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Biomedical subjects

P Buchmann

Publications and source records attributed to P Buchmann.

At least 127 records · Page 7Linked to original sources
PubMed1982

[Early diagnosis of stomach cancer: reality or illusion?].

Cancer of the stomach is, in Switzerland, the fourth most common malignant tumor in both sexes. The five year survival rate is between 10 and 20% in Europe; where the cancer is diagnosed early, however, the patients have a survival rate of 85-95%. Of the 305 cases diagnosed in the last 5 years, 51.5% were operatively curable. In 29.5% of the cases palliative surgery was possible and 19% were inoperable. The rate of early cancer is 12% and thereby constitutes the largest portion of the total five year survival rate. Improvement of prognosis is only realizable through early detection, but even today this prospect is largely illusory. Practicable ways of obtaining optimum results are demonstrated.

Aged↗
PubMed1982

[Percutaneous cholecysto- and cholangiography (author's transl)].

Combined sonographic and radiographic investigations of the biliary duct system using direct percutaneous transhepatic fine needle puncture under constant visualisation and contrast medium demonstration were done in 37 patients. The results show numerous advantages of the method: 1. It is very safe as all tissue and organ areas are under constant surveillance. 2. There is almost no risk of infection. 3. The investigation can be performed on predamaged liver parenchyma. 4. Cytologic material can be obtained; there are no extravasates. The information value of this combined investigation method is greater in a similar group of indications than with radiographic or sonographic methods alone. It appears possible that the risks of ERCP and PTC may be reduced. Further investigations will have to establish the clinical value and risks of this new method.

Biliary Tract Neoplasms↗
PubMed1982

Esophageal and duodenal approach for testing duodenogastric reflux in dogs.

A modified Komarov-Marks esophagostomy is described. It was the aim of our experiments to show that this procedure does not harm the vagal innervation of the stomach. The vagal function was assessed by testing (1) basal secretion, (2) 2-deoxy-D-glucose-stimulated secretion, (3) pentagastrin-stimulated secretion, and (4) serum gastrin levels in five mongrel dogs. Each test was performed at least three times in each dog before and after the esophagostomy procedure, respectively. The secretion rates were not affected by surgery. It is concluded that cervical esophagostomy in dogs does not affect vagal stimulation of gastric acid secretion. For the application of tracer substances into the duodenum, two types of conduits are described: (1) a short jejunal segment and (2) a jejunal segment with an invagination valve. The pros and cons of these procedures are discussed.

Animals↗
PubMed1982

[Bovine pericardium - a new graft material for hernial repair (author's transl)].

We compared glutaraldehyde-fixed bovine pericardium with conventional Mersilene mesh with regard to suitability for repair of large incisional hernias in canine experiments. To test the materials the force needed to rupture them and the percentage of stretching to the breaking point were determined both in vitro and after implantation. The results showed that bovine pericardium is a suitable material for repair of large incisional hernias. Pericardium is superior to Mersilene mesh because of its minimal formation of adhesions with the underlaying bowel.

Animals↗
PubMed1982

Assessment of anorectal function in selection of patients for ileorectal anastomosis in Crohn's colitis.

Anorectal function has been assessed in 53 patients with Crohn's disease by measurement of resting and squeeze anal canal pressures and the maximum volume tolerated during distension of a balloon in the rectum. Radiographs of the rectum from barium enema examination were also reviewed to assess rectal capacity. Thirty-three patients have had a colectomy and ileorectal anastomosis for Crohn's colitis of whom 13 now have a stoma because they either required a protectomy (n=9) or where closure of a loop ileostomy had not been possible (n=4) because of severe anorectal disease. The maximum tolerated volume was less than 150 ml in 12 of 13 patients who now have a stoma compared with none of the 20 patients who have a functioning anastomosis. Although the correlation between a radiological assessment of rectal capacity and the maximum tolerated volume was poor, a severely contracted rectum was associated with the need for a stoma in six of seven patients compared with only two of 13 patients who did not have radiological signs of a narrow rectum.

Adult↗
PubMed1982

[Opening of anorectal abscesses--with or without splitting of the fistula?].

