The European journal of surgery = Acta chirurgica最新文献

{"title":"25 years experience of the surgical treatment of phaeochromocytoma.","authors":"Ulf Niemann,&nbsp;Wolfgang Hiller,&nbsp;Matthias Behrend","doi":"10.1080/00000000000000009","DOIUrl":"https://doi.org/10.1080/00000000000000009","url":null,"abstract":"<p><strong>Objective: </strong>To assess the outcome of the surgical treatment of patients who had adrenalectomy for phaeochromocytoma.</p><p><strong>Design: </strong>Retrospective clinical study.</p><p><strong>Settings: </strong>University hospital, Germany.</p><p><strong>Subjects: </strong>87 consecutive patients with phaeochromocytoma who were operated on.</p><p><strong>Interventions: </strong>29 flank and 58 transabdominal adrenalectomies between 1974 and 2000.</p><p><strong>Results: </strong>The mean tumour diameter was 5 cm (range 2-13), and the mean weight 91 g (range 7-550). The postoperative hospital stay was 11 days. The flank incision entailed the shortest operating time (95 minutes). Two of the phaeochromocytomas were malignant. There were two wound infections but no deaths. With a correct selection of patients, a flank incision is safe. Endoscopic retroperitoneal adrenalectomies should be preferred.</p>","PeriodicalId":22411,"journal":{"name":"The European journal of surgery = Acta chirurgica","volume":"168 12","pages":"716-9"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24677636","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":"Laparoscopic division of Ladd's band.","authors":"Mustafa Taskin,&nbsp;Kagan Zengin,&nbsp;Nevin Sakoglu","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":22411,"journal":{"name":"The European journal of surgery = Acta chirurgica","volume":"168 10","pages":"569-71"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22314985","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":"155 vascular injuries: a retrospective study in Kuwait, 1992-2000.","authors":"Sami Asfar,&nbsp;Jassim Al-Ali,&nbsp;Hussein Safar,&nbsp;Marzouk Al-Bader,&nbsp;Emad Farid,&nbsp;Ahmad Ali,&nbsp;Jalal Kansou","doi":"10.1080/11024150201680010","DOIUrl":"https://doi.org/10.1080/11024150201680010","url":null,"abstract":"<p><strong>Objectives: </strong>To audit the management of vascular trauma in Kuwait, 1992-2000.</p><p><strong>Design: </strong>Retrospective open study.</p><p><strong>Setting: </strong>Vascular surgery unit, teaching hospital, Kuwait.</p><p><strong>Subjects: </strong>155 patients with vascular injuries, most of which (n = 118) involved the extremities. 21 had neck injuries, 10 abdominal, and 6 chest.</p><p><strong>Intervention: </strong>Revascularisation usually using the long saphenous vein in addition to direct repair or end-to-end anastomosis.</p><p><strong>Main outcome: </strong>Morbidity (amputation) and mortality.</p><p><strong>Results: </strong>Four lower limb grafts failed, two of which (2/69, 3%) required amputation. Overall, four patients died (3%), one of pulmonary embolism and 3 of severe injuries to major abdominal vessels. 3/10 patients with abdominal vascular trauma died. Mean (SD) follow up period was 4.4 (2) years.</p><p><strong>Conclusions: </strong>Civilian violence has increased in Kuwait. Vascular trauma to abdominal vessels is associated with high mortality. Autogenous saphenous vein forms an excellent conduit for revascularisation.</p>","PeriodicalId":22411,"journal":{"name":"The European journal of surgery = Acta chirurgica","volume":"168 11","pages":"626-30"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22343375","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":"Laparoscopic preperitoneal mesh repair or tension-free mesh plug technique? A prospective study of 471 patients with 543 inguinal hernias.","authors":"Emmanouil Pikoulis,&nbsp;Christos Tsigris,&nbsp;Theodoros Diamantis,&nbsp;Spiros Delis,&nbsp;Panayiotis Tsatsoulis,&nbsp;Sotiris Georgopoulos,&nbsp;Emmanouil Pavlakis,&nbsp;Ari K Leppäniemi,&nbsp;Elias Bastounis,&nbsp;Stilianos Mantonakis","doi":"10.1080/11024150201680003","DOIUrl":"https://doi.org/10.1080/11024150201680003","url":null,"abstract":"<p><strong>Objective: </strong>To compare two modem mesh-based \"tension free\" hernioplasties, laparoscopic repair and mesh plug technique.</p><p><strong>Design: </strong>Prospective, non-randomised study.</p><p><strong>Setting: </strong>Two major medical centres, Greece.</p><p><strong>Subjects: </strong>471 patients with 543 inguinal hernias.</p><p><strong>Intervention: </strong>Patients entering the study were treated in two major medical centres either by laparoscopic repair under general anaesthesia (n = 237) in hospital A, or by insertion of a mesh plug under monitored local, epidural, or spinal anaesthesia (n = 234) in hospital B. Patients with known bilateral inguinal hernias, femoral hernias, and those with both inguinal hernias and cholelithiasis were encouraged to undergo laparoscopic repair.</p><p><strong>Main outcome measures: </strong>Operative time, hospital mortality, morbidity and length of stay, costs, time to return to work, and recurrence rate.</p><p><strong>Results: </strong>The median operative time for laparoscopic repair was significantly longer (57 compared with 33 minutes, p < 0.001). Laparoscopic repair was more costly (1,200 US dollars compared with 500), and technically more demanding than insertion of a mesh plug. The median postoperative hospital stay, consumption of narcotic analgesics, and return to full work and heavy activities were similar in the two groups, whereas light activities were started earlier after plug repair [5.4 (2.4) compared with 3.4 (1.5) hours, p < 0.0001]. There were 6 recurrences in the laparoscopic group and 1 in the plug group.