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Biomedical subjects

K Rückert

Publications and source records attributed to K Rückert.

At least 19 recordsLinked to original sources
PubMed1992

[Shouldice hernia report with a PTFE suture].

Between 4/90 and 2/91 we repaired 105 inguinal hernias according to Shouldice's technique. Instead of an absorbable suture (PDS no.0) we used a PTFE suture no.0. By this study we tried to assure that it is allowed to use as well the non resorbable PTFE suture no.0. in hernia repair as the slowly resorbable PDS suture no.0. We compared the rate of postoperative hematomas, seromas and pus collections and the rate of early recurrences in both groups. The results of the PTFE group were compared with those of a prospective study (n = 100) between 6.88 and 4.89 when we used PDS suture no 0. In the PTFE group we saw 9.5% hematomas, 1.9% seromas and 0.9% pus collections. In the PDS group 4% of the patients developed a hematoma, 4% a seroma and 2% a pus collection. We saw 1.9% early recurrences after 8 months (PTFE: 7-11; median: 9 months) and 3.2% after 9 months (PDS: 8-13; median: 10 months) medium follow-up time. The results did not significantly differ between both groups. (Chi-square test: p = 1.0). By these results we can draw the following conclusions: 1. The use of a non absorbable PTFE suture no 0 in hernia repair is of no disadvantage. 2. The principle of hernia repair is the induction of scar tissue in the site of hernioplasty; the use of slowly resorbable suture material is allowed as well.

Abscess↗
PubMed1992

[Standardized ultrasound study with computer-assisted documentation of findings in diagnosis of polytrauma patients].

Based on the results of a prospective trial to establish the value of routine ultrasound examination in cases of polytrauma or blunt abdominal trauma, we report on our standard ultrasound examination and computer assisted documentation of the findings. Between May 1988 and December 1990 we examined 233 patients with polytrauma or blunt abdominal trauma. The results were compared with those of abdominal lavage (n = 47) performed during the same period. We found a sensitivity of 100% and a specificity of 99.5% for the ultrasound findings and a sensitivity of 80% and a specificity of 100% for the abdominal lavage. We conclude that ultrasonography should be the first diagnostic procedure used in the emergency room in cases of polytrauma and blunt abdominal trauma.

Abdominal Injuries↗
PubMed1991

[Variable head endoprosthesis in the treatment of femoral neck and trochanteric fractures].

UNLABELLED: During 1978 to 1987 361 patients (312 female, 49 male) were treated with Variokopf-prosthesis (a bipolar hip prosthesis with a variable head) after femoral neck fracture, per- or subtrochanteric fracture. The mean age was 83 years. During postoperative treatment 73 patients (20.2%) died. 288 could be discharged. 98 of these died before the follow-up examination. The follow-up was possible in 103 cases. A good to satisfactory result was found in 91 cases (88%). A poor result in twelve cases (12%) (Score by Merle d'Aubigne et al.). CONCLUSIONS: 1. The Variokopf-prosthesis is a favourable alternative to a normal hip prosthesis (e.g. Moore), 2. The implantation of a Variokopf-prosthesis was found to be indicated as well in the treatment of medial femoral neck fractures as in special cases in the treatment of per- or subtrochanteric fractures. 3. The operation should be performed soon after the trauma--after a two to three days treatment. 4. The dorsal approach is superior to the lateral in the treatment of hip fractures because of short operating time and the possible early mobilisation of the patients.

Aged↗
PubMed1991

[2 rare pancreatic tumors as incidental findings. A case report].

We report two cases of rare tumours of the pancreas: one case of a cystadenoma and one case of a PP-oma with no hormonal activity. Both cases were discovered accidentally while screening examination of other reasons. Guided by these cases we draw the following conclusions: 1. Ultrasound is the outstanding screening in diagnosis of rare pancreas tumours. 2. Surgery is the treatment of choice. 3. Final diagnosis can only be made by histology. 4. Immunohistochemistry is the best method in differentiation of endocrine tumours.

Aged↗
PubMed1989

[The results and complications of 616 percutaneous transhepatic biliary drainages].

During nine years, percutaneous transhepatic biliary drainage was carried out 616 times on 563 patients in the Department of Radiology, University of Mainz Medical School. 50.3% were pre-operative and 39% were palliative. More than 80% were necessitated by malignant lesions. Subsequent improvements in biochemical measurements were observed in 82.4% of patients. Complications of the procedure led to the death of five patients (0.8%) and required surgery in nine patients (1.5%). The following complications were observed: biliary peritonitis in 0.6%, sepsis in 1.9%, bleeding in 1.9% and fever higher than 38 degrees C in 16.2%.

Biliary Tract↗
PubMed1989

Sonography versus peritoneal lavage in blunt abdominal trauma.

