European Journal of Surgery最新文献

{"title":"Improvements in video-endoscopic sympathicotomy for the treatment of palmar, axillary, facial, and palmar-plantar hyperhidrosis","authors":"Joao B. V. Duarte,&nbsp;Peter Kux","doi":"10.1080/11024159850191058","DOIUrl":"10.1080/11024159850191058","url":null,"abstract":"<p>Video-endoscopic sympathicotomy for the treatment of palmar, axillary, facial and palmar-plantar hyperhidrosis was modified as to the type of surgical access and the level of incision in the sympathetic chain and communicating rami, depending on the clinical indications. Under general anaesthesia, using a single lumen endotracheal tube, the patient is put in lateral decubitus and pneumothorax is induced. The patient is then placed in ventral decubitus, with the head elevated, to make two punctures in the posterior axillary line, at the level of the 4th and 7th intercostal spaces, to introduce two ports of 5 and 10 mm in size, respectively. The sympathetic chain and the communicating rami are viewed and severed, according to the indications, at different levels to treat palmar, axillary, facial and palmar-plantar hyperhidrosis and combinations of the above. The operation is performed on both sides of the thorax during the same period of anaesthesia. One hundred-forty patients (280 procedures) have been operated on from 1993 to 1997 using this technique. All were operated on as outpatients. Our results are: 100% of those with facial and palmar hyperhidrosis and 96% of those with axillar hyperhidrosis were cured, and 94% with plantar hyperhidrosis were relieved from 50 to 100%, with the follow-up of between one and 47 months. Copyright © 1998 Taylor and Francis Ltd.</p>","PeriodicalId":100508,"journal":{"name":"European Journal of Surgery","volume":"164 S1","pages":"9-11"},"PeriodicalIF":0.0,"publicationDate":"2003-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/11024159850191058","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20559657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Highlights from the discussions","authors":"Christer Drott","doi":"10.1080/11024159850191157","DOIUrl":"10.1080/11024159850191157","url":null,"abstract":"","PeriodicalId":100508,"journal":{"name":"European Journal of Surgery","volume":"164 S1","pages":"47-50"},"PeriodicalIF":0.0,"publicationDate":"2003-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/11024159850191157","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77476911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in thyroid function and immunological parameters long after subtotal thyroidectomy for Graves' disease","authors":"Yoshio Kasuga,&nbsp;Shinya Kobayashi,&nbsp;Minoru Fujimori,&nbsp;Kiyoshi Shingu,&nbsp;Kazuhiko Asanuma,&nbsp;Yoshihisa Hama,&nbsp;Ken-ichi Ito,&nbsp;Masayuki Maruyama,&nbsp;Jun Amano","doi":"10.1080/110241598750004607","DOIUrl":"10.1080/110241598750004607","url":null,"abstract":"<div>\u0000 \u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective:</h3>\u0000 \u0000 <p>To find out whether subtotal thyroidectomy results in long term stable functional and immunological remission in patients with Graves' disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design:</h3>\u0000 \u0000 <p>Retrospective study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting:</h3>\u0000 \u0000 <p>Teaching hospital, Japan</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Subjects:</h3>\u0000 \u0000 <p>176 patients who underwent subtotal thyroidectomy for Graves' disease, 1970–79.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Intervention:</h3>\u0000 \u0000 <p>Follow up surveys in 1984 and 1992.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main outcome measures:</h3>\u0000 \u0000 <p>- Changes in thyroid function, antibody titres, and lymphocyte subsets.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results:</h3>\u0000 \u0000 <p>29/79 patients (39%) who were euthyroid in 1984 had evidence of thyroid dysfunction in 1992. Of the 8 patients with latent hypothyroidism in 1984, 3 (38%) had become euthyroid by 1992, and none required treatment. Of the 29 patients who were hypothyroid in 1984, 5 had latent hypothyroidism and 1 was euthyroid in 1992, and of the 18 patients with recurrent hyperthyroidism in 1984, 1 had become euthyroid by 1992. The number of positive titres to TSH-binding inhibitory immunoglobulin was significantly higher in the recurrence group (31/36, 86%) compared with the hypothyroid (7/26, 27%), latent hypothyroidism (8/37, 22%), and euthyroid (22/77, 29%) groups (p &lt; 0.01). There were also significant differences in the mean (SD) number of Leu HLA DR subsets between the control (17 (3), <i>n</i> = 18) and recurrence (21 (6), <i>n</i> = 38), hypothyroid (22 (6), <i>n</i> = 35), latent hypothyroidism (22 (6), <i>n</i> = 22), and euthyroid (22 (9), <i>n</i> = 64) groups (<i>p</i> &lt; 0.002). There were no differences in the number of T cell subsets among the groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion:</h3>\u0000 \u0000 <p>Treatment of Graves' disease by subtotal thyroidectomy does not necessarily result in stable late functional or immunological remission. Long term follow up of such patients may be necessary. Copyright © 1998 Taylor and Francis Ltd.