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Biomedical subjects

M Trede

Publications and source records attributed to M Trede.

At least 55 records · Page 3Linked to original sources
PubMed1995

[The Whipple partial duodenopancreatectomy--its value in the treatment of chronic pancreatitis].

The surgical treatment of chronic pancreatitis is indicated only in the complicated disease. The aim is mainly the treatment of pain, of mechanical obstacles and to exclude suspicion of cancer. Between October 1972 and January 1993 713 patients with chronic pancreatitis were treated at the Surgical University Hospital in Mannheim. In 40% of the patients conservative treatment was continued or intensified. Only in 123 patients a Whipple operation was performed. The leading symptom was pain in these patients. We saw postoperative surgical complications in 14 patients (11.4%). One of them died due to an operative leak (0.8%). Late results are based on a median follow up of 4.8 years and showed a complete or substantial pain relief in 94%. 66% went back to work. 77% gained weight with an average of more than 10 kg. The rate of postoperative endocrine insufficiency was 10% (total 40%), of exocrine insufficiency 26 (total 51%). Late mortality was 11% and mostly caused by continued alcoholic abuse. Based on these results, the Whipple operation seems to be the best standardized method for surgery of the complicated chronic pancreatitis within the head of the pancreas.

Alcoholism↗
PubMed1994

[Results of a prospective study of laparoscopic appendectomy].

Laparoscopic appendicectomy for acute appendicitis is being increasingly criticized, because of the possible complications, the technical effort required and the high costs. The results of the present prospective study performed between May 1992 and March 1994 on 222 appendectomies (110 conventional and 112 laparoscopic) are intended to serve as a tentative guide. The use of endoscopic stapling and cutting devices, as well as the observance of exclusion criteria make laparoscopic appendicectomy a safe operation. It can be employed routinely and shows certain advantages for the patient e.g. fewer disturbances of wound healing and shorter postoperative hospitalization. Although laparoscopic appendicectomy has brought us valuable experience, it is by no means the method of choice and for the time being, it is unlikely to replace conventional appendicectomy.

Adult↗
PubMed1994

[Mesh wrapping of the liver. A very promising method for managing severe liver trauma].

Mesh-wrapping is a quick and technically feasible method to achieve definitive hemostasis in severe liver trauma. It can be combined ideally with conventional procedures. Mesh-wrapping has the same spectrum of indications in severe liver trauma as packing with gauze pads. Whereas packing seems to be superior in cases with bleeding from juxta-caval injuries, Mesh-wrapping is considered to be superior in coagulopathy. The Mesh-wrapping technique provides a highly selective, tight compression confined to the liver and does not produce an increased intraabdominal pressure. The mesh is resorbable and therefore reoperation for removal is not necessary. In cases of postoperative fluid collections the Mesh-wrapping can easily be punctured. Because of its own bacteriostatic capacity Mesh-wrapping seems to be superior when the patient has concomitant gastrointestinal injuries. In summary we think that Mesh-wrapping is a useful alternative in the more conservative, organ preserving spectrum of liver trauma management.

Adult↗
PubMed1994

[Results of treatment of esophageal cancer].

From 1.10.1972 until 1.1.1993 176 patients underwent esophageal resection for cancer of the esophagus. There were 72.7% squamous cell carcinomas and 24.4% adenocarcinomas. pTNM staging was as follows: Stage I: 7.3%; stage IIa: 33.5%; stage IIb: 11.9% and stage III 47.1%. The resection was performed in 92.6% by an abdominothoracic approach. Reconstruction was usually performed by transposition of the stomach. Only in 8 patients colon was used for esophageal replacement. The complication rate was 34.6%, mainly pulmonary complications were seen. The rate of anastomotic insufficiency was 6.2%. Hospital mortality was 15.3%, but decreased from 29.1% in the years 1972-1982 to 10.1% in the last decade. There was a significant correlation between the 5-year-survival-rate and the tumor staging respectively the lymph node involvement. The long-term results showed a relatively high percentage of reflux complaints and persistent dysphagia. But the general condition and quality of life were considered subjectively by 53.5% as good and by 42.8% as moderate. From these results it can be concluded, that surgery today offers the best chances for potential cure and a high quality of life.

Adenocarcinoma↗
PubMed1993

Resection for adenocarcinoma of the body and tail of the pancreas.

