[Surgical therapy of severe obesity].

Severely obese patients are vitally endangered by their overweight. Non operative therapies achieve less than 10% of persistent weight reductions in this high-risk group of patients. On condition of correct indications and adequate preoperative information gastric bypass, vertical banded gastroplasty or implantation of the adjustable gastric band represent effective surgical procedures enabling persistent reductions of at least 50% of overweight in 85% of patients.

[Immunoscintigraphy for detection of inflammatory perioperative foci].

The aim of our study was to evaluate the clinical usefulness of a monoclonal antibody (MAB; BW 250/183; Behringwerke, Germany) in patients with suspected perioperative septic foci. The MAB is directed against the nonspecific crossreacting antigen (NCA 95) which has been found on the surface of human neutrophil granulocytes and which represents a murine immunoglobulin isotype of IgG1. Immunoscintigraphy was performed by labelling the MAB with 740 MBq (20mCi) Tc-99m.

Nd:YAG laser treatment of colorectal malignancies: an experience of 4 1/2 years.

Between 1985 and 1990, 517 patients were treated for colorectal malignancies at our department of surgery. Nd:YAG laser therapy was used in 37 cases (7.1%).

Hepatic artery infusion chemotherapy.

Hepatic artery chemotherapy was given to 36 patients, using totally implantable devices consisting of a port and external pump. Twenty-seven patients had inoperable liver metastases of colorectal origin. The infusion system was inserted by laparotomy into the hepatic artery via the gastroduodenal artery.

[Prevention of adhesions in abdominal surgery. A dose finding study with streptokinase/streptodornase].

Unlabelled: Measurement of intraperitoneal fibrinolytic activity on 50 patients having undergone abdominal surgery (four of them controls). Instillation of streptokinase/streptodornase (Varidase) into the abdominal cavity. Determination of total protein, plasminogen, antiplasmin, alpha 2 Mx-plasmin-complex, spontaneous fibrinolysis and fibrinolysis + activator at different points in time p.

Below-knee femoropopliteal bypass using externally supported polytetrafluoroethylene (PTFE) grafts.

Twenty-seven externally supported polytetrafluoroethylene (PTFE) grafts were implanted in the femoropopliteal position crossing the knee joint. All patients underwent surgery because of limb threatening ischemia (rest pain or gangrene). There was one early graft failure (successful thrombectomy).

[Indications for primary anastomosis following resection of acute diverticulitis of the large intestine].

A retrospective review of 102 patients (1979-1987) was performed to evaluate the surgical management of complicated diverticulitis. The following operative strategy was found to be effective: 1. the Hartmann procedure in free perforation and diffuse peritonitis; 2.

[Laser surgery of parenchymatous organs].

Several physical methods of cutting and/or coagulating are available in addition to CO2 or Nd:-YAG-lasertechnology for surgery of the parenchymal organs. The promising experimental results obtained in partial hepatectomies were not reduplicated in clinical situations. Exceptions are the contact Nd-YAG laser which had good or excellent results and the use of lasers in pediatric surgery of parenchymal organs, depending on the patient's physiological condition.

Effect of infusion of salmon calcitonin on the secretion of somatostatin and gastrin in man.

In vitro and animal studies have pointed out complex interrelations between gastrointestinal hormones and calcitonin. To analyse the acute effects of calcitonin in more detail, patients undergoing surgery were infused intravenously with synthetic salmon calcitonin, a potent analog of the human hormone. Samples were taken after 0, 30 and 60 minutes from the hepatic, portal and a peripheral vein.

[Local recurrence following surgery for breast cancer and its relation to the primary intervention].

Unlabelled: 32 cases of local recurrence following curative mastectomy were operated between 1975 and 1984. The primary operation was: radical mastectomy n = 20, simple mastectomy n = 6, lumpectomy with axillary dissection n = 6. The rate of local recurrence amounted to: 4.

[Scalpel and CO2 laser in the animal experiment. A comparative study of inoculation tumors of the mouse].

The study hereby submitted has been designed to show whether there are any differences between using a conventional knife or a CO2-laser when excising and grafting tumors in animal experiments. The animals were C57Bl/6 mice, the tumor was the Lewis lung carcinoma. Eight days after tumor inoculation into the subcutaneous layer of the back, 213 mice were treated by tumor excision either with a conventional knife or a CO2-laser.

Comparative study of conventional scalpel and CO2-laser in experimental tumor surgery.

The study hereby submitted has been designed to show whether there are any differences between using a conventional knife or a CO2-laser when excising and grafting tumors in animal experiments. The animals were C57B1/6 mice, the tumor was the Lewis lung carcinoma. Eight days after tumor inoculation into the s.

[Experimental studies of the danger of ignition of tubes during endolaryngeal microsurgery with the laser].

Experiments on the ignition-risk of tubes used during endolaryngeal laser surgery are reported. The mechanism of the laser as an ignition source is explained. The materials were tested as to their inflammability.

Stapling devices in gastrointestinal surgery.

In a series of 189 patients, 197 operations (251 stapled anastomoses) were performed. U.S.

Polydioxanone in vascular surgery. First experience with an absorbable suture in femoro-popliteal bypass.

The use of synthetic absorbable monofilament suture material (polydioxanone, PDS), is described for operative vascular surgery. Six anastomoses in three femoro-popliteal (tibial) vein bypass operations were performed. Angiographical control was carried out, when absorption was in progress (after a period of five months) or totally completed (within six months), and showed no dilatation or aneurysm formation at the suture line.

[Indications and results of gastric bypass in the treatment of extreme obesity].

A report is presented on gastric bypass (n = 27) and gastroplasty (n = 2) in patients with morbid obesity. One patient died postoperatively (mortality 3.4%).

[Surgical treatment of peripheral arterial occlusive diseases].

Within a period of 18 months 75 operations (25 aorto-femoral, 50 femoro-popliteo-crural reconstructions) were performed: early failure in lower limb reconstructions 8% (rate of amputation 4%), operative mortality 2,7%. Only 15% of the patients had claudication, 85% rest pain or gangrene. Because of the low number of reinterventions (8% postoperative rethrombosis or hemorrhage), the 2,7% mortality and the reasonable 20-2 months' follow-up results (83% good function) we believe that arterial reconstructive surgery has a place in the field of operative activities of a municipal hospital.

[Assessment of the tracheal cross-section by computerised tomography (author's transl)].

Tracheal cross-sections can be measured by means of computerised tomography with hitherto unparalleled accuracy. Among the patients examined by the authors (43) women following tracheopexy because of tracheomalacia), computerised tomography yielded approximately 3 times as many pathological findings as was possible by conventional x-ray diagnosis. Over and above this, it is always possible to calculate the flow resistance, a fact which can be of great importance for therapy planning and control.

[Hyperparathyreoidism and chronic lymphocytic leukemia (author's transl)].

A 55 year old patient with chronic lymphocytic leukemia is reported in whom hypercalcemia occurred associated with hypophosphatemia and elevated parathyroid hormone levels (C-terminal assay). Bone histology gave further evidence for hyperparathyroidism. During neck and mediastinal exploration numerous lymph nodes were exstirpated.