What Is the Reality of Hiatal Hernia Management?-A Registry Analysis.

To date, the guidelines for surgical repair of hiatal hernias do not contain any clear recommendations on the hiatoplasty technique with regard to the use of a mesh or to the type of fundoplication (Nissen vs. Toupet). This present 10-years analysis of data from the Herniamed Registry aims to investigate these questions.

Long-term impact of preventive UDCA therapy after transplantation for primary biliary cholangitis.

Background & Aims: Recurrence of primary biliary cholangitis (PBC) after liver transplantation (LT) is frequent and can impair graft and patient survival. Ursodeoxycholic acid (UDCA) is the current standard therapy for PBC. We investigated the effect of preventive exposure to UDCA on the incidence and long-term consequences of PBC recurrence after LT.

Influencing Factors on the Outcome in Female Groin Hernia Repair: A Registry-based Multivariable Analysis of 15,601 Patients.

Objective: Based on an analysis of data from the Herniamed Registry, this study aims to identify all factors influencing the outcome in female groin hernia repair.

Background: In a systematic review and meta-analysis of observational studies, female sex was found to be a significant risk factor for recurrence. In the guidelines, the totally extraperitoneal patch plasty (TEP) and transabdominal preperitoneal patch plasty (TAPP) laparo-endoscopic techniques are recommended for female groin hernia repair.

Modified plug repair with limited sphincter sparing fistulectomy in the treatment of complex anal fistulas.

Purpose: New technical approaches involving biologically derived products have been used to treat complex anal fistulas in order to avoid the risk of fecal incontinence. The least invasive methods involve filling out the fistula tract with fibrin glue or introduction of an anal fistula plug into the fistula canal following thorough curettage. A review shows that the new techniques involving biologically derived products do not confer any significant advantages.

Prognostic factors for long-term survival in patients with ampullary carcinoma: the results of a 15-year observation period after pancreaticoduodenectomy.

Introduction. Although ampullary carcinoma has the best prognosis among all periampullary carcinomas, its long-term survival remains low. Prognostic factors are only available for a period of 10 years after pancreaticoduodenectomy.

Differences in biomechanical stability using various fibrin glue compositions for mesh fixation in endoscopic inguinal hernia repair.

Background: In hernia surgery, mesh fixation with fibrin glue instead of tacks and sutures can demonstrably reduce postoperative morbidity without increasing recurrence rates. In some cases there are significant differences in the biomechanical properties, depending on the functional structure of the meshes. Furthermore, there are various fibrin glue products on the market and these are used for mesh fixation.

Matched-pair analysis of postoperative morbidity and mortality for pancreaticogastrostomy and pancreaticojejunostomy using mattress sutures in soft pancreatic tissue remnants.

Background: After pancreaticoduodenectomy, the incidence of postoperative pancreatic fistula remains high, especially in patients with "soft" pancreatic tissue remnants. No "gold standard" surgical technique for pancreaticoenteric anastomosis has been established. This study aimed to compare the postoperative morbidity and mortality of pancreaticogastrostomy and pancreaticojejunostomy for "soft" pancreatic tissue remnants using modified mattress sutures.

Single-Incision Cholecystectomy in about 200 Patients.

Background and Aims. We describe our experience of performing transumbilical single-incision laparoendoscopic cholecystectomy as standard procedure for acute and chronic gallbladder diseases. Methods.

Comparison of a lightweight polypropylene mesh (Optilene® LP) and a large-pore knitted PTFE mesh (GORE® INFINIT® mesh)--Biocompatibility in a standardized endoscopic extraperitoneal hernia model.

Purpose: The use of a mesh with good biocompatibility properties is of decisive importance for the avoidance of recurrences and chronic pain in endoscopic hernia repair surgery. As we know from numerous experiments and clinical experience, large-pore, lightweight polypropylene meshes possess the best biocompatibility. However, large-pore meshes of different polymers may be used as well and might be an alternative solution.

Single-port versus multi-port cholecystectomy for patients with acute cholecystitis: a retrospective comparative analysis.

Background: Trans-umbilical single-port laparoscopic cholecystectomy for chronic gallbladder disease is becoming increasingly accepted worldwide. But so far, no reports exist about the challenging single-port surgery for acute cholecystitis. The objective of this study was to describe our experience with single-port cholecystectomy in comparison to the conventional laparoscopic technique.

