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  1. Article: Feasibility of laparoscopic resection for perforated diverticulitis: a retrospective observational study of 77 consecutive patients.

    Paasch, Christoph / De Santo, Gianluca / Berndt, Nadja / Strik, Martin W / Lefering, Rolf / Siegel, Robert

    Acta chirurgica Belgica

    2022  Volume 123, Issue 6, Page(s) 632–639

    Abstract: Background: Perforated colonic diverticulitis with purulent or fecal contamination (PCD) is a surgical emergency with high morbidity and mortality. Traditionally, open surgery as a Hartmann procedure (HP) has been performed. Feasibility of the ... ...

    Abstract Background: Perforated colonic diverticulitis with purulent or fecal contamination (PCD) is a surgical emergency with high morbidity and mortality. Traditionally, open surgery as a Hartmann procedure (HP) has been performed. Feasibility of the laparoscopic approach (LA) either with primary anastomosis (PA) or as an HP has been shown, but evidence and implementation into daily routine remain low. We analysed all patients with PCD and emergency surgery at our institution to compare post-operative outcomes between LA and open surgery. Our results should add more evidence about the potential benefit of LA in treating PCD.
    Methods: This retrospective analysis conducted at a tertiary care centre in Germany included all patients with PCD undergoing emergency surgery between June 2007 and February 2019. Mortality and postoperative morbidity according to Clavien-Dindo-Classification are the primary endpoints. Secondary endpoints were stoma-free survival and length of hospital stay.
    Results: Seventy-seven patients were identified (41 female/36 male; median age 67.9 years). Sixty patients underwent a LA (conversion in 9 of 60, 15%). PA has been performed in 25 of 77 patients (22 LA, 3 with open surgery). Severe complications and death (Clavien-Dindo-Classification grade IIIb-V) were lower in patients with LA (17/60, 28%) compared to open surgery (9/17, 53%;
    Conclusion: The LA is feasible in the majority of patients with PCD and may be warranted as a routine in emergency surgery. Although limited by a selection bias of this retrospective study, the LA seems to reduce morbidity and LOS.
    MeSH term(s) Humans ; Male ; Female ; Aged ; Retrospective Studies ; Feasibility Studies ; Intestinal Perforation/etiology ; Diverticulitis/complications ; Diverticulitis/surgery ; Diverticulitis, Colonic/complications ; Diverticulitis, Colonic/surgery ; Laparoscopy/methods ; Treatment Outcome
    Language English
    Publishing date 2022-09-13
    Publishing country England
    Document type Observational Study ; Journal Article
    ZDB-ID 210274-2
    ISSN 0001-5458
    ISSN 0001-5458
    DOI 10.1080/00015458.2022.2122006
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Mesenchymal chondrosarcoma metastasising to the pancreas.

    Paasch, Christoph / De Santo, Gianluca / Boettge, Katherina Renate / Strik, Martin W

    BMJ case reports

    2018  Volume 11, Issue 1

    Abstract: The mesenchymal chondrosarcoma (MC) is a rare malignant tumour and accounts for less than 3% of primary chondrosarcomas. Mostly MC arises from the craniofacial bones, the ribs, the ilium, the femur and the vertebrae. A 54-year-old man was treated due to ... ...

