Helvetica chirurgica acta
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Helvetica chirurgica acta · Dec 1989
[Clinical significance and treatment concept of Lisfranc dislocation and dislocation fracture].
Dislocations and fracture dislocations of the tarsometotarsal joint are uncommon (only 30 cases have been treated in our hospital in a 20-year period). The late results of tarsometotarsal injuries in 20 patients have been reviewed. The average follow-up was 3.8 years (range 8 months to 20 years). ⋯ Late results clearly correlate with the quality of reduction. An open procedure is usually necessary to achieve anatomical reduction. Diagnostic and operative problems are discussed.
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Helvetica chirurgica acta · Dec 1989
[Blood transfusions and prognosis following curative resection of colorectal cancer: is there an association?].
More recently a number of retrospective analyses in rather ill defined patient populations demonstrated an association between perioperative blood transfusion and recurrence after curative resection of colorectal cancer. In the randomized trial (SAKK 40/81) (adjuvant cytotoxic intraportal infusion versus no further treatment) we evaluated the transfusion status in a well defined, prospectively documented and controlled patient population. ⋯ After a median follow-up of 4 years, the transfused patients developed significantly more recurrences (38.2%) than patients without blood transfusions (23.1%), the death-rate being 33.7% versus 23.0%, respectively. Patients without transfusion but treated with adjuvant intraportal chemotherapy are strikingly doing better (10.5% recurrences) than patients with perioperative blood transfusion not having an adjuvant treatment (44.5% recurrences).
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Helvetica chirurgica acta · Dec 1989
[Magnetic resonance tomography in preoperative analysis of chronic post-traumatic osteomyelitis].
Chronic osteomyelitis in 8 patients was studied preoperatively by magnetic resonance (MR) imaging and in part of them also by computed tomography (CT). Morphologic information about extraosseous and intraosseous changes was important for surgical planning. In long bones CT generally is superior delineating bone structures (sequestra and fragments of devitalized bone in the intramedullary cavity) and MR may be used as an adjunct for localizing extraosseous and intraosseous abscesses. In trabecular bones as the os calcis MR seems to be equivalent to CT.
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Over a period of 2 years 234 patients scheduled for major intraabdominal surgery were fed postoperatively via fine needle jejunostomy catheter. Nutrition ensued directly after surgery. Mean period of nutrition was 7.8 +/- 1.5 days. ⋯ In one patient, catheter nourishment had to be discontinued because of diarrhoea. One further discontinuation occurred due to postoperative non-catheter-related ileus. Clinical postoperative progress and laboratory findings showed no negative results relating to this form of nutrition.