Langenbecks Archiv für Chirurgie. Supplement. Kongressband. Deutsche Gesellschaft für Chirurgie. Kongress
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Langenbecks Arch Chir Suppl Kongressbd · Jan 1998
Multicenter Study[Clinical value of diagnostic score for appendicitis: results of a prospective intervention study].
The clinical benefit of a diagnostic score for acute appendicitis was tested in a prospective interventional multicenter study on patients with abdominal pain. The study was performed in two consecutive phases: standard diagnostic work-up with no additional diagnostic support (870 patients) and additional diagnostic support with a score (614 patients). ⋯ There were no differences in the perforated appendix, negative appendectomy and complication rate, however, the delayed appendectomy rate (2% versus 8%) and the delayed discharge rate (11% versus 22%) were significantly lower with diagnostic support by the score. In summary, the score cannot be recommended as a standard diagnostic tool for diagnostic decision making in acute appendicitis.
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Langenbecks Arch Chir Suppl Kongressbd · Jan 1998
[Thoracoscopic management of fractures of the thoracic and lumbar spine].
In 90 patients, stabilization of injuries of the thoracic spine and the thoracolumbar junction was performed using minimally invasive thoracoscopy. The method includes partial corporectomy with spinal decompression, interposition of a tricortical bone graft, and anterior spondylodesis by planting. Complications were rare and not severe, with only two conversions to open technique. Compared to the open, standard method benefits included reduced postoperative pain, shorter hospital stay and reduced morbidity.
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Langenbecks Arch Chir Suppl Kongressbd · Jan 1998
Randomized Controlled Trial Clinical Trial[Cause-oriented prevention of nosocomial pneumonia: the HI-LO EVAC tube].
Surgical high-risk patients were studied in a prospective randomized trial regarding nosocomial pneumonia (NP) using a subglottic lavage (SL). A total of 100 patients were investigated, in whom the primary infection was localized in the oropharynx. Independent of the kind of stress ulcer prophylaxis, intermittent subglottic lavage reduces the incidence of NP drastically to 3%, which is however, without statistical significance.
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Langenbecks Arch Chir Suppl Kongressbd · Jan 1998
Randomized Controlled Trial Comparative Study Clinical Trial[Efficacy of an Acute Pain Service--a controlled comparative study of hospitals].
The efficacy of an acute pain service was prospectively evaluated on elective abdominal operations by comparing two surgical departments including a total of 498 patients. The patients of the clinic with an acute pain service reported less pain (at rest and in movement) pre- and postoperatively and received more analgetics. They had more appetite, lower sleep requirements and more independence. The patients' overall satisfaction was greater in the clinic with an acute pain service.
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Langenbecks Arch Chir Suppl Kongressbd · Jan 1998
Randomized Controlled Trial Clinical Trial[Effect of kinetic therapy on the course of treatment of patients with post-traumatic lung failure].
This study was conducted to investigate the effects of intermittent prone positioning of patients with post-traumatic respiratory failure (paO2/FiO2 < 280 mm Hg) in comparison with conventional therapy in a supine position. Although the severity of injury of the prone-positioned patients was much higher (ISS 35.8 vs 24.5), the ventilation time (32 vs 31 days) and ICU stay (39 vs 36 days) were similar to patients treated in the supine position. Besides the beneficial effect of prone positioning on oxygenation, for the first time we have evidence that prone positioning improves the outcome of patients with post-traumatic respiratory failure.