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  • 1
    Electronic Resource
    Electronic Resource
    Perioperative treatment with Filgrastim stimulates granulocyte function and reduces infectious complications after esophagectomy (2000)
    Springer
    Annals of hematology 79 (2000), S. 143-151 
    Details
    ISSN: 1432-0584
    Keywords: Neutrophil function ; Esophageal cancer ; Filgrastim ; Infection ; Surgery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: n =27) were measured on days −2, 2, and 10. Neutrophil function was enhanced in the Filgrastim-treated group by factor 1.2 for phagocytosis (p=0.016) and 1.4 for oxidative burst (p=0.154). Leukocyte counts increased from 7.6×109/l (day −2) to a maximum of 45×109/l on day 6. No infection was reported in the study group (mean age 59.7 years; 13 men, seven women) up to 10 days after surgery. In contrast, 23 patients (29.9%) in a historical control group (mean age 56 years; 67 men, ten women) treated at the same center developed infections within the first 10 days (p=0.008). In addition, no postoperative deaths occurred in the study group, compared with 9.1% in the group of historical controls. Thus, in this study, administration of Filgrastim stimulated neutrophil function in patients undergoing esophagectomy, and it might be effective in reducing infectious complications related to the surgical procedure.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002770050570
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  • 2
    Electronic Resource
    Electronic Resource
    Treatment of dysphagia in esophageal carcinoma: Transthoracic En-Bloc esophagectomy and reconstruction 48 hours later (1988)
    Springer
    Dysphagia 2 (1988), S. 222-227 
    Details
    ISSN: 1432-0460
    Keywords: Esophageal cancer ; Transthoracic esophagectomy ; Mediastinal lymphadenectomy ; Delayed reconstruction ; Blunt esophageal dissection
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In 82 consecutive patients with esophageal cancer (90% squamous cell carcinoma, 10% adenocarcinoma) transthoracic “en bloc” esophagotomy with regional lymphadenectomy was performed. The reconstruction with gastric interposition was carried out with delayed urgency in a second operation 48–72 h after the initial procedure. The results of this group were compared to a group of 65 patients who had transmediastinal esophagectomy without thoractotomy and mediastinal as well as suprapancreatic lymphadenectomy and immediate reconstruction by gastric interposition. The number of postoperative risk situations concerning cardiopulmonary features were comparable in both groups. The 30-day mortality rate and postoperative morbidity was not significantly different between both patient groups (mortality rate: transthoracic: 6.6%, transmediastinal: 7.7%). The advantages of a 2-stage procedure are that esophagectomy and especially mediastinal lymphadenectomy can be performed precisely without time pressure. After 2 days the stomach is hypotonic and dilated as a result of truncal vagotomy and can easily be elevated to the neck. The interval of 48–72 hours was chosen because the postoperative right-to-left shunt has nearly normalized after this time period. En bloc esophagectomy and reconstruction with delayed urgency can be performed without disadvantages compared to a 1-stage procedure. It can especially be recommended for operations in which esophagectomy and mediastinal lymphadenectomy are difficult and wearisome.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02414431
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  • 3
    Electronic Resource
    Electronic Resource
    Intraoperative ultrasonographic detection of occult liver metastases in colorectal cancer (1991)
    Springer
    Surgical endoscopy and other interventional techniques 5 (1991), S. 36-40 
    Details
    ISSN: 1432-2218
    Keywords: Colorectal cancer ; Liver metastases ; Intraoperative ultrasonography ; Preoperative ultrasonography ; Computed tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The efficacy of intraoperative ultrasonographic detection of colorectal cancer liver metastases was evaluated in 85 patients undergoing operation for primary colorectal tumors or liver secondaries. The results of intraoperative ultrasonography were compared with those of preoperative ultrasonography and computed tomography, as well as the intraoperative appearances of the liver. Additional information about the number of metastases was obtained in 12 cases (14.1%); 17 (24.3%) out of 70 metastases could only be detected by intraoperative ultrasonography. In 4 cases (4.7%) these lesions were solitary. As a result, the operative procedure of choice was changed in 15.3% of the patients. We conclude that intraoperative ultrasonography has a significantly higher ability to detect colorectal cancer liver metastases than preoperative methods or intraoperative inspection and palpation. Intraoperative ultrasonography should be performed in patients without preoperative evidence of liver metastases and in all patients with planned resection of metastases.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00591385
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  • 4
    Electronic Resource
    Electronic Resource
    En-bloc Oesophagektomie — wann soll die Speisepassage rekonstruiert werden? (1990)
    Springer
    Langenbeck's archives of surgery 375 (1990), S. 166-170 
    Details
    ISSN: 1435-2451
    Keywords: En-bloc esophagectomy ; Esophageal cancer ; Reconstruction
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung In einer prospektiven Studie wurde die einzeitige Speiseröhrenrekonstruktion mit der 4872 h nach Oesophagektomie durchgeführten verglichen. In beiden Gruppen (26/24 Patienten) wurde eine transthorakale en-bloc Oesophagektomie durchgeführt. Als weitere Vergleichsgruppe wurden 45 Patienten mit transmediastinaler Oesophagektomie and einzeitiger Rekonstruktion, die ebenfalls während der Studiendauer operiert wurden, herangezogen. Es ergaben sich in Hinblick auf postoperative Komplikationen (26,9%; 29,1%; 22,2%) and auf die postoperative 30-Tage-Letalität (0%; 4,1%; 2,1%) sowie die Kliniksletalität (3,2%; 4,1%; 4,2%) keinerlei Unterschiede. Somit führt die Rekonstruktion mit aufgeschobener Dringlichkeit zu keiner weiteren Risikoverminderung; andererseits stellt sie aber auch keine Risikoerhöhung dar, so daß sie in das Verfahrensspektrum der Oesophaguschirurgie aufgenommen werden kann.[/p]
