Acta Chirurgica BelgicaPub Date : 2024-06-01Epub Date: 2024-02-23DOI: 10.1080/00015458.2024.2320983
Carl De Crée
{"title":"'Carried away by a moonlight shadow' -<i>In memoriam</i> Prof. em. Dr. med. Paul L.O. Broos 1945-2023.","authors":"Carl De Crée","doi":"10.1080/00015458.2024.2320983","DOIUrl":"10.1080/00015458.2024.2320983","url":null,"abstract":"","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":"124 3","pages":"248-252"},"PeriodicalIF":0.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141070126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Acta Chirurgica BelgicaPub Date : 2024-06-01Epub Date: 2023-07-23DOI: 10.1080/00015458.2023.2234724
Clara Bihain, Jean Delwaide, Paul Meunier, Laurent Gerard, Alexandre Jadoul, Olivier Detry
{"title":"Successful multimodal management of a large hepatocellular carcinoma in a non-cirrhotic liver: a case report.","authors":"Clara Bihain, Jean Delwaide, Paul Meunier, Laurent Gerard, Alexandre Jadoul, Olivier Detry","doi":"10.1080/00015458.2023.2234724","DOIUrl":"10.1080/00015458.2023.2234724","url":null,"abstract":"<p><strong>Background: </strong>Hepatocellular carcinoma (HCC) found in a non cirrhotic liver represents a minority of HCC cases and remains poorly studied. Due to its specific characteristics and evolution, this tumour requires a different management compared to HCC in a cirrhotic liver.</p><p><strong>Case report: </strong>The authors describe the case of a 68-year-old man diagnosed with a large giant and only mildly symptomatic HCC in a non-cirrhotic liver. The 23 cm HCC was discovered when a thoracoabdominal computed tomography was performed following mild abdominal pain. After a multidisciplinary discussion the tumour was judged to be borderline, but potentially resectable after neoadjuvant therapy and preparation for surgery. The patient underwent selective internal radiation therapy radioembolization of the right hepatic artery lobe with 5,5 GBq of 90Y-labeled glass microspheres. It was followed by extended right hepatectomy after preparation by embolization of the right portal and the right hepatic veins. Thirty months after surgical resection the patient showed neither clinical, radiological nor biological signs of HCC recurrence.</p><p><strong>Discussion: </strong>HCC in non-cirrhotic liver is less common than in cirrhotic liver but has a better prognosis, thanks to a greater opportunity for surgical resection. The symptoms often emerge late and are unspecific, thus delaying the HCC diagnosis. Advances in surgical resection by laparotomy or laparoscopy, and neoadjuvant therapy in preparation for surgery, have proven to be effective. However, high mortality persists due to late diagnosis linked to the inability of identifying groups at risk of HCC in the non-cirrhotic population and inadequate screening.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"229-233"},"PeriodicalIF":0.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9912194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Louis Dominique Le Roy and the first documented and successful crural fracture osteosynthesis, performed in Antwerp in 1796.","authors":"Robrecht (Bob) VanHee","doi":"10.1080/00015458.2024.2350114","DOIUrl":"https://doi.org/10.1080/00015458.2024.2350114","url":null,"abstract":"Methods: In 1796 the Antwerp surgeon Louis Dominique Le Roy (1755-1826) performed an osteosynthesis for an open crural fracture, using cerclage of the tibia with a golden thread. The written report...","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":"2012 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140837515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maria Sioula, Konstantinos Tsirozoglou, Panagiotis Georgakopoulos, Evangelos Mavrommatis
{"title":"Charles Boyd Kelsey (1850-1917). The pioneer of rectal surgery in USA","authors":"Maria Sioula, Konstantinos Tsirozoglou, Panagiotis Georgakopoulos, Evangelos Mavrommatis","doi":"10.1080/00015458.2024.2348857","DOIUrl":"https://doi.org/10.1080/00015458.2024.2348857","url":null,"abstract":"Charles Boyd Kelsey (1850-1917) was a pioneer rectal surgeon. His surgical career was dedicated in the surgery of the rectum, anus, hemorrhoids, and pelvis. He invented also surgical instruments. H...","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":"12 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140842264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Paulien Bonny, Constantijn Bogaert, Luís Filipe AbreudeCarvalho, Filip Gryspeerdt, Hasan Eker, Laurens Hermie, Frederik Berrevoet
