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  • 1
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    German Medical Science; Düsseldorf, Köln
    In:  122. Kongress der Deutschen Gesellschaft für Chirurgie; 20050405-20050408; München; DOC05dgch3394 /20050615/
    Publication Date: 2005-06-16
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
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  • 2
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    German Medical Science; Düsseldorf, Köln
    In:  122. Kongress der Deutschen Gesellschaft für Chirurgie; 20050405-20050408; München; DOC05dgch3301 /20050615/
    Publication Date: 2005-06-16
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
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  • 3
    Keywords: Study protocol, PANUSCO, pancreatic adenocarcinoma
    Abstract: Background: Pancreatic cancer is an extremely aggressive malignancy. Subjects are afflicted with a variety of disconcerting symptoms, including profound cachexia. Recent data indicate that the outcome of oncological patients suffering from cancer cachexia could be improved by parenteral nutrition and that parenteral nutrition results in an improvement of quality of life and in prolonged survival. Currently, there is no recommendation of routine use of parenteral nutrition. Furthermore, there is no clear recommendation for 2nd line therapy (or higher) for pancreatic adenocarcinoma but often asked for. Methods/Design: PANUSCO is an open label, controlled, prospective, randomized, multicentre phase IIIb trial with two parallel arms. All patients will be treated with 5-fluorouracil, folinic acid and oxaliplatin on an outpatient basis at the study sites. Additionally, all patients will receive best supportive nutritional care (BSNC). In the experimental group BSNC will be expanded with parenteral nutrition (PN). In contrast, patients in the control group obtain solely BSNC. Parenteral nutrition will be applied overnight and at home by experienced medical staff. A total of 120 patients are planned to be enrolled. Primary endpoint is the comparison of the treatment groups with respect to event-free survival (EFS), defined as the time from randomization till time to development of an event defined as either an impairment (change from baseline of at least ten points in EORTC QLQ-C30, functional domain total score) or withdrawal due to fulfilling the special defined stopping criteria for chemotherapy as well as for nutritional intervention (NI) or death from any cause (whichever occurs first). Discussion: The aim of this clinical trial is to evaluate whether parenteral nutrition in combination with defined 2nd line or higher chemotherapy has an impact on quality of life for patients suffering from pancreatic adenocarcinoma. Trial registration: Current Controlled Trials ISRCTN60516908.
    Type of Publication: Journal article published
    PubMed ID: 19943918
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  • 4
    Keywords: hepatocellular carcinoma ; liver transplantation ; sorafenib ; TRANSARTERIAL CHEMOEMBOLIZATION
    Abstract: Background Liver Transplantation (LT) is treatment of choice for patients with hepatocellular carcinoma (HCC) within MILAN Criteria. Tumour progression and subsequent dropout from waiting list have significant impact on the survival. Transarterial chemoembolization (TACE) controls tumour growth in the treated HCC nodule, however, the risk of tumour development in the untreated liver is increased by simultaneous release of neo-angiogenic factors. Due to its anti-angiogenic effects, Sorafenib delays the progression of HCC. Aim of this study was to determine whether combination of TACE and Sorafenib improves tumour control in HCC patients on waiting list for LT. Methods Fifty patients were randomly assigned on a 1:1 ratio in double-blinded fashion at four centers in Germany and treated with TACE plus either Sorafenib (n = 24) or placebo (n = 26). The end of treatment was development of progressive disease according to mRECIST criteria or LT. The primary endpoint of the trial was the Time-to-Progression (TTP). Other efficacy endpoints were Tumour Response, Progression-free Survival (PFS), and Time-to-LT (TTLT). Results The median time of treatment was 125 days with Sorafenib and 171 days with the placebo. Fourteen patients (seven from each group) developed tumour progression during the course of the study period. The Hazard Ratio of TTP was 1.106 (95% CI: 0.387, 3.162). The results of the Objective Response Rate, Disease Control Rate, PFS, and TTLT were comparable in both groups. The incidence of AEs was comparable in the placebo group (n = 23, 92%) and in the Sorafenib group (n = 23, 96%). Twelve patients (50%) on Sorafenib and four patients (16%) on placebo experienced severe treatment-related AEs. Conclusion The TTP is similar after neo-adjuvant treatment with TACE and Sorafenib before LT compared to TACE and placebo. The Tumour Response, PFS, and TTLT were comparable. The safety profile of the Sorafenib group was similar to that of the placebo group.