Initial experience in laparoscopic single-port appendectomy: a pilot study.

Background: We describe our initial experience performing a single-port (SP) advanced laparoscopic appendectomy in comparison to the conventional port (CP) technique, which uses three ports.

Methods: Between June and September 2009, 40 consecutive patients with acute appendicitis underwent laparoscopic appendectomy at Vivantes Klinikum Am Urban, Berlin, Germany. Twenty patients were operated on using the SP technique (SP group), and the data were compared to a control group of 20 patients operated on using the CP technique (CP group) during the same time period.

Phenotypic and genotypic characterization of carcinomas of the papilla of Vater has prognostic and putative therapeutic implications.

We further characterize the heterogeneous carcinomas of the papilla of Vater (CPVs) in relation to various clinicopathologic patient characteristics and patient survival. Of the 71 reevaluated CPVs, 32 were intestinal, 26 were pancreatobiliary, 6 were mixed, 4 were mucinous, and 3 were poorly differentiated carcinomas. The prevalence of cytokeratin 20 and cytokeratin 7 correlated with the intestinal (25/32 [78%] vs 13/32 [41%]) and pancreatobiliary (6/26 [23%] vs 24/26 [92%]) phenotypes.

Donor influence on outcome in patients undergoing liver transplant for primary biliary cirrhosis.

Objectives: Risk factors for survival after liver transplant owing to primary biliary cirrhosis have been extensively investigated, whereas the donor-specific influence and particularly, the histologic data, have not been sufficiently analyzed.

Patients And Methods: Donor data of 121 patients who underwent liver transplant for primary biliary cirrhosis and histologic findings of 69 donor liver grafts were assessed according to preoperative status and histologic criteria. Findings were correlated with the histologic and clinical course up to 20 years after orthotopic liver transplant.

Surgical strategies for treatment of malignant pancreatic tumors: extended, standard or local surgery?

Tumor related pancreatic surgery has progressed significantly during recent years. Pancreatoduodenectomy (PD) with lymphadenectomy, including vascular resection, still presents the optimal surgical procedure for carcinomas in the head of pancreas. For patients with small or low-grade malignant neoplasms, as well as small pancreatic metastases located in the mid-portion of pancreas, central pancreatectomy (CP) is emerging as a safe and effective option with a low risk of developing de-novo exocrine and/or endocrine insufficiency.

Carcinoma of the distal and middle bile duct: surgical results, prognostic factors, and long-term follow-up.

Background/purpose: Carcinoma of the distal bile duct is associated with poor prognosis. Surgical resection remains the only potentially curative treatment. We conducted a retrospective study to identify prognostic factors determining longterm survival.

Mayo risk score for primary biliary cirrhosis: a useful tool for the prediction of course after liver transplantation?

Background: Survival after orthotopic liver transplantation (OLT) for primary biliary cirrhosis (PBC) is excellent. In order to define the optimal time point for OLT, the Mayo risk score (MRS) was developed and a score of 7.8 was identified for transplantation.

Laparoscopic-assisted placement of peritoneal dialysis catheters: implantation technique and results.

Background: Peritoneal dialysis is a generally accepted method for the treatment of patients with end-stage renal failure. The laparoscopic placement of peritoneal dialysis catheters is a well-established technique and offers some advantages, such as a safer placement of the catheter, less post-operative complications, and a longer functional survival, compared to the conventional open technique. The aim of this study was to describe our implantation technique and to determine the results of our approach.

Influence of donor histology on outcome in patients undergoing transplantation for hepatitis C.

Background: Risk factors for graft loss and recipient death in liver transplantation for hepatitis C virus (HCV) have been extensively investigated. Donor age was defined as one of the most important predictors of outcome in these patients; however, the mechanism leading to more severe recurrent hepatitis has not yet been investigated.

Method: In a retrospective analysis, histological findings of 79 donor liver grafts were assessed according to criteria inflammation, fibrosis, fatty degeneration, and necrosis.

Antineoplastic activity of 2-methoxyestradiol in human pancreatic and gastric cancer cells with different multidrug-resistant phenotypes.

Background And Aim: Chemoresistance often leads to loss of the last treatment option for cancer. 2-Methoxyestradiol (2-ME2) has been shown to inhibit tumor growth. The aim was to examine the efficacy of 2-ME2 on multidrug-resistant human cells from pancreatic and gastric cancer.