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K Wehrmann

Publications and source records attributed to K Wehrmann.

5 recordsLinked to original sources
PubMed2002

Evaluation of a new three-dimensional magnetic imaging system for use during colonoscopy.

BACKGROUND AND STUDY AIMS: A prototype magnetic imaging system (Scope Guide, Olympus Optical Co., Ltd.) provides a new facility for continuous viewing on a monitor of the position of the colonoscope during examination, without exposing patients or medical staff to radiation. The aim of this prospective study was to compare this magnetic imaging system with routine colonoscopy, including fluoroscopy. The study parameters were the detection of loops, the location of the endoscope tip at defined positions, the insertion time, and the premedication rate. MATERIALS AND METHODS: In the first part of the study, 133 consecutive patients were examined - 64 using an integrated three-dimensional colonoscope and 69 with the three-dimensional probe inserted into the biopsy channel of a routine video colonoscope. Fluoroscopy was used in all investigations for comparison at defined anatomical points and loops, and pathological findings and defined anatomic structures were documented using a laser printer both for three-dimensional colonoscopy and fluoroscopy. In the second part of the study, 25 further patients underwent colonoscopy with a modified prototype, now exclusively using the integrated three-dimensional colonoscope. RESULTS: The total time for insertion and the premedication rate did not differ from those of routine colonoscopies with fluoroscopy available. Precise detection of loops was observed in the first study in 79 - 100 % of cases in comparison with fluoroscopy. Precise localization of the endoscopic tip improved from 30 % in the first part of the study to 80 % in part 2. CONCLUSION: Using magnetic three-dimensional imaging systems, the position of the colonoscope, the detection and observation of loops during straightening, and localization of pathological findings can be accurately achieved. Modification of the prototype led to satisfactory improvement in all parameters tested.

Colonoscopy↗
PubMed2000

[Removing adenomas reduces colon carcinoma risk up to 90%. Effective cancer prevention with the endoscope].

Endoscopic polypectomy is considered the method of choice for the diagnosis and treatment of colorectal polyps. 70-80% of all colorectal polyps are adenomas, which are precursors of colorectal carcinoma. The endoscopic detection and rigorous removal of colorectal polyps is an effective means of preventing colorectal carcinoma, since the incidence of the latter can be reduced by 90%. If technically possible, a snare should be used to remove all polyps larger than 5 mm in diameter. Tiny polyps may be removed with forceps. The removed polyp must be send for histological work-up and the results obtained used to plan the further steps or post-polypectomy surveillance. In defined cases (removal with adequate clearance, well-differentiated carcinoma, low risk situation), endoscopic polypectomy of adenomas with invasive carcinoma (pT1 carcinoma) is now the only treatment needed. Further surgical resection is not necessary. Surveillance is as for surgically removed colorectal carcinoma.

Adenomatous Polyps↗
PubMed1988

[Ultrasound controlled fine needle cytology and fine needle histology in circumscribed pancreatic processes].

Using a biopsy transducer 171 fine-needle punctures of focal pancreatic processes were done in 158 patients. The final diagnosis was made in the first group by surgical operation or autopsy, in the second by the further clinical course. The sensitivity of the cytological examination alone was 78% in the first group and 90% in the second. The histological examination alone had a sensitivity of 79% to 100%. Combining both ways of examination according to defined criteria the sensitivity in the first group was 84% and in the second 100%. The specificity was 100% for both. The complications were 2.9%. Of these 5 cases one pancreatitis had to be operated. There were no lethal complications. To optimize the sensitivity and specificity of the ultrasound guided fine needle puncture technique we want to recommend the following points: A biopsy transducer or puncture-aid must be available. The fine needle technique only should be done under the prerequisite of a high frequency of punctures and a high constancy in the relation between puncturer and pathologist. To receive representative material it can be necessary to make several needle passes during one session. Material for cytological und histological examination should always be taken simultaneously.

Adult↗