While a surgeon many decades agotreated diseases from headtotoe, this concept has evolved, and today some degree of specialization is the rule worldwide. In many countries various boards for sub-specializations are designed, and after a broad training in general surgery, many young surgeons move on further into a specific field. Knowledge of anatomy and precise surgical technique remain the foundation of high quality surgery. A knowledgeable surgeon, equipped with excellent theore- cal and clinical skills, will only be accomplished when he or she masters the - erative techniques of the practice of surgery. The legacy of an academic surgeon or a surgical teacher relies in great part onthe transmission of his or her surgical abilities. Significant influence on the development in esophageal surgery arises from the surgical understanding of the anatomical and functional structures of the esophagus as well as the ongoing developments in the multidisciplinary m- agement in this challenging field of surgery. In bringing forth this atlas, we were motivated by the desire to create a comp- hensive and educational atlas on esophageal diseases, emphasizing all details of pathophysiologies, diagnostic strategies, pre- and postoperative management, and operative techniques covering minimally invasive and open procedures ranging fromstraightforward tomore complex procedures.

While a surgeon many decades agotreated diseases from headtotoe, this concept has evolved, and today some degree of specialization is the rule worldwide. In many countries various boards for sub-specializations are designed, and after a broad training in general surgery, many young surgeons move on further into a specific field. Knowledge of anatomy and precise surgical technique remain the foundation of high quality surgery. A knowledgeable surgeon, equipped with excellent theore- cal and clinical skills, will only be accomplished when he or she masters the - erative techniques of the practice of surgery. The legacy of an academic surgeon or a surgical teacher relies in great part onthe transmission of his or her surgical abilities. Significant influence on the development in esophageal surgery arises from the surgical understanding of the anatomical and functional structures of the esophagus as well as the ongoing developments in the multidisciplinary m- agement in this challenging field of surgery. In bringing forth this atlas, we were motivated by the desire to create a comp- hensive and educational atlas on esophageal diseases, emphasizing all details of pathophysiologies, diagnostic strategies, pre- and postoperative management, and operative techniques covering minimally invasive and open procedures ranging fromstraightforward tomore complex procedures.

Kaurn ein Organ ist in den letzten Jahren so in den Blickpunkt des Interesses geriickt wie die Milz. Das Postulat der Postsplenektorniesepsis nach traurnatisch bedingter Splenektornie ftihrte zur Forderung nach Erhaltung der Milz. Von rnanchen Autoren wurde die Unterlassung der Milzerhaltung gar als Kunstfehler erachtet. Die kritische Durchsicht der Literatur gibt jedoch wenig Anhalte fUr ein reales Risiko einer Sepsis nach posttraurnatischer Splenektornie, zurnindest beim Erwachsenen, wahrend irn Kindesalter offenbar eine echte GeHihrdung vorliegt. Dies IaBt die Notwen- digkeit einer Milzerhaltung urn jeden Preis zweifelhaft erscheinen. Auf der anderen Seite stehen tierexperimentelle Befunde an Nagem, die fast ausnahmslos eine Existenz der Post- splenektorniesepsis unter Beweis stell ten. Experimentelle Befunde an Nagem sind nicht ohne weiteres auf den Menschen iiber- tragbar. Es wurde in der vorliegenden Untersuchung daher versucht, das Problernfeld der Postsplenektorniesepsis an einern GroBtier, dessen Irnrnunsystern dern Menschen eher ver- gleichbar ist, zu analysieren. Daneben wurde untersucht, ob eine effektive Prophylaxe einer Sepsis durch Aktivierung des Monozyten-Makrophagen-Systerns gewahrleistet ist Die hier vorliegende Monographie faBt die irnrnunologischen und infektionsexperirnen- tellen Befunde zusamrnen. J. R. IZBICKI Danksagung Meinem hochverehrten Lehrer Herm Prof. Dr. med. L. Schweiberer, Direktor der Chirur- gischen Klinik Innenstadt und Chirurgischen Poliklinik der Universitiit MOOchen, bin ich nicht nur deshalb dankbar, weil er mir die Moglichkeit gab, meine Ausbildung zum Chirur- gen an seiner Klinik zu vollenden, sondem weil er auch alle klinisch- und tierexperimentell- wissenschaftlichen BemUhungen unterstUtzte.