    Notes: Summary In a prospective study direct reconstruction of the esophagus was compared to reconstruction 48–72 h after esophagectomy. In both groups (26/24) transthoracic en-bloc esophagectomy was performed. During the same time period of the study another group of 45 patients had transmediastinal esophagectomy and direct reconstruction and this group was also used as comparison. There were no differences concerning postoperative complications (26.9%; 29.1 %; 22.2%), postoperative 30-days mortality (0%; 4.1%; 2.1%), and hospital mortality (3.2%; 4.1%; 4.2%). Thus reconstruction with delayed urgency does not lead to a further decrease of risk; on the other hand there is also no increase of risk and therefore it can be included in the spectrum of procedures of esophageal surgery.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00206811
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  • 5
    Electronic Resource
    Electronic Resource
    En-bloc Resektion der Speiseröhre beim Oesophaguscarcinom (1988)
    Springer
    Langenbeck's archives of surgery 373 (1988), S. 367-376 
    Details
    ISSN: 1435-2451
    Keywords: Esophageal cancer ; En bloc esophagectomy ; Mediastinal lymphadenectomy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Die en-bloc Oesophagektomie erfaßt neben der Entfernung der Speiseröhre die mediastinale Lymphadenektomie incl. der Resektion von V. azygos und Ductus thoracicus. Zusätzlich beinhaltet sie die suprapankreatische abdominelle Lymphadenektomie und bei oberhalb der Trachealbifurkation gelegenen Tumoren auch die cervicale Lymphadenektomie. Die Operationstechnik kann als ausgereift und standardisiert angesehen werden. Mögliche Komplikationen sind Nachblutungen (3,3%), Chylothorax (1,6%) und Trachealäsionen (4,9%). Die Letalität liegt in erfahrenen Zentren unter 10%, im eigenen Krankengut bei 6,6%. Die en-bloc Oesophagektomie ermöglicht ein exaktes Staging des Oesophaguscarcinoms, führt in einem hohen Prozentsatz zur kompletten Tumorentfernung (R0-Resektion) und scheint die Prognose früher Tumorstadien (T1/2 N0/1) zu verbessern.
    Notes: Summary En-bloc esophagectomy not only comprises the elimination of the esophagus but also the mediastinal lymphadenectomy and the resection of the azygos vein and thoracic duct. Additionally the suprapancreatic abdominal lymphadenectomy is included and in tumors located orally of the tracheal bifurcation also the cervical lymphadenectomy. The surgical technique can be estimated as fully developed and standardized. Possible complications are postoperative hemorrhage (3.3%), chylothorax (1.6%) and tracheal lesions (4.9%). The mortality rate ranges under 10% in experienced centers, in our own patients around 6.6%. With en-bloc esophagectomy an exact staging of esophageal cancer becomes possible. In a high percentage complete tumor elimination (R0-resection) can be achieved and it seems that herewith prognosis in early tumor stages (T1/2 N0/1) can be improved.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01272555
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  • 6
    Electronic Resource
    Electronic Resource
    Intraoperative Sonographie zum Nachweis occulter Lebermetastasen beim colorectalen Carcinom (1989)
    Springer
    Langenbeck's archives of surgery 374 (1989), S. 363-369 
    Details
    ISSN: 1435-2451
    Keywords: Colorectal cancer ; Liver metastases ; Intraoperative ultrasonography ; Ultrasonography ; Computed tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung In einer prospektiven Studie wurde bei 85 Patienten mit Operation colorectaler Carcinome eine intraoperative Sonographie der Leber zum Nachweis von Lebermetastasen durchgeführt. Die Befunde wurden verglichen mit den Ergebnissen der präoperativ vorgenommenen Sonographie und Computertomographie sowie der intraoperativen Inspektion und Palpation der Leber. Siebzehn (24,3%) der insgesamt 70 Metastasen dieser Untersuchungsserie konnten allein durch die intraoperative Sonographie nachgewiesen werden. Dieses betraf 12 (14,1%) der untersuchten Patienten. Vier (5,7%) dieser Herde waren solitär und betrafen 4,7% der Fälle. In 15,3% der Patienten wurde aufgrund der intraoperativen Ultraschallbefunde die Operationstaktik geändert. Beim Nachweis von Lebermetastasen colorectaler Carcinome hat die intraoperative Sonographie eine signifikant höhere Sensitivität als die präoperative Sonographie und Computertomographie bzw. die intraoperative Inspektion und Palpation. Die intraoperative Ultraschalluntersuchung sollte bei allen Patienten ohne präoperativen Nachweis von Lebermetastasen und bei Patienten mit geplanter Metastasenresektion durchgeführt werden.
    Notes: Summary In a prospective study of 85 patients with operation of colorectal cancer intraoperative ultrasonography of the liver was performed for the detection of liver metastases. The findings were compared with the results of preoperative ultrasonography and CT-scan as well as the findings of intraoperative inspection and palpation of the liver. Seventeen (24.3%) of a total of 70 metastases of this series could only be detected by intraoperative ultrasonography. This was related to 12 (14.1 %) of the examined patients. Four (5.7%) of these lesions were solitary and concerned 4.7% of the cases. Due to the intraoperative sonographic findings the tactics of operation was changed in 15.3% of the patients. Intraoperative ultrasonography has a significantly higher sensitivity for the detection of liver metastases from colorectal cancer than preoperative ultrasonography and computed tomography or intraoperative inspection and palpation. Intraoperative ultrasonography of the liver should be applied in all patients without preoperative evidence of liver metastases and in patients with a planned resection of metastases.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01262816
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