[Direct ileum pouch-anal anastomosis in ulcerative colitis. Technique and complications].

Fourty-nine patients (21 female, 28 male) with ulcerative colitis underwent formation of an J-ileal pouch and construction of a direct stapled pouch-anal anastomosis (IPAA) without rectal cuff. 16 patients had previously undergone surgical interventions. Overall after IPAA 7 patients (14%) experienced 11 major complications.

[Clinical aspects and surgery of complicated and uncomplicated Meckel's diverticulum].

Our series of 43 complicated and 35 uncomplicated cases of Meckel's diverticula is reviewed. The complicated courses displayed the typical symptoms, e.g.

[Rectal cancer--results of continence-preserving resections].

In a series of 586 patients with rectal carcinoma who underwent potentially curative resection between January 1977 and December 1990 postoperative complications, incidence of local recurrence and disease free survival are investigated. Of the 401 patients undergoing low anterior resection (LAR) and 89 patients with coloanal anastomosis (CAA) 389 anastomoses were fashioned with staples. The hospital mortality rate was 4.

Obstructive colorectal carcinoma. Principles and technique in 134 cases.

In order to define the influence of intestinal obstruction on therapy and prognosis of colorectal carcinoma, we analyzed retrospectively the records of 1756 patients with this type of malignancy (1966-1990). The incidence of obstruction was 8% among our patients (n = 134), 3% of which suffered perforation (n = 4). Operative mortality was 30% as compared to 7% after elective surgery.

[Transposition of the gluteus maximus muscle for sphincter replacement in anal incontinence].

The replacement of the external anal sphincter by gluteus muscle in fecal incontinence is described in 4 cases. All patients, three children and one adult, had been operated on previously because of different types of anal atresia and suffered from fecal incontinence grade IV. They all showed a congenital defect of the somatic sphincter.

[Intestinal motility after laparoscopic vs conventional cholecystectomy. An animal experiment study and clinical observation].

First descriptions of clinical courses after laparoscopic cholecystectomy indicate a shorter period of postoperative ileus in comparison to conventional cholecystectomy. Early postoperative motility was registered in dogs (n = 10) by implanted serosal electrodes. Further on clinical signs of postoperative motility were documented in patients (n = 100) after laparoscopic and conventional cholecystectomy.

[Results of surgical therapy of choledocholithiasis--a retrospective study].

A multimodal therapeutic concept of choledocholithiasis with endoscopic and surgical procedures is presented. Between January 1986 and December 1990 106 patients with choledocholithiasis were operated. These patients are retrospectively analyzed.

[Endoscopic therapy of benign anastomotic stenoses in the area of the colon and rectum by electro-incision and balloon dilatation].

21 patients with a severe anastomotic stenosis in the colorectal region were treated with hydraulic balloon dilatation and endoscopic electro-incision. The severity of symptoms directly correlates with the extent of stenosis (degree I phi 13 mm, n = 12; degree II phi 7 mm, n = 6; degree III phi 4 mm, n = 3). All patients with a stenosis of degree I and II were symptom-free after the endoscopic therapy.

[Interrupted suture versus adhesive dressing in skin closure of pediatric inguinal hernia--a controlled randomized prospective study].

The skin closure with resorbable interrupted sutures (Dexon 6x0) was compared with adhesive plasters (Leukostrip) in a randomized prospective clinical trial with 100 children with an inguinal hernia. The same operative technique was used in both groups. There were no significant differences referring to the complication rates and the cosmetic results between both groups.

[Spontaneous pneumothorax. Graduated concept of surgical therapy].

The clinical course of 83 patients suffering from spontaneous pneumothorax lead to a modified surgical therapy according to the development of the underlying disease. The indication for non operative therapy, thoracic tube drainage, thoracic endoscopic methods and treatment by thoracotomy are defined and change of treatment from non-invasive procedures described in detail.

The radiation dose to surgical personnel during intraoperative radioimmunoscintimetry.

To estimate the radiation exposure to surgical personnel caused by intraoperative radioimmunoscintimetry, we measured dose rates at different distances from patients who had been injected with 950 MBq technetium-99m-labelled intact carcinoembryonic antigen (CEA)-specific antibodies (Szintimun CEA, Behring AG Marburg, FRG) for immunoscintigraphy 24 h earlier. At 0.05 m (corresponding to working positions during surgery) we found 2.

[Cholecystectomy: laparoscopic or conventional?].

Cholecystectomy remains the gold standard in the treatment of cholelithiasis. With the emerging of laparoscopic techniques a new modality in the surgical therapy is available. However efficacy, morbidity and pretended advantages have to be judged in comparison to the conventional technique.

[Prevention of stress ulcer today].

This article is an overview about the scientific basis, the development and the effects and side effects of the stress ulcer prophylaxis. We analysed international publications and reviewed our own patients. According to this analysis, we could demonstrate, that stress ulcer prophylaxis, preferable with H2-antagonists, remains an unconditional necessary tool in patients undergoing surgical treatment.

[Electromyographic and manometric studies of stomach motility after vagotomy].

Vagotomy coincides not only with a reduction of the cephalic phase of secretion but also with a significant reduction of the motor activity of the stomach. Electrical and mechanical activity of the gastric wall after truncal vagotomy were verified in animal experiments (dog n = 5) by means of implanted electrodes and pressure transducers. Longlasting motility disturbances expressed as a disorganisation of the basic electrical rhythm occurred in the gastric wall.

[Extra-gastric non-Hodgkin's lymphomas of the abdomen--the role of surgical treatment].

A multimodality approach offers the best chance for treatment of Non-Hodgkin lymphoma. Surgery, radiation therapy, and/or chemotherapy when used in combination offer better response and longterm survival rates. Surgical therapy offers good results in stage I and II according to the Ann Arbor classification.

[Jejunal diverticulosis--a rare cause of gastrointestinal hemorrhage].

We report a case of gastro-intestinal bleeding caused by jejunal diverticulosis, in which preoperative diagnosis could be achieved by selective angiography. Even though the small bowel is a rare localisation of bleeding (1% of all cases), this part of intestine should be included into diagnostic considerations. Jejunal diverticulosis only requires operative treatment after occurrence of complications, small bowel resection is regarded as treatment of choice in these cases.