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Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity     Hybrid Journal   (4 followers)
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Elemente der Mathematik     Hybrid Journal  
Emergency Radiology     Hybrid Journal   (4 followers)
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Empirical Economics     Hybrid Journal   (7 followers)
Empirical Software Engineering     Hybrid Journal   (4 followers)
Employee Responsibilities and Rights Journal     Hybrid Journal   (2 followers)
Endocrine     Hybrid Journal   (4 followers)
Endocrine Pathology     Hybrid Journal   (1 follower)
Energy Efficiency     Hybrid Journal   (9 followers)
Energy Systems     Hybrid Journal   (7 followers)
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Environmental and Ecological Statistics     Hybrid Journal   (5 followers)
Environmental and Resource Economics     Hybrid Journal   (16 followers)
Environmental Biology of Fishes     Hybrid Journal   (3 followers)
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Environmental Economics and Policy Studies     Hybrid Journal   (5 followers)
Environmental Evidence     Open Access  
Environmental Fluid Mechanics     Hybrid Journal   (2 followers)
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Environmental Management     Hybrid Journal   (27 followers)
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Environmental Monitoring and Assessment     Hybrid Journal   (9 followers)
Environmental Science and Pollution Research     Hybrid Journal   (11 followers)
Epidemiologic Perspectives & Innovations     Open Access   (1 follower)
Epileptic Disorders     Hybrid Journal   (1 follower)
EPJ A - Hadrons and Nuclei     Hybrid Journal   (1 follower)
EPJ B - Condensed Matter and Complex Systems     Hybrid Journal   (3 followers)
EPJ direct     Hybrid Journal  
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ERA-Forum     Hybrid Journal   (1 follower)
Erkenntnis     Hybrid Journal   (11 followers)
Erwerbs-Obstbau     Hybrid Journal  
Esophagus     Hybrid Journal  
Estuaries and Coasts     Hybrid Journal   (1 follower)
Ethical Theory and Moral Practice     Hybrid Journal   (7 followers)
Ethics and Information Technology     Hybrid Journal   (91 followers)
Ethik in der Medizin     Hybrid Journal  
Euphytica     Hybrid Journal   (7 followers)
Eurasian Soil Science     Hybrid Journal   (2 followers)
EURO Journal of Transportation and Logistics     Hybrid Journal   (4 followers)
EURO Journal on Computational Optimization     Hybrid Journal  
Europaisches Journal fur Minderheitenfragen     Hybrid Journal  
European Actuarial Journal     Hybrid Journal   (2 followers)
European Archives of Oto-Rhino-Laryngology     Hybrid Journal   (3 followers)
European Archives of Paediatric Dentistry     Hybrid Journal   (1 follower)
European Archives of Psychiatry and Clinical Neuroscience     Hybrid Journal   (2 followers)
European Biophysics Journal     Hybrid Journal   (4 followers)
European Child & Adolescent Psychiatry     Hybrid Journal   (4 followers)
European Clinics in Obstetrics and Gynaecology     Hybrid Journal   (3 followers)
European Food Research and Technology     Hybrid Journal   (8 followers)
European Journal for Education Law and Policy     Hybrid Journal   (5 followers)
European Journal for Philosophy of Science     Partially Free   (4 followers)
European Journal of Ageing     Hybrid Journal   (7 followers)
European Journal of Applied Physiology     Hybrid Journal   (5 followers)
European Journal of Clinical Microbiology & Infectious Diseases     Hybrid Journal   (7 followers)
European Journal of Clinical Pharmacology     Hybrid Journal   (9 followers)
European Journal of Drug Metabolism and Pharmacokinetics     Hybrid Journal   (6 followers)
European Journal of Epidemiology     Hybrid Journal   (16 followers)
European Journal of Forest Research     Hybrid Journal   (3 followers)
European Journal of Health Economics     Hybrid Journal   (10 followers)
European Journal of Law and Economics     Hybrid Journal   (104 followers)
European Journal of Nuclear Medicine and Molecular Imaging     Hybrid Journal   (5 followers)
European Journal of Nutrition     Hybrid Journal   (16 followers)
