Acta Chirurgica Belgica最新文献_第2页

Adrenal cortical carcinoma - a case series and literature review of aggressive adrenal incidentalomas. 肾上腺皮质癌：侵袭性肾上腺偶发瘤的病例系列及文献回顾。

IF 0.8 4区医学

Acta Chirurgica Belgica Pub Date : 2025-08-01 Epub Date: 2025-05-17 DOI: 10.1080/00015458.2025.2506935

Liesbeth Verlinde, Sam Kinet, Klaas Van Den Heede, Nele Brusselaers, Sam Van Slycke

{"title":"Adrenal cortical carcinoma - a case series and literature review of aggressive adrenal incidentalomas.","authors":"Liesbeth Verlinde, Sam Kinet, Klaas Van Den Heede, Nele Brusselaers, Sam Van Slycke","doi":"10.1080/00015458.2025.2506935","DOIUrl":"10.1080/00015458.2025.2506935","url":null,"abstract":"Objective: Adrenal cortical carcinoma (ACC) is a rare and aggressive endocrine malignancy. Clinical symptoms are mainly related to excess hormone secretion. Hypercortisolism and virilisation are among the most common presentations.Methods: We report a case series of five patients with ACC, three of which presented as adrenal incidentalomas. Additionally, a literature review on current diagnosis and management of ACC was performed.Results: ACCs are often incidentally detected because of the liberal use of medical imaging. Management of ACC remains challenging, and the poor prognosis makes early diagnosis of crucial importance to increase chances of a better outcome. Biochemical evaluation should be performed to diagnose hormonally active tumours.Conclusion: Surgery is the main and only potentially curative treatment option. Adjuvant treatment with mitotane may improve survival and is indicated for patients with a perceived high risk of recurrence. Aggressive cytotoxic therapy should be given to patients with an unfavourable prognosis.","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"202-210"},"PeriodicalIF":0.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075318","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}

引用次数: 0

Plain versus drug-eluting balloon angioplasty in the treatment of non-thrombotic hemodialysis arteriovenous fistula stenosis: results from a single center comparative retrospective analysis. 普通与药物洗脱球囊血管成形术治疗非血栓性血液透析动静脉瘘狭窄：来自单中心比较回顾性分析的结果。

IF 0.8 4区医学

Acta Chirurgica Belgica Pub Date : 2025-08-01 Epub Date: 2025-05-13 DOI: 10.1080/00015458.2025.2503647

Merve Horoz, Murat Yoğurtçu, Anıl Hüvez, Ömür Ballı, Serkan Gür

{"title":"Plain versus drug-eluting balloon angioplasty in the treatment of non-thrombotic hemodialysis arteriovenous fistula stenosis: results from a single center comparative retrospective analysis.","authors":"Merve Horoz, Murat Yoğurtçu, Anıl Hüvez, Ömür Ballı, Serkan Gür","doi":"10.1080/00015458.2025.2503647","DOIUrl":"10.1080/00015458.2025.2503647","url":null,"abstract":"Purpose: To compare the mid-term primary and assisted-primary patency results of plain balloon angioplasty (PBA) versus drug-eluting balloon angioplasty (DEB) with non-thrombotic arteriovenous fistula (AVF) stenosis in hemodialysis (HD) patients.Subject and methods: A total of 128 consecutive HD patients, who underwent endovascular treatment with DEB or PBA between October 2015 and December 2021, were investigated in this retrospective study. Color Doppler examination was performed for follow-up after 1, 3, 6, 12, 18, 24, and 36 months. Survival curves for primary and assisted primary vein patencies of the PTA and DEB group were generated with Kaplan-Meier survival analysis and were compared with the log-rank test.Results: 78 patients (60.9%) underwent PBA (45 men, 33 women; mean age: 64.2 ± 13.9, range: 29-82 years) and 50 (39%) patients underwent DEB (36 men, 14 women; mean age: 65.6 ± 12.8, range: 28-87 years). The estimated primary patency rates at 6, 12,18, 24, and 36 months for the DEB group (95.5%, 92.8%, 88.6%, 77.1% and 54.0%, respectively) were significantly higher than those in the PBA group (84.5%, 76.9%, 73.9%, 66.4% and 59.0%, respectively) (p = .048). Assisted primary patency rates at 6, 12, 18, 24, and 36 months were higher in the DEB group (97.9%, 95.4%, 90.2%, 87.3% and 75.5%, respectively) than PBA group (94.7%, 86.9%, 85.0%, 78.0%, and 66.9%, respectively) but they were not statistically significant (p = .187).Conclusion: Our study confirms DEB is a safe and effective treatment of dysfunctional AVF. We demonstrate higher primary patency rates in DEB than PBA at 6, 12, 18, 24 and 36 months. However, no statistically significant were detected between the two groups in mid-term follow-up.","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"183-189"},"PeriodicalIF":0.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957166","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}

