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Biomedical subjects

J M Rothenbühler

Publications and source records attributed to J M Rothenbühler.

43 records · Page 3Linked to original sources
PubMed1989

[Colostomy patients--well cared for, if counseled. Experiences of a colostomy counselling center].

The postoperative care of stoma patients concerns the surgeon, the nurse, the relatives as well as the family doctor. In past years, specialized stomatherapy services became more important, and they represent a real necessity for the patients, according to our own experience. We plead for a broad stoma patient care including stomatherapy services in all cases, either during hospitalization or as an out-patient service after having left hospital.

Adult↗
PubMed1989

[Surgical intraoperative complications in simple cholecystectomy].

In a retrospective analysis of all simple cholecystectomies performed between 1970 and 1987, we were particularly interested in the incidence of intraoperative surgical complications and their long-term follow-up. We analyzed 2441 consecutive simple cholecystectomies and found 60 major intraoperative complications with 55 patients (2.25%): there were 31 vascular lesions (1.27%) and 26 lesions of the biliary tract (1.06%). Amongst the patients with biliary tract lesion but one had to be reoperated one year later due to a stricture which occurred as a consequence of an end-to-end-hepatico-choledochostomy over a T-tube. Intraoperative technical complications may happen. Their early recognition and treatment are of utmost importance.

Cholecystectomy↗
PubMed1989

[Postcholecystectomy syndrome after simple cholecystectomy].

In a long-term follow-up, we were particularly interested in the incidence and cause of postoperative abdominal pain following simple cholecystectomy and in the incidence and etiology of reoperations of the biliary tract. For tat we analyzed 1539 patients who were operated by simple cholecystectomy between 1970 and 1979. Thereafter 875 (68.8%) were checked by us. We found 37.4% symptomatic patients, but in most cases no organic cause was detected. The major organic causes were scar problems and extrabiliary disorders; bilio-pancreatic disturbances were rare, but they needed a reintervention in most cases.

Abdomen↗
PubMed1983

[When should cholecystectomy in acute cholecystitis be planned?].

Acute cholecystitis may be treated either by removal of the inflamed gallbladder during the acute stage of the disease or by conservative measures followed later by cholecystectomy. Many authors recommend delayed operation in view of the possibly higher postoperative mortality with early operation. 394 early cholecystectomies for acute cholecystitis have been performed between 1970 and 1979 at the University Hospital of Basle. 14 patients died postoperatively, representing a mortality rate of 3.5%. Large series in the literature show similar mortality of 3.2-4.5%. In four prospective randomized studies no significant difference of the mortality rate has been demonstrated. One retrospective study of the two methods showed a reduction in mortality rate from 7.4% for late operation to 2.7% for early cholecystectomy. Based on our own studies and on the literature, we have come to the conclusion that early cholecystectomy must be recommended for acute cholecystitis. Its advantages are shorter hospital stay, less patient discomfort since there is only one hospitalization, and reduction of costs. These advantages are also coupled with a similar or even lower mortality rate.

Acute Disease↗
PubMed1983

[Primary peritonitis].

Primary peritonitis accounts for 1 to 2 per cent of all paediatric abdominal emergencies and for about 15 per cent of diffuse peritoneal sepsis. The condition is still mainly seen in infants and in mid-childhood years, Most frequently in children four to eight years of age, with females outnumbering the males except among neonates where the males predominate. The mortality rate is about 50 per cent for infants, but drops to 10 to 15 per cent in older children. The origin of the infecting organism may be a haematogenous spread or ascension through the female genital tract, but transdiaphragmatic lymphatics and transmural migration through the gut wall may also be possible sources. The incidence of primary peritonitis is increased in children with nephrotic syndrome, postnecrotic cirrhosis with ascites and immunologic deficiency. Practically all kinds of pathogenic organisms are found, but a relative increase in staphylococcal and gram-negative infections has been noted.

Child↗
PubMedDate not supplied

The single-layer continuous suture for gastric anastomosis.

The single-layer continuous suture technique has proven to be safe for all intestinal anastomoses of intraperitoneal small and large bowel segments. Since 1985, this technique has also been increasingly applied for gastroduodenostomy and gastrojejunostomy following partial gastrectomy. Through December 1989, we performed 96 gastroenteric anastomoses with the single-layer continuous suture technique. This accounts for 64% of all partial gastrectomies performed between 1985 and 1989. The technique was applied in 89.5% of the gastroenteric anastomoses during 1988 and 1989. The rate of complications after gastroenteric single-layer continuous suture technique was low; 2.1% clinical leakage was found, always in patients with perforated ulcer and peritonitis. We conclude that the single-layer continuous suture technique for gastroenteric anastomosis is safe, simple, easy to perform, quick and reliable.

Anastomosis, Surgical↗