    Abstract The mesenchymal chondrosarcoma (MC) is a rare malignant tumour and accounts for less than 3% of primary chondrosarcomas. Mostly MC arises from the craniofacial bones, the ribs, the ilium, the femur and the vertebrae. A 54-year-old man was treated due to an icterus of unknown origin. The medical history of the patient consists of a multimodal treated MC of the thoracic vertebrae. A CT imaging identified a 2×4 cm sized mass of the pancreatic head. Suspecting a pancreatic head carcinoma surgical removal was performed. Histopathological a metastasis of MC was diagnosed. Our patient left the hospital after 17 days and died 23 month after surgery. Metastases of MC to the pancreas are rare. When detecting a mass of the pancreas in patients with a medical history of an MC, a metastasis of these tumour should be taken in consideration.
    MeSH term(s) Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Bone Neoplasms/diagnostic imaging ; Bone Neoplasms/secondary ; Chemotherapy, Adjuvant ; Cholangiopancreatography, Endoscopic Retrograde ; Chondrosarcoma, Mesenchymal/complications ; Chondrosarcoma, Mesenchymal/diagnostic imaging ; Chondrosarcoma, Mesenchymal/secondary ; Chondrosarcoma, Mesenchymal/therapy ; Common Bile Duct ; Epirubicin/administration & dosage ; Humans ; Ifosfamide/administration & dosage ; Ilium/diagnostic imaging ; Jaundice, Obstructive/etiology ; Laminectomy ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Palliative Care ; Pancreatic Neoplasms/complications ; Pancreatic Neoplasms/diagnostic imaging ; Pancreatic Neoplasms/drug therapy ; Pancreatic Neoplasms/secondary ; Radiotherapy, Adjuvant ; Ribs/diagnostic imaging ; Sacrum/diagnostic imaging ; Spinal Fusion ; Spinal Neoplasms/diagnostic imaging ; Spinal Neoplasms/pathology ; Spinal Neoplasms/therapy ; Thoracic Vertebrae/diagnostic imaging ; Tomography, X-Ray Computed
    Chemical Substances Epirubicin (3Z8479ZZ5X) ; Ifosfamide (UM20QQM95Y)
    Language English
    Publishing date 2018-12-31
    Publishing country England
    Document type Case Reports ; Journal Article
    ISSN 1757-790X
    ISSN (online) 1757-790X
    DOI 10.1136/bcr-2018-226369
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Vermeidung von Clustering und Urge bei der chirurgischen transanalen Therapie der distalen tiefen Rektozele.

    Benecke, Claudia / de Santo, Gianluca / Strik, Martin / Keck, Tobias / Zimmermann, Markus

    Zentralblatt fur Chirurgie

    2019  Volume 144, Issue 4, Page(s) 402–407

    Abstract: Discrimination between functional and morphological influences in obstructive defecation syndrome is challenging. The predictability of surgical success is still in discussion. Final understanding of the rectally induced variability in colonic motility ... ...

    Title translation Avoiding Clustering and Urge in Transanal Surgery for Deep Distal Rectocele.
    Abstract Discrimination between functional and morphological influences in obstructive defecation syndrome is challenging. The predictability of surgical success is still in discussion. Final understanding of the rectally induced variability in colonic motility is still missing, so that morphological changes cannot solely serve as indication. Finally the physiology of the enteric nervous system has to be taken into account in choosing an approach. A modified Sullivan procedure was tested in the treatment of distal deep rectocele with respect to short- and long-term results for complications, obstructive symptoms and explicitly with regard to urge and clustering complaints. Between January 2009 and January 2014, 35 women complaining of obstructive symptoms with distal deep rectocele were operated on in a modified Sullivan technique. There were no intraoperative nor early postoperative complications; 4 weeks postoperatively no urge or clustering was discovered. In a long-term questionnaire, more than 80% of the patients were satisfied with the procedure; the mean obstructive defecations score was lowered by 9 points.
    MeSH term(s) Constipation ; Defecation ; Female ; Humans ; Postoperative Complications ; Rectocele ; Surgical Stapling ; Treatment Outcome
    Language German
    Publishing date 2019-08-14
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 200935-3
    ISSN 1438-9592 ; 0044-409X
    ISSN (online) 1438-9592
    ISSN 0044-409X
    DOI 10.1055/a-0961-8025
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Laparoscopic Treatment of an Incarcerated Meckel's Diverticulum in a Femoral Hernia.

    Paasch, Christoph / De Santo, Gianluca / Look, Peter / Boettge, Katherina / Hünerbein, Michael

    Case reports in surgery

    2019  Volume 2019, Page(s) 3140706

    Abstract: Meckel's diverticulum (MD) is the persistence of the omphalomesenteric duct. It is usually asymptomatic but may present with bleeding, infections, and intestinal obstruction. It also may be a content of a hernia sac, a so-called Littre hernia. Herein, we ...

    Abstract Meckel's diverticulum (MD) is the persistence of the omphalomesenteric duct. It is usually asymptomatic but may present with bleeding, infections, and intestinal obstruction. It also may be a content of a hernia sac, a so-called Littre hernia. Herein, we will present the case of a 75-year-old female, who suffered from a painful swelling of the right inguinal region. Ultrasound imaging detected an inguinal hernia with incarcerated blind ending small bowel. Immediately, a laparoscopy was conducted. We diagnosed a right femoral hernia with an incarcerated MD. A TAPP (transabdominal preperitoneal) procedure was performed and the MD tangential stapled. Due to an uneventful postoperative course, the patient left the hospital after two days. An incarceration of a MD in a femoral hernia is rare. Tangential resection of the MD with simultaneous hernia repair in a TAPP technique seems to be a sufficient approach, when it is conducted by an experienced surgeon.
    Keywords covid19
    Language English
    Publishing date 2019-08-08
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2657697-1
    ISSN 2090-6919 ; 2090-6900
    ISSN (online) 2090-6919
    ISSN 2090-6900
    DOI 10.1155/2019/3140706
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: The transversus abdominis plane block may reduce chronic postoperative pain one year after TAPP ingunial hernia repair.

