Biomedical subjects

B Ablassmaier

Publications and source records attributed to B Ablassmaier.

15 recordsLinked to original sources

PubMed2004

[A case of severe gangrenous ischemic colitis following nonsteroidal anti-inflammatory drug intake].

A 48-year-old woman presented with bloody diarrhea, exsiccosis, abdominal pain and fever. A CT-scan showed air inclusions and thickening of the colonic wall. Laparotomy revealed partial necrosis of the colonic wall from the cecum to the rectosigmoid junction. After colectomy with ileorectostomy recovery was uneventful. The histological examination showed erosions, ulcerations, necrosis and some abscesses along the colonic wall which were not typical for ulcerative colitis or Crohn's disease. The patient reported medication with diclofenac for rheumatoid arthritis. The most probable diagnosis was NSAID-induced colitis. That NSAID may cause colitis has often been described in literature, but there have been only few records on nearly total colon necrosis.

Anti-Inflammatory Agents, Non-Steroidal↗

PubMed2003

The influence of adhesion prophylactic substances and taurolidine/heparin on local recurrence and intraperitoneal tumor growth after laparoscopic-assisted bowel resection of colon carcinoma in a rat model.

BACKGROUND: The goal of the study was to investigate the influence of adhesion prophylactic substances (Interceed/lntergel) as well as taurolidine/heparin on intraperitoneal tumor growth and the local recurrence rate after laparoscopic cecum resection in a rat tumor model. METHODS: Sixty BDIX rats were randomized in three therapy groups and one control group. A laparoscopic-assisted cecum resection was performed via three-trocar method after intraperitoneal tumor cell application (10,000 cells) of a colon carcinoma cell line (DHD/K1/TRb) in all animals. According to the randomization, the cecum suture and a 1 x 1-cm peritoneal defect were either covered with Intergel/Interceed or 1 ml of 0.5% taurolidine 10 IU heparin. The control group underwent instillation of 1 ml 0.9% NaCl solution. After 4 weeks the animals were euthanized and intraperitoneal tumor growth, local recurrence rate, and the number of intraperitoneal adhesions were determined. RESULTS: The local recurrence rate was not significantly affected by any of the substances. Nevertheless, taurolidine/heparin significantly reduced the total number and weight of intraperitoneal metastases. The formation of adhesions was not significantly influenced by adhesion prophylaxis substances or by taurolidine/heparin. CONCLUSIONS: Taurolidine/heparin led to a significant reduction of intraperitoneal tumor growth after intraperitoneal application, whereas local tumor recurrence was not significantly influenced. This might be due to the number of injected tumor cells in this cell suspension model. Interceed and Intergel did not reduce intraperitoneal tumor growth. Furthermore, adhesion formation was not reduced by any of the substances.

Adenocarcinoma↗

PubMed2003

[Complication rate after thoracoscopic and conventional lobectomy].

AIM: To determine whether a thoracoscopic lobectomy used for treatment of primary non-small cell lung cancer shows a higher or lower morbidity in comparison to the conventional resection (thoracotomy) postoperatively. METHODOLOGY: 42 patients with the presumption diagnosis of a lung cancer received a thoracoscopic lobectomy (n=28) or a conventional lobectomy (n=14). Postoperative complication rate (30 days) was analysed prospectively. There were no differences between the groups referring to age, co-morbidity, localisation of the tumor and stage. RESULTS: Patients with a conventional operation revealed a significant higher morbidity in comparison to the patients of the thoracoscopic group (50 % vs. 14.2 %, p=0.03). CONCLUSION: The thoracoscopic lobectomy represents a safe operation method and an alternative to the conventional operation (thoracotomy).

Adult↗

PubMed2002

Laparoscopic gastric banding after heart transplantation.

BACKGROUND: Obesity often complicates the postoperative course of heart transplant recipients. Laparoscopic adjustable gastric banding (LAGB) represents a minimal invasive therapeutic possibility for weight reduction in non-transplanted patients. CASE REPORT: We report a 55-year-old diabetic, morbidly obese male (weight 138 kg, height 173 m, BMI 46 kg/m2) in whom 6 years after orthotopic heart transplantation, LAGB and laparoscopic cholecystectomy were successfully performed. At follow-up of 28 months, the patient has lost 32 kg. His present weight is 106 kg (BMI 35.4). Diabetes improved, and oral diabetic medication was withdrawn. Cyclosporine dosage has not had to be changed after LAGB. CONCLUSION: In morbidly obese transplanted patients, LAGB should be considered as an effective alternative to dietetic measures to enable weight reduction and to improve comorbidities. In contrast to bariatric malabsorption techniques, like jejunoileal bypass and gastric bypass, cyclosporine pharmacokinetics do not appear to be influenced by gastric banding.

