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  • Colorectal liver metastases  (1)
  • Idiopathic fecal incontinence  (1)
  • Key words: Laparoscopic — Gastroplasty — Conversions — Complications  (1)
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  • 1
    Electronic Resource
    Electronic Resource
    Colorectal metastases to the liver: Present status of management (1990)
    Springer
    Diseases of the colon & rectum 33 (1990), S. 688-694 
    Details
    ISSN: 1530-0358
    Keywords: Colorectal liver metastases ; Hepatic resection ; Locoregional chemotherapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The management of patients with hepatic metastases from colorectal carcinoma is controversial. While a “no treatment” attitude still persists, other patients undergo systemic chemotherapy with very limited results. Other possible options are hepatic resection and locoregional treatments. One hundred twenty-three patients with hepatic metastases from colorectal cancer were treated at the authors' institution over a period of 15 years. Thirty-nine patients underwent hepatic resection while 84 underwent various forms of locoregional treatment. Several patients in the latter group were registered in one national (RNSI) Phase 2 study and one international (EORTC Phase 3 trial. The authors' experience confirms the opinion that hepatic resection can be performed with the aim of curing in patients with isolated metastases. A five-year survival rate can be achieved in 25 to 30 percent of the resectable patients. Patients with unresectable extrahepatic disease or multiple bilateral metastases are usually excluded from resection. In other cases, hepatic resection should be carried out when technically possible. The value of adjuvant chemotherapy to the remaining liver has to be tested in prospective randomized trials. Patients with diffuse metastases can benefit from locoregional infusion of chemotherapeutic agents. Symptoms improve in most patients; objective responses vary from 53 to 83 percent of the cases, which is a higher rate than that reported for systemic chemotherapy. Survival may be prolonged in respect to untreated patients but this has not been demonstrated yet by prospective randomized studies. Current trends are continuous infusion of chemotherapeutic agents and experimentation of new drugs or drug combinations. Future improvements may be achieved by adding hepatic arterial ischemia, hyperthermia, or radiation therapy. As these kinds of treatments are still experimental, they should be applied to the patients only in the context of prospective clinical trials.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02150746
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Striated anal sphincter electromyography in idiopathic fecal incontinence (1995)
    Springer
    Diseases of the colon & rectum 38 (1995), S. 27-31 
    Details
    ISSN: 1530-0358
    Keywords: Sphincter electromyography ; Idiopathic fecal incontinence ; Anal manometry ; Anal sphincter
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract PURPOSE: This study was designed to determine the importance of innervation of striated anal sphincters, one of the most important structures in idiopathic fecal incontinence. METHODS: Forty-three idiopathic, fecally incontinent patients (40 women and 3 men; mean age, 57.2±11 (range, 33–77) years) underwent anorectal manometry and sphincteric electromyography. On the basis of electromyographic findings, patients were subdivided into three groups: Group A consisted of 21 patients with normal electromyography; Group B consisted of 14 patients with moderate denervation; Group C consisted of 8 patients with severe denervation. Manometric results from the patients were compared with those from 15 healthy subjects (8 women and 7 men; mean age, 35±12 (range, 15–55) years). RESULTS: Incontinent patients had a shorter anal canal (P =0.005), and anal canal pressure was lower at rest (P 〈0.001), at contraction (P 〈0.001), and at coughing (P 〈0.001); rectal distention and rectal compliance were reduced (maximum tolerated volume,P 〈0.003; compliance at 200 ml,P =0.03; at 250,P 〈0.005; at 300 ml,P =0.03). No statistically significant differences were found between the manometric results of the three different groups of patients. A statistically significant linear correlation was reached by comparing the clinical severity of fecal incontinence with age (P =0.02) and some other manometric parameters: the pressure of the anal canal at rest (P 〈0.001) and at contraction (P 〈0.01); rectal compliance at 50 ml (P =0.03), 100 ml (P =0.004), and 150 ml (P =0.004). CONCLUSION: Clinical severity of fecal incontinence is correlated with some manometric parameters. Severity of denervation of the anal striated sphincters does not appear to influence severity of fecal incontinence.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02053853
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Conversions and complications in 185 laparoscopic adjustable silicone gastric banding cases (1997)
    Springer
    Surgical endoscopy and other interventional techniques 11 (1997), S. 268 -271 
    Details
    ISSN: 1432-2218
    Keywords: Key words: Laparoscopic — Gastroplasty — Conversions — Complications
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Kuzmak's gastric silicone banding technique is the least invasive operation for morbid obesity. The purpose of this study was to analyze the complications of this approach. Methods: Between September 1992 and March 1996, 185 patients underwent laparoscopic gastroplasty by the adjustable silicone band technique. A minimally invasive procedure using five trocars was performed. Results: In 11 patients exposure of the hiatus was impeded because of hypertrophy of the left liver lobe which led to conversion in eight patients and abortion of the procedure in three other patients. Anatomical complications: We observed two gastric perforations and one band slippage at the early stage, one infection and three rotations of the access port. Functional complications: There were eight (4%) cases of irreversible total food intolerance resulting in pouch dilation and eight cases (4%) of esophagitis. One fatality on the 45th day in a patient with a Prader-Willi syndrome. Conclusion: The most disturbing complications of gastric banding technique are gastric perforation and pouch dilation. Their incidence may be reduced by improving the technique and by considering pitfalls of the procedure.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004649900341
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    Paper (German National Licenses)
    Fulltext
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