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S Walgenbach

Publications and source records attributed to S Walgenbach.

At least 55 records · Page 3Linked to original sources
PubMed1992

[Results of stomach resection with Roux gastrojejunostomy for gastroduodenal ulcers].

In a follow-up study operative risk, postoperative functional disorders and incidence of anastomotic (recurrent) ulcer after partial gastrectomy with Roux-en-Y gastrojejunostomy for gastroduodenal ulcer were evaluated in 52 patients. Lethality for elective treatment was 0 and for emergency surgery (ulcer bleeding) 16.7%. 29.5% of the patients reported postoperative functional disorders. Because Roux-en-Y reconstruction prevented duodenogastric reflux, intragastric pH was low (median 2.2) and in the absence of ulcer protective, neutralizing reflux anastomotic ulcer occurred in 15.9% of the patients. With regard to the high rate of recurrent ulcer Roux-en-Y reconstruction after partial gastrectomy for primary ulcer surgery should be avoided and reconstruction procedures preferred, which guarantee duodenogastric reflux.

Anastomosis, Roux-en-Y↗
PubMed1991

[Stomach emptying after stomach resection with and without retention of duodenal passage].

On domestic pigs 2/3 gastrectomies with retention and elimination of the duodenal passage were carried out. Postprandial gastric emptying was measured scintigraphically for 4 h and compared with a control group (laparotomy only). For the semi-solid, 99mTc-labeled test meal delayed gastric emptying after elimination of the duodenal passage by Roux reconstruction could not be shown. There was no difference in gastric emptying between B-I and Roux-en-Y partial gastrectomy. Also alteration of the length of the jejunum loop from 40 to 20 cm after Roux-en-Y reconstruction had no influence on gastric emptying. Roux reconstruction (40 cm loop) in combination with truncal vagotomy led to a non-uniform gastric emptying, but there was a statistically proven acceleration compared with B-I resection. After 240 min the mean residual intragastric activity of the control group (n = 5) was 47.8%, 78.9% after B-I resection (n = 5), 59% after Roux reconstruction with 40 cm jejunal loop (n = 5), 38.1% after Roux reconstruction with 20 cm jejunal loop (n = 5) and 20.9% after Roux-en-Y (40 cm loop) with truncal vagotomy (n = 4).

Anastomosis, Roux-en-Y↗
PubMed1991

[Animal experiment studies of development of anastomosis ulcers after reflux-inducing and reflux preventing stomach resection].

In an animal experiment the role of bile reflux in development of anastomotic ulcer after partial gastrectomy was investigated. On 45 pigs 2/3 partial gastrectomies and on 5 animals only laparotomies were carried out. The ulcer risk after reconstruction procedures with possible bile reflux was compared with reflux-free techniques. Anastomotic ulcer developed after maximal exposure of the gastric remnant to bile as well as after reflux-free reconstructions: B-II-Roux, 40 cm jejunum loop (n = 5/10); B-II-Roux, 20 cm jejunum loop (n = 3/5); B-II-Roux, 40 cm jejunum loop and truncal vagotomy (n = 1/5); B-I and choledochojejunostomy (n = 2/10); B-II-Roux, 40 cm jejunum loop and cholecystogastrotomy (n = 4/5). After B-I resection with medium duodeno-gastric reflux (n = 0/10) and in the control group (n = 0/5, laparotomy only) no ulcer occurred. Because basal acid output after B-I and B-II-Roux resection was reduced to O mval/h, stimulated gastric acid seems to be important in development of anastomotic ulcer. The experimental results prove the protective role of postresectional duodenogastric reflux. After partial gastrectomy for primary ulcer surgery reconstruction procedures guaranteeing duodenogastric reflux should be preferred to Roux-en-Y gastrojejunostomy.

Anastomosis, Roux-en-Y↗
PubMed1990

[Resorbable staple sutures for partial stomach and duodenal stump closure. Animal experiment studies].

In two groups of pigs, 10 in each, partial gastrectomies with gastroduodenostomy (Billroth I) respectively gastrojejunostomy (Roux-en-Y) were performed. Absorbable lactomer (Polysorb, Auto-Suture) staple lines--a copolymer of glycolic acid/lactic acid-, used for the closure of the lesser curvature of the stomach and the duodenal stump, were safe. No suture dehiscence was observed. Macroscopic examination showed no major inflammatory adhesions around the staples. Microscopically inflammatory reactions around the staples in the gastrointestinal wall were found. Our results yielded no contraindication for clinical tests of absorbable sutures in gastrointestinal surgery.

