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Biomedical subjects

F Derom

Publications and source records attributed to F Derom.

123 records · Page 7Linked to original sources
PubMedDate not supplied

Transthoracic vagotomy for recurrent peptic ulcer after gastrectomy. An appraisal of fifteen years experience.

The case records of 38 patients operated for recurrent ulcer following partial gastrectomy were examined. They all underwent a transthoracic vagotomy. Two patients died during follow-up, one because of a gastro-intestinal bleeding 14 days after operation and one following a psychiatric disorder (vital depression) three months after his second intervention. According to Visick's grading overall results are very good in 89%, moderate in 5.5% and disappointing in 5.5%. These figures indicate that transthoracic vagotomy is the treatment of choice for recurrent ulceration after partial gastrectomy.

Adult↗
PubMedDate not supplied

[Intraoperative identification of parathyroid glands with methylene blue (author's transl)].

Identification of parathyroid glands during surgery for treatment of hyperparathyroidism remains difficult. The staining with methylene blue was first described by Dudley. Twenty-one patients were explored. Thirty to sixty minutes before surgical incision, an intravenous perfusion of methylene blue was started. The dose varied between 5 to 10 mg per kg. Thirty-seven enlarged glands were found of which 33 were obviously stained; 13 showed some color that could not be attributed with certainty to the dye; 1 adenome was not stained at all. In 89.2% of the cases the staining had the favorable effect of shortening the operation. Only 4 normal glands showed the blue stain. The affinity for methylene blue is thus mainly found in pathological parathyroid glands.

Adenoma↗
PubMedDate not supplied

[Experience with peripheral vascular injures from 1965-1980].

The authors analyse a series of 45 vascular trauma treated during the period 1965-1980. It is very important to make a diagnosis as soon as possible and to limit the interval accident-operation. In 40% of our cases we had to operate rather late. Most of those cases were secondary transfers of other hospitals. Arteriography should be performed if there is any doubt. Now we always perform an angiogram during the operation. If there is any associated orthopedic injury, this is handled first, if possible by external fixation. A fasciotomy can be of value to save a limb. Any venous injury should be repaired also.

Angiography↗
PubMedDate not supplied

[Surgical experiences with traumatic diaphragmatic rupture].

Between 1970 and 1981, 35 patients with traumatic rupture of the diaphragma were treated. Blunt trauma, mostly caused by traffic accidents, predominates. The localization, type and dimensions of the diaphragmatic tear are studied. Among the associated visceral lesions, lacerations of the spleen and the liver are most often seen. Clinical and diagnostic aspects are discussed. Traumatic diaphragmatic rupture is an absolute surgical indication. In the early cases, with few exceptions, a primary abdominal approach is advocated. In the delayed category a thoracotomy is mostly preferred. Operative mortality in the early cases is mainly due to the magnitude of the associated lesions. No mortality occurred in the delayed category. Long term results in controlled patients were very satisfactory.

Adolescent↗
PubMedDate not supplied

Carotid endarterectomy for cerebrovascular insufficiency. Long term follow-up of 141 patients followed up to sixteen years.

Between 1962 and 1978 one hundred and fifty-nine endarterectomies were performed on 141 patients. The operation was done under general anesthesia with the use of a shunt and hypertension as cerebral protection. The arteriotomy was closed using a dacron patch. The postoperative evolution of every neurological symptom was analysed after a follow-up of up to sixteen years. The patients were divided in three groups following their neurological and anatomical situation. On 43 totally asymptomatic patients (group I), there was one perioperative death, 41 remained totally asymptomatic and one developed a transient ischemic attack on the non operative side. On 25 patients (group II) operated after symptomatic contralateral total occlusion, fifteen became asymptomatic, six improved seriously, one remained unchanged, and one suffered from a stroke with complete recuperation. Two perioperative deaths were encountered in this group. On the 73 patients from group III, there were three perioperative deaths. Fifty-two patients became totally asymptomatic, nine patients had a serious amelioration of their residu. Three remained unchanged. Five patients suffered from a long term deterioration of their neurological condition and one patient developed an anastomotic aneurysm.

Adult↗
PubMedDate not supplied

[A case of post-traumatic aortic valve insufficiency (author's transl)].

