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  • 11
    Electronic Resource
    Electronic Resource
    Endosonography and endosonography-guided biopsy of upper-GI-tract tumors using a curved-array echoendoscope (1996)
    Springer
    Surgical endoscopy and other interventional techniques 10 (1996), S. 1205-1209 
    Details
    ISSN: 1432-2218
    Keywords: Key words: Endoscopic ultrasound — Curved array — Staging — Endosonography-guided biopsy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: The purpose of the present study was to evaluate the accuracy of endoscopic ultrasonography (EUS) with a curved-array transducer and to determine the value of endosonography-guided biopsy. Methods: EUS was performed in 162 consecutive patients for preoperative staging of gastric or esophageal cancer (n= 122) or for EUS-guided biopsy (n= 40). All patients were examined using a flexible echoendoscope (Pentax FG32-UA) equipped with a 7.5-MHz curved-array transducer. A specially designed fine needle was used for EUS-guided biopsy of submucosal or extrinsic lesions. Results: Surgery was performed in 19 of 48 patients with esophageal cancer and 60 of 74 patients with gastric cancer. The accuracy in the assessment of the infiltration depth of esophageal cancer and in the determination of lymph node involvement was 84% and 88%, respectively. In gastric cancer the tumor infiltration depth was assessed correctly in only 65% of the patients. The identification of early gastric cancer proved to be a major problem. The accuracy in the detection of lymph node involvement was 73%. Obstructing tumors were examined in 17 patients with carcinoma of the esophagus or the gastric cardia. The accuracy of EUS in determining the T-stage and the N-stage of stenotic tumors was 88% and 86%, respectively. Endosonography-guided needle biopsy was successfully performed in all 40 patients. Histologic analysis revealed malignancy in 50% of the patients. Only two biopsy specimens contained nonrepresentative material (accuracy: 95%). No complications were observed related to the procedure. Conclusions: EUS with a curved-array transducer provides high accuracy rates in staging of esophageal carcinoma. Evaluation of gastric cancer with this technique appears to be more difficult than with radial transducers. A major advantage of the linear transducer is the ability to perform EUS-guided biopsies of submucosal or extamural lesions.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004649900280
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  • 12
    Electronic Resource
    Electronic Resource
    Video-assisted thoracic surgery (1998)
    Springer
    Surgical endoscopy and other interventional techniques 12 (1998), S. 133-136 
    Details
    ISSN: 1432-2218
    Keywords: Key words: VATS — Staging of extrathoracic tumors — Peripheral pulmonary lesions
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: This prospective study was conducted to investigate the value of video-assisted thoracic surgery (VATS) for staging and therapy of thoracic tumors. Methods: VATS was performed in 86 patients presenting peripheral pulmonary nodules. Indications for thoracoscopy included diagnosis of indeterminated pulmonary lesions (n= 55), staging of disseminated disease (n= 24), and therapeutic interventions (n= 7). Previous or simultaneous tumors belonged to gastrointestinal tract (n= 27), sarcoma (n= 19), breast (n= 12), and miscellaneous. VATS was carried out under general anesthesia using double lumen intubation. Results: VATS was successfully performed in 78% of patients. It was converted in 19 patients (22%) because of adhesions (n= 12), technical problems (n= 3), and lesions not to be found (n= 4). VATS revealed malignancy in 81% and benign lesions in 19%. Additional information compared to conventional staging was obtained in 48%, resulting in therapeutic consequences in 34% of the patients. Postoperative complications related to VATS were observed in nine patients. Conclusions: In this study, VATS proved to be a sensitive technique for staging of pulmonary lesions. Thoracoscopic wedge resection may have significant impact on the operative management of carefully selected patients with peripheral pulmonary lesions.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004649900613
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  • 13
    Electronic Resource
    Electronic Resource
    External fixation of intra-articular fracture of the distal radius in young and old adults (1996)
    Springer
    Archives of orthopaedic and trauma surgery 115 (1996), S. 38-42 
    Details