Anastomosis, Roux-en-Y↗
PubMed1989

[Stapler and manual bronchial anastomosis--results of a consecutive trial series].

After lobectomy and pneumonectomy in experimental evaluations stapled bronchial closures showed the lowest incidence of inflammatory reaction and the highest strength determined by leakage pressure compared with other suture material. A total of 233 lung resections-performed at Surgical University Clinic Köln-Lindenthal and the Clinic for General and Abdominal Surgery of the Johannes-Gutenberg-Universität Mainz--were reviewed. Mechanical stapling reduced the rate of bronchopleural fistulas to 2.0% compared with 7.1% after manual suturing. In parallel, mortality related to bronchial stump leakage decreased to 0.7%. Main advantages of bronchial closure with staplers are the simplicity of their use, the speed and the uniformity of the closure. Thereby stapling devices are valuable completions in pulmonary surgery.

Bronchi↗
PubMed1989

[Errors and dangers in use of the surgical stapler in lung surgery].

The staple closure of the bronchus, like the manual technique, depends on some essential prerequisites: vascular supply, the length and thickness of the bronchial stump, the resection line, the type of stapler and the size of staples used. GIA 55 or 90 instruments allow safe and simple closure of lung parenchyma. Familiarity with the stapling technique is essential for success.

Anastomosis, Surgical↗
PubMed1987

[Crohn disease and squamous cell carcinoma of the anorectal transition].

Squamous cell carcinoma of the anorectal junction originated from anal fistulas in two female patients with Crohn's disease which have been suffering from anal and rectovaginal fistulas for many years. In addition one tumour showed paraneoplastic parathyroid hormone synthesis. This findings point out Crohn's disease as a premalignant lesion. Chronic fistulas associated with Crohn's disease must be followed up carefully by clinical examination, endoscopy and biopsy. To prevent malignancy and to cure the anal region and the origin of such fistulas, resective surgical technics should be taken into consideration early.

Adult↗
PubMed1986

[Pleural infiltration by peripheral bronchial carcinoma. Is computed tomography reliable?].

Pre-operative computed tomograms were obtained in 52 patients with histologically confirmed peripheral bronchial carcinomas and possible involvement of the pleura and thoracic wall was analysed. The results were compared with the operative and histological findings. Thickening of the pleura and of the sub-pleural fat line was observed in 24 cases. Amongst these patients there was only one case with histologically confirmed pleural infiltration. In 17 patients the sub-pleural fat line was obliterated, or could not be defined. Amongst these, 11 showed tumour extension to the pleura or soft tissues of the chest wall. It is concluded that the most suspicions sign of pleural tumour extension is absence of the sub-pleural fat line. The more frequently observed pleural thickening cannot be considered as a reliable sign for pleural involvement.

Adenocarcinoma↗
PubMed1986

Lectin-binding sites in human parathyroid tissue.

The aim of this study was to demonstrate several lectin-binding sites in human parathyroid tissue and to correlate these results with functional activity. The following lectins were tested for binding sites with certain carbohydrates (in parentheses): Arachis hypogea (PNA) (galactose), Ulex europaeus I (UEA) (fucose) and concanavalin A (ConA) (mannose). In addition to normal parathyroids used as controls (13 cases), we examined adenomas associated with a clinical picture of primary hyperparathyroidism of differing severity (31 cases), atrophic glands contralateral to a hyperfunctioning adenoma (7 cases), and secondary (renal) hyperplasia (12 cases). Use of PNA (with and without neuraminidase treatment) and UEA yielded negative staining in normal glands, a wide variety of reactions in adenomas, and frequent dense precipitates in atrophic parathyroids, whereas ConA yielded positive staining in all kinds of parathyroid tissue. Assessment of functional activity of adenomas by clinical parameters (pre-operative serum levels of calcium and parathormone) displayed a significant correlation with the semiquantitative grading of the histochemical reactions after PNA and UEA. Lectin-binding sites in parathyroid chief cells of adenomas are believed to indicate some of the cell structures or products directly involved in the secretory process, including degradation. Although ConA may recognize constituent parathyroid glycoproteins, the binding sites for PNA and UEA are thought to be partially associated with secretory glycoprotein (SP-I), as is known from animal experiments. The positive reaction of the atrophic gland may result from degradation enforced by exposure of primarily non-terminal carbohydrate components.