Bandages↗

PubMed2001

Laparoscopic esophagogastrostomy: an alternative minimally invasive treatment for achalasia stage III.

BACKGROUND: The surgical treatment for stage III achalasia with markedly dilated and sigmoid-shaped esophagus is a matter of controversy. Some authors recommend esophagectomy as the primary treatment because they believe that Heller myotomy cannot improve dysphagia in such cases. We present a patient with achalasia stage III in whom we successfully performed a laparoscopic esophagogastrostomy with posterior semifundoplication. METHODS: Using a five-trocar technique, the esophagogastric junction and the distal esophagus up to the tracheal bifurcation were dissected. An endoscopic stapler (Endo-GIA II) was inserted through a small gastrotomy at the cardia, with one branch placed in the gastric fundus and the other, under esophagoscopic control, in the esophagus. By two consecutive stapler applications, a wide side-to-side esophagogastrostomy was created. To prevent gastroesophageal reflux, a posterior semifundoplication was performed. RESULTS: The operation time was 170 min. Oral food intake was started after radiologic control on postoperative day 7. Radiologic study showed rapid passage of the barium meal and no reflux through the gastroesophageal junction. CONCLUSIONS: Laparoscopic esophagogastrostomy with posterior semifundoplication represents an alternative to esophagectomy and laparoscopic Heller-Dor surgery. Because of the wide side-to-side anastomoses, there is no risk of persisting stenosis such as that reported for the Heller operation, and the procedure certainly is less invasive than esophagectomy. As compared with laparoscopic extramucosal myotomy using anterior Dor fundoplication, it presents about the same technical difficulties.

Aged↗

PubMed2001

[Laparoscopic surgery of the upper gastrointestinal tract].

Laparoscopic surgery of the upper gastrointestinal tract is nowadays associated with little morbidity and mortality. Cardiomyotomy with semifundoplication for management of achalasia and the various forms of fundoplication for treatment of reflux syndrome have proved beneficial and have largely replaced conventional surgery. Independent of the operative approach, it has not yet been established with certainty whether gastroesophageal reflux can best be prevented by 360 degrees fundoplication or semifundoplication. A perforated peptic ulcer can be treated effectively by laparoscopic overstitching of omental patch-plasty, although the superiority of the laparoscopic method has yet to be proved. Benign lesions and early malignancies are currently resected laparoscopically, but the role of laparoscopy in the curative treatment of advanced gastric carcinoma remains to be clarified. Diagnostic laparoscopy is used to avoid unnecessary laparotomy in inoperable cancer and to ascertain whether neoadjuvant therapy is indicated in advanced gastric carcinoma.

Esophageal Diseases↗

PubMed2001

[Intra-gastric penetration of an adjustable gastric band].

Between November 1995 and August 2000 we performed adjustable silicone gastric banding laparoscopically in 252 patients. The body mass index varied from 37 to 86 kg/m2. We report on a 38-year-old woman who was operated on in 1997 with a body mass index of 47 kg/m2 (167 cm, 132 kg). The postoperative follow-up was uneventful until January 2000. The patient lost weight until she weighed 78 kg. Then she complained of diffuse epigastric pain. Gastroscopy revealed gastritis. Omeprazol was prescribed. No amelioration occurred. Endoscopic control showed partial intragastric migration of the band. After laparoscopic removal of the band, the patient was free of symptoms. Band erosion is a possible complication of adjustable gastric banding. As is known from intragastric penetration of the Angelchik prosthesis, the clinical symptoms of this complication may be mild. Since the follow-up of most patients with gastric banding is less than 5 years, more complications similar to that one described may be diagnosed in the future.

Adult↗

PubMed2000

Disaster with a new type of band for gastric banding.

BACKGROUND: Laparoscopic gastric banding has become an established therapy for morbid obesity. Typical complications are band dislocation, pouch dilatation and stomach slippage. A new type of adjustable silicone band with eyes for suture fixation was proposed to avoid these complications. The experience with this new kind of band is reported. METHODS: Between April 1998 and August 1998, 15 morbidly obese patients were treated by laparoscopic adjustable gastric banding using a new band type (manufactured by MEDING, Heinsberg, Germany). The band was fixed by single sutures using the eyes at each side of the buckle. There were 13 women and 2 men, with mean age 34 (range 21-54) years and mean body-weight 138.6 (range 113-213) kg. RESULTS: Intraoperative complications did not occur. Postoperatively 8 patients (53%) had increasing capacity for food intake and 2 (13%) had uncharacteristic abdominal pain. Radiographs revealed band rupture in 13 of 15 patients 3-11 months postoperatively. These patients were operated laparoscopically using a new technique for band change. Now, a Lap-band (BioEnterics, Carpinteria, CA, USA) was inserted and fixed to the ventral stomach with three sutures similar to a ventral fundoplication. Radiographic and clinical follow-up have been uneventful in all patients until now. CONCLUSION: This series demonstrated: 1) the importance of clinical follow-up; 2) a material defect of a new band type; and 3) development of a new laparoscopic technique for band change.

