80. Einrichtung einer systematischen Kontrolluntersuchungsklinik

Troidl, H.

doi:10.1007/bf01579377

Cited by 12 publications

(3 citation statements)

References 21 publications

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“…3 and 6 months, and 1.2. 3.4. and 5 years postoperatively [17]. During a follow-up session the patient was interviewed using a standardized questionnaire consisting of 44 questions administered by one person of the study team.…”

Section: Extension Of Lnmentioning

confidence: 99%

Pouch versus esophagojejunostomy after total gastrectomy: A randomized clinical trial

et al. 1987

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This is an interim report of a randomized clinical trial on esophagojejunostomy (E J) versusHunt-Lawrence-Rodino (HLR) pouch as reconstruction techniques following total gastrectomy and systematic lymphadenectomy for gastric cancer treatment. The randomized trial preceded a pilot study comparing the Longmire-Gutgemann interposition ant/ the HLR. The pilot study included 7 patients, the randomized trial 38 patients (60 planned). The main outcome variables in the pilot study were food resorption, caloric intake, and body weight. Survival probability and general well-being (quality of life) were measured in the randomized trial. A score was composed of diseasespecific and socio-personal variables with well-being ranging from 0 (worst) to 14 (best) points.Concerning food resorption in the pilot study, no relevant advantage of the duodenal passage was found. The main postoperative disorder was insufficient food intake. Despite a radical operation, a hospital mortality rate of 16%, and a complication rate of 37%, gastric cancer still has a poor prognosis. In the randomized trial only 15 (39%) of 38 patients were alive 1 year after operation, but the survival probability was higher (58%) after HLR than after EJ (24%) (p < 0.05). Hunger and appetite were strongly reduced during the first 6 months after operation. Food intake was less than half of the preoperative values, which was reflected by an average decrease in body weight of 7 kg.Patients dying within the first year after total gastrectomy suffered an irreversible loss of quality of life (scoring 7 points). They had no objective benefit from the operation. Patients surviving this period regained quality of life and exceeded preoperative values, especially after HLR.We conclude that HLR-operated patients who have a chance of surviving for at least 1 year benefit from total gastrectomy in regard to quality of life.

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Section: Extension Of Lnmentioning

confidence: 99%

Pouch versus esophagojejunostomy after total gastrectomy: A randomized clinical trial

et al. 1987

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“…To put these aspects of clinical research into practice, a structure is helpful, maybe even necessary. This is follow-up and I already discussed this many years ago [21].…”

Section: Conceptionmentioning

confidence: 90%

“…There are many essential aspects of the socalled follow ups which we published many years ago. [21].…”

Section: Integration Modelmentioning

confidence: 95%

Conceptional and structural conditions for successful clinical research

Troidl

1998

Langenbeck's Archives of Surgery

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The efficiency of surgical research has again become the subject of debate. Clinical research is required to improve our understanding of surgical disorders and our ability to treat patients. This involves both experimental research (research in the test tube) and clinical research in actual patients. The surgeon must remain the expert because it is he who deals with the patient and is confronted with his problems. On the other hand, care for the patient, must always be the central issue. Here a new orientation is needed, evaluating the effectiveness of surgical research from the patient's point of view. Surgical treatment, particularly surgical research, must be adapted first to the individual patient and only secondly to the surgical disease - the problem must determine the method, not vice versa. While it is clear that a creative atmosphere, supportive structure and efficient organisation are enormously helpful, today's exaggerated attention to matters of structure and organisation are often poor substitutes for creativity and intuition. Surgical research does not refer solely to therapy research but includes methods for carrying out controlled clinical trials, establishing guidelines and scores and designing instruments for measuring outcome. Socioeconomic and analyses and ethical considerations are crucial for facing such conflicts as "quality versus quantity", "profession versus business", "patient care versus economics costs". Proposals for designing more effective concepts, structure and organisation for clinical research are presented here, and three models are introduced: the cooperation model, the integration model and a mixture of the two.

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Lebensqualität nach laparoskopischen und konventionellen Eingriffen — Argumente für das minimal-invasive Vorgehen?

Eypasch¹

1999

Bilanz Zur Jahrtausendwende

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80. Einrichtung einer systematischen Kontrolluntersuchungsklinik

Cited by 12 publications

References 21 publications

Pouch versus esophagojejunostomy after total gastrectomy: A randomized clinical trial

Pouch versus esophagojejunostomy after total gastrectomy: A randomized clinical trial

Conceptional and structural conditions for successful clinical research

Lebensqualität nach laparoskopischen und konventionellen Eingriffen — Argumente für das minimal-invasive Vorgehen?

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