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  • Key words: Adenoma — Rectal cancer — Pelvic peritoneal reflection — Endorectal ultrasound  (1)
  • Plasmahistaminspiegel  (1)
  • 1
    ISSN: 1432-1440
    Keywords: Standard operations ; anaesthesia ; blood transfusion ; plasma histamine ; Standardoperationen ; Anästhesie ; Bluttransfusion ; Plasmahistaminspiegel
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Eine prospektive kontrollierte klinische Studie wurde über Veränderungen des Plasmahistamin- und Katecholaminspiegels bei 5 Standardoperationen durchgeführt. Diese Mitteilung, als erster Teil der Studie, zeigt nur die Möglichkeiten auf, eine solche Studie durchzuführen und Veränderungen des Plasmahistaminspiegels nachzuweisen. Erhöhte Plasmahistaminkonzentrationen, die einer Histaminfreisetzungsreaktion von 〉1 ng/ml entsprechen, kamen bei 8 von 25 Operationen vor. In einer explorativen statistischen Analyse wurden diese Reaktionen mit bestimmten Phasen der Anästhesie oder des chirurgischen Eingriffs in Verbindung gebracht. Bluttransfusionen tragen das Risiko in sich, „freies Histamin“ in den Patienten zu infundieren — zumal bei Filterpassage, wenn es unter erhöhtem Druck angewandt wird. Da während Operationen recht häufig „freies Histamin“ in die Zirkulation gelangt und möglicherweise schädigende Wirkungen entfaltet, ist möglicherweise eine Prämedikation mit H1- und H2-Rezeptorantagonisten ratsam.
    Notes: Summary A prospective controlled clinical trial was conducted on changes in plasma histamine and catecholamine levels during 5 standard operations. This communication, as the first part of the trial, deals only with the feasibility of such a trial and the changes in plasma histamine levels. Elevated histamine concentrations corresponding to histamine-release responses of 〉1 ng/ml occurred in 8 of 25 operations. In an explorative analysis these reponses were associated with distinct phases of anaesthesia or the surgical procedure. Blood transfusion carried the risk of infusion of “free histamine” into the patient — especially when administered under pressure. Since during operations “free histamine” enters the circulation with a rather high incidence and may cause harmful effects, premedication with H1-+H2-receptor antagonists seems worth consideration.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Surgical endoscopy and other interventional techniques 12 (1998), S. 1401-1404 
    ISSN: 1432-2218
    Keywords: Key words: Adenoma — Rectal cancer — Pelvic peritoneal reflection — Endorectal ultrasound
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Large adenomas and low-risk rectal carcinomas (T1) that are localized distal of the pelvic peritoneal reflection (PPR) are treated by transanal excision. However, the location of the PPR varies widely and cannot be detected reliably by preoperative methods. Therefore, we evaluated the value of endorectal ultrasound (EUS) for the prediction of an intraperitoneal location of rectal tumors. Methods: Fourteen patients with rectal tumors measuring ≤15 cm from the anal verge were examined by EUS. If peristalsis beyond the rectal wall or any intraperitoneal fluid was seen at the proximal tumor edge, the lesion was classified as localized above or in the level of the PPR. During the operation, the surgeon determined whether the upper end of the tumor reached the PPR. Results: In each of our 14 patients, the prediction by EUS was correct. In two patients, a small rectal tumor was excised with an electric sling during rectoscopy, but the polyp bases were not free of dysplastic epithelial tissue. The point where these two polyps were removed could be visualized by endoscopy but not by EUS. Once the relevant area was marked with a titanic endoclip, EUS was able to predict the resection place in relation to the PPR in these two patients as well. Conclusions: Although this knowledge would be very important for the therapeutic strategy of small rectal tumors, it is impossible to determine the location of a rectal tumor with regard to the PPR either clinically or by endoscopy. EUS provides this information with high reliability. Thus, we recommend EUS as the method of choice for predicting the location of the PPR.
    Type of Medium: Electronic Resource
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