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  • 1
    ISSN: 1433-0385
    Keywords: Key words: Gastric cancer ; Elderly patients ; Operative morbidity ; Survival rate ; Prognostic factors. ; Schlüsselwörter: Magencarcinom ; Alter ; perioperative Morbidität ; Überlebenszeit ; Prognosefaktoren.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung. Bereits heute liegt der Anteil der über 70 Jahre alten Patienten mit Magencarcinomen bei 35 %. Diese Patientengruppe wurde in 3 Altersklassen unterteilt und hinsichtlich klinisch-pathologischer Parameter sowie bezüglich der operativen Morbidität und Letalität als auch der Langzeitprognose mit einem jüngeren Vergleichskollektiv (unter 70 Jahren) verglichen. Die Verteilung der UICC-Stadien wie auch der Anteil der Magenfrühcarcinome war in allen Altersgruppen konstant. Der Anteil der distalen Resektionen nahm in den höheren Altersgruppen signifikant zu. Die perioperative Morbidität und Letalität konnte in den letzten 10 Jahren soweit gesenkt werden, daß zum Vergleichskollektiv kaum noch ein Unterschied bestand. Bei den 5-Jahres-Überlebensraten bestand ein signifikanter Unterschied bei den über 80 Jahre alten Patienten (13,7 %) zu den jüngeren Patienten (48,7 %). Während bei der univariaten Analyse der Prognosefaktoren neben dem UICC-Stadium, dem Lymphknotenstatus, dem Resektionslinienbefall auch das Lebensalter von Bedeutung waren, war das Lebensalter in der multivariaten Analyse kein unabhängiger Faktor.
    Notes: Summary. In our hospital 35 % of the patients undergoing resection for gastric carcinoma are over 70 years old. This group was divided into three age groups; clinico-pathological features, operative morbidity and mortality as well as long-term prognosis were compared with findings taken from a control group of subjects under 70 years old. No differences were noted in the distribution of the UICC stages and the incidence of early gastric cancer. The number of subtotal gastric resections was significantly higher in older patients. During the past 10 years the perioperative morbidity and mortality rates have decreased markedly and only minor differences in comparison with the control group have been recorded. However, the 5-year survival rate was significantly lower in the age group above 80 years old (13.7 %) than in the control group (48.7 %). Univariate analysis of prognostic factors showed the UICC stage, lymph node metastases, resection line involvement and the patient's age to be of significance. In contrast, in the multivariate analysis age was not of prognostic value.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1438-2199
    Keywords: Amino acids ; Stable isotopes ; 13C-Leucine ; Tumor metabolism ; Malignant colon tumor
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Own investigations on in-vivo tumor metabolism of the malignant human colon tumor showed a significant uptake of branched chain amino acids by the tumor itself. To study the quantitative tumor protein metabolism (“compartment “tumor”) the13C-leucine-tracer-technique was modified. Beside the common13C-leucine-breath-test we measured also the AV-differences of13C-leucine,13C-ketoisocaproate and13CO2. The “Tumorblood flow” was measured by “venous-outflow-technique” as well as the tumor mass. In this way it is possible to get quantitative results in substrate exchange of branched chain amino acids in malignant human colon tumors.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Der Chirurg 68 (1997), S. 705-709 
    ISSN: 1433-0385
    Keywords: Key words: Pancreas ; Non-functioning neuroendocrine tumors ; Resection ; Chemotherapy ; Schlüsselwörter: Pankreas ; Neuroendokrine Tumoren ; Resektionsverfahren ; Chemotherapie
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung. In den vergangenen 10 Jahren (1987–1996) wurden 842 Patienten wegen eines Pankreas- oder periampullären Carcinoms laparotomiert. Bei 25 Patienten (2,9 %) wurde ein neuroendokriner Pankreastumor diagnostiziert. Bei 19 von diesen 25 Patienten (76 %) war der neuroendokrine Tumor hormoninaktiv; 6 Patienten (24 %) hatten einen hormonaktiven Tumor (4 Insulinome, ein Gastrinom, ein VIPom). Von den 19 hormoninaktiven Tumoren waren 14 maligne. Die Resektionsrate der malignen neuroendokrinen Tumoren betrug 78 % (11 von 14; 3 Resektionen waren palliativ); im Vergleich hierzu beträgt die Resektionsrate der duktalen Adenocarcinome in unserer Klinik 28 %. Die 5-Jahres-Überlebenswahrscheinlichkeit maligner endokriner Tumoren beträgt nach Resektion in dem beschriebenen Kollektiv 73 %, die der duktalen Pankreascarcinome 19 % (jeweils einschließlich palliativer Resektionen). Bei hormoninaktiven endokrinen Tumoren ist aufgrund der sogar postoperativ nicht immer eindeutigen Dignität eine Resektion unter onkologischen Kriterien anzustreben. Eine regelhafte adjuvante Chemotherapie hingegen erscheint uns jedoch nicht erforderlich zu sein.
