Intestinal obstruction in patients with advanced gynecological cancer. A study of 62 cases.

In total, 62 cases with advanced gynecological malignancy were analyzed for the value of interventions for intestinal obstruction. 35 patients had an ileostomy, 7 patients had other palliative surgical intervention and 20 patients were managed conservatively. The median survival after surgical intervention was 7.7 months as against 1.3 months in conservatively treated patients. After surgery, all patients were affected by severe complications due to the primary disease. 22 (52.3%) of surgically treated patients received further therapy. 45 out of 62 patients (77.4%) died of progressive cancer and 14 (22.6%) of ileus. Surgical intervention had a positive effect on survival time, but only a marginal effect on life quality.

[Videodensitometry analysis of stomach wall motility--presentation of a new method]. / Videodensitometrische Analyse der Magenwandmotilität--Vorstellung einer neuen Methode.

The videodensitometry is a suitable method for recording the gastric wall motility. It provides biosignals amenable by computer. There are no special demands to any organic form or kind of contraction. The asymmetry of the stomach makes no difference, therefore. The hitherto usual manometry will not be superseded. Both methods complete themselves in an ingenious manner. The radiation exposure by videodensitometry can be diminished by modifying the system for image causation.

[Bengmark spleen transposition in children]. / Die Milztransposition nach Bengmark bei Kindern.

After a historical review of surgical therapy of portal hypertension experiences are reported with the technique of spleen transposition according to Bengmark in a group of six children. Two thirds of the spleen are removed and the rest is implanted into the abdominal wall. This causes development of subcutaneous portosystemic anastomosis. The method is a true alternative to portosystemic shunt operations.

[Surgical therapy of rectal cancer]. / Zur chirurgischen Therapie des Rektumkarzinoms.

Surgical excision of rectum carcinoma by amputation, resection or locally delimited excision has remained to be the optional curative approach to carcinoma of any position, severity, type and phase. Low-dose heparinisation, oral intestinal washing, and perioperative application of antibiotics have retained their established positions in the run-op to surgical action. The value of perioperative radiotherapy is still unelucidated. Chemotherapy has so far failed to produce a safe adjuvant effect. The age limit to curative intervention is continuously moved upwards. Resection is more often chosen than other approaches. Safely established knowledge is likely to suggest that the atumorous aboral safety zone may be reduced to 2 cm, provided that the perirectal lymphatic channels are severed at equal level. Anastomosis in cases of deeper anterior removal can often be sutured only by staplers. There is a growing number of situations in which the approach can be taken without preceding colostomy. Transanal and transsphincteral access routes are available for locally delimited tumour excision. Postoperative lethality has been continuously lowered and is now below five per cent. Reported in this paper are the authors' own results over the past decade.

[Value of the 14C-aminophenazone inhalation test: inhibition of the demethylation function of the liver by cimetidine]. / Zur Wertigkeit des 14C-Aminophenazon-Atemtests: Hemmung der Demethylierungsfunktion der Leber durch Cimetidin.

On 15 patients with healthy liver and with a peptic ulcer the demethylation capacity of the liver was measured with the 14C-aminophenazone breathing test before the treatment and during the treatment with the H2-antagonist cimetidine (daily dose 1.0 g). As measure of the demethylation capacity the breathed out 14CO2 (DPM/mmol CO2/70 kg body weight) before and 1 hour after intake was chosen. Under influence of cimetidine the mean 14CO2-value of 724.7 DPM (S.D. 127.7) decreased to 404.1 DPM (S. D. 153.1). The enzyme activities (ALAT, ASAT, AP, AAP, GGT, CHE) and the concentrations of serum bilirubin and serum albumin remained unchanged and did not correlate mutually and with the 14CO2-data. The results confirm the independence of the aminophenazone test as technique for the recognition of disturbance of the MFO-system.

[Diseases caused by sutures following stomach operations--yes or no?]. / Fadenkrankheit beim Zustand nach Magenoperation--ja oder nein?

