Andreas R. Köhler

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INTRODUCTION We report on a patient cohort with dorsal horseshoe fistulas-in-ano. We sought to answer the question of whether these fistulas can be operatively treated, implementing a sphincter-preserving fistulectomy with primary closure of the internal opening, as is done when treating transsphincteric anal fistulas. Long-term clinical. course is examined(More)
A rectocele is a herniation of the anterior rectal wall through the rectovaginal septum into the vagina. The most important risk factors are a previous hysterectomy, obstetic injuries and the descending perineum syndrome. In some patients the rectocele becomes symptomatical because of defecation disorders. The patients have to give manual vaginal or(More)
Die Indikation zur Stomaanlage bei den komplizierten Analfisteln und den rektovaginalen Fisteln wird in der Literatur kontrovers diskutiert. Anhand des eigenen Krankengutes sollen Indikationen zur Stomaanlage herausgearbeitet werden. Die Daten aller Patienten, bei denen im Rahmen der Fistelsanierung ein Stoma angelegt worden war, wurden nach einem(More)
Rectovaginal fistulas (RVF) in Crohn’s disease continue to be a challenging problem. Several operations are often necessary to attain definitive healing of the disease process. There are no guidelines concerning optimal therapeutic approaches. Endoanal mobilization techniques such as the advancement flap technique were considered the therapy of choice for(More)
In this study, the genetic relationship of 19 Porphyromonas gingivalis isolates from patients with periodontitis was investigated by multilocus sequence analysis. Internal 400-600 bp DNA fragments of the 10 chromosomal genes ef-tu, ftsQ, hagB, gpdxJ, pepO, mcmA, dnaK, recA, pga and nah were amplified by PCR and sequenced. No two isolates were identical at(More)
A prospective study was carried out on 55 patients with complicated anal fistulas (41 transsphincteric, 5 suprasphincteric and 9 rectovaginal) to evaluate the value of two sphincter-conserving techniques with primary occlusion of the internal ostium and endorectal advancement flap (group A, n=34) or mucosal flap (group B, n=21). Ten of the patients had(More)
From January 1992 until April 1995, 31 patients with trans- and suprasphincteric anal fistulae (transsphincteric n = 21; suprasphincteric n = 4; transsphincteric in Crohn's disease n = 6) underwent a fistulectomy followed by closure of the internal opening by suture and anocutaneous flap. All patients had undergone previous operations, some several times.(More)
PURPOSE The recommended closure techniques for transsphincteric fistulas demonstrate divergent results for postoperative continence and recurrence rates. An incontinence rate of 35 percent and a recurrence rate of up to 54 percent has been reported after transanal advancement techniques. The authors hypothesize that a direct closure of the internal fistula(More)
In a prospective study on 224 patients with so-called high-fistula in ano (189 transsphincteric, 35 suprasphincteric) the long-term results of a sphinctersaving operation technique were assessed. The follow-up period was 1 to 7.5 years. This technique consists of onestage fistulectomy as well as of drainage of the intersphincteric space by internal(More)
Paclitaxel is a radiosensitizing agent that shows a synergistic effect with radiation in malignant glioma cells. A phase I/II trial was performed in order to evaluate both feasibility and outcome of combined radiochemotherapy in malignant glioma. Patients and Methods: 56 patients were included in the trial. Paclitaxel was administered on days 1–4, 15–18 and(More)