Zentralblatt für Chirurgie
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Comparative Study
[Introduction of laparoscopic splenectomy for the treatment of immune thrombocytopenic purpura].
Was to evaluate retrospectively the outcomes and efficacy of the laparoscopic splenectomies for ITP patients, performed at our institution over a period of 7 years and to compare these results with those after open splenectomies. ⋯ Laparoscopic or open splenectomy are equally efficacious in patients with ITP, with an immediate response rate of 100 % in our study. Our study results show that open splenectomy appears superior to laparoscopic procedure in terms of shorter operative time. Laparoscopic splenectomy appears superior to open procedure in terms of postoperative hospital stay, postoperative drainage time, less postoperative secretion through the drains. These two approaches are similar with regard to blood loss during operations and the rate of postoperative complications.
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As colorectal malignancies are relatively well treatable and show acceptable survival rates, the quality of life indicators are very important in this group of patients. ⋯ The quality of life of all patients was poorer than it was prior to the onset of the disease, but most of them could return to their prior way of living with not too many compromises. This process can be well monitored with our score system.
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Radiofrequency ablation is used in our Department of Surgery in cases of unresectable liver tumors. The case of a 22-year old male, who underwent nonanatomical resection of the spleen for trauma, is briefly reported. Splenic resection with the use of the radiofrequency needle could be performed safely and easily without complications. We use radiofrequency coagulation routinely in cases of blunt trauma of the spleen and liver.
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It was the objective of this retrospective study to analyse the causes of injury, surgical approaches, outcome, and complications in patients with vascular trauma and to report our experience with vein homografts for arterial reconstruction in the upper and lower limbs and cervicothoracic region in patients operated on over a period between 1981-2001. ⋯ Most vascular injuries of the extremities can be managed successfully unless associated with severe concomitant damage of the bones, nerves and soft tissues. In the absence of suitable autologous vein grafts, homografts appear to be an interesting alternative for arterial repair. In penetrating cervicothoracic vascular injuries immediate operative repair offers the best chance of recovery.