Search PubMed⌕ Search

Biomedical subjects

A Pier

Publications and source records attributed to A Pier.

14 recordsLinked to original sources
PubMed1996

Coagulation factor V gene mutation associated with activated protein C resistance leading to recurrent thrombosis, leg ulcers, and lymphedema: successful treatment with intermittent compression.

Activated protein C resistance is the most frequent cause of venous thrombosis. We describe a patient with extensive ulcerations and severe lymphedema of the legs after recurrent thrombosis. Laboratory tests revealed a pathologic activated protein C resistance and a reduced functional protein S. The underlying genetic defect was identified as a heterozygous coagulation factor V mutation. A combined therapeutic approach of intermittent compression, repeated debridements and systemic antibiotics resulted in marked improvement of both lymphedema and leg ulcers.

Anti-Bacterial Agents↗
PubMed1996

["Open" versus laparoscopic appendectomy].

A total of 701 patients operated on with the suspected diagnosis of acute appendicitis were included in a prospective study. Three hundred and nine patients were treated conventionally and 387 laparoscopically. In 14 patients the operation had to be converted. Operating time was 44 min in the laparoscopic group and 54 min in the conventional group. The advantages of the laparoscopic technique were better visualisation of the abdominal cavity, fewer complications, shorter hospital stay and better cosmetic result. Complications occurred in 2.9% of the patients in the laparoscopic group and in 13.6% of the patients in the conventional group. All complications following laparoscopic procedures could be treated laparoscopically.

Acute Disease↗
PubMed1994

[Postlaparoscopic pain syndrome. Results of a prospective, randomized study].

The so-called post-laparoscopic algesia is a specific impairment of about 63% of the patients who undergo laparoscopic surgical operations. This impairment takes the form of mild to moderate shoulder pain. Eliminating the causes of pain has a clear advantage over symptomatic treatment using analgetics, a fact worth a good consideration especially with the post-operative sojourn at the hospital becoming shorter and shorter. In a prospective controlled study, involving 42 patients subdivided into four groups namely, higher or lower insufflation pressures, chemically inert insufflation gas and control groups; the use of analgetics, lung function, operation duration, amount of insufflated gas, intraperitoneal pH-values and post-operative complications in the various subgroups were compared to each other with regard to post-operative pain perception. The results did not show any significant differences among the groups regarding the main parameters like pH-value or different insufflation pressures etc. These results led to the termination of the study based on the raised criteria since we anticipated the actual cause of the shoulder pain to be due to an unknown factor. By the evaluation of the individual data, it became apparent that, the pains increase with increasing gas consumption, a fact which led to assumption that the pains are caused by a physical effect such as the cooling of the peritoneum.

Acid-Base Equilibrium↗
PubMed1994

[Laparoscopic suture and knot techniques].

Laparoscopic suture and knot techniques are not yet considered standard laparoscopic procedures. In conventional surgery, it would be unthinkable that a procedure would be attempted without a good working knowledge of suture and knot techniques. In laparoscopic operations, limited mobility, the lever arm through the instruments and especially the conversion of 2D vision to 3D actions and the lack of a direct tactile sense all have limiting effect. The needle holders available leave room for improvement. The initially protracted operating times become shorter with training and a period of adjustment.

Humans↗
PubMed1991

Laparoscopic appendectomy in 625 cases: from innovation to routine.

Invented in 1982 by Semm, a gynecologist, laparoscopic appendectomy began to be used in operative surgery in 1987. Since then, we have modified and performed this promising procedure in > 700 patients. The data of the first 625 cases indicate that laparoscopic appendectomy is safe and practicable. With regard to patient age as well as the acuteness of the inflammation, the patients represent a cross section of the normal appendicitis population. The major benefits and possible problems of the method are presented and discussed.

Adolescent↗
PubMed1991

[Technique in laparoscopic cholecystectomy. Experiences and results in 200 interventions].

This study provides the data and experience of 200 laparoscopic cholecystectomies. The stenosis of the bile duct caused by a ligature in one patient and aberration of the bile duct in two patients led to remarkable intraoperative complications. The average operation time as well as postoperative recovery periods emphasize the importance of laparoscopic cholecystectomy as a relevant alternative to the traditional approach.

Adolescent↗
PubMed1991

[Laser-assisted laparoscopic appendectomy].

Our constantly good experience with approximately 300 laparoscopic appendectomies (almost 520 at present (Feb. 90)) encouraged us in 1988 to introduce Laser technology into laparoscopic abdominal surgery. 22 patients underwent Laser-aided laparoscopic appendectomy. We obtained good results by means of using both an CO2-Laser and a Nd-YAG-Laser.

Adolescent↗
PubMed1991

[Laparoscopic placement of T-drainage in choledocholithiasis].

This case report illustrates the feasibility of bile duct revision and T-tube insertion by laparoscopic approach. The procedure largely employs the traditional action. Laparoscopy demands more skill, particularly regarding the suture of the common bile duct, but does not interfere its realisation.

Adult↗
PubMed1990

Modified laparoscopic appendectomy in surgery. A report on 388 operations.

Laparoscopic appendectomy, introduced in gynecology by Semm in 1982, has been modified and practiced in our surgical ward since May 1987 in more than 450 patients suffering from all stages of acute and chronic vermix diseases. We report our data on the first series of 388 operations, in which we had the encouraging experience that laparoscopic appendectomy is a practicable and reasonable alternative to routine surgery.

Acute Disease↗
PubMed1990

[Laparoscopic appendectomy--alternative therapy in all stages of appendicitis?].

1989 we reported on our first series of 277 laparoscopic appendectomies. This technique was introduced by Semm in 1982. We acquired this procedure in 1987 and modified this operation-technique for surgical routine. We could demonstrate that laparoscopic appendectomy can be performed in chronic, acute and even in peracute cases. We introduce the facts of 500 laparoscopic appendectomies.

Appendectomy↗
PubMedDate not supplied

Laparoscopic appendectomy.

Appendectomy was performed using a laparoscopic approach in 915 patients. The collected data show that the technique is as feasible, rapid, and safe as open surgery. Few wound infections, minimal pain, and rapid postoperative mobilization are the main arguments in favor of laparoscopic appendectomy. The most important potential benefit, a lower incidence of long-term complications such as adhesive intestinal obstruction, remains to be confirmed by prolonged follow-up of our patients.

Adolescent↗