Biomedical subjects

J Fischbein

Publications and source records attributed to J Fischbein.

2 recordsLinked to original sources

PubMed2002

[Stapler hemorrhoidectomy versus conventional procedures - a clinical study].

Stapled Hemorrhoidectomy is when correctly indicated an easy feasible operative procedure for prolapsing internal hemorrhoids with or without a mucosal prolapse offering benefits to the patient. From July 1998 to October 2000 we treated 152 patients with a mean age of 52 (24-91) years for hemorrhoids within this study. We compared 72 patients, treated with stapled hemorrhoidectomy according to Koblandin-Longo with 80 patients who underwent a "conventional" reconstructive operation (Parks or Fansler-Arnold). All resected material was histopathologically examined. With stapler hemorrhoidectomy we found on average shorter operation times (22 vs. 53 min, p < 0.01), shorter hospitalisation (3 vs. 6.1 d, p < 0.01), significantly less postoperative pain (VAS 0-10: 1.83 vs. 3.70, p < 0.01) and fewer cumulative requests for analgesia by the patients (0.92 vs. 3.11 single doses, p < 0.01). The complication rate was 4 % in the stapler group and 11 % in the conventional group. Stapled hemorrhoidectomy was carried out only in patients with 3 degrees hemorrhoids with or without mucosal prolapse. The conventional group consisted of patients with 3 degrees prolapsing or 4 degrees fixated external hemorrhoids. Although very promising results are actually described with stapler hemorrhoidectomy, the established conventional reconstructive operations should be continued until long-term results are published.

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PubMed1999

[Endoscopic harvesting of the vena saphena magna for peripheral vascular reconstruction].

OBJECTIVE: By using an endoscopic, video-assisted instrumentarium we harvested the great saphenous vein for peripheral bypass surgery through minimal skin incisions with the purpose to reduce the wound complications. METHOD: Endoscopic subcutaneous saphenous vein harvesting was performed in 15 patients who underwent peripheral bypass surgery for intermittent claudication. In 6 patients the vein was taken from the affected leg and in 9 patients the vein was harvested from the opposite leg. RESULTS: In every case where the vein was taken from the affected leg we observed severe hematomas, which was in one case complicated by an abscess. Once we converted to the open procedure and in one patient endoscopic preparation led to a small vein injury. When the vein was harvested from the opposite leg no complications occurred. CONCLUSION: The endoscopic subcutaneous saphenous vein harvesting in peripheral bypass surgery with a special video-assisted instrumentarium is feasible. The cosmetic advantages of this procedure are associated with high costs and a long operating time. Although we were not able to demonstrate a reduction of wound complications in our patients, the endoscopic vein harvesting in peripheral bypass surgery should be considered a very promising procedure. Nevertheless we cannot recommend the method for a wide clinical use at this time.

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