Adenoma↗
PubMed1985

[Asymptomatic carcinoid in a Meckel's diverticulum as the incidental finding in the operation of an abdominal aortic aneurysm].

A case report is given of a patient who had surgery because of an aneurysm of the abdominal aorta. During laparotomy a tumor in Meckel's diverticulum was found, which was removed by tangential incision without opening the intestine as to avoid an infection of the prosthesis. The tumor had a diameter of 1.5 cm and histology showed transmural spread of the carcinoid tissue; under these conditions further metastatic spread is possible. After the patient had recovered successfully from aneurysm surgery he was operated again and partial resection of the small intestine including the regional lymphatic system was performed. Carcinoid tissue was found during histological examination in the submucosal layer of the intestine in the area where surgery had been done before; no pathological changes however were found in the mesenterium. Thus the patient can be considered to be cured.

Aorta, Abdominal↗
PubMed1985

[The course of parathyroid hormone following an operation for hyperparathyroidism].

After the operation of hyperparathyroidism not only the level of calcium but also the postoperative course of the parathormone is a very informative parameter. In contrast to the serum calcium there is a very delayed normalisation of the values of parathormone in single cases of primary hyperparathyroidism. In cases of recurrent primary hyperparathyroidism the value of parathormone increases much earlier than the value of serum calcium and before the patient has any complaints. So the parathormone enables the recurrent or persistening hyperparathyroidism to be early recognized or differentiated respectively. In the course of the operative therapy in secondary hyperparathyroidism the recrudescence of the level of parathormone points to a successful replantation of the epithelial bodies. In general increased postoperative values are not to be equated with the recurrence of the disease.

Adenoma↗
PubMed1984

[Squamous epithelial carcinoma of the anorectal junction in Crohn disease with an anal fistula of many years' duration].

A squamous-cell carcinoma of the anorectal junction had developed from a chronic anal fistula in a 27-year-old woman with Crohn's disease who had been suffering from anal and rectovaginal fistulas for many years. In view of their cancerogenic potential, chronic fistulas associated with Crohn's disease must be followed up closely by clinical examination, endoscopy and biopsy. If surgery is indicated, resection of such fistulas should be considered at an early stage.

Adult↗
PubMed1983

[Primary retroperitoneal tumors. Symptoms, diagnosis and therapy].

We reviewed 28 cases of primary retroperitoneal tumors (1972 to 1982). We found 22 malignant and six benign tumors. The tumors revealed no special features. Cardinal symptom was a palpable abdominal mass in 21 of 28 patients (75%). Since 1978 we have at our disposal a modern radiological technique, the computerized tomography, which allows a statement of tumor localization, tumor size and infiltration of neighbouring organs. In our patients no definite statement could be made about resectability and type of the tumors. In spite of computerized tomography there is no change the road-minded operation indication. Surgical therapy is the treatment of choice because of lacking alternatives. Complete extirpation to cure, respectively exploratory laparotomy and biopsy to determine the specific nature of the tumor by histological examination should be aspired. In individual cases palliative gastrointestinal anastomoses are necessary to treat intestinal obstruction. All six benign, but only six of 22 (27%) malignant tumors were completely removable. Although in some cases neighbouring organs were respected, no patient died after operation. For a curative therapy the early diagnosis of the tumors is necessary.

Adolescent↗
PubMed1983

[Circular stapling anastomosis (EEA) following gastrectomy].

After total gastrectomy because of gastric malignancies 31 oesophagojejunostomies performed in end-to-side fashion using a standard manual technique were compared with oesophagojejunostomies performed in end-to-end fashion by mechanical stapling (EEA). After manual suturing there was a leak in 29% and 25.8% out of all patients died. After automatic mechanical suturing anastomotic failure was seen in 12.9% with a postmortality rate of 3.2%. These results show, that by mechanical stapling a secure oesophagojejunostomy is possible and the risk of gastrectomy can be reduced.

Adult↗