Acta chirurgica Hungarica最新文献

{"title":"Referral patterns and motivation for anti-reflux surgery of patients suffering from gastroesophageal reflux disease.","authors":"A Bálint,&nbsp;H J Stein,&nbsp;W K Kauer,&nbsp;H Feussner,&nbsp;R J Siewert","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Due to a better understanding of the pathophysiology of gastroesophageal reflux disease (GERD), as well as the improvements in surgical technique, the number of anti-reflux procedures has increased world-wide during the last decade. This trend has been facilitated by the advent of minimally invasive surgery. Although a great number of publications deal with the indications or selection of patients for surgery, only a few discuss the motivation of patients for choosing surgery rather than long-term medical treatment. In order to evaluate the different elements of motivation of patients suffering from primary gastroesophageal reflux disease, the data of 115 patients who had undergone anti-reflux surgery between January 1990 and June 1997 at the Department of Surgery, Technical University, Munich, were evaluated. As laparoscopic anti-reflux surgery has only been regularly performed since 1994 in our Department, the study period was divided and the two periods (1990-1993 and 1994-1997) were analyzed separately. The data were evaluated according to the referral pattern and the motivation of patients with GERD who chose surgery. In the period from 1990 to 1993, 38.5% of the patients were referred to surgery by general practitioners, 38.5% by internists, 10% by practicing surgeons and 8% by gastroenterologists. In 5% of the cases the patients themselves initiated surgery. The corresponding results for the period from 1994 to 1997 were 29%, 38%, 12%, 8% and 13%, respectively. The most common reason for a patient to choose surgery was moderate or only short-term response to appropriate conservative treatment, which accounted for 98% and 92% of the patients, respectively, during the study periods. This was followed by avoidance of life-long medical therapy and its potential risks in 77% and 85% of the patients. Fear of cancer was reported in 10% and 25%, respectively. In the second period, the option of a minimally invasive procedure was reported as an important factor in 45% of the patients. Although the number of anti-reflux procedures performed per year is increasing and there is also an increasing tendency regarding the application of minimally invasive procedures, the factors leading to referral failed to show significant differences in the two periods. The motivation of patients, however, clearly changed in favour of surgical therapy, mainly because of the availability of a minimally invasive approach.</p>","PeriodicalId":76967,"journal":{"name":"Acta chirurgica Hungarica","volume":"37 3-4","pages":"211-8"},"PeriodicalIF":0.0,"publicationDate":"1998-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21247940","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":"How effective is the routine mediastinal blockdissection in the surgery of non-small cell lung cancer?","authors":"G Egri,&nbsp;Z Mészáros,&nbsp;G Vass,&nbsp;M Juhász","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The performance of ipsilateral mediastinal blockdissection as a routine in every non-small cell lung cancer (NSCLC) operation gives us a chance to judge the accuracy of the preoperative CT examination. The accuracy rate of the CT in our 316 cases was 70.6%, the false positive rate was 69.6%, the false negative rate was 18.2%. Taking into account the 18.2% false negative rate and the slightly better survival of patients operated with routine blockdissection compared to the survival of a group of patients who had mediastinal blockdissection only if suspicion of tumour spread arose, we consider the procedure reasonable in every NSCLC operation.</p>","PeriodicalId":76967,"journal":{"name":"Acta chirurgica Hungarica","volume":"37 1-2","pages":"85-93"},"PeriodicalIF":0.0,"publicationDate":"1998-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21067853","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":"Reverse two-stage procedure in the surgical treatment of esophageal cancer.","authors":"O P Horváth,&nbsp;M Kassai,&nbsp;L Halmos,&nbsp;L Lukács","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Authors have performed 266 one-stage resections and 6 reversed two-stage operations for the treatment of esophageal cancer during a 10-year-period. In six cases first a substernal bypass with colon or stomach was carried out while the tumourous esophagus was removed only 3-4 weeks later from a right thoracic approach. All six patients recovered. The reverse two-stage operation for esophageal cancer can be suggested with rare indications (pulmonary abscess, previous abdominal operations, severe malnutrition, etc.) and it is only justified when the advantage gained by increased operability and decreased morbidity and/or mortality is higher than the disadvantage ensuing from oncological, financial and patient demanding considerations.