[Use of Prosthex in abdominal surgery].
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Biomedical subjects
Publications and source records attributed to L Riedler.
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We report 3 patients with traumatic renal artery thrombosis treated successfully with revascularization. The diagnosis was made preoperatively in 2 cases and intraoperatively in 1. Treatment consisted of reanastomosis with a saphenous vein patch on the side of the arteriotomy in case 1, an aortorenal artery saphenous vein bypass in case 2 and a bypass graft from the aorta to the distal renal artery in case 3. Two patients had functioning kidneys and normal blood pressure, and 1 patient dies 24 hours after reconstruction.
Transanal tumorectomy is an operation with continuing anal continence. With necessary indications give, this operation is justified both curatively and palliatively. Sphincter-stretching in combination with a lateral sphincterotomy of the Musculus sphincter internus and externus to two thirds their height is performed. This technique allows the resection of tumors in the rectum up to 12 cm from the anocutaneous line, a height that cannot be reached by dilatation only. The results from the First Surgery Department of Innsbruck University show that in more than 50% of patients submitted to transanal tumorectomy, this expansion of the operational angle was necessary to remove tumors.
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Anal sphincter dilatation with forefinger and middle fingers of both hands for a two-minute period under strong pressure results in a measurable tonus-decrease of the sphincter ani over a period of 2-3 weeks. This tonus-decrease is of therapeutic advantage in numerous diseases, particularly in those of the anal area. At the same time, the stretching may well be used to protect anastomoses in the colon or to dilate the operative access in transanal operations. Complications arising from the stretching described are insignificant.
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The effects of the main lipoprotein density classes on the human adipose tissue lipoprotein lipase activity were studied. A dose-dependent stimulation of lipoprotein lipase activity was obtained for HDL and, to a lesser extent, for VLDL on a constant weight basis. LDL exerted virtually no effect. At higher concentrations, HDL as well as VLDL inhibited the stimulated lipolytic activity. In type V hyperlipoproteinemia, the stimulating effect of VLDL and of HDL was significantly lower, whereas the inhibiting action of HDL was markedly increased.
Results are reported of 107 patients, which had been operated upon from 1969-1975 at the Innsbruck University Department of Surgery, because of anorectal fistulas. The standard procedure was splitting of the fistula and ample excision of the walls of the fistula down to the skin. This procedure yielded satisfactory results in 74% of all cases. Fistulas penetrating the musculus levator ani were excised below this muscle respectively extracted, whereas the part of the fistula duct reaching above this muscle was left and scratched out cautiously.