引用次数: 0

Outcome of cholecystectomy after endoscopic ultrasound-guided gallbladder drainage with lumen-apposing metal stent, case series. 超声内镜引导胆囊引流置管金属支架后胆囊切除术的疗效，病例系列。

IF 0.6 4区医学

Acta Chirurgica Belgica Pub Date : 2025-07-23 DOI: 10.1080/00015458.2025.2539096

Louise Beckers Perletti, Brecht Pauwels, Ans Verbert, Thibault Sablon

{"title":"Outcome of cholecystectomy after endoscopic ultrasound-guided gallbladder drainage with lumen-apposing metal stent, case series.","authors":"Louise Beckers Perletti, Brecht Pauwels, Ans Verbert, Thibault Sablon","doi":"10.1080/00015458.2025.2539096","DOIUrl":"https://doi.org/10.1080/00015458.2025.2539096","url":null,"abstract":"Background: Laparoscopic cholecystectomy (LCCE) has been the standard treatment for acute cholecystitis since the 1980s, but it may pose a significant hazard for high-risk patients. Endoscopic gallbladder drainage (EUS-GBD) using lumen-apposing metal stents (LAMS) offers a minimally invasive alternative for these patients. While LAMS is effective, the need for subsequent LCCE and long-term outcomes remains under investigation. This study aims to retrospectively assess the safety and feasibility of cholecystectomy after LAMS placement in a series of patients initially deemed unfit for surgery.Methods: A retrospective review included patients who underwent LCCE following EUS-GBD with LAMS between January and September 2024 was conducted. Data on demographics, procedural details, technical success, and postoperative outcomes were retrieved.Results: Eight patients with acute cholecystitis underwent gallbladder drainage with transduodenal LAMS placement. Two required ICU care for sepsis but recovered. All eight subsequently underwent elective LCCE with 100% technical success. LAMS placement facilitated faster resolution of cholecystitis, resulting in a clear visualization of Calot's triangle, allowing precise dissection and closure of the cholecystoduodenostomy without complications. The median interval between LAMS placement and LCCE was 117.5 days (111 days excluding one outlier). LCCE was performed in a median operative time of 49 minutes. No conversions to open surgery or postoperative complications occurred, and the median postoperative hospitalization was 2 days.Conclusion: Interval LCCE following EUS-GBD is a safe and effective option for managing acute cholecystitis in high-risk patients, with outcomes comparable to standard LCCE. Randomized controlled trials are necessary to establish definitive guidelines for this approach.","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"1-10"},"PeriodicalIF":0.6,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144688577","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}

引用次数: 0

Late, Solitary Small Bowel Metastasis of Anaplastic Thyroid Cancer: A Case Report. 甲状腺间变性癌晚期孤立性小肠转移1例。

IF 0.6 4区医学

Acta Chirurgica Belgica Pub Date : 2025-07-18 DOI: 10.1080/00015458.2025.2536364

Margo Hendrickx, Ellen Peters, Paul Willemsen

{"title":"Late, Solitary Small Bowel Metastasis of Anaplastic Thyroid Cancer: A Case Report.","authors":"Margo Hendrickx, Ellen Peters, Paul Willemsen","doi":"10.1080/00015458.2025.2536364","DOIUrl":"https://doi.org/10.1080/00015458.2025.2536364","url":null,"abstract":"BackgroundAnaplastic thyroid carcinoma (ATC) is a rare type of thyroid cancer that is characterized by its rapid onset and progression. It tends to metastasize to various organs, including the lungs, brain, bones and, less commonly, the small bowel.Case presentationThis case report describes a 74-year-old woman who had small bowel metastasis leading to obstruction three years after diagnosis and local resection of ATC, followed by adjuvant chemotherapy.The patient presented at the emergency department with abdominal pain and vomiting.A CT-scan of the abdomen showed signs of intestinal perforation, combined with diffuse dilatation of the ileal small bowel, for which a segmental enterectomy was performed.ResultsHistological findings of the resected small bowel diagnosed the tumor as a jejunal metastasis of an ATC. The morphology of this lesion was compared to that of this patient's ATC.ConclusionWe present a rare case of small bowel metastasis from ATC which has previously been described in just a few case reports in the medical literature. Therefore, this case report contributes to the limited knowledge available on this condition.","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"1-7"},"PeriodicalIF":0.6,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144663865","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}

