Ondansetron is effective to treat spinal or epidural morphine-induced pruritus.

Background: Spinally and epidurally administered morphine is frequently associated with pruritus. Isolated case reports indicate that ondansetron may be effective in this context. This study aims to investigate the effectiveness of ondansetron to treat this side effect.

[Antiemetic effect of propofol].

Propofol is known to possess direct antiemetic effects. Its use for induction and maintenance of anaesthesia has been shown to be associated with a lower incidence of postoperative nausea and vomiting (PONV) when compared to any other anaesthetic drug or technique. However, its mechanism of action in this context is still not well understood.

[Long-term follow-up of acute pancreatitis--significance of cholecystectomy for the biliary form].

Of 83 patients with acute pancreatitis it was possible to control 79 of them 5-16 years later, 33 on the basis of case histories and 46 personally. In 43 cases (54.4%) it was pancreatitis caused by gallstones.

[The mobile cecum syndrome: appendectomy and cecopexy or only appendectomy?].

1159 patients underwent appendectomy via a McBurney incision from 1972 to 1983 at our institution. 115 patients (10%) had a mobile cecum syndrome (CMS) as defined by Nicole, without evidence of appendicitis or other pathologic findings at operation. 102 patients were followed up to 15 years after the operation.

[How great is the risk of cancer and recurrence following benign breast biopsy?].

Four hundred and thirty-eight patients with biopsy-proven benign breast disease were followed annually in a prospective manner for 4-17 years, to analyze breast cancer risk, correlations with cancer development and recurrence during follow-up. Twelve breast cancers developed in 12 patients during follow-up, giving a 2.6 fold increased cancer risk over the reference population.

[Long-term results following surgery of varicose veins].

In a long-term follow-up after operation for primary varicose vein disease, patients were revisited 5, 10 and 15 years after their operation, in an attempt to define the goal of the treatment and the result. The results were analyzed as well as those factors which had a significant influence on the findings at assessment. The long-term results were good with respect to the patient's self-judgement and relative to improvement of trophic disturbances, especially of venous ulceration, however recurrent superficial varicose veins increase significantly with increasing follow-up time.

Long-term follow-up of patients with biopsy-proven benign breast disease.

Three hundred sixty-five patients with biopsy-proven benign breast disease were followed annually in a prospective manner for 4-15 years to analyze breast cancer development, recurrence, and efficacy of management during follow-up. Eleven breast cancers developed in 11 patients during follow-up, giving a 2.6-fold increased cancer risk over the reference population.

[10 years' experience using a modified Shouldice surgical technic for inguinal hernia in adults. I. Method and results in 726 operations with follow-up].

Since 1973 we have used a modified Shouldice repair to treat inguinal hernias in adults. The repair was performed on unselected patients. The procedure was performed by both senior surgeons and surgeons in training.

[10 years' experience using a modified Shouldice surgical technic for inguinal hernia in adults. II. Which factors modify the recurrence of inguinal hernia?].

Many factors seem to influence the recurrence rate after adult inguinal hernia repair. A statistical analysis of data derived from 726 transversalis fascia repairs examined by the authors (with a follow-up rate of 82.5% and a mean follow-up time of 5.

[Bile duct revision, yes or no? Reliability of selection criteria for choledochotomy, tested on the basis of late results following gallbladder operations].

A series of 346 patients with cholelithiasis were followed up 6, 12, 24, and 48 months after the operation and the results were determined by self-assessment and objective criteria (Visick grading) The results were good in over 80% of the patients. The more serious, painful and threatening the situation was before the operation, the better seem to be the later results. The frequency of the postoperative complications and the number of choledochotomies is dependent on the age of the patient.

[Is preventive epilation following sacral dermoid operation useful or ineffective?].

Following operation for pilonidal sinus, 79 patients were followed up for 1-10 years. The ratio male/female was 6 to 1. The majority of the patients had overweight.

[What determines the prognosis following cholecystectomy: anamnesis, surgical findings, postoperative complications?].

In 346 patients followed up 6, 12, 24 and 48 months after cholecystectomy the clinical results (VISICK and self-assessment) were very good in over 80%, 1% had symptoms due to organic disturbances and 15-20% had mostly mild symptoms (pain, fullness, food tolerance) without detectable causes. These functional disorders were found frequently in female patients with long preoperative history and frequent attacks of pain. Age of patient, character of pain, therapy before the operation, postoperative complications or change of body weight showed no correlation with later results.

[The Spigelian hernia: missed? rare? puzzling diagnosis?].

During a period of six years 24 patients with a clinical diagnosis of spigelian hernia were operated in our department (3% of all abdominal wall hernias). The Spigelian hernia could be verified intraoperative in 12 of these patients and in 12 cases there was no evidence of hernia but other findings which could partially cause the pre-operative complaints. It was possible to follow-up on 22 of the patients over a period of 1-6 years postoperative.

[Results following surgical repair of the ankle ligaments].

From a total of 133 patients with acute traumatic rupture of the lateral ligaments of the ankle 118 patients (88%) have been followed up for a period of 6 months to 8 years (average 2 years) after operative repair. According to the patients own statements, 88% reported good or very good results (minimal or no complaints). 12% referred to occasional pain and/or swelling.

[Hydrops of the gallbladder].

Of 739 cholecystectomies carried out from 1971 to 1978, 40 cases revealed intraoperatively a hydrops of the gallbladder. This hydrops was caused in all cases by a stone located in the gallbladder neck or the cystic duct. In 37 cases, the gallbladder contents were examined: clear "white bile" was present in 29 (78%); this was always very viscous.

[Hypoproteinemia causing postoperative "interstitial" paralytic ileus].

On the basis of recent pathophysiological data and clinical observations in three patients, this paper draws attention to the commonly neglected importance of postoperative hypoproteinemia as the cause of an edema of the intestinal wall with a consequent "interstitial" paralytic ileus. The characteristic features of this syndrome are its onset between the third and the eighth postoperative day; the absence of other known causes of intestinal hypomotility; the benign, but protracted course without treatment; and the therapeutic success achieved by the correction of a hypoproteinemic fluid overload with concentrated albumin and a diuretic. In addition, parenteral hyperalimentation and Rheomacrodex-Sorbit may be indicated, but the hypoproteinemia should at any rate be corrected.

[Dissolution of choledochus stones with heparin-saline solution].

In a series of 336 cholecystectomies a revision of the bile ducts was necessary in 60 cases (18%). One to three residual concrements were evident in 6 patients from control cholangiograms made 8-10 days postoperatively (1.8%).

[Spiegeli's hernia].

Spontaneous lateral ventral hernia (spigelian hernia) is briefly reviewed in the light of 7 patients with a total of 8 hernias. The relatively high incidence of spigelian hernia (5% of all abdominal hernias operated on in 1 year) suggests that this hernia type is not uncommon if borne in mind when diagnosing conditions with abdominal pain. Pain, tenderness and a palpable mass along the lateral edge of the rectus abdominis are the leading symptoms.