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T Böttger

Publications and source records attributed to T Böttger.

At least 73 records · Page 4Linked to original sources
PubMed1991

[A prospective study for evaluating postoperative risk and long-term prognosis of mesenteric infarct].

In a prospective study on the patient material of the Surgical Clinic of the Johannes-Gutenberg-University Mainz the prognostically relevant factors in acute mesenteric vascular occlusion were investigated. From September 1, 1985 until August, 31, 1989 46 patients (24 men, 22 women) with an average age of 67.2 years were treated for an acute mesenteric vascular occlusion. Postoperatively 56.5% of the patients died. The postoperative lethality was correlated statistically significant to the period of anamnesis, the aetiology of the occlusion, the patient's age, the preoperative ASA score, and the length of the ischemically damaged bowel. The postoperative blood lactat level correlated with the outcome. Only two patients survived a second operation with a further bowel resection. One of these patients had a normal blood lactat level. The two year survival rate of the postoperative surviving patient's totalled at 70%. These results confirm the known prognostically relevant factors as well as the value of the blood lactat level in the postoperative period. They show as well, that an early second look operation depending on the intraoperative findings of the primarily operation and prior to an increase of the blood lactat level and prior to a deterioration in the patients condition is justified.

Aged↗
PubMed1991

[Prognostically relevant factors in papillary thyroid cancer].

Papillary cancer have the best prognosis of all thyroid carcinomas with a five year survival rate of 98%. Between 1.1.1964 and 31.12.1987 we have operated 86 patients due to an papillary thyroid carcinoma. The five year respectively ten year survival rate was 88% respectively 75%. Prognostic relevant factors were as follows: metastasis, tumor stage, tumor invasion of vessels, multifocal tumor growth, age, pT differentiation and the tumor size.

Adenocarcinoma↗
PubMed1991

[Therapy and prognosis of medullary thyroid cancer].

Medullary thyroid cancers have different morphological, endocrine and biological qualities than all the other tumors of the thyroid. Therapy is the thyroidectomy with modified, radical neck dissection. The ten year survival rate was 65% in our own patient material. The prognosis depended on tumor size, invasion of vessels by the tumor, grade of differentiation, tumor stage, metastasis and radicality of the operation.

Adult↗
PubMed1991

[Pedicled small intestine segment for circular replacement of the extrahepatic bile duct in preserved papillary passage. An animal experiment study].

The effect of a small bowel segment as a extra-hepatic bile duct replacement was examined in 12 pigs followed-up for a period of 420 days. No complications, either during the operation or postoperatively, were observed in any of the animals. The laboratory parameters were within normal range over the entire observation period of 420 days. After 2, 6, and 12 months there was no anastomotic stenosis in the PTC. The intrahepatic biliary tract was not dilated. There was obvious peristalsis of the small bowel transplant towards the papilla of Vater. The autopsy showed that the grafts had healed without any sign of irritation. Histologically the structure of the graft remained undisturbed. There was a clear distinction between the mucosa of the bile duct and that of the small bowel, with no sign of a chronic infection. In the graft as well as in the vascular pedicle the nerve fibres were intact. Liver biopsy showed no pathological changes. In the light of these experiments, a small bowel segment presents a very promising alternative replacement of the extrahepatic biliary tract.

Ampulla of Vater↗
PubMed1991

[Results of surgical therapy of pancreatic pseudocysts].

During the past few years pancreatic pseudocysts have been seen more frequently. Between 1.1. 1978 and 31.12. 1987 145 patients with pancreatic pseudocysts were operated at the Surgical Clinic of Mainz University. In 93 cases internal drainage was performed with a morbidity of 11.8% and a lethality of 1.1%. External drainage and pancreas resection had a lethality of 6.5% resp. 4.7%. After a mean follow-up of 7.3 years patients with non-resection therapy had a better endocrine function but a worse pain relief than those with pancreas resection. Pseudocyst recurrences developed after internal drainage in 9.3. after external drainage in 55.5% and after resection therapy in 1 of 5 cases. Cystojejunostomy within Y-Roux-anastomosis is therefore a safe method with good long-term results for the treatment of pancreatic pseudocysts.

Adult↗
PubMed1991

[Initial results of image cytometric DNA analysis in the evaluation of prognosis in papillary thyroid cancer].

