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Dynamic Games and Applications     Hybrid Journal   (Followers: 2)
Dysphagia     Hybrid Journal   (Followers: 144, SJR: 0.684, h-index: 46)
e & i Elektrotechnik und Informationstechnik     Hybrid Journal   (Followers: 7, SJR: 0.146, h-index: 8)
e-Neuroforum     Hybrid Journal  
Early Childhood Education J.     Hybrid Journal   (Followers: 11, SJR: 0.367, h-index: 12)
Earth Science Informatics     Hybrid Journal   (Followers: 3, SJR: 0.245, h-index: 5)
Earth, Moon, and Planets     Hybrid Journal   (Followers: 3, SJR: 0.436, h-index: 28)
Earthquake Engineering and Engineering Vibration     Hybrid Journal   (Followers: 7, SJR: 0.433, h-index: 17)
Earthquake Science     Hybrid Journal   (Followers: 9, SJR: 0.486, h-index: 7)
East Asia     Hybrid Journal   (Followers: 6, SJR: 0.165, h-index: 9)
Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity     Hybrid Journal   (Followers: 6, SJR: 0.289, h-index: 23)
EcoHealth     Hybrid Journal   (Followers: 1, SJR: 0.651, h-index: 22)
Ecological Research     Hybrid Journal   (Followers: 7, SJR: 0.698, h-index: 38)
Economic Botany     Hybrid Journal   (Followers: 8, SJR: 0.666, h-index: 40)
Economic Bulletin     Hybrid Journal   (Followers: 3)
Economic Change and Restructuring     Hybrid Journal   (Followers: 1, SJR: 0.263, h-index: 6)
Economic Theory     Hybrid Journal   (Followers: 5, SJR: 1.857, h-index: 31)
Economic Theory Bulletin     Hybrid Journal  
Economics of Governance     Hybrid Journal   (Followers: 2, SJR: 0.367, h-index: 12)
Ecosystems     Hybrid Journal   (Followers: 18, SJR: 1.793, h-index: 83)
Ecotoxicology     Hybrid Journal   (Followers: 10, SJR: 1.041, h-index: 53)
Education and Information Technologies     Hybrid Journal   (Followers: 129, SJR: 0.207, h-index: 15)
Educational Assessment, Evaluation and Accountability     Hybrid Journal   (Followers: 11, SJR: 0.519, h-index: 14)
Educational Psychology Review     Hybrid Journal   (Followers: 13, SJR: 1.781, h-index: 52)
Educational Research for Policy and Practice     Hybrid Journal   (Followers: 6, SJR: 0.211, h-index: 8)
Educational Studies in Mathematics     Hybrid Journal   (Followers: 7, SJR: 0.946, h-index: 27)
Educational Technology Research and Development     Partially Free   (Followers: 132, SJR: 1.124, h-index: 45)
Electrical Engineering     Hybrid Journal   (Followers: 8, SJR: 0.352, h-index: 17)
Electrocatalysis     Hybrid Journal   (SJR: 0.542, h-index: 7)
Electronic Commerce Research     Hybrid Journal   (Followers: 3, SJR: 0.636, h-index: 14)
Electronic Markets     Hybrid Journal   (Followers: 5, SJR: 0.326, h-index: 5)
Electronic Materials Letters     Hybrid Journal   (Followers: 2, SJR: 0.566, h-index: 11)
Elemente der Mathematik     Hybrid Journal  
Emergency Radiology     Hybrid Journal   (Followers: 4, SJR: 0.446, h-index: 22)
Empirica     Hybrid Journal   (Followers: 3, SJR: 0.185, h-index: 12)
Empirical Economics     Hybrid Journal   (Followers: 7, SJR: 0.5, h-index: 29)
Empirical Software Engineering     Hybrid Journal   (Followers: 4, SJR: 2.319, h-index: 33)
Employee Responsibilities and Rights J.     Hybrid Journal   (Followers: 2, SJR: 0.21, h-index: 13)
Endocrine     Hybrid Journal   (Followers: 4, SJR: 0.659, h-index: 55)
Endocrine Pathology     Hybrid Journal   (Followers: 2, SJR: 0.555, h-index: 27)
Energy Efficiency     Hybrid Journal   (Followers: 9, SJR: 1.056, h-index: 10)
Energy Systems     Hybrid Journal   (Followers: 8, SJR: 0.589, h-index: 5)
Engineering With Computers     Hybrid Journal   (Followers: 5, SJR: 0.497, h-index: 26)
Entomological Review     Hybrid Journal   (Followers: 3, SJR: 0.128, h-index: 5)
Environment Systems & Decisions     Hybrid Journal   (Followers: 2)
Environment, Development and Sustainability     Hybrid Journal   (Followers: 25, SJR: 0.319, h-index: 26)
Environmental and Ecological Statistics     Hybrid Journal   (Followers: 5, SJR: 0.389, h-index: 29)
Environmental and Resource Economics     Hybrid Journal   (Followers: 16, SJR: 1.651, h-index: 46)
