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H Stirnemann

Publications and source records attributed to H Stirnemann.

At least 19 recordsLinked to original sources
PubMed1992

[Long-term follow-up of acute pancreatitis--significance of cholecystectomy for the biliary form].

Of 83 patients with acute pancreatitis it was possible to control 79 of them 5-16 years later, 33 on the basis of case histories and 46 personally. In 43 cases (54.4%) it was pancreatitis caused by gallstones. After an operative procedure, there followed in each case an auspicious progress without recurrence. By the patients who were not operated, there was a recurrence rate of 45.5%. In cases of pancreatitis not caused by gallstones the late progress is marked by a high recurrence and complication rate.

Acute Disease↗
PubMed1989

[How great is the risk of cancer and recurrence following benign breast biopsy?].

Four hundred and thirty-eight patients with biopsy-proven benign breast disease were followed annually in a prospective manner for 4-17 years, to analyze breast cancer risk, correlations with cancer development and recurrence during follow-up. Twelve breast cancers developed in 12 patients during follow-up, giving a 2.6 fold increased cancer risk over the reference population. No association was found between patients who developed cancer and those who did not with respect to the initial histologic feature (p = 0.9), the age at entry by decades (p = 0.4) and relative to menopause (p = 0.3), the presence of cysts (p = 0.5) or calcification (p = 0.2) in the biopsy specimen, a family history of breast cancer (p = 0.7) or the follow-up time (p = 0.9). Benign breast disease does not inevitably lead to recurrence. Moreover, 47% of the 438 patients never had any recurrence and were free of symptoms during follow-up, and 84% never required a further operation. We conclude that an aggressive approach to benign breast disease is not justified, for any type of lesion as defined in this report.

Adenofibroma↗
PubMed1989

[The mobile cecum syndrome: appendectomy and cecopexy or only appendectomy?].

1159 patients underwent appendectomy via a McBurney incision from 1972 to 1983 at our institution. 115 patients (10%) had a mobile cecum syndrome (CMS) as defined by Nicole, without evidence of appendicitis or other pathologic findings at operation. 102 patients were followed up to 15 years after the operation. 82% of the 102 patients were free of symptoms at assessment. 36 patients underwent appendectomy and 63 appendectomy and cecopexy. The two cohorts were comparable with respect to sex, age at operation, duration of right lower abdominal pain, operative findings and length of follow-up. There was no significant difference in the postoperative result of patients with appendectomy alone and those with appendectomy and cecopexy. Moreover, we were not able to identify patients who may benefit from an additional cecopexy, on the basis of patient related factors or intraoperative findings.

Adolescent↗
PubMed1988

Long-term follow-up of patients with biopsy-proven benign breast disease.

Three hundred sixty-five patients with biopsy-proven benign breast disease were followed annually in a prospective manner for 4-15 years to analyze breast cancer development, recurrence, and efficacy of management during follow-up. Eleven breast cancers developed in 11 patients during follow-up, giving a 2.6-fold increased cancer risk over the reference population. No association was found between patients who developed cancer and those who did not with respect to the initial histologic feature (p = 0.62), the age at entry by decades (p = 0.40), and relative to menopause (p = 0.54), the presence of cysts (p = 0.87), or calcification (p = 0.74) in the biopsy specimen, a family history of breast cancer (p = 0.80), or the number of observation years (p = 0.27). We conclude that an aggressive approach to benign breast disease is not justified for any type of lesion as defined in this report. Benign breast disease does not inevitably lead to recurrence. Moreover, 41% of our patients never had any recurrence and were free of symptoms during follow-up; 67% never had a mammogram and 82% never required a further operation. There was no association with initial histologic feature in patients who had clinical examination only and those who had mammogram, biopsy, or both during follow-up (p = 0.93). Mammograms were mainly used to clarify a clinical recurrence than as a screening tool, regardless of histologic feature (p = 0.76). Mammograms were mainly used in premenopausal patients (p less than 0.001) having lumps (p less than 0.001), namely, the most difficult patients for radiologic interpretation. This may be one important reason for the rather low sensitivity (75%) and specificity (40%) of mammography in this report. In conclusion, clinical examination is the outstanding investigational tool to follow patients with biopsy-proven benign breast disease, especially in young premenopausal patients.

Age Factors↗
PubMed1988

[Long-term results following surgery of varicose veins].

