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Biomedical subjects

A Thiede

Publications and source records attributed to A Thiede.

At least 217 records · Page 12Linked to original sources
PubMed1993

[Enteral anastomoses in the area of the upper gastrointestinal tract with the biofragmentable anastomosis ring].

In a prospective study, 184 enteral anastomoses in the upper G1-tract using the biofragmentable anastomosis ring (BAR) Valtrac are described in 136 patients. 43 patients had 2 or 3 BAR in upper GIT, 4 patients one BAR in upper and one BAR in lower GIT and 1 patient had 2 BAR in lower GIT. 152 small bowel-small bowel anastomoses, 23 gastroenterostomies, 2 small bowel-colon and 6 colon anastomoses were created. One insufficiency was seen in a small bowel to small bowel anastomoses and one in a gastroenterostomy. One bleeding occurred in the anastomotic region of a gastroenterostomy. Even in cases of multiple use of the BAR no stenoses occurred. The use of these rings can be recommended beside in colon and small bowel to colon anastomoses also in upper GIT.

Adult↗
PubMed1993

[Healing of the anastomosis in various suture techniques in the gastrointestinal tract. Physiology, experimental and clinical results].

New and further development of anastomoses induce new orientation for selection and indication of the several suture procedures in the gastrointestinal tract. Based on the wound healing principles, the different techniques are evaluated experimentally and in clinical tests. The results allow to discriminate indications for the different suture techniques. For the gastrointestinal tract the technique of choice is the serosubmucous single row suture with an absorbable 4.0 monofilament. For the esophagus and rectum, the stapled anastomosis offers more safety and better practicability than manual sutures. Studies have shown comparable results in colonic surgery for compression ring anastomoses. Additional procedures are of minor importance for the safety of anastomoses.

Anastomosis, Surgical↗
PubMed1993

[Experiences with laparoscopic technique in anti-reflux surgery].

The introduction of the laparoscopic techniques in antireflux surgery has created hopes for an improvement in the patients' outcome. Initial experience with minimally invasive procedures show that the application in antireflux surgery is possible without major problems. However, the functional result of antireflux surgery rather depends more on a differentiated indication for operation and an operative procedure designed to remove or compensate the underlying pathophysiologic functional defect. The method of access is of lesser priority. The promising results of this series may encourage to continue the demonstrated protocol and operative technique. However, generalized application of laparoscopic antireflux surgery should not be performed until further data of its advantages are available.

Adult↗
PubMed1992

[Laparoscopic cholecystectomy--what is the value of laparoscopic technique in "difficult" cases?].

This prospective study with an external control group of patients investigates the technical aspects of laparoscopic cholecystectomy in patients with difficult intraabdominal situations as well as the postoperative quality of life of these persons. Difficult concomitant circumstances were defined when those patients had multiple adhesions after previous abdominal surgery in the middle and upper quadrants, acute cholecystitis, and severe obesity. 100 patients after classic cholecystectomy represented the external control group. 170 patients were followed after laparoscopic cholecystectomy. Endpoints of investigation were duration of operation, complications, postoperative hospitalization, and postoperative quality of life. Major complications occurred in 1.2%. Although in patients after laparoscopy minor complications were registered at a higher incidence than in classic cholecystectomy, the patients' postoperative quality of life improved significantly faster after laparoscopy in all patients groups. These results show that even patients with severe adhesions, with acute cholecystitis and with prolonged duration of operation still profit from the laparoscopic technique in comparison to laparotomy.

Adolescent↗
PubMed1991

[Enteral anastomosis with the biofragmentable Valtrac ring. A prospective study].

In a prospective study, 150 enteral anastomoses using the new Valtrac biofragmentable anastomosis ring (BAR) are described. The manipulation involved was simple to learn and standardised intestinal anastomoses could be created at various bowel segments. No stenoses or postoperative bleeding occurred, the suture dehiscence rate was low. The use of these rings can be recommended to achieve a high level of standardisation for colon anastomoses and small bowel-colon anastomoses without restriction, whereas for other localisations the number of cases is too small to allow a final assessment to be made.