    Type of Publication: Journal article published
    PubMed ID: 25957784
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  • 5
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  124. Kongress der Deutschen Gesellschaft für Chirurgie; 20070501-20070504; München; DOC07dgch7629 /20071001/
    Publication Date: 2007-10-02
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
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  • 6
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  124. Kongress der Deutschen Gesellschaft für Chirurgie; 20070501-20070504; München; DOC07dgch7329 /20071001/
    Publication Date: 2007-10-02
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
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  • 7
    ISSN: 1433-0385
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 1433-0385
    Keywords: Key words: Laparoscopy ; Groin hernia ; Mesh repair ; Laparoscopic hernia repair ; TAPP. ; Schlüsselwörter: Laparoskopie ; Inguinalhernie ; Netzplastik ; laparoskopischer Hernienverschluß ; TAPP.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung. Der Stellenwert der minimal-invasiven Chirurgie zur Therapie von Leistenhernien ist auch heute noch nicht klar definiert. Der aktuelle Standard zur Versorgung einer Primärhernie entspricht in Europa einem offenen Verfahren (Shouldice) ohne Implantation von Fremdmaterial. Der Vorteil der Netzimplantation liegt in der Versorgung von komplizierten Bruchformen mit einem vorhandenen myopektinealen Defekt sowie Rezidiv- und Bilateralhernien. Hier kann die minimal-invasive Technik trotz dem erhöhten Schwierigkeitsgrad der Operation und der direkten Mehrkosten Vorteile bieten. Ob ein transabdomineller (TAPP) oder ein präperitonealer Zugang (TEP) bevorzugt wird, hängt von der Art des Bruches, dem Patientenrisiko und der Erfahrung des Operateurs ab. Beide Techniken der minimal-invasiven Chirurgie (TAPP und TEP) sind bzgl. Morbidität und Langzeitverlauf vergleichbar. Die Vorteile der TAPP-Reparation liegen in der einfacheren Technik, dem größeren Arbeitsraum und der guten Diagnostik.
    Notes: Summary. The value of the minimal invasive approach for treating groin hernias is not yet well defined. The standard treatment for primary hernia repair in Europe is an open approach (i.e. Shouldice) without mesh implantation. A mesh may be used to repair a so-called complicated hernia with a complete myopectineal defect, as well as for recurrent and bilateral hernias. These hernias can well be treated laparoscopically despite the fact that the approach is difficult and that there is an increase of direct costs. Whether or not a transabdominal (TAPP) or preperitoneal (TEP) endoscopic approach is used depends on the type of hernia, the risk to the patient, and the surgeon's experience. Morbidity and long-term follow-up are identical for both techniques (TAPP and TEP). The advantages for TAPP repair are that the technique is simpler, with a large working space and good diagnostic tools.
