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Biomedical subjects

H Pichlmaier

Publications and source records attributed to H Pichlmaier.

At least 127 records · Page 7Linked to original sources
PubMed1985

[Transanal endoscopic microsurgery].

A new endoscopic surgical method was developed for removal of large sessile adenomas of the rectum and lower sigmoid. Stereoscopic sight and magnifying glasses do allow precise surgery of these tumors. If adenomas are present they can be removed using the technique of mucosa excision; if on the other hand rectum carcinomas have to be removed the complete wall of the rectum in an appropriate extension can be excised. Hemorrhages which occur during preparation always can be stopped by diathermy. The surgical intervention is terminated by a transverse continuous suture of the defect. 33 patients were operated upon in this way from July 1983 to April 1985. Areas with an diameter of up to 10 cm could be removed, even located up to 18 cm in the colon. Suturing of the defect could always be performed without problem. In 1 patient a relapse occurred.

Humans↗
PubMed1984

[Use and limits of preventive antilymphocyte globulin therapy following kidney transplantation. A prospective randomized study].

The influence of prophylactic ALG treatment immediately after transplantation on the results of renal transplantation was examined in a prospectively randomized trial (n = 94). An improved graft survival rate was found after 9 months (ALG group 72.3%, control group 59.6%) which, however, was associated with an increased risk of infections. The increased infection rate was due to the duration of the ALG treatment which was too long in this study (21 days). Prophylaxis should rather be finished after 14 days. The immediate renal function after transplantation was significantly improved in the ALG group. Therefore, it is suggested to give ALG directly after transplantation until normalization of renal function and to change over to cyclosporin afterward.

Antilymphocyte Serum↗
PubMed1984

Energy metabolism and histomorphological findings in replanted rat hind limbs using various conservation methods.

Using various storage and conservation methods, we examined amputated and subsequently replanted limbs for their ischaemia tolerance level by investigating the changes in the adenylphosphocreatine system and glycolysis cycle. After replantation, amputated limbs that had been stored at room temperature (21.0 +/- 1.5 degrees C) for 2 hours were examined 14 days after operation. The adenosine triphosphate level of the skeletal muscle was reduced to 51% and the creatine phosphate to 77% of that of the control group. The glycogen was 13% of the normal value. The biochemical findings correlate with the histomorphological findings. After 2 hours ischaemia, the cross striations of the skeletal muscle and nuclear staining remained intact. There is a breakdown of the biochemical systems after 4 hours of ischaemia. They are no longer intact and the ischaemic limb does not recover. Histologically, muscle necrosis can be observed.

Adenosine Triphosphate↗
PubMed1984

[Blood vessel wall regeneration in the use of a new monofilament, resorbable suture material for arterial anastomoses].

A new synthetic, absorbable suture has been tested on 15 mongrel dogs. A total of 132 simple end-to-end anastomoses has been performed in common carotid, iliac and femoral arteries and the aorta abdominalis with monofilament, absorbable polydioxanon. Aneurysms or infections did not occur. The patency rate up to 250 days was 98.5%. All vessels were studied by angiography and light- or electron-microscopy. The new monofilament suture material is characterized by extended absorption time and low foreign body reaction. It leads more rapidly to the restitution of the vascular wall than nonabsorbable sutures.

Arteries↗
PubMed1984

[Esophageal cancer].

Surgery of oesophageal cancer has a high risk demonstrated by the hospital lethality. 72 resections of the oesophagus done by one surgeon are analysed. The following parameters were used: 1) a nutritional index developed in carcinoma patients in a prospective analysis, 2) the EKG result, 3) the lung-function. Adding these 3 indices we get a certain correlation between the judgement of the preoperative risk and hospital lethality. The preoperative criteria of risk are essential for patients with cancer of the oesophagus since we have to choose among 3 groups of surgical treatment, the risks of which are significantly different.

Electrocardiography↗
PubMed1984

[Acute pancreatitis--discontinuation of conservative therapy, indications for operation and operation technic].

The surgical treatment of acute pancreatitis aims at the removal of stones in the distal biliary duct, toxic implications and necroses and to treat complications. The correct diagnosis, according to the 3 stages of Kümmerle is the basis for surgery. This staging is possible to a high degree of security by angio-CT and sonography. The effect of the following modalities has been proven: Early peritoneal dialysis which, however, decreases lethality only in combination with a delayed operation; removal of the biliary duct obstruction, and necrosectomy in stage II from the second week onwards. Early duodeno-pancreatectomy did not prove to be a successful procedure.

Acute Disease↗
PubMed1984

[Treatment of colorectal cancer in the last 35 years--perioperative requirements and postoperative results].

