Library

X
feed icon rss

Your email was sent successfully. Check your inbox.

An error occurred while sending the email. Please try again.

Proceed reservation?

Export
  • 1
    Electronic Resource
    Electronic Resource
    Surgical therapy of Zenker's diverticulum: Low risk and high efficiency (1990)
    Springer
    Dysphagia 5 (1990), S. 13-19 
    Details
    ISSN: 1432-0460
    Keywords: Zenker's diverticulum ; Cervical myotomy ; Diverticulectomy ; Deglutition ; Deglutition disorders
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Surgery for the treatment of Zenker's diverticulum was performed at our institution in a total of 43 patients over 6½ years. Cervical myotomy with diverticulectomy was performed in 32 of the patients and myotomy alone in 11. Mortality totaled 0%, with a reversible lesion of the recurrent nerve occurring in 7%. In 60% of the cases investigated preoperatively (N=40), motility disorders of the upper esophageal sphincter (UES) could be demonstrated using manometry as well as with cineradiography in 92% of the patients. Follow-up studies in 39 of the cases 25 months (mean) postprocedure indicated 82% of the patients to be symptom-free, with the remaining 18% demonstrating a marked improvement. Postoperative manometry as well as cineradiography carried out in 12 patients revealed the presence of UES motility dyscoordination in 8% and 25%, respectively. There were, however, no signs of recurrence of the diverticulum. The high number of patients in our study group demonstrating motility disorders of the UES emphasizes the need for cervical myotomy as part of the surgical therapy for Zenker's diverticulum.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02407389
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 2
    Electronic Resource
    Electronic Resource
    The surgical management of motility disorders (1993)
    Springer
    Dysphagia 8 (1993), S. 135-145 
    Details
    ISSN: 1432-0460
    Keywords: Esophageal motility ; Surgical therapy ; Deglutition ; Deglutition disorders
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Surgical treatment is either the therapy of choice or a facultative procedure in various types of esophageal motility disorders. In achalasia, cardiomyotomy, frequently combined with fundoplasty, achieves good or excellent results in 〉80% of cases, and is, therefore, advised in cases when pneumostatic dilatation fails. Diverticulectomy and myotomy of the upper or lower esophageal sphincter are proven procedures to treat cervical and epiphrenic diverticula, leading to good/excellent results or at least an improvement in more than 95%. If, exceptionally, parabronchial diverticula require therapy, they should be excised transthoracically. Cervical myotomy is indicated in cases of cervical achalasia, when sufficient pharyngeal propulsion is preserved. In systemic diseases like scleroderma reflux induced complications may require surgical intervention in medically intractable cases. In these rather few cases, subtotal gastrectomy with a Roux-en-Y anastomosis is advised. In patients suffering from diffuse esophageal spasm or symptomatic “nutcracker” esophagus, extended esophageal myotomy can relieve symptoms. If a clear diagnosis is provided, about 75% of patients will have an improvement of symptoms.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02266994
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 3
    Electronic Resource
    Electronic Resource
    The place of esophageal manometry in the diagnosis of dysphagia (1993)
    Springer
    Dysphagia 8 (1993), S. 98-104 
    Details
    ISSN: 1432-0460
    Keywords: Esophageal manometry ; Motility disorders ; Deglutition ; Deglutition disorders
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Esophageal manometry allows to quantify intraluminal pressure changes as the basis of normal or abnormal esophageal motility. It is a complementary diagnostic procedure which should only be performed after endoscopic and fluoroscopic examinations and may be helpful in the detection of various motility disorders like diffuse esophageal spasm, nutcracker esophagus and vigorous achalasia. Manometry is recommendable for therapy control after medical and surgical therapy, and mandatory prior to surgical reflux therapy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02266988
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 4
    Electronic Resource
    Electronic Resource
    pH monitoring: The gold standard in detection of gastrointestinal reflux disease? (1993)
    Springer
    Dysphagia 8 (1993), S. 118-121 
    Details
    ISSN: 1432-0460
    Keywords: Gastroesophageal reflux disease ; Diagnosis ; pH monitoring ; Diagnostic studies ; Deglutition ; Deglutition disorders