{"title":"Evolution in Liver trauma management: A single centre experience","authors":"Paulien Bonny, Constantijn Bogaert, Luís Filipe AbreudeCarvalho, Filip Gryspeerdt, Hasan Eker, Laurens Hermie, Frederik Berrevoet","doi":"10.1080/00015458.2024.2342132","DOIUrl":"https://doi.org/10.1080/00015458.2024.2342132","url":null,"abstract":"OBJECTIVESLiver trauma is common and can be treated non-operatively, through radiological embolisation, or surgically. Non-operative management (NOM) is preferred when possible, but specific criter...","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":"7 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140559923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Acta Chirurgica BelgicaPub Date : 2024-04-01Epub Date: 2023-06-01DOI: 10.1080/00015458.2023.2219521
Mustafa Okumuş, Değer Devecioğlu, Muazzez Çevik, Burak Tander
{"title":"Anastomotic leaks and the relationship with anastomotic strictures after esophageal atresia surgery; effects of patient characteristics.","authors":"Mustafa Okumuş, Değer Devecioğlu, Muazzez Çevik, Burak Tander","doi":"10.1080/00015458.2023.2219521","DOIUrl":"10.1080/00015458.2023.2219521","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate the link between anastomotic leaks (AL) and anastomotic strictures (AS) after esophageal atresia surgery and the influence of patient demographics.</p><p><strong>Materials and methods: </strong>The clinical data of neonates who underwent surgical repair for esophageal atresia were retrospectively reviewed. The results of AL treatment and the relationship with AS, also the effects of patient characteristics were examined with logistic regression analysis.</p><p><strong>Results: </strong>Primary repair was performed on 122 of 125 patients who underwent surgery for esophageal atresia. AL occurred in 25 patients and 21 were treated non-operatively. While 4 patients were re-operated, AL recurred in 3 and led to the death of one. There was no correlation between the development of AL and sex or the presence of additional anomalies. The gestational age and birth weight of patients with AL were significantly higher than those of patients without. AS developed in 45 patients. The mean gestational age was significantly higher in patients who developed AS (<i>p</i> < .001). While the development of AS was significantly higher in patients with AL (<i>p</i> = .001), the number of dilatation sessions needed was also significantly higher in these patients (<i>p</i> = .026). Complications related to anastomosis were less common in patients whose gestational age was ≤33 weeks.</p><p><strong>Conclusion: </strong>Non-operative treatment remains effective for AL after esophageal atresia surgery. AL increases the risk of developing AS and significantly increases the number of dilatation sessions needed. Anastomotic complications are less common in patients with lower gestational age.NOVEL ASPECTSGestational age and birth weight were found to be significantly higher in patients with anastomotic leaks than in those without and fewer anastomotic complications were encountered in patients whose gestational age was ≤ 33 weeks.Anastomotic stricture development was significantly higher in patients with anastomotic leaks and the number of dilatation sessions needed for treatment was also significantly higher in these patients.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"114-120"},"PeriodicalIF":0.8,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9550901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Primary angiosarcoma of the Pancreas - A case Report and review of the literature.","authors":"Emre Bozkurt, Samet Yigman, Volkan Adsay, Bengi Gurses, Gurkan Tellioglu, Orhan Bilge","doi":"10.1080/00015458.2024.2309718","DOIUrl":"10.1080/00015458.2024.2309718","url":null,"abstract":"<p><strong>Background: </strong>Angiosarcomas are malignant neoplasms that originate from endothelial cells. The symptoms exhibit a non-specific nature, and achieving a preoperative diagnosis is frequently challenging. They are seldom encountered in the abdomen, and their occurrence in the pancreas is even rarer.