Langenbecks Archiv für Chirurgie. Supplement II, Verhandlungen der Deutschen Gesellschaft für Chirurgie. Deutsche Gesellschaft für Chirurgie. Kongress
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Langenbecks Arch Chir Suppl II Verh Dtsch Ges Chir · Jan 1990
[Surgical measures for preventing abdominal adhesions].
The extent of intraabdominal adhesions can be limited by reducing the degree of operative trauma. This may be achieved by: prevention of ischaemia, moistening of the peritoneal surface, gentle handling of tissue, and the use of thin atraumatic suture material. The most recent development, minimally invasive surgery, reduces the actual area of operative trauma, and possibly lessens the risk of postoperative adhesions. Should a re-laparotomy be indicated for complaints due to adhesions, the laparoscopic approach to adhesiolysis has increased in importance.
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Langenbecks Arch Chir Suppl II Verh Dtsch Ges Chir · Jan 1990
[Effects of intuition on determining indications and intraoperative procedure].
Intuition is used in medical decision-making, especially in a decision for surgery and in selection of the surgical procedure. Intuitive decisions are made without reasoning. ⋯ Intuition is related to heuristic techniques and uses them (representativeness, availability, anchoring). Decisions made on the basis of intuition must be controlled by systematic and logical reasoning.
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Langenbecks Arch Chir Suppl II Verh Dtsch Ges Chir · Jan 1990
[Perioperative chemotherapy of stomach cancer].
Surgery is the treatment of choice in early stages of gastric carcinoma. Systemic chemotherapy (CTx) is indicated in unresectable and metastatic disease. ⋯ Moreover CTx induced resectability in 47-80% of the patients. Therefore, younger patients in these stages of disease should be treated with effective CTx, such as EAP, in order to induce objective remissions so that residual tumor masses can be surgically removed.
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Langenbecks Arch Chir Suppl II Verh Dtsch Ges Chir · Jan 1990
[Effect and importance of experience in determining indications and surgical technique].
Medicine is an empirical science in which there are very heterogeneous view about the importance of experience. Numerical data attempt to quantify the required experience for student education and clinical practice. ⋯ Beyond all strategies of decision-making lies the accumulated individual experience of making the right decision at the right time. Experience is also at the bottom of the often cited intuition, clinical judgement and common sense.
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Langenbecks Arch Chir Suppl II Verh Dtsch Ges Chir · Jan 1990
[Heart injuries: diagnosis and therapy].
The clinical manifestation of wounds of the heart is determined by the mode, site and size of the injury as well as the structure of the pericardial and myocardial lesion. Diagnosis can be confirmed by ECG and echocardiography. ⋯ An aggressive surgical approach is mandatory. Cardiopulmonary bypass is necessary only to correct of concomitant lesions.