Risk factors for wound complications after associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) compared to repeated liver resection - a propensity score matching analysis.

Aim: Sufficient liver function is crucial in extracellular matrix growth, hemostasis, and wound healing. Repeated abdominal surgery is a known risk factor for the development of wound complications. This study aimed to evaluate this high-risk constellation in patients undergoing associated liver partition and portal vein ligation for staged hepatectomy (ALPPS) and repeated liver resections (RLR) in comparison to single liver resection (SLR).

Prospective Validation of the Pancreatic Fistula Risk Classification by the International Study Group for Pancreatic Surgery (PARIS trial).

Objective: The aim of this study was a prospective validation of the recently established ISGPS pancreas classification as a parenchymal risk classification system for pancreatic fistula after pancreatoduodenectomy.

Summary Background Data: Postoperative pancreatic fistula (POPF) is the major driver for complications after partial pancreatoduodenectomy (PD). Recently, the International Study Group for Pancreatic Surgery (ISGPS) published a pancreas classification containing the parameters main pancreatic duct diameter (MPD) and pancreatic texture to help assess the risk of POPF development following pancreatoduodenectomy.

Prevention of incisional hernia with prophylactic onlay and sublay mesh reinforcement vs. primary suture only in midline laparotomies (PRIMA): long-term outcomes of a multicentre, double-blind, randomised controlled trial.

Background: Incisional hernia occurs approximately in 40% of high-risk patients after midline laparotomy. Prophylactic mesh placement has shown promising results, but long-term outcomes are needed. The present study aimed to assess the long-term incisional hernia rates of the previously conducted PRIMA trial with radiological follow-up.

The effect of prophylactic mesh implantation on the development of incisional hernias in patients with elevated BMI: a systematic review and meta-analysis.

Background: Incisional hernia is a common complication after midline laparotomy. In certain risk profiles incidences can reach up to 70%. Large RCTs showed a positive effect of prophylactic mesh reinforcement (PMR) in high-risk populations.

Extracorporeal albumin dialysis in patients with Amanita phalloides poisoning.

Background: Ingestion of Amanita phalloides is the most common cause of lethal mushroom poisoning. The relative late onset of symptoms is a distinct diagnostic feature of Amanita intoxication and also the main reason of failure for extracorporeal removal of Amanita-specific toxins from the gut and circulation.

Patients And Methods: Extracorporeal albumin dialysis (ECAD) has been used on six consecutive patients admitted after A.

The influence of 2 surgical bandage systems on wound tissue oxygen tension.

Hypothesis: Local wound heating improves tissue oxygen tension in postoperative patients.

Setting: University hospital.

Patients: Forty normothermic and well-hydrated patients recovering from elective open abdominal surgery.

Peri-operative thoracic epidural analgesia for thoracotomy.

In a prospective study, experiences with peri-operative thoracic epidural analgesia (TEA) for thoracic surgery were documented. Two hundred and seven patients scheduled for elective thoracotomy were investigated. All patients received thoracic epidural catheters 2 h pre-operatively.

Early cardiorespiratory patterns in severely burned patients with concomitant inhalation injury.

Hemodynamic and oxygenation parameters were determined during the first 24 h in 13 burned patients with concomitant inhalation injury (burn surface area 40-60 percent). In all patients right ventricular function was severely compromised evidenced as a significant increase in end-diastolic volumes, decrease in ejection fractions, low stroke work indices and increased pulmonary vascular resistances. Inotropic support with dobutamine and careful titration of volume infusion according to end-diastolic volume indices improved the hemodynamics as demonstrated by significant increases in right ventricular ejection fractions in all patients without any changes in mean arterial pressures, urine output and oxygenation.

Influence of prostaglandin E1 on tissue ischemia during surgical repair of the abdominal aorta.

Objective: To evaluate tissue protection by PGE1 during leg ischemia in patients undergoing aortic surgery.

Design: Randomized, controlled prospective clinical trial.

Setting: Single university hospital.

Pharmacodynamics of mivacurium in severely burned patients.

