Zentralblatt für Chirurgie
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Comparative Study
[Preoperative chemoradiation in esophageal cancer: experience of a single center in 102 patients].
The (dis-)advantages of preoperative chemoradiation in patients with esophageal cancer (EC) are still controversial as data are lacking showing a clear cut benefit. Therefore, data of neoadjuvant therapy of our hospital have been analyzed. Since 1994 102 patients with an EC (33 % adenocarcinoma, 67 % squamous cell cancer, scc) were operated after receiving preoperative chemoradiation (36 Gy radiation, 1.8 Gy/day for 4 weeks, 500 mg/m (2) 5-FU for 4 weeks and 20 mg/m (2) Cisplatin, day 1-5, week 1 and 4). ⋯ These results underline the benefit of neoadjuvant therapy in patients with a CR. Further on, a pN0 stage is an important prognostic indicator. However, it remains open, whether neoadjuvant therapy leads to a downstaging of lymph node involvement, as histological confirmation in clinically positive lymph node is seldom performed prospectively.
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Comparative Study
[Laparoscopic splenectomy: first experiences with a 3-trocar-technique and the 'hanging-spleen-maneuver'].
Laparoscopic splenectomy has been established as standard procedure for elective splenectomy and is performed for a variety of haematological diseases. However, different techniques have been used and a four- to five trocar technique is applied in most instances. We report our experience with a three-trocar technique using the triangular liver retractor and the so-called "hanging spleen" maneuver. ⋯ Laparoscopic splenectomy can be performed safely in the vast majority of patients. The described technique using three trocars with the so-called "hanging spleen" maneuver can be used in about 90 % of cases.