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The impact of the CUSA ultrasonic dissection device on major liver resections. CUSA超声解剖装置在肝大切除术中的应用。
The Netherlands journal of surgery Pub Date : 1991-08-01
B H Storck, E J Rutgers, E Gortzak, F A Zoetmulder
{"title":"The impact of the CUSA ultrasonic dissection device on major liver resections.","authors":"B H Storck,&nbsp;E J Rutgers,&nbsp;E Gortzak,&nbsp;F A Zoetmulder","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Between 1982 and 1990 major liver resections were carried out in 28 patients, in 14 with the conventional technique, in 14 with the Cavitron ultrasonic surgical aspirator (CUSA) dissection device. The patients in the CUSA group were older and had more often multiple metastases. Peroperative blood loss, duration of operations, postoperative morbidity and mortality, ICU stay and overally hospital stay were all reduced in the CUSA group; for peroperative blood loss (p less than 0.05) and duration of operation (p less than 0.01) the reduction was statistically significant. The use of CUSA has contributed to the increased safety of liver resections.</p>","PeriodicalId":77640,"journal":{"name":"The Netherlands journal of surgery","volume":"43 4","pages":"99-101"},"PeriodicalIF":0.0,"publicationDate":"1991-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13104511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Hepatic resection: haemostatic control by means of compression sutures: a new method. 肝切除术:加压缝合止血:一种新方法。
The Netherlands journal of surgery Pub Date : 1991-08-01
M Cromheecke, R T Wijffels, D Meijer, H J Hoekstra
{"title":"Hepatic resection: haemostatic control by means of compression sutures: a new method.","authors":"M Cromheecke,&nbsp;R T Wijffels,&nbsp;D Meijer,&nbsp;H J Hoekstra","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Blood loss during partial hepatic resection is a major concern. Controlling haemorrhage by means of non-cutting compression sutures, without the risk of disrupting the liver tissue, was experimentally investigated. Twenty-two beagles underwent a partial resection of the right median liver lobe with this technique. Blood loss was negligible and no complications occurred during surgery or follow-up. There were no deaths. The method of using compression sutures is a simple, quick and efficient technique to prevent blood loss during and after partial hepatic resection.</p>","PeriodicalId":77640,"journal":{"name":"The Netherlands journal of surgery","volume":"43 4","pages":"95-8"},"PeriodicalIF":0.0,"publicationDate":"1991-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13104510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Breast-conserving therapy of ductal carcinoma in situ: frequency of local recurrence after wide excision with and without additional radiotherapy, a retrospective study of 42 cases. 导管原位癌保乳治疗:42例导管原位癌广泛切除加放疗后局部复发率回顾性分析
The Netherlands journal of surgery Pub Date : 1991-06-01
B C Vrouenraets, J L Peterse, J A van Dongen
{"title":"Breast-conserving therapy of ductal carcinoma in situ: frequency of local recurrence after wide excision with and without additional radiotherapy, a retrospective study of 42 cases.","authors":"B C Vrouenraets,&nbsp;J L Peterse,&nbsp;J A van Dongen","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Clinicopathologic features were retrospectively studied in 42 patients with ductal carcinoma in situ (DCIS), who underwent breast-conserving therapy at the Netherlands Cancer Institute from 1974 to 1987. During follow-up (13 to 128 months, average 73 months) five of the 14 patients treated with an excision alone recurred locally. Recurrence occurred in only one out of 28 patients who received additional radiotherapy. Secondary mastectomy was performed in five patients with recurrence, all are alive with no evidence of disease (average follow-up 21 months). One patient developed disseminated disease. Breast-conserving therapy might be considered in selected cases of DCIS with a limited extent, when a complete excision can be accomplished. Additional radiotherapy may reduce the risk of recurrence. Because most series in literature are small, retrospective, selected and with a short follow-up randomized prospective trials have to demonstrate what subset of patients with DCIS can safely be treated with breast-conserving therapy. Therefore, participation in these studies, is of the utmost importance.</p>","PeriodicalId":77640,"journal":{"name":"The Netherlands journal of surgery","volume":"43 3","pages":"51-5"},"PeriodicalIF":0.0,"publicationDate":"1991-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12822063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Prognostic scoring systems in differentiated thyroid carcinoma: which is the best? 分化型甲状腺癌的预后评分系统:哪个是最好的?