European Journal of Orthopaedic Surgery & Traumatology     Hybrid Journal   (4 followers)
European Journal of Pediatrics     Hybrid Journal   (7 followers)
European Journal of Plant Pathology     Hybrid Journal   (2 followers)
European Journal of Plastic Surgery     Hybrid Journal   (2 followers)
European Journal of Population/Revue europĂ©enne de DĂ©mographie     Hybrid Journal   (3 followers)
European Journal of Psychology of Education     Hybrid Journal   (6 followers)
European Journal of Trauma and Emergency Surgery     Hybrid Journal   (8 followers)
European Journal of Wildlife Research     Hybrid Journal   (5 followers)
European Journal of Wood and Wood Products     Hybrid Journal   (3 followers)

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European Surgery    [4 followers]  Follow    
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
     ISSN (Print) 1682-4016 - ISSN (Online) 1682-8631
     Published by Springer-Verlag Homepage  [2187 journals]   [SJR: 0.135]   [H-I: 13]
  • Are we facing a post-antibiotic future in surgery'
    • PubDate: 2014-04-11
  • Antibiotic resistance: a long term, serious problem…getting worse.
           Thoughts on the future of surgery in a post-antibiotic era
    • Abstract: Summary Background Last year the Director General of the World Health Organisation warned that ‘the medical advances of the past 80 years are at risk of being wiped away at a stroke’, due to progressive antibiotic resistance. Widespread unnecessary antibiotic use cannot go on and the World Health Organisation is getting increasingly worried. Until the 1980’s the ‘golden age’ of antibiotics reigned, with stronger and more targeted antibiotics joining the market. Since then the graphs shows a sorrier tale. In the 10 years between 1980 and 1989, 29 new antibiotics were approved by the United States Food & Drug Administration. Since 2005 the number is 4, and the trend shows no mercy. Coupled with organisms’ ability to develop resistance there is a threat that even minor injuries may again prove fatal. And in that scenario, consider the risk of major abdominal surgery. Methods and Results Not applicable. Conclusion So where does all this leave us' What does this mean for the junior doctors of tomorrow, the consultants of the future' As we near crisis point we have to realise that our attempts at protecting our antibiotic reserve are failing. The difficulty arises in finding the balance between treating our patients today and safeguarding the future. We have to be sensible, but mindful of future perils. The surgeon of 2050 will face many new challenges, but will the threat of a post antibiotic era limit development and expertise' ‘Antibiotic resistance: A long term, serious problem…getting worse’
      PubDate: 2014-04-11
  • Essence-based surgery: a taste for fruitful reasoning
    • PubDate: 2014-04-09
  • Esophageal schwannoma: report of a case and review of the literature
    • Abstract: Summary Background Esophageal schwannomas are very rarely seen neurogenic tumors and constitute less than 2 % of all esophageal tumors. The current study reports a case of benign esophageal schwannoma and re-evaluates esophageal schwannomas including our case with the other 42 cases in the literature. Methods A 61-year-old female patient was referred to our clinic with the complaints of dysphagia and a weight loss. In her upper gastrointestinal system endoscopy, a 20–25-cm submucosal lesion was seen, which compressed the esophagus from outside. On computerized tomography and magnetic resonance imaging of the thorax, a mass lesion was detected at the posterior mediastinum. After a preoperative detailed evaluation, a right posterolateral thoracotomy was performed. The mass was excised with the enucleation technique. The diagnosis of benign esophageal schwannoma was made with immunohistochemical examination. Results Postoperative period was uneventful. Conclusions Generally, the prognosis of esophageal schwannomas is excellent. Complete removal of the mass producing a negative surgical margin, and in malignant cases, excision of the regional lymph nodes, should be essential for long-term disease-free survival.
