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Biomedical subjects

W Wayand

Publications and source records attributed to W Wayand.

At least 55 records · Page 3Linked to original sources
PubMed1992

[Initial results of minimally invasive lung surgery].

From June 1991-February 1992 we have performed in 10 patients wedge resection of the lung by means of minimally invasive surgery. Indications were: spontaneous pneumothorax (5), tumours (3), suspected systemic disease (2). In all patients the pathological specimen preoperatively diagnosed by x-ray and CT, could be harvested without any problem. Minimally invasive, atypical wedge resection is considered as an effective procedure with low risk and discomfort for the patient.

Adult↗
PubMed1991

Laparoscopic cholecystectomy--how does it work and how long does it take?

In the present paper we report on our experience with laparoscopic cholecystectomy in 145 patients. The success rate was 95.2%; during the procedure, seven cases had to be converted to conventional laparotomy. During the study period, the duration of laparoscopic cholecystectomy decreased from 180 to 45 min.

Cholecystectomy↗
PubMed1991

[Surgical therapy of complicated diverticular disease].

From 1975-1989 55 patients were operated on for complicated diverticular disease at our unit. Intraoperative we found the following complications: 21 walled of perforations, 22 stenosis of the sigmoid colon combined with obstruction of the small and/or large bowel, 8 free perforations with generalized, faecal peritonitis, 7 diverticular fistulae (5 colovesical, 1 colojejunal and 1 colocutaneous fistula) and diverticular bleedings. In 33 cases we performed a resection with primary anastomosis (8 times with protecting stoma). 17 times the Hartmann's procedure was carried out and 5 times a transverse colostomy and drainage was elected. Lethality was 20% and morbidity came to 25%. We consider the primary resection with primary anastomosis to be the procedure of choice for complicated diverticulitis except for free perforation with generalized and faecal peritonitis where we prefer the Hartmann's procedure.

Adult↗
PubMed1986

[Should the injured spleen be preserved?].

Splenectomy is primarily followed by reduced defence against infection due to encapsulated bacteria, such as pneumococci. Organ preservation, therefore, has been emphasised in the treatment of traumatic rupture of the spleen, especially when it comes to patients in childhood. There are several practicable approaches to orthotopic preservation of the spleen, including conservative treatment of patients for smallest ruptures under stringent clinical control and, even more, fibrin sealing. Growth in accurate knowledge of the segmental structure of the spleen have enabled partial removal of the organ along the poorly vascularised intersegmental regions. Autologous transplantation of splenic pulp into the major omentum should be considered an alternative to splenectomy alone in strictly selected cases of massive splenic rupture.

Antibody Formation↗
PubMed1986

[Endoscopic treatment of bronchial stump insufficiency with fibrin adhesive in animal experiments].

The bronchial stump insufficiency after lung resection specially after pneumonectomy is known as a dangerous complication. The occlusion of an experimentally produced bronchial stump fistula after pneumonectomy on the left succeeded in all cases (n = 7) by means of a fibrin adhesive. The adhesive was applied in the endoscopic way by a plastic catheter. This method appeared to us as the treatment of choice for the so-called early fistulas. This method was applied successfully in one clinical case.

Adhesives↗
PubMed1985

[Vagotomy for the surgical treatment of severe gastroduodenal hemorrhages].

24 patients (8 female, 16 male) with severe gastroduodenal haemorrhage were treated by vagotomy; in 17 cases highly selective vagotomy was performed, in 3 case truncal vagotomy + pyloroplasty and in 4 patients vagotomy was combined with excision or purse-string suture of the ulcer. Treatment was effective in 23 patients, without recurrence of haemorrhage. In 19 patients vagotomy not only curbed the bleeding but provided definitive therapy (Visick I-II); 4 patients died (mortality rate 16%).

Aged↗
PubMed1985

The treatment of acute necrotizing pancreatitis, using a mediastinoscope postoperatively and antiseptic rinses.

In the years before 1981, the mortality of acute necrotizing pancreatitis was about 70%. By better timing of surgery and intra- as well as postoperative rinsing with povidone-iodine mortality could be lowered to 50%. Leaving the peritoneal cavity open enables easy surgical access to further septic complications. In 10 patients with conservative closure of the abdominal wall five patients died. In seven patients whose abdominal wall was left open and the pancreatic space packed, with the possibility of endoscopic removal of further necroses, only one patient died.