    Paasch, Christoph / Fiebelkorn, Jennifer / De Santo, Gianluca / Azarhoush, Sascha / Boettge, Katherina / Anders, Stefan / Gauger, Ulrich / Strik, Martin

    Annals of medicine and surgery (2012)

    2020  Volume 55, Page(s) 190–194

    Abstract: Introduction: Chronic postoperative inguinal pain (CPIP) is defined as pain impacting daily activities lasting at least 3 months. With an incidence of 0.5-6.0%, chronic pain affects many patients who underwent inguinal hernia repair (IHR). Early severe ... ...

    Abstract Introduction: Chronic postoperative inguinal pain (CPIP) is defined as pain impacting daily activities lasting at least 3 months. With an incidence of 0.5-6.0%, chronic pain affects many patients who underwent inguinal hernia repair (IHR). Early severe postoperative pain has been described as a risk factor for CPIP. Thus, we aim to investigate the impact of the transversus abdominis plane (TAP) block on CPIP.
    Methods: From 2013 to 2019 we collected data from individuals who were operated on electively in TAPP technique and who received a preoperative TAP block.
    Results: Data from 289 patients were selected. 259 patients were male. The mean age was 59.93 years and the mean BMI was 25.72 kg/m2. 252 patients suffered from a primary inguinal hernia. No mesh fixation was conducted. 21 patients reported pain at rest, 26 pain under physical exertion and 13 patients required treatment of their pain. In 6.25% of cases patients reported CPIP. We compared our findings with data from the German Herniamed Registry (unilateral, primary IH, men, no mesh fixation; n = 8.799), because we assume that the majority of these patients did not receive a TAP block. The rate of pain under physical exertion (9.2% vs. 10.05%) and pain requiring treatment (2.45% vs. 2.95%) one year after surgery slightly differs without a statistical significance.
    Conclusions: We assume that the TAP block may reduce CPIP, postoperative pain during physical exertion and pain requiring treatment following IHR in TAPP technique. Additional randomized clinical trials are mandatory to evaluate the hypothesis.
    Language English
    Publishing date 2020-05-23
    Publishing country England
    Document type Journal Article
    ZDB-ID 2745440-X
    ISSN 2049-0801
    ISSN 2049-0801
    DOI 10.1016/j.amsu.2020.04.011
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: Patient reported outcome following incisional hernia repair: A survey on 163 patients at two maximum care hospitals.

    Paasch, Christoph / Lorenz, Eric / Anders, Stefan / De Santo, Gianluca / Boettge, Katherina / Gauger, Ulrich / Croner, Roland / Strik, Martin W

    Annals of medicine and surgery (2012)

    2019  Volume 44, Page(s) 5–12

    Abstract: Introduction: Incisional hernias of the abdominal wall are frequent complications after laparotomy (9-20%) and often need incisional hernia repair (IHR). In order to ensure wound healing and to therefore prevent postoperative short and long term ... ...

    Abstract Introduction: Incisional hernias of the abdominal wall are frequent complications after laparotomy (9-20%) and often need incisional hernia repair (IHR). In order to ensure wound healing and to therefore prevent postoperative short and long term morbidity carrying an abdominal binder (AB) and physical rest is frequently advised. However, there is a lack of evidence concerning clinical effects regarding these recommendations. Hence, we conducted a survey to analyze the patient reported outcome following IHR.
    Methods: From December 2017 to May 2018, we conducted a survey among 270 patients who underwent open and laparoscopic IHR at two maximum care hospitals. They were interviewed about their type of operation, postoperative treatment, recommendations, and outcome.
    Results: 163 patients replied to the questionnaire. The average age was 63.2 ± 12 years. 74 patients were female and 89 were male. 32.6% of the patients reported an AB-induced immobility and 71.2% reported that the AB reduced pain after IHR. A prolonged period of physical rest and the use of an AB had no statistical significance on postoperative morbidity.
    Conclusions: Due to our findings we assume that the AB may induce immobility and reduce postoperative pain. A prolonged period of physical rest and wearing an AB does not seem to have an impact on the postoperative outcome following IHR. Therefore, a shortened duration of physical rest and wearing an AB following IHR should be taken under consideration. To reveal more evidence on this topic further clinical trials are essential.
    Language English
    Publishing date 2019-06-15
    Publishing country England
    Document type Journal Article
    ZDB-ID 2745440-X
    ISSN 2049-0801
    ISSN 2049-0801
    DOI 10.1016/j.amsu.2019.06.005
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article: Vermeidung von Clustering und Urge bei der chirurgischen transanalen Therapie der distalen tiefen Rektozele

