Biomedical subjects

I Opitz

Publications and source records attributed to I Opitz.

9 recordsLinked to original sources

PubMed2003

The influence of adhesion prophylactic substances and taurolidine/heparin on local recurrence and intraperitoneal tumor growth after laparoscopic-assisted bowel resection of colon carcinoma in a rat model.

BACKGROUND: The goal of the study was to investigate the influence of adhesion prophylactic substances (Interceed/lntergel) as well as taurolidine/heparin on intraperitoneal tumor growth and the local recurrence rate after laparoscopic cecum resection in a rat tumor model. METHODS: Sixty BDIX rats were randomized in three therapy groups and one control group. A laparoscopic-assisted cecum resection was performed via three-trocar method after intraperitoneal tumor cell application (10,000 cells) of a colon carcinoma cell line (DHD/K1/TRb) in all animals. According to the randomization, the cecum suture and a 1 x 1-cm peritoneal defect were either covered with Intergel/Interceed or 1 ml of 0.5% taurolidine 10 IU heparin. The control group underwent instillation of 1 ml 0.9% NaCl solution. After 4 weeks the animals were euthanized and intraperitoneal tumor growth, local recurrence rate, and the number of intraperitoneal adhesions were determined. RESULTS: The local recurrence rate was not significantly affected by any of the substances. Nevertheless, taurolidine/heparin significantly reduced the total number and weight of intraperitoneal metastases. The formation of adhesions was not significantly influenced by adhesion prophylaxis substances or by taurolidine/heparin. CONCLUSIONS: Taurolidine/heparin led to a significant reduction of intraperitoneal tumor growth after intraperitoneal application, whereas local tumor recurrence was not significantly influenced. This might be due to the number of injected tumor cells in this cell suspension model. Interceed and Intergel did not reduce intraperitoneal tumor growth. Furthermore, adhesion formation was not reduced by any of the substances.

Adenocarcinoma↗

PubMed2002

Esophageal necrosis and perforation of the left main bronchus following photodynamic therapy of esophageal carcinoma.

Photodynamic therapy is an effective palliative treatment of esophageal cancer. Minor complications associated with this therapy include pleural effusions, fever or esophageal strictures. In addition to this major complications such as respiratory-esophageal fistula and bronchus perforation have been described. We report here our experience with a patient who developed a complete esophageal necrosis and perforation of the left main bronchus following photodynamic therapy. The surgical and intensive care management of the patient is described and the literature discussed.

Bronchial Diseases↗

PubMed2002

[Aortic reconstruction and resection of malignant tumors--one- or two-stage procedure?].

Surgical tactics in case of aortic aneurysms and simultaneously performed cancer resections are not uniform and still remain a matter of debate. From Jan. 1, 1995 - Oct. 31, 2001 we operated on 37 patients suffering from aortic aneurysms (34 infrarenal, 2 combined thoraco- abdominal, 1 thoracic aneurysm) and cancer (11 esophageal, 6 gastric carcinomas, 3 small-bowel tumors, 5 large-bowel, and 12 renal carcino-mas). None of the above mentioned patients presented with any graft infection, or other severe p. op. complications. According to these results, the one-stage operation of aortic aneurysms and cancer resection is feasible if appropriate care is given to patients selection, technical details and the rules of antisepsis, without affecting surgical morbidity and mortality.

Aged↗

PubMed2002

Immunologic changes during minimally invasive surgery.

Although recent experimental and clinical trials have documented that postoperative inflammation and changes in different immunologic parameters are less pronounced after laparoscopic approaches in comparison to open surgery, it still remains unclear what influence the pneumoperitoneum itself has on immunologic defense and function. This is mainly due to the endpoints of the different studies which investigate changes in the so-called immunologic parameters (cell subunits, C-reactive protein, cytokines, catecholamines or other stress hormones in plasma samples) rather than analyzing immunologic functions, such as cell activation, production of proteins, cell proliferation or in vivo immune defenses. So far, especially in clinical trials, no correlation has been demonstrated between the changes in immunologic parameters and relevant postoperative clinical endpoints, such as postoperative complications. Thus further clinical prospective randomized studies with relevant clinical endpoints and additional investigations of immunologic parameters are needed to prove the consequences of either minimally invasive surgery or open procedures on postoperative immune functions.

