Perioperative Leitsymptome in der Allgemein- und Viszeralchirurgie Books

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PIPAC


PIPAC
  • Author : Marc A. Reymond
  • Publisher : Walter de Gruyter GmbH & Co KG
  • Release : 2014-10-14
  • ISBN : 9783110366617
  • Language : En, Es, Fr & De
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Peritoneal dissemination is a common route of cancer metastasis. The benefit of administering chemotherapy directly into the peritoneal cavity is supported by preclinical and pharmacokinetic data. In comparison to intravenous (IV) treatment, intraperitoneal (IP) administration results in a several-fold increase in drug concentration within the abdominal cavity. There is now growing evidence from clinical studies showing a survival advantage for IP chemotherapy in various tumor typies, including ovarian, gastric and colorectal cancer. However, while the use of IP chemotherapy is slowly gaining acceptance, it is not universal, largely due to the greater toxicity associated with this approach. Moreover, efficacy of IP chemotherapy is limited by poor distribution within the abdominal cavity and by poor tissue penetration. A new way of IP chemotherapy is the application of cytotoxics in form of a pressurized aerosol into the abdominal of thoracic cavity. Pressurized intraperitoneal aerosol chemotherapy (PIPAC) is applied through laparoscopic access using two balloon trocars in an operating room equipped with laminar air-flow. In a first step,a normothermic capnoperitoneum is established with a pressure of 12 mmHg. A cytotoxic solution (about 10% of a normal systemic dose) is nebulized with a micropump into the abdominal cavity, and maintained for 30 min. The aerosol is then removed through a closed suction system. Applying an aerosol in the peritoneal cavity allows a homogeneous distribution of the chemotherapeutic agent within the abdomen. Furthermore, an artificial pressure gradient is generated that overcomes tumoral interstitial fluid pressure, an obstacle in cancer therapy. This results in a higher local drug concentration compared to conventional IP or IV chemotherapy. At the same time the plasma concentration of the chemotherapeutic agent remains low. In first clinical studies with limited number of patients in ovarian, gastric and colorectal cancer, as well as peritoneal mesothelioma, PIPAC has obtained encouraging tumor response rates and survival, with a low-side effects profile. Larger clinical trials are currently ongoing to examine if these data can be reproduced and extrapolated to other situations.

Anal Fissure


Anal Fissure
  • Author : Volker Wienert
  • Publisher : Springer
  • Release : 2017-03-29
  • ISBN : 9783319492445
  • Language : En, Es, Fr & De
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This highly informative monograph offers a comprehensive and interdisciplinary reference guide for the management and treatment of the whole spectrum of painful tears in the anus and anal canal. Based upon a systematic review of all relevant papers on the topic since 1865, it addresses primary, acute and chronic anal fissures – providing a new definition of the last form – and secondary anal fissures in detail, particularly their medical history, etiology, signs and symptoms, medical findings, therapy and its evaluation, and differential diagnosis. The book also covers all available evidence-based therapeutic strategies. As such, it will appeal to a wide readership, from proctologists and surgeons to gynecologists, urologists, dermatologists and gastroenterologists.

Mitochondrial Medicine


Mitochondrial Medicine
  • Author : Anna Gvozdjáková
  • Publisher : Springer Science & Business Media
  • Release : 2008-02-01
  • ISBN : 1402067143
  • Language : En, Es, Fr & De
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Mitochondrial medicine deals with diseases that are related to mitochondrial dysfunction due to a number of causes from free radical damage to genetic mutation. This book is based on extensive data gathered over 30 years of clinical and experimental research. In it, internationally recognized authors share their experience in various fields of their expertise and guide readers through the disease process, from basic biochemical mechanisms to diagnosis to therapeutic aspects.

Peritoneal Surface Malignancies


Peritoneal Surface Malignancies
  • Author : Emel Canbay
  • Publisher : Springer
  • Release : 2015-07-09
  • ISBN : 9783319129372
  • Language : En, Es, Fr & De
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This book has been designed to provide the full description of the comprehensive management of peritoneal surface malignancies as a new emerging specialty. Combined treatment of cytoreductive surgery (CRS) and hyperthermic intraoperative intraperitoneal chemotherapy (HIPEC) introduced by our leader Paul H. Sugarbaker are performed to treat peritoneal metastases by surgeons all around the world. Therefore this book is focused on detailed surgical anatomy of the peritoneum, preoperative clinical assessment of the peritoneal surface malignancy, patient preparation and operation room equipments, different surgical procedures for CRS and reconstruction, intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) and neoadjuvant intraperitoneal chemotherapy, early postoperative intraperitoneal chemotherapy (EPIC) and molecular basis of peritoneal surface malignancies. The chapter on molecular mechanisms of the formation of peritoneal carcinomatosis provides insight into a rapidly expanding knowledge within this speciality. This book should be valuable for surgical oncologists who deal with multimodal treatment for peritoneal surface malignancies, as well as for the trained peritonectomy surgeons. For the senior surgeons, it will also introduce new techniques and approaches in this field such as dealing with the omental cakes and massive organ involvement that requires multi-organ resection.

Atlas of General Surgery


Atlas of General Surgery
  • Author : Volker Schumpelick
  • Publisher : Thieme
  • Release : 2011-01-01
  • ISBN : 9783131496812
  • Language : En, Es, Fr & De
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The Atlas of General Surgery is a highly practical, how-to reference for the most frequently performed operations. The book opens with a section on general aspects of surgery, such as the application of sutures, drains, catheters, venous ports, and punctures. The main section demonstrates the operations in step-by-step format, covering the anatomic regions including the skin and soft tissues, the neck, the thoracic wall and cavity, the abdominal cavity, the retroperitoneum, and the external genital organs. The author also covers surgery for hernias, colorectal surgery, pediatric surgery, vascular surgery, amputations, and trauma surgery. For precise and quick orientation, each surgical chapter presents a brief introduction to surgical preparation, anesthesia, positioning, relevant anatomy, risks, complications, and postoperative care, and then illustrates the operative technique through excellent drawings and detailed legends. Key features: Covers all common surgeries any general surgeon needs to know Step-by-step guide to each operative procedure More than 1,200 high-quality drawings demonstrate surgical anatomy and technique, with each illustration showing one operative step Didactic page layout allows for easy comprehension of the material Practical tips, tricks, and pitfalls highlight crucial information Ideal for all surgeons in training the Atlas of General Surgery is a handy, one-volume text that provides an overview of this broad field. It also serves as a valuable reference for the bookshelf of practicing surgeons who would like to consult a rapid review before surgery.