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Biomedical subjects

H Pichlmaier

Publications and source records attributed to H Pichlmaier.

At least 91 records · Page 5Linked to original sources
PubMed1990

[Percutaneous transluminal angioplasty of the infrarenal abdominal aorta].

The results of percutaneous transluminal angioplasty (PTA) (n = 13) of the lower abdominal aorta are reported in 12 patients. The mean patient age was relatively low (46 years). In 7 cases there were isolated aortic obstructions (6 stenoses, 1 occlusion). In the remaining 6 aortic stenoses, there were also major atherosclerotic lesions distally. The mean diameter of the aortic section in which PTA was performed, measured 8.2 mm. The total diameter of the PTA balloon(s) averaged 19.1 mm. The arterial gradient dropped significantly from 41.4 mm Hg (mean) to 2 mm Hg after PTA. The arm-ankle index increased significantly from 0.64 to 0.97. The follow-up included 9 patients; 1 showed restenosis 38 month after PTA. There were no clinically relevant complications. The data published on abdominal PTA in atherosclerotic lesions are summarized.

Adult↗
PubMed1990

[Results of surgical treatment of pulmonary metastases].

During the period from 1. 1. 1980-31. 12. 1989 71 patients underwent lung resection for pulmonary metastases. In 21 cases, the primary tumours were sarcoma, in 19 cases carcinoma of the kidney, and 14 cases of melanoma. There were 9 cases of testicular carcinoma, 5 of colorectal carcinoma, and in 1 case each larynx-, oesophagus-, and oral cavity-carcinoma. In 51 patients we could perform an atypical wedge resection, lobectomy was carried out in 19 patients. 1 patient underwent segmental resection. Hospital lethality counted with 0.7%. For all patients, the cumulative survivals revealed an one-year actuarial about 60%, a 3-year actuarial survival of 40%, and a 5-year actuarial survival rate of 38%.

Follow-Up Studies↗
PubMed1989

[Lung injuries].

Even though lungs can be injured solitarily, most of pulmonary lesions occur within the scope of multiple trauma. Because of various patho-physiological processes resulting from the multiple trauma, the valuation of extent, course and prognosis of pulmonary injuries is difficult. Depending on examined cases, mortality of thoracic injuries as stated in various references amounts to between 6 and 55%. Concerning thoracic injuries we dealt with severe traumas of the thorax. This explains the relatively high rate of thoracotomy of 17% as well as the high mortality of 34% we confirmed. Because of described variety of injuries, it is necessary for better comparison of clinical investigations to specify the lesions in accordance with general and specific thoracic severity of injury--as described in the multiple trauma score of the Medical University of Hannover--. Especially pulmonary contusions with associated conspicuous injuries are often primarily underestimated concerning their dimensions and consequences. Therefore the importance of subtle inquiry of pulmonary findings must be strictly underlined.

Humans↗
PubMed1989

[Surgical treatment of early stomach cancer].

At the department of surgery at the university hospital in Cologne 94 patients suffering from early gastric cancer of the stomach were operated in the years between 1968 and 1983. From 1972 till 1987 the department of surgery at the university hospital Mainz has had 74 patients. Survival rates and times without recurrence were calculated dependent on the surgical treatment carried out. In both collectives the prognosis for the patients with mucosal carcinoma was good no matter which operation was carried out. In the case of submucosal infiltration the frequency of recurrence was smaller and the survival rates significantly higher in those patients who subjected to a cancer operation than in those on whom only a resection of two third of the stomach was performed. The results indicate a radical approach in the treatment of early gastric cancer. At least in the case of submucosal carcinoma a dissection of the N2 lymph nodes is advisable.

Female↗
PubMed1989

[Stapler and manual bronchial anastomosis--results of a consecutive trial series].

After lobectomy and pneumonectomy in experimental evaluations stapled bronchial closures showed the lowest incidence of inflammatory reaction and the highest strength determined by leakage pressure compared with other suture material. A total of 233 lung resections-performed at Surgical University Clinic Köln-Lindenthal and the Clinic for General and Abdominal Surgery of the Johannes-Gutenberg-Universität Mainz--were reviewed. Mechanical stapling reduced the rate of bronchopleural fistulas to 2.0% compared with 7.1% after manual suturing. In parallel, mortality related to bronchial stump leakage decreased to 0.7%. Main advantages of bronchial closure with staplers are the simplicity of their use, the speed and the uniformity of the closure. Thereby stapling devices are valuable completions in pulmonary surgery.

