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W Kozuschek

Publications and source records attributed to W Kozuschek.

At least 19 recordsLinked to original sources
PubMed1998

[Pancreas transplantation with bladder and intestinal drainage technique with systemic-venous and initial experiences with portal venous drainage. Which technique can be recommended today?].

The experience worldwide with pancreas transplantation includes more than 9000 cases. In the most popular patient group (simultaneous pancreas-kidney transplantation, SPK) the graft-function rate at 1 year now reaches more than 80%. More than 90% of all pancreas transplants were performed using the bladder-drainage technique (BD) with systemic venous anastomosis. Late problems with the BD require enteric conversion in 10-20% in the long term. In the present study we report the results of 40 SPK using the BD (n = 20) and enteric drainage (ED) techniques (n = 20). After 3 months, the patients pancreas and kidney survival rates in the BD group were 100, 95 and 100% and in the ED group 100, 100 and 100%, respectively. No anastomosis leakage occurred in either group. In two cases of the ED group the pancreas grafts were drained portal venously via the superior mesenteric vein without surgical complications. With growing experience, excellent SPK results can be reached with both the BD and ED techniques.

Adult↗
PubMed1997

Simultaneous pancreas-/kidney transplantation--the Bochum experience.

Since the introduction of the bladder drainage technique, the number of pancreas transplants performed has now reached 1,000 per year worldwide. Most of these transplants have been performed in the United States. In contrast, the number of pancreas transplants performed in the Eurotransplant community has remained at a low level for several years. The results of a consecutive series of 40 simultaneous pancreas/kidney transplantations (SPK) performed between June 1994 and July 1996 demonstrate that high 1-year graft function rates of 87.1% for pancreas and 94.8% for kidney grafts can be achieved. Therefore, SPK can be recommended as a standard procedure for patients with insulin-dependent diabetes mellitus and end-stage renal disease in Germany, too.

Adult↗
PubMed1997

The change of therapy in esophagus carcinoma between 1975-1996.

196 patients were assigned to an operation because of esophagus carcinoma between 20.05.1975 and 30.09.1996. Whereas until 1984 the surgical treatment was predominantly characterized by the uni-cavity operation, we increasingly practice the bi-cavity operation since them. By this procedure the resection rate could be extended up to 70.1%. As to be expected, most of the carcinomas were positioned in the medium third of the esophagus, the predominant tumor type was the squamos cell carcinoma, 85% of the patients had a stage three tumor. The mortality rate was 19.1% within the period of 6 weeks after the operation.

Adult↗
PubMed1997

The oncological approach to pylorus preserving pancreatoduodenectomy (PPPD) in pancreas malignancies.

There has been a considerable debate about whether pylorus preservation significantly detracts from the radicality in a palliative procedure where a conventional Whipple operation would have been curative. We know now, that the extending radicality of the Whipple operation does not improve the long-term survival rates. Our results of 127 PPPD and 54 Whipple procedures in pancreas malignancies from 1985 to 1996 showed the nutritional benefits of the PPPD group as compared to the standard Whipple group. 84% (99/121) vs. 24% (13/50) were able to gain postoperatively. The long-term survival rates of both groups and the results in the literature are similar.

Breath Tests↗
PubMed1996

[Current indications for pylorus saving duodenopancreatic head resection in malignancy].

The Whipple procedure has been improved by preservation of a functioning pylorus. A functioning pylorus is important because marginal ulceration is avoided and, compared to the standard Whipple procedure with gastric resection, more patients can gain weight postoperatively. The most common indications are carcinomas of ampulla of Vater and periampullary tumors. In patients with pancreatic adenocarcinoma the pylorus-preserving variety results in equal or better survival rates. In 56 patients with pylorus preservation, 32 with ductal carcinoma, and 28 with Kausch-Whipple between 1985 and 1993, our results showed slightly better survival rates and better postoperative nutrition. The weakest aspect of the radical resection addresses the retroperitoneal margin of the pancreas head and not the gastric resection.

Adenocarcinoma↗
PubMed1996

[Combined pancreas/kidney transplantation as standard procedure in therapy of type I diabetic patients in renal failure].

Sinde the introduction of the bladder drainage technique, the number of pancreas transplants performed has now reached 1000/year worldwide. Most of these transplants have been performed in the United States. In contrast, the number of pancreas transplants performed in the Eurotransplant community has remained at a low level for several years. The results of a consecutive series of 20 simultaneous pancreas/kidney grafts (SPK) performed between June 1994 and October 1995 demonstrate that high graft function rates of 83.5% for pancreas and kidney grafts can be achieved. Therefore SPK can be recommended as a standard procedure for patients with insulin-dependent diabetes mellitus and end-stage renal disease in Germany, too.

