Eduard Gitsch

The Vienna method of prophylaxis against complications after radical surgery for cancer of the uterus.

With the help of thz Vienna method, the most important urological, intestinal and thromboembolic complications can be reduced substantially: ureterovaginal fistulae from 5 to 0.68%, residual urine from 19.28 to 3.75 %, pyelitis and pyelonephritis from 9.28 to 2.13%, whereas postoperative surgical complications, c.g. ileus and postoperative meteorism, can be avoided altogether. Thromboembolic complications dropped from 10.6% (without prophylactic Marcoumar medication) to 2.8% (with prophylactic Marcoumar medication).

Diagnostic and intraoperative immunoscintigraphy in ovarian cancer

A new strategy for tumor detection using immunoscintigraphic techniques was used in an attempt to improve the diagnostic potential of conventional external immunoscintigraphy. Twelve patients who were strongly suspected to either suffer from primary or recurrent ovarian cancer were investigated as follows: radioimmuno-scintigraphy (RIS) by means of radiolabelled antibodies was performed in all patients prior to operation (first or second look). During the operative procedure, which always took place immediately after completion of the diagnostic RIS, a hand-held gamma-ray detection probe, especially developed for this purpose was used for the purpose of identifying radiolabelled tumor sites intra-operatively in the open abdomen. In 10 out of 12 of the investigated patients, Radioisotope-Assisted Surgery (RAS) could be performed successfully. The count rates in cancer sites ranged from 150-250 cts per 6 s vs. 30-50 cts per 6 s in normal tissues. While the presence of malignant-tumor sites could always be predicted by conventional RIS, RAS failed twice, but revealed more accurate information concerning the real extent of the disease.

4 Radio-immunoscintigraphy and intraoperative tumour detection by means of anti-tumour antibodies in patients with ovarian cancer

Summary A hand-held gamma-ray detection probe was developed by us to circumvent the problems of conventional radio-immunoscintigraphy (RIS). The intraoperative use of this probe in terms of radionuclide-assisted surgery (RAS) should help to overcome problems associated with insufficient accumulation by the tumour of the radio-active antibodies, unfavourable localization of tumour sites, collimation problems, etc., in patients with ovarian cancer. The probe was designed as a scintillation counter. Twelve patients were operated upon and investigated by RAS. It could be shown that RAS is able to detect tumour tissue intraoperatively, although we have already seen that improvements in the probe are necessary to make the method of real clinical value.

Radioisotope Radical Operation for Cancer of the Cervix

Abstract. By performing the radioisotope radical operation (pre‐surgical labelling of the lymphatic tissue of the pelvis with colloidal 198Au) with the aid of a gamma camera, it was possible in 78 out of 93 cases to completely extirpate the regional lymphatic tissue of the pelvis. in eight out of 24 cases with positive findings on the lymph nodes we were also able to extirpate with this technique residues of carcinomatous lymphatic tissue during the course of a secondary isotope lymphadenectomy. This fact is likely to further improve the recovery rate—all the more so since even the scanner and eye probe technique already reduced the mortality rate due to recurrence by 16.4% after 5 years.