Anastomosis, Surgical↗
PubMed1990

Development and perspectives of experimental pancreas transplantation in the rat.

Whole organ pancreas transplantation in the rat was first described by Sun Lee in 1972. Since that time the basic technique has been modified in several ways and this model can now be used for a variety of experiments. Various techniques for transplantation and representative results of functional and immunological experiments are summarized.

Animals↗
PubMed1990

[Experimental animal studies of the stability of colon anastomoses after supplementary fibrin glue sealing].

Sutures of the colon can be insufficient or leaking. This leads in some cases to a peritonitis or sepsis sometimes with lethal outcome. Therefore experiments in animals were performed to investigate the effect of additional applied biogenic glue. Especially in the beginning of the wound healing, at the 4th postoperative day, the firmness could be improved by fibrin glue. The bursting pressure of fibrin glue sealed colon sutures was 94 mmHg, whereas only 66 mmHg was observed in the control group. This additional firmness remains over the whole observation time of 3 weeks. An intensified proliferation of the connective tissue is responsible for this observation which could be substantiated by histological investigations and by measuring the thickness of the scar. If biogenic glue is used in animals it can have the consequence that the recipient reacts with the production of antibodies, since the components of the glue are proteins from different species. Investigations of the serum of animals which had been treated with fibrin glue revealed in a part of them precipitating antibodies against fibrinogen. With regard to this observation a second application of biogenic glue must be done with the necessary precaution.

Anastomosis, Surgical↗
PubMed1989

[Technical prerequisites for performing controlled studies with the goal: postoperative quality of life after gastrectomy].

A study of 78 cases of gastrectomy in which two reconstruction procedures Roux-en-Y + pouch and interposition + pouch were compared and which is still in progress, yielded the following results: 1. It is possible to use both methods only with staplers and have few complications in a time-saving procedure. 2. A Roux-en-Y + pouch takes mean = 50 min; an interposition + pouch requires mean = 90 min (net time of reconstruction). 3. It is sometimes impossible for anatomical reasons to use an interposition + pouch. 4. The more complex procedure--the interposition + pouch--does not have a higher rate of complications. 5. Technical development permits controlled studies investigating the long-term target: quality of life.

Anastomosis, Roux-en-Y↗
PubMed1989

[Tricks, errors and dangers in use of staplers in the colorectal area].

Ten years' experience of performing 970 operations in which circular colorectal anastomoses were stapled chiefly in the lower two-thirds of the rectum according to the open standard method is reviewed. The deeper the anastomosis and the narrower the pelvis, the higher the rate of complications, especially leakages. This is not only due to pathological, anatomical reasons or technical difficulties, but also to inappropriate application and handling of the staplers. Accurate diagnosis and a systematic procedure after sufficient training can reduce this rate. A precise analysis of the mistakes and risks resulted in a number of standard techniques and tricks which perfect the use of this technology.

Anastomosis, Surgical↗
PubMed1989

[Value of ambulatory clinic-associated stoma therapy, analysis of expenses, success and cost effectiveness from the public economic viewpoint].

A pilot project providing ambulant, hospital-associated stoma care for the affected patients both in the hospital and at home has been in progress in the Kiel/Neumünster area since 1982. An evaluation of the stoma therapist's activities in 1988 and a survey in 1989 demonstrated that patients and family physicians are increasingly accepting the project. Besides a markedly better quality of life, a cautious cost analysis is proved that more than DM 200,000 can be saved annually by avoiding hospitalization and adapting the care system to the needs of the patients.

Ambulatory Care↗
PubMed1989

[Perineal resection of rectal prolapse in risk patients].

A method for perineal resection of rectal prolapse in high-risk patients which uses a circular stapling device was evaluated. After the external rectal layer was dissected 2 cm above the dentate line, the sigmoid colon was mobilized distally as far as possible. An anastomosis was then performed with the stapler under gentle tension on the sigmoid colon. None of the eight patients died; mucosal prolapse recurred in one patient. Continence was improved in six of the eight patients.

Colon, Sigmoid↗