Surgical Repair of a Traumatic Gastrobronchial Fistula.

BACKGROUND Gastrobronchial fistulas mostly occur as a result of postoperative complications, including those of bariatric, esophageal, and spleno-pancreatic surgery. Other causes are pneumonia, neoplasm, gastric ulcer, and subphrenic abscess. Traumatic fistulous communications between the stomach and the lung tissue are rare, with only 8 cases reported in the English-language literature (PubMed search) until now.

Pre-Operative Assessment of Micronutrients, Amino Acids, Phospholipids and Oxidative Stress in Bariatric Surgery Candidates.

Obesity has been linked to lower concentrations of fat-soluble micronutrients and higher concentrations of oxidative stress markers as well as an altered metabolism of branched chain amino acids and phospholipids. In the context of morbid obesity, the aim of this study was to investigate whether and to which extent plasma status of micronutrients, amino acids, phospholipids and oxidative stress differs between morbidly obese (n = 23) and non-obese patients (n = 13). In addition to plasma, malondialdehyde, retinol, cholesterol and triglycerides were assessed in visceral and subcutaneous adipose tissue in both groups.

[Epidemiology and surgical treatment of pancreatic cancer in the State of Brandenburg : Analysis of 5418 cases].

Background: Pancreatic cancer is the second most frequent cause of death among all forms of cancer in Germany with more than 19,000 deaths per year. The evaluation of the nationwide clinical cancer register aims to depict the reality of treatment and to improve the quality of treatment in the future by targeted analyses.

Method: The data from the clinical cancer register of Brandenburg-Berlin for the diagnosis years 2001-2017 were analyzed with respect to the treatment of pancreatic cancer.

Minimally invasive accessory splenectomy for recurrent gastric variceal bleeding due to left-sided portal hypertension: report of the first case.

Upper gastrointestinal bleeding from esophagogastric varices is a common scenario, especially in patients with portal hypertension induced by liver cirrhosis or other diseases with thrombosis of the splenic vein. However, accessory spleen as pathophysiological cause of a regional, left-sided portal hypertension and consecutive development of isolated gastric varices is rare. We report a case of recurrent gastric variceal bleeding resulting from sinistral portal hypertension associated with an accessory spleen in a patient who had traumatic splenectomy many decades before.

Differences in the outcomes of scrotal vs. lateral vs. medial inguinal hernias: a multivariable analysis of registry data.

Introduction: There are hardly any studies on the outcome of scrotal compared with medial and lateral inguinal hernias. Therefore, this present multivariable analysis of data from the Herniamed Registry compared the outcome of scrotal vs. lateral vs.

Do drains have an impact on the outcome after primary elective unilateral inguinal hernia repair in men?

Introduction: The use of drains continues to be a controversial topic in surgery. In a review of that topic for incisional hernia it was not possible to find sufficient evidence of the need for a drain. Likewise, for inguinal hernia surgery the data available are insufficient.

Negative Pressure Wound Therapy vs Conventional Wound Treatment in Subcutaneous Abdominal Wound Healing Impairment: The SAWHI Randomized Clinical Trial.

Importance: Negative pressure wound therapy (NPWT) is an established treatment option, but there is no evidence of benefit for subcutaneous abdominal wound healing impairment (SAWHI).

Objective: To evaluate the effectiveness and safety of NPWT for SAWHI after surgery in clinical practice.

Design, Setting, And Participants: The multicenter, multinational, observer-blinded, randomized clinical SAWHI study enrolled patients between August 2, 2011, and January 31, 2018.

[Colorectal tumor surgery in the elderly: results of quality assurance].

The age group ≥ 80 years has become of great importance in the surgical treatment of colorectal cancer due to the demographic changes over the years. To assess patient risk, early postoperative and oncologic long-term outcome 64,740 patients with colorectal cancer were enrolled in various nationwide multicenter observational studies through two study periods (2000-2004 and 2009-2011) and analyzed according to various age groups, in particular ≥ 80 years. The percentage of octogenarians increased from 2009 to 2011, which was associated with an increased patient risk.

Endorectal ultrasound in rectal carcinoma--do the literature results really correspond to the realities of routine clinical care?

Background And Study Aims: This multicenter, prospective, country-wide quality-assurance study at more than 300 hospitals in Germany was designed to characterize and analyze the diagnostic accuracy of rectal endoscopic ultrasound (EUS) in the routine clinical staging of rectal carcinoma (depth of tumor infiltration).

Patients And Methods: Patients were surveyed between 1 January 2000 and 31 December 2008. Those who received neoadjuvant therapy after EUS were excluded.

Risk adjustment as basis for rational benchmarking: the example of colon carcinoma.

Background: The results of resection of colorectal carcinoma can vary greatly from one hospital to another. However, this does not necessarily reflect differences in the quality of treatment. The purpose of this study was to compare various tools for the risk-adjusted assessment of treatment results after resection of colorectal carcinoma within the context of hospital benchmarking.

Influence of hospital volume on the frequency of abdominoperineal resection and long-term oncological outcomes in low rectal cancer.

Aim: Studies analysing the outcome after resection of low rectal cancer that has not infiltrated the anal sphincter reveal poorer long-term outcomes after abdominoperineal resections (APR) in comparison with low anterior resections (LAR). Further, a relationship between the frequency of APR and LAR for low rectal cancer and hospital volume is known. Our aim was to investigate the independent impact of hospital volume and type of resection on oncological outcomes after resection of low rectal cancer.

