[Indications for intraoperative irrigation of the large intestine].
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Biomedical subjects
Publications and source records attributed to V Mendel.
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The insulinoma is the most common pancreas tumour with endocrine activity, with more than 2,000 cases being described in the literature worldwide. The first successful extirpation was performed by Graham in 1928. Clinical appearance is characterized by severe paroxysmal hypoglycaemia together with inadequately increased serum insulin levels. Surgery is indicated in such situations because of limited effectiveness of medicamentous therapy. Surgical approach and long-time results are discussed in this paper, with reference being made to 13 cases of the authors.
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Our modified all-layer suture technique allows surgery of colon and rectum with a low rate of anastomotic leaks (2%). In experimental animal research on pigs we compared the modified all-layer suture with the Gambee and the stapling technique. The circulation was examined by radioactive marked microspheres, by microangiograms and by special injection preparations.
Intestinal noise analysis by means of a computerized analyser is a method by which various functional states of the gastro-intestinal tract can be diagnosed. Interference noise from respiration and cardiac action can be suppressed by filtering. Frequency patterns determined were in good correlation with the clinical picture and auscultation findings. It is, basically, possible to identify the original causative organ.
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Laparotomy was performed on 36 patients with persistent "adhesion complaints". Good therapeutic success was obtained from detachment of omental adhesions on the abdominal wall and of omental cords from the minor pelvis as well as from adhesiolysis in the hypogastric region. No peritoneal adhesions at all were recorded from nine patients, although they had undergone several operations before. Complaints were removed from one third of all patients, while nearly 20 per cent were improved. One death occurred, following exploratory laparotomy, due to stress-induced ulcer perforation. No peritoneal adhesion had been present in that case. No complications at all were experienced with any of the other patients.
Detailed studies on autograft and allograft amniotic membranes implanted in the subcutaneous tissues to form tunnels are described. Autograft amniotic membranes appear to become permanent structures whereas allografts of this material, though accepted by the host for a longer time than most allografts, were eventually rejected. Serial histological studies were performed.
The successful clinical application of the amniotic membrane as a surgical dressing is discussed as to the mode of healing. The amniotic membrane does not appear to be a permanent structure when used as an allograft.
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