[Psychiatric interventions for the unemployed]. / Psychiatrische Interventionen für Arbeitslose.

Unemployment is related to a higher risk for psychological distress and mental disorders, which cause individual suffering and socioeconomic costs for society in general. This selective review surveys the relationship between unemployment and psychological well-being and mental disorders. The most important programs for the improvement of the mental health of the unemployed are summarized: 1. Interventions for the unemployed with the aim of improving coping strategies reduce the risk of developing depressive symptoms. 2. The SUPPORT liaison outpatient unit collaborates closely with the unemployment agency and offers a low-threshold screening for mental disorders for unemployed subjects as well as counseling for those in need of treatment. 3. A group training based on cognitive behavioral therapy improves the psychological well-being of unemployed participants. 4. Supported employment is an effective means of placing severely mentally ill patients in a work-place accompanied by an extensive professional support.

[Laparoscopic colorectal resections: indications, surgical technique and outcome in 410 prospective cases]. / Laparoskopische kolorektale Resektionen: Indikation, Operationstaktik und Ergebnisse bei 410 prospektiv untersuchten Fällen.

UNLABELLED: From April 1993 to August 1997 410 patients underwent laparoscopic surgery for colon and rectal diseases. In the beginning we only operated on patients with benign disorders. Since July 1995 colorectal malignancies have also been resected. A total of 181 patients (47.6%) with benign colorectal diseases were operated on; 116 patients (31%) had diverticulosis, diverticulitis or benign tumor; 26 with rectal prolapse were resected in MIS-technique. In all, 199 patients were treated for colorectal malignancies, 171 (85.9%) with curative intention. RESULTS: Mean operation time was between 60 and 520 min. After 40 operations the learning curve had reduced the operation time significantly. Severe complications appeared in 4.7% of all cases.

[Laparoscopic rectum resection with truncal ligation of the inferior mesenteric artery and mesorectal excision]. / Laparoskopische Rektumresektion mit trunkulärer Ligatur der Arteria mesenterica inferior und mesorektaler Exzision.

Laparoscopic techniques in surgical treatment of colorectal cancer are performed present in prospective trials. Operation times are clearly decreasing with growing surgical experience and oncological criteria concerning resection margins and lymphatic dissection are comparable with open surgery. Indications for laparoscopic rectal resections are the endoscopic non removable adenoma and cancer of the upper and lower rectum endosonographic up to maximum uT3-stage. All laparoscopic resections are performed under conventional oncological criteria: after exploration of the abdominal cavity and laparoscopic ultrasound of the liver we perform the ligature of the inferior mesenteric vein and artery. Dissection and resection of the mesorectum is done by the Harmonic Scalpel. The rectum is taken out by mini laparotomy and anastomosis is done by transanal stapler.

[Laparoscopic colorectal surgery in routine at a municipal hospital]. / Laparoskopische Kolonchirurgie in der Routine eines Stadtkrankenhauses.

UNLABELLED: The importance of laparoscopic techniques in colorectal surgery as routine service in a municipal hospital is described in a prospective study. PATIENTS AND METHOD: From April 1993 to March 1997 359 patients were operated laparoscopically for colon and rectum diseases in the surgical department of the municipal hospital Zehlendorf Berlin, local area Behring. In the beginning we operated only patients with benign disorders. Since July 1995 patients with colorectal malignancies were resected on the basis of oncological criteria within a multicenter prospective trial. 149 patients (41.5%) were operated for benign colorectal diseases. 93 patients (25.9%) had diverticulosis, diverticulitis or benign tumors. 26 were resected in MIS-technique for rectum prolapse. 180 patients presented with colorectal malignancies and were operated in 153 cases (42.9%) with curative intention. RESULTS: Mean operation time was between 60 and 520 min. Learning curve reduces after 40 operations operation time significantly. Severe complications appeared in 4.5% of all cases.

[Laparoscopic appendectomy as standard procedure. Technique and outcome in 409 patients]. / Die laparoskopische Appendektomie als Standardverfahren. Technik und Ergebnisse bei 409 Patienten.

UNLABELLED: In the framework of a prospective clinical trial we wanted to show that minimal access surgery as a standard treatment of acute appendicitis leads to good results. PATIENTS AND METHOD: From January 1993 to December 1996 409 patients had a laparoscopic appendectomy in the Surgical Department of Krankenhaus Zehlendorf, Berlin. We treated 252 female (62%) and 157 male (38%). The mean age was 31.5 years (min. 8 years, max. 81 years) The conversion rate was 8% (33 patients). Reasons for conversion were perforation or difficult anatomical conditions. In 189 patients we found additional diagnosis as adhesions, gynecological diseases or chronic inflammatory bowel diseases. RESULTS: The clinical diagnosis sensitivity histological correlated was 83%. The mean operating time was 46 minutes (min. 10, max. 120 minutes). The basis of appendix was routinely carried by loop of catgut in 342 cases. In 23 cases was used the Endo-GIA. Severe postoperative complications were seen in 2%. In 1.3% planned second-look laparoscopy with drainage was performed. The patients stayed in hospital for 5 days in median (min. 1 day, max. 21 days). The rate of wound infections was decreased specially in fat patients.