    Benecke, Claudia / de Santo, Gianluca / Strik, Martin / Keck, Tobias / Zimmermann, Markus

    Zentralblatt für Chirurgie - Zeitschrift für Allgemeine, Viszeral-, Thorax- und Gefäßchirurgie

    2019  Volume 144, Issue 04, Page(s) 402–407

    Abstract: Die Behandlung obstruktiver Beschwerden des Anorektums stellt eine Herausforderung dar. Die Vorhersagewahrscheinlichkeit eines Erfolges chirurgischer Maßnahmen ist weiterhin unsicher. Aufgrund der aus dem tiefen Rektum intramural vermittelten ... ...

    Abstract Die Behandlung obstruktiver Beschwerden des Anorektums stellt eine Herausforderung dar. Die Vorhersagewahrscheinlichkeit eines Erfolges chirurgischer Maßnahmen ist weiterhin unsicher. Aufgrund der aus dem tiefen Rektum intramural vermittelten Rückmeldesignale und konsekutiver Motilitätsmodulation des Kolorektums können morphologische Veränderungen nicht allein zur Indikationsstellung herangezogen werden. Andererseits gilt es, die Physiologie des enterischen Nervensystems in die Indikationsstellung und Verfahrenswahl mit einzubeziehen. Rektozelen können ein morphologisches Korrelat für eine Outlet-Obstruktion darstellen. Es kann hier nach der Höhenlokalisation in hohe, mittlere und distale Formen unterteilt werden, deren Erscheinungsbild sich in den oberen Dritteln eher flächig darstellt, deren Genese eng mit der Anzahl der Geburten korreliert und die Evaluation der Levatorenschenkeldistanz erforderlich macht. Die distalen tiefen verhaltbildenden Formen finden sich auch bei Nulliparae und haben ihre Ursache in einem transversen Querriss direkt oberhalb der Verankerung des Septums am Perineum. Bei diesen Patientinnen mit ventraler distaler Ventilrektozele überprüften wir die Ergebnisse der Versorgung mittels interner Vollwandraffung und Mukosaresektion im Hinblick auf die Kurz- und Langzeitergebnisse, Komplikationen, ODS-Symptomatik und insbesondere mit der Frage nach der Entstehung von De-novo-Urge oder Clustering. Im Zeitraum zwischen Januar 2009 und Januar 2014 erfolgten 35 Eingriffe bei distalen tiefen symptomatischen ventralen Rektozelen in modifizierter Technik nach Sullivan. Es fanden sich keine intraoperativen oder frühpostoperativen Komplikationen, in den Kontrollen nach 2 Wochen keine Nahtdehiszenzen oder Blutungen, 4 Wochen postoperativ keine Urge-Symptomatik, kein Clustering. In einer Langzeitbefragung (2 – 7 Jahre) postoperativ gaben über 80% an, ihr Operationsergebnis subjektiv dauerhaft positiv zu bewerten. Der mittlere obstruktive Defäkations-Score (ODS) nach Altomare et al. wurde um 9 Punkte reduziert.
    Keywords Rektozele ; ODS ; Sullivan ; Langzeitergebnisse ; rectocele ; ODS ; Sullivan ; long-term outcome
    Language German
    Publishing date 2019-08-01
    Publisher Georg Thieme Verlag KG
    Publishing place Stuttgart ; New York
    Document type Article
    ZDB-ID 200935-3
    ISSN 1438-9592 ; 0044-409X
    ISSN (online) 1438-9592
    ISSN 0044-409X
    DOI 10.1055/a-0961-8025
    Database Thieme publisher's database

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