In a long-term follow-up after operation for primary varicose vein disease, patients were revisited 5, 10 and 15 years after their operation, in an attempt to define the goal of the treatment and the result. The results were analyzed as well as those factors which had a significant influence on the findings at assessment. The long-term results were good with respect to the patient's self-judgement and relative to improvement of trophic disturbances, especially of venous ulceration, however recurrent superficial varicose veins increase significantly with increasing follow-up time. The outstanding role of incompetent communicating veins is discussed with respect to trophic disturbances and recurrent varicose veins.

Adult↗
PubMed1987

[10 years' experience using a modified Shouldice surgical technic for inguinal hernia in adults. II. Which factors modify the recurrence of inguinal hernia?].

Many factors seem to influence the recurrence rate after adult inguinal hernia repair. A statistical analysis of data derived from 726 transversalis fascia repairs examined by the authors (with a follow-up rate of 82.5% and a mean follow-up time of 5.5 years) revealed a significantly higher recurrence rate in patients with chronic bronchitis (p less than 0.05) or with postoperative complications (p less than 0.001). Lower recurrence rates were found after resection of lipomas of the cord (p less than 0.01) or cremasteric muscle resection (p less than 0.05). No significant difference of recurrence rate could be established for following parameters: Sex, side, age distribution, profession, prostatism, obesity, type of hernia (direct, indirect, combined, sliding), suture material (silk, polyglycolic acid), surgeon, anesthesia (local, spinal, full), elective or emergency operation, and whether the repair was unilateral or simultaneously bilateral. Recurrent repairs showed no significantly higher recurrence rate than primary repairs.

Adult↗
PubMed1987

[10 years' experience using a modified Shouldice surgical technic for inguinal hernia in adults. I. Method and results in 726 operations with follow-up].

Since 1973 we have used a modified Shouldice repair to treat inguinal hernias in adults. The repair was performed on unselected patients. The procedure was performed by both senior surgeons and surgeons in training. Over a 10-years period, 880 transversalis fascia repairs were done and 726 (82.5%) were examined by the authors 12-142 months after the operation (mean time 66.1 months). In 94.2% of the 726 repairs the patients were satisfied with the result. Follow-up studies revealed testicular atrophy in 0.6%, deep wound infection in 0.8% and an overall recurrence rate of 5.8%. The recurrence rate was not significantly different after direct, indirect, combined or sliding hernias. In 25% of recurrences the patients were asymptomatic and unaware of the recurrence.

Adult↗
PubMed1979

[Hypoproteinemia causing postoperative "interstitial" paralytic ileus].

On the basis of recent pathophysiological data and clinical observations in three patients, this paper draws attention to the commonly neglected importance of postoperative hypoproteinemia as the cause of an edema of the intestinal wall with a consequent "interstitial" paralytic ileus. The characteristic features of this syndrome are its onset between the third and the eighth postoperative day; the absence of other known causes of intestinal hypomotility; the benign, but protracted course without treatment; and the therapeutic success achieved by the correction of a hypoproteinemic fluid overload with concentrated albumin and a diuretic. In addition, parenteral hyperalimentation and Rheomacrodex-Sorbit may be indicated, but the hypoproteinemia should at any rate be corrected.

Aged↗
PubMed1978

[Transsexualism].

Explore the source record for details and available documents.

Diagnosis, Differential↗
PubMed1978

[Dissolution of choledochus stones with heparin-saline solution].

In a series of 336 cholecystectomies a revision of the bile ducts was necessary in 60 cases (18%). One to three residual concrements were evident in 6 patients from control cholangiograms made 8-10 days postoperatively (1.8%). Three of these patients were successfully reoperated. The remaining three were treated by irrigation with a herparin solution: the stones of two patients disappeared in 13 and 20 days, respectively. The third patient had to be reoperated due to septic fever on the 13th day, whereby soft, decayed material could be extracted. All patients had a complication-free recovery. Check-ups made six to twelve months later revealed painfree patients and normal cholangiographic values.

Aged↗
PubMed1977

[Spiegeli's hernia].

Spontaneous lateral ventral hernia (spigelian hernia) is briefly reviewed in the light of 7 patients with a total of 8 hernias. The relatively high incidence of spigelian hernia (5% of all abdominal hernias operated on in 1 year) suggests that this hernia type is not uncommon if borne in mind when diagnosing conditions with abdominal pain. Pain, tenderness and a palpable mass along the lateral edge of the rectus abdominis are the leading symptoms. Since the operation is simple and the postoperative period uneventful, operative treatment is strongly recommended. Accurate diagnosis with resultant surgery for this type of hernia spares the patient unnecessary examinations and totally relieves symptoms.

Adult↗