</p><p><strong>Methods: </strong>Here we document a 67-year-old man with pancreatic angiosarcoma and analyse the literature to outline the clinicopathologic characteristics of this rare phenomenon.</p><p><strong>Results: </strong>This patient with family history of pancreas cancer presented with abdominal pain, and the CT-scan revealed a 4 cm mass at the neck of the pancreas but CA19-9 was normal. Radiologic findings were unusual for ordinary pancreas cancer. Fine-needle aspiration biopsy through endoscopic ultrasound revealed \"undifferentiated malignant cells for which the diagnosis of \"carcinoma\" was favoured. Total pancreatectomy, splenectomy and portal vein reconstruction were performed and epithelioid angiosarcoma were diagnosed. Despite an uneventful postoperative period, discharge on postoperative day 8 without any complications, as well as diligent post-discharge clinical care, the patient died 65 days postoperatively, attributed to the presence of extensive metastasis. A comprehensive literature search has identified a limited number of documented cases of primary pancreatic angiosarcoma, with only ten cases reported to date.</p><p><strong>Conclusions: </strong>Pancreatic angiosarcomas are very rare and prone to misdiagnosis. The formation of a more demarcated but high-grade tumour with necrosis is a feature that distinguishes angiosarcomas from ordinary carcinomas of this organ. Pathologic diagnosis is also highly challenging closely resembling undifferentiated carcinomas. Angiosarcomas are highly aggressive when they occur in the pancreas. Prompt diagnosis at an early stage is crucial as surgery with curative intent serves as the primary treatment approach.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"73-80"},"PeriodicalIF":0.8,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139541014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Acta Chirurgica BelgicaPub Date : 2024-04-01Epub Date: 2023-07-05DOI: 10.1080/00015458.2023.2231210
Tevfik Ilker Akcam, Ahmet Kayahan Tekneci, Tiffany Melissa Ergin, Rza Memmedov, Ayse Gul Ergonul, Ali Ozdil, Kutsal Turhan, Alpaslan Cakan, Ufuk Cagırıcı
{"title":"Factors influencing postoperative recurrence of early-stage non-small cell lung cancer.","authors":"Tevfik Ilker Akcam, Ahmet Kayahan Tekneci, Tiffany Melissa Ergin, Rza Memmedov, Ayse Gul Ergonul, Ali Ozdil, Kutsal Turhan, Alpaslan Cakan, Ufuk Cagırıcı","doi":"10.1080/00015458.2023.2231210","DOIUrl":"10.1080/00015458.2023.2231210","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to explain the factors that may influence recurrence after surgical resection for early non-small cell lung cancer (NSCLC).</p><p><strong>Methods: </strong>A retrospective analysis was made of 302 patients who underwent lung resection for stage I-IIA NSCLC in our clinic between January 2014 and August 2021.</p><p><strong>Results: </strong>The recurrence rate was higher in patients with squamous cell carcinoma (SCC) than in those with adenocarcinoma (AC) (<i>p</i> = 0.004). Disease-free survival (DFS) was shorter in SCC (<i>p</i> = 0.004). According to histopathological subtypes, the presence of lymphovascular invasion (LVI), vascular invasion (VI), visceral pleural invasion (VPI) and tumor spread through air spaces (STAS) caused an increased risk of recurrence ((<i>p</i> = 0.004), (<i>p</i> = 0.001), (<i>p</i> = 0.047), (<i>p</i> = < 0.001)) and shorter DFS ((<i>p</i> = 0.002), (<i>p</i> = < 0.001), (<i>p</i> = 0.038), (<i>p</i> = < 0.001)). LVI and VI was more common in patients with distant recurrence (<i>p</i> = 0.020, <i>p</i> = 0.002), while the STAS was more common with locoregional recurrence (<i>p</i> = 0.003).</p><p><strong>Conclusion: </strong>The presence of LVI, VI, VPI, and STAS are negative risk factors for recurrence and DFS in all patients and in patients with AC. In patients with SCC, the diagnosis of SCC itself and the presence of STAS were risk factors for recurrence and DFS. Moreover, the risk of distant recurrence is higher in the presence of LVI or VI, and the risk of locoregional recurrence in the presence of STAS is higher.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"121-130"},"PeriodicalIF":0.8,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10127412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Acta Chirurgica BelgicaPub Date : 2024-04-01Epub Date: 2023-06-06DOI: 10.1080/00015458.2023.2217565