The reliability of sonography and peritoneal lavage in assessing the need for immediate surgical intervention in blunt abdominal trauma was examined in a prospective study (n = 71). Statistical analysis revealed a sensitivity of 100% for peritoneal lavage compared to 84% for sonography; the accuracy was 99% versus 86%, the predictive value 97% vs. 89%. The statistical difference was significant (p less than 0.05). The results demonstrate that sonography cannot replace peritoneal lavage in the diagnosis of blunt abdominal trauma. The discussion of the advantages and disadvantages of both methods shows that sonography and peritoneal lavage are not competing, but rather, are complementary examinations.

Abdominal Injuries↗
PubMed1988

[Intraoperative sonography of the bile ducts].

The experience with intraoperative ultrasonography (IOUS) during biliary surgery demonstrates positive and negative aspects. An evaluation of the method is possible by two prospective studies from the literature. The IOUS of the bile ducts is not a substitute for intraoperative cholangiography. Imaging of the papilla is possible in 30% only and examination of the drainage into the duodenum is impossible. The predictive value of a positive IOUS test is higher in comparison with cholangiography.

Bile Duct Neoplasms↗
PubMed1987

[Surgery in chronic pancreatitis. II. Late results following non-resection operations].

Between 1966 and 1985, 994 patients with chronic pancreatitis were treated at a University Surgical Department, 346 by drainage or diversion procedure, 339 by resection and 309 conservatively. The most frequent non-resecting procedures were: pancreatic pseudocyst drainage in 146, biliary-digestive tract anastomosis in 80, gastro-enterostomy in 15, biliary-tract revision in 58 and pancreatic duct drainage in 7 patients. More than half the patients had previously been operated on at least once. Overall postoperative death rate was 6.6%. Of those operated on up to 1983, whose subsequent course was analysed retrospectively, 16% had died (mean observation period 4.6 years). As many as 29% of patients had further bouts of pancreatitis. Weight remained steady or increased in 82%, the number of those with diabetes increased by 6%. All but 12% remained free of pain postoperatively or had only minor and occasional symptoms. Alcohol abuse decreased markedly. If alcohol consumption remained moderate (less than 50 g daily), late mortality rate was definitely decreased. Drainage or diversion procedures and pancreas resection are not competitive but complementary methods in chronic pancreatitis. Imaging techniques have helped the trend towards more conservative management.

Adolescent↗
PubMed1987

[Surgery of chronic pancreatitis. I. Late results after resection management].

From 1966 to 1985, 994 patients were treated for chronic pancreatitis. In 339 (34%), a resection of the pancreas was carried out. There were 166 left resections as compared to 175 right resections (Whipple, total duodenopancreatectomy). Almost half of the patients had already been operated on beforehand. The surgical lethality after partial duodenopancreatectomy could be lowered from 15% to 1.6%. After left resection, it continued without change to be 4% to 7%. Total duodenopancreatectomy and subtotal left resection were no longer carried out. 31% of the 246 patients followed up in a retrospective study died in the later course (mean period of follow-up observation: 6.5 years). Less than 10% of the patients died of complications due to pancreatitis. Three quarters of the patients maintained constant weight or gained weight. In half of the patients, there was a manifest diabetes mellitus postoperatively. 76% were free of pain postoperatively or had only slight symptoms. The late results are essentially determined by the readiness of the patients to adopt a disciplined style of life with reduction of alcohol consumption. This must be considered in the establishment of the indication for pancreatectomy in chronic pancreatitis.

Adolescent↗
PubMed1987

Ductal adenocarcinoma of the head of the pancreas: incidence of tumor involvement beyond the Whipple resection line. Histological and immunocytochemical analysis of 37 total pancreatectomy specimens.

Intrapancreatic tumor spread of ductal adenocarcinoma of head of pancreas was examined histologically in 37 total pancreatectomy specimens. Five to 10 tissue blocks were prepared from grossly tumor-free tissue of each pancreas and coded by anatomic location. Step sections from each block were analyzed for carcinoma in situ lesions, invasive carcinoma, and benign ductal lesions. Immunocytochemical staining with monoclonal antibodies (MAb) against carcinoembryonic antigen (CEA) and nonspecific cross-reacting antigen 95 (NCA 95) were used to help in discriminating carcinoma in situ from papillary duct hyperplasia. In 3 of 37 pancreatectomy specimens (8%) tumor was found to spread in continuity from the primary carcinoma into the body and tail. In two of these three cases with tumor beyond the usual Whipple resection line, the tumor was present as a "carcinoma in situ" lesion along the main pancreatic duct. Since discontinuous tumor growth was not observed, multicentricity of duct type adenocarcinoma seems to occur less frequently than was previously reported.

Adult↗