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Biomedical subjects

Marco Paul

Publications and source records attributed to Marco Paul.

8 recordsLinked to original sources
PubMed2006

Submandibular ectopic thyroid gland.

Ectopic thyroid glands are generally a rare entity appearing mostly in the cervical midline (90% of the cases) and even more rarely in other anatomical sites (10%). We present the case of an ectopic submandibular thyroid gland. An 81-year-old woman was referred to our department with a history of right-sided submandibular swelling. Preoperative FNA revealed benign ectopic thyroid tissue. The patient was submitted to resection of the mass. Histological examination of the specimen confirmed the diagnosis. A substitution treatment with thyroxin was initiated postoperatively, as this was the only functional thyroid tissue. Review of the literature revealed 18 similar cases. Physicians should be aware of the possibility that a submandibular swelling could be an ectopic thyroid gland. This entity poses specific diagnostic and therapeutic difficulties. Thorough preoperative diagnostics and resection of the ectopic tissue guarantee a good outcome.

Aged, 80 and over↗
PubMed2006

Intracolonic penetration of the laparoscopic adjustable gastric banding tube.

The laparoscopic adjustable gastric band (LAGB) has become a common, usually successful treatment for morbid obesity. Complications occur in 10-20%, most commonly band slippage and port system problems, especially infection of the port area. A rare complication is penetration of the band into the stomach. We report the penetration of the tube connecting the port system with the gastric band, into the colon 1 year after treatment of a port infection.

Body Mass Index↗
PubMed2005

Sexual function before and after mesh repair of inguinal hernia.

AIM: Several factors having an influence on the quality of life after an inguinal hernia repair have been studied, yet little has been reported on sexual function before and after this operation. METHODS: In a prospective follow-up study from January 1999 to July 2002, 210 men and 14 women were asked to answer an anonymous questionnaire of 40 questions before elective inguinal hernia repair to assess pre- and postoperative sexual function (preoperatively, 3 months postoperatively and every 6 months afterwards). Inguinal hernia repair was performed using a standardized Plug and Patch mesh technique. RESULTS: Fifty-two (23.2%) patients mentioned preoperative sexual dysfunction related to the groin hernia. Postoperatively, the surgical repair had a positive influence on the sexual function in these patients. Thirty-six (16%) patients complained of postoperative sexual dysfunctions, which improved or disappeared over the next few months. All patients suffered surgical complications, which were surgically treated in six cases. Symptoms specifically associated with inguinal hernias can cause certain limitations in the sexual life. CONCLUSIONS: In most cases, and in the absence of postoperative complications, the operative repair can lead to a recovery of the sexual life in patients with preoperative sexual dysfunction, while, in most cases, it does not affect patients with a preoperative normal sexual life.

Female↗
PubMed2004

Prevention of catheter disconnection after laparoscopic adjustable gastric banding.

In a consecutive series of 138 laparoscopic adjustable gastric bandings (LAGB) we observed disconnection of the gastric band catheter at the site of the port connector in 17 patients. During operative revision we established a new port position with a minimal distance of 10 cm between the connector and the entrance of the catheter to the abdominal cavity. Using this technique no complications and no catheter disruptions occurred during a median followup period of 25 months.

Adult↗
PubMed2004

Introduction of polyethylene terephthalate mesh (KoSa hochfest) for abdominal hernia repair: an animal experimental study.

