Laparoscopic approach to treatment of sigmoid diverticulitis: changes in the spectrum of indications and results of a prospective, multicenter study on 1,545 patients.

Background: The aim of the present study was to analyze changes regarding the indications for and results of laparoscopic treatment of sigmoid diverticulitis.

Methods: The data were collected within the framework of an ongoing prospective multicenter study carried out by the Lapa roscopic Colorectal Surgery Study Group and were submitted to a statistical subgroup analysis. The institutions participating in the study were divided into three groups by experience (Group I, >100 procedures; Group II, 30-100 procedures; Group III, < 30 procedures).

Oncological quality and preliminary long-term results in laparoscopic colorectal surgery.

Background: Our aim here was interpret data on the perioperative course, oncological quality, and preliminary long-term results of laparoscopic colorectal surgery carried out with a curative intent.

Methods: The data were collected within the framework of a prospective multicenter observational study that has been ongoing since 1 Aug 1995 and includes 46 hospitals. Of a total of 3133 patients, 826 (26.

Laparoscopic treatment of rectal prolapse: experience gained in a prospective multicenter study.

Background: We report the findings of a prospective multicenter observational study carried out by the Study Group for Laparoscopic Colorectal Surgery on patients undergoing laparoscopic or laparoscopic-assisted surgery for rectal prolapse. The study investigated the safety of various laparoscopic techniques in terms of perioperative and postoperative general and technique-specific complications and compared the results with those reported for open surgery in this area.

Methods: Of the 150 patients undergoing laparoscopic or laparoscopic-assisted colorectal surgery for rectal prolapse 124 received rectopexy combined with resection and 26 rectopexy alone.

Laparoscopic abdominoperineal resection and anterior resection with curative intent for carcinoma of the rectum.

Background: Within a 5-year period, 380 rectal carcinoma patients undergoing laparoscopic abdominoperineal excision or laparoscopic anterior resection were recruited to a multicenter study by 23 institutions in Germany and Austria. This study was initiated by the Laparoscopic Colorectal Surgery Study Group.

Results: One hundred forty-nine patients (39.

Laparoscopic anterior resection for rectal carcinoma. Results of a registry.

At the present time, laparoscopic anterior resection of the rectum cannot be recommended for routine use. Such operations should be performed for curative intent only within scientifically valid studies. Furthermore, only interventions involving the upper part of the rectum or the rectosigmoidal junction can, on the basis of the morbidity rate, be justified.

Experience as a factor influencing the indications for laparoscopic colorectal surgery and the results.

Background: The influence of experience on the results of treatment with laparoscopic surgery is indisputable. The establishment of indications and contraindications is relative, and varies depending on the experience of the surgeon. Learning curves have been described for a number of laparoscopic interventions, in particular laparoscopic cholecystectomy.

Importance of conversion for results obtained with laparoscopic colorectal surgery.

Purpose: The need for a conversion is a problem inherent in laparoscopic surgery. The present study points up the significance of conversion for the results obtained with laparoscopic colorectal surgery and identifies the risk factors that establish the need for conversion.

Method: The study took the form of a multicentric, prospective, observational study within the Laparoscopic Colorectal Surgery Study Group.

Laparoscopic abdominoperineal resection: early postoperative results of a prospective study involving 116 patients. The Laparoscopic Colorectal Surgery Study Group.

Purpose: Although laparoscopic colorectal surgery is attracting ever more attention, its use for curative treatment of colorectal carcinoma in particular continues to be controversial. The present study was an attempt to analyze the results of the perioperative course, oncologic quality, and preliminary long-term results.

Method: The data considered here were collected within the framework of a prospective, observational study initiated on August 1, 1995, and involving a total of 18 institutions in Germany and Austria.

Laparoscopic surgery for the cure of colorectal cancer: results of a German five-center study.

Purpose: The aim of this study was to assess the feasibility and safety of laparoscopic surgery for the cure of colorectal cancer with emphasis on oncologic follow-up in particular.

Methods: A study was performed of patients with colorectal cancer treated by laparoscopy in five German centers between May 1991 and September 1997. Surgical and pathologic data were recorded in an anonymous registry database and analyzed by type of resection.

Laparoscopic colorectal anastomosis: risk of postoperative leakage. Results of a multicenter study. Laparoscopic Colorectal Surgery Study Group (LCSSG).

Background: We report on a prospective observational multicenter study of more than 1,000 consecutive patients undergoing laparoscopic colorectal procedures. The aim of the current study was to investigate the safety of laparoscopic colorectal surgery as reflected by the anastomotic insufficiency rates in the various sections of the bowel, and to compare these rates with those of open colorectal surgery.

Methods: The study was begun on August 1, 1995.

Laparoscopic resection of sigmoid diverticulitis. Results of a multicenter study. Laparoscopic Colorectal Surgery Study Group.

Background: In the large bowel, resection of the sigmoid colon is the most commonly performed laparoscopic intervention because large bowel lesions often are located in this part of the bowel and the procedure technically is the most favorable one. A number of publications involving case series or the results of highly experienced individual surgeons already have confirmed the feasibility of laparoscopic resection in cases of diverticulitis. The aim of the present prospective multicentric investigation was to check the results obtained by a large number of surgeons performing laparoscopic resection of the sigmoid colon for diverticulitis in various stages of severity.

[Laparoscopic colorectal resections: indications, surgical technique and outcome in 410 prospective cases].

