H-Conducting Aromatic Multiblock Copolymer and Blend Membranes and Their Application in PEM Electrolysis.

As an alternative to common perfluorosulfonic acid-based polyelectrolytes, we present the synthesis and characterization of proton exchange membranes based on two different concepts: (i) Covalently bound multiblock-co-ionomers with a nanophase-separated structure exhibit tunable properties depending on hydrophilic and hydrophobic components' ratios. Here, the blocks were synthesized individually via step-growth polycondensation from either partially fluorinated or sulfonated aromatic monomers. (ii) Ionically crosslinked blend membranes of partially fluorinated polybenzimidazole and pyridine side-chain-modified polysulfones combine the hydrophilic component's high proton conductivities with high mechanical stability established by the hydrophobic components.

Early Ileocecal Resection Is an Effective Therapy in Isolated Crohn's Disease.

Despite the increasing incidence and prevalence of Crohn's Disease (CD), no curative options exist and treatment remains complex. While therapy has mainly focused on medical approaches in the past, growing evidence reveals that in cases of limited inflammation, surgery can suffice as an alternative primary treatment. We retrospectively assessed the disease course and outcomes of 103 patients with terminal Ileitis who underwent primary surgery ( = 29) or received primary medical treatment followed by surgery ( = 74).

Hepatic angiomyolipoma: A case report and literature review.

Introduction: Hepatic angiomyolipoma (HAML) is a rare mesenchymal liver tumour which belongs to the family of perivascular epithelioid cell tumours (PEComas). It is typically composed of blood vessels, smooth muscle, and adipose cells, and shows strong immunoreactivity for HMB-45.

Presentation Of The Case: A 57-year-old woman was referred to our hospital with an unclear liver lesion.

Anorectal angle at rest predicting successful sacral nerve stimulation in idiopathic fecal incontinence-a cohort analysis.

Purpose: Sacral nerve stimulation is an effective treatment for patients suffering from fecal incontinence. However, less is known about predictors of success before stimulation. The purpose of this study was to identify predictors of successful sacral nerve stimulation in patients with idiopathic fecal incontinence.

Perioperative management of anticoagulant therapy.

About 10% of patients taking a chronic, oral anticoagulant therapy require an invasive procedure that can be associated with an increased risk for peri-interventional or perioperative bleeding. Depending on the risk for thromboembolism and the risk for bleeding, the physician has to decide whether the anticoagulant therapy should be interrupted or continued. Patient characteristics such as age, renal function and drug interactions must be considered.

Proximal jejunal stoma as ultima ratio in case of traumatic distal duodenal perforation facilitating successful EndoVAC treatment: A case report.

Introduction: During damage control surgery for blunt abdominal traumata simultaneous duodenal perforations can be missed making secondary sufficient surgical treatment challenging. Endoluminal vacuum (EndoVAC™) therapy has been shown to be a revolutionary option but has anatomical and technical limits.

Presentation Of The Case: A 59-year old man with hemorrhagic shock due to rupture of the mesenteric root after blunt abdominal trauma received damage control treatment.

Impact of surgical proficiency levels on postoperative morbidity: a single centre analysis of 558 ileostomy reversals.

Purpose: Defunctioning ileostomies reduce the consequences of distal anastomotic leakage following bowel resections. Ileostomy reversal in itself, however, is associated with appreciable morbidity (3-40%) and mortality (0-4%). Despite being a common teaching procedure, there is limited information on the impact of surgical proficiency levels on postoperative outcome.

[Perioperative handling of anticoagulation].

A growing number of patients in Germany receive a long-term prophylactic anticoagulation with phenprocoumone or one of the novel direct oral anticoagulants (NOAC), such as dabigatran, rivaroxaban or apixaban. The most common indication for an oral anticoagulant therapy is atrial fibrillation (approximately 75%) where the anticoagulant therapy can reduce the risk for an embolic event, particularly stroke by 60%. Operations carried out during such a therapy can result in major bleeding complications.

[Perioperative handling of immunosuppressive therapy].

Every year 16 million operations are performed in Germany. Many patients have an autoimmune disorder, for example rheumatoid arthritis, psoriasis or chronic inflammatory bowel disease, which requires treatment. Immunosuppressants are widely applied.

[The use of tumor therapeutics in the perioperative period].

In 2010 Germany had 447,300 new cases of cancer. From 2000 to 2010 the incidence of cancer increased by 21% in men and by 14% in women. The change in the age structure with an aging population is the crucial influencing factor.

[Perioperative handling of antidiabetic drugs].

Diabetes mellitus is the most frequent metabolic disorder in the western world with a prevalence of 3% in adults under 65 years of age and 14.3% in adults over 65 years of age. Due to the increasing age of our population, the number of patients taking oral antidiabetic drugs has increased.

[The use of platelet aggregation inhibitors in the perioperative period].

Every year 16 million operations are performed in Germany. Many patients take platelet aggregation inhibitors as a primary or secondary prevention to reduce the risk of cardiovascular events. Especially during the perioperative period, this risk reduction is relevant due to an increased risk for cardiac events (in approximately 6.

Impact of incisional negative pressure wound therapy on perineal wound healing after abdominoperineal rectum extirpation.

Introduction: Perineal wound healing disorders are one of the major complications following abdominoperineal rectum extirpation.

Methods And Results: We evaluated the impact of an "incisional negative pressure wound therapy" (iNPWT) system after abdominoperineal rectum extirpation in six patients. All patients had a neoadjuvant radiochemotherapy with 50.

