Surgery For Conditions Research Articles

Endoskopisches Clipping zur Behandlung einer komplikationsbehafteten Nahtinsuffizienz nach Divertikulotomie eines epiphrenischen Ösophagusdivertikels

BACKGROUND: Diverticula of the lower esophagus are a rare, but severe entity. 25-50 % of all patients have to be treated by surgery. Iatrogenic perforation is a major and life threatening postoperative complication. However, there is no consensus as to the best management - surgical, conservative or interventional. CASE REPORT: A 50-year-old patient underwent transabdominal diverticulotomy of an epiphrenic diverticulum. The postoperative course was complicated by an anastomotic insufficieny with mediastinitis and pleuritis. As to the critical condition surgery was no viable option. Thus, the leakage was sealed endoscopically by nine clips placed in two sessions. Afterwards the patient improved rapidly by combined external drainage, endoscopic lavage and conservative treatment. CONCLUSION: So far, reports about endoscopic treatment of iatrogenic esophageal perforations concentrated on placement of self-expandable, covered stents. This ist the first report on a positive outcome after endoscopic clipping of the leak. Endoscopic clipping, combined with conservative treatment, can be a promissing option for these critical patients.

Use of P300 Cognitive Evoked Potentials in the Diagnosis of Impairments of Higher Mental Functions after Cardiac Surgery in Conditions of Cardiopulmonary Bypass

A total of 40 patients with ischemic heart disease undergoing aortocoronary shunting surgery in conditions of cardiopulmonary bypass were studied. Parameters of the P300 cognitive evoked potentials were studied before surgery and 7-9 days after surgery. Neurological and neuropsychological assessments were also performed. The most significant parameters of the P300 potential were found to be the latencies of the P3 and N2 components, increases in which showed positive correlations with the extent of the developing cognitive deficit. Evidence supporting the neuroprotective effects of Trasylol given during surgery was obtained. Patients given Trasylol showed less marked cognitive deficit and smaller changes in P300 parameters. Analysis of the P300 cognitive evoked potential can be recommended for detecting early cognitive dysfunction and assessing the efficacy of neuroprotective therapy in patients undergoing surgery with cardiopulmonary bypass.

More on Radiosurgery for Acoustic Neuroma and Trigeminal Neuralgia

Gamma-knife radiosurgery is an increasingly popular alternative to conventional surgery for conditions such as acoustic neuroma and trigeminal

The Organization of Micro and Reconstructive Surgery in Conditions of War—The Chechen Experience

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Surgery for Conditions Causing Decreased Fertility in Mares: Case Selection

Many factors should be considered before one makes a decision to perform surgery, and it is the practitioner's responsibility to make certain the client makes an informed decision. This article considers the various factors of importance in the decision-making process.