Zentralblatt für Chirurgie
-
Complications of gastroduodenal ulcers such as bleeding and perforation have been afflicted with a mortality of up to 40 % in the past. Altered ulcer manifestation by improvement of medical treatment as well as advances in surgical techniques and intensive care medicine might currently have improved the outcome of these severely ill patients. ⋯ Altered ulcer manifestation, minimized surgical therapy and improved intensive care medicine led to a recent reduction in postoperative mortality of patients suffering from perforated or bleeding gastroduodenal ulcer. A further reduction of this still high mortality might be expected by improvement of surgical training and/or restriction of therapy to a limited number of surgeons.
-
Sustained increase of the intra- abdominal pressure is recently recognized as a potential risk factor of early organ dysfunction in patients with severe acute pancreatitis. Assessment of the possible mutual relevance between increased intra-abdominal pressure and early organ dysfunction is important for optimisation of the treatment strategy in this category of patients. ⋯ Increased intra-abdominal pressure could be an important risk factor of early organ dysfunction in patients with severe acute pancreatitis. Critical increase of the intra-abdominal pressure and persisting organ dysfunction are an indication for reassessment of the treatment strategy.
-
Tracheal stenosis represents a serious complication of tracheostomy or of endotracheal intubation. The objective of this article was to evaluate the results of resective therapy of patients with tracheal stenosis. ⋯ Resection is the optimum therapeutic method for tracheal stenosis with low postoperative mortality and a small number of postoperative complications. Successful tracheal resection is a definitive solution in comparison with stent placement.
-
A 63-year old man suffering from bilateral leg pain was admitted to our hospital with an occlusion of the infrarenal abdominal aorta. A bifurcated dacron graft was implanted and a histological examination of the thrombotic material was performed. ⋯ Histology revealed a primary sarcoma. The patient is doing well 6 months after operation.
-
The surgical treatment of pilonidal sinus with the Limberg transposition flap will be demonstrated in 40 patients (22 male; 18 female). First step is draining the infect by incision, followed by radical excision of the pilonidal sinus and covering of the defect by a rhomboid transposition flap. In 39 out of 40 cases primary wound healing occurred. ⋯ In one case a seroma was observed which was drained and showed secondary wound healing. The mean hospital stay was 7.9 days and the mean time until return to work was about 15 days. We consider the Limberg transposition flap to be an effective treatment of pilonidal sinus disease due to its technical simplicity and low complication rate.