Bronchi↗
PubMed1989

[Continued education at a university clinic with integrated specialties].

During a 14 year period 145 medial doctors were employed at the Chirurgische Universitätsklinik Köln 45 became certified general surgeons after a mean of 7.2 years. 18 received a PhD. 4800 operations year permitted the training and qualification of 0.7 doctors for the subspeciality vascular surgery and 0.8 doctors for traumatology per year. Despite extended selection 53 did not accomplish board certification for surgery in the hospital of their initial training.

Curriculum↗
PubMed1989

[Quality of life after thoracic surgery].

Quality of life is difficult to define. The Karnofsky-Index has little contributed to the objective evaluation and self assessment appears to be rather important. A study of 88 patients of which 58 were subjected to thoracic surgery revealed, that quality of life following thoracic surgery is basically dependent on the postoperative physical condition. Following surgery of the esophagus the ability to swallow, after lung resection the respiratory capacity are important for the postoperative well being.

Activities of Daily Living↗
PubMed1989

Results of esophagectomy and gastric bypass for cancer of the esophagus.

Improvements in operative technique and perioperative management have lowered hospital mortality of esophageal resection at our department from 31% to 8% during the past decade. Cumulative 5-year-survival rate depending on the tumor stage only remained unchanged at 21%. Neither extended resection nor perioperative chemo- or radio-therapy show any advantage compared to conventional resection or blunt dissection regarding long-term survival.

Adenocarcinoma↗
PubMed1989

Long-term results of highly selective vagotomy for the treatment of duodenal ulcer.

Between 1971 and 1987, highly selective vagotomy (HSV) was carried out in 984 patients suffering from duodenal ulcer disease. In 97.3% of these cases, the surgical intervention was uncomplicated, the related mortality being 0.3%. During the follow-up period the postoperative condition of the patients was checked once a year wherever possible; in 92.3%, follow-up was continued until december 1987, the maximum period of postoperative follow-up being 16 years. No prognostically reliable indication of the risk of ulcer recurrence was obtained from an analysis of gastric juice. In 79.1% of the cases who underwent surgery, the result was good to satisfactory, while 11.7% had functional complaints such as dumping or diarrhea. The probability of developing a recurrent ulcer within 16 years after the initial operation was 29.7%. This rate of recurrence is determined among other things, by the discovery of clinically quiescent ulcers during the yearly follow-up examinations, when these are performed carefully, and over a sufficiently long period.

Adult↗
PubMed1988

[Surgery of bronchial cancer and demands on radiology].

The most important demand the surgeon can make in respect of the radiologist's work is earliest possible diagnosis of lung cancer. Secondly, the surgeon is always grateful for any pointer leading to diagnosis of the type (and status) of the tumor. This supplies decisive information for both operative planning and perioperative technique. For example, it is essential to know, if x-ray reveals a circular focus, whether this represents tuberculosis of a carcinoma. In case of tuberculosis, drug treatment will be prescribed perioperatively, and the site of operation is limited as much as possible, whereas bronchial carcinoma requires immediate surgery which should be as radical as possible.

Carcinoma, Bronchogenic↗
PubMed1988

[Results of resection of the esophagus in cancer].

Since 1964 245 resections of the esophagus because of cancer were performed at the University Hospital of Cologne. Hospital mortality was 27%. It was reduced to 12.1% during the last 5 years. Surgeon's experience turned out to be of major influence upon hospital mortality whereas tumor and organ related risk factors or kind of the operating procedure didn't influence hospital mortality at all. Five year survival rates that included hospital mortality were 15.5% and were 23.2% without. Patient's late outcome was influenced significantly by tumor staging and histological grading. Radical operating procedure--blunt dissection or transthoracal esophagectomy--were of no prognostic value.

Adenocarcinoma↗
PubMed1987

[Quality assurance in surgery by prospective assessment of the risk of complications by a simple point score].

3654 general surgical interventions were prospectively registered during a 40 month period. Postoperative complications (wound infection, pneumonia, reoperation, mortality) were recorded and were quantified numerically by a complication score which describes the precise number of complications per ten operations. In this way the risk of a single operation can be monitored continuously and quality control programs can do without classification of operations in clean, contaminated and dirty interventions. The length of postoperative hospital stay and the amount of postoperatively applied antibiotics correlated well with the score.

Humans↗