In this study we analysed DNA-ploidy as a potential prognostic parameter in papillary thyroid carcinoma. Paraffin embedded histological material, obtained by resection from 19 patients with a papillary thyroid carcinoma, was selected for analysis. Tumor areas within the paraffin-embedded material were identified by HE-stained reference sections. One 50 microns section was dewaxed, rehydrated and mechanically and enzymatically prepared to form a suspension of 10,000 cells/ml. 1 ml of the suspension, which contained bare nuclei with small rests of cytoplasma, was centrifuged on glass slides. The fixed nuclei were air-dried and stained by Feulgen SITS technique, which allows for the quantitative measurement of DNA. The DNA analysis was carried out with a computer-controlled single-cell cytophotometry. In contrast to using flow cytometry, only the tumor cells were measured by image-cytometry. Overlapping nuclei, dirt and other artifacts as well as inflammatory cells were efficiently eliminated. With DNA image-cytometry, we could differentiate between diploid (n = 13) and aneuploid (n = 6) tumors. Best prognosis with a survival rate of 92% after 103 months had patients with diploid tumors in contrast to patients with aneuploid tumors who did not survive more than 72 months.

Carcinoma, Papillary↗
PubMed1991

[Animal experiment studies of pedicled small intestine transplantation as partial extrahepatic bile duct replacement].

A pedicle graft of the jejunum can in some cases enlarge a bile duct stricture. The enlargement of the patch and its consequences on the liver function are possible problems. In an animal experiment the following questions were sought. 1) Is a partial replacement of the bile duct with a pedicle graft of small bowel possible? 2) Is there an enlargement of the patch in every case and what are the consequences on the biliary tract and on liver function. The experiments were performed on 14 minipigs over a long-term observation period of 450 days. The red and white blood cell count, the GPT, GOT, GPT, bilirubin and alkaline phosphatase and copper were checked monthly. After 2, 6 and 12 months the intra- and extrahepatic biliary tract were visualized via a PTC. After 8 months an angiography of the pedicle graft was performed. 15 months later the animals were killed and the bile duct, the graft and the liver were histologically examined. 1) With a pedicle graft of small bowel a partial replacement of the extrahepatic bile duct is possible. 2) An enlargement of the patch is seen in every case. The enlargement is a consequence of tension at the pedicle. After 15 months no morphological changes were observed at the patch nor were there any irregularities in liver function.

Ampulla of Vater↗
PubMed1991

[Image analysis of DNA cytometry for assessing prognosis after resection of esophageal cancer].

Esophagus cancer is a heterogeneous disease with considerable differences in malignant behaviour. Some relevant factors for prognosis are known. In this study we analyzed DNA-ploidy as a potential prognostic parameter in esophagus carcinoma. Paraffin embedded histological material from 50 patients with an esophagus cancer, obtained by resection, were selected for analysis. Tumor areas within the paraffin material were identified by HE-stained reference sections. One 50 microns section was dewaxed, rehydrated and mechanically and enzymatically treated to a suspension of 10,000 cells/ml. 1 ml of the suspension, containing bare nuclei with small rests of cytoplasma was centrifuged on glass slides. The fixed nuclei were air-dried and stained by Feulgen-SITS technique, which allows quantitative measurement of DNA. The DNA analysis was carried out with a computer-controlled single cell cytophotometry (Leytas 2, Leitz, Wetzlar). In contrast to the flow cytometry with image cytometry only tumors cells were measured. Overlapping nuclei, dirt and other artefacts as well as inflammatory cells were efficiently eliminated. With the DNA image cytometry we could differentiate between diploid and hypotriploid, hypertriploid aneuploid tumors. Best prognosis had diploid and hypotriploid tumors, the worst hypertriploid carcinomas. In the multivariate analysis the DNA-content of the tumor cells in esophagus cancer was the only prognostic parameter. DNA-content of tumor cells may become considerably clinical relevant in esophagus cancer for the decision to perform a resection or palliative treatment. In patients with hypertriploid tumors an adjuvant oncological therapy may increase the prognosis.

Adenocarcinoma↗
PubMed1991

[Image analytic DNA cytometry--a possibility for assessment of prognosis after resection of ductal pancreatic cancers?].

In this study we analysed DNA-ploidy as a potential prognostic parameter in ductal pancreatic carcinoma. Paraffin embedded histological material, obtained by resection from 34 patients with a ductal pancreatic carcinoma, was selected for analysis. Tumor areas within the paraffin embedded material were identified by HE-stained reference sections. One 50 microns section was dewaxed, rehydrated and mechanically and enzymatically prepared to form a suspension of 10000 cells/ml. One milliliter of the suspension, which contained bare nuclei with small rests of cytoplasma, was centrifuged on glass slides. The fixed nuclei were air-dried and stained by Feulgen SITS technique, which allows for the quantitative measurement of DNA. The DNA analysis was carried out with a computer-controlled single-cell cytophotometry. In contrast to using flow cytometry, only the tumor cells were measured by image-cytometry. Overlapping nuclei, dirt and other artifacts as well as inflammatory cells were efficiently eliminated. With DNA image-cytometry, we could differentiate between hypotriploid, triploid, hypertriploid and tetraploid tumors. The DNA-content provided the strongest influence on prognosis in the multivariate analysis.

Carcinoma, Intraductal, Noninfiltrating↗
PubMed1991

Long-term results after surgical treatment of iatrogenic injury of the bile ducts.

