[Glucose-xylitol 35% (1:1) versus glucose 40%. Effectiveness and metabolic effects after major surgery].

Injury and stress are accompanied by a characteristic hormonal response and altered energy utilisation. Hyperglycaemia and negative nitrogen (N) balance are the leading symptoms of the metabolic changes in the post-operative state. In a prospective, randomised study the efficacy and metabolic effects of glucose-xylitol (GX) 35% (1:1) versus glucose (G) 40% were investigated in patients undergoing major surgery.

[More successful and cost effective--the non-transendoscopic method of TPCD].

With TPCD best results are gained with large diameter endoprostheses. In this instance special duodenoscopes with a working channel of 3.2 or 4.

[Can resorbable suture material be used in surgery of the supra-aortic branches?].

The experience with the use of monofilament absorbable suture (5/0 USP) in supraaortal vessels shows the same results related to neurological complication. The postoperative technical complications (bleeding, occlusion, restenosis) could be significantly reduced (p less than or equal to 0.05).

[Protein oriented peripheral venous nutrition following surgical trauma].

In the postoperative state, hypercaloric parenteral nutrition is not indicated in every patient where enteral nutrition is not feasible. Low caloric protein oriented peripheral venous parenteral feeding might be an alternative nutritional regimen in moderate catabolic postoperative states. In a prospective study, 18 females received a completed nutritional solution during 4 days postoperatively following major colon surgery.

[New aspects of preoperative imaging diagnosis in aggressive fibromatosis].

Aggressive fibromatosis is a surgical problem due to its tendency to recur following excision. The imaging methods available are presented and their diagnostic value discussed. A combination of different investigative procedures allows preoperative assessment of tumor type and extent and accurate planning of surgical procedure.

[Diagnosis and therapy of anorectal injuries].

Causes and management of anorectal injuries were examined in 16 patients. The outcome depends on the extent of local defects, on concomitant injuries and on the patient's age. We also stress the importance of immediate diagnosis and adequate treatment, which will result in a reduction of complications and mortality, ranging from 12 to 15% in patients with larger injuries of the colon and rectum.

[Restoration of work capacity after major vascular surgical interventions. Expectations and reality].

130 patients who had been working pre-operatively were examined and interviewed at least one year after an aorto-femoral bypass operation; 40.8% had continued smoking. Although 83.

[Transient reduced adrenal gland function following large vascular surgical interventions].

In 48 patients with aorto-femoral bypass-operations pre- and postoperative measurements of total serumcorticoids were performed. All serum levels were then compared to a control group undergoing large abdominal operations. In contrast to the control group twelve patients with aorto-femoral bypass-operations showed values that were for a time clearly below preoperative levels.

[Reconstruction surgical therapy of esophageal cancer. Personal experiences and results].

Within the last nine years 125 patients underwent surgery for carcinoma of the oesophagus. In our cases oesophagogastrostomy has proved to be the most successful operative technique. The disappointing results of the first years could be improved significantly by standardized perioperative therapeutic measures.

[Intrathoracic dislocation of a metal-piece after the use of wires in bone-surgery (author's transl)].

Two cases of intrathoracic dislocation of Kirschner's wire are reported. In one case the migration of the wire had been discovered 3 years after osteosynthesis of the acromioclavicular joint and incomplete removal of the metal. In another case a fragment of Kirschner's wire had to be removed by mediastinoscopy five months after fixation of the sternoclavicular joint.