</p>","PeriodicalId":76967,"journal":{"name":"Acta chirurgica Hungarica","volume":"37 1-2","pages":"45-50"},"PeriodicalIF":0.0,"publicationDate":"1998-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21067917","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":"Studies on tumourous and other urogenital patients with respect to antigens of oncogenic adenovirus.","authors":"G Kulcsár,&nbsp;J Ongrádi","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The possible connection of viruses with tumours was investigated by serologic examinations. Concerning the presence of antibodies against adenoviruses, especially those against the early non-virion antigen of oncogenic adenovirus type 12, approximately 4000 tests were made with sera of 446 urogenital patients with and without tumours and 70 ones with internal diseases. It was found by complement fixation tests that antibodies against non-virion antigens of adenoviruses were present in 53% of urogenital patients suffering from malignant tumours and prostatic hypertrophy, in 18% of non-tumourous urological patients and in 4% of patients with internal diseases, respectively. The results suggest that adenoviruses may play a role in tumourous diseases of the urogenital organs.</p>","PeriodicalId":76967,"journal":{"name":"Acta chirurgica Hungarica","volume":"37 3-4","pages":"171-5"},"PeriodicalIF":0.0,"publicationDate":"1998-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21247934","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":"Comparison of propofol-fentanyl or midazolam-fentanyl intravenous anaesthesia for carotid endarterectomy.","authors":"E Dárdai,&nbsp;L Szeredi","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Carotid endarterectomy has become a standard surgical operation in the therapy of cerebrovascular insufficiency. The cardiovascular status of the patients needs special attention, since the long-term prognosis is predominantly influenced by concomitant coronary artery disease. General anesthesia techniques are raising the challenge of maintaining cardiovascular stability and establishing adequate cerebral monitoring. Randomly selected 30 patients gave informed consent to this approved study. Fifteen patients were anaesthetised with propofol-fentanyl or midazolam-fentanyl combined with N2O-O2. Haemodynamic parameters (mean arterial pressure, heart rate) showed not significant changes during anaesthesia. Recovery profil proved to be significantly better after propofol-fentanyl compared to midazolam-fentanyl anaesthesia.</p>","PeriodicalId":76967,"journal":{"name":"Acta chirurgica Hungarica","volume":"37 3-4","pages":"177-82"},"PeriodicalIF":0.0,"publicationDate":"1998-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21247935","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":"Testicular sperm aspiration (first Hungarian results).","authors":"G Papp,&nbsp;K Rajczy,&nbsp;A Bernard,&nbsp;Z Kopa","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Authors summarize the first results with the use of spermatozoas retrieved with direct surgical method in intracytoplasmic injection in Hungary (1995-1997). Eighty-nine procedures were performed in 65 patients and 84 cases were successful. Out of 84 cases 23 clinical pregnancies could be achieved (27.3%). Thirteen children were born, including one case of twins and one triplets.</p>","PeriodicalId":76967,"journal":{"name":"Acta chirurgica Hungarica","volume":"37 3-4","pages":"195-9"},"PeriodicalIF":0.0,"publicationDate":"1998-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21247937","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":"Re-evaluation of the role of impedance plethysmography in the diagnosis of deep vein thrombosis in surgical patients.","authors":"M Cete,&nbsp;A Soran,&nbsp;E Yücel,&nbsp;I Ziraman,&nbsp;S Hengirmen","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The clinical diagnosis of deep-vein thrombosis (DVT) is nonspecific and nonsensitive. As a result invasive and non-invasive laboratory tests are needed. In order to detect the diagnostic value of impedance plethysmography (IPG), a widely used non-invasive laboratory test, a prospective clinical trial was performed to compare IPG with color Doppler-ultrasonography (CDUS) and venography. Seventy-six (41 female, 35 male) high-risk abdominal surgery patients were included in the study. IPG and CDUS were performed preoperatively. During the postoperative period IPG, CDUS and venography were carried out. