Zentralblatt für Chirurgie
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Randomized Controlled Trial Comparative Study
[Postoperative pain in the acute phase after surgery: VATS lobectomy vs. open lung resection - results of a prospective randomised trial].
Minimally invasive procedures, e.g. video-assisted thoracoscopic lobectomy, are less traumatic and thus one may expect a lower level of postoperative pain compared to open procedures. This assumption is supported by several studies/metaanalyses. However, confirmation by larger prospective randomised studies is lacking. In the present study we analysed 2 groups of patients with lobectomy for early-stage lung cancer performed by VATS or by antero-lateral thoracotomy. ⋯ Regardless of procedure (VATS vs. open) pain control can be achieved with an adequate analgetic regime. For VATS during the first days a lower amount of medication is required. The VATS group showed a higher proportion of patients with very low postoperative pain profile: patients with pain score always under 4 and patients without pain at certain points before the 10th postoperative day or at discharge.
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The relevance of hollow organ trauma in severely injured patients within a large collective has not been thoroughly reviewed as yet. This study aimed at assessing the prevalence of hollow organ trauma in relation to the outcome and the currently established method of treatment. ⋯ The results presented here show the prevalence and the outcome of hollow organ injury in a large collective within the Trauma Register of the DGU for the first time.
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The therapeutic strategies for oligometastatic non-small cell lung cancer have changed over the last decade from palliative to curative intent. The role of surgery in this multimodal treatment in selected patients remains a subject for open discussion. ⋯ Surgery in oligometastatic non-small cell lung carcinoma is feasible for primary tumour and for metastases. It is an effective option in the multimodal treatment in highly selected patients. The lymph node dissection should remain an important integral part of the surgical treatment.
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Review Comparative Study
[Therapeutic decisions in patients with operable, non-metastatic oesophageal cancer].
Therapy for oesophageal carcinoma is a subject of controversial debate. The aim of this study is to answer the question how the therapeutic decision in patients with operable, non-metastatic oesophageal cancer should be made. ⋯ Therapeutic decisions in patients with oesophageal cancer should only be made after standardised staging and accurate risk analysis.