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Biomedical subjects

H Hamelmann

Publications and source records attributed to H Hamelmann.

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

[Locoregional recurrence following the operative treatment of rectal cancer. Basic principles of prevention and therapy].

The frequency of local recurrences has been observed in dependence on sex, tumour specific parameters (typing, grading, staging, macroscopical form of growth, level of primary tumour) and technical parameters (method of operation, distal margin of resection). In case of early diagnosis, there is a possibility of differentiating technically caused local recurrences from those caused by the tumour because of their localization. Recurrences caused by the tumour may proceed from incompletely removed primary tumours. Technically caused recurrences may be primarily due to insufficiently resected tumours, which could have been removed completely. Only technically caused recurrences make a curative second operation possible. If the criteria of radicality are strictly observed during the primary operation, there should be no need for the so-called 'surgically curative' local recurrences to be treated anymore.

Adenocarcinoma↗
PubMed1985

[Interpretation of results of clinical studies for practical colon and rectum surgery].

Systemic antibiotic prophylaxis in surgery of the colon and rectum is principally useful. It should be administered only on the day of surgery. Stapling makes it possible to enlarge the indication for deeper rectal resection. In cases of deep rectal anastomoses in men bladder dysfunction has to be expected in a considerable percentage. Anal continence does not depend on the anastomotic technique but on the anastomotic level in relation to its distance from the ano-cutaneous line and in consequence on the loss of reservoir capacity.

Cefotaxime↗
PubMed1985

[Significance of the suture technic and anastomosis sites for continence following deep rectum resection].

In a controlled clinical trial of 60 patients who underwent low anterior resection we found no influence of anal continence due to suture technique. Continence depends on the level and healing of anastomosis. Below a level of 6 cm from the anocutaneous line we more frequently found a reduction of functional reservoir in the 'neorectum', especially in cases with suture line leakage at anastomosis. Usually, the weakness of continence due to reduced functional reservoir was a temporary situation which lasted not longer than 6 months, if anastomosis healed without insufficiency.

Fecal Incontinence↗
PubMed1984

[Diagnosis and therapy of ileus].

This disease caused by intestinal obstruction progresses rapidly. Therefore diagnosis and therapeutic procedures have to be performed quickly. Whereas the diagnosis of the ileus itself can be made by simple methods which do not discomfort the patient, diagnosis of localization and etiology of bowel obstruction causes considerable strain for the patient. Nevertheless X-ray investigations and endoscopy have proved to be effective. Therefore these methods can be recommended in special cases. Operative procedures of ileus treatment have to be adapted to the patient's condition and cannot be generally recommended.

Diagnosis, Differential↗
PubMed1984

[The past, present and future of German surgery].

It is imperative that all surgeons familiarize themselves with the history and development of his chosen field. Until the 18th century, surgery in Germany and other areas of Europe was not performed by physicians but by barber surgeons. Surgeons originated from these ranks. In the second half of the 18th century, Bernhard von Langenbeck was one on the founders of surgery in Germany. He was one of the most respected teachers of his time and his most famous student was Theodor Billroth who formed the school from which von Miculicz and Sauerbruch graduated. This was the time of remarkable innovations, namely the development of asepsis by Bergmann, the first laryngectomy and the first gastric resection by Billroth and the first cholecystectomy by Langenbuch. Bier introduced lumbar anesthesia, Schleich infiltration anesthesia, Kehr developed surgery of the bile ducts and von Esmarch performed amputations of the extremities, under conditions of exsanguination. In 1872, Langenbeck, Simon, and Volkmann founded the German Association of Surgery. The world-known Operationslehre von Bier-Braun-Kümmell and the surgical manual by M. Kirschner was then published. At the beginning of the 19th century, Sauerbruch paved the way for thoracic surgery with use of the low pressure method. Forssmann succeeded in the catheterization of the right heart. M. Kirschner performed the first successful embolectomy and the first bridging of an defect of the esophagus. During world War II, German surgery lost touch with international developments and reestablishment followed with the schools of K.H. Bauer in Heidelberg and of R. Zenker in Marburg and Munich and others. Zenker's contributions to cardiosurgery are particularly remarkable.(ABSTRACT TRUNCATED AT 250 WORDS)

General Surgery↗
PubMed1984

[Results of multiple surgical therapy in pronounced acne conglobata].

Acne conglobata - hidradenitis suppurativa - as a particular form of acne vulgaris is, in its pronounced, chronic progressive form, incontrollable by conservative means. Smaller foci of infection need only a local excision of skin and subcutis followed by primary wound closure or secondary healing. When large areas are involved, a generous excision including removal of the fistula system is followed by a 1-3 week intermediary phase with hydrotherapy and antiseptic local treatment. Clean granulation is waited upon and covered in a second session with a skin grafting. In the area of joints, a third session with flap-plastic under sterile conditions is necessary, if limitations to motility are present or are threatened by scar contracture. From 1975-1982, 14 patients with pronounced acne conglobata were successfully treated by a surgical procedure in multiple sittings. All patients could, in this manner, be rehabilitated both professionally and socially.

