[Assessment of the resectability of Wilms' tumors in childhood]. / Beurteilung der Resektabilität von Wilmstumoren im Kindesalter.

Over the last ten years 62 children were operated for renal tumours. The therapeutic aim in Wilms' tumours is complete macroscopic resection of the primary tumour, assessing resectability as accurately as possible. Overestimating surgical possibilities may lead to intraoperative rupture of the tumour (three cases), while overestimating local tumour extent may result in too much preoperative chemotherapy, which resulted in the life-threatening complication of venous occlusive disease of the hepatic veins (VOD) in three infants. The assessment of resectability may become particularly problematic in bilateral (six cases) or multifocal Wilms' tumours (two cases), and in nephroblastomatosis (two cases), i.e. the persistence of embronal renal tissue, a facultatively precancerous lesion, which requires quarterly sonographic controls and which induced a second metachronous contralateral Wilms' tumour in one child.

[Surgical correction of venous insufficiency following arteriovenous fistula for hemodialysis]. / Die operative Korrektur der venösen Insuffizienz nach arterio-venöser Fistel zur Hämodialyse.

The percentage of venous insufficiency in the original Cimino-Brescia shunt is very low. In cases of venous insufficiency, early diagnosis is important; operative correction is then easily performed. Ligature of the distal venous limb next to the anastomosis is the treatment of choice, providing the proximal limb is still open. If the proximal limb is obstructed, the distal venous part is dissected and anastomosed to a more proximal vein. The result is an immediately functioning shunt for dialysis.

[Surgical treatment of radiation injuries of the intestinal tract after radiotherapy of malignant tumors]. / Zur chirurgischen Behandlung von Komplikationen am Intestinaltrakt nach Strahlenbehandlung maligner Tumoren

From 1962-1975 in our hospital 44 patients were operated because of complications of the bowel after irradiation of malignant tumors. 3 patients were operated in the region of subsequent irradiation. While at the small intestine stenoses were the most frequent complication, at the great gut fistula of rectum, colon sigmoideum or vagina besides stenoses were frequent. The time between irradiation and operation differed between 5 weeks and 22 years. The peak of frequency in the region of the great gut was seen about the first year after termination of irradiation, in the region of the small intestine about the second year. Among the operations of the small intestine resection predominates, at the great gut colostomy. Half of the patients were without complications in the postoperative course. 10 patients died postoperatively, 4 of them of peritonitis. In 3 cases suture insufficiency was verified, in 2 further cases this was doubtful. 36 of 44 patients were without carcinoma at the time of operation or control examination. 16 patients survived 5 years or more.

[The surgical treatment of villous tumours of the large bowel (author's transl)]. / Die chirurgische Behandlung des villösen Dickdarm- und Mastdarmpolypen

The treatment of 12 patients with villous tumours of the rectum is described. In benign lesions a sphincter conserving operation should be employed. With the technique of submucosal local excision per anum which was described by A.G. Parks it is possible to remove large villous tumours of the rectum. If there is malignant change with invasion of the muscularis muscosae which is found in about 20% of the cases resection therapy is necessary.