Environmental Biology of Fishes     Hybrid Journal   (Followers: 3, SJR: 0.486, h-index: 53)
Environmental Chemistry Letters     Hybrid Journal   (Followers: 3, SJR: 0.664, h-index: 22)
Environmental Earth Sciences     Hybrid Journal   (Followers: 10, SJR: 0.601, h-index: 55)
Environmental Economics and Policy Studies     Hybrid Journal   (Followers: 5, SJR: 0.35, h-index: 3)
Environmental Evidence     Open Access  
Environmental Fluid Mechanics     Hybrid Journal   (Followers: 2, SJR: 0.732, h-index: 23)
Environmental Geochemistry and Health     Hybrid Journal   (Followers: 2, SJR: 0.909, h-index: 32)
Environmental Geology     Hybrid Journal   (Followers: 11)
Environmental Health and Preventive Medicine     Hybrid Journal   (Followers: 2, SJR: 0.388, h-index: 14)
Environmental Management     Hybrid Journal   (Followers: 29, SJR: 0.773, h-index: 60)
Environmental Modeling & Assessment     Hybrid Journal   (Followers: 11, SJR: 0.413, h-index: 27)
Environmental Monitoring and Assessment     Hybrid Journal   (Followers: 9, SJR: 0.671, h-index: 46)
Environmental Science and Pollution Research     Hybrid Journal   (Followers: 11, SJR: 0.878, h-index: 42)
Epidemiologic Perspectives & Innovations     Open Access   (Followers: 1, SJR: 1.002, h-index: 14)
Epileptic Disorders     Hybrid Journal   (Followers: 1, SJR: 0.669, h-index: 34)
EPJ A - Hadrons and Nuclei     Hybrid Journal   (Followers: 1, SJR: 1.435, h-index: 58)
EPJ B - Condensed Matter and Complex Systems     Hybrid Journal   (Followers: 3, SJR: 0.749, h-index: 85)
EPJ direct     Hybrid Journal  
EPJ E - Soft Matter and Biological Physics     Hybrid Journal   (Followers: 1, SJR: 0.661, h-index: 57)
EPMA J.     Open Access   (SJR: 0.161, h-index: 4)
ERA-Forum     Hybrid Journal   (Followers: 1, SJR: 0.13, h-index: 2)
Erkenntnis     Hybrid Journal   (Followers: 11, SJR: 0.62, h-index: 14)
Erwerbs-Obstbau     Hybrid Journal   (SJR: 0.173, h-index: 8)
Esophagus     Hybrid Journal   (SJR: 0.268, h-index: 9)
Estuaries and Coasts     Hybrid Journal   (Followers: 3, SJR: 1.111, h-index: 61)
Ethical Theory and Moral Practice     Hybrid Journal   (Followers: 7, SJR: 0.278, h-index: 8)
Ethics and Information Technology     Hybrid Journal   (Followers: 151, SJR: 0.363, h-index: 20)
Ethik in der Medizin     Hybrid Journal   (SJR: 0.204, h-index: 6)
Euphytica     Hybrid Journal   (Followers: 7, SJR: 0.709, h-index: 57)
Eurasian Soil Science     Hybrid Journal   (Followers: 2, SJR: 0.271, h-index: 10)
EURO J. of Transportation and Logistics     Hybrid Journal   (Followers: 4)
EURO J. on Computational Optimization     Hybrid Journal  
EURO J. on Decision Processes     Hybrid Journal  
Europaisches J. fur Minderheitenfragen     Hybrid Journal  
European Actuarial J.     Hybrid Journal   (Followers: 2)
European Archives of Oto-Rhino-Laryngology     Hybrid Journal   (Followers: 3, SJR: 0.737, h-index: 37)
European Archives of Paediatric Dentistry     Hybrid Journal   (Followers: 1, SJR: 0.446, h-index: 12)
European Archives of Psychiatry and Clinical Neuroscience     Hybrid Journal   (Followers: 2, SJR: 1.334, h-index: 62)
European Biophysics J.     Hybrid Journal   (Followers: 4, SJR: 0.979, h-index: 53)
European Child & Adolescent Psychiatry     Hybrid Journal   (Followers: 4, SJR: 1.269, h-index: 51)
European Clinics in Obstetrics and Gynaecology     Hybrid Journal   (Followers: 4)
European Food Research and Technology     Hybrid Journal   (Followers: 8, SJR: 0.773, h-index: 49)
European J. for Education Law and Policy     Hybrid Journal   (Followers: 5)
European J. for Philosophy of Science     Partially Free   (Followers: 4, SJR: 0.165, h-index: 2)
European J. of Ageing     Hybrid Journal   (Followers: 8, SJR: 0.49, h-index: 17)
European J. of Applied Physiology     Hybrid Journal   (Followers: 7, SJR: 1.044, h-index: 74)
European J. of Clinical Microbiology & Infectious Diseases     Hybrid Journal   (Followers: 9, SJR: 0.958, h-index: 74)
European J. of Clinical Pharmacology     Hybrid Journal   (Followers: 9, SJR: 0.916, h-index: 69)
European J. of Dermatology     Hybrid Journal   (Followers: 7)
