Acta Chirurgica Belgica最新文献

{"title":"Venous reconstruction thrombosis after pancreaticoduodenectomy with superior mesenteric/portal vein resection due to pancreatic cancer: an 8 years single institution experience.","authors":"Oguzhan Ozsay, Mehmet Can Aydin, Kagan Karabulut, Mahmut Basoglu, Osman Nuri Dilek","doi":"10.1080/00015458.2023.2264630","DOIUrl":"10.1080/00015458.2023.2264630","url":null,"abstract":"<p><strong>Background: </strong>Superior mesenteric/portal vein reconstruction (SMPVR) thrombosis remains a challenging complication following pancreaticoduodenectomy concomitant with venous resection. In this context, we aimed to present our SMPVR experiences and identify potential clinicopathological factors that increased SMPVR thrombosis.</p><p><strong>Methods: </strong>A total of 33 patients who underwent SMPVR during pancreaticoduodenectomy were analyzed. Of these, 26 patients who experienced pancreatic head ductal adenocarcinoma met our inclusion criteria. Patients' data were compared as classified by SMPVR type and the development of SMPVR thrombosis. All interposition grafts were Dacron in this cohort.</p><p><strong>Results: </strong>Types of SMPVR included: tangential resection with primary repair (<i>n</i> = 12); segmental resection with splenic vein preservation and either primary anastomosis (<i>n</i> = 8) or 14 mm tubular Dacron grafting (<i>n</i> = 1); segmental resection with splenic vein division either 14 mm tubular Dacron grafting (<i>n</i> = 2) or 14/7 mm 'Y'-shaped Dacron grafting (<i>n</i> = 3). A total of four patients having 14/7 mm 'Y'-shaped (<i>n</i> = 3) and 14 mm tubular Dacron (<i>n</i> = 1) developed SMPVR thrombosis (<i>p</i> = .001). Dacron grafting (<i>p</i> = .001) and splenic vein division (<i>p</i> = .010) were associated with SMPVR thrombosis. The median time to detection of SMPVR thrombosis was 4.3 months (2.5-21.0 months). The median follow-up time was 12.2 months (3.0-45 months).</p><p><strong>Conclusions: </strong>During pancreaticoduodenectomy for pancreatic head ductal carcinoma, extended venous resection requiring SMPVR with 'Y'-shaped and use of Dacron interposition grafts appeared to be associated with the development of SMPVR thrombosis. This result warrants further investigations.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"200-207"},"PeriodicalIF":0.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41105163","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":"Can stage-IIB lung cancer be divided into subgroups in terms of prognosis? A modelling study<sup />.","authors":"Necati Çitak, Volkan Erdoğu, Yunus Aksoy, Atilla Pekçolaklar, Muzaffer Metin, Adnan Sayar","doi":"10.1080/00015458.2023.2251802","DOIUrl":"10.1080/00015458.2023.2251802","url":null,"abstract":"<p><strong>Introduction: </strong>Whether changes should be made to the TNM classification of non-small cell lung cancer (NSCLC) according to the newly proposed nodal classification is unclear. We aim to compare the survival between stage-IIB subsets using a modelling study performed using the newly proposed nodal classification.</p><p><strong>Patients and methods: </strong>A total of 682 patients with stage-IIB NSCLC based on the 8th TNM classification were analysed. Hazard ratio (HR) values calculated from survival comparisons between stage-IIB subgroups were used to create a model for patients with stage-IIB NSCLC, and modelling was performed according to the HR values that were close to each other.</p><p><strong>Results: </strong>Patients with T1N1a cancer had the best survival rate (58.2%), whereas the worst prognosis was observed in those with T2bN1b cancer (39.2%). The models were created using the following HR results: Model A (T1N1a, <i>n</i> = 85; 12.4%), Model B (T2a/T2bN1a and T3N0, <i>n</i> = 438; 64.2%), and Model C (T1/T2a/T2bN1b, <i>n</i> = 159; 23.4%). There was a significant difference between the models in terms of overall survival (<i>p</i> = 0.03). The median survival time was 69 months in Model A, 56 months in Model B, and 47 months in Model C (Model A vs. Model B, <i>p</i> = 0.224; Model A vs. Model C, <i>p</i> = 0.01; and Model B vs. Model C, <i>p</i> = 0.04). Multivariate analysis showed that age (<i>p</i> < 0.001), pleural invasion (<i>p</i> < 0.001), and the developed modelling system (<i>p</i> = 0.02) were independently negative prognostic factors.</p><p><strong>Conclusion: </strong>There was a prognostic difference between stage-IIB subsets in NSCLC patients. The model created for stage-IIB lung cancer showed a high discriminatory power for prognosis.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"191-199"},"PeriodicalIF":0.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10103645","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":"Patient management after primary rectal cancer diagnosis. Special focus on surgical treatment for non-metastatic disease.","authors":"L Mattart, P Magotteaux, N Blétard, L Brescia, N Debergh, C De Meester, G Demolin, F Dister, C Focan, D Francart, S Godin, G Houbiers, C Jehaes, F Jehaes, G Namur, B Monami, V Verdin, J Weerts, N Witvrouw, S Markiewicz","doi":"10.1080/00015458.2023.2278238","DOIUrl":"10.1080/00015458.2023.2278238","url":null,"abstract":"<p><p><b>Background:</b> Rectal cancer is a public health priority. Primary objectives of this study were to evaluate the quality of care for non-metastatic rectal cancer using process and outcome indicators. Delay of management, length of stay and readmission rate, sphincter preservation, morbidity, number of examined lymph nodes, mortality, overall and disease-free survivals were evaluated. Secondary objectives were to estimate the relationship between possible predictive parameters for (1) anastomotic leakage (logistic regression), (2) overall or disease-free survivals (cox regression).<b>Methods:</b> We performed a retrospective study on 312 consecutive patients diagnosed with primary rectal cancer between 2016 and 2019. We focused on the 163 patients treated by surgery for non-metastatic cancer.<b>Results:</b> The treatment began within 33 days (range 0-264) after incidence, resection rate was 67%. Digestive continuity rate in lower, middle and upper rectum was 30%, 87% and 96%. Median of 14 lymph nodes (range 1-46) was analyzed. Length of stay and readmission rate were 11 days (range 3-56) and 4%, respectively. Within 90 postoperative days, clinical anastomotic leakage occurred in 9.2% of cases, major morbidity rate was 17%, mortality 1.2%. Multivariate analysis revealed that stoma decreased the risk of anastomotic leakage [hazard ratio: 0.16; 95% confidence intervals: 0.04-0.63; <i>p</i> = 0.008]. The 5-year overall survival after surgery was 85 ± 4%, disease-free survival 83 ± 4%. Patients with major complications, male gender and R1/R2 resection margin had a poorer prognosis.<b>Conclusion:</b> This work showed encouraging results in rectal cancer treatment in our institution, our results were in line with recommendations at the time.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"208-216"},"PeriodicalIF":0.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"107590038","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":"'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}

{"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}

{"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}

{"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}

{"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}