Sklavenhandel als Verbrechen gegen die Menschlichkeit –: Geschichtskultur, Gedenken und Geschichtswissenschaft in Europa

This essay focuses on the consequences that new perspectives on slavery and slave trade as well as the political functionalising of the past are having on historical sciences, addressing the recent forms of public commemoration of slavery and slave trade in European countries. This debate is especially fostered by the global discourse on coming to terms with the past and the UN-declaration of slavery as a crime against humanity. The differing narratives on slavery from governments, museums, victims, historians and NGOs are shaping the historical awareness within European societies. The breaking of silence on slave trade is resulting in various commemoration activities, exhibitions, slavery monuments and new research institutions. Thus the need for specific attention and research in the field of politicized public history and the upholding of their scientific standards against a normative history narrative is emerging within historical sciences. Only in this way can history produce insight in the mechanisms of guilt, responsibility and historical injustice

The duration of postoperative ileus after elective colectomy is correlated to surgical specialization

Aim: Postoperative ileus is an important factor of complications following gastrointestinal procedures. Its pathophysiology and the parameters, which may impact on its duration, remain unclear. The aim of this study was to measure the role of various clinical determinants on restoration of intestinal function after elective colorectal surgery. Methods: From July 2002 to September 2003, all patients who underwent laparotomy for colectomy (laparoscopic resections excluded) with either an ileotransverse, colocolic, or high colorectal anastomosis were entered in this prospective study. The intervals in hours between the end of the surgical procedure and passing of flatus (PG) and passing of stool (PS) were recorded by an independent investigator. PG and PS were eventually correlated with the following parameters: type of colectomy, early removal of nasogastric tube (NGT), mechanical bowel preparation (MBP), type of underlying disease, systemic administration of opiates, and surgical training (colorectal fellowship or other). Results: One hundred twenty-four patients were entered in this study. Four patients (3.2%) developed septic complications (3 anastomotic leaks and 1 intraabdominal abscess) and were excluded from the analysis. Median age in this population was 68 (range 30-95) years. Mean duration of postoperative ileus was 70±28h (PG) and 99±34h (PS). The type of colectomy, underlying disease, MBP, and early NGT removal failed, in univariate analysis, to correlate with the duration of postoperative ileus. By contrast, time intervals PG and PS were statistically shorter in the group of patients treated by a colorectal surgeon [56±23 vs 74±28h (PG); 82±26 vs 103±35h (PS), p=0.004], as well as in patients who received systemic opiates for less than 2days [64±27 vs 75±28h (PG), p=0.04; 88±32 vs 108±33h (PS), p=001]. Conclusion: Restoration of normal intestinal function after elective open colectomy takes 3 (PG) to 4 (PS) days. In our series, specialized training in colorectal surgery has a positive impact on the duration of postoperative ileus. Surgical specialization should be considered an important parameter in future clinical trials aiming to minimize postoperative ileu

Laparoscopic versus open sigmoid resection for diverticulitis: long-term results of a prospective, randomized trial

Background: Elective laparoscopic sigmoid resection for diverticulitis has proven short-term benefits, but little data are available from prospective randomized trials regarding long-term outcome, quality of life, and functional results. Methods: Of 113 patients randomized to undergo laparoscopic (LAP) versus open (OP) sigmoid resection for diverticulitis, 105 (93%, LAP=54, OP=51) patients were examined and answered the Gastrointestinal Quality of Life Index (GIQLI) questionnaire, with a median follow-up of 30 (range, 9-63) months after surgery. Results: Incisional hernias were detected in five (9.8%) patients in the OP group versus seven (12.9%) in the LAP group, P=0.84). Overall satisfaction with the operation on a scale of 0 (very poor) to 10 (excellent) was 9 (range, 2-10) in the OP group versus 9 (range, 2-10) in the LAP group (P=0.78). Median GIQLI score was 115 (range, 57-144) in the OP group versus 110 (range, 61-134) in the LAP group (P=0.17). Overall satisfaction with the cosmetic aspect of the scar on a scale of 0 (very poor) to 10 (excellent) was 8 (range, 1-10) in the OP group versus 9 (range, 0-10) in the LAP group (P=0.01). Finally, median hospital cost (including reoperations for hernias) was 11,606 (5,230-147,982) CHF in the LAP group versus 12,138 (6,098-39,786) CHF in the OP group (P=0.47). Conclusions: Both open and laparoscopic approaches for sigmoid resection achieve good long-term results in terms of gastrointestinal function, quality of life, and patients' satisfaction. Significant long-term benefits of laparoscopic surgery are restricted to cosmetic (ClinicalTrials.gov protocol #NCT00453830