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Gastroesophageal reflux disease (GERD) is one of the most frequent benign diseases of the gastrointestinal tract and in some cases the diagnosis may be very difficult. There are many diagnostic procedures but none of them could prove or definitely exclude the disease. The 24-h pH-monitoring is the “gold standard” for detection of gastroesophageal reflux and in many patients the reflux correlates with the GERD. The evaluation of a diagnostic method has to be done in a similar manner to the evaluation of therapeutic study (phase 1 to phase 4). For the definition of the “gold standard” for detection of a special diagnosis (e.g., the gastroesophageal reflux disease), the results of phase 3 studies for different methods had to be compared. The method with the best values for sensitivity and specificity is yet to be discovered. Until now, pH monitoring has been the gold standard for the diagnosis of GERD. However, there are many problems connected with using this method in clinical practice.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02266991
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 5
    Electronic Resource
    Electronic Resource
    Barrett's esophagus: Pathogenesis, epidemiology, functional abnormalities, malignant degeneration, and surgical management (1993)
    Springer
    Dysphagia 8 (1993), S. 276-288 
    Details
    ISSN: 1432-0460
    Keywords: Barrett's esophagus ; Gastroesophageal reflux ; Adenocarcinoma ; High grade dysplasia ; Deglutition ; Deglutition disorders
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Barrett's esophagus (i.e. columnar epithelial metaplasia in the distal esophagus) is an acquired condition that in most patients results from chronic gastroesophageal reflux. It is a disorder of the white male in the Western world with a prevalence of about 1/400 population. Due to the decreased sensitivity of the columnar epithelium to symptoms, Barrett's esophagus remains undiagnosed in the majority of patients. Gastroesophageal reflux disease in patients with Barrett's esophagus has a more severe character and is more frequently associated with complications as compared with reflux patients without columnar mucosa. This appears to be due to a combination of a mechanically defective lower esophageal sphincter, inefficient esophageal clearance function, and gastric acid hypersecretion. Excessive reflux of alkaline duodenal contents may be responsible for the development of complications (i.e., stricture, ulcer, and dysplasia). Therapy of benign Barrett's esophagus is directed towards treatment of the underlying reflux disease. Barrett's esophagus is associated with a 30- to 125-fold increased risk for adenocarcinoma of the esophagus. The reasons for the dramatic rise in the incidence of esophageal adenocarcinoma, which occurred during the past years, are unknown. High grade dysplasia in a patient with columnar mucosa is an ominous sign for malignant degeneration. Whether an esophagectomy should be performed in patients with high grade dysplasia remains controversial. Complete resection of the tumor and its lymphatic drainage is the procedure of choice in all patients with a resectable carcinoma who are fit for surgery. In patients with tumors located in the distal esophagus, this can be achieved by a transhiatal en-bloc esophagectomy and proximal gastrectomy. Early adenocarcinoma can be cured by this approach. The value of multimodality therapy in patients with advanced tumors needs to be shown in randomized prospective trials.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01354551
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 6
    Electronic Resource
    Electronic Resource
    19. Chirurgische Therapie des Plattenepithelcarcinoms des Oesophagus -erweiterte Radikalität (1987)
    Springer
    Langenbeck's archives of surgery 372 (1987), S. 129-139 
    Details
    ISSN: 1435-2451
    Keywords: En-bloc-esophagectomy ; Esophageal carcinoma ; Standard esophagectomy ; Transmediastinal esophagectomy ; En-bloc-Oesophagektomie ; Oesophaguscarcinom ; Standard-Oesophagektomie ; Transmediastinale Oesophagektomie
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Die Analyse des eigenen Krankengutes zeigt, dass die sog. en-bloc-Oesophagektomie nicht risikoreicher ist als vergleichbar limitierte Eingriffe wie die Standard-Oesophagektomie oder die transmediastinale Oesophagektomie. Die Letalität und die Komplikationen liegen jeweils im vergleichbaren Bereich (n = 147; Letalität:I 6,6%-,II 7,7%). Die Analyse der Überlebenszeiten von 83 Patienten mit Plattenepithelcarcinom des thorakalen Oesophagus ergibt eine 4-Jahres-Überlebenszeit von 54% für die T1/2-Kategorie. Dabei ist die Prognose von NO- und N1-Metastasierungen gleich, was als Erfolg der en-bloc-Resektion gewertet werden kann. Die Prognose der T3/4-Tumorkategorien ist wesentlich schlechter.