</p><p><strong>Conclusions: </strong>Mesh plug insertion is faster, cheaper, technically easier, does not require general anaesthesia, and is suitable to be done by surgeons as part of their general practice without special instruments and by junior surgeons. Plug repair resulted in fewer short or long term complications and reduced the recurrence rate.</p>","PeriodicalId":22411,"journal":{"name":"The European journal of surgery = Acta chirurgica","volume":"168 11","pages":"587-91"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22344645","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":"Traumatic complete transsection of the left hepatic duct: another approach to repair.","authors":"Massimiliano Veroux,&nbsp;Umberto Cillo,&nbsp;Carmelo Madia,&nbsp;Pierfrancesco Veroux,&nbsp;Enrico Gringeri,&nbsp;Pietro Fiamingo,&nbsp;Davide Francesco D'Amico","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":22411,"journal":{"name":"The European journal of surgery = Acta chirurgica","volume":"168 10","pages":"563-5"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22314983","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":"Haemorrhoidectomy in outpatient practice.","authors":"Peter Labas,&nbsp;Bernard Ohradka,&nbsp;Marek Cambal,&nbsp;Juraj Olejnik,&nbsp;Juraj Fillo","doi":"10.1080/11024150201680008","DOIUrl":"https://doi.org/10.1080/11024150201680008","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate our results of haemorrhoidectomy done as an outpatient procedure.</p><p><strong>Design: </strong>Retrospective study.</p><p><strong>Setting: </strong>University hospital Bratislava, Slovak Republic.</p><p><strong>Subject: </strong>256 patients who required haemorrhoidectomy in 1996-2001.</p><p><strong>Interventions: </strong>Milligan-Morgan haemorrhoidectomy under local (0.5% lignocaine with adrenaline 1:200,000, 100 ml) or epidural (0.5 bupivacaine, marcain, 20 ml; or 1% lignocaine, 20 ml).</p><p><strong>Main outcome measures: </strong>Mortality, morbidity, need for admission to hospital, and acceptability to patients.</p><p><strong>Results: </strong>No patient died. All patients were observed in the recovery room for 0.5-8 hours (mean 5 hours). 23 of the 256 patients (9%) developed minor complications including bleeding (n = 6), pain (n = 15), anal discharge (n = 1), and retention of urine (n = 1). 5 patients (2%) were admitted for pain or retention of urine. During the first 3 days after operation 29 patients required increased analgesia for discomfort. 223 patients (87%) were satisfied with outpatient treatment, while the remaining would have preferred to be admitted to hospital.</p><p><strong>Conclusion: </strong>Day case haemorrhoidectomy is a safe and effective way of reducing costs without increasing morbidity, mortality, and is acceptable to most patients.</p>","PeriodicalId":22411,"journal":{"name":"The European journal of surgery = Acta chirurgica","volume":"168 11","pages":"619-20"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22343373","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":"Behaviour of estrogen receptor, histological correlation, and clinical outcome in patients with benign breast disorders.","authors":"A K Khanna,&nbsp;J K Tapodar,&nbsp;H D Khanna,&nbsp;S Khanna,&nbsp;Anuradha Khanna","doi":"10.1080/11024150201680011","DOIUrl":"https://doi.org/10.1080/11024150201680011","url":null,"abstract":"<p><strong>Objective: </strong>To estimate the value of estrogen receptor (ER) in benign breast diseases and to find out if the response of benign breast diseases to danazol depends on the ER status of the tissue.</p><p><strong>Design: </strong>Prospective study.</p><p><strong>Setting: </strong>University hospital, India.</p><p><strong>Material: </strong>Samples of tissue from benign breast lesions, 40 fibrocystic disease and 10 fibroadenomas.</p><p><strong>Interventions: </strong>Enzyme immunoassay for the presence of cytosolic ER.</p><p><strong>Main outcome measures: </strong>ER concentrations, and correlation with effect of treatment with danazol.</p><p><strong>Results: </strong>Fibrocystic disease and fibroadenomas showed 30% and 40% ER positivity, respectively. The mean (SD) ER concentration was significantly higher in premenopausal than postmenopausal patients 14.75 (3.79) fmol/mgm compared with 6.2 (1.59) fmol/mg (p < 0.05). All ten patients with mastalgia who had ER-positive lesions (n = 26) responded to danazol, compared with 6 of 16 patients who had ER-negative lesions (p < 0.05). Lesions with diffuse fibrosis (n = 14) and five with lymphocytic infiltration on histology were all ER-negative.</p><p><strong>Conclusion: </strong>The patients with ER positive breast disease responded better to danazol than patients with ER negative breast disease.