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Biomedical subjects

F P Gall

Publications and source records attributed to F P Gall.

At least 73 records · Page 4Linked to original sources
PubMed1986

[Differential indications of conservative and surgical possibilities of treating splenic rupture].

Conservative therapy of splenic trauma in the adult cannot be recommended, since 2/3 of patients with polytrauma will prove to have additional abdominal organ lacerations. The new methods of local haemostasis, suture and partial resection and their application and contraindications according to Barrett's classification of splenic trauma are discussed. Our own salvage rate has been 50% (70/140) in trauma and 77% (116/151) in iatrogenic lacerations during the past 5 years.

Aprotinin↗
PubMed1986

Early (microinvasive) colorectal carcinoma. Pathology, diagnosis, surgical treatment.

The term early colorectal carcinoma is used for an infiltrating carcinoma with submucosal spread, but no involvement of the muscle coat (muscularis propria). Our experience with 249 such tumours is reported. Lymph node metastases were detected in only 3% of 130 patients subjected to classical surgery. Early colorectal carcinoma represents a cancer stage with an excellent prognosis (age-corrected 10-year survival rate 100%). The survival rates after limited therapeutic procedures (endoscopic polypectomy, local surgical excision, segmental/tubular resection) or after classical radical surgery do not differ significantly provided that certain selection criteria are strictly observed.

Adenocarcinoma↗
PubMed1986

Pancreatic surgery, gastric secretion and ulcers in the rat. Increased ulcer development following pancreatic half resection or duct occlusion.

In the rat, both partial resection of the pancreas and occlusion of the side branches of the biliodigestive duct were investigated with respect to their influence on gastric secretion (acid, pepsin, sodium), gastric mucosal blood flow (MBF), development of gastric ulcers, and gastrin and somatostatin in the blood. On the 14th postoperative day the exocrine pancreatic function is reduced and ulcer index and severity are significantly enhanced. There are no simultaneous changes in gastric secretion or MBF. Aortal gastrin was decreased and somatostatin was unchanged. We conclude that: in the rat, reduction of exocrine pancreatic function should be considered an ulcerogenic factor; factors others than gastric hypersecretion or reduced MBF are responsible for ulcer formation, and an etiological role of either circulating gastrin or somatostatin is doubtful.

Animals↗
PubMed1986

Intravenous glucose tolerance after Whipple's procedure in patients with chronic pancreatitis--relative influence of occlusion of the pancreatic duct.

An intravenous glucose tolerance test was carried out to compare chronic pancreatitis patients (n = 17) who had undergone partial duodenopancreatectomy with (n = 9) and without (n = 8) occlusion of the residual pancreatic duct by Prolamin. The results obtained in 10 healthy volunteers were plotted as background information reflecting the normal metabolic response. Insulin- and C-peptide secretion were greatly decreased after both resection alone, and resection plus occlusion. However, the glucose tolerance (integrated glucose; K-values) appeared relatively well preserved in the two groups. The decrease in insulin appeared more marked after resection plus occlusion as compared with the non-occluded group. It is concluded that partial duodenopancreatectomy without or with ductal occlusion impairs insulin secretion, and leaves tolerance to an intravenous glucose load relatively stable. The mechanism underlying the latter observation is unknown at present.

Adult↗
PubMed1985

[Operative tactics and results in extensive operations for colorectal cancer].

Between 1969 and 1983 a total of 1918 patients with colorectal carcinoma were curatively operated. In 121 of these patients a curative procedure could be achieved despite tumor invasion of adjacent organs by extending the operation to include these involved structures. In 45% of these patients the histological examination revealed that there were only peritumorous inflammatory adhesions while in 55% of the cases a direct tumor invasion of the neighbouring organ was present. The 5-year-survival-rate in the 121 patients was 44%. The operative mortality of 12% (14 out of 121) is included. The final results were considerably worse if the tumor could not be removed en bloc.

Colonic Neoplasms↗
PubMed1985

[Colorectal cancer as surgical emergency].

295 out of 3014 patients (9.8%) treated for colorectal carcinoma between 01/1969 and 12/1983 presented as emergencies. The postoperative mortality rate of 28% was high in the emergency group compared with 6% after elective surgery. The tumor stage was far more advanced with 27% distant metastases. The overall 37% 5-year-survival rate was significantly different from that after elective operations (57%, p.o. deaths not included). Differences were statistically not significant when respective UICC-stages were compared.

Colonic Neoplasms↗
PubMed1985

[Preneoplasias of the large intestine].

The adenoma-carcinoma sequence was related to size, histology and macroscopic appearance in 6770 adenomas. In ulcerative colitis prophylactic proctocolectomy is indicated only when neoplastic dysplasia is documented by repeated biopsies. In adenomatosis coli ileo-rectostomy is followed by rectal cancer at a low rate of 4% only in cases with polypectomy at 6-12 months interval, without this follow-up the risk is increased to 25%. Colectomy, proctomucosectomy, ileoanal anastomosis with a pouch completely eliminates the malignant potency. It is the operation of choice in all cases with diffuse rectal involvement. In 25 cases, operated without mortality and a morbidity of 20%, our preliminary results are promising.

Adenocarcinoma↗
PubMed1985

[Vascular anatomic principles of surgery of the terminal ileum].

The terminal ileum has a reputation for poor vascularisation. In nontumoral lesions a maximum preservation of the terminal ileum and the ileocaecal valve for functional reasons should be aimed at. Therefore we carried out a study on 200 cadavers by preparation of the superior mesenteric artery and the ileocolic artery and their branches. We used the classification of the arrangements of the arteries of the terminal ileum of Chevrel und Guéraud. We found a lower origin of the anastomosis between the superior mesenteric artery and the ileocolic artery in 56%, an upper origin in 44%. A recurrent ileal artery was present in 84%. Surgical applications can be drawn from this study.

Arteries↗
PubMed1985

New aspects in the surgical treatment of gastric carcinoma--a comparative study of 1636 patients operated on between 1969 and 1982.

During the last 15 years in our department, the overall 5-year survival rate in patients with gastric cancer has increased from 20% to 30%. This improvement in prognosis is explained by three factors: (1) the reduction in surgical mortality, (2) an increase in the resectability rate, (3) the introduction of a histology-oriented surgical approach that takes account of the differences in growth behaviour between the intestinal and diffuse types of carcinoma as defined by Laurén. A further new aspect in gastric cancer surgery is the concept of extended lymph node dissection.

Gastrectomy↗
PubMed1984

[Vascular surgery in advanced age. Evaluation of risk based on 317 vascular surgery interventions in patients over 70].

The general caution in the diagnosis of elderly patients needing vascular surgery is not always founded and should remain the right of the surgeon. The selective, reconstructive vascular surgery does not have a considerably higher risk in the elderly. Depending on the localisation the mortality following revascularisation is considerably less with 3,3 to 21,1% than following the amputation of limbs with 42,5%. A further reduction in the rate of complications after reconstruction is possible due to extra-anatomical procedures and early diagnoses before irreversible damage occurs. The possibility of revascularisation should be tested in good time, particularly in elderly persons with disturbed circulation and especially before an amputation.

Aged↗