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991.
992.
Annett Wunder 《MedR Medizinrecht》2007,25(1):21-28
Ohne Zusammenfassung 相似文献
993.
Stomach rupture can occur as a consequence of the expansion of compressed air during rapid ascent after diving. We present
the case of a middle-aged woman who suffered a gastric tear from surfacing too quickly after diving, and discuss the diagnosis
and management of such patients by reviewing previously reported similar events. Gastric barotrauma should be suspected in
divers who complain of abdominal pain, even in the absence of frank signs of peritoneal irritation. Although pneumoperitoneum
is always present in these patients, it can also occur as a consequence of pulmonary barotrauma, making gastroscopy or radiological
contrast studies, or both, essential for a definitive diagnosis. Surgical repair represents the treatment of choice for an
active full-thickness tear and, if associated with arterial gas embolism or decompression sickness, should ideally be performed
in a center where a category I (intensive care-capable) hyperbaric unit is available.
Received: March 18, 2002 / Accepted: September 3, 2002
Reprint requests to: L.V. Titu 相似文献
994.
Kazumasa Fujitani Jaffer A. Ajani Christopher H. Crane Barry W. Feig Peter W. Pisters Nora Janjan Garrett L. Walsh Stephen G. Swisher Ara A. Vaporciyan David Rice Angela Welch Jackie Baker Josephine Faust Paul F. Mansfield MD 《Annals of surgical oncology》2007,14(4):1305-1311
Background Significant tumor downstaging has been achieved in patients with localized gastric or gastroesophageal adenocarcinoma by induction
chemotherapy and preoperative chemoradiotherapy (CTX–CTXRT). However, the influence of CTX–CTXRT on operative morbidity and
mortality has not yet been clarified. The aim of the present study was to document the frequency and nature of morbidity and
mortality after surgery combined with CTX–CTXRT, and identify factors predictive of postoperative complications in patients
with localized gastric or gastroesophageal adenocarcinoma.
Methods A prospectively collected database on 71 consecutive patients who underwent CTX–CTXRT at M.D. Anderson Cancer Center between
January 1997 and August 2004 was reviewed. Postoperative morbidity and mortality were investigated, and risk factors for overall
complications were identified by multivariate logistic regression analysis.
Results Overall morbidity and mortality rates were 38.0% (27 patients) and 2.8% (2 patients), respectively. Age greater than 60 years
[relative risk 11.3 (95% confidence interval 2.50–50.6)] and body mass index (BMI) of 26 kg/m2 or above [relative risk 4.08 (95% confidence interval 1.08–15.4)] were significant risk factors for overall complications.
Conclusions CTX–CTXRT can be performed safely with an acceptable operative morbidity and a low operative mortality rate in patients with
gastric or gastroesophageal cancer, with careful consideration of added risk associated with age and obesity. 相似文献
995.
Gautham Kulamarva Mark Wilbourn Rajiv Anand Constantinos Mourouzis Anne V Spedding Peter A Brennan 《Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics》2007,104(2):240-242
Chordoma is a rare tumor, arising from notochord remnants, which usually occurs in the axial skeleton and rarely metastasizes. Although there have been 3 previous reports of metastatic disease to the facial bones from sacrococcygeal chordoma, this is the first to describe spread to the mandible from a vertebral primary chordoma. 相似文献
996.
Robert M Bennett Jessie Jones Dennis C Turk I Jon Russell Lynne Matallana 《BMC musculoskeletal disorders》2007,8(1):27
Background
This study explored the feasibility of using an Internet survey of people with fibromyalgia (FM), with a view to providing information on demographics, sources of information, symptoms, functionality, perceived aggravating factors, perceived triggering events, health care utilization, management strategies, and medication use. 相似文献997.
Roderik Metz Gino MMJ Kerkhoffs Egbert-Jan MM Verleisdonk Geert J van der Heijden 《BMC musculoskeletal disorders》2007,8(1):108
Background
We present the design of an open randomized multi-centre study on surgical versus conservative treatment of acute Achilles tendon ruptures. The study is designed to evaluate the effectiveness of conservative treatment in reducing complications when treating acute Achilles tendon rupture. 相似文献998.
Michael B. Farnell Gerard V. Aranha Yuji Nimura Fabrizio Michelassi 《Journal of gastrointestinal surgery》2008,12(4):651-656
With improvements in the safety of Whipple resection in recent decades, surgeons have continued to explore the role of more
extensive lymphadenectomy in hope of improving long-term survival. A systematic literature search of level I evidence addressing
the role of the extent of lymphadenectomy was undertaken. Only reports of prospective, randomized controlled trials comparing
pancreaticoduodenectomy with standard lymphadenectomy to pancreaticoduodenectomy with extended lymphadenectomy where information
regarding survival, morbidity, mortality, the number of resected lymph nodes in each group and detailed operative technique
were included. Four prospective, randomized trials comprising some 424 patients and one meta-analysis were identified. In
aggregate, these studies confirmed that the number of resected lymph nodes was significantly higher in the pancreaticoduodenectomy
with extended lymphadenectomy group. Morbidity and mortality rates were comparable. Postoperative diarrhea in the early months
after operation was problematic in patients undergoing extended lymphadenectomy. In none of the studies was a benefit in long-term
survival demonstrated. Standard pancreaticoduodenectomy continues to be the operation of choice for adenocarcinoma of the
head of the pancreas.
Presented at The Society for Surgery of the Alimentary Tract Postgraduate Course “Systematic Reviews of Pancreaticobiliary
Disease Customized for the Gastroenterologist and Gastrointestinal Surgeon” on May 20, 2007, Washington, D.C. 相似文献
999.
Treatment of Hemorrhoids in Day Surgery: Stapled Hemorrhoidopexy vs Milligan–Morgan Hemorrhoidectomy
Vito Maria Stolfi Pierpaolo Sileri Chiara Micossi Isabella Carbonaro Marco Venza Paolo Gentileschi Piero Rossi Alessandro Falchetti Achille Gaspari 《Journal of gastrointestinal surgery》2008,12(5):795-801
Background Recently, it has been demonstrated that surgical treatment of hemorrhoids in a day-care basis is possible and safe. The aim
of this study was to compare the Longo stapled hemorrhoidopexy (SH) and the Milligan–Morgan hemorrhoidectomy (MMH).
Methods One hundred seventy one patients (95 cases in SH group and 76 cases in MMH group) entered the study: 83 cases were III degree
hemorrhoids, 88 IV degree. A priori and a post hoc power analysis were performed. Results, prospectively collected, were compared
using chi squared test and student t test. Visual analog scale was used for pain evaluation. Postoperative pain, duration of pain, wound secretion, bleeding,
resumption of a normal lifestyle, and postoperative complication were evaluated.
Results Surgical time was 28.41 ± 10.78 for MMH and 28.30 ± 13.28 min in SH (P = 0.94). Postoperative pain was not different between MMH and SH during the first two postoperative days (4.73 ± 2.91 vs
5.1 ± 3.048; P = 0.4), during the following 6 days, patients treated with SH had less pain (4.63 ± 2.04 in MMH vs 3.60 ± 2.35 in SH; P = 0.006). In the SH group, seven patients needed further hospital stay for complicated course. SH showed higher incidence
of anal fissure compared with MMH (6.3% vs 0%; P = 0.025) but no differences in urinary retention, anal stricture, urgency, or anal hemorrhage.
Conclusions This study confirms that SH is associated with less postoperative pain and shorter postoperative symptoms, compared with MMH.
SH may be a viable addition to the therapy for hemorrhoids with some advantages in early postoperative pain and some disadvantages
in postoperative complications and costs. 相似文献
1000.