In this study, angiographic scoring and Doppler flow measurements were equally valid means for the assessment of run-off. Our system allows an objective assessment of run-off independently of the distal bypass anastomosis level and provides a functional estimation of run-off.

Measurement of flow volume could be used as a screen, in order to filter out reconstructions, which must be further clarified with an angiogram. A further prospective evaluation of the value of volume flow is needed before any conclusive recommendations can be drawn.

Zusammenfassung. Grundlagen: Retrospektive Analyse einer konsekutiven Serie von 30 Patienten, die aufgrund einer Femoralhernie operiert wurden.Methodik: Der Zeitpunkt der Diagnosestellung, der Zustand nach Operation einer Inguinalhernie und das Rezidiv nach Operation einer Femoralhernie wurden hinsichtlich des Einflusses auf die Notwendigkeit einer akuten Operation untersucht. Der postoperative chronische Schmerz wurde mittels VAS und MPQ-Score fü r akute und elektive Eingriffe verglichen. Nachbeobachtungszeitraum 50 Monate (Median).Ergebnisse: 11 Patienten (33,3%) wurden akut, 22 (67,7%) elektiv operiert. Der Zeitpunkt der Diagnosestellung unterschied sich je nachdem, ob die Operation akut oder elektiv durchgefü hrt wurde, signifikant in den beiden Gruppen (p ¼ 0,001). Ein Rezidiv ist nicht aufgetreten. Weder der Zustand nach Operation einer Inguinalhernie (p ¼ 0,212) noch das Rezidiv nach Operation einer Femoralhernie (p ¼ 0,143) sind signifikante Risikofaktoren fü r die Notwendigkeit einer akuten Operation. VAS und MPQ-Score zeigten keinen signifikanten Unterschied hinsichtlich akuter oder elektiver Operationen.Schlussfolgerungen: Weder der Zustand nach Operation einer Inguinalhernie noch ein Rezidiv nach Operation einer Femoralhernie sind signifikante Risikofaktoren für die Notwendigkeit einer akuten Operation. Die Inzidenz des postoperativen chronischen Schmerzes war bei akut und elektiv operierten Patienten vergleichbar.Schlüsselwörter: Femoralhernie, Rezidiv, chronischer Leistenschmerz.Summary. Background: Retrospective analysis of a consecutive series of 33 patients undergoing femoral hernia repair.Methods: Time from diagnosis to operation, previous inguinal hernia repair and recurrent femoral hernia were evaluated for their impact on the need to undergo emergency surgery. Postoperative chronic pain was measured by VAS and MPQ and compared for elective and emergency procedures.Results: Eleven patients (33.3%) had to undergo emergency surgery, while 22 (66.7%) were operated electively. Follow-up was 50 months in median (range 16-72). Overall, time periods between diagnosis and surgery differed significantly in acute and elective patients (p ¼ 0.001). Neither previous inguinal hernia repair (p ¼ 0.212) nor recurrent femoral hernia (p ¼ 0.143) increased the risk for acute operation. There was no recurrence. VAS and MPQ did not reveal a significant difference between emergency and elective patients.Conclusions: Previous inguinal hernia repair and recurrent femoral hernia do not increase the risk for emergency repair of femoral hernia. The incidence of postoperative chronic pain following acute and elective repairs was comparable.

Detection of CTC in blood of metastatic breast cancer patients 4/2008 original report 281 Purpose: Th e prognostic relevance of circulating tumour cells (CTC) in blood of metastatic breast cancer patients was evaluated and compared with established prognostic criteria.Patients and methods: Blood samples from 119 breast cancer patient were examined in a retrospective analysis. For the detection of CTC in blood, a nested RT-PCR assay for mammaglobin mRNA was applied.Results: In 42/119 (35%) patients CTC were detected. Patients with CTC positive blood samples at the time of diagnosis of metastases lived signifi cantly shorter (median 18 months) than CTC-negative patients (median 51 months), suggesting that CTC serve as an additional prognostic parameter. CTC in blood were an independent prognostic parameter, associated with the highest risk of death compared to other risk factors examined (HR: 2.9). In addition, the appearance of CTC in blood of metastatic patients during treatment indicated poor prognosis. CTC-positive patients had a signifi cantly shorter survival compared to patients remaining CTC negative during followup (p < 0.01).Conclusions: CTC at the time of diagnosis of metastases are an independent prognostic factor for overall survival. During therapy, the detection of CTC is predictive for a shorter survival of patients with metastatic breast cancer.