The early postoperative results of 1273 operations for inguinal hernia are reported. In addition, the late outcome of 688 operations of patients answering the questionnaires was analysed according to the surgeons stage of training. In group 1, the operator was in the first two years of his training, in group 2, he was older but had not yet achieved his title as a specialist for surgery and in group 3, all are fully trained surgeons. The postoperative complications are distributed equally among the 3 groups. Wound infection was leading in 37% to recurrent inguinal hernia. The overall figure of recurrent inguinal hernia was highest in group 2 with 7.8% (14 out of 179), followed by group 1 with 5.5% (22 out of 399) and group 3 with 4.5% (5 out of 110). Early post-operative recurrence was again highest in group 2 with 7 out of 14 compared with 9 out of 22 in group 1 and 2 out of 5 in group 3. We conclude from these results that inguinal hernia may be performed by a very young surgeon in training; supervision in those who are over the first steps, but have not completed their training has to be intensified and that asepsis has to be observed very carefully.

Adolescent↗

PubMed1983

[Carcinoembryonic antigen (CEA) in surgically treated cancer of the large intestine].

Preoperative CEA value. Dukes stage and recurrence rate have been evaluated in 112 patients with large bowel cancer. Recurrence rate within 24 months was significantly higher (33% vs. 10%, p = 0.01) for preoperative CEA values of more than 5 ng/ml. In patients with moderately or poorly differentiated adenocarcinoma the recurrence rate was nearly 40% if the preoperative CEA value was elevated. Among 13 CEA-detected early recurrences, 3 (23%) have been cured by resection.

Carcinoembryonic Antigen↗

PubMed1983

[Angio-follicular lymph node hyperplasia (Castleman's lymphoma)].

Two patients with angio-follicular lymph node hyperplasia are described, and the literature is reviewed. In one symptom-free man, the chest x-ray showed a tumour of the upper mediastinum the size of a fist (which is known to have been present for 20 years), in another man there was a 4 cm. node in the right hilum, which was shown by computer tomography not to be due to vessels. In each case the tumour was removed. Histologically they proved to be a hyaline-vascular type of angio-follicular lymph node hyperplasia. This is probably an inflammatory-reactive process.

Adolescent↗

PubMed1982

[Bovine pericardium - a new graft material for hernial repair (author's transl)].

We compared glutaraldehyde-fixed bovine pericardium with conventional Mersilene mesh with regard to suitability for repair of large incisional hernias in canine experiments. To test the materials the force needed to rupture them and the percentage of stretching to the breaking point were determined both in vitro and after implantation. The results showed that bovine pericardium is a suitable material for repair of large incisional hernias. Pericardium is superior to Mersilene mesh because of its minimal formation of adhesions with the underlaying bowel.

Animals↗

PubMed1981

[Experiences with non-human material for vascular access for long-term hemodialysis (author's transl)].

From 1975 until June 1980 a total of 115 arteriovenous fistulas were constructed in 81 patients, using non-human material for interposition. The results after implantation of human umbilical vein (n = 5) were poor because of high frequency of thrombosis, and after implantation of synthetic vascular grafts (n = 11) a high incidence of local infections had to be noted. In most patients therefore a bovine xenograft (n = 99) was used. After a follow-up of 1-48 months the calculated failure rate for the first year is 38%. The most common complication was thrombosis, with better results in curved than in straight grafts (P less than 0.05). Early thromboses were caused by a narrow anastomosis, late thromboses (after 2 months) by venous narrowing after the anastomosis. The time delay between construction and first use of the fistula had no influence on the survival rate of the fistulas. Longterm antithrombocyte medication showed better results than anticoagulation (P less than 0.05). We recommend the use of bovine xenografts for arteriovenous fistulas whenever the construction of a normal, direct arteriovenous fistula is not possible.

Adolescent↗

PubMed1980

[Morphologic diagnosis of breast tumors (author's transl)].

Explore the source record for details and available documents.

Biopsy, Needle↗

PubMedDate not supplied

Superselective coil embolization in acute gastrointestinal hemorrhage: personal experience in 10 patients and review of the literature.

PURPOSE: To evaluate the safety and efficiency of microcoil embolization in upper and lower gastrointestinal hemorrhage. PATIENTS AND METHODS: Superselective microcoil embolization was performed in 10 patients (upper gastrointestinal bleeding, n = 3; lower gastrointestinal bleeding, n = 7) who had acute gastrointestinal hemorrhage. Embolization was performed as peripherally as possible with use of coaxial catheter systems. Embolization materials included microcoils (2-4 mm) alone (n = 5), microcoils and polyvinyl alcohol particles (355-500 microm) (n = 4), and microcoils and gelatin sponge particles (n = 1). RESULTS: Immediate hemostasis was achieved in eight patients. In two patients with dual blood supply of the bleeding site, significant reduction of hemorrhage resulted. In these two patients, it was technically impossible to place the coaxial catheter distally enough to allow safe embolization of both feeding vessels. No clinical signs of ischemia or infarction were observed after intervention. CONCLUSION: Microcoil embolization is a safe and efficient procedure for controlling acute lower gastrointestinal bleeding if performed in a superselective catheter position. In upper gastrointestinal bleeding, microcoil embolization is an established treatment and can be performed more proximally.

Acute Disease↗