Unlabelled: From April 1993 to August 1997 410 patients underwent laparoscopic surgery for colon and rectal diseases. In the beginning we only operated on patients with benign disorders. Since July 1995 colorectal malignancies have also been resected.

[Laparoscopic appendectomy as standard procedure. Technique and outcome in 409 patients].

Unlabelled: In the framework of a prospective clinical trial we wanted to show that minimal access surgery as a standard treatment of acute appendicitis leads to good results.

Patients And Method: From January 1993 to December 1996 409 patients had a laparoscopic appendectomy in the Surgical Department of Krankenhaus Zehlendorf, Berlin. We treated 252 female (62%) and 157 male (38%).

Prospective multicenter study of the quality of oncologic resections in patients undergoing laparoscopic colorectal surgery for cancer. The Laparoscopic Colorectal Surgery Study Group.

Purpose: Laparoscopic colorectal surgery for cancer is currently under discussion. Results of large, randomized studies will not be available for a number of years yet. This study analyses the results of such resections in consecutive patients operated on by unselected surgeons.

[Laparoscopic rectum resection with truncal ligation of the inferior mesenteric artery and mesorectal excision].

Laparoscopic techniques in surgical treatment of colorectal cancer are performed present in prospective trials. Operation times are clearly decreasing with growing surgical experience and oncological criteria concerning resection margins and lymphatic dissection are comparable with open surgery. Indications for laparoscopic rectal resections are the endoscopic non removable adenoma and cancer of the upper and lower rectum endosonographic up to maximum uT3-stage.

Early results of a prospective multicenter study on 500 consecutive cases of laparoscopic colorectal surgery. Laparoscopic Colorectal Surgery Study Group (LCSSG).

Background: Prospective randomized multicenter studies comparing laparoscopic with open colorectal surgery are not yet available. Reliable data from prospective multicenter studies involving consecutive patients are also lacking. On the basis of the personal caseloads of specialized surgeons or of retrospective analyses, it is difficult to judge the true effectiveness of this new technique.

[Laparoscopic colorectal surgery in routine at a municipal hospital].

Unlabelled: The importance of laparoscopic techniques in colorectal surgery as routine service in a municipal hospital is described in a prospective study.

Patients And Method: From April 1993 to March 1997 359 patients were operated laparoscopically for colon and rectum diseases in the surgical department of the municipal hospital Zehlendorf Berlin, local area Behring. In the beginning we operated only patients with benign disorders.

[Manometric study on the effect of Hedenstedt's selective proximal vagotomy on the lower esophageal sphincter].

A manometric examination of the oesophagus was carried out before and after selective proximal vagotomy according to Hedenstedt in 20 patients in whom operations were performed at the Dept. of Surgery of the Steglitz Medical Center within the period from 1980 to 1982. The resting pressure of the lower oesophageal sphincter could be shown to be unaltered postoperatively (preoperative median 17,5 mm Hg, postoperative 18 mm Hg, p greater than 0,1 non-significant).

[Gastroduodenal surgery in patients over 80].

Between 1969 and 1981 surgery was performed in 118 patients over eighty years old with gastroduodenal diseases. The main indications were carcinomas and ulcers. The combined mortality amounted to 34.

[Functional evaluation of islet cells following pancreatic duct occlusion--a long-term study].

The transduodenal occlusion of the pancreatic duct with Prolamin (Ethibloc) was carried out in an experiment with 38 Göttinger minipigs. Occlusion of the pancreatic duct leads to selective atrophy of the excretory pancreatic parenchyma. Up until now it has not been clear whether the endocrine functional capacity of the gland stays intact in a long-term experiment or whether the islands of Langerhans are also altered by the pancreatic duct occlusion.

[Primary tumors of the small intestine (author's transl)].

From 1969 to 1979, 19 patients were operated for tumors of the small intestine: 8 were benign and 11 malignant. Of the benign, mesenchymal tumors predominated, the malignant tumors were epithelial. The difficulty of diagnostic confirmation and its effect of the prognosis of the disease are discussed with reference to the literature.

[Intraoperative open transluminal angioplasty (IOTA)].

Percutaneous transluminal angioplasty (PTA), is a nonsurgical method of treating atherosclerotic ischaemic peripheral vascular disease. This paper describes the technique of intra-operative open transluminal angioplasty (IOTA) as an adjuvant therapy during vascular surgery. The main advantage is the shorter duration of surgical procedures.

[The lower-limb amputation in geriatrics suffering from occlusive artery disease (author's transl)].

Owing to the biology of arteriosclerosis elderly previously affected patients have, as a rule, to undergo lower limb amputation for occlusive artery disease. This creates particular problems which must be taken into account when choosing the surgical technique and providing the prosthesis. The article surveys the common methods and describes, in particular, the knee disarticulation including the early prosthetic fitting carried out at the author's hospital, which in their experience can decisively improve the patient's rehabilitation.

[Swine liver ultrastructure following hypothermia and hyperbaric oxygenation preservation].

The livers of 20 pigs were preserved for up to 16 hours, applying hypothermia (4 degrees C) and hyperbaric oxygenation (3 ata). As a preparation solvent we used in one group the solution by Lie (17) which is rich in potassium and glucose, and in the other group the cryoprecipitated serum by Belzer (5). After 8 and 16 hours of preservation, the fine structure was examined light- and electronmicroscopically.