Primary Open Versus Closed Implantation Strategy for Totally Implantable Venous Access Ports: The Multicentre Randomized Controlled PORTAS-3 Trial (DRKS 00004900).

Objectives: PORTAS-3 was designed to compare the frequency of pneumothorax or haemothorax in a primary open versus closed strategy for port implantation.

Background Data: The implantation strategy for totally implantable venous access ports with the optimal benefit/risk ratio remains unclear.

Methods: PORTAS-3 was a multicentre, randomized, controlled, parallel-group superiority trial.

Preoperative staging of esophageal carcinoma: miniprobe sonography versus conventional endoscopic ultrasound in a prospective histopathologically verified study.

Background And Study Aims: Endosonographic staging of esophageal carcinoma may be limited by non-traversable tumor stenoses. Dilation of malignant esophageal strictures carries a significant risk of esophageal perforation. We therefore evaluated the use of ultrasonic miniprobes in the staging of stenotic esophageal carcinoma compared with conventional endoscopic ultrasound.

[Preoperative staging of stenosing esophageal carcinoma--prospective comparison of mini-endosonography with conventional endosonography].

Staging of esophageal malignancies can easily and safely be performed with ultrasonic miniprobes. Unlike large-diameter ultrasonic instruments, miniprobes may pass even high-grade malignant esophageal strictures without prior bouginage. Image quality and resolution of miniprobe sonography exceeds that of conventional endosonography, thus achieving higher accuracy rates for T staging, while those for N staging have found to be similar.

A multimodal approach to control postoperative pathophysiology and rehabilitation in patients undergoing abdominothoracic esophagectomy.

Unlabelled: This two-armed study was designed to determine whether recovery after esophageal resection may be improved by introducing a new multimodal approach. For 8 mo after the new approach was introduced, all patients undergoing abdominothoracic esophageal resection were studied (Group 2; n = 42). For comparison, a retrospective analysis was also conducted using the data of all patients who had undergone this operation in the 8 mo before the introduction of the new regimen, when the traditional therapy was still in use (Group 1; n = 49).

Surgical cure for early rectal carcinomas (T1). Transanal endoscopic microsurgery vs. anterior resection.

Purpose: This study was undertaken for the comparison of local resection for early rectal carcinomas using transanal endoscopic microsurgery or anterior resection.

Methods: Data from 50 of 52 patients with proven adenocarcinoma (GI/II) and intraluminal ultrasound with Stage uT1 N negative (uTNM) were evaluated in a prospective randomized study with two therapeutic arms: transanal endoscopic microsurgery (TEM; n = 24) or anterior resection (AR; n = 26), performed under general anesthesia.

Results: Patients' ages and rectal tumor locations showed insignificant differences of distribution in comparison of TEM with AR (Welsh's alternate t-test; t-test).

[Surgical therapy of hemorrhage after endoscopic sphincterotomy. Indications and technique].

Postinterventional bleeding occurs in 2.5% after endoscopic sphincterotomy (EST). It is the most frequent complication of this technique.

[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.

Clinical and functional results of abdominal rectopexy with absorbable mesh-graft for treatment of complete rectal prolapse.

Objective: To report the long term results of abdominal rectopexy in patients with complete rectal prolapse.

Design: Ongoing prospective randomised study.

Setting: Department of Surgery, Westfälische Wilhelms-University, Münster.