    Type of Medium: Electronic Resource
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  • 9
    ISSN: 1433-0385
    Keywords: Key words: Chronic pancreatitis ; Surgery ; Duodenum-Preserving resection of the head of the pancreas. ; Schlüsselwörter: Chronische Pankreatitis ; Chirurgie ; duodenumerhaltende Pankreaskopfresektion.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung. Die duodenumerhaltende Pankreaskopfresektion wurde vor 25 Jahren von Beger entwickelt. Dieses Verfahren ist indiziert bei Patienten mit chronischem Schmerzsyndrom, entzündlichem Pankreaskopftumor und/oder Gallengangstenose, Pankreasgangstenose und Obstruktion der retropankreatischen Gefäße. 74 Patienten wurden zwischen 1993 und 1996 am Inselspital in Bern mit diesem Operationsverfahren chirurgisch versorgt. Die mittlere Operationszeit betrug 380 min bei einem medianen intraoperativen Transfusionsbedarf von 0 (0–6) Konserven. Postoperativ ist kein Patient verstorben. Die Gesamtmorbidität betrug 13 %. Ein Patient wurde am Tag 17 wegen Ileus reoperiert. Die mittlere Hospitalisationszeit betrug 11 Tage. Postoperativ trat bei 2 Patienten ein Diabetes neu auf. Die duodenumerhaltende Pankreaskopfresektion ist ein organerhaltendes chirurgisches Prinzip, welches die Komplikationen der Erkrankung behandelt und auch im Langzeitverlauf bei über 80 % der Patienten Schmerzfreiheit ermöglicht.
    Notes: Summary. Duodenum-preserving resection of the head of the pancreas was developed 25 years ago by Beger. This procedure is indicated in patients suffering from chronic pain in combination with inflammation of the head of the pancreas, common bile duct obstruction, pancreatic duct obstruction and/or obstruction of the retropancreatic vessels. At the Inselspital in Berne, 74 patients underwent this operation between 1993 and 1996. The median length of the operation was 380 min, with the need for transfusion in a median of 0 units (0–6). There was no postoperative mortality. Total postoperative morbidity was 13 %. One patient needed relaparotomy on day 17 for small bowel obstruction. Median length of hospital stay was 11 days. Postoperatively, two patients developed diabetes. Duodenum-preserving resection of the head of the pancreas represents an organ-preserving principle of surgery. This procedure treats the complications of chronic pancreatitis and provides long-term pain relief in more than 80 % of patients.
    Type of Medium: Electronic Resource
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  • 10
    ISSN: 1433-0385
    Keywords: Key words: Oesophageal cancer ; Gastroplasty ; New technique ; Fundus rotation gastroplasty. ; Schlüsselwörter: Oesophaguscarcinom ; Gastroplastik ; neue Technik ; Fundusrotationsgastroplastik.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung. Die cervicale Nahtinsuffizienz ist mit einer Frequenz von 20–50 % einer der wesentlichen Morbiditätsfaktoren in der Chirurgie des Oesophaguscarcinoms. Wir berichten über eine neue Technik der Gastroplastik, die Fundusrotationsgastroplastik, welche bei 53 Patienten angewandt wurde. Es handelte sich um 49 Patienten mit Oesophaguscarcinom und 4 Patienten mit gutartigen Erkrankungen. Die Klinikletalität nach Oesophagektomie und Fundusrotationsgastroplastik betrug 5,7 % (3/53), die Nahtinsuffizienzrate 7,5 % (4/53). Vorteile der Fundusrotationsgastroplastik gegenüber der konventionellen Magenplastik liegen in der besseren Durchblutung und der größeren Länge des Schlauchmagens. Klinische Vergleichsstudien werden belegen müssen, ob die Fundusrotationsgastroplastik der konventionellen Magenplastik überlegen ist.
    Notes: Summary. Cervical leakage, occuring on average in 20–50 % of the patients, is one of the major causes of morbidity following oesophagectomy for cancer. We report on a new technique of gastroplasty, namely fundus rotation gastroplasty which was used in 53 patients. There were 49 patients with oesophageal cancer and 4 with benign lesions. Hospital mortality was 5.7 % (3/53) and the leakage rate 7.5 % (4/53). The advantages of fundus rotation gastroplasty over conventional gastroplasty are the better blood supply and the greater length of the gastric tube. Controlled clinical trials will be necessary to confirm the advantages of fundus rotation gastroplasty versus conventional gastroplasty.
    Type of Medium: Electronic Resource
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