引用次数: 0

Parental satisfaction and long term standardized outcome evaluation after percutaneous endoscopic vs laparoscopic gastrostomy in children. 儿童经皮内镜与腹腔镜胃造口术后家长满意度及长期标准化结果评价。

IF 0.6 4区医学

Acta Chirurgica Belgica Pub Date : 2025-06-18 DOI: 10.1080/00015458.2025.2520698

Thomas Pattyn, Matthias Verbesselt, Kirsten Das, Ilse Hoffman, Marguerite Stas, Tania Claeys, Marc Miserez

{"title":"Parental satisfaction and long term standardized outcome evaluation after percutaneous endoscopic vs laparoscopic gastrostomy in children.","authors":"Thomas Pattyn, Matthias Verbesselt, Kirsten Das, Ilse Hoffman, Marguerite Stas, Tania Claeys, Marc Miserez","doi":"10.1080/00015458.2025.2520698","DOIUrl":"10.1080/00015458.2025.2520698","url":null,"abstract":"Introduction: Percutaneous endoscopic (PEG) and laparoscopic gastrostomy (LG) are two widely used techniques for gastrostomy placement in infants. We aimed to compare the risk of complications using a validated grading system and parent satisfaction.Methods: Infants undergoing gastrostomy placement in a tertiary referral center were retrospectively included. Local and general complications were graded using the Clavien-Dindo (CD)system and categorized as early (≤ 30 days) vs late (>30 days) postoperatively. Parent satisfaction was evaluated prospectively using a questionnaire (Numeric Rating Scale 0- 10).Results: Out of 102 patients, 52 underwent LG and 50 PEG. General complications (CD IIIa, IIIb and IV) were rare and occurred all late (n = 3), local complications were common: twice as much minor local early complications occurred in the LG cohort, however this was not statistically significant (28.8% vs 14.0%; p = 0.092). There was a trend toward more major local late CD IIIb complications in the PEG group, but this was not statistically significant (20.4% vs 8.0%; p = 0.088). After button removal, there was a higher risk of gastrocutaneous fistula requiring surgical closure after LG (53.1% vs 26.7% after PEG; p = 0.003). Parental satisfaction was high in both groups (mean score 8.3 for PEG vs 7.9 for LG; p = 0.341).Conclusion: While the risk of general complications after gastrostomy placement is low, local complications are common. However not significant, PEG was associated with a higher risk of major long-term local complications, while LG required more surgical closures after button removal. Parental satisfaction was high in both groups. Further prospective comparisons are needed.","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"1-8"},"PeriodicalIF":0.6,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144309399","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}

引用次数: 0

Surgical reconstruction of the columella after necrosis caused by an infantile hemangioma. 婴儿血管瘤坏死后小柱的外科重建。

IF 0.6 4区医学

Acta Chirurgica Belgica Pub Date : 2025-06-17 DOI: 10.1080/00015458.2025.2520785

Rocío Terrados, María San Basilio, Manuel de la Torre, Concepción Lorca-García, Beatriz Berenguer

{"title":"Surgical reconstruction of the columella after necrosis caused by an infantile hemangioma.","authors":"Rocío Terrados, María San Basilio, Manuel de la Torre, Concepción Lorca-García, Beatriz Berenguer","doi":"10.1080/00015458.2025.2520785","DOIUrl":"10.1080/00015458.2025.2520785","url":null,"abstract":"Background: Infantile hemangiomas are common vascular tumors in childhood that usually undergo spontaneous involution. However, complications may arise, particularly in visible areas such as the centrofacial region, leading to significant aesthetic and functional sequelae. Columellar necrosis is a rare but challenging complication requiring specialized reconstruction techniques.Methods: This report presents two cases of columellar necrosis caused by infantile hemangiomas. Reconstruction was achieved using a 3-component technique: cartilage grafts for tip support, oral vestibule mucosal flaps for lateral lining, and cutaneous turn out flaps from the columellar stumps for anterior skin coverage.Results: Both patients achieved excellent functional and aesthetic outcomes. The described technique allowed for reliable reconstruction of the columella, addressing both structural integrity and cosmetic appearance.Conclusion: Reconstruction of columellar defects, particularly in pediatric cases, is challenging due to the columella's small size and challenging anatomy. The described 3-component technique offers a reproducible and effective approach for isolated columellar defects, ensuring satisfactory functional and aesthetic results.","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"1-6"},"PeriodicalIF":0.6,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144300934","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}

引用次数: 0

Post-esophagectomy aortogastric-tube fistula treated successfully with TEVAR: case report and review of the literature. TEVAR成功治疗食管切除术后主动脉胃管瘘1例报告及文献复习。

