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  • 1
    Electronic Resource
    Electronic Resource
    High-resolution magnetic resonance imaging of the anorectal region without an endocoil (1999)
    Springer
    Abdominal imaging 24 (1999), S. 576-581 
    Details
    ISSN: 1432-0509
    Keywords: Key words: Magnetic resonance imaging—Phased array coil—Anal fistula—Rectal neoplasm—Anal sphincter defect.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: To evaluate the feasibility of a high-resolution magnetic resonance imaging (MRI) technique in detailed imaging of the anal sphincter and lower pelvic region without the use of an endoluminal coil. Methods: MRIs with an external phased array coil (T1- and T2-weighted turbo spin echo) were performed in 22 volunteers and 12 patients with an anal fistula, an anal sphincter defect, or a rectal tumor. The normal scans were evaluated by three independent observers. The scans of the patients were compared with surgical and/or histologic findings. Results: The anal sphincter was visualized with detail. In the anal canal, hemorrhoidal tissue and the submucosae ani muscle could be seen. The MRI technique also allowed detailed imaging of anatomical structures above the pelvic floor. The MR findings in the 12 patients showed exact correlation with surgery and/or histology. Conclusions: High-resolution MRI of the anorectal region without an endoluminal coil is feasible. The MR technique with an external phased array coil allows detailed imaging of the anal sphincter at rest, the rectum, and the surrounding pelvic structures with one single investigation. The results are promising and suggest useful applications in the management of anorectal diseases.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002619900567
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Preoperative assessment of local tumor extent in advanced rectal cancer: CT or high-resolution MRI? (2000)
    Springer
    Abdominal imaging 25 (2000), S. 533-541 
    Details
    ISSN: 1432-0509
    Keywords: Key words: Rectum—Recurrence—Magnetic resonance imaging—Computed tomography—Neoplasms—Gastrointestinal tract.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: We compared high-resolution magnetic resonance imaging (MRI) with computed tomography (CT) in the assessment of tumor infiltration in surrounding structures for locally advanced primary and recurrent rectal cancer. Methods: Twenty-six patients with operable, locally advanced rectal cancer (15 recurrent and 11 primary) were evaluated with conventional pelvic CT and 1.5-T high-resolution MRI with a quadrature phased-array coil. The images were scored for invasion of nine neighboring pelvic structures, and the results were compared with surgical and histologic findings. Results: A total of 234 structures in 26 patients was evaluated for tumor invasion. For MRI the, sensitivity was 97% and the specificity 98%; for CT, the sensitivity was 70% and the specificity was 85%. The difference in performance was statistically significant (p 〈 0.001). The failure most frequently made on CT was the false-positive prediction of pelvic floor and piriform muscle invasion (14), whereas MRI showed only four false-positive predictions. MRI correctly predicted all four cases of sacral bone invasion, three of which were missed by CT. MRI was accurate in 20 patients (80%) and CT in only five patients (19%). Conclusion: High-resolution MRI using a quadrature phased-array coil is highly accurate and superior to CT in predicting tumor infiltration in surrounding structures for locally advanced primary or recurrent rectal cancer and is recommended in the preoperative work-up of these tumors.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1107/s002610000086
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Long-term foreign-body reaction to preperitoneal polypropylene mesh in the pig (1998)
    Springer
    Hernia 2 (1998), S. 153-155 
    Details
    ISSN: 1248-9204
    Keywords: Inguinal hernia ; Prosthetic mesh ; Polypropylene ; Biocompatibility
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The aim of the study is to establish the long-term foreign-body reaction to a polypropylene mesh used for inguinal hernia repair in a pig model. Twenty-two Surpipro® meshes were implanted in 22 preperitoneal inguinal areas in 11 female 10-week-old Yorkshire and Dutch landway swine. The prosthetic mesh was implanted using a laparoscopic transperitoneal technique. At 1, 2, 3, 4, 6, 12 and 26 weeks, the animals were sacreificed and the number of foreign-body giant-cells at the mesh-tissue interface was counted. The mean numbers of giant-cells (SD) after 1, 2, 3, 4, 6, 12 and 26 weeks were: 0.9 (2.4), 7.3 (5.4), 19 (8.2), 15.2 (7.9), 15.9 (6.9), 14.1 (5.6), and 8.2 (4.7). The mean number of giant-cells at 12 weeks was significantly lower than at 3 weeks. The mean number of giant-cells at 26 weeks was significantly lower than at 3, 4, 6, and 12 weeks. We conclude that the foreign-body giant-cell reaction to polypropylene mesh increases until the third week after implantation. Thereafter, it gradually decreases, and at six months it persists at half the maximal level at 3 weeks.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01569134
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    Paper (German National Licenses)
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  • 4
    Electronic Resource
    Electronic Resource
    Open or laparoscopic preperitoneal mesh repair for recurrent inguinal hernia? (1999)
    Springer
    Surgical endoscopy and other interventional techniques 13 (1999), S. 323-327 
    Details
    ISSN: 1432-2218
    Keywords: Key words: Inguinal hernia — Laparoscopy — Mesh — Randomized trial
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Giant prosthetic reinforcement of the visceral sac (GPRVS), an open preperitoneal mesh repair, is a very effective groin hernia repair. Laparoscopic transabdominal preperitoneal repair (TAPP), based on the same principle, is expected to combine low recurrence rates with minimal postoperation morbidity. Methods: Seventy-nine patients with 93 recurrent and 15 concomitant primary inguinal hernias were randomized between GPRVS (37 patients) and TAPP (42 patients). Operating time, complications, pain, analgesia use, disability period, and recurrences were recorded. Results: Mean operating time was 56 min with GPRVS versus 79 min with TAPP (p 〈 0.001). Most complications were minor, except for a pulmonary embolus and an ileus, both after GPRVS. Patients experienced less pain after a laparoscopic repair. Average disability period was 23 days with GPRVS versus 13 days with TAPP (p= 0.03) for work, and 29 versus 21 days, respectively (p= 0.07) for physical activities. Recurrence rates at a mean follow-up of 34 months were 1 in 52 (1.9%) for GPRVS versus 7 in 56 (12.5%) for TAPP (p= 0.04). Hospital costs in U.S. dollars were comparable, with GPRVS at $1,150 and TAPP at $1,179. Conclusions: Laparoscopic repair of recurrent inguinal hernia has a lower morbidity than GPRVS. However, laparoscopic repair is a difficult operation, and the potential technical failure rate is higher. With regard to recurrence rates, the open preperitoneal prosthetic mesh repair remains the best repair.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004649900981
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    Paper (German National Licenses)
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