    Notes: Summary The analysis of our own patients shows that the so-called en-bloc-esophagectomy does not bear more risks compared to standard esophagectomy or transmediastinal esophagectomy. Lethality and complications are within comparable ranges (n = 147; lethality: 16.6%,II 7.7%). In 83 patients with squamous cell carcinoma of the thoracic esophagus the analysis of survival time shows a 4-year survival time in 54% for the T1/2-category. At the same time the prognosis is equal for both NO- and Nl-metastasis. This can be seen as a success of the en-bloc resection. The prognosis of the T3/4-tumor category is much worser.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01297803
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 7
    Electronic Resource
    Electronic Resource
    301. Transthorakale „en-bloc-Resektion” des Oesophaguscarcinoms (1987)
    Springer
    Langenbeck's archives of surgery 372 (1987), S. 924-924 
    Details
    ISSN: 1435-2451
    Keywords: Esophageal carcinoma ; En-bloc esophagectomy ; Mediastinal lymphadenectomy ; Esophagogastrostomy ; Oesophaguscarcinom ; En-bloc-Oesophagektomie ; Mediastinale Lymphadenektomie ; Oesophago-Gastrostomie
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Der Film zeigt die Technik der en-bloc-Oesophagektomie beim Oesophaguscarcinom. Bei dieser Operationstechnik werden der Oesophagus nebst angrenzendem mediastinalem Lymph- und Fettgewebe inclusive der V. azygos und des Ductus thoracicus entfernt. Diese Ausräumung des Mediastinums führt zu einer mediastinalen Lymphadenektomie. Zusätzlich werden Ausmass und Technik der abdominellen Lymphadenektomie gezeigt. Die Rekonstruktion der Speisepassage erfolgt durch Mageninterposition mit cervicaler Oesophago-Gastrostomie.
    Notes: Summary The film shows the technique of en-bloc esophagectomy in esophageal carcinoma. With this surgical technique it is possible to resect the esophagus with the surrounding lymphatic and fatty tissue, including the azygos vein and the thoracic duct. This mediastinectomy leads to a regional lymphadenectomy. In addition, the extent and technique of abdominal lymphadenectomy are also shown. Reconstruction of the food passageway is done by gastric interposition with cervical esophagogastrostomy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01298086
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 8
    Electronic Resource
    Electronic Resource
    Ernährungsstatus beim Oesophaguscarcinom: Erfassung und Bedeutung für eine präoperative Risikoabschätzung (1989)
    Springer
    Langenbeck's archives of surgery 374 (1989), S. 25-31 
    Details
    ISSN: 1435-2451
    Keywords: Esophageal carcinoma ; Malnutrition ; Esophageal resection ; Risk factors
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung In einer prospektiven Untersuchung von 60 Patienten mit Oesophagus-carcinom wurde der Ernährungsstatus anhand anthropometrischer, laborchemischer und immunologischer Daten bestimmt. Nach dem Vorschlag von Gofferje und Fekl wurde jeder Einzel-parameter entsprechend seiner Minderung in 10%-Stufen gewertet und mit einer linear ansteigenden Punktezahl belegt; die Summe aller 11 Einzelwerte gilt als Maß zur Beurteilung einer bestehenden Malnutrition. Als zweites Verfahren zur Einschätzung des Ernährungsstatus wurde der PNI (prognostic nutrition index) nach Buzby und Mullen verwendet. Sowohl Score als auch Index wurden in Beziehung gesetzt zu schwerwiegenden postoperativen Komplikationen (Wundheilungs-störung, Sepsis, Organinsuffizienz, Tod). Das Ergebnis zeigt, daß eine präoperative Risikoabschätzung aufgrund von Ernährungsparametern allein nicht möglich war. Grund hierfür ist wahrscheinlich der in den meisten Fällen noch zufriedenstellende Ernährungszustand, so daß die davon ausgehende Risikobelastung zu gering war. Deshalb erscheint auch eine routinemäßige operationsvorbereitende Ernährungstherapie nicht gerechtfertigt.
    Notes: Summary In a prospective study including 60 patients with esophageal carcinoma the nutritional status was evaluated by means of anthropometric, biochemical and immunological data. As a first measure of malnutrition the diminuation of each single parameter was estimated in a 10%-scale, according to this a linear rising number of points given and the sum for all 11 parameters expressed as a score (Gofferje and Fekl). Second the nutritional status was judged by the prognostic nutritional index (Buzby and Mullen). Both score and index were correlated with serious postoperative complications (wound infection, anastomotic leakage, sepsis, organ failure, death). The results show that it was not possible to assess the risk of esophagectomy preoperatively on the ground of nutritional parameters solely. The reason could be that the nutritional status was rather normal in most cases and its risk burden therefore low. In conclusion performing preoperative nutritional therapy routinely seems not to be justified.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01261932
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
Close ⊗
This website uses cookies and the analysis tool Matomo. More information can be found here...