The Netherlands journal of surgery Pub Date : 1991-06-01
G Kingma, H A van den Bergen, J E de Vries
{"title":"Prognostic scoring systems in differentiated thyroid carcinoma: which is the best?","authors":"G Kingma,&nbsp;H A van den Bergen,&nbsp;J E de Vries","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The usefulness of three prognostic scoring systems in differentiated thyroid carcinoma (the TNM system, the EORTC score and the AGES index) were evaluated for use in a medium size teaching hospital. Twenty-one patients with papillary (n = 13), mixed (n = 2) and follicular tumours (n = 6) were studied. Median follow-up was over seven years (range 10-194 months). Four patients died. The TNM system gives a poor discrimination between patients with a good prognosis and those with a lethal outcome and is of little value in these tumours. The EORTC score, which is easy to calculate, gives a good prediction of survival. The best discrimination between a good and a bad prognosis was found using the more complicated AGES index for papillary tumours. Of patients with a papillary or mixed papillary carcinoma, one of the two patients with a score of four or more actually died, while all with a good index of less than 4 (13/15 of this subgroup) survived, giving the best prognostic bisection of our patient group. Even in the combined group of all differentiated thyroid carcinomas, the AGES index gives the best prognostic bisection, with 33 percent of patients in the poor prognostic group, of whom 57 percent died. This makes the AGES index the most useful prognostic scoring system.</p>","PeriodicalId":77640,"journal":{"name":"The Netherlands journal of surgery","volume":"43 3","pages":"63-6"},"PeriodicalIF":0.0,"publicationDate":"1991-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13083005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The femoro-femoral cross-over bypass. 股股交叉搭桥。
The Netherlands journal of surgery Pub Date : 1991-06-01
L N van Adrichem, D P van Berge Henegouwen, H J Lobach, C van der Werken
{"title":"The femoro-femoral cross-over bypass.","authors":"L N van Adrichem,&nbsp;D P van Berge Henegouwen,&nbsp;H J Lobach,&nbsp;C van der Werken","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>From 1984 to 1990 64 patients (56 men and 8 women) with a mean age of 67.1 years (36-88 yrs.) were treated with a femoro-femoral cross-over bypass (45 primary and 19 secondary procedures). All patients had an occlusion of one iliac artery. In 26 patients there were factors that made a central reconstruction unattractive. These disorders were congestive heart failure, COPD, CVA, an age over 80 years, etc. In 19 patients an occlusion of one leg of a former aortobifemoral bypass determined the choice for cross-over bypass. Three patients died (5 per cent), two patients of the so-called redo-group (septicaemia, one patient and arteriojejunal fistula one patient), the third patient died after a primary femoro-femoral bypass (myocardial infarction). The overall patency rate after three years was 78 per cent. Especially primary cross-over bypasses showed a good outcome with a primary patency of 80 per cent and a secondary patency of 85 per cent after three years. Considering that 23 of the 45 (51 per cent) primary procedures were for treatment of critical ischaemia (stage III and IV of Fontaine), a favourable limb-salvage of 21 out of 23 (91 per cent) was obtained. The cross-over bypass can be recommended as first choice therapy for patients with a unilateral iliac artery occlusion.</p>","PeriodicalId":77640,"journal":{"name":"The Netherlands journal of surgery","volume":"43 3","pages":"67-70"},"PeriodicalIF":0.0,"publicationDate":"1991-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13081304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Transmural ischaemic colitis following operation for ruptured abdominal aortic aneurysm. 腹主动脉瘤破裂术后的经壁缺血性结肠炎。
The Netherlands journal of surgery Pub Date : 1991-06-01
T J van Vroonhoven, H J Verhagen, W F Bröker, I M Janssen
{"title":"Transmural ischaemic colitis following operation for ruptured abdominal aortic aneurysm.","authors":"T J van Vroonhoven,&nbsp;H J Verhagen,&nbsp;W F Bröker,&nbsp;I M Janssen","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A total of 20 patients with transmural ischaemic colitis following operation for ruptured abdominal aortic aneurysm were studied (4 retrospectively and 16 prospectively). The diagnosis was made during laparotomy in five patients and by flexible sigmoidoscopy in 15 patients. Eighteen patients underwent large bowel resection (11 left-sided hemicolectomy, 7 subtotal colectomy). None of the 20 patients survived long enough to leave the hospital. The unfavourable prognosis of transmural ischaemic colitis following emergency abdominal aortic aneurysmectomy makes an early diagnosis by routine postoperative endoscopy mandatory and questions bowel resection in these patients.</p>","PeriodicalId":77640,"journal":{"name":"The Netherlands journal of surgery","volume":"43 3","pages":"56-9"},"PeriodicalIF":0.0,"publicationDate":"1991-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13083003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cardiac myxoma: the grand masquerader. 心脏黏液瘤:大假面舞者。
The Netherlands journal of surgery Pub Date : 1991-06-01