The pharmacodynamics of mivacurium, a new short-acting non-depolarizing muscle relaxant, were studied in nine severely burned patients with concomitant inhalation injury. Complete neuromuscular blockade was achieved within 1.3 min (controls 3.

Anticoagulation with prostacyclin and heparin during continuous venovenous hemofiltration.

Objectives: To investigate anticoagulation with prostacyclin (prostaglandin I2 [PGI2]) and/or heparin during continuous venovenous hemofiltration, and the role of in vitro tests of primary hemostasis in controlling anticoagulation.

Design: Prospective, randomized, controlled trial.

Setting: Intensive care unit.

The level of neuromuscular block needed to suppress diaphragmatic movement during tracheal suction in patients with raised intracranial pressure: a study with vecuronium and atracurium.

The effects of tracheobronchial suction before and after neuromuscular blockade with vecuronium (0.12 mg.kg-1; ED95 x 2; group A) and atracurium (0.

Coeliac plexus block with bupivacaine reduces intestinal dysfunction in neurosurgical ICU patients.

Coeliac plexus block, an established method of treatment for pain associated with pancreatitis and cancer, was used in neurosurgical patients with gastrointestinal dysfunction. The study was performed in 16 patients whose gastric reflux volume exceeded 600 ml per day for 3 consecutive days. Patients were allocated to a block group (n = 8) or a control group (n = 8).

Porcine model for studying the passage of non-depolarizing neuromuscular blockers through the blood-brain barrier.

A method has been developed for blood-brain barrier disruption to provide reproducible access to the cerebrospinal fluid of the cerebello-medullary cistern. The technique was used successfully to investigate transfer of pancuronium to the cerebral CSF compartment in pigs. After osmotic disruption of the blood-brain barrier, pancuronium concentrations increased significantly in the cerebrospinal fluid.

[Preclinical management of patients with intracerebral hemorrhage].

The prehospital treatment of patients with intracerebral hemorrhage must be aimed at prevention of secondary brain damage and provision of an optimal physiologic environment to maximize the potential of recovery. Adequate cerebral oxygenation and the prevention of hypercarbia is a priority. This can only be managed by early intubation and artificial ventilation in patients with a Glasgow-coma-scale below eight, together with the restoration of normal hemodynamics to guarantee adequate cerebral perfusion.

In vitro NMR investigation of controlled single and repeated isoflurane anesthesia.

Immobilization of laboratory animals is a basic requirement for experimental in vivo NMR measurements. The effect of single and repeated isoflurane anesthesia on proton NMR relaxation times T1 and T2 in rat liver was studied. Furthermore, physiological monitoring was performed to evaluate the influence of isoflurane anesthesia (up to 2 hr) on biological parameters.

[Requisite muscle relaxation using vecuronium for tracheobronchial suction in neurosurgical intensive care patients].

Coordination of respiratory care with protection of the brain is critical in neurosurgical intensive care. Therefore, in addition to hyperventilation, adequate sedation and muscle relaxation are applied to mitigate the difficulties with control of intracranial pressure (ICP) during routine tracheobronchial suctioning (TBS). Although hypnotics have been shown to be effective in mitigating increases in ICP in response to endotracheal suctioning in paralyzed patients, brisk bucking and coughing with further increases in ICP may occur without muscle relaxation.

[Traumatic spinal cord lesion. An interdisciplinary challenge--a synopsis of the early trauma phase].

Increased morbidity and mortality in patients with spinal cord injuries present the anesthesiologist with many problems. The extent of neuronal damage is determined not only by the initial trauma, but also by subsequent activation of lipid peroxidation and lipase reactions due to local ischemia of the spinal cord. Complete transection of the spinal cord is characterized by impairment of diaphragmatic function and cardiovascular depression due to functional sympathectomy.

[Atrial arrest and intraventricular conduction disorders due to accidental hyperkalemia during kidney transplantation].

Besides anemia, coagulopathies, and hypertension, electrolyte disturbances are among the most significant features of end-stage renal disease. Although plasma potassium represents only 1.5%-2% of the whole-body content, hyperkalemia has definite effects on cardiac pacemaker cells and myocardial conduction.