Zentralblatt für Chirurgie
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Due to poor willingness in the population to donate organs and increasing number of patients on the waiting list for organ transplantation there is an imminent need on cadaveric organs. Although efforts have been to optimize the prerequisites for organ donation, less than 50% of possible organ harvesting procedures take place. In our country, only 13.1 organ donations .per 1 million inhabitants were realized in 2001. ⋯ The quality of a graft has a significant impact on the outcome of transplantation. An optimal graft function will not only be achieved with an adequate surgical and preservation technique but also with an appropriate management of the brain-dead donor on the intensive care unit. Basic knowledge of brain death definition, insight into the organization of organ donation, management of the donor, and modern surgical harvesting techniques are presented.
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Case Reports Comparative Study
[Knotted intravascular catheters--what should be done?].
Fixed intravasal catheters are mainly caused by knots. Removal can be achieved by intervention or surgical exploration, but this is associated with additional morbidity and mortality. ⋯ Most of all "lost" intravasal catheters are removed by radiological intervention; only one third needs open surgical therapy. These procedures are harmful for the patient and bear considerable risks for complications.
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Comparative Study
[Results of video-assisted thoracoscopic surgery for pneumothorax].
Video-assisted thoracoscopic surgery has been used in the treatment of pneumothorax since 1990. There is still no general agreement regarding the procedure to obliterate the pleural space or regarding the indication for wedge resection if no blebs or bullae can be found. ⋯ Apical parietal pleurectomy and wedge resection of blebs or bullae are effective methods to prevent recurrences. Considering the specific complications of parietal pleurectomy alternative methods to obliterate the pleural space should be used depending on the intraoperative situation. Among other factors underlying pulmonary diseases or thoracic surgery in the patient's history strongly influence the postoperative outcome independently of the operative procedure.
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Comparative Study
[Calcaneus fractures. Open reduction and internal fixation].
Critical analysis of the medium-term results of open reduction and internal fixation (ORIF) of displaced intra-articular calcaneus fractures with a standardized protocol in a greater patient cohort. ⋯ Management of intra-articular calcaneus fractures with a standardized protocol of ORIF and early mobilization leads to reproducible good or excellent clinical results in a majority of patients. New approaches like an interlocking calcaneus plate, the use of subtalar arthroscopy, early soft tissue coverage for complex open injuries and percutaneous screw fixation for selected fractures should further improve prognosis.