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T Böttger

Publications and source records attributed to T Böttger.

At least 91 records · Page 5Linked to original sources
PubMed1990

[Surgical therapy of insulinoma].

From 12 Patients surgically explored because of suspected insulinoma, the diagnosis was correct in 11. In 8 patients there was a solitary insulinoma, which was diagnosed in every case by preoperative ultrasonography, computed tomography or angiography. In one patient with three adenomas, only one was diagnosed preoperatively, the second by palpation and the third by intraoperative sonography. One patient had a diffuse hyperplasia. The intraoperative frozen section was correct in 9 from 11 patients. The preoperative localisation of insulinoma assisted in the intraoperative identification. The intraoperative pancreatico sonography is an useful help in localisation of insulinoma. For treatment the enucleation of tumor is preferable.

Adenoma, Islet Cell↗
PubMed1990

[A mucocele of the appendix--a case report].

Mucoceles are rare lesions in the region of the appendix and occur in only 0.4% of all tumours of the appendix. Although their radiological-morphological pattern varies, a correct preoperative diagnosis is nevertheless possible in most cases via imaging methods and taking the pattern of clinical findings into consideration.

Appendix↗
PubMed1990

[Prognostically relevant factors in follicular thyroid cancer].

The discussion of the prognosis of follicular thyroid carcinoma is controversial. To evaluate the factors which influence the prognosis we retrospectively analyzed our patients from 1. 1. 1964 to 31. 12. 1987. 76 patients with a follicular thyroid carcinoma were treated during this time. Factors influencing the prognosis were: (1) multiple tumor growth; (2) pT-classification; (3) vascular invasion; (4) tumor stage; (5) degree of cellular differentiation and (6) metastases. Because of the prognostic influence of multiple tumor growth and the slight prognostic influence of lymph node metastases we recommend a total thyroidectomy with neck dissection for follicular thyroid carcinoma.

Adenocarcinoma↗
PubMed1990

[Value of preoperative diagnosis in mesenteric vascular occlusion. A prospective study].

In a prospective study the value of preoperative diagnostics in acute mesenteric vascular occlusion was investigated in 46 patients. Seventeen patients had an arterial thrombosis, 17 a venous thrombosis, 10 had an emboli and 2 patients suffered from a non-occlusive mesenteric infarction. All patients had leucocytosis with an average of 21,000/nl; serum lactate was increased in 91.4% and phosphate was increased in 36.4%. In 82.6% of the cases loops of the small bowel were seen on the X-ray of the abdomen, but in none of the patients an acute mesenteric vascular occlusion was suspected based on the X-ray alone. In 5 of the 46 cases the occlusion could be seen sonographically. The angiography had a sensitivity of 77%.

Abdomen, Acute↗
PubMed1990

[Long-term results of corrective surgery of iatrogenic bile duct injuries].

Little is known about the long-term results after surgical correction of iatrogenic bile duct injuries. In 72 (64.9%) out of 111 patients who were treated at the University of Mainz between 1.1. 1964 and 31.21. 1987 it was possible to obtain reliable observations on the course of the disease after an average period of 9.4 years. After a follow-up time of 23 years only 20% (end-to-end anastomosis) and 34% (choledocho- or hepaticojejunostomy) were free of complaints. Within 10 years 35% were relaparotomized after choledocho- or hepaticojejunostomy and 58% were relaparotomized after end-to-end anastomosis because of complaints. After choledocho- and hepaticoduodenostomy 20 out of 22 patients required a second operation. Long-term results were statistically depended on the localization of the stenosis, the number of interventions and the operation method. Long-term results were independent on the fact if the lesion was primarily seen or not.

Adolescent↗
PubMed1989

[Value of diagnostic localization of insulinoma].

The value of diagnostic localization of insulinoma The value of diagnostic localization statements are contradictory. Basing on our own patient material (n = 41) the preoperative localization of an insulinoma was correct with sonography in 57.7%, with computed tomography in 21.4%, with computed tomography with bolus injection of contrast medium in 73.3%, with angiography 63.9% and with percutaneous transhepatic portal vein catheterisation with selective test of hormones (PTP) in 76.9%. Intraoperative 38 of 41 insulinomas were palpable and twelve of 16 insulinomas were seen during intraoperative sonography. Although we palpate more than 90% of all insulinomas we support a preoperative diagnostic localization for easier intraoperative palpation.

