Klaus E. Matzel

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OBJECTIVE Total mesorectal excision (TME) as proposed by R.J. Heald more than 20 years ago, is nowadays accepted worldwide for optimal rectal cancer surgery. This technique is focused on an intact package of the tumour and its main lymphatic drainage. This concept can be translated into colon cancer surgery, as the mesorectum is only part of the mesenteric(More)
Background. Anastomotic leakage is the most threatening early complication in sphincter-preserving rectal cancer surgery. While the oncological consequences have been well examined, only few data exist about the functional outcome. Patients and methods. We investigated continence function in 150 patients after curative sphincter-preserving rectal cancer(More)
PURPOSE This study contained herein assessed long-term results, toxicity, and prognostic variables following combined modality therapy of patients with International Union Against (Cancer Classification T1-4, N0-3, M0 squamous-cell carcinoma of the anal canal. PATIENTS AND METHODS Between 1985 and 1996, 62 patients completed treatment with combined(More)
Functional deficits of the striated anal sphincteric muscles without any apparent gross defect often result in a lack of ability to postpone defaecation by intention or in faecal incontinence in response to increased intra-abdominal or intra-rectal pressure. We applied electrostimulation to the sacral spinal nerves to increase function of the striated(More)
BACKGROUND In patients with faecal incontinence in whom conservative treatment fails, options are limited for those with a functionally deficient but morphologically intact sphincter. We investigated the effect of sacral nerve stimulation on continence and quality of life. METHODS In this multicentre prospective trial, 37 patients underwent a test(More)
OBJECTIVE Function after anterior, low anterior and intersphincteric resection for rectal cancer was studied. METHOD Of 139 patients 122 responded to a standardized questionnaire (Cleveland Clinic Continence Score) 108 +/- 46 weeks postoperatively and 70 underwent anorectal manometry at 26 +/- 15 weeks. RESULTS The postoperative continence score was(More)
OBJECTIVE The most extended form of rectal resection, representing the very last option for sphincter preservation is abdomino-peranal intersphincteric resection for tumours of the lower third which otherwise would not be resectable with preservation of the sphincter by an abdominal approach alone. PATIENTS AND METHODS The data of 476 patients with a(More)
BACKGROUND Injection of a bulking agent in the anal canal is an increasingly used treatment for faecal incontinence, but efficacy has not been shown in a controlled trial. We aimed to assess the efficacy of injection of dextranomer in stabilised hyaluronic acid (NASHA Dx) for treatment of faecal incontinence. METHODS In this randomised, double-blind,(More)
PURPOSE Dynamic graciloplasty has been used for intractable fecal incontinence, and good results have been reported. The aim of this study was to assess prospectively the safety and efficacy of dynamic graciloplasty for intractable fecal incontinence in a prospective, multicenter trial. METHODS A total of 123 adults were treated with dynamic graciloplasty(More)
OBJECTIVE To determine the therapeutic efficacy and safety of recombinant human interleukin-1 receptor antagonist (rhIL-1ra) in the treatment of patients with severe sepsis. DESIGN Prospective, randomized, double-blind, placebo-controlled, multicenter trial with a planned, midstudy, interim analysis. SETTING Ninety-one academic medical center intensive(More)