Langenbecks Archiv für Chirurgie. Supplement. Kongressband. Deutsche Gesellschaft für Chirurgie. Kongress
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Langenbecks Arch Chir Suppl Kongressbd · Jan 1997
[Surgical interventions in extracorporeal membrane oxygenation (ECMO)].
Extracorporeal membrane oxygenation is a suitable technique for short-term treatment of resistant respiratory failure with a comparably low mortality rate of 32%. However, pulmonary complications are quite often encountered during ECMO therapy making thoracic interventions necessary. The most frequent of these complications is hemorrhage followed by lung fistula, which remain resistant to conventional therapy. The indication for operative lung resection during ECMO treatment must remain restricted to selected cases, since these procedures have a high morbidity.
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Langenbecks Arch Chir Suppl Kongressbd · Jan 1997
[Minimal invasive bypass operations on the beating heart and using mechanical stabilization of the heart surface].
Different minimally invasive techniques are currently being controversially discussed among cardiac surgeons. For revascularization of anterior myocardial vessels, off-bypass procedures were performed in 64 cases through an anterolateral submammary minithoracotomy using the left internal mammary artery. Application of mechanical epicardial stabilization facilitated adequate exposure of the anastomosis and resulted in good patency rates and a low number of complications.
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Langenbecks Arch Chir Suppl Kongressbd · Jan 1997
[Outcome of primary surgical management of liver trauma].
We evaluated retrospectively 43 patients with liver trauma undergoing laparotomy between 1/89 and 12/95. Blunt trauma (27 patients) and penetrating trauma (16 patients) to the liver had a mortality of 37% and 0%, respectively. The overall mortality was 23.3% and was significantly related to concomitant injuries (p = 0.002), whereas age, severity of the liver trauma as well as the surgical treatment had no significant influence on the outcome.
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Langenbecks Arch Chir Suppl Kongressbd · Jan 1997
[The trauma register of the 'Polytrauma' Committee of the German Society of Trauma Surgery as the basis for quality management in the management of severely injured patients].
The data of 1037 severely injured patients (mean ISS = 20) from 15 clinics were centrally and prospectively collected in the Trauma Registry of the German Society of Trauma Surgery and analyzed anonymously. Significant differences in respect to the treatment criteria (i.e., duration of basic diagnostics in severe trauma) and quality of outcome (TRISS method and Z statistic) were revealed for some clinics. The feedback of their data offers the associated clinics the possibility of identification of treatment phases that are worth being optimized.
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Langenbecks Arch Chir Suppl Kongressbd · Jan 1997
[Measuring epidural intracranial pressure in patients with severe craniocerebral trauma].
In 30 patients with severe head injury (SHI), intracranial pressure (ICP) was monitored using epidural transducers. In 22 patients, the measurements were reliable, with average values of 19.4 mmHg in the survivors and 64.6 mmHg in those who died. It is concluded that epidural measurement of ICP provides a helpful method for the management of SHI and to control the indication for CT scans.