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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Der Chirurg 68 (1997), S. 99-106 
    ISSN: 1433-0385
    Keywords: Key words: Minimally-invasive adrenalectomy ; Indications ; Results. ; Schlüsselwörter: Adrenalektomie ; minimal-invasiv ; Indikationen ; Ergebnisse.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung. Die minimal-invasive Adrenalektomie ist eine inzwischen anerkannte Alternative zu der konventionellen Nebennierenentfernung. Wie in der offenen Chirurgie gibt es auch verschiedene endoskopische Zugangswege zu den Nebennieren. Prinzipiell muß zwischen laparoskopischen und retroperitoneoskopischen Zugängen unterschieden werden. Mit Ausnahme des Nebennierencarcinoms können alle Nebennierentumoren – Phäochromocytome eingeschlossen – endoskopisch entfernt werden. Der Einsatz dieser Verfahren ist bei sehr großen Tumoren jedoch problematisch. Die bisher mitgeteilten Ergebnisse sind überzeugend. Aussagekräftige Daten zum Vergleich mit der konventionellen Adrenalektomie liegen nur ansatzweise vor. Wegen der Seltenheit operationspflichtiger Nebennierenerkrankungen ist die minimal-invasive Adrenalektomie ein Eingriff, der zunächst Zentren mit besonderem laparoskopischen und endokrin-chirurgischen Interesse vorbehalten bleiben wird.
    Notes: Summary. Minimally invasive adrenalectomy is now an accepted alternative to conventional adrenalectomy. As in open surgery, several different endoscopic approaches to the adrenal glands have been described. In principle, one must distinguish between the laparoscopic and the retroperitoneoscopic access. All adrenal tumors – pheochromocytomas included – except adrenal carcinomas can be removed endoscopically. However, the use of these techniques is limited in patients with particularly large tumors. The results reported to date are convincing. Only limited data are available as yet to compare conventional and endoscopic adrenalectomy. Because adrenal diseases requiring surgery are rare, endoscopic adrenalectomy is an operation that, for the present, will be limited to centers with a particular interest in laparoscopic and endocrine surgery.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Journal of neurology 246 (1999), S. 162-164 
    ISSN: 1432-1459
    Keywords: Key words Cerebrospinal fluid ; (CSF) leakage ; Postural headache ; Intracranial hypotension ; Pseudo-chiari type-I malformation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Cerebrospinal fluid (CSF) leakage may occur spontaneously, iatrogenically or from spinal trauma. Postural headache is the cardinal symptom; dizziness, diminished hearing, nausea and vomiting are additional symptoms. In neurological examinations cranial nerve palsies may be found. Due to low CSF pressure neuroimaging studies may reveal dural enhancement and vertical displacement of the brain. We describe a patient with the history of an uncomplicated lumbar discectomy at the level L4-5 and the typical clinical symptoms of intracranial hypotension. MRI of the craniocervical junction schowed typical features of a Chiari type-I malformation. After neurosurgical ligation of a CSF leak at L4-5 caused by lumbar disc surgery, the patient was free of orthostatic headache. A repeated MRI showed a striking reduction of the previous downward displacement of the cerebellar tonsils and pons.
    Type of Medium: Electronic Resource
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