Matthias Van Aerde, Frederic Lebrun, Georges Decker
{"title":"Intrapericardial liver herniation after coronary artery bypass grafting: a case report of minimally invasive repair with 20-year follow-up.","authors":"Matthias Van Aerde, Frederic Lebrun, Georges Decker","doi":"10.1080/00015458.2023.2217565","DOIUrl":"10.1080/00015458.2023.2217565","url":null,"abstract":"<p><strong>Background: </strong>Transdiaphragmatic intrapericardial herniation (DIPH) of intra-abdominal organs is a rare but potentially life-threatening phenomenon often requiring urgent repair. There are currently no guidelines on the preferred repair technique in this situation.</p><p><strong>Methods: </strong>Retrospective case report with long-term follow-up. We describe a case in which the left liver herniated into the pericardium after coronary artery bypass grafting (CABG) using the right gastroepiploic artery (RGEA).</p><p><strong>Results: </strong>Urgent laparoscopic reduction of the liver herniation and repair of the large diaphragmatic defect was performed using an expanded polytetrafluoroethylene (ePTFE) mesh in a 50 year old male patient. Hemodynamic instability normalized after the hernia reduction. The postoperative course was uneventful. CT-scan evaluation after 9 and 20 years of follow-up showed perfect integrity of the mesh.</p><p><strong>Conclusion: </strong>A laparoscopic approach for DIPH is feasible in emergency situations provided sufficient hemodynamic stability of the patient. On-lay ePTFE mesh repair is a valid option for such repairs. We illustrate the long-term durability and safety of ePTFE for DIPH repair in what seems to be by far the longest documented follow-up after laparoscopic ePTFE mesh repair for DIPH.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"153-155"},"PeriodicalIF":0.8,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9581130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Acta Chirurgica BelgicaPub Date : 2024-04-01Epub Date: 2024-02-05DOI: 10.1080/00015458.2023.2191073
Ahmed M Chaoui, Ismaël Chaoui, Frederick Olivier, Joachim Geers, Mohamed Abasbassi
{"title":"Outcomes of robotic versus laparoscopic ventral mesh rectopexy for rectal prolapse.","authors":"Ahmed M Chaoui, Ismaël Chaoui, Frederick Olivier, Joachim Geers, Mohamed Abasbassi","doi":"10.1080/00015458.2023.2191073","DOIUrl":"10.1080/00015458.2023.2191073","url":null,"abstract":"<p><strong>Introduction: </strong>Minimally invasive ventral mesh rectopexy is considered the standard of care in the surgical management of rectal prolapse syndromes in fit patients. We aimed to investigate the outcomes after robotic ventral mesh rectopexy (RVR) and compare them with our laparoscopic series (LVR). Additionally, we report the learning curve of RVR. As the financial aspect for the use of a robotic platform remains an important obstacle to allow generalized adoption, cost-effectiveness was also evaluated.</p><p><strong>Patients and methods: </strong>A prospectively maintained data set including 149 consecutive patients who underwent a minimally invasive ventral rectopexy between December 2015 and April 2021 was reviewed. The results after a median follow-up of 32 months were analyzed. Additionally, a thorough assessment of the economic aspect was performed.</p><p><strong>Results: </strong>On a total of 149 consecutive patients 72 underwent a LVR and 77 underwent a RVR. Median operative time was comparable for both groups (98 min (RVR) vs. 89 min (LVR); <i>p</i> = 0.16). Learning curve showed that an experienced colorectal surgeon required approximately 22 cases in stabilizing the operative time for RVR. Overall functional results were similar in both groups. There were no conversions or mortality. There was, however, a significant difference (<i>p</i> < 0.01) in hospital stay in favor of the robotic group (1 day vs. 2 days). The overall cost of RVR was higher than LVR.</p><p><strong>Conclusions: </strong>This retrospective study shows that RVR is a safe and feasible alternative for LVR. With specific adjustments in surgical technique and robotic materials, we developed a cost-effective way of performing RVR.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"91-98"},"PeriodicalIF":0.8,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9140891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}