The importance of remaining suture material in the operated stomach was studied on two groups of patients. Group I consisted of 560 patients who were found among about 6,000 gastroscopically examined patients. Group II consisted of 102 non-selected patients who underwent a gastric operation and in certain intervals were repeatedly examined gastroscopically and clinically after operation. The most frequent gastric operation was Billroth II, followed by Billroth I and the selective proximal vagotomy with pyloroplasty. Group I shows that the proof of suture material in the operated stomach depends on the postoperative time interval. During the first postoperative year the proof is most frequent with 48.5% and permanently decreases in the following years. After the 15th postoperative year no threads were found. Suture material could be more frequently proved in the Billroth I stomach (52.5%) than in the Billroth II stomach (21.7%). In group II in 56% of the patients suture material was found in the stomach. Also here the Billroth I stomach was at the top. The analysis of the complaints in patients with and without suture material resulted in the fact that remaining suture material is responsible for epigastric complaints and complications such as ulcer and haemorrhage. The notion of "thread disease" is justified. The frequency of the symptomatic thread disease during the first two years after operation is 30%. A plan of measures for the decrease of this complication is proposed which among others provides the use of absorbable suture material for all sutures at the stomach and demands the endoscopic removal of all rests of sutures.

[Intraluminal diverticulum of the duodenum]. / Das intraluminale Divertikel des Duodenums.

The intraluminal diverticulum of the duodenum is a rare disease. Up to now about 50 cases were described. The case in question is a saccate evagination of the duodenal mucous membrane near Vater's papilla. The diverticulum lies within the duodenal lumen and inside and outside it is coated by duodenal mucous membrane. The clinical symptomatology is unspecific. As a rule, the diagnosis is made roentgenologically by a gastrointestinal passage. In the present case the diverticulum contained gallstones and could be represented by an intravenous cholangiography. This was conditioned by the position of the papilla in the diverticulum.

[Dental care of prison inmates in Switzerland]. / Die zahnärztliche Versorgung von Strafanstaltsinsassen in der Schweiz

The dental status of inmates of 10 Swiss penitentiaries (capacity 50 to 245 persons) was investigated, and also organization and economic questions pertaining to dental treatment of penitentiary inmates. In all 10 institutions, the minimal claims of the UNO (1955) relative to dental treatment of penitentiary inmates are fulfilled. Nevertheless, there are significant differences between the 10 institutions. In some, practically only pain therapy is customary, while in others the whole spectrum of modern dentistry is used. Preventive measures are uniformly insufficient. Since the administering of punishment in Switzerland is cantonal, the differences in dental treatment will not be easy to eliminate.

[Complications and risks of abdominal diseases in old surgical patients (author's transl)]. / Komplikationen und Gefahren bei abdominalen chirurgischen Erkrankungen im Senium

732 patients older than 70 years suffering from abdominal diseases were studied regarding postoperative complications and mortality. The rate of complications in connection with surgical procedures corresponds to that of younger patients. But complication depending on organs and organ systems impaired by age and pre-existing diseases were found in higher percentage.

[Results of treatment of cholelithiasis and its consequences; the so called "postcholecystectomy-syndrome" (author's transl)]. / Behandlungsergebnisse des Gallensteinleidens und seiner Folgezustände unter dem besonderen Aspekt des sogenannten Postcholezystektomie-Syndroms

Our analysis of 378 patients made after operations for diseases of the gallbladder and bile tract underlines the demand of an exact preoperative diagnostic examination of other abdominal organs, e.g. the oesophagus, stomach, duodenum, liver and pancreas. The value of using modern intraoperative diagnostic procedures for the biliary tract is confirmed. Our analysis also demonstrates the necessity of traeting cholelithiasis surgically at an early stage. Complications of cholelithiasis include a higher risk, a worse prognosis with regard to permanent healing and a higher rate of postoperative lethality.