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J Bannenberg

Publications and source records attributed to J Bannenberg.

3 recordsLinked to original sources

[Quality of a non-subsidised multicentre randomised trial in non-academic hospitals; an audit].

OBJECTIVE: To determine whether a randomised clinical trial in general hospitals can be performed in a reliable way without financial support. DESIGN: Descriptive. METHOD: The trial involved 1040 patients in whom an inguinal hernia had been corrected with a propylene mat in the period 1998-2003. They were randomised to either a single dose of prophylactic antibiotics or a placebo. The primary outcome measure was 'wound infection during the 3 months after the operation'. The audit concerned 98 patients, chosen at random, for whom 3 investigators from an independent bureau collected data from the patient charts and study forms during 3 clinic visits in the period 2000-2003. Whether various quality criteria had been fulfilled was assessed on the basis of these data. RESULTS: In all 4 participating clinics, approval of the medical ethics assessment committees had been obtained. The trial protocol corresponded to the consent form. A proper informed consent was obtained from 63/98 patients (64%). The last (third) follow-up was missed in 23/98 patients (23%). During the trial, the patients who had missed this follow-up were contacted by telephone, which succeeded in 98%. The status and trial forms had been filled out completely and correctly with regard to the peroperative randomisation forms in 90% of the cases and with regard to the follow-up in 75% of the cases. The trial protocol was adhered to on almost every point. CONCLUSION: The data collection in the studied, not financed trial was adequate, probably as a result of the relatively simple questions posed, the easily determinable outcome measure and the efforts expended above and beyond the protocol.

Antibiotic Prophylaxis↗

Controlled balloon dilatation for laparoscopic extraperitoneal bladder neck suspension in patients with previous abdominal surgery.

PURPOSE: The balloon dilator is used in a variety of minimally invasive preperitoneal and retroperitoneal operations. In this study, we compared the ability to create an extraperitoneal cavity using a balloon spacer in patients with and without previous abdominal surgery undergoing laparoscopic bladder neck suspension. PATIENTS AND METHODS: This prospective study included 38 patients in total, 15 of whom had had previous abdominal wall surgery and 23 who had not. A balloon spacer technique was used to develop the extraperitoneal space. RESULTS: In 80% of the patients with previous surgery, the introduction of the balloon spacer was recorded as simple; in 20%, it was considered difficult. In 78% of the patients without previous surgery, the introduction of the balloon spacer was recorded as simple, in 17% it was difficult, and in 4% it failed. In 80% of the patients with previous surgery, the extraperitoneal view was good or acceptable, in 20% it was poor, and in 13% it failed. In 92% of the patients without previous surgery, the extraperitoneal view was good or acceptable, in 4% it was poor, and in 4% dilatation failed. Morbidity was equally divided between the groups. CONCLUSIONS: Previous abdominal surgery is not a contraindication to laparoscopic extraperitoneal surgery using a balloon spacer. The approach carries low morbidity, similar to that in patients without previous abdominal surgery.

Abdomen↗

[Laparoscopic splenectomy revisited].

We present a new technique for laparoscopic splenectomy which allows manual control of endoscopic dissection. After induction of pneumoperitoneum and insertion of an endoscope to check the absence of any contraindications, an incision is made for insertion of the hand and forearm. An airtight system allowing insertion of the hand while maintaining the pneumoperitoneum is fixed around the incision. A second port is inserted in the left flank. The procedure is then performed with laparoscopic instruments while the left hand allows for spleen mobilisation and easier exposure of the structures to be dissected and divided. Eight patients with a mean age of 51.3 years have been operated on for Idiopathic Thrombocytopenia. The average duration of the procedure was 90 min (80-130 min). No postoperative complication occurred. The mean duration of stay was 3.8 days (3-7 days). These results of this technique are encouraging. The procedure is quicker and safer than an exclusive laparoscopic approach. The incision allows removal of the intact spleen. Other applications of this system can be envisaged.

Adult↗