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Biomedical subjects

H E Wagner

Publications and source records attributed to H E Wagner.

64 records · Page 4Linked to original sources
PubMed1986

[Acute compartment syndrome following snake bite].

The experience with snake bites, causing local complications is discussed. Whenever systemic envenomation occurs, antivenin is the treatment of choice. Tissue necroses are treated by early debridement and a possible closed compartment syndrome demands the open fasciotomy.

Acute Disease↗
PubMed1985

[Colorectal carcinoma in persons under 40 years of age].

A retrospective review of 30 patients under 40 years of age with colorectal cancer is described. Sex ratio was almost equal. The presenting symptoms depended on the localisation of the tumor, and the length of the clinical history averaged 18 weeks. No correlation was found between duration of symptoms and prognosis. 26 patients were operated on electively. In 3 patients the tumor was found by chance and one case presented with intestinal obstruction. Left-sided tumor location was found in 73%. Patients with right-sided tumors had a slightly better prognosis (p = NS). Radical surgery was performed in 20 patients (67%). The operative mortality was 0%. Localized cancer was found in 12 patients, and 18 patients had lymph nodes or distant metastasis. 11 patients (37%) have survived 5 years or more. It is concluded that colorectal cancer in patients under 40 differs in no respect from the disease in older patients.

Adult↗
PubMedDate not supplied

Swiss health care delivery system: impact of financial restrictions on surgical education.

In 1990 Swiss health care expenditures totaled 26.3 billion Swiss francs, corresponding to 7.8% of the gross national product. Over the last 5 years expenditures have increased by 43.1%. Given the economic and political realities, future endeavors must be directed at stemming escalating costs. As 51.5% of health care resources are spent on hospital care, a substantial portion of financial restrictions and reorganization have been directed at this sector. These restrictions on hospital care have a direct impact on surgical practice and education. The resulting concentration of manpower and resources demand a new definition of the role of the general surgeon within the revised hospital system. In the face of a dilution of experience and knowledge due to an increasing number of specialized surgeons, the role of the general surgeon who provides basic surgical care must be redefined. These new trends must also be integrated into future training programs. The introduction of a structured surgical curriculum can limit the number of surgical trainees and maintain a high standard of quality.

Delivery of Health Care↗
PubMedDate not supplied

Pre-, intra- and postoperative staging of gastric carcinoma and clinical outcome.

BACKGROUND: We compared preoperative (combined clinical and radiological staging and endoscopical Borrmann classification), intraoperative (by the surgeon: curative/palliative; R0/R1/R2-resection; intraoperative stage I to IV) and postoperative staging including histological results (pTNM) in respect of resectability and prognosis. METHODS: All patients with adenocarcinoma of the stomach were prospectively and consecutively included in the study protocol and were staged during the hospitalisation by the different specialists. Out of 215 patients with malignant tumors of the stomach, 153 were finally evaluated for the study. We excluded 62 patients with other malignancies or with a follow up of less than 6 months. Preoperative endoscopic Borrmann classification was done by the gastroenterologist, preoperative TNM-classification by the radiologist and surgeon, intraoperative classification by the surgeon and postoperative classification by the pathologist. All results were immediately described in the protocol. Follow-up and survival curves were performed by the Regional Tumor Registry and statistics by the Statistical Department of the University using Kaplan-Meier survival curves and Log-Rank and Wilcoxon Test for significance. RESULTS: Preoperative staging was unreliable and there was no relationship between preoperative and postoperative staging nor survival. In opposite intra- and postoperative staging correlated significantly between the different groups and with survival (p < 0.001). CONCLUSIONS: As long as preoperative staging systems are not improved (which may be in the future the case with endosonography), all operable patients with gastric carcinoma should undergo a laparotomy or laparoscopy, because only intraoperative evaluation of the surgeon allows a decision on a possible curative resection. Patients with stages I-III should be resected radically with complete dissection of lymph node compartments 1 and 2. This policy is justified especially in view of a minimal hospital mortality (3%).

Adenocarcinoma↗