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Biomedical subjects

B Ulrich

Publications and source records attributed to B Ulrich.

At least 73 records · Page 4Linked to original sources
PubMed1984

[Results of stomach pull-through operations without thoracotomy in the treatment of advanced esophageal cancer].

Between 1960 and 1983 we have seen 525 cases of oesophagus carcinoma at the Surgical Dept. of the University of Düsseldorf. Up to 1980 we performed the thoraco-abdominal approach with a resection rate of 30%. After that we performed blind dissection of the oesophagus using the abdominal approach only and the resection rate increased to 75%. This last group of patients was treated preoperatively with 3000 R. In spite of very late cancer stages our operative mortality rate decreased considerably and the 2 year survival rate improved. We believe our method to be a standard one because there is a very bad long-term prognosis of the condition.

Adult↗
PubMed1983

[Technic for implantation of the Oreopoulos-Zellerman catheter in peritoneal dialysis].

The continuous ambulatory peritoneal dialysis is a routine measurement under certain circumstances in nephrological units, which is preferentially performed in patients who cannot be adapted to haemodialysis. Certain risks are inherent in this method. They are dependent on the patient himself as well as on measurement used. Typical complications are canalicular infections along the catheter loop, intra- and extraabdominal dislocations of the catheter tube, abdominal wall leaking and the CAPD-peritonitis. Our own patients are analyzed according to this aspect; the value of a standardized technique of implantation of the Oreopoulos-Zellermann-Catheter is described with regard to the reduction of surgical risks.

Catheterization↗
PubMed1982

[Diagnosis and therapy of colorectal polyps with special reference to adenomas].

Colo-rectal adenoms occur more frequently in the elderly and should be considered as precancerous. The structural changes of the glandular epithelium are known as dysplasia or atypia and are classified into three grades of severity; the "severe epithelial dysplasia" has all the histological characteristics of a malignant tumor which however has not infiltrated the muscularis mucosa and so has not gained access to the lymphatic system. Whenever these structural changes were present the terms focal carcinoma or carcinoma in situ were used. However in 1976 the WHO accepted to change the nomenclature to "severe epithelial dysplasia", as Morson had proposed. Their aim was to avoid superfluous radical surgical intervention. Whenever severe dysplasia is present in an adenoma, the necessary therapy is the local excision of the adenoma together with its pedick. An exact complete histological examination is necessary. Between 1976 and 1980 we saw 201 cases of adenoma of the colon or rectum at the Surgical Clinic, University of Düsseldorf. 27 of these cases showed severe epithelial dysplasia. As described in the literature there was a correlation between the size of the adenoma, the histological picture and the risk of malignancy. The reexamination of 105 patients showed that there was a significant percentage of recurrency at the site of excision or new polyps at a different site. Therefore, regular checkups are a must for all those patients in whom polyps of the large bowel have been removed.

Adenoma↗
PubMed1981

[Hiatal hernia--reflux disease. Indications for surgery and initial results of a new treatment method].

Indications for the operative treatment of hiatus hernia with reflux oesophagitis are grade III and IV reflux oesophagitis; if the total acid period equals or exceeds 1.3% of the time of the period of time during which the patient was in supine position (pH-examination); if acid clearance lasts 2.86 min or more after a single reflux period; if radioisotopic counts over the sternal region exceed 3.5--4% of those obtained over the stomach area. Since 1977 we performed a new anti-reflux-operation, which we call "Teres-plasty"in 42 patients with axial hiatus hernia. The procedure is a modified gastropexy by using the ligamentum teres. First results seem to prove that this method can avoid reflux without postoperative syndromes as gas bloat syndrome and dysphagia, which are known to occur after fundoplication.

Adult↗
PubMed1981

[Mechanical sutures in esophageal surgery (author's transl)].

Hospital lethality in patients with esophagoenteral anastomosis is high: in carcinoma of the esophagus, it is about 30%; in total gastrectomy for carcinoma, it is 43.6%. In both cases, sutureline insufficiency is responsible for more than 43%. As our results indicate, anastomosis with the EEA is the fastest and most secure in all esophagoenteral junctions if it is secured by invagination or covered by serosa. This is shown by our results in patients with carcinoma of the esophagus and stomach, as well as in dissecting procedures in patients with esophagus varices.

Esophageal Neoplasms↗
PubMed1981

[Stapling devices on stomach and small bowel (author's transl)].

Sutures, blind closures, and anstomoses can be performed on the stomach and the small bowel with LDS, GIA, TA, and EEA staplers. The advantage of using these devices is a fast, clean operation, with safety comparable to the conventional technique. Leakage in sutures and anastomoses occur in 1% and after duodenal closure in 2.6%. Bleeding has been observed with the GIA and LDS staplers (0.7%-1%). Mortality is equal to the conventional technique. The time saved during operations and fewer infections justify the elevated costs of the stapling devices.

Duodenum↗
PubMed1980

[Surgery of esophageal cancer].

In the last 12 months 40 patients underwent surgery for carcinoma of the esophagus. In 18 cases the tumor was located in the lower third of the esophagus. An abdomino-thoracic approach was employed and a 2/3 resection of the esophagus and an esophagogastrostomy were performed. The resected area was bridged by an isoperistaltic gastric tissue tube and anastomosis was carried out using the EEA stapler. A telescope antirefluxplasty was performed to protect the anastomosis and to prevent a gastroesophageal reflux. One patient died of pneumonia. In all cases a secure anastomosis was achieved and in most cases gastroesophageal reflux was prevented.

Esophageal Neoplasms↗