Christian Alexander Gutschow

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BACKGROUND Diaphragmatic herniation is a rare but morbid complication after esophagectomy. This retrospective study estimates its incidence after transthoracic esophagectomy and describes the clinical spectrum of diaphragmatic herniation. METHODS Between February 1, 1997, and June 31, 2007, 355 consecutive patients with esophageal cancer underwent(More)
OBJECTIVES A considerable percentage of morbidity and mortality after esophagectomy and gastric pull-up is due to leakage of the esophagogastrostomy, which is mainly caused by ischemia of the gastric fundus. Previous clinical studies demonstrated that impaired microcirculation of the gastric conduit almost recovers within the first 5 postoperative days.(More)
Anastomotic leakage is still the major surgical complication following transthoracic esophagectomy with intrathoracic esophagogastrostomy (Ivor-Lewis procedure). Modifications of this standard procedure aim to reduce postoperative morbidity and mortality. In this retrospective analysis of a 12-year period, 419 patients who had an Ivor-Lewis (IL) procedure(More)
Increasing adipocyte size as well as numbers is important in the development of obesity and type 2 diabetes, with adipocytes being generated from mesenchymal precursor cells. This process includes the determination of mesenchymal stem cells (MSC) into preadipocytes (PA) and the differentiation of PA into mature fat cells. Although the process of(More)
BACKGROUND Incomplete symptomatic relief of pharyngoesophageal (Zenker's) diverticulum after endoscopic stapling or laser division has been reported by some authors. The clinical relevance of cricomyotomy, although supported by experimental data, remains controversial. METHODS Operative procedures consisted of transcervical resection (n = 34, group I),(More)
BACKGROUND Skip metastasis to mediastinal lymph nodes is a well-known phenomenon in non-small cell lung cancer (NSCLC). Little is reported in the literature about its clinical importance. It is still under discussion whether any prognostic differences exist between resected NSCLC with either skip metastases or continuous mediastinal lymph node metastases(More)
In patients with obesity and type 2 diabetes, adipose tissue is infiltrated by macrophages known to alter adipogenesis of mesenchymal precursor cells via secretion of proinflammatory cytokines. Recently, it has been shown that under certain conditions, immune cells can also express wnt-5a, a factor known to inhibit adipogenesis in humans. Therefore, in this(More)
OBJECTIVE To define "best possible" outcomes in total minimally invasive transthoracic esophagectomy (ttMIE). BACKGROUND TtMIE, performed by experts in patients with low comorbidity, may serve as a benchmark procedure for esophagectomy. PATIENTS AND METHODS From a cohort of 1057 ttMIE, performed over a 5-year period in 13 high-volume centers for(More)
Cancer of the papilla of Vater (CPV) has a significantly better outcome compared to pancreatic cancer (PC) after curative resection. Increasing evidence suggests that prognostic differences are influenced by a different tumor biology. Secreted protein acidic and rich in cystein (SPARC)/osteonectin is a multifunctional matricellular protein involved in(More)
OBJECTIVE To identify differences in survival of patients with pT1 esophageal cancer relating to depth of wall infiltration. BACKGROUND DATA Histologic analysis of mucosal and submucosal infiltration in thirds has shown an increasing rate of lymph node metastases (LNM) according to the depth of wall infiltration in pT1 esophageal cancer. METHODS One(More)