</p>","PeriodicalId":22411,"journal":{"name":"The European journal of surgery = Acta chirurgica","volume":"168 11","pages":"631-4"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22343376","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":"Caval stenting and side-to-side portocaval shunt in the treatment of Budd-Chiari syndrome.","authors":"Genoveffa Balducci,&nbsp;Giorgio Lucandri,&nbsp;Paolo Mercantini,&nbsp;Giovanni Di Giacomo,&nbsp;Pietro Maria Amodio,&nbsp;Gennaro D'Amico,&nbsp;Filippo M Salvatori,&nbsp;Vincenzo Ziparo","doi":"10.1080/11024150201680016","DOIUrl":"https://doi.org/10.1080/11024150201680016","url":null,"abstract":"","PeriodicalId":22411,"journal":{"name":"The European journal of surgery = Acta chirurgica","volume":"168 11","pages":"651-3"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22343908","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":"Chemotherapy in gastric cancer: a review and updated meta-analysis.","authors":"Karl-Gunnar Janunger,&nbsp;Larsolof Hafström,&nbsp;Bengt Glimelius","doi":"10.1080/11024150201680005","DOIUrl":"https://doi.org/10.1080/11024150201680005","url":null,"abstract":"<p><strong>Unlabelled: </strong>The five years survival rate for patients with gastric cancer is 15-25%. With the aim of improving survival, chemotherapy has been used in different adjuvant settings. Similarly, but with the aim of improving quality of life and prolonging life, chemotherapy has been used extensively in metastatic disease. In this review we have included studies of systemic and intraperitoneal chemotherapy given before, during or after operation and for advanced disease. A meta-analysis has been made on the 21 randomised studies that used adjuvant systemic chemotherapy postoperatively. A significant survival benefit for the patients treated postoperatively compared with controls was identified (odds ratio (OR) 0.84, 95% confidence interval (CI) 0.74 to 0.96). When western and Asian studies were analysed separately we found no survival benefit for the treated patients in the western groups (OR 0.96 (95 CI 0.83 to 1.12)). Flaws in the conduct of several trials made it difficult to draw firm conclusions, including the exclusion of a small but clinically meaningful survival benefit. Preoperative or neoadjuvant chemotherapy has shown effects in some patients, but no significant benefit was found in the few randomised studies. The few studies that reported intraperitoneal therapy showed no detectable survival benefit either. In patients with advanced disease, four small randomised studies found significantly longer survival in the treated patients. The survival benefit is in the range of 3-9 months, and there were also improvements of the quality of life. Several drug combinations have been tested, however, with no confirmed superiority for a particular regimen.</p><p><strong>Conclusions: </strong>Adjuvant chemotherapy cannot be recommended as a routine because of the lack of confirmed beneficial effects. Some patients with advanced disease will have a clinically important benefit from palliative chemotherapy, so this can be recommended for patients who are otherwise in good health.</p>","PeriodicalId":22411,"journal":{"name":"The European journal of surgery = Acta chirurgica","volume":"168 11","pages":"597-608"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22344649","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":"Management of appendiceal masses.","authors":"Bobby Tingstedt,&nbsp;Elinor Bexe-Lindskog,&nbsp;Mats Ekelund,&nbsp;Roland Andersson","doi":"10.1080/11024150201680001","DOIUrl":"https://doi.org/10.1080/11024150201680001","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the outcome of patients treated for appendiceal abscess, and managed either conservatively or surgically, and to describe the short and long-term outcome as well as incidence of interval appendicectomy in those treated conservatively.</p><p><strong>Design: </strong>Retrospective study.</p><p><strong>Setting: </strong>University hospital, Sweden.</p><p><strong>Patients: </strong>Ninety-three patients with the diagnosis of appendiceal abscess, 50 treated conservatively and 43 who were operated on, with a mean age of 46 (14-93) years. Mean (range) follow-up for patients operated on was 65 (11-135) and for those treated conservatively 66 (6-136) months.</p><p><strong>Main outcome measures: </strong>Course of acute disease, recorded complications, recurrence of appendicitis and incidence of interval appendicectomy during follow-up.</p><p><strong>Results: </strong>The duration of pain before admission was 4 (0.5-82) days for those operated on and 7 (2-60) days for those treated conservatively. A palpable mass was more common in the conservatively managed group. Complications were common among patients who were operated on. No interval appendicectomies were done during the second half of the study period. 4 of the patients treated conservatively (8%) had an underlying tumour diagnosed at follow-up.</p><p><strong>Conclusions: </strong>Operative management of patients with appendiceal masses seems to be associated with a high risk of postoperative complications and the risk of a more extensive surgical procedure. If possible, a conservative approach should be advocated. Because of inaccurate radiological imaging during the acute phase and the risk of an underlying malignancy, routine follow-up is necessary. Routine interval appendicectomy cannot be recommended.</p>","PeriodicalId":22411,"journal":{"name":"The European journal of surgery = Acta chirurgica","volume":"168 11","pages":"579-82"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22344724","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}