Kidney transplantation improves survival and is indicated in Fabry's disease.

Background: Fabry's disease (FD) is an inborn error of glycosphingolipid catabolism with progressive systemic deposition of globotriaosylceramide thereby leading to renal and cardiac failure. Current therapy involves symptomatic medical management, dialysis, enzyme replacement therapy, kidney transplantation (KTx), and more recently gene therapy. Case fatalities occur in the fourth decade of life resulting from uremia unless dialysis or KTx is undertaken.

[Mesenteric cyst as the etiology of abdominal pain--a case report].

Introduction: Mesenteric cysts are part of the differential diagnosis of abdominal tumors. We want to remember this diagnosis with the following case report.

Case Report: A 35-year-old woman was admitted for abdominal pain that had begun two weeks previously.

Ultrasound scans done by surgeons for patients with acute abdominal pain: a prospective study.

Objective: To evaluate the routine use of abdominal ultrasonography (US) in patients admitted to the surgical emergency unit with acute abdominal pain.

Design: Prospective study with a three-step evaluation of patients over a 12-month period.

Setting: University hospital, Switzerland.

[The "buried bumper syndrome"--a rare complication of percutaneous endoscopic gastrostomy].

The buried bumper syndrome is a rare complication of percutaneous endoscopic gastrostomy (PEG). Hereby the PEG bumper is overgrown by hypertrophic gastric mucosa and embedded into the gastric wall. This is probably a consequence of enforced tightening of the PEG tube causing an ulcer in the gastric mucosa.

[Kidney retransplantation in relation to organ shortage].

This article reviews our experience with renal regrafting in the past 16 years with particular emphasis on long-term outcome and prognostic parameters. Among 1094 renal transplants there were 15.8% regrafts, and the proportion of patients awaiting a regraft procedure on our current waiting list is 33%.

[33 years kidney transplantation in Zurich].

This article summarizes our experience with renal transplantation over the past 33 years and shows progressive improvement of the clinical outcome over time. In parallel we observed an increasing proportion of elderly recipients and diabetics. The increasing shortage of cadaver grafts was compensated by using donor hearts from legally dead donors (heart no longer beating) and establishing a living donor program.

[Detection of unexpected extrathoracic metastases in preoperative staging of non-small-cell bronchial carcinoma (NSCLC) with positron emission tomography (PET)].

Accurate staging of non-small cell lung cancer (NSCLC) is essential for subsequent treatment. This study was designed to evaluate the value of FDG-PET in detecting unexpected extrathoracic metastases (ETM) in patients with NSCLC qualifying for surgical treatment based on conventional staging. One hundred patients with stage IIIa or less were included and underwent clinical evaluation, chest and upper abdominal CT scan, mediastinoscopy, and routine laboratory tests.

[Transanal endoscopic microsurgery--experiences at the Zurich University Hospital].

The advantages of TEM (transanal endoscoic microsurgery) are minimally invasive, exact and full thickness excision of tumors in the rectum and a very low morbidity with excellent comfort for the patient. In a retrospective study all transanal endoscopic operations at Zurich University hospital in the last 5 years have been analyzed (n = 18). 11 adenomas and 5 carcinomas of the rectum have been resected with TEM (one mucosectomy, 16 full wall resections and one segmental resection of the rectum).

Prospective, randomized comparison of extrapleural versus epidural analgesia for postthoracotomy pain.

Background: Thoracic epidural analgesia is considered the method of choice for postthoracotomy analgesia, but it is not suitable for every patient and is associated with some risks and side effects. We therefore evaluated the effects of an extrapleural intercostal analgesia as an alternative to thoracic epidural analgesia.

Methods: In a prospective, randomized study, pain control, recovery of ventilatory function, and pulmonary complications were analyzed in patients undergoing elective lobectomy or bilobectomy.

Percutaneous drainage of abdominal abscesses: are large-bore catheters necessary?

Objective: To find out whether small-bore catheters (7 F) are as effective as the 14F sump drains generally used for drainage of abdominal abscesses.

Design: Retrospective review.

Setting: University hospital, Switzerland.

Intussusception of the small bowel due to Peutz-Jeghers syndrome: a case report.

We report the case of a 45-year-old woman with an intussusception of the small bowel due to Peutz-Jeghers syndrome. Immediate laparotomy was performed, and approximately 5 cm of the small bowel had to be removed because of ischemic areas. Six other polyps were removed through buttonhole enterotomies.

Stones spilled during cholecystectomy: a long-term liability for the patient.

