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R Lischke

Publications and source records attributed to R Lischke.

34 records · Page 2Linked to original sources
PubMed2002

[Bouveret's syndrome: biliary ileus manifested by acute upper gastrointestinal hemorrhage and impaired gastric emptying].

The authors present a very rare case of impaired gastric evacuation, known as Bouveret's syndrome, caused by a large biliary concrement wedged in the duodenum as a result of the development of a cholecystoduodenal fistula in a 77-year-old man. The condition was manifested clinically by developed high ileus and subsequent haemorrhage into the upper GIT. The diagnosis was established on the background of the clinical picture, passage through the upper GIT and endoscopy. As the attempt to remove the concrement endoscopically failed, laparotomy had to be used. In the conclusion of this case-record the authors discuss the method of assessment of the correct diagnosis endoscopically and possibilities of therapeutic strategy.

Aged↗
PubMed2001

[Bronchial anastomoses after lung transplantation: results with single running suture technique].

BACKGROUND: The standard technique for the bronchial anastomosis in LTX is a running suture on the membranous and single stitches on the cartilaginous portion of the bronchus. The aim of this retrospective study was to compare the results of this technique to the new single running suture technique. METHODS: Between January and December 1998, 56 consecutive single (n = 17) and bilateral (n = 39) lung transplants in 52 patients were performed. Eighty-three bronchial anastomoses were retrospectively analyzed and evaluated by separating into two groups: group 1 (24 patients, 39 anastomoses) with standard technique and group 2 (24 patients, 44 anastomoses) with single running suture. The two groups were comparable with regard to age, primary diagnosis, intraoperative use of extracorporeal circulation, ischemia time, duration of mechanical ventilation, ICU and number of acute rejections/100 days. Bronchial healing was assessed with bronchoscopic follow-up (5-16 months). RESULTS: Primary excellent airway healing was observed in 36 anastomoses (92%) in group 1 and in 41 (93%) in group 2. In 2 anastomoses in group 1 (5%) and in 2 anastomoses in group 2 (4.6%) necrosis less than 5 mm was observed. In one anastomosis in group 1 (2.7%) a 10-mm bronchial necrosis with partial occlusion of the bronchial lumen by necrotic tissue necessitated temporary intraluminal stenting. In one anastomosis in group 2 (2.3%) malacia of the bronchus intermedius occurred. CONCLUSION: The single running suture technique for bronchial anastomosis is a safe technique providing the same results as the established technique and we advocate its use for bronchial anastomosis.

Adult↗
PubMed2001

[Excision of extrahepatic bile ducts in laparoscopic cholecystectomy].

The authors describe the case of an excision of the extrahepatic portion of the right, left and common hepatic duct. Concurrently the authors discuss indications for peroperative drainage of biliodigestive anastomoses. At the Third Surgical Clinic the authors operated during the last three years nine patients with injuries of the biliary pathways during laparoscopic cholecystectomy. In three patients it was possible to suture partial injuries to a T-drain. In six patients with complete severing of the pathways a hepatoenteral anastomosis was established.

Adult↗
PubMed2000

[Bronchial anastomoses in lung transplantation].

Bronchial anastomosis is as to the number of complications the most risky anastomosis of transplanted lungs. The most suitable of hitherto used techniques is simple suture with continuous stitches or individual absorbable stitches. The authors prefer the latter technique. They performed a total of 34 bronchial anastomoses. In none dehiscence or stenosis of the anastomosis was occurred. In case of complication of the anastomosis, surgeons often consider the cause of the failure to be ischaemia of the border of the tissue at the time of suture of the anastomosis, corticoid treatment or a poor nutritional status of the patient. The authors cannot confirm the above statements from their own experience, similarly as other authors. They are however aware of the fact that their group of anastomoses is small.

Adult↗
PubMed2000

[Healing of bronchial anastomoses in lung transplantation: comparison of two techniques].

