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Preclinical experimental transplantation research that is based on
microsurgical models in rats fulfills two indispensable conditions
for modern organ transplanta tion research: Almost all organ grafts
can be performed on the rat with an amount of technical effort that
is still justifiable. Thus transplantation models that are
analogous to human organ transplantation can be developed, tested,
and evaluated. This fulfills a necessary condition from the
standpoint of surgery. With the species rat, we have a great
variety of genetically different inbred strains. From the
immunological point of view this is an indispensable prerequisite
for the investigation of preclinical transplantation models that
can be expected to produce controllable, reproducible results. In
vivo experimental results can be supplemented by and correlated to
in vitro tests. Lately these experimental results are being greatly
expanded and more precisely defined by the application of
immunohistological methods that have been established recently in
Kiel. In this book we hope to present a cross section of the
microsurgical models in use today and of current immunological and
immunohistological models. Furthermore, we wish to record the
present state of microsurgical organ transplantation research and
to show its relationship to the current state and development of
clinical organ transplantation. A special aspect of our Kiel
research group is the long-term, well-functioning,
interdisciplinary cooperation between surgery, immunology, and
pathology. Through this cooperation we attempt to provide an
atmosphere in which theoretical and practical viewpoints can
mutually influence each other."
Biofragmentable anastomoses rings represent a fascinating concept:
Stan dardization of anastomoses, secure technique in application,
expulsion of the material without residuals. In addition, one
single technique allows to perform the classical end to end, end to
side, and side to side anastomoses in most areas of the
gastrointestinal tract, without any auxiliary tool. This means a
great advantage of practicability. Controlled studies evidenced
that the rate of complications is very small for the intestinal
tract. Therefore, it is important to establish the localization for
present indication and contra indications. Two chapters especially
deal with upper GI anastomoses in cluding esophagus anastomoses and
with BAR anastomoses in inflammatory bowel disease. This is done by
analysing the data and by an exchange of experience between the
clinical research groups. This book is to communi cate experimental
data and to increase understanding about pathophysiology of the
healing of anastomoses by means of compression anastomoses.
Wiirzburg, Germany, Prof. Dr. R. ENGEMANN October 1994 Prof. Dr. A.
THIEDE Contents Experimental Research Histological and Clinical
Aspects of Early Healing of the Valtrac Anastomosis in the Colon R.
GULLICHSEN . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . 3 Colorectal Intramural Blood
Supply and Microcirculation in Man M. A. R. AL FALLOUJI (With 5
Figures) . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Biofragmentable Anastomosis Ring Versus Stapled Anastomoses in the
Extraperitoneal Rectum: Experimental Study in Dogs N. G. CZECZKO,
B. POLONIO, L. F. COLA"
In this book, the recent developments in immunology and the impact
on the treatment of infections in critical care and in surgery are
presented, also describing how cellular immunology influences
clinical treatment. This information helps in understanding the
pathogenesis of infections in surgery and critical care. The impact
of a standard treatment such as antibiotic therapy is evaluated and
possible future therapy modalities outlined. This book will be of
interest to clinicians and immunologists as scientists of both
specialties have contributed to the book.
The anastomotic technique plays a predominant role in
gastrointestinal surgery. A feared complication is leakage due to
the sutures. Such leakage cannot be detected early; consequently,
infection spreads locally and systemically. An anastomotic method
is generally evaluated according to its rate of leakage, related to
the localization, bur real scientific comparisons, i.e., controlled
studies, are almost totally lack ing. The criteria of evaluation
include the type of suture, the localization, the auxiliary
technical tools, practicability, the different forms of wound
healing, angiogenesis, and vascularization, among others. The
postoperative criteria are complications shortly after surgery,
such as bleeding, ruptures, and stenoses of the anastomosis. A
standard comparison is made difficult by the variety of
cytophysiological and biochemical factors that influence wound
healing. In the comparison of larger series one must always take
into account differences of auxiliary tools, strategies, and
inhomogeneity of patients. A change of one auxiliary tool or of one
strategy implies the modification of various target criteria. Often
enough, however, one does not sufficiently consider the surgeon's
most. important role."
Der Einzug der minimalinvasiven Chirurgie hat in der Chirurgie in
den letzten 3 Jahren zu einem Umbruch gef}hrt. Aber erst die
Einf}hrung von speziell entwickelten Klammer- nahtinstrumenten f}r
den laparoskopischen undthorakosko- pischen Einsatz hat zur
Verbreitung dieser Techniken f}hren k-nnen. Dies ist eine aktuelle
Zusammenstellung der M-glichkeiten und Indikationsgebiete f}r die
Anwendung von Klammernaht- instrumenten in der konventionellen und
minimalinvasiven Chirurgie. Das Buch behandelt schwerpunktm{ ig die
klinische und praktische Anwendung der Klammernahtinstrumente,
zeigt neue Perspektiven f}r die minimalinvasive Chirurgie durch die
Anwendung von Klammernahtinstrumenten auf und gibt eine ]bersicht
}ber Indikationen, Ergebnisse und Komplikationen.
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