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100508,"journal":{"name":"European Journal of Surgery","volume":"164 3","pages":"173-178"},"PeriodicalIF":0.0,"publicationDate":"2003-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/110241598750004607","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20483039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pancreatoblastoma in an adolescent girl: case report and review of 26 Japanese cases","authors":"Atsushi Imamura,&nbsp;Akihiko Nakagawa,&nbsp;Masashi Okuno,&nbsp;Souichirou Takai,&nbsp;Hisanao Komada,&nbsp;A-Hon Kwon,&nbsp;Shouji Uetsuji,&nbsp;Yasuo Kamiyama,&nbsp;Noriko Sakaida,&nbsp;Akiharu Okamura","doi":"10.1080/110241598750004553","DOIUrl":"10.1080/110241598750004553","url":null,"abstract":"","PeriodicalId":100508,"journal":{"name":"European Journal of Surgery","volume":"164 4","pages":"309-312"},"PeriodicalIF":0.0,"publicationDate":"2003-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/110241598750004553","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20559654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Secondary sympathetic chain reconstruction after endoscopic thoracic sympathicotomy","authors":"Timo Telaranta","doi":"10.1080/11024159850191076","DOIUrl":"10.1080/11024159850191076","url":null,"abstract":"<p>Thoracoscopic sympathicotomy by electrocautery is an irreversible procedure. Thus the indications must be meticulously considered before the final decision to operate is taken by both the surgeon and the patient. All possible side effects should be dealt with and written informed consent required. A case of an open nerve reconstruction of the divided sympathetic chains is presented. One year after the reconstruction the patient reported subjective relief of the compensatory oversweating and restoration of sweating in the face and the armpit. Reversible methods like clipping the sympathetic chain should be considered whenever feasible instead of the irreversible electrocoagulation of the sympathetic chain. Copyright © 1998 Taylor and Francis Ltd.</p>","PeriodicalId":100508,"journal":{"name":"European Journal of Surgery","volume":"164 S1","pages":"17-18"},"PeriodicalIF":0.0,"publicationDate":"2003-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/11024159850191076","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20559659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The borås experience of endoscopic thoracic sympathicotomy for palmar, axillary, facial hyperhidrosis and facial blushing","authors":"Lars Olsson Rex,&nbsp;Christer Drott,&nbsp;Göran Claes,&nbsp;Gunnar Göthberg,&nbsp;Peter Dalman","doi":"10.1080/11024159850191094","DOIUrl":"10.1080/11024159850191094","url":null,"abstract":"<div>\u0000 \u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective:</h3>\u0000 \u0000 <p>To study the outcome of endoscopic thoracic sympaticotomy (ETS) for palmar, axillary, facial hyperhidrosis and facial blushing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Subjects:</h3>\u0000 \u0000 <p>1152 patients, 59% women and 41% men.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Intervention:</h3>\u0000 \u0000 <p>ETS was performed by transection of the sympathetic chain where it overlies the second and third rib. The nerve was divided also over the fourth rib in patients with axillary hyperhidrosis. Questionnaires were sent to all patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main outcome measures:</h3>\u0000 \u0000 <p>The effect of surgery was assessed by a 10 grad visual analogue scale (VAS) by the patients. The results were divided into effect rate (the effect on the symptom) and overall satisfaction rate, taking into account any side effects and complications apart from the effect.