Esophageal sarcoidosis presenting as pseudodiverticulum.

Sarcoidosis is a multisystem granulomatous disorder that may involve many organs. However, the involvement of the gastrointestinal tract is very rare. This report describes an unusual case of esophageal sarcoidosis presenting as a pseudodiverticulum and reviews the world literature.

Median liver lobe of woodchuck as a model to study hepatic outflow obstruction: a pilot study.

Background: Hepatic vein outflow obstruction represents an important clinical problem in living-liver transplantation. An animal model is required to study the influence of outflow obstruction on the intrahepatic regulation of liver perfusion and the subsequent effects on liver injury and recovery during liver regeneration. The size of woodchucks enables the use of standard clinical imaging procedures.

Value of staging laparoscopy for multimodal therapy planning in esophago-gastric cancer.

The importance of multimodal treatment for advanced esophago-gastric cancer has contributed to the development of more accurate preoperative staging strategies. The impact of staging laparoscopy and cytology after conventional staging is evaluated in this study. Staging laparoscopy was performed in 125 patients with potentially resectable cancer of the distal esophagus or gastric cancer.

Posterior retroperitoneoscopic adrenalectomy--results of 560 procedures in 520 patients.

Background: The posterior retroperitoneoscopic adrenalectomy is less popular than the laparoscopic transabdominal method. Due to the direct approach to the adrenal glands, however, the posterior retroperitoneal access is easy to use and may offer advantages not available with other endoscopic procedures for adrenalectomy.

Methods: Between July 1994 and March 2006, we performed 560 adrenalectomies (right side: n = 258; left side: n = 302) by the posterior retroperitoneoscopic approach in 520 patients (200 male, 320 female; age, 10 to 83 years).

Posterior retroperitoneoscopic adrenalectomy: a comparison between the initial experience in the invention phase and introductory phase of the new surgical technique.

Background: Today, the posterior retroperitoneoscopic technique has become a standard procedure in adrenal surgery. The procedure allows direct access to the adrenal glands, but it seems to be difficult because of the uncommon anatomic view. This study compares the learning period of the new procedure of "posterior retroperitoneoscopic adrenalectomy" in the primary invention phase and the secondary introductory phase in a different hospital 10 years later.

Partial versus total adrenalectomy by the posterior retroperitoneoscopic approach: early and long-term results of 325 consecutive procedures in primary adrenal neoplasias.

The retroperitoneoscopic approach is a standardized operative procedure for primary adrenal gland tumors. It allows direct access with a detailed view of the adrenal gland. Thereby, a clear differentiation between normal and neoplastic adrenal tissue is often possible, which permits a planned partial resection of the gland in selected cases.

[Laparoscopic therapy of appendicovesical fistula -- two case reports].

Two cases of appendicovesical fistula are reported. One case was caused by Crohn's disease, the second case by a chronical appendicitis. The guiding symptoms in both cases were coprosuria and pneumaturia, with chronical infection of the urinary tract.

[Pilonidal Sinus -- Primary Closure also in Case of Abscess?].

After excision of pilonidal sinus treatment consists either in open procedure or primary closure. We present the results of 45 consecutive patients (male 29, female 16, age 32 +/- 13 years), who underwent surgery between September 2001 and December 2002. Fourteen patients had simple fistula without infection, 18 had fistulas with putride secretion and 13 had abscess.

[Laparoscopic-assisted colonoscopic polypectomy--indications and results].

Objective: Endoscopic treatment of large, sessile or awkward localized polyps, especially in the colon sigmoideum or the coecum holds the risk of colonic perforation. For these cases the combined colonoscopic-laparoscopic approach is described in this publication as an alternative procedure.

Patients And Methods: Since 1995 23 patients (male 11, female 12, age 70.

[Laparoscopic splenectomy by the "Essen-manoeuvre" for treatment of benign and malignant haematological diseases].

Despite its early description, laparoscopic splenectomy has not yet reached the level of a standard operation as a therapeutic option for haematological disease, especially for malignant disorders. We performed laparoscopic splenectomies in a modified 4 port technique and dissection of the splenic vessels by the "Essen-Manoeuvre" and report on 68 attempted laparoscopic splenectomies for benign (n = 42) and malignant (n = 26) haematological disorders. Conversion rate was 9 %, 30-days-mortality was 1.

Endoscopic treatment of solitary, bilateral, multiple, and recurrent pheochromocytomas and paragangliomas.

Because of extensive intraoperative catecholamine release, extreme vascularization, and demanding localization, laparoscopic and retroperitoneoscopic excision of pheochromocytomas and retroperitoneal paragangliomas is challenging. In a prospective clinical study, 61 chromaffin neoplasms (52 pheochromocytomas, 9 paragangliomas) were removed endoscopically from 52 patients (30 males, 22 females; age 44.4 +/- 16.