European J. of Drug Metabolism and Pharmacokinetics     Hybrid Journal   (Followers: 6, SJR: 0.24, h-index: 25)
European J. of Epidemiology     Hybrid Journal   (Followers: 17, SJR: 1.946, h-index: 60)
European J. of Forest Research     Hybrid Journal   (Followers: 3, SJR: 0.864, h-index: 25)

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Journal Cover 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  [2209 journals]   [SJR: 0.135]   [H-I: 13]
  • Can obstetrical brachial plexus palsy be caused by a cervical rib'
    • Abstract: Summary Background The incidence of obstetric brachial plexus palsy (OBPP) is between 0.38 to 2.6 per 1000 live births. However, incidence of OBPP caused by cervical rib is unknown. Cervical ribs prevalence is 0.74–12 % and is higher in females. We describe such a case of OBPP successfully treated with early operative intervention. Method Patient with normal weight and uncomplicated vaginal birth suffered from brachial plexus injury (Narakas II) with no clinical improvement postpartum, after 3 months of observation. Preoperative imaging (X-ray/magnetic resonance imaging) showed no findings, but intraoperative exploration revealed that C7 root was riding on the cervical rib with a thick neuroma-incontinuity involving C5, C6, and C7 roots. After resecting the neuroma and cervical rib, nerve defects were reconstructed microsurgically with spinal-accessory nerve transfer and nerve grafts. Results Postoperatively, shoulder- and arm-function after 1 year were nearly fully restored (Gilbert 120 and Mallet V). Shoulder strength rated M4. Elbow and hand strength rated M4 and M5 with Gilbert and Raimondi functional scores of IV and V, respectively. Conclusion While OBPP caused by cervical rib is rare, this etiology should be identified during the prenatal screening sonography. Thus, extra precautions can be taken during deliveries to decrease incidence of OBPP secondary to cervical rib. Early surgical intervention for OBPP is successful in achieving functional restoration of the arm.
      PubDate: 2014-06-07
  • Short hospital stays after laparoscopic gastric surgery under an Enhanced
           Recovery After Surgery (ERAS) pathway: experience at a single center
    • Abstract: Summary Introduction Recently, first reports on benefits from Enhanced Recovery After Surgery (ERAS) pathway in patients undergoing gastric surgery have appeared. It seems that maximal reduction of unfavorable surgery-induced trauma in patients with gastric malignancy via ERAS protocol combined with minimally invasive techniques can improve outcomes. Objective The aim of this study was to determine the influence of laparoscopic surgery and ERAS protocol in oncological gastric surgery on early outcomes. Materials and methods Prospective analysis involved 28 patients (18 female and 10 male) with gastric malignancy who underwent laparoscopic gastric resection between 2009 and 2013. Gastric tumors (gastrointestinal stromal tumors or adenocarcinoma) were the indication for the surgery. A total of 17 patients underwent laparoscopic local excision, and 11 patients with adenocarcinoma or multiple neuroendocrine tumors underwent laparoscopic D2 total gastrectomy. Perioperative care was based on ERAS principles. Length of hospital stay, postoperative course, perioperative complications, and readmission rates were analyzed. Results There was one conversion in the gastrectomy group. All patients were mobilized on the day of surgery. Oral fluids were introduced on day 0 and were well tolerated. Full hospital diet was started on day 2 in all patients, but was well tolerated in only 18 of them. One postoperative complication requiring reoperation was noted. The length of stay after gastrectomy and gastric wedge resection was 4.6 (2–6) and 3.3 (2–6) days, respectively. No readmissions were noted in the entire group. Conclusions The implementation of ERAS protocol to clinical practice in combination with laparoscopy in patients with gastric tumors can result in improved postoperative care quality, shortening of hospital stay, and quicker return to normal activity.