An anorectal abscess has to be deroofed. If, in addition, a fistula is present, it is our policy (in a teaching institution with surgeons in training) to incise it only if easily visualized and situated up to the dentate line. Of 79 anorectal abscesses drainage alone was performed in 55 (group 1) and drainage with fistulatomy in 24 (group 2). One-third of the patients in group 1 needed a secondary fistula operation, but most of the others were free of symptoms after one intervention. In group 2 all but one of the patients were cured by the combined procedure. Incontinence was observed in none.

Abscess↗
PubMed1982

[Ischemic colon and rectum necrosis after resection of the abdominal aorta].

Colorectal infarctions are a rare but serious complication following aortoiliac reconstruction. Their incidence has been reported to be about 2% in retrospective and 7-35% in prospective studies. The perioperative mortality rate reaches 40-75%. About 85% of these ischemic lesions follow resection of the infrarenal aorta because of aneurysm, only 15% after aortoiliac occlusive disease. Principal cause of the infarctions is the ligation of the inferior mesenteric artery without sufficient collateral circulation. Blood supply of the large intestine and pathogenesis of ischemic colitis are discussed in detail. The pathological and clinical presentation contains three intensity degrees. For early detection colonoscopy is useful. Prevention preoperatively consists of precise analysis of aortography, intraoperatively in perfusion control of visceral arteries. The best precaution is reimplantation of the inferior mesenteric artery into the prosthetic graft.

Aged↗
PubMed1981

The prognosis of ileorectal anastomosis in Crohn's disease.

A total of 105 patients have been treated with colectomy and ileorectal anastomosis from 1958 to 1978 in Birmingham, England (48) and in Leiden, Netherlands (57). At the end of 1978 the mean follow-up was 7.6 years (6 months-20 years). Mild or moderate degrees of proctitis were not considered as contraindications for ileorectal anastomosis. The presence or absence of ileal disease or perianal disease at the time of ileorectal anastomosis did not effect the long term prognosis but patients with sigmoidoscopic proctitis appeared to fare less well (69 per cent still functioning) than those with an apparently normal rectum (87 per cent). However, no statistical significance was obtained. The risk of reoperation for recurrence of Crohn's disease after ileorectal anastomosis calculated by actuarial methods shows a 50 per cent cumulative reoperation rate after 16-20 years. This result suggests that ileorectal anastomosis is a safe and useful procedure for most patients with Crohn's colitis who did not have severe proctitis.

Adolescent↗
PubMed1981

[Experiences with non-human material for vascular access for long-term hemodialysis (author's transl)].

From 1975 until June 1980 a total of 115 arteriovenous fistulas were constructed in 81 patients, using non-human material for interposition. The results after implantation of human umbilical vein (n = 5) were poor because of high frequency of thrombosis, and after implantation of synthetic vascular grafts (n = 11) a high incidence of local infections had to be noted. In most patients therefore a bovine xenograft (n = 99) was used. After a follow-up of 1-48 months the calculated failure rate for the first year is 38%. The most common complication was thrombosis, with better results in curved than in straight grafts (P less than 0.05). Early thromboses were caused by a narrow anastomosis, late thromboses (after 2 months) by venous narrowing after the anastomosis. The time delay between construction and first use of the fistula had no influence on the survival rate of the fistulas. Longterm antithrombocyte medication showed better results than anticoagulation (P less than 0.05). We recommend the use of bovine xenografts for arteriovenous fistulas whenever the construction of a normal, direct arteriovenous fistula is not possible.

Adolescent↗
PubMed1981

Pathogenesis of urgency in defaecation in Crohn's disease.

In 39 patients with Crohn's disease with 20 suffering from urgency in defaecation, the degree of proctitis, anal basal and squeeze pressures and anal sphincter responses to passive rapid or slow rectal filling were not correlated to the presence or absence of urgency or its severity. However, there was a positive correlation between urgency and both defaecation frequency and looseness of stools as well as extent of disease, with invariable involvement of the small intestine in urgency patients. Disease confined to the colon was found only in non-urgency cases. It was proposed that extensive disease involving both the small and large intestine could elicit abnormal bowel motility, and lead to unusually rapid rectal filling, inevitably followed by rapid reflex relaxation of the anal sphincter, manifesting itself as urgency. This hypothesis would be consistent with the observation that operative removal of diseased bowel with ileorectal anastomosis may abolish urgency.

Adolescent↗