The influence of blood on the efficacy of intraperitoneally applied phospholipids for prevention of adhesions.

Background: The formation of adhesions following abdominal surgery is a well known problem. In previous studies we demonstrated the efficacy and safety of intraperitoneally applied phospholipids in order to prevent adhesion formation. This study evaluates the influence of blood on the efficacy of intraperitoneally applied phospholipids for prevention of adhesions.

The inhibition of tumor cell adhesion on human mesothelial cells (HOMC) by phospholipids in vitro.

Background And Aims: Intraperitoneal tumor cell adhesion to extracellular matrix and to mesothelial cells mediated by integrins is an important step in developing peritoneal carcinosis. In former animal studies, we could demonstrate that intraperitoneal treatment with a new phospholipid (PL) emulsion significantly reduces the amount of peritoneal carcinosis by adhesion prevention. This in vitro study tries to elucidate the influence of phospholipids on cells of the human gastric cancer cell line (NUGC-4) and the human rectal cancer cell line (HRT-18) adhering to mesothelial cells (HOMC) in a monolayer culture in vitro.

Adhesion prevention comparing liquid and solid barriers in the rabbit uterine horn model.

Objective: The purpose of this study was to assess the ability of four different either solid or fluid barriers to reduce adhesions in an established model of gynecological surgery.

Study Design: 50 Chinchilla rabbits underwent bilateral deperitonealization and devascularization of the uterine horns (DUH). Afterwards solid membranes of either hyaluronic acid-carboxymethylcellulose (HA-CMC) or lactide-caprolactone-copolymer (LCC) were placed around the injured uterine horns or fluids (icodextrin (ID) or phospholipids (PL)) were intraperitonealy administered.

Inhibition of gastric cancer cell adhesion in nude mice by inraperitoneal phospholipids.

Adhesion of tumor cells to mesothelial cells or extracellular matrix components is a pivotal step in developing peritoneal dissemination after gastric cancer. As phospholipids were found to reduce adhesion formation, especially at sites of peritoneal lesions, we assessed the inhibition of attachment of NUGC-4 gastric cancer cells by local treatment with phospholipids to the peritoneum in nude mice. Gastric cancer cells (1xl0(6)) suspended in either normal saline (controls) or phospholipid suspension 75 mg/kg body weight (PL75) or 150 mg/kg (PL150) were injected intraperitoneally into 90 female BALB/c nu/nu mice.

Phospholipids reduce gastric cancer cell adhesion to extracellular matrix in vitro.

Background: Nidation of floating tumour cells initiates peritoneal carcinosis and limits prognosis of gastro-intestinal tumours. Adhesion of tumour cells to extracellular matrix components is a pivotal step in developing peritoneal dissemination of intraabdominal malignancies. Since phospholipids efficaciously prevented peritoneal adhesion formation in numerous animal studies we investigated their capacity to reduce adhesions of gastric cancer cells to extracellular matrix components (ECM).

Phospholipids reduce the intraperitoneal adhesion of colonic tumor cells in rats and adhesion on extracellular matrix in vitro.

Objective: To evaluate the influence of intraperitoneal treatment with phospholipids on the formation of peritoneal carcinosis after inoculation of colonic tumor cells in rats. The presence of tumor cells in the peritoneal cavity serves as a prognostic marker for postoperative survival after resection of gastrointestinal cancer. Intraperitoneal tumor cell attachment is a pivotal step in developing peritoneal carcinosis.

Experimental evaluation of phospholipids and icodextrin in re-formation of peritoneal adhesions.

Background: The formation of further adhesions after adhesiolysis is a major problem. Not all agents that are supposed to reduce de novo adhesions can reduce further adhesion formation. The efficacy and safety of intraperitoneally applied phospholipids has been shown previously.

Effects of intra-abdominal drainages on adhesion formation and prevention by phospholipids in a rat model. Drainages and adhesion formation.

Background And Aims: The study was designed to asses the adhesiogenic capacity of silicone drainages and the protective effect of phospholipids (PL).

Materials And Methods: A total of 75 Wistar rats were randomly assigned to the different groups. In a preliminary trial (pt; n = 15), all rats underwent midline laparotomy.

Effect of intraperitoneal antiadhesive fluids in a rat peritonitis model.

Hypothesis: Phospholipids and icodextrin reduce peritoneal adhesions resulting from general peritonitis without promoting abscess formation.

Design: Evaluation of adhesion reduction fluids in a randomized animal study using a standardized peritonitis model.

Setting: Experimental animal model in a university laboratory.

[Material and structure of drainages].

The long history of surgical drainages stands in contradiction to available and reliable data. As of today, closed systems made of silicone are preferable. Taking possible complications into consideration and the good results of routine operations without drainages, indication for use should be critically evaluated.

Phospholipids reduce adhesion formation in the rabbit uterine horn model.

Objective: To access the ability of intraperitoneal phospholipids to reduce adhesions in a standardized model for gynecologic operations.

Design: A randomized, experimental, blinded study using the double uterine horn model.

Setting: Academic animal research laboratory.

Influence of early drainage of intraperitoneal phospholipids on efficacy of adhesion prevention.

Postoperative peritoneal adhesions impose a long-term risk of morbidity and mortality. Adjunctive means are needed to prevent these complications. In previous studies we could demonstrate the efficacy and safety of intraperitoneally applied phospholipids with regard to adhesion prevention and wound healing, respectively.