The development of colorectal surgery during the last 35 years was analyzed on the basis of case reports of a University Surgical Department. It was found, that lethality of the procedure was reduced during this period and that the number of tumor resections per year increased. In cases of carcinoma of the rectum extirpation of the rectum was reduced in favour of deep resection of the tumor in the recent time. In addition the analysis showed, that time of hospitalization was definitely reduced. Postoperative results have improved considerably due to improved methods of preparing the intestinal tract for surgery, due to preoperative prophylactic treatment with antibiotics--this reduces the postoperative need of antibiotics rather definitely--but only due in a limited extent to change of suturing techniques. The extent of pre- and postoperative diagnostic and therapeutic procedures increased, which however was justified because results improved quite definitely.

Adult↗
PubMed1984

[Profundaplasty in older persons].

The profunda femoris artery has become the most important collateral vessel for compensating femoro-popliteal arterial occlusion. The circulation of the ischaemic limb can be obtained by profundaplasty. From 1972 to 1982, 70 patients with a mean age of 75,7 years underwent surgery. Good results were obtained in 75,9%.

Aged↗
PubMed1983

[Primary retroperitoneal tumors. Symptoms, diagnosis and therapy].

We reviewed 28 cases of primary retroperitoneal tumors (1972 to 1982). We found 22 malignant and six benign tumors. The tumors revealed no special features. Cardinal symptom was a palpable abdominal mass in 21 of 28 patients (75%). Since 1978 we have at our disposal a modern radiological technique, the computerized tomography, which allows a statement of tumor localization, tumor size and infiltration of neighbouring organs. In our patients no definite statement could be made about resectability and type of the tumors. In spite of computerized tomography there is no change the road-minded operation indication. Surgical therapy is the treatment of choice because of lacking alternatives. Complete extirpation to cure, respectively exploratory laparotomy and biopsy to determine the specific nature of the tumor by histological examination should be aspired. In individual cases palliative gastrointestinal anastomoses are necessary to treat intestinal obstruction. All six benign, but only six of 22 (27%) malignant tumors were completely removable. Although in some cases neighbouring organs were respected, no patient died after operation. For a curative therapy the early diagnosis of the tumors is necessary.

Adolescent↗
PubMed1983

[APUDoma of the abdominal area and bronchial system. Surgical therapy and prognosis].

28 patients with APUDomas of the abdomen or bronchial system were reexamined up to 30 years after operation to take a view on therapy and prognosis of these tumors. All patients with benign hyperinsulinism remained free of symptoms after partial pancreatectomy or tumor enucleation, in the mean 12.9 years after operation. In contrast the two patients with islet cell carcinoma died 5 months after operation at the latest. The prognosis of the carcinoid tumors depended decisively on tumor location: The prognosis was favorable in patients with carcinoid tumors of the appendix or bronchial carcinoid (survival time up to 10 years after operation). In contrast all patients with carcinoid tumors of the small intestine died within two years after operation. Tumor size had the most important influence on the prognosis of the disease.

Adult↗
PubMed1983

Total parenteral nutrition as the sole therapy in Crohn's disease--a prospective study.

The effect of total parenteral nutrition (TPN) as sole therapy was studied in 30 consecutive cases of complicated Crohn's disease. After insertion of a Broviac-type central venous catheter patients were nourished parenterally for 3 weeks in the hospital and then for an additional 9 weeks at home. During this time no medication or oral intake was allowed. Surgery was avoided in 25 patients by TPN. These patients returned to work, ate normal meals and needed no medical support. In 5 cases it was not possible to control the acute disease and the patients were treated by resection. During TPN, catheter-related sepsis occurred in 3 patients (0.9 cases/1000 days TPN) and catheter embolism in 2. Four other patients developed intrahepatic cholestasis. A relapse of Crohn's disease was observed in 17 cases 3-48 months after the course of TPN. The cumulative recurrence rate is 60 per cent after 2 years and 85 per cent after 4 years. Compared with the results of resection, obtained from a 10-year period before TPN was instituted at our hospital, the cumulative recurrence rate after TPN is four times higher. It is concluded that TPN is not an alternative to resection in the treatment of Crohn's disease and should be reserved for patients with multifocal lesions, when surgery is not advisable because of the risk of a short bowel syndrome.

Adult↗
PubMed1983

[Hepatic resection for tumors, trauma and Echinococcus].

52 patients with hepatic resection due to liver tumor, metastases, Echinococcus or liver trauma are reported. Hepatic resection represents a relatively harmless procedure in case of benign liver tumor; however, in case of a malignant disease, the prognosis after hepatic resection is impaired by the difficulty to predict the regeneration capability of the liver. The indication for the different operative procedures is being discussed. It is suggested to perform hepatic resection in the border lines of the liver lobes without extensive preparation of the liver hilus and to clamp the liver hilus during resection. If the liver hilus was occluded after steroid pretreatment, 40 min of hepatic ischemia were well tolerated without any consequences and intraoperative bloodloss could be reduced significantly.

Echinococcosis, Hepatic↗