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E Deltz

Publications and source records attributed to E Deltz.

At least 19 recordsLinked to original sources

[Minimally invasive video-assisted thyroid resection (MIVAT)--a well accepted operative procedure].

INTRODUCTION: We report on our results of MIVAT operations. METHOD: Nineteen Patients including 15 females and 4 males were operated with MIVAT, corresponding to 11 % of all patients undergoing an operation for benign goitre in our hospital. A single node of the thyroid gland within 30 mm and enlargement of a thyroid lobe up to 25 ml were the selection criteria. The median age was 34 years (range 16-61). We performed 2 thyroidectomies, 6 Hartley-Dunhill resections, 9 hemihyroidectomies and 2 enucleations. Eighteen patients (95 %) were followed-up postoperatively. The median follow-up period was 8 months (range 1 -21). RESULTS: The median operation time was 83 min (range 60-124). The median preoperative thyroid gland volume was 25 ml (range 10-54) measured by ultrasound. The resected thyroid tissue ranged from 12 to 51 g (median 29 g). A statistical significant difference (P = 0.04 paired t-test) between the preoperative and postoperative estimated serum-calcium levels (2.31 vs. 2.25 mM) was observed. But both parameters were inside the physiological range. Paresis of the recurrent laryngeal nerve was not observed. 89 % of the patients rated the postoperative cosmetic result as very good and all patients would prefer this operation procedure once again. CONCLUSION: The MIVAT procedure is a safe operation also in small groups with excellent cosmetic results postoperatively and a high acceptance by the patients.

Adolescent↗

Meckel's diverticulum: a disease associated with a colored clinical picture.

Meckel's diverticulum is reported in only 1 or 2% of the population. In most cases, it is free of clinical symptoms. The diagnostic modalities are effective in only 60-70% of all cases. The diagnostic laparoscopy is a safe and effective method for patients suffering from unclear abdominal pain with the option of a definitive surgical therapy. We describe the case of a 10-year-old girl with recurrent abdominal pain caused by a chronic subileus due to a Meckel's diverticulum in combination with a fibrous cord from the base of diverticulum to the mesenterial root. Both were resected in a laparoscopic technique.

Abdominal Pain↗

[A rare case of a primary intrabronchial neurofibroma].

HISTORY AND CLINICAL FINDINGS: A 42-year-old woman, a smoker for many years, had suffered from dry cough for some time. She was admitted because of haemoptyses, the first one month previously. Physical examination was unremarkable. INVESTIGATIONS: Chest radiography in two planes showed no abnormality. Computed tomography revealed a space-occupying lesion adjacent to the right main bronchus, strongly suspicious of a central bronchial carcinoma. Bronchoscopy showed a smoothly circumscribed tumour in the upper lobe bronchus which almost occluded its lumen. Multiple biopsies failed to establish the benignity/malignity of the tumour. TREATMENT AND COURSE: The tumour was removed by upper lobe resection. There was no macroscopic intraoperative evidence of infiltration. Histology provided the surprising diagnosis of a benign neurofibroma. CONCLUSION: Thoracotomy should, if at all possible, be performed whenever biopsy of a pulmonary mass fails to establish its benignity. Intrapulmonary neurofibroma is very rare, unless it is part of v. Recklinghausen's disease.

Adult↗

[Distribution of immunocompetent cells small intestine transplantation in rats].

Heterotopic small bowel transplantation was performed in allogeneic rats with and without cyclosporine. Syngeneic animals served as controls. Small bowel allografts, lymphoid tissues and small bowel of the host were investigated by immunohistochemistry using antibodies against T-cells and macrophages. During rejection, increasing numbers of macrophages infiltrated preferentially the deep layers of the small bowel wall, whereas only a slight T-cell infiltration was observed. No histological changes were noted in the organs of the host. Cyclosporine prevented lymphoid as well as macrophage infiltration of the transplant. Rejection monitoring of small bowel transplants is possible by investigation of macrophage infiltration in deep biopsies including the submucosa.

Animals↗

[Small intestine transplantation--a causal therapy in short bowel syndrome].

The problems of surgical technique, graft physiology and immunological reactions in small-bowel transplantation have been investigated in extended animal experiments. In these experiments, the fundamentals of a successful clinical application of small-bowel transplantation could be laid. A successful human small-bowel transplantation could be carried out by the Kiel Group for the first time in 1988. A graft which had been removed from a related donor showed a complete adaptation after 22 months, so that the patient became completely independent from parenteral nutrition. After that, in several cases small-bowel and combined liver and small-bowel transplantation have been carried out. Thus, the clinical small-bowel transplantation represents the causal therapy of short-bowel syndrome and should be developed in further clinical trials.

Adult↗

Small bowel transplantation.

Small intestinal transplantation has had several clinical attempts based on extensive experimental work during the past two decades. Several models, such as auxiliary (heterotopic) or orthotopic models, have been developed in regard to problems with graft immunology and function. The question of mesenteric-portal or mesenteric-caval graft drainage was raised, and the answer seems to be open. Concerning lipid absorption, interest was directed to the reconstitution of lymphatic vessels, because orally administered cyclosporine A is absorbed by the lipid mechanism. Carbohydrate digestion and absorption are used for determination of graft function and for monitoring graft rejection. This article summarizes these problems and deals with the surgical procedure of small bowel transplantation in the rat.

Anastomosis, Surgical↗