Rekonstruktive Chirurgie bei alten Radikalhöhlen

Ohne Zusammenfassung     

Die Erhaltung des äußeren Gehörganges bei der Radikaloperation und eine neue Art der Tympanoplastik

Ohne Zusammenfassunga. G.     

A simple photometric method for determination of blood loss during transurethral surgery.

A new method for determining blood loss during transurethral operations is presented. Its basic principle is photometry of blood concentrations in haemolysed irrigating fluid. At test study was run on 50 patients who underwent transurethral prostatic resection because of hyperplasia. The photometer was of a type commonly used for routine determination of a haemoglobin concentration in blood. The apparatus for the test is therefore readily available. The test is simple to perform and gives highly reliable results within a few minutes. In seven cases double sampling was done. Since the results within each pair of samples were practically identical, double sampling was considered superfluous for the rest of the case series. Visual estimation of blood loss during transurethral operations seems to be customary in most urologic units in Sweden. We found this method to be unreliable, with underestimates of about 100% in several cases.     

Prospective comparison of gastric secretory function after gastrectomy with either Billroth II or Roux-en-Y anastomosis

In order to delineate the role of enterogastric reflux in changes of postoperative gastric secretory functions, 22 patients with peptic ulcers, who were randomly assigned to partial gastrectomy without vagotomy with either Billroth II or Roux-en-Y anastomosis, were prospectively studied before and 6 months after surgery. Preoperatively, there were no significant differences in gastric secretory functions between the two groups of 11 patients. Postoperatively, median fasting bile acids in the stomach increased in the Billroth II patients from 0.35 to 16.10 mumol/hr (p less than 0.01), but significantly decreased in the Roux-en-Y patients from 0.30 to 0.10 mumol/hr (p less than 0.05), which indicated adequate prevention of enterogastric reflux after the Roux-en-Y procedure. Gastrectomy resulted in significant reductions of median values of basal acid output (4.6 vs 0.6 mmol/hr, p less than 0.01, and 4.2 vs 0.4 mmol/hr, p = 0.02), peak acid output (31.6 vs 4.2 mmol/hr, p less than 0.01, and 38.7 vs 4.5 mmol/hr, p less than 0.01), serum pepsinogen A (121 vs 86 micrograms/L, p less than 0.01, and 92 vs 45 micrograms/L, p less than 0.01), meal-stimulated serum gastrin secretion (1472 vs 199 pM.60 min, p less than 0.0001, and 1017 vs 199 pM.60 min, p less than 0.0001) in the patients with Billroth II and Roux-en-Y anastomosis, respectively. There were, however, no significant differences in gastric secretory parameters between the two groups when studied 6 months after surgery. Therefore it is concluded that after gastrectomy, enterogastric reflux does not affect the secretory function of the gastric remnant within the first 6 months after surgery.