[Video-assisted hemithyroidectomy: surgical technique and early results].

To date, there are only very few data on minimally invasive thyroid surgery. In a prospective study (11/99-11/00), videoscopically assisted hemithyroidectomy was performed on 18 patients (3 M, 15 F; age 22-56 years) with uninodular thyroid disease. The length of the cervical incision was between 15 and 25 mm; 8 patients were operated on using initial gas insufflation and 10 patients with a gasless technique.

Laparoscopic splenopexy by peritoneal and omental pouch construction for intermittent splenic torsion ("wandering spleen").

Wandering spleen is an extremely rare anatomic variant with potentially serious clinical implications. Usually, splenectomy is advocated for treatment of this disease. Various methods for preserving the wandering spleen by means of splenopexy have been described, including two reports on laparoscopic splenic refixation.

Posterior retroperitoneoscopic adrenalectomy: lessons learned within five years.

Posterior retroperitoneoscopic adrenalectomy is one of the new endoscopic methods in endocrine surgery. In a prospective clinical study 142 posterior retroperitoneoscopic adrenalectomies (72 right, 70 left) were performed in 130 patients (52 males, 78 females, age 49.1 +/- 14.

Laparoscopic gastrostomy: results of 121 patients over 7 years.

Laparoscopic gastrostomy was introduced in various technical variants 7 years ago. However, larger series and long-term results of these new methods are still lacking. In a prospective study, laparoscopic gastrostomies were performed by two institutions in 121 patients (88 men, 33 women; mean age, 58.

[Endoscopic excision of extra-adrenal pheochromocytomas (paragangliomas)].

We describe the successful endoscopic removal of six extra-adrenal pheochromocytomas in three patients. One neoplasia was located retrocavally, two between the aorta and vena cava, two by the para-aortal, and one by the parailiacal. The tumors were removed by the posterior retroperitoneoscopic or by the anterior laparoscopic approach, respectively.

Intraperitoneal and retroperitoneal carbon dioxide insufflation evoke different effects on caval vein pressure gradients in humans: evidence for the starling resistor concept of abdominal venous return.

Background: The authors hypothesized that intraperitoneal and retroperitoneal carbon dioxide insufflation during surgical procedures evoke markedly different effects on the venous low-pressure system, induce different inferior caval vein pressure gradients at similar insufflation pressures, and may provide evidence for the Starling resistor concept of abdominal venous return.

Methods: Intra- and extrathoracic caval vein pressures were measured using micromanometers during carbon dioxide insufflation at six cavity pressures (baseline and 10, 15, 20, and 24 mmHg and desufflation) in 20 anesthetized patients undergoing laparoscopic (supine, n = 8) or left (n = 6) or right (n = 6) retroperitoneoscopic (prone position) surgery. Intracavital, esophageal, and gastric pressures also were assessed.

Campylobacter jejuni-induced severe colitis--a rare cause of toxic megacolon.

The development of toxic megacolon as a sequel of infectious colitis is rare. We have observed the very rare case of a campylobacter jejuni-induced toxic megacolon. A 28-year-old man was admitted with severe enterocolitis and appearance of blood in stools.

[Surgical management of type III thoracic shotgun injury].

Reporting the case of a short-range severe thoracic shotgun injury the differentiated management of this trauma is discussed. Indication for operative exploration under emergency conditions is hemorrhagic shock, perforation of esophagus/stomach and pericardial tamponade. Even under a toxicological point of view there is no indication for emergency revisions.

[Subtotal retroperitoneoscopic adrenal gland resection--an alternative to adrenalectomy?].

Primary adrenal tumors were removed in 24 patients by the posterior retroperitoneoscopic approach, maintaining tumor-free parts of the ipsilateral adrenal gland. These partial adrenal resections did not cause a significantly different operating time or blood loss compared to 58 complete adrenalectomies performed during the same period. All 20 patients with hormonally active tumors are biochemically and clinically cured (mean follow-up 18 months).

[Extended resection of locally advanced primary and recurrent rectal carcinomas by interdisciplinary cooperation of various surgical specialties].

Multivisceral resections have been performed on 35 patients with primary and 45 with recurrent rectal cancer. Lethality was 3.7%, morbidity was 9%.

Percutaneous dilatational tracheostomy--early results and long-term outcome of 326 critically ill patients.

Objective: To analyze perioperative and postoperative complications and long-term sequelae following percutaneous dilatational tracheostomy (PDT).

Design: A prospective clinical study of patients undergoing PDT.

Setting: Seven intensive care units at a University hospital

Patients: 326 intensive care patients (202 male, 124 female; age: 11-95 years) with indications for tracheostomy.