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PubMed1990

[The HELLP syndrome--3 case reports with clinically different course].

Three case reports of patients with HELLP-syndrome show how different the clinical courses in HELLP-syndrome may be. A maternal case of death after eclampsia and HELLP-syndrome explains that early diagnosis and immediate therapy are important for success in the treatment of HELLP-syndrome. After delivery--at present the only efficient causal therapy (we recommend a quick cesarean section after making the diagnosis)--an increase of the number of thrombocytes and a normalization of the liver enzymes can be observed within a few days. An intensive co-operation of obstetricians, anesthetists, and pediatricians in the treatment of patients with HELLP-syndrome is necessary.

Adult↗

PubMedDate not supplied

Randomized trial comparing a radially expandable needle system with cutting trocars.

Sharp trocar insertion for laparoscopic procedures carries with it increased risk for vascular and visceral complications and incisional hernia. In a trial, which randomized 87 patients to treatment with either sharp trocars or a radially expanding needle system with blunt dilator, results showed that with the latter system there was statistically improved patient assessment of pain, a lower complications rate, and shorter procedure time. In the group of patients randomized to treatment with conventional trocars, there were a total of six instrument-related adverse events (6/42): four cases (five incidences) of abdominal wall injuries and one small bowel perforation caused by a Veress needle. Of the 45 patients randomized to the blunt dilator/cannula treatment, there was one adverse event (1/45) that was unrelated to the blunt dilator/cannula system: Veress needle injury to abdominal vasculature. The radially expanding access system demonstrates statistically improved patient postoperative comfort and improved patient safety.

Adult↗