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  • 1
    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.
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  • 2
    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.
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  • 3
    ISSN: 1569-8041
    Keywords: classical Whipple operation ; extended lymph node dissection ; left resection ; mortality ; morbidity ; long-term outcome ; pancreatic cancer ; pylorus-preserving duodenopancreatectomy ; regional pancreatectomy ; total pancreatectomy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Pancreatic cancer is the third leading neoplasm of the gastrointestinal system and has a dismal prognosis. The majority of patients are no more suitable for resection at time of diagnosis due to early development of distant metastases or major infiltrations of adjacent structures. However, due to the resistance of pancreatic cancers against chemoradiation, curative resection represents the only therapy with a potential for cure. For the surgical treatment of pancreatic head cancer, the classical Whipple operation is still the standard procedure but during the last two decades, pylorus-preserving duodenopancreatectomy has been evolved as a more conservative procedure in order to omit the consequences of partial gastrectomy. For cancer of the pancreatic body and tail, distal pancreatectomy or total pancreatectomy represent the current standard treatment. More radical methods like regional pancreatectomy and resection with extended lymph node dissection have failed so far to demonstrate any improvements in long-term survival compared to the standard types of resection. To further improve the treatment of pancreatic cancer, prospectively randomised trials are needed to compare these extended surgical procedures with the standard types of resection.
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  • 4
    ISSN: 1573-2568
    Keywords: EXPERIMENTAL COLITIS ; SUBSTANCE P RECEPTOR ANTAGONIST ; HISTOLOGY ; SMOOTH MUSCLE CONTRACTILITY
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The etiology of inflammation, edema, and smoothmuscle contraction characteristic of inflammatory boweldisease is not clearly understood. There is evidencethat several neuropeptides, including substance P (SP), may play a role. In this study weevaluated the ability of a SP-antagonist (SR140333) tomodify the course of experimental colitis induced in therat by trinitrobenzene sulfonic acid (TNB). Colitis was induced in 24 rats using TNB applied byintrarectal enema. Twelve TNB-treated rats receivedSR140333, 0.1 mg/kg intraperitoneally, 30 min before theadministration of TNB and every 48 hr until death. Twelve rats receiving only intrarectal 0.9%saline served as controls. Rats of each group werekilled after 14 days. At day 14, the control groupshowed no signs of inflammation whereas the TNB-treated rats without SR140333 treatment exhibited awell-established colitis. The TNB-treated group had ahigher level of inflammation, as seen histologically andby the significantly greater weight of colon strips, compared to the controls (0.30 ± 0.09 gvs 0.13 ± 0.03 g, P 〈 0.001) and to theSR140333-treated rats (0.30 ± 0.09 g vs 0.14± 0.05 g, P 〈 0.001). In addition, smoothmuscle contractility was significantly reduced in the inflamedcolons of TNB-treated rats when compared with thecontrols (carbachol: 42.7 ± 20.3 vs 254.2± 69.78 mg/mm2± 10.02 vs 89.45± 23.17 mg/mm2 11.4 ± 2.2 vs 98.32 ± 33.57mg/mm21). However, SR140333-treated ratsshowed a recovery from inflammation and motoralterations caused by TNB (carbachol: 150.9 ±46.1 mg/mm21; SP: 32.5 ± 9.4 mg/mm25; KCl:125.7 ± 36.1 mg/mm21). In conclusion,treatment with SP antagonist SR140333 reduces theseverity of colitis and has beneficial effects on theconcomitant alterations of contractility. Thus, theblockade of substance P may represent a possibility inthe treatment of intestinal inflammation.
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  • 5
    ISSN: 1573-2568
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
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  • 6
    ISSN: 1432-1440
    Keywords: Pancreatic cancer ; Growth factor receptors ; Growth factors ; Adhesion molecules ; Gene mutations
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Molecular alterations play a key role in the pathogenesis of gastrointestinal cancers. In the present paper we describe relevant molecular alterations in human pancreatic adenocarcinomas. Overexpression of growth factor receptors (EGF receptor, c-erbB2, c-erbB3, TGFβ receptor I–III), growth factors (EGF, TGFα, TGFβ-1-3, aFGF, bFGF), adhesion molecules (ICAM-1, ELAM-1) and gene mutations (p53, K-ras, DCC, APC) are present in a significant number of these tumors. These changes stimulate tumor growth and enhance the metastatic behavior of pancreatic cancer cells and thereby may contribute to shorter postoperative survival following tumor resection.
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