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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Surgical endoscopy and other interventional techniques 1 (1987), S. 155-164 
    ISSN: 1432-2218
    Keywords: Achalasia ; Dilatation ; Myotomy ; Endoscopy ; Long-term results
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In a prospective clinical trial, 26 consecutive patients underwent endoscopic pneumatic dilatation over a 10-year period. Dilatation was achieved by means of a ballon attached to a normal gastrointestinal fiberscope. With the endoscope in an inverse position, the device was placed in the cardia and the dilatation process was monitored macroscopically. Before dilatation, patients suffered from dysphagia (92%), reduced speed of swallowing (100%), symptom aggravation under stress (73%), weight loss (50%), aspiration, pain, regurgitation, and vomiting. After dilatation and long-term follow-up (mean of 5 years), symptoms could be markedly reduced, especially the speed of eating and symptom aggravation under stress. Excellent and good results (Visick scale) were achieved in 76%. Fair results were achieved in 20%. To date, perforation and other complications have not occurred. Mortality was zero. Our series was an uncontrolled trial, so the results are hardly comparable to other studies. Furthermore, the small number of patients in our study represents a weak point with regard to complications. We conclude that the main advantages of the procedure are its simplicity and practicability. The simple procedure may be the method of choice in elderly patients. Of course, no final decision can be made until a well-designed controlled trial has been carried out.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1435-2451
    Keywords: Duodenal ulcer ; Three therapeutic concepts ; Analysis of failures ; Simple and careful operation ; Chronisches Ulcus duodeni ; 3 Therapiekonzepte ; Versageranalyse ; kleinster, schonendster Eingriff
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung 64 Patienten mit chronischem Ulcus duodeni wurden mit der individuellen „UlcusChirurgie” I, 62 Patienten mit der selektiven Vagotomie mit Pyloroplastik II und 110 Patienten mit der selektivproximalen Vagotomie III behandelt. Analyse der Operationen anhand der Operationsversager:Letalität I–III 0%;Rezidivulcusrate I 0%,II 3%,III4,5%;Visick 3 und 4 - I 14 %,II 12,8%, III 4,5 %;Syndromwande}I 0%, II 0%, III 1%;keine Säurereduktion I 0%, II 4,9%,III 16,4%. Niedrigste Rezidivulcusrate beim Konzept I — das beste klinische Befinden beim Konzept III — der selektiv-proximalen Vagotomie. Sie ist momentan als kleinster, schonendster Eingriff zu empfehlen.
    Notes: Summary Three surgical concepts were used to treat patients with chronic duodenal ulcer: I. 64 patients were treated with “individual ulcer surgery”; II. 62 patients with selective vagotomy and pyloroplasty; III. 110 patients with highly selective vagotomy. After 1 year the operations were analyzed according to operative failures:lethality I–III 0%;recurrent ulcer I 0%, II 3%,III 4.5 %; Visick 3 and 4-I 14%, II 12.8%, III 4.5 %;changing symptoms I 0%, II 0%, III 1 %;no acid reduction I 0%, II 4.9%, III 16.4%. The lowest recurrence rate was concept I, the best overall clinical outcome concept III. Highly selective vagotomy at present is preferred as the least major and most careful procedure.
    Type of Medium: Electronic Resource
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