Biomedical subjects

H Striffeler

Publications and source records attributed to H Striffeler.

23 records · Page 2Linked to original sources

PubMed1993

Thoracoscopic pleurectomy for treatment of complicated spontaneous pneumothorax.

This report describes a thoracoscopic approach for performing parietal pleurectomy. We have developed and used this technique successfully in 12 patients for treatment of recurrent spontaneous pneumothorax with extended bullous lung alterations (stage 4 according to the classification of Vanderschueren). For this purpose we need videoendoscopy and specially designed equipment, including pliable silicone trocars and angled instruments. The mean age of the patients was 38 years; no deaths and no complications occurred. The average period of postoperative hospitalization was 3.3 days. During the follow-up period ranging between 5 and 10 months (mean 7.5), no relapsing pneumothorax was observed.

Adult↗

PubMed1993

[Thoracoscopic lobectomy in the animal model].

To evaluate the possibility of a pure thoracoscopic lobectomy by preparation and selective division of hilar structures we performed left cranial lobectomies in 5 Göttingen mini-pigs. The vessels and the main bronchus were isolated and divided by an Endo-GIA stapler. As an alternative technique we used clips or endoscopic ligation. Inside the thoracic cavity the resected lobes were divided into 2 or 3 parts by the Endo-GIA. They could be extracted without destroying the tissue therefore making macroscopic examination possible. The intraoperative blood loss was minimal and all the pigs survived the operation. Two pigs were sacrificed initially, the remaining three one month later. These three showed no evidence of pleural fistula or atelectasis in remaining lung tissue either macroscopically or histologically. It appears that thoracoscopic selective lobectomy is technically possible at least in pig studies. Further studies will show whether thoracoscopic lobectomy in patient with malignancy is as effective as open radical thoracotomy techniques and if endoscopic mediastinal division is possible.

Animals↗

PubMed1992

[Surgical thoracoscopy--indications and technique. Early results in spontaneous pneumothorax].

The use of minimally invasive techniques in the thoracic cavity allows for the application of operative techniques through endoscopic ways, avoiding the functional burdening of a thoracotomy. Indications of operative thoracoscopy are mentioned. Endoscopic surgical techniques are described. For example, the therapy of spontaneous pneumothorax can be carried out in its entirety by endoscopic leak ligature, wedge resection of the lung and parietal pleurectomy. Three of the 49 patients with spontaneous pneumothorax suffered from an early recurrence after thoracoscopic treatment (6.1%). Long-term results are still outstanding. The final merit of the method cannot yet be set.

Algorithms↗

PubMed1991

"Standard" microsurgical lumbar discectomy vs. "conservative" microsurgical discectomy. A preliminary study.

The "conservative" microsurgical lumbar discectomy described by Williams for the treatment of herniated lumbar disc is compared in a retrospective study with the standard microsurgical technique of Caspar and Loew. In order to enable such a retrospective comparison, a special randomization had to be chosen. The data concerning outcome are based on a questionnaire, in which the patient can describe his actual health situation. The result in the group of 56 patients operated on by the Williams technique with a mean follow-up of 27 months is excellent or good in 89% vs. 74% in the standard technique group. Reoperations due to a recurrence were identical in both groups (3.6% and 3.9%).

Adult↗

PubMedDate not supplied

Thoracoscopic wedge resection.

Thoracoscopic surgery is decidedly expanded by the ability to perform pulmonary wedge resections of the lung by using the Endo-GIA-stapler. In addition to thoracoscopic biopsies, since July 1991 we have carried out wedge resections in 12 patients suffering from spontaneous pneumothorax (nine) or peripheral bronchial carcinoma (three). Postoperatively one air fistula persisted over 9 days. The chest tube was removed within 48 h in all other patients. There was no other major complication. The postoperative hospitalization period lasted 4.6 days (1-9 days). Operating time was 44 min (30-70 min). The benefit for the patient consists in the little-impaired breathing mechanics, the short hospital stay, and the favorable cosmetic result.

Adenocarcinoma↗