      PubDate: 2014-06-07
  • 55th Annual Meeting of the Austrian Society of Surgery
    • PubDate: 2014-06-03
  • Selected commentary to “Radiofrequency ablation vs endoscopic
           surveillance for patients with Barrett esophagus and low-grade dysplasia.
           A randomized clinical trial”
    • Abstract: Summary Background Barrett’s esophagus (BE) results from gastroesophageal reflux disease (GERD) and harbors an increased cancer risk. Via low (LGD) and high grade dysplasia (HGD) BE may progress towards cancer (0.5 %–0.75 % annual risk). Radiofrequency ablation (RFA) represents a novel endoscopic method for durable elimination of BE. RFA is effective for cancer prevention persons with HGD. Remains to be questioned the value of RFA in those with LGD. Methods Critical analysis of the paper by Phoa K et al., published in the recent issue of JAMA. The randomized clinical study compared the effect of surveillance vs. RFA in persons with BE and LGD. Results After 3 years, RFA was superior vs. surveillance as it significantly inhibited progression to cancer and/or high grade dysplasia (1.5 % vs. 26.5 %). The number necessary to treat to prevent cancer/HGD and cancer was 4.0 and 13.6, respectively. Conclusions RFA is superior to surveillance to prevent the progression of BE with LGD to HGD/cancer and cancer. Thus RFA should be recommended as the treatment of choice for the management of BE with LGD in those fit for the endoscopic procedure. Future studies will have to elicit the impact of orchestrated therapy of dysplastic BE including anti reflux surgery. Finally the value of RFA for cancer development in those with non-dysplastic BE should be addressed.
      PubDate: 2014-05-21
  • Is day surgery safe' A systematic literature review
    • Abstract: Summary Background In many countries, day surgery is very common for some indications, especially in the USA, the UK and Scandinavia. In other countries—for example, Austria, Germany and Switzerland—day surgery is rare. This is due to financial disincentives, different systemic structures and shorter waiting lists for surgery. Methods We focused on the 15 most frequently delivered operations in Austria, from which we selected those that could be done in day surgery. For these 11 interventions, we made a systematic literature search in various databases. Results We researched 35 studies for data synthesis. On the basis of the summarised studies, we concluded that the following operations can be done safely (and effectively) in both day surgery and in inpatient setting in those patients who fulfil the eligibility criteria for day surgery: cataract surgery, arthroscopic operations of the knee, vein ligation (stripping), cholecystectomy (laparoscopic), adenoidectomy and repair of inguinal and femoral hernia. For the removal of implanted devices from bone, appendectomy, paracentesis, carpal tunnel decompression of median nerve and curettage, studies with a higher evidence level for robust assessment of the safety (and effectiveness) of day surgery are required, although these operations are already undertaken in a day surgery setting in many countries. Conclusion Day surgery can be defined as safe for selected interventions and patients. Day surgery requires increasing attention in countries such as Austria with a low level of day surgery, which is particularly evident when making international comparisons.
      PubDate: 2014-04-24
  • The development of sphincter saving surgery for rectal cancer: the long
           way from a perineal colostomy to restoration of continence
    • Abstract: Summary The treatment of rectal cancer started with the first perineal resection by Lisfranc in 1826. In the beginning of rectal surgery sphincter salvage had no priority. Hochenegg published the first successful rectal resection with preservation of the sphincter in Vienna in 1888. The further development of sphincter salvage was inhibited by the discovery of a high recurrence rate after perineal resection by Miles. He proposed the abdominoperineal resection for all cancers of the rectum independent of their localization. Most surgeons in Europe and USA followed Miles’ proposal, but in Vienna sphincter salvage was further practiced by Hochenegg and his team. Later, his assistant Finsterer developed the abdominosacral resection. Dixon from the Mayo Clinic reported good results with a solely abdominal operation for tumors of the upper part of the rectum, which he called “anterior resection” in contrast to the posterior (perineal and sacral) resections. From this point sphincter salvage became slowly popular, supported by the use of stapling instruments. The final step was the development of techniques to save the sphincter even in tumors of the lower third of the rectum by ultralow resections.