Within the last 2 years, an increasing number of case reports concerning stone spillage during laparoscopic cholecystectomy and its long-term consequences have been published. Recently three patients were treated for abscesses caused by spilled stones at our institution. One of them had the longest interval between cholecystectomy and abscess formation on record.

Long-term results of hepaticojejunostomy for benign lesions of the bile ducts.

Background: Hepaticojejunostomy has been the method of choice for the treatment of benign lesions of the extrahepatic bile ducts for years. In the era of minimally invasive and interventional techniques, a review of its long-term results is necessary to set the standard with which these new techniques have to be compared.

Methods: A retrospective analysis was carried out for 51 patients (16 females, 35 males) aged 24 to 83 years (average 48 +/- 13) who had undergone hepaticojejunostomy for benign lesions at our institution between 1980 and 1989.

Magnetic resonance-guided laparoscopic interstitial laser therapy of the liver.

Background: There is a necessity for an imaging method during laparoscopy to get a three-dimensional access to the target. In this study we evaluated laparoscopic interstitial laser therapy of the liver under magnetic resonance imaging guidance.

Methods: Five domestic pigs underwent laparoscopy in an open-configuration magnetic resonance system.

Experimental technique for (laparoscopic) bowel anastomosis: transient endoluminally stented anastomosis (TESA).

A new technique for bowel anastomosis is presented. The principle of transient endoluminally stented anastomosis (TESA) is based on anastomosing the two bowel ends around a resorbable stent of polyglycolic acid (PGA) in seroserosal contact. To evaluate the feasibility of TESA for bowel anastomosis, laparoscopic colon anastomosis following sigma resection was performed in five juvenile pigs.

Lung herniation through a postthoracoscopy chest wall defect: demonstration with spiral CT.

The incidence of complications following thoracoscopy is approximately 10%, the most prevalent being prolonged air leak and chest pain. We report two cases of lung herniation through the chest wall defect created by thoracoscopy. Use of the Valsalva maneuver during CT scanning is recommended as a diagnostic imaging method in cases with suspected lung herniation.

Long-term complete remission of melanoma liver metastases after intermittent intra-arterial cisplatin chemotherapy and surgery.

This paper presents the case of a female patient with liver metastases of a malignant melanoma showing complete remission after 10 courses of regional, intra-arterial chemotherapy with cisplatin. The drug was administered as continuous infusion for 5 days. The daily dosage amounted to 30 mg/m2.

Prospective evaluation of pretransplant blood transfusions in cadaver kidney recipients.

Background: A beneficial effect of pretransplant transfusions on graft survival was demonstrated in the early 1970s. In the mid-1980s, however, retrospective studies showed that transfusions had lost their graft-protective effect in the cyclosporine era. During the last 10 years, deliberate transfusion pretreatment of transplant patients has been discontinued.

Laparoscopic Roux-en-Y choledochojejunostomy.

Objective: Although surgical biliary bypass for nonresectable periampullary tumors is superior to endoscopic stent placement, the latter has become popular because of the "minimally invasive" approach. Laparoscopic biliary bypass would appear to offer the advantages of both. However, this technique remains technically difficult using existing instrumentation.

Laparoscopic anterior extended seromyotomy with posterior truncal vagotomy: an experimental study.

We describe a new laparoscopic modification of parietal cell vagotomy. The laparoscopic anterior extended seromyotomy with posterior truncal vagotomy was performed in five pigs weighing 21 to 25 kg each. Congo-red and pH tests were undertaken 2 weeks later by open gastrotomy.

[Passive smoking in the workplace: a survey in the Zurich University Hospital].

The consequences of involuntary smoking are well documented. We conducted a survey among all employees of the University Hospital, Zurich, to assess their smoking habits and feelings about restrictions or a ban on smoking. In March 1995, a questionnaire was mailed to all 5230 hospital employees, 2620 (50.

Experimental cryosurgery of the liver under magnetic resonance guidance.

The feasibility and the advantages of magnetic resonance (MR)-guided interstitial cryosurgery of the liver in an 0.5 Tesla open MR system have been evaluated. Cryosurgery was performed using an Erbocryo PS system with a nonmagnetic cryoprobe of 6 mm diameter.

[Bilateral video-assisted thoracoscopic volume reduction surgery for treatment of advanced pulmonary emphysema].

In a prospective study, we investigated the functional results, complications, and survival of patients who underwent bilateral video-assisted thoracoscopic (VAT) lung volume reduction surgery (VRS) for severe, diffuse pulmonary emphysema (FEV1 0.77 +/- 0.03 [1], RV/TLC 0.