To find out the long term results of repair of iatrogenic bile duct injuries we carried out a retrospective analysis of 111 patients treated at the General and Abdominal Surgery clinics of the Johannes Gutenberg-University of Mainz between 1 January 1964 and 31 December 1987. In 72 of the 111 patients (65%) reliable data were obtained about the course of the disease over a mean period of 9.4 years. Long term results depended on the site of the stenosis, and the number and type of operations. The number of operations depended on whether the injury was immediately recognised, and was higher in this type of repair.

Adolescent↗
PubMed1991

[Esophageal perforation--indications for surgical therapy].

From January 1, 1970 to April 1, 1990, we treated 32 patients with esophageal perforations. 19 patients underwent surgical repair by bilateral closing suture (n = 10), mucosal suture, extramyotomy and semifundoplication in the presence of achalasia (n = 6). Three patients had subtotal esophagus resection with esophageal graft. Four of these patients died postoperatively, the site of intervention being unremarkable. We lost 7 out of 13 patients from the group subjected to conservative therapy. These results suggest a low risk in the surgical treatment of esophageal perforations when carried out at early stage. The conservative approach on the other hand constitutes an uncalculable risk factor. It should be thus be employed with utmost precaution, e.g. in case of minor perforation only, or in patients with incurable carcinoma.

Adult↗
PubMed1991

[Sensitivity of preoperative diagnosis in mesenteric vascular occlusion].

In a consecutive series the sensitivity of the preoperative diagnostic in acute mesenteric vascular occlusion was investigated prosprectively in 62 patients. 22 patients had an arterial thrombosis, 20 patients a venous thrombosis, 13 patients had an embolism, six patients a non-occlusive disease and one patient suffered from a dissection of the aorta. All but three patients (95.2%) had a leukocytosis with an average of 18,700/nl. The serum lactate was increased in 88.7% of the patients. The percutaneous ultrasonography was without any pathological findings in 45% of the patients. The x-ray of the abdomen shows signs of an ileus in more than half of the patients. The angiography had a sensitivity of 74%.

Aged↗
PubMed1990

[Long-term results following surgical treatment of islet cell adenoma].

To evaluate the long term results after operation of islet cell adenomas we analyzed our own patient material from 1.1.1967 to 30.11.1988. During this time we operated 43 patients with islet cell tumors. 36 patients had benign adenomas. After a medium time of 6.7 years we analyzed the outcome of 33 patients. Only one out of 29 patients with a solitary adenoma had a recurrence of the disease. Two patients after pancreas resection had diabetes mellitus. In contrast to this only one out of four patients with multiple adenomas was free of symptoms. One patient had diabetes mellitus. In two patients five operations were necessary up to now, nevertheless one of the patients had persistent hypoglycaemic symptoms. These results show that the most important factor in therapy of patients with islet cell tumors is the recognition and complete removal of multiple adenomas.

Adenoma, Islet Cell↗
PubMed1990

[Surgical, endoscopic or radiologic interventional therapy in bile duct cancer].

The therapy of bile duct cancer is in some cases under controversial discussion. A retrospective comparison between patients who underwent surgery or endoscopic treatment is difficult because of patient selection. It seems that there is no difference in the two groups with regard to 30 days mortality. A prospective or randomized study about this point of discussion is not available. Some retrospective studies show that patients with non-operative treatment had more late complications than had operated patients. Because of tumor extension resection is only possible in a few patients. Operation and endoscopic treatment are therefore not contradictory methods.

Adenocarcinoma↗
PubMed1990

[Preoperative localization in organic hyperinsulinism--useful or superfluous].

In our own patient material (n = 43) the percutane sonography had a sensitivity of 61.9%, the CT 73.3%, the angiography 66.6% and the PTP 76.9%. Intraoperatively 95.2% of all insulinomas were palpable and the intraoperative sonography (IOS) had a sensitivity of 81.2%. In Germany all clinics except for one recommended a sonography and a CT and 83.8% an angiography prior to the first operation. A preoperative localization diagnostic is therefore not absolutely necessary, but may however be helpful in single cases.

Diagnostic Imaging↗
PubMed1990

[Value of preoperative diagnosis in assessing tumor extension of ductal pancreatic carcinoma].

The value of preoperative diagnostics in evaluating the extension of pancreatic carcinoma can be important in some cases for planning its therapy. In ca. 90% of our own patient material only the combination of angiography and computed tomography allowed a correct decision regarding tumor invasion of the vessels. Retrospectively metastases of the liver were seen in 80% and prospectively in 66.7% (sonography), respectively 58.3% (computed tomography) with a specificity of 86.9% respectively 91.3%. These results support our procedure of performing preoperative diagnostics in order to evaluate local operability and resectability only in patients with bad physical condition.

Angiography↗