Biomedical subjects

P Buchmann

Publications and source records attributed to P Buchmann.

At least 73 records · Page 4Linked to original sources

PubMed1989

Rubber band ligation for piles can be disastrous in HIV-positive patients.

We report a patient with haemorrhoids treated with rubber band ligation who developed a huge supralevator abscess. A diverting sigmoidostomy had to be established as surgical drainage via the rectum was not adequate. Eventually the patient accepted the HIV-testing which proved positive. Six months later the sigmoidostomy was still needed as the abscess cavity remained large. We conclude that rubber band ligation in HIV-positive patients should be abandoned.

Abscess↗

PubMed1989

HPV 16-positive bowenoid papulosis and squamous-cell carcinoma of the anus in an HIV-positive man.

A homosexual man in stage IV of HIV infection, who suffers from HPV 16-positive bowenoid papulosis of the anal region, is described. In one area the patient developed an HPV 16-positive squamous-cell carcinoma of the anus. Bowenoid papulosis represents a squamous-cell carcinoma in situ, and usually follows a benign clinical course. The possibility exists that immunocompromised individuals are at higher risk to develop cancer on the basis of bowenoid papulosis.

Adult↗

PubMed1989

[Surgical techniques and long-term results for hemorrhoids from the clinical viewpoint].

The decongestion of the hemorrhoidal cushion is the main principle in treating piles. This is achieved with a diet high in roughage. Although severe hemorrhoids are not cured by buld-forming agents, they are of central importance to prevent recurrences. Hemorrhoidectomy should be performed mainly in cases of hemorrhoidal prolapse. Results of the three most often used techniques (Milligan-Morgan, Parks, Ferguson) are more or less comparable, although the presentation of the details in the literature is contradictionary. Each surgeon should use the technique that suits him best. We prefer the closed operation described by Ferguson.

Follow-Up Studies↗

PubMed1989

[Liver transplantation: initial experiences from Zurich].

Liver transplantation program in Zurich was started in 1986. Between November 1986 and May 1988, 29 patients have been referred for evaluation. 19 (65%) of the admitted patients were accepted for transplantation, 7 patients died while waiting for a suitable organ. 9 patients have been transplanted. This report summarizes the results with the first 9 transplantations.

Follow-Up Studies↗

PubMed1989

[The value of thymectomy in myasthenia gravis].

In the management of Myastenia gravis thymectomy has gained an important position. Still in discussion is whether a transsternal approach gives a superior result to a collar approach. Between 1970 and 1986 35 patients with Myasthenia gravis underwent thymectomy, in 12 by a collar approach, in 19 by sternotomy and 4 by thoracotomy. Results were equivalent independent of the approach but only after transsternal incision complications occurred in 3 patients. At 6 months after operation 18 of 35 patients were classified in a lower category following Ossermann's classification, an other 12 were stable and in 5 the information unobtainable. At the end of follow-up between 1 and 17 years, 19 out of 29 were improved; 4 unchanged and 5 demonstrated progressive disease, 1 patient died due to the disease. Almost 70% of patients judged the operation as helpful. We conclude that the collar approach is safe and effective in patient without thymoma and that in our department thymectomy has an important place in the treatment of Myasthenia gravis.

Adolescent↗

PubMed1989

[Can truncal vagotomy still be justified?].

The aim of the study was to determine the severeness of the postvagotomy side-effects in patients who underwent truncal vagotomy and pyloroplasty in emergency situations because of perforation or haemorrhage of a gastro-duodenal ulcer. Fullness (21%) and diarrhoea (17%) were found to be the most important side-effects. Although there were 31% of Visick Grades 3 and 4.86% of the patients were content with their general condition after the operation. None were disabled in their social or working life. It is concluded that because of the well tolerated side-effects truncal vagotomy and pyloroplasty may still be performed in case of emergency-complications of the gastro-duodenal ulcer.

Female↗

PubMed1989

[Improvement of perineal wound healing following rectum amputation by omentum flap].

The aim of the presented study was to find whether significant improvement in perineal woundhealing could be achieved by placing pedunculate parts of greater omentum in the sacral cavity after rectal amputation. 70 patients undergoing rectal amputation were evaluated, in 34 patients pedunculate parts of the greater omentum were positioned in the presacral cavity. Results show that an omentum flap improves primary perineal woundhealing and reduces per secundam woundhealing time (p less than 0.025). Since regular placement of pedunculate parts all wounds were closed after 3 months. Sinus formation is reduced (p less than 0.05). Suction drainage must be removed early, otherwise infections aggravate woundhealing going up the tube (p less than 0.001). We conclude from our results that the placement of pedunculate parts of the greater omentum in the sacral cavity after rectal amputation is a useful method to improve perineal woundhealing and should be done as routine procedure.

Aged↗

PubMed1988