Results of emergency Hartmann's operation for obstructive or perforated left-sided colorectal cancer

<p>Abstract</p> <p>Background</p> <p>Up to 15% of colorectal cancer (CRC) patients present with obstructive or perforated tumours, and require emergency surgery. The Hartmann's procedure (HP) provides the opportunity to achieve a potentially curative (R0) resection, while minimizing surgical trauma in poor-risk patients. The aim of this study was to assess the surgical (operative mortality), and oncological (long-term survival after curative resection) results of emergency HP for obstructive or perforated left-sided CRC.</p> <p>Methods</p> <p>A retrospective review of 50 patients who underwent emergency HP for perforated/obstructive CRC in our institution between 1995 and 2006.</p> <p>Results</p> <p>Median age of patients was 75 (range 22–95) years and the indications for HP were obstruction (32) and perforation (18 patients). Operative mortality and morbidity were 8% and 26% respectively. 35 patients (70%) were operated with a curative intent; in this group, overall 1-, 3- and 5-year survival rates were 80%, 54% and 40%. In univariate analysis, the presence of lymph node metastases was associated with poor 5-year survival (62% [Stage II] vs. 27% [Stage III], log-rank test, p = 0.02). Eleven patients (22%) had their operation reversed with a median delay of 225 (range 94–390) days. In this subgroup, two patients died from distant metastases, but there were no instances of loco-regional recurrence.</p> <p>Conclusion</p> <p>Hartmann's operation remains a good option to palliate symptoms in 30% of patients with left-sided CRC who are not candidates to a curative resection. For those who have a curative resection, the oncological outcome is acceptable, especially stage II patients, who appear to benefit the most from this surgical strategy.</p

Incidence, consequences, and risk factors for anastomotic dehiscence after colorectal surgery: a prospective monocentric study

Background: Anastomotic dehiscence is the most severe surgical complication after large bowel resection. This study was designed to assess the incidence, to observe the consequences, and to identify the risk factors associated with anastomotic leakage after colorectal surgery. Materials and methods: All procedures involving anastomoses of the colon or the rectum, which were performed between November 2002 and February 2006 in a single institution, were prospectively entered into a computerized database. Results: One thousand eighteen colorectal resections and 811 anastomoses were performed over this 40-month period. The most frequent procedures were sigmoid (276) and right colectomies (217). The overall anastomotic leak rate was 3.8%. The mortality rate associated with anastomotic leak was 12.9%. In univariate analysis, the following parameters were associated with an increased risk for anastomotic dehiscence: (1) ASA score ≥ 3 (p = 0.004), (2) prolonged (>3h) operative time (p = 0.02), (3) rectal location of the disease (p  25 (p = 0.04). In multivariate analysis, ASA score ≥ 3 (OR = 2.5; 95% CI 1.5-4.3, p  3h [OR = 3.0; 95% CI 1.1-8.0, p = 0.02), and rectal location of the disease (OR = 3.75; 95% CI 1.5-9.0 (vs left colon), p = 0.003; OR = 7.69; 95% CI 2.2-27.3 (vs right colon), p = 0.001] were factors significantly associated with a higher risk of anastomotic dehiscence. Conclusions: Three risk factors for anastomotic leak have been identified, one is patient-related (ASA score), one is disease-related (rectal location), the third being surgery-related (prolonged operative time). These factors should be considered in perioperative decision-making regarding defunctioning stoma formatio

Der «Hype» um den Ersten Weltkrieg. Ausgangspunkt eines neuen Narrativs über die Schweiz im Grossen Krieg?

Der Beitrag fragt am Beispiel des Hypes um die Schweiz im Ersten Weltkrieg danach, was Jubiläen wie das Centenaire mit historischer Forschung tun. Kann Forschung die öffentliche Aufmerksamkeit nutzen, um neue Erkenntnisse zu popularisieren und in die öffentliche Diskussion einzubringen? Eröffnet der Hype so eine neue Phase bezüglich der Inhalte und Zugänge historischer Forschung oder bestätigt er traditionelle Sichtweisen und Mythen