Adenoma, Islet Cell↗
PubMed1989

[Prognostically relevant factors in cancer of Vater's ampulla].

In order to evaluate the relevant factors for prognosis for patients with cancer of Vater's papilla our own patient material between 1. 1. 1978 and 31. 12. 1987 was studied retrospectively. The influence of age, sex, duration of anamnesis, tumor size, tumor morphology and tumor stage on the prognosis were analyzed in 32 patients with cancer of Vater's papilla. The 5 year survival rate after Whipple procedure was 56.1%. Statistically significant factors for prognosis were tumor size, lymph node metastases and tumor stage.

Adult↗
PubMed1989

[Prognostically relevant factors in ductal pancreatic cancer].

Prognosis of patients with pancreatic carcinoma is bad. Less than 1% of all patients and even after pancreas resection only 10% survive more than 5 years. To evaluate the factors which influence the prognosis we analyzed retrospectively all patients who were operated on a pancreas cancer (n = 484) from January 1, 1978 to December 31, 1987. Age, sex, perineural invasion and lymphangiosis carcinomatosa had no prognostic influence. The duration of symptoms, degree of cellular differentiation, tumor size, preoperative level of the tumor associated antigen CA-19-9, nodal involvement and stage were statistically significant for prognosis. R1 and R2-resections had no better prognosis than other palliative procedures.

Antigens, Tumor-Associated, Carbohydrate↗
PubMed1989

[Progressive papillomatosis of the intra- and extrahepatic bile ducts].

The papillomatosis of the bile duct may occur at any age but more often at the age of 40 and 50 with a slight preference for men. The main symptom is an icterus often combined with right-sided epigastric pain. ERC and PTC allows the preoperative diagnosis on the basis of the typical clinical picture. The papillomatosis of the bile duct has to be considered as a disease with cancer risk. The prognosis in case of incomplete removal is unfavorable because of the continuous growth, the intrahepatic spread and the elevated degenerative tendency. Therefore a complete removal should be considered.

Adenocarcinoma↗
PubMed1989

Progressive papillomatosis of the intrahepatic and extrahepatic bile ducts. Case report.

Papillomatosis of the bile ducts is uncommon, with only 26 cases in the available literature. The salient symptom is icterus, often with right-sided abdominal pain. Endoscopic retrograde cholangiography and percutaneous transhepatic cholangiography nowadays permit preoperative diagnosis. Complete removal should be the aim, because of the tendency to continuous growth, intrahepatic spread and malignant degeneration. Four cases are presented.

Adult↗
PubMed1988

[Diagnostic strategy of the liver and bile ducts].

The diagnosis of gallbladder and liver diseases depends primarily on noninvasive techniques (ultrasound and computer tomogram). Gallstones can be detected by ultrasonography in more than 90% of such patients and this is a sufficient indication for operation. The preoperative diagnosis of stones of the biliary tract by sonography is however, unreliable. Even a preoperative endoscopic retrograde cholangio-pancreaticography cannot justify foregoing an intraoperative cholangiogram. Detection of metastasis is still a problem in the diagnosis of liver tumors. Further developments in computed tomogram and scintigram techniques, however, promise improvements.

Bile Duct Diseases↗
PubMed1986

[Rupture of the diaphragm--a frequently undetected injury].

Traumatic ruptures of the diaphragm are acquired separations of the diaphragm which are aetiologically divided into indirect and rare direct ruptures. The force required to produce indirect ruptures will usually lead to additional intraabdominal lesions of liver and spleen as well as to rib fractures and fractures at the lower extremity. Hence the sequels of these accompanying lesions are often prominent in the clinical pattern to such an extent that 50 to 70% of the diaphragmatic ruptures remain primarily unrecognised. Abdominal and/or cardiorespiratory signs and symptoms become manifest only if there is an evisceration. Hence surgical strategy in preoperatively identified diaphragmatic ruptures depends on the localisation of the rupture, on the severity of the accompanying lesions, and the time until surgical treatment can be effected. Depending on the type and severity of the accompanying lesions an average lethality of 33% must be taken into account in fresh diaphragmatic ruptures. In chronic uncomplicated eviscerations the operations lethality is about one per cent.

