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  • 11
    Electronic Resource
    Electronic Resource
    Springer
    Probability theory and related fields 19 (1971), S. 243-256 
    ISSN: 1432-2064
    Source: Springer Online Journal Archives 1860-2000
    Topics: Mathematics
    Type of Medium: Electronic Resource
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  • 12
    Electronic Resource
    Electronic Resource
    Springer
    Surgical endoscopy and other interventional techniques 11 (1997), S. 1013-1016 
    ISSN: 1432-2218
    Keywords: Key words: Tumor localization — Laparoscopic surgery — Colon tumors — Rectal tumors
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Because of the inability to palpate colonic tumors during laparoscopy, their location must be precisely identified before resection is undertaken. Method: A retrospective study was performed of 58 patients in order to be able to describe our methods of tumor localization for laparoscopic colorectal operations and to review their effectiveness. Results: In all patients, the entire colon was examined preoperatively by colonoscopy. In one patient, preoperative colonoscopic localization was inaccurate. In 31 patients, tumors were easily detectable at surgery. In five patients with the tumor in the right colon, even though the lesion was not detectable at surgery, right colectomy was performed without marking because preoperative colonoscopy reliably identified the lesion adjacent to the ileocecal valve. Twenty-two patients required some type of procedure to localize the tumor. The procedures and their problems were as follows: preoperative tattoo (five)—tattoo not visualized (one); intraoperative colonoscopy alone (six), combined with intraoperative tattoo (four) or clip (three)—poor operative exposure due to bowel distension (nine), hard to see the clip (three), dislodged clip (two), inadequate resection margin (one); intraoperative proctoscopy alone (two), combined with laparoscopic stitch (two)—no problems. In no patient was tumor present at a resection line and in no patient was the wrong segment resected. Conclusions: Reliable preoperative identification of the tumor adjacent to the ileocecal valve can permit right colectomy without marking. Lesions in the upper rectum can be approached via intraoperative proctoscopy ± suture placement. If the surgeon anticipates intraoperative localization may be difficult, lesions other than rectal or cecal ones should probably be marked by preoperative tattooing. Further studies regarding the technique of tattooing are warranted.
    Type of Medium: Electronic Resource
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  • 13
    Electronic Resource
    Electronic Resource
    Springer
    Surgical endoscopy and other interventional techniques 8 (1994), S. 784-787 
    ISSN: 1432-2218
    Keywords: Colonoscopy ; Painful ; Prediction
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Colonoscopy is sometimes painful for the patient and often difficult for the endoscopist, but it is hard to predict how difficult or painful the examination will be. The purpose of this study was to identify factors that influence difficulty and pain during colonoscopy. Some 1,284 consecutive patients undergoing office colonoscopy by three endoscopists were prospectively studied. A standard questionnaire was completed by the nursing staff, who assessed the degree of difficulty and pain associated with each exam on a four-point scale. There were 682 men and 551 women (sex not recorded in 51). There was no pain in 27%, mild pain in 39%, moderate pain in 25%, and severe pain in 9%. There was no difficulty in 25%, mild difficulty in 33%, moderate difficulty in 28%, and severe difficulty in 14%. Colonoscopy was significantly easier (P〈0.001, chi square) and less painful (P〈0.001, chi square) in patients after sigmoidectomy. It was more painful after hysterectomy (P〈0.05, chi square) and more difficult and painful in women than in men (P〈0.01, chi square). There were significant differences between endoscopists in the assessment of pain associated with colonoscopy. Most colonoscopies are associated with little or no pain (66%) and are easy or only mildly difficult to perform (58%). Patients who have had sigmoid resection are especially easy and painless to examine while women, especially after hysterectomy, are at higher risk of having a painful experience. Colonoscopy technique can influence the amount of pain experienced by the patient.
    Type of Medium: Electronic Resource
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