Acute Disease↗
PubMed1984

[Pancreatic duct occlusion. Experimental studies and clinical application].

After Whipple's procedure or pancreatic transplantation complications may be caused by the persistance of the exocrine function. Since 1978 pancreatic duct occlusion with prolamin ("Ethibloc") has been performed occasionally to eliminate the exocrine function. The endocrinological and morphological consequences of pancreatic duct occlusion were studied in 81 piglets. After occlusion there is a sharp rise of the serum-amylase levels, normalizing within 2 to 4 weeks. Up to a follow up of one year the animals remained normoglycemic, proved by measurements of fasting blood glucose, intravenous glucose tolerance and insulin levels. Based on our experimental studies Whipple's procedures combined with pancreatic duct occlusion were performed in seven patients. All patients survived, no pancreatic fistulas could be observed. 12 months postoperatively glucose tolerance tests proved to be normoglycemic in three patients.

Aged↗
PubMed1984

[Importance of x-ray examinations in the diagnosis of ileus].

From 1972-1982 350 operations were performed on 327 patients suffering from ileus. In 315 cases (90%) preoperatively the following X-ray examinations were performed. 315 plain abdominal X-rays (92.7% correct radiological findings), 21 oral gastrografin-passages (95.2%), 52 barium enemas (98.1%). If by all radiological means an exact preoperative diagnosis was possible, the lethality was significantly lower (22%) than in the overall group (33%).

Barium Sulfate↗
PubMed1984

[Transplant conditioning and transplant size in heterotopic autologous spleen transplantation].

In an experimental study we compared two methods of preparing transplants in rabbits (n = 66): 4-5 splenic fragments with a thickness of 1 mm and graduated weight (5-800 mg) were attached onto the peritoneal peritoneum. Splenic homogenates with increasing weight (5-800 mg) were placed in 4-5 preformed pockets in the parietal peritoneum. At different postoperative intervals (maximum 42 days), a relaparotomy was performed. The regenerated splenic tissue was dissected, weighted and histologically examined. We found a linear correlation between pre- and postoperative weight. However, this correlation applies only to the homogenates with a weight of maximal 200 mg and to the fragments with a weight of maximal 300 mg. We have come to the conclusion that homogenates regenerate better than fragments.

Animals↗
PubMed1984

[Single or double layer? A controlled prospective study on the comparison of 2 suture technics in gastrointestinal anastomoses].

In a controlled clinical trial in 165 patients single layer anastomoses (n = 103) were compared to two layer anastomoses (n = 62). All anastomoses were controlled radiologically. The rate of dehiscence was 7.7% (n = 8) for the single layer group, 6.5% (n = 4) for the two layer group. Six patients died, 3 of both groups (2.9%:4.8%). There was no significant difference. However, for gastrectomies and anastomoses of small and large bowel single layer anastomoses seem to be preferable, for partial gastric resection two layer anastomoses. Factors predisposing for anastomotic breakdown are: age beyond 50, colo-rectal anastomoses, protein levels beyond 6 mg%, carcinosis peritonei.

Adult↗
PubMed1983

[Functional diagnosis after anorectal injuries].

Anorectum - rectum and rectosigmoid functions can be separately investigated by employing water-filled probes which have been connected to a pressure transducer. Sphincter ani externus - internus and the puborectal muscle functions particularly well. In cases of injuries to the continent organ preoperative electromanometry clarify the extent of damage. Postoperative examination then enables the evaluation of the success or failure of the reconstruction procedure. Four select cases are presented graphically and in detail illustrating the complexity of the process.

Adult↗
PubMed1982

[Perioperative antibiotic prophylaxis with cefamandole before appendectomy. A prospective randomized double-blind study].

In a prospective randomized double blind study, prophylactic cefamandol therapy was compared to placebos before appendectomy. 25 of 220 patients had to be excluded. The overall infection rate was reduced from 13,1% (1977/78) to 7,6% (1979/80). The infection rate differed in both groups (antibiotic and placebo) only for perforated appendices significantly. If there was a wound infection, the hospital stay of the treatment group was significantly reduced to the placebo group (p less than 0,0005). Predisposing factors for wound infection are leucocytosis greater than 12 000, anamnesis greater than 24 hours, operation time greater than 45 minutes.

Appendectomy↗