[Radiological follow-up of anastomotic insufficiency following partial esophageal resections or gastrectomies. The effects of barium-containing contrast media]. / Radiologische Kontrolle von Anastomoseninsuffizienzen nach Osophagusteilresektionen oder Gastrektomien. Effekte bariumhaltiger Kontrastmittel.

Fistulae after abdomino-thoracic operations are usually treated conservatively because of the high complication rate of repeated surgery. If the anastomoses function adequately, healing usually occurs spontaneously after four to six weeks. Amongst 271 patients with intrathoracic oesophago-gastric or oesophago-jejunal anastomoses, entero-cutaneous fistulae occurred 29 times. Extension of the fistula into the pleura or peritoneum was first excluded by using an absorbable contrast medium and then a barium contrast examination was carried out. Thoracic fistulae closed, on average, after 21.8 days and fistulae in the upper abdomen after 20.3 days. Barium sulphate stimulates granulation tissue in the fistula and therefore leads to more rapid obliteration. This improves the quality of the patient's life and reduced the time the patient has to spend in hospital. There were no local or systematic complications.

[Polyglycolic acid mesh in surgery of the liver and spleen]. / Polyglycolsäure-Netze in der Chirurgie der Leber und der Milz.

Since 1987 absorbable PGA-mesh (Dexon) has been used as a pad for mattress sutures and as remaining tamponade in surgery of the liver and spleen. In 25 cases atypical resections of liver tumors have been performed using PGA-mesh to secure mattress sutures. Blood loss was below 500 cm3 in all cases, operating time was decreased and no infection was seen. Six times this technique was also used in cases with splenic trauma. In all patients the organ could be preserved. In 10 patients with severe trauma of the liver PGA-mesh was successfully used as a remaining tamponade. Also in these cases no infection occurred although 50 mesh had been implanted in one case.

[10 years experiences used resorbable synthetic mesh in treatment of rectal prolapse]. / Zehn Jahre Erfahrungen mit der Verwendung von resorbierbaren Kunststoffnetzen in der Behandlung des Rektumprolapses.

Rectopexy is the most widespread method in the treatment of rectal prolapse. In the Department of Surgery of the University Hospital Münster and the Josephs-Hospital Warendorf in 102 cases absorbable mesh was used for the fixation of the mobilized rectum. The role of lethality and infection was 0%. The rate of recurrence was 4.9%, as low as it can be achieved with non-absorbable material.

[Reversible fixation of the small intestine for minimizing radiation damage with polyglycolic acid mesh--initial experiences]. / Die reversible Dünndarmhochnähung zur Minimierung des Strahlenschadens mittels Polyglycolsäure-Netzen--erste Erfahrungen.

In ten patients with tumors of the small pelvis the bowel was fixed to the upper abdomen by use of Polyglycolic acid mesh (Dexon) to minimize radiation associated small bowel injury. In one case formation of abscess was seen ducto suture dehiscence of the rectal stump which could successfully be handled by lavage. No severe disturbance of bowel motility was seen. By sonographic and barium controls it could demonstrated that it was possible to keep the small intestine above the radiation fields as long as it was necessary for radiation treatment. After 3-4 months it could be demonstrated that the small bowel had descended into the pelvis again.

[Can resorbable suture material be used in surgery of the supra-aortic branches?]. / Ist resorbierbares Nahtmaterial einsetzbar in der Chirurgie der supraaortalen Aste?

The experience with the use of monofilament absorbable suture (5/0 USP) in supraaortal vessels shows the same results related to neurological complication. The postoperative technical complications (bleeding, occlusion, restenosis) could be significantly reduced (p less than or equal to 0.05). Suture ruptures of aneurysms were not observed after resorbable vascular suture. The resorbable monofilament suture material is useful in high pressure vessel system.

[Effects of roentgen contrast media containing barium sulfate on enterocutaneous fistulas]. / Effekte bariumsulfathaltiger Röntgenkontrastmittel auf enterokutane Fisteln.

Fistulation in the wake of thoracic and epigastric interventions are conservatively treated, as a rule, because of the high rate of complications expected from reoperation. With properly functioning anastomotic transit, insufficiencies usually undergo spontaneous healing, within four to six weeks. Enterocutaneous fistulae developed in 29 of 271 patients with intrathoracic oesophagogastric or oesophagojejunal anastomosis. Syringeal ramification into pleural or abdominal cavities were ruled out by means of an absorbable contrast medium, before barium sulphate was orally administered to all patients. Thoracic fistulae were closed after 21.8 days on average, while 20.3 days was the average period required for closure of epigastric fistulae. Barium sulphate was found to exercise stimulating effects on fistular tissue granulation, so that obliteration of the fistular system occurred much sooner, as compared to conservative treatment. The patient's quality of life can thus be improved, and hospitalisation can be shortened. Neither locally delimited nor systemic complications were observed in any of the cases described.