ABSTRACT
From 1984 to 1996, 136 carcinomas of the esophagus and 8 of the hypopharynx were resected using 3 different procedures (94 transmediastinal, 36 transthoracic, 14 cervicoabdominal). The hospital mortality rate for cervicoabdominal resection (0%) is unequivocally lower than that of the transmediastinal (17.1%) or transthoracic (14.3%) methods. The 5-year survival rates are not significantly different (24%, 22%, 17%).
Subject(s)
Carcinoma, Squamous Cell/surgery , Esophageal Neoplasms/surgery , Hypopharyngeal Neoplasms/surgery , Microsurgery , Patient Care Team , Adult , Aged , Carcinoma, Squamous Cell/mortality , Carcinoma, Squamous Cell/pathology , Esophageal Neoplasms/mortality , Esophageal Neoplasms/pathology , Female , Follow-Up Studies , Humans , Hypopharyngeal Neoplasms/mortality , Hypopharyngeal Neoplasms/pathology , Male , Middle Aged , Neoplasm Staging , Reoperation , Surgical Flaps , Survival RateABSTRACT
In a 6-year period, we treated 14 patients with severe groin infections involving the femoral artery following drug injection in addicts. In 13 cases, we used autologous material for arterial reconstruction; in one case of massive bleeding the femoral artery had been embolized. Ten patients were treated with full success, two patients had claudication postoperatively, and in two cases above-knee amputations were necessary.
Subject(s)
Aneurysm, False/surgery , Femoral Artery/surgery , Skin Diseases, Bacterial/surgery , Soft Tissue Infections/surgery , Substance Abuse, Intravenous/complications , Amputation, Surgical , Aneurysm, False/etiology , Groin/blood supply , Hemorrhage/etiology , Hemorrhage/surgery , Humans , Ischemia/etiology , Ischemia/surgery , Leg/blood supply , Postoperative Complications/etiology , Postoperative Complications/surgery , Recurrence , Skin Diseases, Bacterial/etiology , Soft Tissue Infections/etiologyABSTRACT
Since January 1996, Fallpauschalen (fee for case) and Sonderentgelte (fee for service) lead up to a new dictatorship of economy over surgeons affairs. A detailed economical analysis for the surgical treatment of benign diseases of the thyroid gland was made. Comparing the costs and our financial benefits, it is evident that there are no reserves for complications or longterm patients.
Subject(s)
Ethics, Medical , Fees, Medical/statistics & numerical data , National Health Programs/economics , Thyroid Diseases/economics , Thyroidectomy/economics , Cost Savings , Fee Schedules , Germany , Humans , Length of Stay/economics , Thyroid Diseases/surgeryABSTRACT
Since 1977 we treated more than 7,000 out of 20,000 patients with risk of thromboembolic complications with intermittent pneumatic compression of the legs. Complications due to prophylaxis with heparin can so be avoided. Our statistical analysis makes it reasonable to use this physical method routinely for surgical in-patients. It is as effective as prophylaxis with heparin. The intermittent pneumatic compression is accepted by the patients and is more economical.