Influence of intraperitoneal phospholipid dosage on adhesion formation and wound healing at different intervals after surgery.

Background: Adjuvant therapy is needed to prevent adhesion formation as a major cause of postoperative morbidity and mortality. The efficacy of phospholipids (PLs) has been proven; however, information on dosage and drug safety are still outstanding.

Materials And Methods: Forty-eight Chinchilla rabbits underwent median laparotomy, abrasion of the peritoneum, jejunal anastomosis, and an electrocautery incision of the liver.

Comparison of adhesion reformation after laparoscopic and conventional adhesiolysis in an animal model.

This study set out to compare adhesion reformation after conventional and laparoscopic adhesiolysis using two different laparoscopic dissection techniques. In a first operation, 36 rabbits underwent fixation of 6 cm2 of the cecum with the serosa removed to the lateral abdominal wall to induce standardized adhesions. After 4 weeks, adhesiolysis was performed laparoscopically (n = 12) or via laparotomy (n = 12) using sharp and blunt dissection.

Efficacy of adhesion prevention and impact on wound healing of intraperitoneal phospholipids.

Background: Postoperative peritoneal adhesions are a major complication of abdominal surgery. Adjuvant therapy is needed to prevent adhesion formation and subsequent sequelae. Previously published data proved the efficacy of phospholipids (PL) for this indication; however, additional information on drug safety was still outstanding.

New adhesion formation after laparoscopic and conventional adhesiolysis: a comparative study in the rabbit.

This study aimed to compare new adhesion formation after laparoscopic and conventional adhesiolysis. In a first operation, 24 rabbits underwent fixation of deserosated cecum (6 cm2) to the lateral abdominal wall to induce standardized adhesions. After 4 weeks, adhesiolysis was performed by laparoscopy (n = 12) or laparotomy (n = 12).

[Prevention of adhesions. Wish and reality].

For more than a century peritoneal adhesions are being recognized as frequent sequelae following abdominal surgery. Intraoperative lesions of the mesothelial lining by abrasion, ischemia, dissication, and foreign bodies result in complaints, intestinal obstruction, female infertility, and problems during reoperations. The global increase of life expectancy and surgical procedures are leading to rising incidences of adhesion-related complications and subsequent socio-economic implications.

Postoperative necrotizing soft-tissue infections of the abdominal wall.

Objective: The aim of the underlying study was the evaluation of an aggressive surgical regimen for treatment of postoperative necrotizing soft-tissue infection (NSTI).

Methods: Eight patients with postoperative NSTI of the abdominal wall after emergency (n=6) and elective (n=2) surgery were reviewed over a 9-year period.

Results: Initially, three patients presented with general peritonitis.

Intraperitoneal transplantation of isologous mesothelial cells for prevention of adhesions.

Objective: To study the effect of transplantation of mesothelial cells on the formation of adhesions after peritoneal abrasion.

Design: Animal study.

Setting: Teaching hospital, Germany.

Value of intravenous cholangiography prior to laparoscopic cholecystectomy.

We performed a retrospective study on 163 patients for evaluation of the benefit of intravenous cholangiography prior to laparoscopic cholecystectomy. Radiographic evaluation of the various areas of the biliary system was classified regarding resolution of anatomic structures: well detailed (excellent), impaired image but reliable interpretation possible (good), insufficient contrast with limited assessment (poor), no reliable judgment possible (insufficient). The common bile duct could be described as "good" in 96.

[Not Available].

Perioperative management requires close cooperation between the referring practitioner, anesthesiologist, surgeon, and nursing staff. Standards in diagnostics, risk assessment, and choice of procedure, as well as integration of the anesthesiologist into the surgical out-patient department, are all important prerequisites for the optimum preparation of patients. Elective operations are to be planned in advance, taking into account the surgical resources available.

[Artificial pressure increase in subcutaneous abscess with evidence of general systemic reaction].

Abscess is customarily thought of as a collection of a large number of microorganisms, inflammatory cells and necrotic debris separated from the surrounding tissue by a fibrous capsule. Modern work focussed attention on more physico-chemical parameters in abscess pathogenesis. Recent experiences from animal models underline the impact of abscess pressure and bio-physicochemical parameters in the "abscess compartment" for systemic spreading.

True carcinosarcoma of the colon. Case report.

A second case of true carcinosarcoma of the colon is reported. A 79-year-old women was diagnosed as having an obstructing tumour of the caecum and liver metastases in both lobes. Histological examination of operative specimen from a right hemicolectomy revealed malignant epithelial and mesenchymal components.

[Epidemiology of appendicitis].

Epidemiological data reveal a decline in the incidence of appendicitis and appendectomy in the industrialized countries. A peak is found in adolescents aged 10-19 years; however, the highest rates of perforation are reported for the extremely young and old age groups. The elevated rate of appendectomies without histological evidence of acute inflammation, especially in young women, and the high perforation ratio in small children and elderly patients reflect poor diagnostic accuracy.

Low-dose, single-shot perioperative antibiotic prophylaxis in colorectal surgery.

Reductions of frequency of administration and dosage of antibiotic agents used in colorectal surgery may lower costs and the occurrence of adverse side effects. In a prospective randomized trial we evaluated two single-short regimens, a low dose of 1 g cefotiam against a standard dose of 2 g cefotiam, both in combination with 500 mg metronidazole. The low-dose group had twice the number of patients with wound sepsis (4 of 30) than the group receiving the standard antibiotic regimen (2 of 30).