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Biomedical subjects

T Junginger

Publications and source records attributed to T Junginger.

At least 307 records · Page 17Linked to original sources
PubMed1988

Technique of transanal endoscopic microsurgery.

Sessile adenomas are predominantly localized in the rectum and lower sigma. Surgical removal is indicated but often implies an invasive surgical procedure. Using conventional transanal surgical techniques, only the lower rectum can be reached and there are high rates of recurrence. The new technique combines an endoscopic view of the rectum under gas insufflation via a stereoscopic telescope with conventional surgical preparation and suturing. Adenomas can be excised using the mucosectomy technique or full-thickness-excision, whereas carcinomas should be excised using full-thickness excision with a sufficient border of healthy mucosa. In carcinomas of the sacral cavity, we remove the retrorectal fat up to the fascia of Waldeyer, including the regional lymph nodes. Transanal endoscopic microsurgery is the most economical and tissue-saving surgical technique for the removal of rectal adenomas and early rectal carcinomas.

Adenoma↗
PubMed1988

Clinical results of transanal endoscopic microsurgery.

Using the "transanal endoscopic microsurgery" technique, 140 patients were treated at the Department of Surgery in Cologne and Mainz. Of the patients with adenomas, 68.2% had typical symptoms preoperatively. The postoperative hospital attendance was 8.7 days, with an average resection size of 14.4 cm2. The postoperative complication rate was 5%, and there were no deaths related to the technique. In a prospective controlled trial, 2.2% of the patients with adenomas treated endoscopically in Mainz showed recidivation, requiring reoperation. The follow-up rate was 100%. In 30 cases, microscopic examination revealed carcinoma. Radical reoperation in 8 pT1 tumours showed neither remaining tumour nor lymph node metastases. Twelve patients with pT1 carcinoma treated by local surgery alone were recurrence-free with an average follow-up period of 12.3 months. So far, there have been no late results.

Adenoma↗
PubMed1988

Hemangiopericytoma of the lung--a rare differential diagnosis of lung tumors.

The authors report of a 50 year old woman who was operated on because of a rectum carcinoma 5 years ago. At a follow-up examination a 2 x 2 x 1 cm sized tumor was found in the lower lobe of the right lung. Under the diagnosis of lung metastasis after rectum carcinoma resection, operation (wedge resection) was carried out. The histological examination revealed the rare tumor hemangiopericytoma. Based on this case, frequency of the tumor, clinical symptoms, surgical treatment, prognosis as well as recurrence rate and formation of metastases are discussed.

Diagnosis, Differential↗
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↗
PubMed1988

[Intraoperative measurement of radiation dosage following 123-iodine meta-iodobenzylguanidine scintigraphy in surgical therapy of metastatic pheochromocytoma].

We investigated whether preoperative injection of 123-Jod-MIBG might be useful for intraoperative staging of chromaffine tumor cells. This was performed in a 46 year old patient in whome the diagnosis of a malignant pheochromocytoma had been established by 123-Jod-MIBG image and in catacholamine secretion. The rational for intraoperative staging of this patient was a discrepancy between computer tomography (CT) and the radio nuclide imagine. Intraoperative the tumor mass was identified with an activity of 10 x 10(4) Imp/sec as compared to normal tissue (15 x 10(2). A lymph node metastasis was found to be identified only by prior MIBG imagine and not by CT scanning. We thus conclude that intraoperative employment of this single probe measurement method might help to identify chromaffine tumor cells that have not been located fully by CT.

3-Iodobenzylguanidine↗
PubMed1987

[Biomedical and clinimetric approaches in determining the causes of perioperative risk: developing a German ASA classification].

Perioperative risk research with biomedical (biochemical, physiological) methods must grow up as a main topic in surgical research. However, operative risk has also to be analysed with methods of clinimetrics, such as formal (objective) decision making and epidemiology. Only by this way a convincing practical dimension is added to basic scientific statements. ASA-classification of the preoperative physical status is a global index for estimating the operative risk. It contains objective findings, subjective impressions and the final clinical judgement. For this reason it is so flexible. For a multicentre trial on perioperative risk and histamine an empirical index was constructed using both the ASA-classification and the Mannheim-Munich risk check list.

Germany, West↗
PubMed1987

[Principles of radical treatment in surgery of colonic cancer].

The principles of radical surgical treatment of carcinomas of the colon are: 1) the en-bloc-resection of tumor, regional lymph nodes and lymph vessels and nearby organs, 2) avoiding of tumor spreading caused by the operation itself. To avoid tumor spreading, there are different kinds of treatment, the value of which are unknown, but which do not rise the risk of the operation. Predisposition for the evaluation of the radical surgical treatment of colon carcinoma is a standard operative technique and a standard pathohistological evaluation.

Colectomy↗
PubMed1987

Endoscopic microsurgery of rectal tumors.

Seventy-five patients with sessile adenomas or early carcinomas of the rectum or rectosigmoid were operated on with the new technique "transanal endoscopic microsurgery" Employing a newly developed complex endoscopic operating system, complete removal of sessile adenomas can be accomplished up to a distance of 25 cm from the anal verge, accurately and non-invasively. Complications occurred in three cases, with no resulting mortality. In the follow-up period we discovered only one adenomatous recurrence that required operative treatment. The superior accuracy of preparation, a short average stay in hospital, and low recurrence and complication rates are the advantages of this transanal endoscopic operative technique.

Humans↗
PubMed1987

[Liver CT with portal vein administration of a contrast medium].

Contrast administration through the superior mesenteric or splenic arteries provided additional information in 22 out of 31 patients, when compared with intravenous contrast bolus for CT of the liver. In 11 patients, the demonstration of a tumour lead to a change in treatment. False positive findings occurred in four of the 31 patients. In 2 patients intrahepatic lesions were overlooked, but were found during angiography carried out at the same examination. The diagnosis of intrahepatic space-occupying lesions is discussed as well as the CT appearances of portal-venous liver perfusion.

Adult↗
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

[Life expectancy after gastric resection for gastroduodenal ulcer].

Retrospective analysis of 1045 patients who had had a Billroth II partial gastric resection for benign gastroduodenal ulcers revealed a significantly shorter life expectancy for them than for a control group matched for age and sex (mean and maximal periods of observation 14.6 and 22 years, median 17.6 years; 15 217 observation years). After resection for duodenal ulcer there were more deaths from bronchial carcinoma, liver cirrhosis or suicide than after resection for gastric ulcer. Gastric stump carcinoma was more frequent in patients with gastric ulcer and was the cause of death in 5.8% of all patients who had died after the fifth postoperative year. The results suggest that life expectancy after gastric resection depends less on the operation than on the existing risk factors.

Adult↗