"Rendezvous technique" for intraluminal vacuum therapy of anastomotic leakage of the jejunum.

Background: Anastomotic leakage (AL) is one of the most common and serious complications following visceral surgery. In recent years, endoluminal vacuum therapy has dramatically changed therapeutic options for AL, but its use has been limited to areas easily accessible by endoscope.

Case Presentation: We describe the first use of endoluminal vacuum therapy in the small intestine employing a combined surgical and endoscopic "rendezvous technique" in which the surgeon assists the endoscopic placement of an endoluminal vacuum therapy sponge in the jejunum by means of a pullback string.

The Incidence of Trocar Site Hernia After Single-Port Laparoscopic Cholecystectomy-A Single Center Analysis and Literature Review.

Background: Single-port laparoscopic cholecystectomy (SLC) requires a larger initial umbilical incision than conventional multiport laparoscopic cholecystectomy (MLC). In this retrospective analysis study we compared the demographics, clinical data, and incidence of postoperative trocar site hernias (TSH) in patients undergoing SLC with those in patients undergoing MLC.

Patients And Methods: A total of 161 patients were included in this study.

Sphincter-sparing intersphincteric rectal resection as an alternative to proctectomy in long-standing fistulizing and stenotic Crohn's proctitis?

Purpose: Long-standing fistulizing and stenotic proctitis (LFSP) in Crohn's disease (CD) indicates the end stage of the disease. Definitive diversion such as proctectomy is considered to be the only surgical option. The impact of intersphincteric sphincter-sparing anterior rectal resection (IAR) as an alternative to proctectomy is unclear.

Small bowel volvulus after transabdominal preperitoneal hernia repair due to improper use of V-Loc™ barbed absorbable wire - do we always "read the instructions first"?

Introduction: Transabdominal preperitoneal endoscopic hernia repair (TAPP) is part of primary surgical health care. While both, the reported recurrence rate and procedure specific morbidity are consistently low, rare serious complications occur.

Presentiation Of Case: A 36-year-old male patient developed bowel obstruction three days after both-sided TAPP for inguinal hernia repair.

Neurostimulated levator augmentation--a new approach in restoring continence.

Purpose: Restoration of continence remains a major challenge in patients after abdominoperineal rectal excision (APE) or with end-stage fecal incontinence. A new surgical technique, the neurostimulated levator augmentation, was introduced for pelvic floor augmentation using dynamic graciloplasty in order to restore anorectal angulation. The aim of this study was to assess feasibility and efficiency.

Recurrence after perineal rectosigmoidectomy: when and why?

Aim: Reported recurrence rates after perineal rectosigmoidectomy (Altemeier's procedure) in patients with full-thickness rectal prolapse vary from 0% to 60%. The object of this study was to analyse risk factors for recurrence after this procedure.

Method: From May 2004 to December 2012, 63 consecutive patients suffering from full-thickness rectal prolapse undergoing perineal rectosigmoidectomy were included.

Single-port laparoscopic cholecystectomy versus standard multiport laparoscopic cholecystectomy: a case-control study comparing the long-term quality of life and body image.

Purpose: To study the postoperative quality of life and body image of patients who underwent either single-port cholecystectomy (SPC) or standard multiport laparoscopic cholecystectomy (SMLC) in a long-term assessment.

Methods: Fifty patients who underwent SPC using the reusable X-Cone™ Laparoscopic Device were compared with a matched group (age, sex, body mass index) of 50 patients after SMLC. The health-related quality of life (HRQOL) and body image at 17 months postoperatively (median, range 9-23) was analysed by means of the Short-Form 12 Health Survey and the Body Image Questionnaire, respectively.

Single-port laparoscopic cholecystectomy in patients of advanced age: why not?

Objective: To compare the perioperative outcome of elderly patients undergoing either single-port cholecystectomy (SPC) or standard multiport laparoscopic cholecystectomy (SMLC).

Patients And Methods: Patients older than 50 years who underwent SPC using the reusable X-Cone were compared with age-matched, sex-matched, and body mass index-matched patients after SMLC, and postoperative outcome was analyzed.

Results: Of 97 patients who underwent SPC during July 2009 and August 2011, 33 patients (34%) were older than 50 years.

Single-port cholecystectomy in obese patients: our experience and a review of the literature.

Purpose: The objective of the present study was to compare the postoperative outcomes between obese and normal-weight patients undergoing single-port cholecystectomy (SPC) for gallstone disease.

Methods: A prospectively maintained SPC-database was retrospectively analyzed, and the outcomes of obese [body mass index (BMI) ≥30 kg/m(2)] and normal-weight patients were compared. All patients underwent SPC using the reusable X-Cone™ device.

Trocar-site hernia after single-port cholecystectomy: not an exceptional complication?

Background: When compared with standard multiport laparoscopy, the larger fascial incision in single-port surgery (SPS) may imply a potentially increased risk of surgical-site complications, such as herniation. The long-term risk of access-site complications in SPS is still unpredictable.

Methods: Between July 2009 and May 2011, n=78 patients (n=54 females), with a median age of 42 years (range: 18-85 years), underwent single-port cholecystectomy.

Early-elective single-incision laparoscopic sigmoidectomy for perforated diverticulitis using a totally reusable single-port device.

Background: Single-port access (SPA) is an emerging concept in minimally invasive colorectal surgery. The authors report their experience using SPA sigmoidectomy as an early-elective approach to complicated diverticulitis with paracolic abscess.

Methods: Between September 2009 und April 2010, 4 patients underwent SPA sigmoidectomy for Hinchey-I diverticulitis using the reusable X-Cone device.