Langenbeck's archives of surgery
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Langenbecks Arch Surg · Sep 2009
Multicenter StudyImpact of modern techniques on short-term outcome after surgery for primary hyperparathyroidism: a multicenter study comprising 2,708 patients.
Preoperative localization procedures and the use of intraoperative parathyroidism (iOPTH) have led to a shift of paradigm from bilateral neck exploration to focused parathyroidectomy in primary hyperparathyroidism (pHPT). However, only a small number of randomized trials from specialized centers have been published. The main purpose of the study was to analyze the impact of localization procedures and iOPTH on short-term outcome after pHPT surgery in a multi-institutional setting. ⋯ Localization procedures and iOPTH decreased the risk for hypocalcemia after pHPT surgery. Additionally, iOPTH influenced short-term cure rate favorably.
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Langenbecks Arch Surg · May 2009
Fast-track concepts in routine pediatric surgery: a prospective study in 436 infants and children.
The aim of this study was to investigate fast-track concepts in routine pediatric surgery in a university clinic over 1 year. ⋯ Fast-track concepts are feasible in one third of pediatric patients undergoing routine in-hospital surgery. Fast-track pediatric surgery achieves accelerated convalescence, minimal hospital stay, and high patient and parent satisfaction.
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Langenbecks Arch Surg · May 2009
Parkinson's disease influences the perioperative risk profile in surgery.
Aim of this study was to define the perioperative risk profile in surgery of patients suffering from Parkinson's disease (PD) in order to improve treatment options in these patients. ⋯ Concomitant Parkinson's disease is a significant factor of perioperative morbidity in surgical patients, especially of patients treated in the trauma unit. Perioperative morbidity in PD patients may be influenced by early diagnostic and therapeutic measures.
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Langenbecks Arch Surg · Mar 2009
Multicenter StudyAdult living donor liver transplantation: body mass index and MELD score of recipients are independent risk factors for hospital mortality.
Adult living donor liver transplantation (LDLT) has been established as elective procedure or urgent procedure to save the life of patients with terminal liver diseases. The outcome of LDLT varies between transplant centers. Here, we aim to evaluate the outcome of LDLT in our center and to identify the risk factors that are associated with hospital mortality of recipients. ⋯ Adult living donor liver transplantation should be reserved to less "sick" patients in the era of organ allocation based on MELD score.
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Langenbecks Arch Surg · Mar 2009
Multicenter StudyDirect hemoperfusion with polymyxin-B-immobilized fiber columns improves septic hypotension and reduces inflammatory mediators in septic patients with colorectal perforation.
Although some studies have reported favorable effects of direct hemoperfusion with polymyxin-B-immobilized fiber columns (PMX) for the treatment of septic shock, few studies have demonstrated the efficacy of PMX in studies with a uniform case definition and without any other blood purification techniques. ⋯ Our findings suggested that PMX treatment appears to adsorb endotoxin and also modulates circulating cytokine during a 2-h interval of direct hemoperfusion in septic patients with such condition.