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J J Brugger

Publications and source records attributed to J J Brugger.

12 recordsLinked to original sources
PubMed2001

Randomized controlled trial of laparoscopic transabdominal preperitoneal hernioplasty vs Shouldice repair.

BACKGROUND: There is a scarcity of data on long-term results after laparoscopic hernia repair. Herein we report on the outcome of a group of patients who were followed up for 5 years in a multicenter study on hernia repair. METHODS: A total of 100 patients with 127 hernias were randomized to undergo either transabdominal preperitoneal (TAPP) or Shouldice hernia repair. Follow-up was by clinical examination and standardized questionnaire. RESULTS: Of the 100 patients who underwent surgery, 84 were available for follow-up at 5 years. The TAPP procedure was less painful than the Shouldice repair, with fewer patients receiving narcotic analgesics. The median time to return to 100% activity was shorter in the laparoscopic group (21 days) than in the Shouldice group (40 days). Up to 60 months after the operation, the complication rate was lower in laparoscopically repaired hernias (19/66) than in the open group (25/61). There were two recurrences (3.9%) in the TAPP group and five in the Shouldice group (10.2%). CONCLUSION: The TAPP hernia repair yields comparable or better results than Shouldice herniorrhaphy in terms of postoperative pain, recovery, and recurrence rate.

Aged↗
PubMed2000

[Is appendectomy really performed too frequently? Results of the prospective multicenter study of the Swiss Society of General Surgery].

Scientific publications and provoking criticism from the lay press have recently pointed out, that appendices may be surgically removed too frequent and without indisputable necessity. In an attempt to verify these questionable statements, the Swiss Society for General Surgery (SGAC) initiated a prospective controlled multi center trial. From September 1997 to December 1998, hundred and twenty-five institutions documented 4603 appendectomies performed due to a suspected appendicitis. Histological investigation of all specimens revealed a 7% rate of normal appendices, 7.2% for patients with national health service (NHS) and 5.9% for patients with private insurances respectively. Compared to the results of the literature, where a frequency of normal appendices around 15% is judged as standard, these results are excellent. In 17.2% of the patients (15.9% NHS and 23.6% privately insured patients) an "appendicitis perforata" was observed. This percentage remains in the range reported by other authors. The analysis of time of admission (i.e. day or night) and the delay from admission to surgery shows a distribution independent to the insurance of the patients. Therefore, the planned appendectomy for patients with private insurances does not exist. A different choice of the surgical technique could be observed depending on the insurance status. In 30.4% of the private insured patients a laparoscopic appendectomy was performed as compared to 22.6% of patients with NHS. Surprisingly, an identical median hospitalization time can be observed for both groups (laparoscopic 5.5 days, open surgery 5.5 days).

Adolescent↗
PubMed1999

Bowel obstruction caused by dislocation of a suprapubic catheter.

In patients with a suprapubic catheter, the differential diagnosis of acute lower abdominal pain must include a possible dislocation of this device. We report a case that illustrates such a complication, leading to bowel obstruction in our patient.

Abdomen, Acute↗
PubMed1990

[Diarrhea and recurrent vomiting of fecal matter in a 56-year-old patient].

A gastro-jejuno-colic fistula detected by upper gastric contrast-radiography was the cause of severe diarrhea, miserere and weight loss. It had developed after gastro-jejunal anastomosis. Surgical correlation was achieved by a single intervention, possible because of preoperative care and modern suture technology.

Colonic Diseases↗
PubMed1985

[Is rigid rectoscopy obsolete?].

Flexible fiberoptic sigmoidoscopy more and more replaces sigmoidoscopy with a rigid tube. In a retrospective series of 152 rigid sigmoidoscopies we analysed depth of endoscopy and findings. In 36% of patients without anaesthesia endoscopy had to be stopped at 15 cm and in further 31% at 20 cm leading to a highly significant difference to the anesthetized patients (p less than 0.0005). A good history of the present illness allows separating of bleeding carcinoma and polyps proximal to the sigmoid colon which have to be examined by colonoscopy. In routine screening for blood loss per anum it is desirable to achieve in all patients a maximal security not to overlook a finding, because of the medical costs. We have enlarged the list of indications for the rigid sigmoidoscopy by Marks et al. as a practical compromise: delineation of rectal lesions, side localization and critical rectal measurements, surveillance of disease states or anastomoses within its reach, for performing rectal biopsy and rectal polypectomy, in patients with possible contamination of the instrument, endoscopy in the anesthetized patient before a proctological operation if case history excludes a higher sited lesion. In all other cases there is an indication for colonoscopy or barium contrast enema. It is stressed that in patients with blood loss per anum the search for the source always is done by flexible fiberoptic sigmoidoscopy.

Adult↗
PubMed1982

Tricuspidal annuloplasty. Results and complications.

Between 1976 and 1979, 76 patients underwent tricuspid annuloplasty (TA) for predominant tricuspid regurgitation (TR). The TR was functional (secondary to mitral valve disease) in 70, postrheumatic in 4, posttraumatic in one and secondary to myxomatous degeneration in one. The mean preoperative functional class was 3.05 and cardiac index 2.15 +/- 0.53 l/min/m2. All but 8 were in atrial fibrillation. Pulmonary vascular resistance over 250 dyn x sec x cm-5 was present in 28 patients. The original de Vega technique was applied in 55, a modified annuloplasty technique was used in the remaining 21 cases. There were 3 early and 6 late deaths, none being related to annuloplasty. One early and 2 late complications were attributable to tricuspid annuloplasty. At control after 6 months, 64 of 72 patients had improved at least one functional class. Three presented moderate TR on clinical examination. Mean observation time now averages 30 months (20 to 48 months). De Vega annuloplasty is a safe and effective method for the treatment of functional TR. It is of particular value during the early postoperative period in preventing right ventricular overload.

Adolescent↗