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J Gauwerky

Publications and source records attributed to J Gauwerky.

10 recordsLinked to original sources
PubMed1996

[The value of laparoscopic and laser-assisted techniques in reconstruction of distal fallopian tube pathology].

In an overall study population (3 different study designs) of n = 285 patients the role of laparoscopic resp. laser-assisted techniques was evaluated on the basis of the results of distal tubal reconstruction. An interventional comparison of a laparoscopic (n = 150) with a retrospective microsurgical (n = 135) group of patients with distal tubal pathology showed a significantly higher baby-take-home rate in the laparoscopically treated patients (38% vs. 22.2%, p < 0.05), but detailed critical analysis of indication revealed a certain selection effect in the laparoscopic group. A prospective study on laser (n = 100) and non-laser techniques for salpingostomy showed in no significant differences between the two groups, as results were concerned (delivery 35% in the laser, 44% in the non-laser cohort). In a prospective randomized subgroup laparoscopic fimbrial eversion with the laser was compared to suture eversion (n = 20). In both groups the reocclusion rate was of 20%. On may thus conclude, that the most important surgical approaches for treatment of a tuboperitoneal sterility: micro-surgery and endoscopy, resp. the various surgical techniques: laser and non-laser, should not be regarded as competing procedures, but as components of a multimodal strategy. The indication, however, must be critically viewed in every particular case. Of major importance being strict scientific evaluation criteria to prevent misinterpretations, e.g. based on indication-specific selection.

Adult↗
PubMed1995

[Tissue glue in endoscopic surgery].

Tissue-glue stands out by virtue of its ability to ensure non-traumatic tissue apposition and hemostasis, leading to a reduction in operative time. This explains the use of this technique in a wide range of indications in gynecological endoscopy. These include ovarian reconstruction after the extraction of cysts, tubal anastomoses and even closure of iatrogenic perforations of the uterus. In these indications, the application of tissue-glue can be considered as the method of choice because of its excellent long term results. In contrast, its effect in the sealing of peritoneal or serosal defects with the aim of avoiding adhesions has not yet been clearly demonstrated. Analysis of a sufficient number of cases with long follow-up is essential before any final assessment can be made. Among 75 instances of endoscopic use of tissue-glue up to now, we have never encountered any post-operative complications, nor during subsequent follow-up. In addition to its ability to stimulate tissue healing, tissue-glue offers a simple and non-traumatic alternative to the lengthy technique of endoscopic sutures, with a hemostatic action in parallel.

Dissection↗
PubMed1991

[Fibrin gluing in surgical, laser-assisted laparoscopy].

Fibrin sealing has proved a successful procedure for a variety of indications in operative gynecologic laparoscopy. Ovaries can be reshaped after cystectomy, serosa and peritoneal defects as well as perforations of the uterus can be sealed with fibrin adhesive. At present, application for salpingotomy, fimbrial eversion and tubal anastomosis is being investigated in clinical studies. Yet larger collectives and a longer follow-up are necessary for a final evaluation of the method. No complications were observed in 75 laparoscopic fibrin sealing performed at our department for established indications. Fibrin adhesive can replace time-consuming, complicated endoscopic sutures. It is an atraumatic tissue-sealing and hemostatic technique, easy in handling, thus leading to a considerable reduction in operation times. The excellent hemostyptic and wound healing characteristics of fibrin adhesive are also an advantage.

Female↗
PubMed1985

[Complications and side effects of artificial ascites for adhesion prevention].

