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Biomedical subjects

M Röthlin

Publications and source records attributed to M Röthlin.

51 records · Page 3Linked to original sources
PubMed1990

[Surgery of chronic pancreatitis].

Between 1982 and 1988 47 patients underwent surgery for chronic pancreatitis at our institution. The main etiological factor was alcohol (41 cases). The mean age of the patients with alcohol-induced chronic pancreatitis was 15 years below that of the other patients. Calcifications were found in 27 patients at the time of surgery. Calcifications and exocrine insufficiency increased from 40% and 27% to 80% and 79% respectively if the history was shorter than 5 years or more than 10 years. The main indications for surgery were cholestatic jaundice (23 cases) and pseudocysts (22 cases), while only 6 patients had surgical treatment for pain alone. Only one of seven recurrences of chronic pancreatitis were in a patient with a history of more than ten years. Operative mortality was 4%. The length of the history of chronic pancreatitis influences the indication for surgery, the surgical technique and postoperative prognosis. Studies comparing different operative techniques are only of value if they take the natural history of the disease into account.

Adult↗
PubMed1990

[Initial experiences with the intraoperative sonography in visceral surgery].

Intraoperative sonography (IOUS), which had gained importance from the mid-seventies, was introduced at our clinic in November 1987. To this day, 32 patients have been examined, of which twelve had an examination of the liver, eight of the pancreas and one of the bile ducts. In ten cases surgical strategy was influenced by IOUS. After a comment on the equipment and on the conditions this has to meet, the technique and the difficulties of the IOUS examination of the liver, the pancreas and the bile ducts are discussed. Our own results are compared with those of the literature.

Gastrointestinal Diseases↗
PubMed1990

[Long-term results of surgical treatment of lung metastases].

A retrospective review covered 110 patients who had had 130 thoracotomies for 193 lung metastases between 1960 and 1988. The cumulative survival rate after 5 years was 39%, 24% after 10 years and 13% after 15 years. The median survival was 3.8 years; the average survival was 7 years. In a multivariate analysis, response to prior chemotherapy, local tumor extent (intrapulmonary versus extrapulmonary disease) and venous drainage (caval versus portal) were the most important prognostic factors. The number of metastases and the interval between primary tumor and lung metastases were of minor prognostic importance.

Adolescent↗
PubMed1990

[5 and 10 years results of surgical treatment of lung metastases].

This is a report on 105 patients who had 125 thoracotomies for 188 lung metastases between 1960 and 1987. The cumulative survival rate at 5 years was 39% and 24% at 10 years and 13% at 15 years. The median survival is 3.7 years, the average survival is 7 years due to prolonged follow-up. With combined modality therapy, testicular and uterine cancers yielded the best survival results with a 5-year survival rate of 100% and 67%, respectively. In multi-variate analysis, response to prior chemotherapy, local tumor extent (intrapulmonary versus extrapulmonary disease) and venous drainage (caval type versus portal type) were the most important prognostic factors whereas the number of metastases and the interval between primary tumor and lung metastases were of minor prognostic importance. The present results are compared with long-term results of other centres and emphasize the importance of resection in combined modality therapy concepts of lung metastases.

Adolescent↗
PubMed1990

[Intraoperative sonography].

Intraoperative sonography was introduced at our institution in November 1987. We have since examined 55 patients, of which 27 suffered from liver disease, 16 from pancreatic problems and 11 from hyperparathyroidism. A short description of the technique applied is given for each organ. The intraoperative sonography of the liver showed additional information in one third of the cases. The sensitivity of intraoperative sonography in hyperparathyroidism was 78%, the specificity 72%.

Adenoma↗
PubMed1990

[Does the surgeon have to master sonography? Results of a survey in Swiss clinics].

The range of applications for sonography in medicine is widening rapidly. More and more specialists are doing their particular sonographic examinations themselves. In other countries ultrasound is already part of the postgraduate surgical training. A questionnaire was sent to 142 surgical clinics in Switzerland to assess the present situation of ultrasound in surgery and to find out if changes are desirable. 112 questionnaires were returned. In 107 hospitals ultrasound equipment was available. Only 31 clinics had a surgeon trained in sonography amongst their staff, although 71 would like to start sonography in their clinic. Courses in sonography were considered necessary 87 times and most important, 83 clinics (74%) agreed to the introduction of ultrasound into the postgraduate training of Swiss surgeons.

Curriculum↗
PubMed1989

[Clinical aspects of acute pancreatitis].

55 patients with acute pancreatitis were treated at this institution between 1979 and 1984. The female/male ratio was 3:2. Biliary pancreatitis was found in 51%. In 15% alcohol was the cause, while in 34% the etiology remained unknown. The main symptoms were acute abdominal pain (100%), nausea and vomiting (51%), fever (35%), and peritoneal irritation (27%). Twenty-two patients were treated conservatively, while the remainder underwent surgery either in or after the acute phase of the disease. Hospital mortality was 0% for a Ranson Score up to 4.25% for 5/6 and 50% for greater than 6.

Acute Disease↗
PubMed1988

[The tumor markers CA 19.9, Ca 50 and CEA in the differential diagnosis of pancreatic carcinoma].

The tumour markers CA 19.9, CA 50 and CEA were measured preoperatively in 178 patients with symptoms of the upper abdomen and in 30 healthy individuals. Raising the cutoff of CA 19.9 and CA 50 and combining the three markers resulted in a sensitivity of 81.5% and a specificity of 86.7%. With increasing local tumour size and tumour spread, a non-significant tendency to greater tumour marker concentrations was observed. The tumour markers tested proved of great value in differentiating between pancreatic cancer and chronic pancreatitis. Sensitivity and specificity in this context were 81.5% and 100% respectively. In postoperative follow-up and in evaluation of new therapy regimens we recommend CA 19.9 as the marker most closely related to tumour progression or recurrence.

Adenocarcinoma↗
PubMed1988

Present indications and future expectations of ultrasound in surgery.

With the improvement of resolution in the ultrasound image, this technique has become more and more popular as a diagnostic means in various fields of medicine. Surgeons use diagnostic ultrasound pre-, intra- and postoperatively. Preoperatively, it is mainly employed for tumour staging, differential diagnosis of the acute abdomen, assessment of intra-abdominal and intrathoracic fluid in polytrauma and lately for arthrosonography. Intraoperative ultrasound has developed into one of the most important tools in intraoperative decision making in surgery of the liver, the bile ducts and the pancreas. Adenomas of the parathyroid glands may represent an indication for intraoperative ultrasound. Postoperative ultrasound has become increasingly important in the follow-up of tumour patients and the monitoring of patients in the intensive care unit. Interventional sonography can either be diagnostic or therapeutic. Both pre- and postoperatively, it can be used to help acquire material for microbiological, chemical and cytological examination. On the other hand, it is applied for drainage of abscesses and pancreatic pseudocysts, as well as pleural and intra-abdominal fluid collections. The main problem for the surgeon beginning to work with ultrasound today is the lack of training facilities with an experienced teacher. This is the origin of most of the other problems, such as quality control, 24-h service and interobserver-variations. With the new technologies already available or being developed, ultrasound is bound to gain even more importance for the surgeon in the future.

Diagnosis, Differential↗