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S Kriwanek

Publications and source records attributed to S Kriwanek.

12 recordsLinked to original sources
PubMed1995

[Therapeutic failures after gastric bypass operations for morbid obesity].

BACKGROUND: Although gastric bypass is an effective treatment for morbid obesity, the postoperative results are unsatisfactory in 10% of all patients. Therapeutic failures after an operation performed with the sole purpose of reducing the risk of obesity-associated diseases have to be taken seriously. The goal of this study was to investigate the causes of these failures. METHOD: From 1979 to 1993, 165 gastric bypass operations (technique: Mason-Griffen) were performed. Long-term results were obtained in 60 patients after an average of 6.6 years (range 3-13). On follow-up all patients were examined and asked about their level of satisfaction with the weight loss achieved and changes in eating habits. RESULTS: In 6 patients the weight reduction was regarded as insufficient (BMI > 35 and reduction of BMI < 10). The causes of these failures were technical in 3 cases (gastric pouch to 0 large in 1, dilatation of gastrojejunostomy in 2). Three patients had a high calorie intake through an intact gastric bypass by snacking. Three patients regarded the operation as a failure although they had achieved significant weight loss, because they could no longer eat the usual amounts of food. CONCLUSION: Correct surgical technique and preoperative information on the changes in eating habits after a gastric bypass operation are the most important steps in preventing therapeutic failures.

Adolescent↗
PubMed1995

[Arthur Biedl and the beginnings of modern endocrinology. On the 125th birthday of the Austrian pathophysiologist].

Modern endocrinology began to develop at the end of the nineteenth century in four stages: the recognition and localization of endocrine glands, the experimental proof of internal secretion by means of destruction and substitution in animals, their isolation and lastly the synthesis of pure hormones. Arthur Biedl (1869-1933), an assistant of Salomon Stricker (1834-1898), was essentially involved in the first two stages of this research process. This paper presents his work from 1895 to 1914.

Austria↗
PubMed1994

Prognostic factors for survival in colonic perforation.

Colonic perforation is an abdominal emergency with high morbidity and mortality. This retrospective study was performed to evaluate the prognostic relevance of several factors and to characterize patients at high risk. One hundred and twelve patients (61 women, 51 men) were treated for colonic perforation from 1979 to 1992. Diverticulitis [65 patients (58%)] and carcinoma [24 patients (21%)] were the commonest pathology. In 62 cases (55%) perforation was found to be covered; 50 (45%) times it was free. 34 (30%) patients had diffuse peritonitis. Resection with primary anastomosis was performed 43 times (7 times with a protective colostomy). Resection without restoration of the intestinal continuity was carried out 53 times (including 49 Hartmann operations). Suture with drainage was performed 16 times mainly after iatrogenic perforation (8 times with a colostomy). The overall mortality was 19.6% (22 patients). The prognostic importance of various factors was investigated by univariate analysis (Wilcoxon and Chi-square test) and stepwise logistic regression including sex, age, underlying disease, localization and type of perforation, degree of peritonitis, pre- or postoperative organ failure, surgical procedure, reoperation, sepsis and the Mannheimer Peritonitis Index (MPI) score. Age over 65 years (relative risk 4.6, P = 0.0089), organ failure (relative risk 40, P = 0.001) and MPI (relative risk for an increase of 10 points 2.72, P = 0.001) proved to be the only risk factors of significance. The patient's course is determined by the septic state, while the underlying pathology and degree of peritonitis did not significantly influence survival.

Adolescent↗
PubMed1993

[Dorso-ventral continuous irrigation using the Incise Pouch].

Dorso-ventral lavage procedures in the treatment of abdominal sepsis are often complicated by technical and nursing problems. With the help of the Incise Pouch, which consists of an adhesive foil with a plastic bag around it, we have succeeded in solving the main problems of the dorso-ventral lavage procedure. (1) All the lavage solution is collected in the bag and drawn into a vacuum pump. The suction drains are placed directly in the bag. This enables us to measure the lavage solution exactly. (2) There is no leakage of liquid into the bed, so that the patient remains dry. (3) The danger of intestinal fistulas or intraabdominal bleeding caused by suction drains is eliminated (by putting them into the bag of the Incise Pouch). If reexploration of the abdominal cavity ("on demand" or planned) is done, the Incise Pouch remains in position. This method makes early diagnosis and treatment of postoperative complications possible.

Bandages↗
PubMed1990

[Appendix cancer].

Explore the source record for details and available documents.

Adenocarcinoma, Mucinous↗
PubMed1989

[The place of selective proximal vagotomy in complicated duodenal ulcers].

From 1980 to 1988 417 patients underwent surgery for peptic duodenal ulcer. Complications were present in 217 patients: perforation (40%), bleeding (32%), stenosis (20%) or penetration (8%). Highly selective vagotomy was performed in 67% of all patients. The number of operations for duodenal ulcer decreased (1984 n = 61, 1988 n = 28) due to fewer operations for uncomplicated ulcers, whereas the number of operations for complicated cases remained equal. Mortality after highly selective vagotomy for complicated duodenal ulcer was 5.2%. All fatalities occurred after bleeding. Whereas highly selective vagotomy was performed frequently for stenosing (72%) and bleeding (68%) ulcers it was the exception in perforate duodenal ulcers (13%). A tendency to increased performance of highly selective vagotomy in complicated cases is evident (1981 40%, 1988 70%). A further increase seems possible by using more liberal indications for selective vagotomy in perforated ulcers and by more frequently carrying out preoperative endoscopic hemostasis in bleeding duodenal ulcers.

Duodenal Obstruction↗
PubMed1989

[Gastric bypass in the management of morbid obesity].

A report is presented on 82 gastric bypass operations performed from 1979 to 1988. The average preoperative body weight was 132 kg, the body mass index (BMI) 45.0 +/- 7.0. 1 patient died (mortality 1%). 88 per cent of all patients were followed up 2 months to 9 years (2.5 years on average) postoperatively. The mean weight loss was 40.8 kg (reduction of BMI 15.1). Obesity-related diseases decreased remarkably, 3 stomal ulcers and 5 cases of anemia occurred as late complications. On the basis of these results gastric bypass is shown to be an effective and safe treatment of morbid obesity.

Adolescent↗
PubMed1989

[Indications for primary anastomosis following resection of acute diverticulitis of the large intestine].

A retrospective review of 102 patients (1979-1987) was performed to evaluate the surgical management of complicated diverticulitis. The following operative strategy was found to be effective: 1. the Hartmann procedure in free perforation and diffuse peritonitis; 2. resection with primary anastomosis in free perforation and localized peritonitis, covered perforation, inflammatory tumor and fistulas, if healthy bowel ends could be used for anastomosis.

Acute Disease↗