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results:</h3>\u0000 \u0000 <p>The response rate was 90%. The mean follow up time, effect rate and overall satisfaction rate were: 38 months for palmar hyperhidrosis, 99,4% and 87%; 26 months for axillary hyperhidrosis, 94,5% and 68%; 31 months for facial hyperhidrosis, 97% and 76%; 8 months for facial blushing, 96% and 85%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion:</h3>\u0000 \u0000 <p>ETS is a very effective procedure in palmar, axillary and facial hyperhidrosis and facial blushing. The overall satisfaction rate is very good for palmar hyperhidrosis and facial blushing, not equally good but acceptable for facial hyperhidrosis. The lower satisfaction rate in patients with axillary hyperhidrosis makes this a questionable indication for ETS. Copyright © 1998 Taylor and Francis Ltd.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100508,"journal":{"name":"European Journal of Surgery","volume":"164 S1","pages":"23-26"},"PeriodicalIF":0.0,"publicationDate":"2003-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/11024159850191094","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20560831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are enemas given before abdominal operations useful?","authors":"François Mosimann,&nbsp;Patrick Cornu","doi":"10.1080/110241598750005886","DOIUrl":"10.1080/110241598750005886","url":null,"abstract":"<div>\u0000 \u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective:</h3>\u0000 \u0000 <p>To assess the effect of preoperative enemas on the recovery of peristalsis after non-colonic abdominal operations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design:</h3>\u0000 \u0000 <p>Prospective randomised trial.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting:</h3>\u0000 \u0000 <p>University hospital, Switzerland.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Subjects:</h3>\u0000 \u0000 <p>116 adult patients (&gt;16 year old) about to undergo elective non-colonic abdominal operations under general anaesthaesia were considered.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Intervention:</h3>\u0000 \u0000 <p>Two groups were randomised to receive a one litre water and glycerine enema the day before operation (<i>n</i> = 53) or no preoperative intestinal preparation (<i>n</i> = 53).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main outcome measures:</h3>\u0000 \u0000 <p>Return of peristalsis after operation, assessed by auscultation of bowel sounds and time of the first spontaneous faeces. All participants were followed daily for 10 days or until discharge by the same observer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results:</h3>\u0000 \u0000 <p>110 patients gave informed consent, 6 refused to participate, and 4 had to be withdrawn after randomisation, leaving 106 for analysis. The patients without an enema recovered bowel sounds activity sooner (<i>p</i> = 0.02) and passed their first spontaneous faeces significantly earlier (<i>p</i> = 0.01). No subgroup of patients benefited from an enema.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion:</h3>\u0000 \u0000 <p>Preoperative enemas delay rather than improve the return of normal peristalsis after surgery. We recommend this practice should be abandoned. Copyright © 1998 Taylor and Francis Ltd.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100508,"journal":{"name":"European Journal of Surgery","volume":"164 7","pages":"527-530"},"PeriodicalIF":0.0,"publicationDate":"2003-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/110241598750005886","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20612869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rectal endometriosis: transanal endoscopic microsurgery or laparoscopic resection?","authors":"Martin Kilgus,&nbsp;Othmar Schöb,&nbsp;Felix Largiadèr","doi":"10.1080/110241598750004706","DOIUrl":"10.1080/110241598750004706","url":null,"abstract":"","PeriodicalId":100508,"journal":{"name":"European Journal of Surgery","volume":"164 3","pages":"231-232"},"PeriodicalIF":0.0,"publicationDate":"2003-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/110241598750004706","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20484301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Total compared with subtotal thyroidectomy in benign nodular disease: personal series and review of published reports","authors":"Giuseppe Pappalardo,&nbsp;Antonio Guadalaxara,&nbsp;Fabrizio Maria Frattaroli,&nbsp;Giovanni Illomei,&nbsp;Paolo Falaschi","doi":"10.1080/110241598750005840","DOIUrl":"10.1080/110241598750005840","url":null,"abstract":"<div>\u0000 \u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective:</h3>\u0000 \u0000 <p>To evaluate the outcome after total and subtotal thyroidectomy for the treatment of single and multinodular goitres in two comparable groups of patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design:</h3>\u0000 \u0000 <p>Prospective randomised study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting:</h3>\u0000 \u0000 <p>University hospital, Italy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Subjects:</h3>\u0000 \u0000 <p>141 Patients operated on for benign goitre from 1975–85.