IF 0.6 4区医学

Acta Chirurgica Belgica Pub Date : 2025-06-01 Epub Date: 2025-03-03 DOI: 10.1080/00015458.2025.2470535

Natasha Hasemaki, Dimitrios Schizas, Chrysovalantis Vergadis, Stavros Sougioultzis, Athanasios Katsargyris, Christos Klonaris

{"title":"Post-esophagectomy aortogastric-tube fistula treated successfully with TEVAR: case report and review of the literature.","authors":"Natasha Hasemaki, Dimitrios Schizas, Chrysovalantis Vergadis, Stavros Sougioultzis, Athanasios Katsargyris, Christos Klonaris","doi":"10.1080/00015458.2025.2470535","DOIUrl":"10.1080/00015458.2025.2470535","url":null,"abstract":"Background: Aortogastric-tube fistula is a rare but fatal complication of esophagectomy, most commonly induced by anastomotic leakage and peptic ulcer formation.Methods: We report a rare case of a 55-year-old male patient presenting with an aortogastric-tube fistula located in the gastric conduit due to a recurrence of esophageal carcinoma.Results: The patient was treated successfully with Thoracic Endovascular Aortic Repair (TEVAR) followed by esophageal stent placement to relieve dysphagia.Conclusion: Although aortogastric-tube fistula is an extremely rare entity, the advent of esophageal cancer surgery, has led to the recognition of aortogastric-tube fistula with increasing frequency in the literature. Herein, we provide a comprehensive review of the literature, focusing on the pathophysiology, time interval between surgery and presentation, type of treatment and survival of reported cases with post-esophagectomy aortogastric-tube fistula.","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"156-163"},"PeriodicalIF":0.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466618","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}

引用次数: 0

TRUMATCH^TM Graft Cage-Long Bone as a solution for tibial bone defect in traumatic aseptic non-union: a case report. TRUMATCH TM移植物笼-长骨治疗外伤性无菌骨不连胫骨缺损1例报告。

IF 0.6 4区医学

Acta Chirurgica Belgica Pub Date : 2025-06-01 Epub Date: 2025-02-18 DOI: 10.1080/00015458.2025.2467482

Maud A M Vesseur, Isobel M Dorling, Bert Boonen, Kostan W Reisinger, Raoul van Vugt

{"title":"TRUMATCHTM Graft Cage-Long Bone as a solution for tibial bone defect in traumatic aseptic non-union: a case report.","authors":"Maud A M Vesseur, Isobel M Dorling, Bert Boonen, Kostan W Reisinger, Raoul van Vugt","doi":"10.1080/00015458.2025.2467482","DOIUrl":"10.1080/00015458.2025.2467482","url":null,"abstract":"Background: Tibial fractures, with an annual incidence of 51.7 per 100.000 adults, often result in complications like non-union and infection, particularly in open fractures. Non-union rates after intramedullary nailing are 9.7%. Hypertrophic non-union stems from unstable fracture sites, while atrophic non-union arises from inadequate biological environments. Treatment involves rigid bone fixation for hypertrophic non-union and combining biological tissue supply with mechanical stability for atrophic non-unions. This case report outlines a complex tibial non-union post-high-impact injury, detailing the surgical technique and TRUMATCHTM Graft Cage-Long Bone usage. In addition, we outlined the current literature on this topic.Case report: A male patient suffered a traumatic Gustilo II comminuted tibia and fibula fracture, Lisfranc injury and a Schatzker I tibial plateau fracture of the right leg. During follow-up the patient developed an aseptic non-union with eight-centimeter anterolateral bone defect after primary surgery. Surgical intervention was performed using the three-dimensional printed TRUMATCHTM Graft Cage-Long Bone. At one year follow-up, clinical and radiological consolidation of the right tibia was seen.Conclusion: This case report describes a challenging case of aseptic traumatic non-union of the tibia with a critical-sized defect treated with a novel patient-specific implant in a one-stage procedure. The application of the TRUMATCHTM Graft Cage-Long Bone is promising and warrants further investigation in larger, more controlled studies to substantiate our findings.","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"148-155"},"PeriodicalIF":0.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143412703","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}

引用次数: 0

Safety analysis of a multispecialty surgical volunteerism mission over 13 years - age alone is not a contraindication. 十三年来多专科外科志愿服务任务的安全分析--年龄本身并不矛盾。

IF 0.6 4区医学

Acta Chirurgica Belgica Pub Date : 2025-06-01 Epub Date: 2025-04-28 DOI: 10.1080/00015458.2021.1920669

