[Treatment of pancoast tumors].
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Biomedical subjects
Publications and source records attributed to H Säuberli.
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Proctocolectomy with conventional ileostomy cures patients with severe ulcerative colitis but ileostomy appliances must be worn for the rest of their lives. The continent ileostomy, as devised by Kock, provides the patient with an intraabdominal ileal reservoir and a valve constructed by invaginating the efferent ileal segment into the reservoir. The patient empties his reservoir 2-3 times a day by inserting a catheter through the valve. Our experience with 14 patients is reported. The continent ileostomy was in most cases constructed as a second procedure after proctocolectomy. Minor postoperative complications, such as abscess, fistula or partial luxation of the valve were easily corrected. One patient who underwent proctocolectomy and simultaneous construction of a continent ileostomy died in acute liver failure due to a severe preexisting cirrhosis. All the other patients are continent for feces and gas and do not need external appliances. The construction of a continent ileostomy as a secondary procedure can be recommended in patients with proctocolectomy. It offers patients a life situation with differs only insignificantly from that of normal persons.
In a prospective, randomized study, proximal selective vagotomy with or without pyloroplasty was used as the exclusive procedure for elective treatment of duodenal ulcer without pyloric stenosis in man. Three months postoperatively 32 out of the first 35 patients exhibited incomplete vagotomy assessed by the 2-deoxy-D-glucose test. This incomplete vagal denervation of the parietal cell mass is due mainly to the principle of proximal selective vagotomy. In order to maintain the motility of the gastric antrum the denervation should be halted at a distance of 7 cm from the pylorus.
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A Thiry-vella loop was performed in 37 dogs and 147 intussescepted intestinal valves were constructed and tested on their stability. Stabilisation of the valve through a nylonnet pulled through the mesenterium without destroying the vessels and fixed between the serosal layers of the valve with seromuscular silk sutures has been proved to be the best method.
A method for constructing a continent ileal bladder has been tested in dogs. The requirements for a continent ileal bladder: continence, reservoir function, prevention of reflux, could be fulfilled in our experimental study.
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