Accidents, Traffic↗
PubMed1986

[Interwoven wire suture with fascia lata-plasty in the treatment of subcutaneous rupture of the Achilles tendon--an obsolete method?].

Lately there has been an increased incidence of rupture of the Achilles tendon following the general increase in mass sports. Surgery is the treatment of choice, and various methods are being described. We have been using the wire suture method with fascia lata plasty for more then twenty years. The rate of infection is 3.8% and that of rerupture 1.2%, figures that correspond to those stated for other surgical methods. Moreover, 87% of the patients were very satisfied with the result of the operation; they are fit for work without any restriction, and some of them even practise their sports activities as before. For this reason we consider that wire suturing with fascia lata plasty is by no means obsolete in the treatment of rupture of the Achilles tendon.

Achilles Tendon↗
PubMedDate not supplied

Value of quantitative DNA analysis in endocrine tumors of the pancreas.

BACKGROUND: The diagnosis of malignancy can be difficult in endocrine tumors of the pancreas. Moreover prognostically relevant factors are not available. The aim of this study was to evaluate retrospectively whether the DNA distribution pattern can differentiate between benign and malignant pancreatic endocrine tumors and secondly whether the DNA content of tumor cells gives prognostic information. METHOD: Image cytometry of paraffin-embedded tumor material of 42 pancreatic endocrine tumors. RESULTS: In 27 benign endocrine pancreatic tumors (25 insulinomas, 2 benign nonfunctioning endocrine tumors) we could differentiate between 6 diploid, 15 hypotriploid and 6 triploid DNA histograms. In 15 malignant endocrine tumors of the pancreas we could differentiate between 1 diploid, 1 hypotriploid, 9 triploid and 4 hypertriploid tumors. All 4 patients with a hypertriploid tumor died as a consequence of their disease in contrast to only 1 patient with a diploid, hypotriploid or triploid tumor even in case of a nonradical resection. CONCLUSION: With the help of quantitative DNA measurement a differentiation between malignant and benign endocrine pancreatic tumors is not possible even if the risk of malignancy increases with the DNA content. The DNA content of malignant endocrine pancreatic tumors has an influence on the long-term survival. Hypertriploid tumors have a statistically significantly worse prognosis than diploid, hypotriploid or triploid tumors.

Adenoma↗
PubMedDate not supplied

The impact of clinical types of disease manifestation on the risk of early postoperative recurrence in Crohn's disease.

BACKGROUND/AIMS: Surgery for Crohn's disease is frequently followed by symptomatic recurrence, which in up to 40% requires reoperation within 6 years. Whilst there is evidence that postoperative medical prophylaxis can be efficient, the results of clinical trials are inconsistent regarding the achieved benefit for the patient. Several parameters have been claimed to indicate an increased intrinsic risk of early surgical recurrence. METHODOLOGY: Patient charts of 287 patients who had undergone abdominal surgery for Crohn's disease were reviewed. Mean follow-up was 4.4 years. Recurrence-free intervals were calculated by the Kaplan-Meier method. A uni- and multivariate analysis was conducted to assess the impact of possible indicators of the need of repeated surgery. RESULTS: Patients with fistulizing type of symptoms, extraintestinal manifestations, corticosteroid treatment or male gender experienced significantly earlier reoperation. Recurrent disease, histologic evidence of inflamed resection margins, patient's age at the time of primary diagnosis and operation and the presence of epitheloid granulomas did not show significant influence on recurrence-free intervals. CONCLUSIONS: We conclude that the natural course of disease after intestinal resection in patients with one or more of these risk factors tends towards earlier recurrence requiring surgical intervention. The risk factors identified in this trial may be useful for patient stratification for randomized trials on the efficacy of medical prophylaxis.

Adult↗