Emanuel Sporn

Medical University of Vienna | MedUni Vienna

To the Editor: In their study, Ganz and colleagues (Feb. 21 issue)(1) found that the effect of an esophageal device on the median percentage of time in a 24-hour period in which the pH was less than 4 (fraction time) was 3.3%, which is disappointingly near the upper limit of the normal range, leaving about half the patients with still-abnormal acid...

Ventral incisional hernias still remain a common surgical problem. We tested the feasibility of transvaginal placement of a large synthetic mesh to repair a porcine hernia. Seven pigs were used in this survival model. Each animal had creation of a 5-cm hernia defect and underwent a transvaginal repair of the defect with synthetic mesh. A single col...

Background Placement of stents may be an alternative option to treat gastrojejunal (GJ) anastomotic leaks after Roux-en-Y gastric bypass (RYGB) surgery. The aim was to evaluate the performance of a covered metal stent (Alimaxx-E, 18 × 100 mm) across a GJ leak in a porcine model. Methods In eight pigs, a RYGB was performed and a 1-cm leak was create...

Incisional abdominal wall hernias currently require repair with open or laparoscopic surgery, which is associated with wound complications and recurrent hernia formation. Natural orifice transluminal endoscopic surgery (NOTES) techniques may have the potential to decrease the morbidity associated with hernia repair. The aim of this study was to rep...

Recent advances in the treatment of early breast cancer have improved clinical outcomes and prolonged survival, especially in women with endocrine-responsive disease. However, cancer therapies including cytotoxic chemotherapy, ovarian suppression, and aromatase inhibitors can drastically reduce circulating estrogen, increasing bone loss and fractur...

Background Patients with gastroesophageal reflux disease (GERD) and abnormal esophageal motility are the most controversial subgroup of surgically treated patients because of potentially increased risk of postoperative dysphagia. Our study aim was to determine if Nissen fundoplication is associated with increased postoperative dysphagia in patients...

Background Anastomotic leaks after Roux-en-Y gastric bypass (RYGB) cause significant morbidity and mortality. Placement of enteral stents may be an improvement to the current treatment, which is withholding of oral intake and total parenteral nutrition. Methods We established an open RYGB porcine model with a leak at the gastrojejunostomy in three...

Background This study aimed to evaluate the effect of two different sterilization protocols on the bacterial counts in the swine colon as preparation for natural orifice translumenal endoscopic surgery (NOTES) surgery. Methods In this study, 16 swine were randomized to two different colonic sterilization protocols: low colonic irrigation using 300...

Adhesion-related complications after abdominal surgery result in significant morbidity and costs. Results from animal studies investigating prevention or treatment of adhesions are limited due to lack of consistency in existing animal models. The aim of this study was to compare quality and quantity of adhesions in four different models and to find...

Background Incisional hernia repairs have a risk of wound complications that may be decreased using a natural orifice transluminal endoscopic surgery (NOTES) approach. The aim of this study was to determine the feasibility and safety of transgastric mesh placement to the anterior abdominal wall in a porcine model as a precursor to future studies of...

Endocrine therapy has become a key part in the adjuvant treatment of hormone responsive breast cancer. The positive effect on relapse risk reduction is well defined, but therapy is not free from bothersome side effects for which estrogen deprivation accounts to a great extent. Since endocrine therapy is usually prescribed for 5 years or longer to o...

Although laparoscopic appendectomy is widely used for treatment of appendicitis, it is still unclear if it is superior to the open approach. From the Nationwide Inpatient Sample 2000 to 2005, hospitalizations with the primary ICD-9 procedure code of laparoscopic (LA) and open appendectomy (OA) were included in this study. Outcomes of length of stay...

Transgastric cholecystectomy has been shown to be feasible in animal models and human case reports but cumbersome with current available instrumentation. To evaluate a prototype endoscope with 2 working channels with deflectors at the distal tip for performance of transgastric cholecystectomy. Animal study, nonsurvival and survival. Sixteen male pi...

Anastomotic leaks after colorectal operation continue to be a significant cause of morbidity. A covered endoluminal stent could seal a leak and eliminate the need for diversion. The aim of this study was to test the efficacy of a temporary covered stent to prevent leak related complications. Sixteen adult pigs (80-120 lbs) underwent open transectio...

Treatment of adhesion-related complications is cost intensive and presents a considerable burden to the health care system. The objective of this study was to compare open (OLA) and laparoscopic lysis of adhesions (LLA) in the treatment of intestinal obstruction, based on a nationwide representative sample. Patients with intestinal obstruction unde...