Abscess↗
PubMed1984

[Anorectal continence following manual and mechanical anastomosis suture. Results of a controlled study of rectal surgery].

In a controlled clinical trial-manual vs. stapler anastomosis in rectal surgery-it was found that both suture techniques per se made no difference in the function of anal continence. The anal pressures at rest and sphincter contraction remained unchanged. A linear reduction of functional reservoir of the "neorectum" could be shown, which depended on the level and healing of the anastomosis. An anastomosis level at 6 cm from anocutaneous line is important for functional reasons. Anastomoses above this level do not cause any consequences for anal continence. Anastomoses below this level result in a reduced functional reservoir for at least 6 months. Within this period a decrease in anal continence is possible, especially in cases of disturbed healing of the anastomosis.

Adult↗
PubMed1984

[Operation or conservative therapy? New aspects based on further differentiation of emergency endoscopy findings in hemorrhage of gastrointestinal ulcers].

In a retrospective study the clinical courses of 121 patients with bleeding peptic ulcers were reviewed. The possibility for endoscopic prediction of recurrent bleeding was evaluated. The criteria specific to recurrent hemorrhage, which we found in bleeding ulcers during emergency endoscopy, led us to a modification of the Forrest-classification. All spurting arterial bleedings, which could be stopped by endoscopic means and all lesions with a big visible vessel in the ulcer crater had a high risk of recurrent bleeding. Therefore early surgical treatment should be performed soon after stabilisation of all vital functions and compensation of the blood loss. The emergency endoscopy enables not only an accurate diagnosis, but also a prediction and prognostic judgement of recurrent bleeding. This will give the surgeon valuable informations on deciding an operative or conservative treatment.

Emergencies↗
PubMed1984

[Aggressive fibromatoses].

Benign by nature, aggressive fibromatoses (desmoid fibromas) may represent as difficult therapeutic problems as malignant tumours. When subtotally resected they tend to recur. But spontaneous regression is possible. Expense and limits of their surgical treatment are discussed with reference to seven patients. In five cases primary affliction of bone was evident. There are three reports given in detail: In the first, malignant transformation may be due to radiation therapy and hemipelvectomy could not prevent recurrence. In the second, spontaneous regression of untreated pelvic affection may have occurred. In the third, several resections and amputation of the leg failed to cure congenital infantile fibromatosis.

Adolescent↗
PubMed1983

Overwhelming infection after splenectomy in spite of some spleen remaining and splenosis. A case report.

A fatal case of overwhelming postsplenectomy pneumococcal sepsis is presented occurring in a 37-year-old female 11 years after removal of the spleen because of traumatic rupture. The patient died 11 h after admission to hospital and about 32 h after sudden onset of illness. At necropsy splenic tissue, splenosis, disseminated intravascular coagulation, and thrombi within the arterioles consisting of gram-positive cocci and adrenal hemorrhage were found. The clinical, laboratory, and postmortem findings are described. Reports had been published of 41 other cases of overwhelming postsplenectomy infection (OPSI) in patients aged 20 years or more, but only three of these cases of OPSI syndrome occurred in spite of remaining splenic tissue. The longest interval between extirpation of spleen and subsequent sepsis was 42 years, indicating a small but lifelong risk of severe infection in asplenic patients. In view of the literature, the role of spleen in infection defence, the splenic function in blood clearance, and the prevention of postsplenectomy infections by antibiotic prophylaxis, pneumococcal vaccine, and reimplantation of autochthonous splenic tissue or infrared contact coagulation are discussed.

Adult↗
PubMed1983

Surgically treated bronchial carcinoma patients--results of systematic follow-up.

A systematic follow-up was carried out on 63 patients treated surgically for bronchial carcinoma. Thirty-four patients died within 2 years after the operation. No evident benefit was noted when comparing their preoperative and postoperative physical status. The quality of life was considerably influenced by surgery and adjuvant therapies. While 19 patients died from the tumor disease alone, the death of 14 patients was caused by additional therapeutic complications (surgery, irradiation, cytostatic treatment). Eighteen patients survived more than 2 years without evidence of recurrence. Performance status reached the preoperative level after 9 months. All had good or excellent objective findings, but the disease had altered the lives of 7 patients considerably, psychological problems being the main reason.

Adenocarcinoma↗
PubMed1983

[Occlusion of chronic decubitus ulcers by musculocutaneous gluteus maximus flaps].

Early coverage of long-standing pressure sores in patients with paraplegia, multiple sclerosis and prolonged immobilisation due to fractures of the lower extremities should be performed in order to avoid further bone destruction and septic complications. Musculocutaneous flaps offer several advantages in covering infected soft tissue defects and proved to be superior to cutaneous flaps. Surgical repair of pressure sores requires a prospective selection of available musculocutaneous flaps. Planning should include the possibility of ulcer recurrence or of pressure sores in adjacent regions. Sacral and ischial pressure sores were covered by a musculocutaneous gluteus maximus flap in 11 patients.

Adolescent↗