Shekhar Gogna, Mahir Gachabayov, Rifat Latifi

{"title":"Safety analysis of a multispecialty surgical volunteerism mission over 13 years - age alone is not a contraindication.","authors":"Shekhar Gogna, Mahir Gachabayov, Rifat Latifi","doi":"10.1080/00015458.2021.1920669","DOIUrl":"10.1080/00015458.2021.1920669","url":null,"abstract":"Introduction: About five billion people worldwide lack access to safe surgery and multispecialty surgical volunteerism missions (SVMs) offer a plausible solution to this problem. This study aimed to evaluate the outcomes of elderly patients operated on over 13 surgical missions between 2006 and 2019 from 'Operation Giving Back Bohol' (OGBB) Tagbilaran, Philippines.Patients and methods: This was a retrospective analysis of prospectively collected data on all patients treated during SVM over 13 years (2006-2019). Non-elderly (age 16-64 years) were compared with the elderly (age ≥ 65 years) for pre-, intra-, and postoperative variables. Multivariable logistic regression was utilized to identify independent predictors of postoperative complications.Results: Of 1184 patients, the majority (1030) was in the non-elderly group and 154 in the elderly. The mean age was 36 ± 13.6 and 68.3 ± 3.8 years in the non-elderly and elderly groups, respectively. Comorbidities, type of surgery, type of anesthesia, operating time, estimated blood loss, estimated blood loss, need for blood transfusion, postoperative complication rates, comprehensive complication index, length of hospital, ICU requirement, and mortality rates stay did not significantly differ between the groups. Multivariable logistic regression found pelvic surgery (OR (95%CI)=3.7 (1.3-10.8); p=.01), hypertension (OR (95%CI)=8.4 (2.2-32.9); p<.01), and intraoperative blood loss (OR (95%CI) = 1.007 (1.005-1.009); p<.01) to be independent predictors of postoperative complications.Conclusions: Elderly patients may safely undergo general surgery procedures in surgical volunteer missions, and age alone should not preclude them.","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"132-138"},"PeriodicalIF":0.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38925919","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}

引用次数: 0

How to address post-Roux-en-Y gastric bypass late dumping in a patient with a history of Nissen fundoplication converted to bypass for obesity. 如何处理有尼森胃底扩张史的肥胖患者转行胃分流术后roux -en- y胃分流术晚期倾倒。

IF 0.6 4区医学

Acta Chirurgica Belgica Pub Date : 2025-06-01 Epub Date: 2025-03-04 DOI: 10.1080/00015458.2025.2468063

Jean-Philippe MmK Magema, Jacques Himpens

{"title":"How to address post-Roux-en-Y gastric bypass late dumping in a patient with a history of Nissen fundoplication converted to bypass for obesity.","authors":"Jean-Philippe MmK Magema, Jacques Himpens","doi":"10.1080/00015458.2025.2468063","DOIUrl":"10.1080/00015458.2025.2468063","url":null,"abstract":"Introduction: Reversal of Roux-en-Y gastric bypass (RYGB) may be indicated for possible side effects such as malnutrition, intolerance, dumping syndrome, or late dumping. Reversal can however induce significant gastro-esophageal reflux disease (GERD).Method: We report the case of a 55 years old Caucasian woman, who had undergone conversion of Nissen fundoplication performed for GERD (Grade B) into RYGB because of recurrent reflux, though Grade A esophagitis and increasing obesity (37.5 kg/m2 BMI). She developed invalidating symptoms of late dumping syndrome and severe diarrhea. Pre- and postoperative evaluation an eso-gastroscopy with esophagitis grade evaluation. Treatment consisted of physiologic reversal of the RYGB, by reimplantation of the alimentary limb into the remnant stomach.Result: Pre-reversal endoscopy showed Grade A esophagitis. Oral glucose test demonstrated severe hypoglycemia persisting till 120 min post-ingestion and clinical symptoms of hypoglycemia (Whipple triad) (40 to 53 mg/dl). Three months after reversal the diagnostic tests had significantly improved, both in terms of glucose metabolism and GERD symptoms. At 22 months after surgery, the patient still did not suffer from diarrhea anymore, her glycemic profile was stable under antidiabetic medications and her BMI raised to 29 kg/m2.Discussion and conclusion: Reversal of Roux-en-Y gastric bypass by incorporation of the alimentary limb between the gastric pouch and the gastric remnant seems to successfully address the dual issue of post-RYGB late dumping and preventing GERD, the different mechanisms involved will be explained latter in this paper.","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"170-174"},"PeriodicalIF":0.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143497813","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}

引用次数: 0