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Interventions:</h3>\u0000 \u0000 <p>69 Patients were randomised to have total thyroidectomy and 72 subtotal thyroidectomy by standard techniques.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main outcome measures:</h3>\u0000 \u0000 <p>Temporary or permanent palsy of the recurrent laryngeal nerve, temporary or permanent hypoparathyroidism, recurrence of the goitre, and the incidence of iatrogenic injuries after completion thyroidectomy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results:</h3>\u0000 \u0000 <p>Patients were followed up for a median of 14.5 years (range 10–21). After total thyroidectomy 2 patients (3%) developed temporary palsy of the recurrent laryngeal nerve but there were no permanent lesions; and 24 (35%) developed temporary and 2 (3%) permanent hypoparathyroidism. After subtotal thyroidectomy 2 (3%) developed temporary and 1 (1%) permanent palsy of the recurrent laryngeal nerve; and 13 (18%) developed temporary and 1 (1%) permanent hypoparathyroidism. In addition, there were 10 recurrent goitres (14%). After completion thyroidectomy (<i>n</i> = 9) there were 2 cases of temporary and 1 of permanent palsy of the recurrent laryngeal nerve, and 2 cases of temporary and 2 of permanent hypoparathyroidism.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion:</h3>\u0000 \u0000 <p>Total thyroidectomy is the procedure of choice for the treatment of benign nodular goitre. Copyright © 1998 Taylor and Francis Ltd.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100508,"journal":{"name":"European Journal of Surgery","volume":"164 7","pages":"501-506"},"PeriodicalIF":0.0,"publicationDate":"2003-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/110241598750005840","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20612865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methicillin-resistant Staphylococcus aureus: acquisition and risk of death in patients in the intensive care unit","authors":"Maaike M. S. Ibelings,&nbsp;Hajo A. Bruining","doi":"10.1080/110241598750004210","DOIUrl":"10.1080/110241598750004210","url":null,"abstract":"OBJECTIVE\u0000To evaluate the risk of patients in intensive care units (ICU) of becoming infected with methicillin-resistant Staphylococcus aureus (MRSA) and to assess the mortality during a six week follow-up period, compared with patients who developed methicillin-sensitive S. aureus (MSSA) infection.\u0000\u0000\u0000DESIGN\u0000Point prevalence survey.\u0000\u0000\u0000SETTING\u00001417 ICU in 17 Western European countries.\u0000\u0000\u0000SUBJECTS\u000010038 patients in ICU who were part in the EPIC (European Prevalence of Infection in Intensive Care) Study.\u0000\u0000\u0000MAIN OUTCOME MEASURES\u0000Prevalence of MRSA and MSSA ICU-acquired infections, risk factors, and mortality.\u0000\u0000\u0000RESULTS\u0000On the study day 21% of patients had ICU-acquired infections. The most commonly reported pathogen was Staphylococcus aureus (30%). Overall, 60% of strains of S. aureus were resistant to methicillin (with a wide intercountry variation). The most commonly reported MRSA infections were pneumonia and lower respiratory tract infections. The most important risk factor for MRSA was the length of stay in the ICU. MRSA infection reduced the chance of survival, particularly when it was found in lower respiratory tract infections: the risk of mortality was three times higher in patients with MRSA than in those with MSSA.\u0000\u0000\u0000CONCLUSION\u0000Patients in ICU are at high risk of becoming infected with MRSA. The longer they stay, the higher the risk. Patients with MRSA infections are less likely to survive than those with MSSA.","PeriodicalId":100508,"journal":{"name":"European Journal of Surgery","volume":"164 6","pages":"411-418"},"PeriodicalIF":0.0,"publicationDate":"2003-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/110241598750004210","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20613210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}