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Biomedical subjects

A Tuchmann

Publications and source records attributed to A Tuchmann.

45 records · Page 3Linked to original sources
PubMed1978

[Intraoperative biliary tract injuries].

Twelve iatrogene bile duct injuries are reported. Eleven occurred in operations of the bile system, and one in a gastric resection (B II). The injury should be diagnosed immediately, especially by intraoperative cholangiography. Operative treatment is discussed. Eleven patients survived, one died of pulmonary embolism (operative mortality, 8,3%). One patient had to be reoperated because of stenosis of the common bile duct. Choledochoduodenostomy was performed. The follow-up of 11 patients showed good results without any recurrence of jaundice or pain.

Adult↗
PubMed1978

[Pseudomyxoma of the peritoneum (author's transl)].

A case report is given of a peritoneal pseudomyxoma originating from pseudomucineous cystadenomata of both ovaries. The diagnosis was established by peritoneoscopy and histological examination. Both ovaries were removed surgically and cytostatic treatment initiated thereafter; hyperthermic peritoneal perfusion was done as well. The patient lives after surgery now for more than a year without recurrence of the disease.

Ascites↗
PubMed1978

[Significance of ulnar ligament injuries in typical radius fractures].

In 20 patients with COLLES' fractures, stress-films of the wrist demonstrated that without fracture of the ulnar styloid ruptures of the ulnar ligaments are possible, and lead to increased radial abduction of the carpus. This instability together with interposition of the ruptured soft tissue produces a tendency to radial subluxation of the hand, in spite of good alignment of the fragments. In conclusion, we suggest that in younger patients closed reduction should be stabilized by means of percutaneous Kirschner-wires and that the interposed soft tissue should be excised.

Colles' Fracture↗
PubMed1976

[Mechanical ileus (author's transl)].

UNLABELLED: 181 patients with mechanical bowel obstruction were treated between 1965 and 1974 at the First Surgical Clinic of the University of Vienna. 172 were operated, 7 had conservative treatment. RESULTS: 1. the mortality was 24,3% and infavorably influenced by a) advanced malignant tumors, b) age over 60 years, c) preexistent peritonitis. -2. Enterotomy for bowel-decompression was in no case followed by a complication.- 3. Nobles operation should be performed only totally and in cases of severe adhaesions. 4. Discussion of the one stage operation in large bowel obstruction, which is only indicated in patients with good general condition. The high letality of 47% after operations in cases with ileus due to carcinosis peritonei requires critical indications for these operations.

Aged↗
PubMedDate not supplied

Stapling devices in gastrointestinal surgery.

In a series of 189 patients, 197 operations (251 stapled anastomoses) were performed. U.S. Surgical Corporation instruments (GIA n = 156, EEA n = 36, TA n = 59) were used in surgery of the stomach, pancreas, small and large bowel, and the rates of complications were investigated. The EEA gave 14% complications because of the frequent failure (33%) of the anastomosis after low anterior resection. The reasons for failure were incomplete rings, colonic wall damage and too short rectal stumps. The use of the EEA in esophago-jejunostomy and esophago-gastrostomy was safe and the postoperative course uneventful. The GIA was used in intestinal and colonic surgery and was pleasant and quick to use (right hemicolectomy: 1 hour 40 minutes; sigmoid resection: 1 hour 45 minutes). Complications occurred in the intestine (6%) and colon (7%). Only with GIA stapled anastomoses was there a risk of hemorrhage (2.5%). The incidence of anastomotic leakage (all staplers) was 3.6%; the stapler was responsible for a 2.0% mortality. Weighing up the indications and contraindications of stapling devices, this method presents an advantageous but not indispensable method in gastrointestinal surgery.

Adult↗
PubMedDate not supplied

Polydioxanone in vascular surgery. First experience with an absorbable suture in femoro-popliteal bypass.

The use of synthetic absorbable monofilament suture material (polydioxanone, PDS), is described for operative vascular surgery. Six anastomoses in three femoro-popliteal (tibial) vein bypass operations were performed. Angiographical control was carried out, when absorption was in progress (after a period of five months) or totally completed (within six months), and showed no dilatation or aneurysm formation at the suture line. One anastomosis was excised five months after the first intervention. Histological examination showed fragmented suture material and slight tissue reaction. Suture material characteristics in respect of tensile strength, pliability, knotting properties and visibility were judged critically.

Aged↗