Adenocarcinoma of the pancreatic body and tail often presents late and is widely regarded as incurable by surgical resection; long-term survivors are rare. Thirteen patients underwent left resection (n = 7) or total pancreatectomy (n = 6) in a consecutive series of 105 patients with carcinoma of the body or tail of the pancreas. Comparison was made with 17 patients with locally advanced or metastatic disease. Preoperative computed tomography predicted irresectable disease when a large perivascular lymph node mass was demonstrated. Preoperative angiography predicted irresectable disease when there was encasement or obliteration of the coeliac axis or its major branches, or of the superior mesenteric artery or vein. Splenic vessel involvement was sometimes compatible with resection. After resection, median survival was 13 (range 3-50) months, with a minimum follow-up of 2 years. Five patients survived more than 2 years, and three are still alive 30, 43 and 50 months after resection. Resection of carcinoma of the body or tail of the pancreas was possible in 12 per cent of patients and long-term survival was observed in some of these.

Adenocarcinoma↗
PubMed1992

[Multivisceral and extended resection in pancreatic cancer].

Out of 303 pancreatoduodenectomies performed for carcinoma in the past 19 years, 100 patients required a multivisceral or (in 39 cases) a regional pancreatectomy. Although the operative and hospital mortality for these extended resections was only 2%, long-term survival (only 1 patient survived more than 5 years) was inferior to conventional radical pancreatoduodenectomy with a 25% 5-year survival rate.

Actuarial Analysis↗
PubMed1991

[Leiomyosarcoma of the vena cava. Case report and review of the literature].

The leiomyosarcoma of vascular origin is a very rare tumor which is rarely recovered before the disease has reached an advanced stage because of non-specific and late symptoms. This is a report of 3 cases with leiomyosarcoma of the vena cava and a review of the literature. A high local recurrence rate and high frequency of distant metastases are responsible for the bad long-term prognosis. Early hematogenous tumor spread is favored by intraluminal tumor growth. Only complete surgical resection--if necessary with vascular reconstruction--can improve the bad long-term prognosis.

Aged↗
PubMed1991

The European experience with laparoscopic cholecystectomy.

A retrospective survey of 7 European centers involving 20 surgeons who undertook 1,236 laparoscopic cholecystectomies was performed. The procedure was completed in 1,191 patients. Conversion to open cholecystectomy was necessary in 45 patients (3.6%) either because of technical difficulty (n = 33), the onset of complications (n = 11), or instrument failure (n = 1). There were no deaths reported, and the total postoperative complication rate was 20 of 1,203 (1.6%), with 9 being serious complications requiring laparotomy. The total incidence of bile duct damage was 4 of 1,203. The median hospital stay was 3 days (range: 1 to 27 days) and the median time to return to full activity after discharge was 11 days (range: 7 to 42 days).

Adolescent↗
PubMed1991

Acute pancreatitis: the role of early surgery.

Conservative treatment for an attack of acute pancreatitis still takes priority. The treatment of choice in biliary pancreatitis is endoscopic papillotomy with extraction of any bile duct stones. After this procedure the patient usually recovers quickly and cholecystectomy should be done as an interval operation. An early operation has to be done when conservative treatment fails and organ failure occurs. The 'gold standard' of surgical therapy today is the opening of the lesser sac with continuous postoperative lavage and drainage, digital elimination of necrotic tissue and drainage of the paracolic areas. Other described surgical procedures do not produce significantly better results. Necrotizing pancreatitis still has a high mortality in contrast to mild oedematous pancreatitis, which is rarely a problem.

Acute Disease↗
PubMed1991

[Coincidence of sigmoid cancer and sigmoid diverticulitis].

From 1985 to 1989 265 patients with a carcinoma of the sigmoid or sigmoid diverticulitis have been operated in our clinic. 23 of the treated patients synchronously had a carcinoma and a diverticulitis. The carcinoma in these cases was found to be significantly more frequent in a stage T1 or T2. We also found a significantly higher rate of perforations in this group of patients.

Adenocarcinoma, Mucinous↗
PubMed1991

[Vascular surgery techniques in cancer surgery].

Forty heads of university departments of surgery and 17 heads of vascular units answered a questionnaire concerning the problem "How much vascular surgery does the general surgeon need?" There was general agreement that every surgeon should be competent in the care of trauma (including vascular trauma) and that he should be familiar with vascular techniques as required in cancer surgery. Problems in surgical training arise whenever general and vascular surgical units operate completely separately, since the lack of training posts makes rotation of junior staff all but impossible.

Curriculum↗