Biomedical subjects
Publications and source records attributed to T Speil.
Seventy patients after rectosigmoid resection were randomized to a rectal anastomosis either in the single or double stapling technique. There was no statistically significant difference between the two groups. A trend in favor of the double stapling technique was noted: 2.8 percent clinical leaks vs. 8.6 percent in the single stapling technique.
UNLABELLED: The subjective incommodation of the patient by the well established methods of colonic cleansing for operation or endoscopic examination gave a reason to evaluate the efficacy of a new mechanical method in a prospective randomized study. 60 patients were divided in two groups: Colonic preparation was performed by YAL-irrigation in group 1, by oral lavage with PEG (polyethylene glycol electrolyte) in group 2. We found no fecal residue in 29.6% of the YAL group compared to 22.2% in the PEG group, a small amount of liquid stool in 29.6% (YAL) compared to 48.1% (PEG), a large amount of liquid stool in 25.9% of both groups and a solid stool in 14.8% (YAL) compared to 3.7% (PEG). The examination of the mucosal surface was hindered by solid or large amounts of liquid stool in 14.8% of group 1 and in 11.1% in the PEG group, particularly localized in the right hemicolon. In group 1, a significantly better valuation in subjective patient tolerance was found: 18.9% (YAL) compared to 77.8% (PEG) (p less than 0,0001) showed symptoms of patient discomfort. IN CONCLUSION: The simple mechanical preparation with YAL has been shown not to be as safe as with the PEG lavage. However, the YAL method seems to be a useful alternative in patients with suspected stenosis, tendency for vomiting as well as for examination or operation of the left hemicolon.
This paper reports 121 laparoscopic cholecystectomies (LC) in patients who had had previous abdominal surgery between June 1990 and August 1992. There were 93 cases with lower abdominal scar (LS) and 28 with upper or umbilicus midline scar (US). For insertion of the laparoscope in the scarred abdomen we use the conventional laparoscopic approach (CLA), the peritoneum perforation under vision approach (PP), and the open laparoscopic approach (OLA). One hundred twenty scarred abdomens were completed successfully. Conversion to an open procedure was required in one case with previous LS, because of injury of the jejunum. One postoperative intraabdominal hematoma was noted and treated with percutaneous catheter drainage. No reoperation was required and no further complications were noted. Patients who had a previous laparotomy had no substantially longer operative time or postoperative hospital stay. Revealing a total complication rate of 1.6%, this study shows that previous abdominal surgery should no longer be considered a contraindication to LC.
Spontaneous pneumothorax carries a high risk of recurrence after treatment by intercostal drainage only. In such cases and in patients with persistent air leaks under adequate drainage we avoided correction by open thoracotomy using thoracoscopic techniques. On five patients we performed six resections of lung areas bearing blebs or bullae. An ENDO-GIA-Stapler was used for transection and closure of the lung tissue. In one patient a partial apical pleurectomy was added and in four patients an additional pleurodesis with silver nitrate was performed. An immediate air-tight suture was achieved in every case. There were no complications associated with this method. The postoperative pain and the length of hospital stay were markedly reduced compared to open thoracotomy procedures. During the follow-up period (3-7 months) no recurrence was noticed.