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Biomedical subjects

J Zieren

Publications and source records attributed to J Zieren.

43 records · Page 3Linked to original sources

Resection of colorectal liver metastases in old patients.

In a consecutive series of 90 patients in whom colorectal liver metastases were resected over a ten-year-period at a single institution, 18 patients (20%) were older than 70 years. In these patients 9 major and 9 minor hepatic resections were performed. The postoperative complication rate was 28% and resection mortality 6%. Operative mortality included, the median survival time was 18 months. Estimated 1-, 3-, and 5-year survival rates were 69%, 38% and 25%, respectively. In comparison with 72 younger patients, no significant differences were found in surgical strategies, operative procedures, or early and late postoperative results. As a result of these findings, even older patients should be regarded as potential candidates for curative resection of colorectal liver metastases.

Adult↗

[Laparoscopic hernia surgery].

While classical inguinal hernia repair has recently been brought up for discussions among surgeons, at present various modified techniques are being reintroduced in general surgery. Surgical hernia repair techniques which partly are known since several decades are being carried out laparoscopically since 1989. Between August 1992 and June 1993, the authors performed 52 laparoscopic inguinal hernia repairs using the preperitoneal placement of nonresorbable mesh. There were no intraoperative complications. Merely one patient had an abdominal wall hematoma at the site of a trocar which resolved spontaneously. All patients have been followed up for 3-13 months. To date, all postoperative check ups revealed no recurrences, testicular atrophy or paresthesia. Even though little can yet be said regarding long-term results especially about recurrences, laparoscopic preperitoneal hernia repair seems to be a promising surgical procedure concerning early postoperative results.

Adult↗

Closure of partial median sternotomy with absorbable sutures: a practical and safe option.

A technique for the closure of upper median sternotomy with absorbable polyglycolid acid sutures is described. In a consecutive series of 130 refixations, no major complications occurred. After a mean follow-up period of 66 +/- 61 months, the long-term results concerning sternotomy closure were determined in 86 patients: 84 (98%) sternotomies were completely consolidated, in 75 cases (87%) without any dislocation and in nine cases (11%) with a minor dislocation in the transverse osteotomy. In two patients (2%) who had received postoperative radio- and chemotherapy, an isolated pseudarthrosis of the transverse osteotomy was observed, whereas the median sternotomy was consolidated completely. As a result of our clinical experience, we consider the closure of partial upper sternotomy with absorbable polyglycoid acid sutures as a practical and safe technique.

Absorption↗

[Closure of upper median sternotomy with resorbable polyglycolic acid sutures].

Since 15 years we use absorbable polyglycolic acid sutures (Dexon) for closure of partial median sternotomies. In a consecutive series of 121 refixations, minor superficial wound infections developed in 4 patients. All infections healed completely by local treatment. No major sternal complication occurred. Of 92 patients, who were still living, 82 patients were controlled between 3 and 180 months postoperatively. 80 (98%) sternotomies were consolidated completely; 71 (87%) without any dislocation and 9 (11%) with a small dislocation of the fragments. In 2 cases (2%) an isolated pseudarthrosis of the transverse osteotomy occurred; in both cases the median osteotomy was consolidated completely. In the literature no comparable publication about closure of partial median sternotomies could be found. According to our experiences we consider, that the closure of partial upper sternotomies with polyglycolic acid sutures is as a practical and reliable method.

Adult↗

[Trevira: a new polyester implant for the treatment of incisional hernia. Results of an experimental study].

OBJECTIVE: The synthetic implant meshes in clinical use for the treatment of abdominal hernias are generally made of polyester in France and of polypropylene in Germany. Serving as an implant material for the replacement of the cruciate ligament, the Trevira is another polymer of polyester in clinical use with excellent results. This animal trial was performed to ascertain whether it offers any advantages over polypropylene for abdominal incisional hernia repair. MATERIAL AND METHODS: [corrected] In 12 pigs 10 x 10 cm of the abdominal wall preserving the peritoneum was resected and subsequently implanted a 15 x 15 cm synthetic mesh of polyethylene terephthalate (Trevira) in half of them and of polypropylene (Prolene) in the other half using a sublay technique. After two and six month the implant size was measured and the extend of the foreign body reaction determined by the microscopically presence of foreign body giant cells. RESULTS: No significant differences concerning the implant size were shown between the two groups at any of the time periods. The acute inflammatory reaction observed was significantly higher at the polypropylene than at the polyethylene terephthalate implant (number of giant cells after 2 month: Prolene 2.2 +/-0.4, Trevira: 0.8 +/-0.2, after six month: Prolene: 4.6 +/-1.3, Trevira: 1.1 +/-0.5). In contrast to the polyethylene terephthalate all polypropylene samples showed calcification areas after six month. CONCLUSION: In this animal trial Trevira mesh showed a high biocompatibility with a low foreign body reaction. It appears to be a promising new implant for the treatment of hernia.

Animals↗

The impact of patient's age on surgical therapy of colorectal liver metastases.

In a consecutive series of 90 hepatic resections for colorectal liver metastases which were performed during a 10-year period at one institution, the influence of patient's age on surgical strategies and postoperative results was investigated. The mean age of all patients was 61 +/- 11 years with a range from 27-78 years; 19 patients (21%) were younger than 50 years and 18 patients (20%) were older than 70 years. Thirty-six (40%) major and 54 (60%) minor hepatic resections were performed. The postoperative complication rate was 26% and resection mortality 3%. Estimated overall median survival time was 27 months, operative mortality included. 1-, 3-, and 5-year survival rates were 78%, 45%, and 32%, respectively. Although there is some suggestion that selection criteria are more aggressive in younger patients, neither surgical procedures nor postoperative results were found to be determined by the numeric age of the patient in a significant way.

Adenocarcinoma↗