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of IPG were all determined. The preoperative IPG was positive in 32 patients, being (+) in 29 patients postoperatively. On the other hand, two of the 29 postoperative IPG (+) patients had DVT diagnosed postoperatively by CDUS and venography. One of 47 IPG (-) patients had DVT diagnosed postoperatively. According to these findings, the sensitivity of IPG was 67%, specificity 63%, and PPV, NPV and accuracy were 7%, 98% and 63%, respectively. Our study showed that IPG was not a reliable non-invasive laboratory method in the diagnosis and screening of DVT of the lower extremity.</p>","PeriodicalId":76967,"journal":{"name":"Acta chirurgica Hungarica","volume":"37 1-2","pages":"23-31"},"PeriodicalIF":0.0,"publicationDate":"1998-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21067914","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":"Serologic examinations in acute appendicitis.","authors":"A Antal,&nbsp;B Kocsis,&nbsp;S Jeges,&nbsp;G Hideg,&nbsp;E Tornoczky","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Authors studied the formation of endotoxic antibody level in healthy adults and in patients with appendicitis with a technique (indirect haemagglutination) not used till now. They found the antibody level against endotoxin to be increased in 91% of their patients in the postoperative period. Decrease in the antibody level against endotoxin was observed in two patients with gangrenous appendicitis and two patients with perforated appendicitis. Summarizing their results, authors consider mixed (aerobic, anaerobic) infection to be of decisive importance in the development of acute appendicitis, contributing to the weakened immune response of the host.</p>","PeriodicalId":76967,"journal":{"name":"Acta chirurgica Hungarica","volume":"37 1-2","pages":"39-44"},"PeriodicalIF":0.0,"publicationDate":"1998-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21067916","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":"Experiences on 25 cases of radical cystectomy.","authors":"D L Répássy,&nbsp;S Csata,&nbsp;G Tamás,&nbsp;A Bécsi,&nbsp;T Weninger","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Authors review their early experiences and the oncopathological relations in respect to 25 cases of radical cystectomy involving orthotopic bladder substitution. The difficulties of diagnostics and indication are discussed. Attention is drawn to the fact that pathological \"staging\", \"grading\" are not entirely exact and reliable, though surgical indication is positioned on these. It is the opinion of authors that in case of TIG3 radical surgery is indicated. Due to the shortness of the follow-up periods, no studies on survival were performed. It remains an open question whether radical cystectomy is indicated as opposed to the possible choice of organ-preserving surgery.</p>","PeriodicalId":76967,"journal":{"name":"Acta chirurgica Hungarica","volume":"37 3-4","pages":"243-9"},"PeriodicalIF":0.0,"publicationDate":"1998-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21247308","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":"Data to the clinical manifestation of the Krukenberg tumour.","authors":"S Csömör,&nbsp;Z Melczer,&nbsp;Z Kazy","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Ovarian cancer is one of the most frequent malignant tumours in the female population. The screening of this tumour type is unsolved. The tumours are usually diagnosed in the advanced stage; thus the results of survival are unfavourable. Their histopathological appearance has a wide variety, with the occurrence of numerous metastatic forms. In these metastatic cases the choice of treatment is more difficult and prognosis is also worse. Among the metastatic tumours, the primary tumours of the gastrointestinal tract occur the most frequently. They are known as the Krukenberg tumour. Authors present two cases of Krukenberg tumours in order to summarize our knowledge on this rare tumour type and to give some practical advice.</p>","PeriodicalId":76967,"journal":{"name":"Acta chirurgica Hungarica","volume":"37 1-2","pages":"101-6"},"PeriodicalIF":0.0,"publicationDate":"1998-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21067855","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}