C-Reactive Protein↗

PubMed2001

Laparoscopic esophagogastrostomy: an alternative minimally invasive treatment for achalasia stage III.

BACKGROUND: The surgical treatment for stage III achalasia with markedly dilated and sigmoid-shaped esophagus is a matter of controversy. Some authors recommend esophagectomy as the primary treatment because they believe that Heller myotomy cannot improve dysphagia in such cases. We present a patient with achalasia stage III in whom we successfully performed a laparoscopic esophagogastrostomy with posterior semifundoplication. METHODS: Using a five-trocar technique, the esophagogastric junction and the distal esophagus up to the tracheal bifurcation were dissected. An endoscopic stapler (Endo-GIA II) was inserted through a small gastrotomy at the cardia, with one branch placed in the gastric fundus and the other, under esophagoscopic control, in the esophagus. By two consecutive stapler applications, a wide side-to-side esophagogastrostomy was created. To prevent gastroesophageal reflux, a posterior semifundoplication was performed. RESULTS: The operation time was 170 min. Oral food intake was started after radiologic control on postoperative day 7. Radiologic study showed rapid passage of the barium meal and no reflux through the gastroesophageal junction. CONCLUSIONS: Laparoscopic esophagogastrostomy with posterior semifundoplication represents an alternative to esophagectomy and laparoscopic Heller-Dor surgery. Because of the wide side-to-side anastomoses, there is no risk of persisting stenosis such as that reported for the Heller operation, and the procedure certainly is less invasive than esophagectomy. As compared with laparoscopic extramucosal myotomy using anterior Dor fundoplication, it presents about the same technical difficulties.

Aged↗

PubMed2001

[Symptomatic aneurysm of the right gastroepiploic artery. Case report and review of the literature].

Aneurysms of the splanchnic arteries have rarely been reported. Aneurysms of the splenic artery are the most common aneurysms of the splanchnic vessels, followed by the hepatic and the mesenteric artery. Aneurysms of the gastroepiploic vessels show an incidence of only 0.4%. Due to a rupture rate of nearly 90% they are of great clinical importance. Therefore treatment is indicated for every diagnosed aneurysm of the gastroepiploic artery. While for ruptured aneurysms a conventional operation is inevitable, for asymptomatic aneurysms laparoscopic or interventional therapy is an alternative.

Abdomen, Acute↗

PubMed2001

[Intra-gastric penetration of an adjustable gastric band].

Between November 1995 and August 2000 we performed adjustable silicone gastric banding laparoscopically in 252 patients. The body mass index varied from 37 to 86 kg/m2. We report on a 38-year-old woman who was operated on in 1997 with a body mass index of 47 kg/m2 (167 cm, 132 kg). The postoperative follow-up was uneventful until January 2000. The patient lost weight until she weighed 78 kg. Then she complained of diffuse epigastric pain. Gastroscopy revealed gastritis. Omeprazol was prescribed. No amelioration occurred. Endoscopic control showed partial intragastric migration of the band. After laparoscopic removal of the band, the patient was free of symptoms. Band erosion is a possible complication of adjustable gastric banding. As is known from intragastric penetration of the Angelchik prosthesis, the clinical symptoms of this complication may be mild. Since the follow-up of most patients with gastric banding is less than 5 years, more complications similar to that one described may be diagnosed in the future.

Adult↗

PubMed2001

Inguinal hernia repair in the new millennium: plug and patch repair with local anesthesia.

Plug and patch repair is a safe, economic method for repairing inguinal hernias, with patient comfort comparable to that with laparoscopic hernia repair. The technique is simple to perform under local anesthesia and easily learned without a learning curve. Complications are rare, and recovery and return to work are rapid. After performing plug and patch repair on 400 patients with a follow-up examination rate of 93% and a median postoperative observation time of 42 months, we have recorded a recurrence rate of only 0.25%.

Adult↗

PubMed2001

[Aneurysm of the femoral vein as differential diagnosis of femoral hernia].

Venous aneurysms are rare, especially those of the femoral vein. Groin hernias and femoral hernias are in contrast to this more frequent enteties. The literature includes only six cases of aneurysms of the femoral vein. We report on a 61-year-old patient who underwent an operation for femoral hernia. An aneurysm of the femoral vein was found intraoperatively and directly resected. The differential diagnosis of femoral hernias and the following diagnostic and therapeutic strategies are described.

Aneurysm↗