Ascariasis is an endemic disease in developing countries. The parasite can invade the hepatobiliary tree and cause symptoms. Medical therapy can be ineffective in these patients and intervention techniques required. A retrospective review of patient charts between February 1992 and February 2007 in the Hospital Latinoamericano, Cuenca, Ecuador, was...

An effective, safe, and long-lasting endoluminal treatment for gastroesophageal reflux disease (GERD) would be an attractive prospect. We developed an endoluminal technique to restrict and tighten the lower esophageal sphincter (LES), by using a transoral endoscopic stapling device in a porcine model. Pre-interventional evaluation comprised endosco...

Safe, reliable, and efficient endoscopic closure of a colotomy is paramount for endoscopic full thickness excision of the colon. Two newly developed devices, the Tissue Apposition System (TAS) and the InScope Multi-Clip Applier (IMCA), may help to achieve this. The aim of this study was to determine the feasibility of using each device to close col...

Safe and efficient gastrotomy creation and closure is pivotal for natural orifice transluminal endoscopic surgery (NOTES). To test a method of transgastric access and closure with commercially available devices. An animal survival study. University hospital. Fifteen pigs. By using a surgical suture passer, under endoscopic guidance, 3 percutaneous...

Permanent metal stent placement for malignant intestinal obstruction has been proven to be efficient. Temporary stents for benign conditions of the colon and rectum are less studied. This is a case study, review of the literature, and observation from an animal model on placement of stents in the colorectum for benign disease. A 55-year-old man pre...

Safe and efficient endoscopic closure of a colotomy is essential for transcolonic peritoneal access or endoscopic full-thickness resection of the colon, if open or laparoscopic surgery is to be avoided. To compare the feasibility and safety of colotomy closure with the newly developed Tissue Approximation System (TAS, Ethicon Endo-Surgery, Inc.) to...

Zusammenfassung GRUNDLAGEN: Technische Vorraussetzungen und Instrumentarium für NOTES (Natural Orifice Transluminal Endoscopic Surgery) stecken noch immer in ihren Kinderschuhen. METHODIK: Literaturübersicht, persönliche Erfahrungen und Expertenmeinungen. ERGEBNISSE: Sterilität von Endoskopen und der dazugehörigen Instrumente machen Adaptationen im...

Background: Fundamental challenges to the safe introduction of Natural Orifice Transluminal Endoscopic Surgery (NOTES) are peritoneal access and closure. We describe decontamination and sterilization protocols and explain various methods to open and close the stomach and the colon endoscopically. Methods: A literature research was undertaken using...

BACKGROUND: Natural Orifice Transluminal Endoscopic Surgery (NOTES) is emerging as a novel approach in minimally invasive surgery. Cholecystectomy, the most common elective procedure in general surgery, has benefited from the minimally invasive approach, and may be applicable for NOTES. METHODS: A literature search was performed in PubMed. The resu...

Background: In this long-term follow-up of a prospective randomized multicentric trial, warp-knitted gelatin-coated double-velour Dacron (GEL-D), warp-knitted collage-coated double-velour Dacron (COL-D) and stretch PTFE bifurcation grafts implanted in patients with abdominal aortic aneurysms(AAA) werecomparedfor their long-term results and their di...

Background: The objective of our study was to assess the efficacy of multimodal hepatic cytoreduction in symptomatic patients with advanced hepatic metastases from carcinoid disease. Methods: A retrospective analysis of prospectively collected data was performed. All consecutive patients, who underwent cytoreductive treatment for their metastatic c...

Die Durchführung einer präoperativen systemischen Chemotherapie (PST) stellt heute einen wichtigen Eckpfeiler in der multimodalen Therapie des fortgeschrittenen Mammakarzinoms dar. Dadurch wird eine Brusterhaltung in Behandlungssituationen, die früher eine Mastekomie erforderlich gemacht hätten, bei einem Teil der Patientinnen möglich. Allerdings s...

Phyllodes tumors are fibroepithelial neoplasms that are extremely rare, comprising less than 1% of all breast neoplasms. Malignant transformation may occur, usually within the stromal component of the phyllodes tumor. The most common patterns of stromal malignancy are fibrosarcoma and myxoliposarcoma. Other patterns include chondrosarcoma, osteosar...