    Notes: Summary. During the past 10 years (1987–1996), 842 laparotomies were performed for pancreatic or periampullary neoplasms; in 25 patients (2.9 %) a neuroendocrine tumor was diagnosed. In 19 of these 25 patients (76 %) a non-functioning endocrine tumor and in 6 patients (24 %) a hormone-active tumor (four insulinoma, one gastrinoma, one VIPoma) was found. Of 19 non-functioning neuroendocrine tumors, 14 were malignant. The resection rate of these malignant tumors was 78.6 % (11 of 14; 3 resections were palliative); in comparison, the resection rate of ductal pancreatic carcinoma in our hospital was 28.1 %. The probability of 5-year survival amounts to 73 % after surgical resection in malignant endocrine tumors and to 19 % in ductal pancreatic carcinoma (including palliative resections). As it is not always clear whether non-functioning endocrine tumors are benign or malignant, oncological resection is recommended. Adjuvant chemotherapy seems not to be necessary.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Surgical endoscopy and other interventional techniques 13 (1999), S. 878-881 
    ISSN: 1432-2218
    Keywords: Key words: Laparoscopic hernia repair — Nerve irritation — Reduction of clips
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Between October 1992 and May 1996, 893 hernia repairs were performed at the Surgical Clinic in Mannheim: 448 (50%) using laparoscopy (TAPP-method) and 445 (50%) using the conventional anterior approach (Shouldice). Materials and methods: For this study, 723 (81%) of these repairs were followed up in a prospective trial of postoperative nerve irritations. Results: The rate of nerve entrapment in the laparoscopic group was 4.2% (n= 19), and in the group that underwent conventional surgery 1.8% (n= 8). The genitofemoral nerve was affected with particularly high frequency (2%), and the ilioinguinal nerve and lateral cutaneous nerve of the thigh (LCNT) each was affected in 1.1% of the cases. Conclusions: Reduction in the number of clips used and careful attention to the anatomic nerve course during preparation and placement of mesh led to a significant reduction in the occurrence of nerve irritations. In the last 100 patients who underwent laparoscopic hernia repair, only one nerve lesion was seen.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    Langenbeck's archives of surgery 372 (1987), S. 885-885 
    ISSN: 1435-2451
    Keywords: Colorectal carcinomas ; TNM classification ; Dukes' classification ; Late results ; Colorectale Carcinome ; TNM Klassifikation ; Dukes-Klassifikation ; Spätergebnisse
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Die Klassifizierung colorectaler Carcinome nach dem TNM System erweist sich gegenüber der Einteilung nach Dukes deutlich überlegen. Der TNM Vorschlag der UICC von 1979 jedoch hatte erhebliche Mängel. Insbesondere wurde dort nicht zwischen den prognoserelevanten Grenzschichten Lamina muscularis mucosae, Muscularis propria sowie Serosa differenziert. Ausserdem wurde lediglich zwischen dem Befall der regionalen bzw. juxtaregionären Lymphknoten unterschieden. Die Bedeutung einer solchen Differenzierung zeigt sich an unseren Spätergebnissen von 1231 operierten colorectalen Carcinomen. Erst der neue TNM Vorschlag der UICC von 1987 berücksichtigt diese Unterschiede.
    Notes: Summary Classification of colorectal carcinomas in accordance with the TNM system is clearly superior to Dukes' classification. However, the TNM classification system in accordance with UICC in 1979 had substantial defects. In particular, no distinction was made between the boundary layers relevant to prognosis: the lamina muscularis mucosa, muscularis propria, and the serosa. In addition, only the involvement between the regional or juxtaregional lymph nodes was distinguished. The importance of differentiating between the boundary layers is shown in our late operative results on 1231 colorectal carcinomas. For the first time, the new 1987 TNM classification (UICC) takes these differences into account.
    Type of Medium: Electronic Resource
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