BACKGROUND: Nowadays the surgical treatment of abdominal hernias includes the use of synthetic meshes in most cases. Due to chronic foreign body reactions, however, the most commonly used polypropylene meshes can lead to material hardening and recurrent hernias. As a proven cruciate ligament replacement polyethylene terephthalate (KoSa hochfest showed only little foreign body reactions and provided excellent clinical outcomes. In an animal trial it was therefore tested as mesh implant for hernia treatment and compared with Prolene. MATERIAL AND METHOD: The study was carried out in 12 mini-pigs. 10 x 10 cm of the musculofascial abdominal layer was resected, the peritoneum was preserved. A 15 x 15 cm synthetic mesh was implanted in sublay-technique (either KoSa hochfest, Telos GmbH, Marburg, Germany or Prolene, Ethicon, Norderstedt, Germany), mainly to test for chronic foreign body reactions. An independent pathologist tested the mesh size and foreign body reaction at 2 and 6 months, analysing the number of foreign body giant cells. RESULTS: No significant differences in mesh size were observed, neither between the compared groups nor with respect to the time periods. Compared to KoSa hochfest the foreign body reaction was significantly stronger in the Prolene implants, both at 2 and at 6 months (number of foreign body giant cells at 2 months: Prolene/KoSa hochfest: 2.2 +/- 0.4/0.8 +/- 0.2, at 6 months: 4.6 +/- 1.3/1.1 +/- 0.5). In contrast to KoSa hochfest, Prolene still showed significant foreign body reactions at 6 months as well as calcifications of all samples. CONCLUSION: The animal trials revealed that due to its high biocompatibility and little foreign body reaction KoSa hochfest is a promising implant for the treatment of hernias.

Animals↗
PubMed2003

Inguinal hernia: obligatory indication for elective surgery? A prospective assessment of quality of life before and after plug and patch inguinal hernia repair.

BACKGROUND: Incarcerated inguinal hernia may be treated effectively by recent surgical techniques with a low rate of complications, but it is unclear whether quality of life is improved by elective inguinal hernia repair. Therefore we investigated the quality of life before and after inguinal hernia repair using plug and patch technique. PATIENTS AND METHODS: Quality of life was prospectively assessed in 123 patients before and 3 months after plug and patch inguinal hernia repair using the Short Form 36 questionaire and a visual analog scale. All patients complained preoperatively of pain associated with the clinical findings of inguinal hernia (visual analog scale: reduced quality of life 6.8+/-2.7; reduced daily activity: 5.5+/-2.6). Clinical characteristics (operation times, in-hospital stay, complications, need for pain medication) were documented. Inclusion criteria were patients with symptomatic inguinal hernia, scheduled for elective unilateral inguinal hernia repair by plug and patch technique. RESULTS: There were no major in-hospital complications. At 3 months no recurrences of inguinal hernia or late onset complications were observed; seven patients complained of dumbness, and eight felt pressure at the operation site with a tendency for resolving pain within this time. At 3 months patients had a significantly improved quality of life regarding freedom from pain, vitality, and physical activity compared to preoperatively. CONCLUSIONS: Plug and patch repair of unilateral inguinal hernia improves quality of life with a very low rate of procedural complications. Regarding freedom from pain, vitality, and physical activity there is significant improvement as compared to preoperatively. Therefore inguinal hernia repair should be intended in all elective cases and plug and patch repair appears as an excellent technique to improve quality of life.

Aged↗
PubMed2002

Polyurethane-covered dacron mesh versus polytetrafluoroethylene DualMesh for intraperitoneal hernia repair in rats.

PURPOSE: Abdominal hernia repair using the intraperitoneal implantation of a prosthesis requires mesh with impervious properties, such as expanded polytetrafluoroethylene (ePTFE). A newly developed polyurethane-covered polyester mesh with impervious properties has recently been introduced as a less expensive alternative to PTFE, and we compare these materials herein. METHODS: The adhesion formation and stability of intraperitoneal abdominal hernia repairs with DualMesh (macroporous ePTFE mesh with a microporous component) and PolyesterComposite (the newly developed polyurethane-covered Dacron mesh) were compared in a rat model. Forty rats were randomly divided into two groups; ten animals from each group were killed after 14 days, and the other ten after 90 days. RESULTS: The number and intensity of adhesions were comparable in the PolyesterComposite and PTFE groups. Loose adhesions were seen in 13 animals and appeared only selectively at the fixation sutures. Both PolyesterComposite and PTFE induced the formation of a smooth neoperitoneum on the intraperitoneal surface and showed a complete ingrowing of the prosthesis in the surrounding tissue. There were no significant differences between the prostheses in terms of clinical herniation pressure and hydroxyproline concentration. CONCLUSIONS: PolyesterComposite and PTFE are both suitable prostheses for intrapertoneal implantation, but PolyesterComposite is less expensive, which is an important advantage for clinical use.

Animals↗