Impact of anastomotic leakage on oncological outcome after rectal cancer resection.

Background: : Anastomotic leakage has a major impact on morbidity and mortality in rectal cancer surgery. Its relevance to oncological outcome is controversial. This observational study investigated the influence of anastomotic leakage on oncological outcome.

Oncological outcome of local vs radical resection of low-risk pT1 rectal cancer.

Hypothesis: Despite the noninclusion of locally draining lymph nodes, limited resection of low-risk pT1 rectal cancer can achieve an adequate oncological outcome with lower morbidity and mortality compared with radical resection.

Design: Based on the data of a prospective multicenter observational study performed from January 1, 2000, through December 31, 2001, patients with low-risk pT1 rectal cancer underwent analysis with regard to the early postoperative outcome and the oncological long-term results achieved after limited vs radical resection with curative intent.

Setting: Two hundred eighty-two hospitals of all categories.

Risk factors and management of arterial emboli of the upper and lower extremities.

Aim: Analysis of risk factors for the outcome of arterial embolism of the extremities (EE).

Methods: Between 1999 and 2003, all patients (n=200) with an EE diagnosed in various departments of the hospital were recruited and analysed retrospectively (single center study). Exclusion criteria were isolated digital emboli, iatrogenic emboli and arterial thromboses.

Incurable stenosing colorectal carcinoma: endoscopic stent implantation or palliative surgery?

Background: Palliative surgery for the treatment of incurable obstructive colorectal carcinoma is associated with a considerable perioperative morbidity and mortality but no substantial improvement of the prognosis. The aim of the present study was to study the effectiveness of colorectal stenting compared with palliative surgery in incurable obstructive colorectal carcinoma.

Patients And Methods: From April 1999 to April 2005, data of consecutive patients with incurable stenosing colorectal carcinoma, either treated with stent implantation or palliative surgical intervention, were prospectively recorded with respect to age, sex, tumor location (including metastases), ASA-score, peri-interventional morbidity, mortality, rates of complications, and re-interventions as well as survival.

[A benign abdominal schwannoma presenting as postrenal failure--a case report].

Background: Benign schwannomas are uncommon soft-tissue tumors in childhood. The occurrence of an abdominal schwannoma effecting an acute postrenal failure has not been reported thus far.

Patients: It is to describe the case of a 14-year-old male teenager who was admitted to our department because of inappetence and oedema in his face and on both feet.

Palliative stent implantation in the treatment of malignant colorectal obstruction.

Background: Palliative surgical interventions for the management of colonic obstruction in cases of metastasized or locally irresectable colorectal carcinoma show remarkable morbidity and mortality rates for mostly older and multimorbid patients. For manifest obstruction, placement of a self-expanding metal stent (SEMS) is considered to be a suitable minimally invasive therapeutic option. This study aimed to investigate the efficacy of stent-based treatment for malignant large bowel obstruction.

Feasibility and accuracy of TRUS in the pre-treatment staging for rectal carcinoma in general practice.

Aims: Transrectal ultrasonography (TRUS) is the diagnostic tool of choice for local staging of rectal carcinoma. The accuracy in determining of tumour infiltration depth has been reported to reach 95% (on average, 85%). The aim of the study was to analyse the diagnostic accuracy of the TRUS in the clinical routine.

[Options for quality improvement in the treatment of rectum carcinoma].

By means of a prospective multi centre study, 13 419 cases of surgically treated patients with rectum carcinomas were registered between 1.1.2000 and 31.

Protective defunctioning stoma in low anterior resection for rectal carcinoma.

Background: Anastomotic leak is a serious complication of resection for low rectal carcinoma.

Methods: Data from a prospective multicentre study conducted between January 2000 and December 2001 were analysed to determine the early outcome after low anterior resection in patients with and without a protective stoma. The morbidity and mortality rates associated with ileostomy and colostomy closure were compared.

The impact of the risk factor "age" on the early postoperative results of surgery for colorectal carcinoma and its significance for perioperative management.

The risks and benefits of surgery for colorectal cancer in old patients have not been unequivocally defined. The present investigation was carried out in 309 hospitals as a prospective multicenter study. In the period between 1 January 2000 and 31 December 2001, a total of 19,080 patients were recruited for the study; 16,142 (84.

Influence of muscle relaxation on neuromonitoring of the recurrent laryngeal nerve during thyroid surgery.

Background: The influence of muscle relaxation on the intra-operative neuromonitoring of the recurrent laryngeal nerve during thyroid surgery is unclear.

Methods: In a prospective study involving 200 patients undergoing elective thyroid surgery, the influence of muscle relaxation on neuromonitoring of the recurrent laryngeal nerve was investigated. The patients received balanced anaesthesia with oxygen-nitrous oxide-isoflurane, and rocuronium bromide was used as the non-depolarizing neuromuscular blocking agent.

Intrauterine torsion of a testicular teratoma: a case report.

Neonatal testicular tumors and intrauterine testicular torsions are very rare. The presented case is the first describing intrauterine torsion of a descended testis with a teratomatous tumor. Immediately after birth, right hemiscrotal swelling was seen in a preterm male newborn.