      PubDate: 2014-04-23
  • A systematic review of hernia surgery in SIL (single-incision laparoscopy)
    • Abstract: Summary Background Hernia repair in single-incision laparoscopic surgery (SIL) technique has become increasingly common at specialized centers. Still, safety issues and potential benefits of SIL hernia repair have to be elucidated. This review summarizes available literature and provides an overview of current developments. Materials and methods A literature search was performed in PubMed, the Cochrane Database, and Google for peer-reviewed publications on SIL hernia repair. Main outcome parameters were defined, and it was attempted to define clinical recommendations. Results SIL technique can be applied for inguinal, ventral, and hiatal hernia repair. Operation times and early results seem to be comparable with standard multiport laparoscopy. Conclusion Distinct advantages of SIL hernia surgery have yet to be demonstrated, as the level of evidence in this field is low. Randomized controlled trials investigating the incidence of incisional hernias at the trocar site and safety in large cohorts are missing.
      PubDate: 2014-04-17
  • Electrical stimulation of the lower oesophageal sphincter: an emerging
           therapy for treatment of GORD
    • Abstract: Summary Background A significant proportion of gastro-oesophageal reflux patients remain unsatisfied with medical treatment and suffer from residual symptoms or quality-of-life issues. Anti-reflux surgery demonstrates excellent results in clinical trials, but is not widely utilized due to concerns of side effects, long-term failures and suboptimal results from low-volume centres. Hence, the search for a less invasive treatment has been an active area of clinical development. Electrical stimulation is increasingly utilized for various neuromuscular disorders and has recently emerged as a new minimally invasive treatment option for gastro-oesophageal reflux disease (GORD) by modulating the dysfunctional lower oesophageal sphincter. Methods This review article includes available data from five peer-reviewed publications summarizing three human trials. s from major international conferences provided additional long-term results and interim data on an ongoing international trial. Four published trials with animal data are also reported. Results Published in vivo animal studies showed that electrical stimulation can be safely used to enhance lower oesophageal sphincter pressure. Feasibility clinical trials with temporary stimulation reproduced this effect in GORD patients and demonstrated preservation of swallow function. Two long-term trials showed improvement in oesophageal acid exposure, GORD symptoms and proton pump inhibitor (PPI) medications use with minimal side effects. Conclusions Enhancement of the anti-reflux function of the lower oesophageal sphincter using electrical stimulation is a safe and effective GORD treatment and can potentially address the unmet need of patients who are unsatisfied with PPIs. Additional data will help in a wider adoption of this technology.
      PubDate: 2014-04-17
  • Selected commentary to review on novel concepts of columnar lined
    • Abstract: Summary The focus of this review article is on the novel and challenging concepts that have emerged in the field of gastroesophageal reflux disease (GERD) and Barrett’s esophagus over the recent years. Lenglinger et al. (Wien Klin Wochenschr. 2013;125:577–590) have made an in-depth PubMed research on studies dealing with histopathology of nondysplastic columnar lined esophagus (CLE). The aim of the review is to summarize the current body of knowledge regarding the pathophysiology of nondysplastic CLE and its implications for the diagnosis and treatment of this pre-neoplastic condition.
      PubDate: 2014-04-15
  • Inguinoscrotal herniation of bladder: case series and literature
    • Abstract: Summary Background Bladder hernias are relatively rare condition while only accounts for 1–4 % of inguinal hernias. It is not the surgery but the diagnosis that remain the major challenges of clinical practice. Methods Herein, we report five cases of bladder hernias with different clinical presentation, and review of current literature. Results The definite diagnosis relies on clinical suspicion and multiple urographic imaging. Sonography is a preferred image modality for its inexpensive and noninvasive nature. Abdominal computed tomography (CT) could depict the anatomic details of the hernia lesion and its relationship with the surrounding pelvic organs. Although bladder herniation is not a malignant condition, it can be fatal due to iatrogenic surgical complications. Conclusions In addition to current indications, refractory urinary tract infection should be viewed as another indication of partial cystectomy. Besides, repeated urography should be considered as the tool to ensure the result of surgery.
      PubDate: 2014-04-15
  • 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
  • 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
  • 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
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Heriot-Watt University
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