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Forty patients (18–89 years old, mean 58 years) with comminuted intra-articular fractures of the distal radial end (AO-type C 2 or C 3) treated with external fixation could be followed for an average of 2.3 years. After 3 weeks, the distraction was released, and after another 3 weeks, the device was removed. Complications seen were one malunion, one radial shaft fracture caused by excentric drilling of a Schanz screw, one Sudeck atrophy, and one subcutaneous pin-track infection. Radial and ulnar deviations were reduced to 52% and 71% of the untreated wrist, whereas the range of motion in the other planes reached about 80% or more of the healthy side. In all, 82.5% of the patients showed good or excellent radiological and functional results. This study demonstrates that external fixation of distal radial C 2 and 3 fractures for 6 weeks results in good recovery for young patients and elderly patients with osteoporosis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00453215
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  • 14
    Electronic Resource
    Electronic Resource
    Staging und stadiengerechte operative Therapie des Plattenepithelkarzinoms der Speiseröhre (1997)
    Springer
    Der Onkologe 3 (1997), S. 629-635 
    Details
    ISSN: 1433-0415
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Ein stadiengerechtes Vorgehen bei der Therapie des Ösophaguskarzinoms erfordert eine akkurate präoperative Diagnostik mit Risikoanalyse und einem umfassenden Staging. Nur auf dieser Basis kann entschieden werden, inwieweit ein operativer Eingriff möglich und als alleinige Maßnahme sinnvoll oder ob ein multimodales Vorgehen zu wählen ist.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s007610050161
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  • 15
    Electronic Resource
    Electronic Resource
    Prospective comparison of endorectal ultrasound, three-dimensional endorectal ultrasound, and endorectal MRI in the preoperative evaluation of rectal tumorsrid="" (2000)
    Springer
    Surgical endoscopy and other interventional techniques 14 (2000), S. 1005 -1009 
    Details
    ISSN: 1432-2218
    Keywords: Key words: Endorectal ultrasound — Three-dimensional endorectal ultrasound — Rectal cancer — Staging — Endorectal MR imaging — Surface coil — Cancer
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: The aim of this study was to compare the value of endorectal ultrasound (EUS), three-dimensional (3D) EUS, and endorectal MRI in the preoperative staging of rectal neoplasms. Methods: Thirty consecutive patients with rectal tumors were assessed by EUS and endorectal MRI. Additionally, three-dimensional ultrasound was performed in a subgroup of 25 patients. EUS data were obtained with a bifocal multiplane transducer (10 MHz) and processed on a 3D ultrasound workstation. MR imaging was carried out with a 1.5 T superconducting unit using an endorectal surface coil. Results: EUS was carried out successfully in all 30 patients, whereas endorectal MRI was not feasible in two patients. Compared with the histopathological classification, EUS and endorectal MRI correctly determined the tumor infiltration depth in 25 of 30 and 28 patients, respectively. The comparative accuracy of EUS, 3D EUS, and endorectal MRI in predicting tumor invasion was 84%, 88%, and 91%, respectively. EUS, three-dimensional EUS, and endorectal MRI enabled us to assess the lymph node status correctly in 25, 25, and 24 patients, respectively. Both three-dimensional EUS and endorectal MRI combined high-resolution imaging and multiplanar display options. Assessment of additional scan planes facilitated the interpretation of the findings and improved the understanding of the three-dimensional anatomy. Conclusion: The accuracy of three-dimensional EUS and endorectal MRI in the assessment of the infiltration depth of rectal cancer is comparable to conventional EUS. One advantage of both methods is the ability to obtain multiplanar images, which may be helpful for the planning of surgery in the future.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004640000345
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  • 16
    Electronic Resource
    Electronic Resource
    Three-dimensional endoscopic ultrasound of the esophagus (1997)
    Springer
    Surgical endoscopy and other interventional techniques 11 (1997), S. 991-994 
    Details
    ISSN: 1432-2218