Adult↗
PubMed1996

[Kidney donation by the elderly--an emergency solution?].

In 1994 the number of kidney donors once again decreased in Germany. On the other hand, more and more old people are being considered for renal transplantation; thus the shortage of transplants is becoming more severe. The kidneys of elderly donors might improve this situation. The results available are inconsistent. There is no doubt that kidney function declines with age, but the individual aging process depends mainly on concomitant disease, especially arterial hypertension. Transplantation of kidney from an elderly person requires appropriate selection of donors as well as good perioperative management. Doctors in medical intensive care units should contact transplant centres more often to evaluate potential elderly kidney donors. More open-minded assessment of certain situations is necessary in conservative medical disciplines.

Adult↗
PubMed1996

Laparoscopic marsupialization of lymphocele after combined pancreas-kidney transplantation.

Early definitive treatment of symptomatic posttransplant lymphoceles offers good results with fewer graft losses and reduced morbidity. If interventional therapy fails, laparoscopic internal marsupialization to the peritoneal cavity may be performed with excellent results and at low cost. In combined pancreas-kidney transplantation the transperitoneal laparoscopic access may be difficult due to adhesions caused by the intraabdominal positioning of the pancreatic graft and posttransplantation pancreatitis. Both posttransplantation lavage of the abdominal cavity as well as immunosuppression reduce formation of intraabdominal adhesions subsequent to combined pancreas-kidney transplantation. Thus, posttransplant lymphoceles may be treated safely even after combined kidney-pancreas transplantation.

Humans↗
PubMed1995

[Morphology and biological integration of autodermoplasties in large incisional hernias. Results of an experimental study].

UNLABELLED: Their aim of the experimental study was to investigate the morphology and wound healing of "Kutisplastik"-technique, originally introduced by Loewe (1913) and Rehn (1914), from different conditions. We want to clarify the mechanism and development of revascularisation. RESULTS: The well known phases of wound healing also appear in the situation of a cutisplasty. In the exsudative reaction the cutis is covered from fibrin fibers. This leads to the development of granulation tissue. The cellular reaction demonstrates first the in-growth of capillary bundles and vessels in the collagen network of corium. The revascularisation is finished up to 14 days after the operation. The other part is the immigration of granulocytes and macrophages in the graft. The release of enzymes leads to the lysis of epidermal structures, cutaneous appendages and at least to collagen fibers of corium. There is also a proliferation from fibroblasts. The genesis from new collagen fibers is then observed so a scar tissue reveals. The "Kutisplastik"-technique contains that the epidermal side of the graft is turned upside-down towards the peritoneum and is sutured under as high tension as possible to the healthy fascia around. This morphology of healing is seen only under high-tension suturing. In the experimental mode of non-tension suturing there is a lack of success in cutisplasty for abdominal wall defects.

Animals↗
PubMed1994

A comparison of long term results of the standard Whipple procedure and the pylorus preserving pancreatoduodenectomy.

The standard Whipple procedure involves intestinal disturbances, such as dumping, diarrhea, dyspeptic complaints and the occurrence of ulcers of the anastomoses. A postoperative weight loss was observed ranging between 10 and 40 kilograms. Only a few patients were able to compensate after several months. It was thought that preservation of the intact stomach would prevent the complications arising from a loss of gastric reservoir function and thus the malnutrition could be improved postoperatively. Between 1985 and March 1992, we performed the pylorus-preserving Whipple procedure and treated a group of 43 patients with this method. In the same period, 15 patients were operated upon with the standard Whipple procedure. The present evaluation of the accumulated patient data, including extensive functional studies, led to the following results comparing the pylorus preserving Whipple procedure with the standard Whipple procedure. First, the capacity for food uptake and the development of body weight postoperatively is significantly better. Second, gastric or jejunal ulcers were not observed. Third, there were no clinical signs of digestive disorders, such as different forms of dumping. Nutrition and digestion were not impeded by the preserved opening mechanism of the pylorus. Fourth, the postoperative exocrine function was only slightly decreased. Fifth, glucose metabolism postoperatively was influenced only slightly by preservation of the pylorus. In taking the results of all the examinations into consideration, it can be said that the restricted organ loss in the Whipple procedure with pylorus preservation leaves the secretory and functional capacity of the upper part of the gastrointestinal tract almost unchanged.

Adult↗