J A van Son, P M Corten, E F Poels, H J van de Wal, L K Lacquet
{"title":"Cardiac myxoma: the grand masquerader.","authors":"J A van Son,&nbsp;P M Corten,&nbsp;E F Poels,&nbsp;H J van de Wal,&nbsp;L K Lacquet","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Cardiac myxoma is the most common primary tumor of the heart. A high suspicion of this potentially lethal disease is warranted because it may mimick a large variety of diseases. Two patients with different symptoms and signs are presented, in whom resection of the tumor was successful. Complete resection of the tumor is the only effective method of treatment.</p>","PeriodicalId":77640,"journal":{"name":"The Netherlands journal of surgery","volume":"43 3","pages":"75-8"},"PeriodicalIF":0.0,"publicationDate":"1991-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13081306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Leiomyoma of the distal oesophagus mimicking achalasia. 食管远端平滑肌瘤，类似贲门失弛缓症。
The Netherlands journal of surgery Pub Date : 1991-06-01
F J Idenburg, L M Akkermans, A J Smout, C D Kooijman, H Obertop
{"title":"Leiomyoma of the distal oesophagus mimicking achalasia.","authors":"F J Idenburg,&nbsp;L M Akkermans,&nbsp;A J Smout,&nbsp;C D Kooijman,&nbsp;H Obertop","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>An unusual case of a patient with symptoms suggestive of oesophageal achalasia is described. Most oesophageal tumour growths causing secondary achalasia are associated with malignant tumours. This patient had a large oesophageal leiomyoma closely mimicking achalasia. Treatment consisted of oesophagectomy by laparotomy and right-sided thoracotomy. A gastric tube was constructed with a cervical oesophago-gastrostomy. The patient responded well to the treatment and left the hospital after 13 days. Five other cases of benign oesophageal tumours inducing achalasia-like symptoms could be traced. Three of these were leiomyomas.</p>","PeriodicalId":77640,"journal":{"name":"The Netherlands journal of surgery","volume":"43 3","pages":"79-81"},"PeriodicalIF":0.0,"publicationDate":"1991-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13081307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Local thrombolytic therapy for axillary-subclavian vein thrombosis. 局部溶栓治疗腋窝-锁骨下静脉血栓。
The Netherlands journal of surgery Pub Date : 1991-06-01
H W Koot, H F Veen
{"title":"Local thrombolytic therapy for axillary-subclavian vein thrombosis.","authors":"H W Koot,&nbsp;H F Veen","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Thrombosis of the axillary-subclavian vein can be primary and secondary. The case histories of three patients with spontaneous idiopathic thrombosis of the axillary vein are presented. Successful treatment with low-dose local streptokinase infusion could be confirmed by daily venography. Instead of weeks of heparine infusions, the patients could leave the hospital after a couple of days (range 10 to 12 days), long-term follow-up (4 months) showed no recurrence.</p>","PeriodicalId":77640,"journal":{"name":"The Netherlands journal of surgery","volume":"43 3","pages":"71-4"},"PeriodicalIF":0.0,"publicationDate":"1991-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13081305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Gallstone disease in women younger than 30 years. 30岁以下女性的胆结石疾病。
The Netherlands journal of surgery Pub Date : 1991-06-01
E J van Beek, K C Farmer, D M Millar, W H Brummelkamp
{"title":"Gallstone disease in women younger than 30 years.","authors":"E J van Beek,&nbsp;K C Farmer,&nbsp;D M Millar,&nbsp;W H Brummelkamp","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The relation between symptomatic cholelithiasis in women under 30 years of age and pregnancy, obesity and oral contraceptive use was retrospectively studied. A total of 885 cholecystectomies were carried out in an English district hospital. In the age group under 30 years the female-male ratio was 9.7:1 vs 2.3:I in the total group (p less than 0.01). Gallstones were present in 39 women with a previous pregnancy and in 14 women without pregnancy. Compared to an age and sex matched control group of appendicectomies a relative risk of 1.6 was found for pregnancy related gallstone disease requiring cholecystectomy (p less than 0.05). 455 Cholecystectomies were carried out in a Dutch academic hospital. The female-male ratio in the group younger than 30 years was 7.0:I vs 2.3:I in the total group (p less than 0.01). In the Dutch group more women under 30 years were operated on than in the English group: 23% vs 10% (p less than 0.001). There was no significant association between symptomatic gallstones and previous pregnancies in the Dutch group (p = 0.07). Gallstone disease occurs earlier in women than in men. There appears to be a relationship between early symptomatic cholelithiasis and pregnancy in the English group only. No relationship could be found between cholelithiasis and obesity or oral contraceptive use in either group.</p>","PeriodicalId":77640,"journal":{"name":"The Netherlands journal of surgery","volume":"43 3","pages":"60-2"},"PeriodicalIF":0.0,"publicationDate":"1991-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13083004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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