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 Trial[Procalcitonin as marker of systemic inflammatory reaction after isolated extremity perfusion].
The systemic side effects of isolated limb perfusion (ILP) with rhTNF alpha and melphalan are characterised by the induction of a systemic inflammatory response syndrome (SIRS). Procalcitonin (PCT), a serum marker of bacterial sepsis, was investigated with respect to its role in SIRS after TNF-ILP. Serum-PCT was analysed in 24 patients (12 male, 12 female), who treated by ILP for regionally metastasized melanoma (n = 8) or locally advanced soft tissue sarcoma (n = 16). ⋯ Serum procalcitonin is induced as part of the specific SIRS after ILP with rhTNF alpha and melphalan. It may be induced directly by rhTNF alpha or by different cytokines, as serum peaks of IL-6 and IL-8 are reached well before the peak of PCT. Determination of PCT prior to and after ILP with TNF might be useful to assess patients at risk of developing hyperdynamic shock.
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Langenbecks Arch Chir Suppl Kongressbd · Jan 1998
Comparative Study[Effect of pneumoperitoneum with carbon dioxide and helium on hemodynamic parameters after compensated acute hemorrhage].
If animals have been properly resuscitated after moderate bleeding and hypovolemia has been corrected with colloidal solution, pneumoperitoneum with 12 mmHg does not appear to be harmful in a porcine model. Helium showed no clear advantage as insufflating gas over carbon dioxide.
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Langenbecks Arch Chir Suppl Kongressbd · Jan 1998
Comparative Study[Quality of life after inguinal hernia operation--results of a prospective study (Shouldice, Lichtenstein, TAPP)].
Data concerning quality of life and rehabilitation after inguinal hernia repair are still poor. A prospective survey on 269 patients was conducted following standardized Shouldice, Lichtenstein and TAPP hernioplasty by means of questionnaire. General health perception, pain scores and physical activity were significantly improved by all of the mentioned techniques. Laparoscopic repair was beneficial in indirect, recurrent and bilateral hernia and small defects of the transverse fascia.
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Langenbecks Arch Chir Suppl Kongressbd · Jan 1998
[Information exchange via internet--possibilities, limits, future].
Today, the exchange of information in the Internet is dominated by the WWW and e-mail. Discussion groups like mailing lists and newsgroups also permit communication in groups. Information retrieval becomes a crucial challenge in using the Internet. ⋯ Future developments will not only improve the existing services, but also lead to fundamental changes in the transfer technologies: Safer data transfer is to be ensured by new encrypting software together with the planned transfer protocol IPv6. Introducing the new transfer mode ATM will lead to better and resource saving transmission. Computer, telephone and TV networks will grow together, resulting in convergence of media.
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Langenbecks Arch Chir Suppl Kongressbd · Jan 1998
Comparative Study[Stragegies for evaluation of non-randomized therapeutic comparisons exemplified by prehospital volume therapy after trauma].
Non-randomized comparisons of therapeutic approaches require extensive description of the patients. Classical subgroup analysis suffers from small sample sizes. Estimation of outcome based on known prognostic factors (e.g. scores) allow for an indirect comparison of treatment effects. ⋯ The propensity score approach classifies all patients according to their chance of receiving a certain therapy or not, thus giving comparable situations for stratified analysis. The preclinical fluid resuscitation for trauma patients can hardly be assessed by randomized trials. Application of the above mentioned methods shows no overall effect but polytraumatized patients seem to have a worse outcome with high volume resuscitation.