Langenbecks Archiv für Chirurgie. Supplement. Kongressband. Deutsche Gesellschaft für Chirurgie. Kongress
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Langenbecks Arch Chir Suppl Kongressbd · Jan 1996
[Surgery in the elderly--extent and status in surgery].
The results of selected elective and emergency operations of patients treated in the surgical department of Bonn University in 1994 and 1995 are presented and compared to the ASA-score. It was possible to show that old age itself is not a contraindication for major surgical interventions but that lethality mainly depends on concurrent diseases, i.e. the biological age. ⋯ An age-specific factor which cannot be measured is the psychosocial age, the mental health. Mental health has an important influence on surgery in the aged patient.
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Langenbecks Arch Chir Suppl Kongressbd · Jan 1996
[Diagnostic problems in acute appendicitis and indications for laparoscopic appendectomy].
A retrospective study analyzing the outcome of 400 appendectomies for acute appendicitis in two different hospitals revealed a negative appendectomy rate of over 25%. As a consequence we altered the operative strategy by employing diagnostic laparoscopy in combination with laparoscopic appendectomy in all uncertain cases while still carrying out a conventional appendectomy when there was diagnostic certainty. Preliminary results show that laparoscopic appendectomy is a safe procedure and that the new concept reduces the negative appendectomy rate.
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The main problem facing the German transplantation program is the failure to obtain a continuous increase in organ procurement. To overcome the resulting lack of transplantable organs it is absolutely necessary to have a final parliamentary decision on a transplantation law in Germany. Organisational structures for transplantation, organ allocation and organ donation can be immediately implemented once legislation exist.
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Langenbecks Arch Chir Suppl Kongressbd · Jan 1992
[Mesothelioma of the pleura--diagnosis with imaging procedures].
Typical radiological findings in patients with diffuse malignant pleural mesothelioma are nodular opacities of the pleura including the fissures, pleural effusion, shrinking of the ipsilateral hemithorax, and mediastinal shift. The radiological differentiation between pleural mesothelioma and benign pleural tumors is possible; however, a secondary metastatic pleural involvement imitates pleural mesothelioma. Magnetic resonance imaging is superior to computed tomography in the preoperative assessment of tumor extension, because it demonstrates exactly the tumor extension in the coronal or sagittal plane. The noninvasive ultrasound examination is helpful in the evaluation of the diaphragmatic pleura and the costodiaphragmatic spaces.