      PubDate: 2014-02-22
  • The history of organ transplantation in Austria
    • Abstract: Abstract In 1902, the first successful kidney transplant ever was performed by E. Ullmann in Vienna. Also, the first clinical renal transplant in Austria was performed on June 17, 1965, by F. Piza in the same city. The first combined pancreas–kidney transplant was performed by R. Margreiter in 1979 in Innsbruck. H.J. Böhmig did the first liver transplant in 1972 in Vienna. The world’s first combined liver–kidney transplant was carried out by R. Margreiter in 1983 in Innsbruck. The same year as the first heart transplant, in 1985 the first combined heart–lung transplant and in 1986 the first double lung transplant were performed in Innsbruck by R. Margreiter and F. Gschnitzer, respectively. In 1989, for the first time, a single lung was transplanted in Vienna by W. Klepetko and E. Wolner. In 1989, the first successful multivisceral transplant including the entire small bowel worldwide took place in Innsbruck, with R. Margreiter and A. Königsrainer being the surgeons. An isolated bowel transplant was performed in Vienna by F. Mühlbacher in 1983. The world’s second double-hand transplant was performed in Innsbruck in 2000 by a team led by H. Piza and R. Margreiter. These pioneering transplants led to three multiorgan- and two kidney-transplant programs in Austria and generated activities that are among the best worldwide in terms of volume, and also quality.
      PubDate: 2014-02-07
  • Future of science to foster being
    • PubDate: 2014-02-07
  • Guidelines for complications after thyroid surgery: pitfalls in diagnosis
           and advices for continuous quality improvement
    • Abstract: Summary Background There are four major complications after thyroidectomy, including palsy of the recurrent laryngeal nerve (RLN), hypoparathyroidism, postoperative bleeding, and surgical site infection (SSI). Another clinical problem is the injury and palsy of the external branch of the superior laryngeal nerve (EBSLN). We present a 1-year analysis of our prospective data on complications and outline our guidelines for follow-up and management, including quality assessment. Methods We prospectively analyzed 1,384 thyroid operations. Vocal fold/RLN function was determined routinely before surgery and on postoperative day 1 or 2 by laryngoscopy and/or stroboscopy. Postoperative hypoparathyroidism was defined as hypocalcemia in conjunction with low or low-normal parathormone levels or symptoms. Postoperative bleeding was specified as bleeding after wound closure that required reoperation. SSI was classified according to the Centers for Disease Control and Prevention. Palsy of the EBSLN was not determinable. Permanent impairment was defined if the complication persisted for more than 6 months. Results Postoperative palsy of the RLN occurred in 96 of 2,458 nerves-at-risk (3.9 %), of which 78 % fully recovered. The overall incidence of permanent palsy was 0.7 % per nerve-at-risk and highly dependent on the surgeon (range: 0–3.2 %, p < 0.001). Postoperative hypoparathyroidism was diagnosed in 487 patients (35.2 %), of whom full recovery was noted in 93.0 %. There were 26 postoperative bleedings (1.9 %) requiring reoperation. Three patients (0.2 %) developed superficial SSI with Staphylococcus aureus after a postoperative interval of 2, 6, and 7 days, respectively. Conclusions Our definitions and diagnostic and therapeutic approaches are presented and should be a proposal for standardization. Standardization will facilitate benchmarking and comparison of complication rates and surgical techniques among surgeons and institutions. An interdisciplinary team is necessary for quality control. Only continuous quality improvement of the individual surgeon will ultimately improve quality of a surgical department.