The side-effects of "artificial ascites" induced with Dextran 60 (Makrodex 6%) as a mean of preventing adhesions were investigated in 47 patients (treatment group: 32 patients; control group: 15 patients) in whom microsurgery had been performed for infertility with adhesiolysis. On the day of surgery and the following four days 300 to 500 ml of Makrodex was instilled via an intraperitoneal catheter (7.5 ml/kg body weight on day of surgery; 5 ml/kg body weight on days 2 to 5). In addition, the patients received, on the day of surgery, single doses of 450 IU of hyaluronidase (Kinetin), 500,000 KIU of aprotinine (Trasylol) and 1 g of hydrocortisone acetate instilled intraperitoneally. In the group treated with Dextran, there was a significantly higher number of patients who felt unwell and had abdominal complaints and dyspnea. In six cases in the Dextran group a vulval edema was seen, and in 2 cases a thigh edema. A significant weight increase and elevation of central venous pressure occurred for the duration of the "artificial ascites" in this group. There were a few cases of bradycardia with frequencies of under 50 beats per minute. On the fifth p.o. day 75% of the patients in the Dextran group had a pleural effusion. Such changes were not observed in the control group. In view of these side-effects and the fact that it is still not proven that Dextran effectively prevents adhesions we no longer carry out this form of adhesion prophylaxis.

Adult↗
PubMed1983

[Premature fetal membrane rupture: report of a case of severe intrauterine fungal infection].

A case of extremely rare intra-uterine candida infection is reported following premature rupture of the membranes. The diagnostic possibilities by transabdominal amniocentesis and determination of the causative organism in the amniotic fluid are presented. Even systemic antimykotic treatment is not capable of treating intra-uterine candidiasis sufficiently. This is proved among other parameters by the concentration of miconazol in the amniotic fluid and in the plasma of the newborn.

Adult↗
PubMed1982

[Diagnosis of intra-uterine growth retardation by intensive ultra-sound biometry].

In a prospective study on 125 maternity patients with suspected intra-uterine growth retardation, simple ultrasound biometry (measuring of the distance) and intensive ultra-sound biometry (measurement of the circumference and the surface) were compared. Of 85 newborn born within two weeks following the biometry 34 newborn had intra-uterine growth retardation with a weight percentile smaller than 5, and 32 newborn were growth retarded with a percentile of 5-10. In 19 cases no growth retardation was found. (12 newborn in this group had a weight percentile 10-25). The measurement of the biparietal diameter was capable of diagnosing at the most 50% of the growth retardations (percentile under 5). The accuracy of the diagnosis of intra-uterine growth retardation increased to 85% with the thoraco-abdominal transverse diameter. The so-called borderline cases (percentile 5-10) were diagnosed with the bi-parietal diameter in 38 percent of the cases and by the transverse thoracic diameter in 41% of the cases. Measurement of the circumference of the head resulted in no better measurements than the bi-parietal diameter. The addition of the measurement of the thoracic circumference increased the diagnosis of severe fetal growth retardation (percentile under 5) to 90% and in borderline cases to 88%. The head thorax index and the ratio of head circumference and thoracic circumference increase in our investigation the accuracy of the diagnosis of intra-uterine fetal growth retardation substantially.

Female↗
PubMed1981

[Methodical and critical analysis of the determination of target volumes in case of hypopharyngeal and epiglottic tumors and the adaptation of the dose distribution to their dimensions.--Part 1 (author's transl)].

After having discussed the problem of optimization with regard to the dose distribution in space, the authors enter into the particulars of the classification of hypopharyngeal and epiglottic tumors according to the TNM system. Taking into consideration the communications of literature and the cases of the Radiologic Hospital of the University of Heidelberg, the authors describe the clinical manifestations of these tumors, their histology, their distribution to age and sex, their symptomatology and time of anamnesis as well as the therapeutic results.

Adult↗
PubMed1981

[Methodical and critical analysis of the determination of target volumes in case of hypopharyngeal and epiglottic tumors and the adaption of the dose distribution to their dimensions - Part 2 (author's transl)].

Seventy-five patients with a hypopharynx or epiglottis carcinoma were treated between 1954 and 1974 at the Radiologic Hospital of the University of Heidelberg. The clinical study of these cases provides a survey of the extension and formation of metastases of these tumors. This allows to establish empirically justified target volumes for hypopharyngeal and epiglottic tumors.

Adult↗