Adult↗

PubMed1997

[Perioperative nutritional therapy and its relevance for postoperative outcome].

The clinical effect of perioperative nutrition was analyzed from 28 controlled clinical trials. Preoperative nutritional support is indicated only in patients with high-grade malnutrition and can reduce the postoperative morbidity and mortality in these patients. If the nutritional status is normal preoperatively, artificial nutrition may influence the postoperative outcome negatively. A clinical benefit from postoperative nutritional support has been proven only in patients not able to eat an adequate oral diet within 1 week. In 20% of these case a cardiopulmonary complication was observed during total parenteral nutrition. The infusion of D5W is sufficient in the majority of surgical patients even after major procedures.

Enteral Nutrition↗

PubMed1996

Laparoscopic Billroth-II gastrectomy.

Although the use of laparoscopic techniques in gastric surgery had become a focus in upper gastrointestinal surgery, standardized procedures have not yet been developed. The purpose of the study was to develop a standardized technique for laparoscopic Billroth-II resection in a cadaver model. End points were intraoperative complications and patency of the gastro jejunostomy. Laparoscopic partial stomach resection was performed in seven cadavers. The specimen was removed through an enlarged trocar incision. The first part of the jejunum was temporarily taken out through the same incision and a side-to-side jejuno-jejunostomy created. The gastrojejunostomy was stapled intracorporally. After surgery, all cadavers underwent autopsy. No lesions of intraabdominal organs were found, and the gastrojejunostomy was patent with correct stapling. No major intraoperative complications were recorded. Using the described technique, a laparoscopic Billroth-II operation can safely be accomplished. The technique has been successfully performed in three patients in the last month.

Aged↗

PubMed1996

[Laparoscopic gastrectomy. A case report].

Although laparoscopic techniques in gastric surgery have become an important part of upper gastrointestinal surgery, they are mainly utilized for organ preserving procedures. A standardized technique for laparoscopic gastrectomy has not yet been described in detail. The purpose of this study was to develop a standardized technique for laparoscopic gastrectomy with reconstruction by a stapled termino-lateral esophago-je-junostomy and Roux-en-Y-anastomosis in a cadaver model. The resected stomach was removed through an enlarged trocar incision. The described technique has been successfully performed in one patient with early gastric cancer.

Adenoma, Villous↗

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↗

PubMed1995

[Laparoscopic surgery of a thoracic stomach].

We report the case of a 54-year-old patient with up-side-down-stomach with recurrent gastric bleeding. Reposition of the stomach, closure of the diaphragmatic opening with interrupted silk sutures, fundophrenicopexy and corpopexy to the anterior abdominal wall was done laparoscopically. Because the patient presented no reflux symptoms, but hypomotility of the oesophagus, no fundoplication was done. To prevent recurrence of the hernia a polypropylene mesh was fixed over the hiatus.

Gastroesophageal Reflux↗

PubMed1994

[100 years after Billroth... Laparoscopic Billroth I and Billroth II distal stomach resection].

In the period October 1993-February 1994, we performed three distal stomach resection operations laparoscopically (two Billroth-II anastomoses, one Billroth-I anastomosis combined with truncal vagotomy). The first patient, 83-year old, presented a stenosing, bleeding, prepyloric, malignant Non-Hodgkin lymphoma. The second patient, 84-year old, presented an ulcerated, non-malignant leiomyoblastoma of the antrum. Due to the histological type of the tumors a radical lymphadenectomy was not performed. The partially resected stomach (two thirds) was removed in a lap sac through a 3.5 cm infraumbilical incision. The third patient presented a persisting, prepyloric ulcer combined with an almost complete stenosis of the pylorus. In all three cases, it was possible to follow the principles of conventional open surgery. The anastomoses were all stapled intracorporally, no intraabdominal complications occurred. However, the first patient died on the 21st postoperative day from cardiopulmonary failure, the remaining two patients were discharged on day 11/day 12 postoperatively.

Aged↗

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↗