      PubDate: 2014-02-05
  • Results of 3-dimensional mesh implantations at the time of Miles operation
           to prevent parastomal hernia
    • Abstract: Summary Background Parastomal hernia is observed in every third patient having a stoma. The different methods of repair still have a recurrence rate of 12–35 %. According to increasing literature data, placing a mesh with a preventive intention seems to decrease dramatically the possibility of parastomal hernia formation. Methods Between 2003 and 2009 we have placed a 3-dimensional mesh extraperitoneally, at the time of Miles operations (14 open and 3 laparoscopic cases, total 17). This group of patients was compared in a non-randomized, prospective, observational study to a control group consisting of the same number of patients in which open Miles operations were performed in the same observational period. From 2012, based on this experience, a new settled device was introduced to the market and applied for prevention and for repair of parastomal hernia at our institute. Results In the first trial, in the mesh group, after a 4.7-year mean follow-up period there were no parastomal hernia formations at all. In the non-mesh group, after 4.6-year mean follow-up period parastomal herniation was found in 55 % of the cases. In the mesh group, two strictures were observed as complications, both of which could be managed conservatively. Second trial’s interim results are also very promising. Conclusions Our experiences confirm the literature data that placing a mesh at the time of definitive stoma formation is preferable. The devices used by us unite the advantages of strengthening both sheets of the rectus abdominis muscle. In addition, changing the operative strategy to a laparoscopic approach gives an extra advantage to this procedure.
      PubDate: 2014-02-05
  • Single-incision laparoscopic sleeve gastrectomy: initial experience in 20
           patients and 2-year follow-up
    • Abstract: Summary Background The transumbilical route began being clinically feasible with or without unique access devices. Setting The setting for this study was a private practice at Clínica Las Condes, Santiago, Chile. Objective The objective was to describe our experience performing a laparoscopic sleeve gastrectomy (LSG) via transumbilical route using a single-port access device in addition to standard laparoscopic instruments. Method A prospective nonrandomized protocol was applied to patients fulfilling the following inclusion criteria: to have been medically indicated for an LSG, to have a body mass index (BMI) of less than or equal to 40 kg/m2, and the distance between the xiphoid appendix and umbilicus should be less than 22 cm. All patients were female with a median (p50) age of 34.5 (ranging from 21 to 57) years, a median weight of 92 (ranging from 82.5 to 113) kg, and a median BMI of 35.1 (ranging from 30.5 to 40) kg/m2. The device insertion technique, the gastrectomy, and postoperative management are described. Results LSG via transumbilical route was successfully carried out in 19 of the 20 patients in whom the procedure was performed; one patient had to be converted to a conventional laparoscopic procedure. Mean operating time was 127 (ranging from 90 to 170) min. On the second postoperative day, all patients were assessed through an upper gastrointestinal barium-contrasted radiological series. There was neither morbidity nor mortality in this group. Excess weight loss at 25 months after surgery was 114 %. Conclusions Single-port LSG can be successfully performed in selected obese patients with a BMI of less than 40 kg/m2 using traditional laparoscopic instruments. The technique allows performing a safe and effective vertical gastrectomy.
      PubDate: 2014-02-05
  • Radiofrequency-based treatments for esophageal disease
    • Abstract: Summary Background Gastroesophageal reflux disease and its complication, Barrett’s esophagus, are two modern Western epidemics, and they are managed by a combination of medical and surgical approaches. Two new radiofrequency-based endoscopic methods, Stretta and HALO, have been introduced recently, and they are aiming at altering the compliance of the gastroesophageal junction and ablating the Barrett’s metaplastic mucosa, respectively. Methods We reviewed PubMed for all studies pertaining to Stretta and HALO technologies and collected data on techniques, clinical efficacy, safety, tolerability, and durability of effect. Results Although limitations exist, the safety, efficacy, tolerability, and durability of endoscopic radiofrequency energy application are robust and poised to facilitate the nonsurgical management of gastroesophageal reflux disease (GERD) and Barrett’s esophagus. Conclusions Over the past decade, Stretta and HALO have become valuable options in the current algorithms of management of refractory GERD and Barrett’s esophagus. Ongoing vigilance on the long-term benefits of radiofrequency and its effect on esophageal structure and function will allow even wider and more successful applications.
