophagitis↗
PubMed1981

[Benign and semimalignant soft tissue tumours (author's transl)].

1033 cases of benign and semimalignant tumours of the soft somatic tissue are examined. Tumours of the fatty tissue and those of blood vessels do not cause any difficulties in diagnostics and therapy. Concerning semimalignant tumours there is a high risk of recidivation but no metastasising. Likewise there is a high risk of recidivation in tumours of the fibrillar and embryomorphous tissue. Patients suffering from these tumours are included in the aftercare programme corresponding to the postoperative treatment of patients with malignant tumours.

Adolescent↗