Several case reports and clinical studies in the literature demonstrate needle track seeding after core needle biopsy in patients with breast cancer in up to 50% of cases. The impact of this observation on local recurrence and overall survival rate is, however, not fully investigated. We retrospectively analysed 719 patients after breast conserving...

Background: The benefit of preoperative chemotherapy on outcome in breast cancer has been shown to be highest in patients with complete pathological response (pCR). The objective of this analysis was to determine the predictive value of progesterone receptor status on pCR rate in primary breast cancer patients receiving preoperative chemotherapy. M...

In primary breast cancer, the expression levels of biological markers relevant to the progression of the disease may be altered by administration of anticancer drugs. Since neoadjuvant chemotherapy with epirubicin and docetaxel is increasingly used in advanced breast cancer, our purpose was to assess the influence of this neoadjuvant chemotherapy o...

HER-2/neu is a valuable prognostic marker in primary breast carcinoma. Controversy surrounds the correlation between HER-2/neu expression and other prognostic markers, as has been discussed in preclinical and clinical studies. The objective of the current study was to investigate the probability, calculated using parameters that are assessed routin...

Local blood flow failure (no-reflow phenomenon) during ischemia/reperfusion (I/R) injury may be mediated by interstitial edema formation (passive vasoconstriction) and/or microvascular spasm (active vasoconstriction). The development of the no-reflow phenomenon in the rabbit hind limb I/R model and the influence of treatment with L-arginine and/or...

BACKGROUND: Endothelial cells cultured in vitro are commonly used as a model for testing the effects of therapeutic or detrimental agents on endothelium. Cells originating from different vascular beds display, however, a heterogeneity of function and phenotype. Here we compared the production of angiogenic growth factors and the sensitivity to exog...

In this prospective randomized multicenter trial, knitted gelatine-coated Dacron, knitted collagen-coated Dacron, and stretch polytetrafluoroethylene (PTFE) aortic bifurcation grafts were compared for their long-term results. Between 1991 and 1998, 149 patients undergoing elective revascularization for aortoiliac occlusive disease were prospectivel...

In breast cancer patients receiving adjuvant tamoxifen after unilateral treatment, contralateral breast cancer (CBC) is extremely rare. As a result, only limited data are available on the hormone receptor status of CBCs evolving in tamoxifen-treated patients. The aim of our investigation was to evaluate the pattern of hormone receptor status of CBC...

Background: Any surgical manoeuvre that involves cessation of blood supply to an organ with subsequent re-establishment of blood flow can result in ischaemia/reperfusion (I/R) injury. The consequences of such injury are local and remote tissue destruction. Methods: I/R is characterized by 'no reflow phenomenon' and interstitial oedema formation. Ch...

Background: Peroxisome proliferator-activated receptor-γ (PPARγ) ligands were shown to induce the vascular endothelial growth factor (VEGF) synthesis in several cell types. We tested the effect of ciglitazone, one of the most specific PPARγ agonists, on the angiogenic activity of VEGF. Methods: Experiments were performed on human umbilical vein end...

Zusammenfassung:Grundlagen: Das Alter urämischer Patienten auf einer Nierentransplantationswarteliste verschiebt sich zusehends in höhere Altersgruppen. Der Anteil der über 65jährigen Empfänger auf der Wiener Warteliste erreichte 1995 – 1999 12,2 %. Der Anteil der über 65jährigen Nierentransplantierten betrug im gleichen Zeitraum 15,6 %. Mit Anfang...

Grundlagen: Das Alter urämischer Patienten auf einer Nierentransplantationswarteliste verschiebt sich zusehends in höhere Altersgruppen. Der Anteil der über 65jährigen Empfänger auf der Wiener Warteliste erreichte 1995–1999 12,2%. Der Anteil der über 65jährigen Nierentransplantierten betrug im gleichen Zeitraum 15,6%. Mit Anfang 1999 startete Eurot...

Abstract In recent years, alcoholic cirrhosis has been accepted as an indication for OLT, compliance of patients suffering from alcoholic cirrhosis is still under discussion, however. 118 patients who had undergone OLT for alcoholic cirrhosis were considered for analysis. The mean follow-up time of the study population was 53.7 ± 38.9 months. Compl...

In recent years, alcoholic cirrhosis has been accepted as an indication for OLT, compliance of patients suffering from alcoholic cirrhosis is still under discussion, however. 118 patients who had undergone OLT for alcoholic cirrhosis were considered for analysis. The mean follow-up time of the study population was 53.7 +/- 38.9 months. Compliance w...