      PubDate: 2014-01-28
  • Anatomical–coloproctological skills lab
    • Abstract: Summary Background Profound anatomical knowledge is mandatory for coloproctologists. We established a training concept for young surgeons consisting of an anatomical and surgical skills lab as part of a coloproctological training course. The aim is to apply anatomical skills to surgical approaches within a training curriculum, and to offer workstations for implementing new techniques in coloproctology. Methods The 2-day training course comprises a gross anatomy course using preserved pelvic specimens for compartmental dissection of the pelvic floor. Lectures on embryological development and systematic and topographical anatomy of the pelvic floor precede the hands-on training in the wet lab. On day 2, the participants are trained in specific coloproctological techniques at four dummy workstations in a step-by-step approach by experienced coloproctologists. Results The participants benefit from the direct application of their anatomical skills to specific surgical questions. Conclusions Skills labs support surgical training concepts and are proposed to be integrated in postdoctoral educational curricula. Anatomical basics are mandatory for coloproctological approaches and implementing new techniques into clinical routine. Proper mentorship is the foundation for training quality surgeons.
      PubDate: 2014-01-10
  • Detection of rare variant of “circumaortic venous collar”
           during infrarenal abdominal aortic aneurysm repair: case report and
           literature review
    • Abstract: Summary Background Congenital retroperitoneal veins anomalies (RVAs) are very infrequent, but have a relevant clinical importance in abdominal aortic surgery. Methods We hereby present a unique case of a man with infrarenal abdominal aortic aneurysm associated with a rare anatomical variation of the left renal vein (LRV) consisting of a small ventral suprarenal and a large retroaortic vein, both draining directly into the inferior vena cava. Starting from this case we carried out an extensive literature review on clinical and surgical implications of RVAs. Results The retroaortic renal vein was detected preoperatively by computed tomography angiography (CTA), but the suprarenal vein was unexpected. Both infrarenal aortic clamping and aneurysm resection resulted demanding and required careful exposure of the anomalous suprarenal vein and identification of both renal arteries origin. No intraoperative bleeding or other complications occurred. Conclusions The awareness and recognition of RVAs is mandatory to avoid injuries during abdominal aortic surgery.
      PubDate: 2014-01-10
  • Cardiovascular research days 2014: organ preservation and regeneration
           from basic science to clinic
    • PubDate: 2014-01-08
  • The 125-year anniversary of the first sphincter-saving resection of a
           rectal cancer by Julius von Hochenegg in Vienna
    • PubDate: 2013-11-27
  • Rainbow country surgery reggae seeds smile
    • PubDate: 2013-11-26
  • Upper GI natural orifice translumenal endoscopic surgery: what is new'
    • Abstract: Summary Background Natural orifice translumenal endoscopic surgery (NOTES) is an evolving field. The aim of this study was to assess recent developments in the upper gastrointestinal NOTES. Methods A MEDLINE, CINAHL and Science Direct search was made for all published English literature relevant to upper gastrointestinal NOTES between January 2009 and January 2013. A total of 769 articles were found, and 57 studies were selected for this review based on relevance. Results Upper gastrointestinal NOTES is evolving, with feasibility, safety and efficacy ensured for several operations. A total of 1,201 operations were reported on patients, of which 673 (56.03 %) were cholecystectomies. The number of patients in each study ranged between 1 and 551, with a median of 5 patients. A total of 504 operations were performed on animals to explore safety and feasibility of a wide spectrum of operations. The sample size of these studies ranged from 3 to 250, with a median of 10. Conclusions There is a continuous development and refinement of the NOTES technique, and modern technology is helping to perform demanding procedures. Cholecystectomy is the commonest NOTES operation on human subjects, whereas animal studies are testing the safety and feasibility of a spectrum of operations in different surgical fields.