    Keywords: Key words: Endoscopic ultrasound — Three-dimensional imaging — Esophageal cancer — Staging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: The aim of this study was to develop a technique for three-dimensional endoscopic ultrasound of the esophagus based on standard ultrasonic images. Methods: Endoscopic ultrasound was performed in five esophageal cancer patients using a high-resolution miniprobe (360°, 12.5 MHz). For acquisition of three-dimensional data sets, the miniprobe was attached to a stepping motor that enabled ECG-triggered withdrawal of the transducer. Three-dimensional images were reconstructed from serial transverse sections on a PC-based 3D work station. Results: Twelve volume scans were obtained in five patients with esophageal cancer. The system enabled the acquisition of accurate three-dimensional ultrasound data within 30– 50 s. Computed image processing allowed us to display the data in transverse, longitudinal, and oblique sections, or as a 3D reconstruction. Three-dimensional imaging provided accurate visualization of the tumor and surrounding structures in all cases. The tumor stage was determined correctly in four of five patients. Longitudinal scan planes and 3D views improved the assessment of longitudinal tumor infiltration and the spatial relation of the tumor to relevant mediastinal structures. Conclusion: This study shows that three-dimensional endoscopic ultrasound of the esophagus is technically feasible. The technique allows the assessment of local tumor spread in previously unattainable scan planes and 3D views. This promising preliminary experience should encourage further exploration of this method.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004649900509
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  • 17
    Electronic Resource
    Electronic Resource
    Evaluation and biopsy of recurrent rectal cancer using three-dimensional endosonography (1996)
    Springer
    Diseases of the colon & rectum 39 (1996), S. 1373-1378 
    Details
    ISSN: 1530-0358
    Keywords: Threedimensional endosonography ; Transrectal biopsy ; Recurrence ; Rectal cancer
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract PURPOSE: The value of endorectal ultrasonography for postoperative follow-up of rectal cancer is limited by the inability to distinguish recurrent malignancy from benign lesions,e.g., fibrotic tissue. This study was conducted to investigate the role of three-dimensional (3D) endosonography for evaluation and biopsy of recurrent rectal cancer. METHODS: Endorectal ultrasonography was performed in routine follow-up program after resection of rectal cancer. 3D volume scans were recorded using a bifocal multiplane 3D transducer (7.5/10 MHz) with a 100
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02054526
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  • 18
    Electronic Resource
    Electronic Resource
    Three-dimensional endorectal ultrasonography for staging of obstructing rectal cancer (1996)
    Springer
    Diseases of the colon & rectum 39 (1996), S. 636-642 
    Details
    ISSN: 1530-0358
    Keywords: Three-dimensional imaging ; Endorectal ultrasonography ; Rectal cancer ; Stenosis ; Preoperative staging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract PURPOSE: Preoperative staging of advanced carcinoma of the rectum by conventional endorectal ultrasonography is often impossible because of the presence of obstruction, which does not allow passage of the endoprobe. In a prospective Study, we investigated the value of three-dimensional endorectal ultrasonography for staging of obstructing rectal cancer. This technique permits examination of obstructing rectal tumors because scan planes can be chosen deliberately within a scanned volume. METHODS: Overall obstructing tumors not accessible for conventional endoprobes were found in 26 of 94 patients who were subjected to endorectal ultrasonography for staging of rectal cancer. Three-dimensional volume scanning was performed using a three-dimensional frontfire transducer or a three-dimensional bifocal multiplane transducer (7.5/10 MHz). Data of the three-dimensional scans were stored on a hard disk for subsequent evaluation with a combison 530 processor. RESULTS: Three-dimensional transrectal endosonography enabled visualization of local tumor spread in all 26 patients. In 18 patients, obstruction was caused by advanced primary rectal carcinoma. Endosonography accurately determined the tumor infiltration depth in three T2 tumors, eight T3 tumors, and three T4 tumors. Overall accuracy for assessment of infiltration depth was 78 percent. Accuracy for assessment of perirectal lymph node involvement was 75 percent. In eight patients, the obstruction was attributable to extramural regrowth of rectal cancer after surgery. Diameter of the lesions ranged between 3 and 6 cm. Although all lesions were clearly depicted by three-dimensional endosonography, only five lesions (62 percent) were detected by computed tomography. CONCLUSIONS: Three-dimensional endorectal ultrasonography provides previously unattainable scan planes and enables accurate staging of obstructing rectal tumors. This technique may improve therapy planning in advanced rectal cancer by selecting patients who require preoperative adjuvant therapy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02056942
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