The authors present a group of patients with transplantations made in 1988 at the Department of Cardiac and Thoracic Surgery of the Surgical University Clinic in Vienna under the guidance of Prof. W. Klepetko. This department serves also as a training place for the centre for transplantations of the lungs in the Faculty Hospital Motol. The standard technique of suture of bronchial anastomoses in transplantations of the lungs is continuous suture on the pars membranacea and individual stitches on the pars cartilaginea of the bronchus. The objective of this retrospective study was to compare the results when using the established technique with the use of a new technique--suture of the anastomsis by one continuous stitch. The technique of one continuous stitch when suturing bronchial anastomoses is a safe method which gives similar results as the established technique. As it is simpler and saves time, it may be recommended for bronchial anastomoses during transplantation of the lungs. While using the mentioned techniques only a minimum of complications was recorded.

Adult↗
PubMed1999

[Aspergillus osteomyelitis of the sternum].

The objective of the work was to describe experience with the treatment of Aspergillus osteomyelitis of the sternum. Radical resection of the affected portion of the bone with subsequent filling of the defect of the part of the omentum majus proved useful. Complete healing occurred after 4 months. Based on their own experience the authors assume that resection therapy is the method of choice in pulmonary aspergilloma. In the described case with affection of the thoracic wall its resection with subsequent filling of the defect by the omentum majus proved useful. The operation was implemented in a single stage.

Aspergillosis↗
PubMed1998

[Techniques and tactics in multiorgan harvesting].

The eighties and nineties are characterized by potent development of transplantology. Despite this the number of patients with organ failures waiting for a suitable organ is steadily increasing. Due to the permanent shortage of donors transplantation surgery tries to implement the maximum possible multiple organ collection. In the conclusion the authors emphasize the importance of satisfactory cooperation of the anaesthesiologist attending donors and the organ collection teams.

Humans↗
PubMed1997

[Perforation of gastric and duodenal ulcers--laparoscopic sutures].

The authors compare in a small group of patients the results of treatment of perforation of peptic gastroduodenal ulcers. Some patients were treated by suture using a miniinvasive approach and some by classical laparotomy. The first laparoscopic treatment of a perforated ulcer was made at the Third Surgical Clinic in July 1995. Since then up to February 1997 thus eight patients were treated. During the same period seven patients were treated by the classical approach. Comparison of the period of hospitalization, postoperative complications, consumption of analgesics and postoperative temperature in these almost identical groups revealed that the results are more favourable after laparoscopic sutures.

Adult↗
PubMed1996

[Zenker's diverticulum].

In the course of 10 years 72 patients with an oesophageal diverticulum were operated, incl. 56 with a Zenker diverticulum. The incidence of operative and postoperative complications declined markedly after the introduction of peroperative fibroscopy and the use of fine absorbable atraumatic fibres, in indicated cases also puncture pharyngostomy was used. The authors did not record practically any relapses of diverticula, 81.4% of the patients are after a long-term follow up free from complaints.

Aged↗
PubMedDate not supplied

Lung transplantation for cystic fibrosis: immune system and autoimmunity.

BACKGROUND: In the current study we focused on changes in the immune parameters of patients with CF after lung transplantation (Tx), with particular emphasis on the interaction of the immune system, infection, the autoimmune phenomenon observed in some CF patients, and immunosuppression. MATERIAL AND METHODS: Seven transplant patients with CF were investigated, 3 men and 4 women; the average age at Tx was 24.2 years (20.2-32.3). The parameters of both humoral immunity (immunoglobulins, complement, CRP, antinuclear and antineutrophil cytoplasmic antibodies) and cellular immunity (T and B lymphocytes, NK cells) were traced. RESULTS: We observed marked initial hyperimmunoglobulinemia, with a sharp drop in immunoglobulin levels within 1 month after Tx. Positivity for antineutrophil cytoplasmic antibodies (ANCA) was found in 3 patients before Tx. A strong ANCA positivity persisted 2 months after Tx despite deep introductory immunosuppression. In one patient ANCA positivity, after a transient negative result at months 2 and 12 after Tx, reappeared one year after Tx. The Burkholderia cepacia infections found in 2 patients proved to be lethal. CONCLUSIONS: In our series of CF lung transplant recipients, we found Burkholderia cepacia infection to be a risk factor. The robust appearance of autoantibodies and their persistent positivity for many months despite deep immunosuppression is a remarkable feature observed in some CF patients.

Adult↗