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Laparoscopic surgery for benign and malign diseases of the digestive system:Indications,limitations,and evidence

World journal of Gastroenterology 2014年第17期20卷 4883-4891页

作者： Markus Alexander Küper Friederike Eisner Alfred K?nigsrainer j?rg glatzle Department for General and Visceral Surgery Bundeswehr Hospital BerlinD-10115 BerlinGermany Department for General Visceral and Transplant SurgeryUniversity Hospital Tübingen72076 TübingenGermany

The laparoscopic technique was introduced in gastrointestinal surgery in the mid 1980s. Since then, the development of this technique has been extraordinary. Triggered by technical innovations (stapling devices or coagulation/dissecting devices), nowadays any type of gastrointestinal resection has been successfully performed laparoscopically and can be performed laparoscopically dependent on the patient’s condition. This summary gives an overview over 30 years of laparoscopic surgery with focus on today’s indications and evidence. Main indications remain the more common procedures, e.g., appendectomy, cholecystectomy, bariatric procedures or colorectal resections. For all these indications, the laparoscopic approach has become the gold standard with less perioperative morbidity. Regarding oncological outcome there have been several high-quality randomized controlled trials which demonstrated equivalency between laparoscopic and open colorectal resections. Less common procedures like esophagectomy, oncological gastrectomy, liver and pancreatic resections can be performed successfully as well by an experienced surgeon. However, the evidence for these special indications is poor and a general recommendation cannot be given. In conclusion, laparoscopic surgery has revolutionized the field of gastrointestinal surgery by reducing perioperative morbidity without disregarding surgical principles especially in oncological surgery.

关键词： Laparoscopy Gastrointestinal surgery Esophagus Stomach Cholecystectomy Colorectal surgery Liver resection Pancreas resection Laparoscopic resection of gastrointestinal

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Experience after 100 patients treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy

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World journal of Gastroenterology 2012年第17期18卷 2061-2066页

作者： Ingmar Knigsrainer Derek Zieker jrg glatzle Olivia Lauk julia Klimek Stephan Symons Bjrn Brücher Stefan Beckert Alfred Knigsrainer Department of Surgery University of TübingenHoppeSeyler-Strasse 3D-72076 TübingenGermany Center for Bioinformatics Tübingen Sand 14D-72076 TübingenGermany

AIM:To investigate perioperative patient morbidity/mortality and outcome after cytoreductive surgery(CRS) and hyperthermic intraperitoneal chemotherapy(HIPEC).METHODS:Of 150 patients 100 were treated with cytoreductive surgery and HIPEC and retrospectively *** and postoperative follow-up data were *** mass index(BMI),age and peritoneal carcinomatosis index(PCI) were chosen as selection criteria with regard to tumor-free survival and perioperative morbidity for this multimodal ***:CRS with HIPEC was successfully performed in 100 out of 150 *** patients were excluded because of intraoperative *** PCI was 17(1-39).In 89% a radical resection(CC0/CC1) was *** patient died postoperatively due to multiorgan *** PCI,age nor BMI was a risk factor for postoperative complications/outcome according to the DINDO *** 9% Re-CRS with HIPEC was performed during the follow-up ***:Patient selection remains the most important *** PCI,age nor BMI alone should be an exclusion criterion for this multimodal therapy.

关键词： Peritoneal carcinomatosis Single-center experience Hyperthermic intraoperative chemotherapy Complications Risk assessment Selection criteria

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Severe Methodological Deficiencies Associated with Claims of Domestic Livestock Driving Climate Change

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journal of Environmental Science and Engineering(B) 2013年第10期2卷 586-601页

作者： Albrecht glatzle INTTAS (Initiative for Research and Extension of Sustainable Agrarian Technologies) Filadelfia 317 9300 Fernheim Paraguay

Reduction of global livestock numbers and meat consumption have been recommended for climate change mitigation. However, the basic assumptions made to come up with that kind of recommendations reveal severe methodological deficiencies：（1） Carbon footprint, emission intensity, and life-cycle assessments of domestic livestock products reported in scientific literature consistently overlooked the necessity of correcting non CO2 GHG （greenhouse gas） emissions （nitrous oxide and methane） from managed ecosystems for baseline emission scenarios over time and space （pristine ecosystem and/or pre-climate change emissions）; （2） Uncertainties associated with the climate sensitivity of anthropogenic GHG-emissions have been ignored; （3） Inconsistencies in the methodological treatment of land use change （deforestation） in emission intensity calculations （per unit of product） can be detected in the literature; （4） The virtual lack of a discernable livestock signal in global methane distribution and historical methane emission rates has not been acknowledged; theoretical bottom up calculations do not reflect the relative insignificance of livestock-born methane for the global methane budget; （5） Potential substrate induced enhancement of methane breakdown rates have not been taken into consideration. A tremendous over-assessment of potential livestock contribution to climate change is the logical consequence of these important methodological deficiencies which have been inexorably propagated through recent scientific literature.

关键词： Global warming GHG (greenhouse gases) methane nitrous oxide biodiversity deforestation baseline scenarios lifecycle assessment carbon footprint emission intensity.

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Gradient analysis of saline groundwater dynamics along spatial transects in the Chaco

Gradient analysis of saline groundwater dynamics along spati...

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ⅩⅪ International Grassland Congress and the Ⅷ International Rangeland Congress

作者： A.glatzle L.Reimer G.Roth j.Cobo Nunez Iniciativa para la Investigacion y Trans ferencia de Tecnologia Agraria Sostenible（INTTAS） Loma Plata 1045 C.d.c.883 AsuncionParaguay

＜正＞Introduction The transitional zone between the dry and the semi-humid Chaco is characterized by a high table of saline *** salinity is commonly observed at the edges of seasonally inundated grasslands in landscape depressions without external runoff（so called water camps） surrounded by native drought deciduous thorn *** far,little information had been available on groundwater characteristics（depth and conductivity） as related to soil salinity.

关键词： dryland salinity groundwater grassland bushland electrical conductivity soil humidity Chaco

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