      PubDate: 2013-11-19
  • One hundred double adenomas in primary hyperparathyroidism
    • Abstract: Summary Background Double adenomas (DAs) occur in 2–15 % of primary hyperparathyroidism (pHPT) patients. To date, the existence of this distinct entity remains controversial. The aim of this study was to evaluate the clinical characteristics and anatomic distribution of DAs to identify anatomic patterns and implications for surgical management. Methods We reviewed prospective database records of 1,464 unselected, consecutive patients who were treated for pHPT in our institution between 1986 and 2012. We identified 100 DA patients (6.8 %) and compared their clinical characteristics with those of solitary adenomas (SAs; n = 1,226) and hyperplasia (including multiple endocrine neoplasia; n = 101). Results A total of 74 % of our patient collective was female. DAs were predominantly located on the right side (30 %) or crossed (23 %) and demonstrated an increased incidence of atypical position (38 %). Patients with DA showed significantly more neuropsychiatric disorders and pancreatitis compared with those in the other groups. Our results revealed higher parathyroid hormone levels in patients with DA compared with those with SA or hyperplasia. In 74 patients, the DA was primarily found, whereas 26 patients needed reoperation. Only nine DAs had developed metachronously. The overall cure rate of all patients with pHPT was 96.4 % (carcinomas excluded). Conclusions DAs are a distinct entity and show no specific characteristic features that could facilitate easy detection. The chance of a metachronous appearance is statistically low, but has significant clinical impact as a major cause for late recurrence of hyperparathyroidism and need for reoperation.
      PubDate: 2013-11-09
  • Impact of pneumoperitoneum on collagen I expression in vitro
    • Abstract: Summary Background There is little and contradictory data about the impact of laparoscopy on wound healing. In this experimental study, gas-related effects of pneumoperitoneum on collagen I mRNA synthesis were analysed separately in fibroblast cultures in vitro. Methods 3T3 mouse fibroblasts were incubated for 1 h with either CO2 or helium (gas flow: 1 l/min, pressure: 12 mmHg). Control fibroblasts were exposed to room air for 1 h. Hereafter, expression of collagen type IA1 was analysed by real-time PCR. Results Expression of collagen type IA1 analysed was 0.7 times lower after incubation with CO2 when compared with controls. After helium insufflation, collagen type IA1 expression showed a 1.1-fold increase. Conclusions The observed gas-related influence on collagen synthesis might give evidence of a potential effect of laparoscopy on intra-abdominal wound healing.
      PubDate: 2013-11-08
  • Erratum to: Massive panniculectomy and hernioplasty as a salvage procedure
    • PubDate: 2013-10-29
  • Altemeier’s procedure for complete rectal prolapse in elderly and
           frail patients: should we be afraid of'
    • Abstract: Summary Background Complete rectal prolapse is more common in the elderly, with considerable effects on patient’s quality of life. Whenever co-existing morbidities render abdominal procedures impossible, perineal rectosigmoidectomy combined with levatorplasty as described by Altemeier is a viable option. However, performing a coloanal anastomosis without fecal diversion bears the risk of life-threatening (anastomotic) complications. We present our experience performing Altemeier’s procedure (AP) in a series of old and frail patients, and a review of literature. Methods Demographic, perioperative and postoperative data of patients undergoing AP for complete rectal prolapse between January 2008 and April 2013 were analysed retrospectively. In addition, we reviewed the literature in regard to anastomotic complications, morbidity and mortality after AP. Results In total, 16 (15 female) patients with a median age of 84.6 (range: 75–94) years underwent AP within the study period. American Society of Anaesthesiologists (ASA) score was I, II and III in four, six and six cases, respectively. General (n = 12), spinal (n = 3) or local (n = 1) anaesthesia was applied according to anaesthetist’s decision. No anastomotic leak was seen, and no patient died perioperatively. Minor complications were observed in three patients (18.8 %). According to the reviewed literature, overall anastomotic leak rate, morbidity and mortality after AP have been 2.7, 12.1 and 0.5 %, respectively (median values). Conclusions AP proved to be a safe repair for complete rectal prolapse in the elderly.
      PubDate: 2013-10-22
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