A case of posttraumatic aortic valve insufficiency is presented. A brief discussion of etiology, mechanism, evolution, diagnosis and treatment is included. Some important historical events are reviewed from the literature. The treatment of this uncommon heart injury is aortic valve replacement. In this case an intimal repair also had to be done.

Adult↗
PubMedDate not supplied

[Surgical therapy of uremic pericarditis (author's transl)].

During a five year period (January 1975 - September 1980) 33 patients, in a population of 262 chronic hemodialysis patients, were treated for uremic pericarditis. They all underwent a pericardiostomy either through a lateral (15 cases) or through a subxiphoid approach (18 cases). Immediate clinical relief occurred in all but one patient who showed a progressive cardiac failure even after drainage. Operative mortality was absent and complications were minimal. There were two recurrences of pericardial effusion after an initial lateral approach through thoracotomy. A subsequent partial pericardectomy was successful in both cases.

Adult↗
PubMedDate not supplied

The true value of the carotid steal syndrome after the carotid subclavian by-pass. Human experimental study.

Between 1964 and 1978 sixteen patients underwent a carotid subclavian by-pass in the Akademisch Ziekenhuis of Gent. Most of these patients were submitted to tests to evaluate the importance of the carotid steal effect. The patency of the vertebral artery was found to influence these tests. Two of the three patients with an occluded vertebral artery had cerebral symptoms when the peripheral resistance was lowered in the involved limb. No positive tests could be found in the twelve patients with a patient vertebral artery. These results indicate that the carotid subclavian artery by-pass performed in the presence of an occluded vertebral artery does not protect the patient from the carotid steal effect.

Adult↗
PubMedDate not supplied

[Surgical therapy of pheochromocytoma (author's transl)].

Between 1958-1978 a total of 19 patients, 11 men and 8 women, were treated for pheochromocytoma. Their age varied between 9 and 67 years (overage 39 years). In all cases with unilateral tumor located in the adrenal gland a lateral approach was preferred. When not certain of the tumor location or when presumed outside the adrenals a laparotomy was deemed necessary. Fourteen thoraco-abdominal lateral approaches and 5 laparotomies were performed. Due to minimal manipulation, especially with the lateral approach, peroperatory hypertensive crises could be reduced to a minimum. Sofar no recurrence has been seen. There was no operative mortality.

Adolescent↗
PubMedDate not supplied

[Hyperplasia of the thyroid gland. Surgical indications and treatment (author's transl)].

The surgical indications of a benign multinodular euthyroid struma are: compression of trachea and oesophagus or a possible malignity of the lesion. The operation of choice is a bilateral subtotal lobectomy. To avoid postoperative vocal cord paralysis or hypocalcemia due to damage of the parathyroid glands, it is important to demonstrate systematically the recurrent nerve and spare the inferior thyroid artery.

Goiter↗
PubMedDate not supplied

The use of homologous veins in arterial reconstructions. An experimental study.

In order to evaluate under what conditions the use of venous homografts could yield the best results. 230 arterial reconstructions were performed in mongrel dogs bypassing their ligated femoral arteries. Cumulative 6-month patency-rates were: Group 1: Prosthetic materials: a) Dacron grafts: 48%, b) PTFE grafts: 53%. Group 2: Fresh veins: a) autografts: 100%, b) allografts: 37%, c) allografts treated with cyclosporin 4 mg/kg.day for one month: 74% (100% after one month). Group 3: Veins preserved in saline at 4 degrees C. for one month: a) autografts: 44%, b) allografts: 34%. Group 4: Frozen veins preserved in saline at -70 degrees C. for one month: a) autografts: 58%, b) allografts: 47%. Group 5: Veins preserved in glutaraldehyde 0.25% for one month: a) autografts: 26%, b) allografts: 22%. Group 6: Veins preserved in 15% DMSO in Hanks solution at -160 degrees C for one month: a) autografts: 77%, b) allografts: 35%, c) allografts treated with cyclosporin 4 mg/kg.day for one month: 72%, d) allografts treated with methylprednisolone 1 mg/kg.day for one month: 38%, e) allografts treated with cyclosporin 4 mg/kg and methylprednisolone 1 mg/kg daily for one month: 83%. Fresh veins and veins preserved in 15% DMSO at -160 degrees C. are viable but immunologically active grafts. In allografts rejection phenomena cause a relatively high occlusion rate which, however, can be prevented with low dose cyclosporin. The optimal duration of immunosuppressive therapy remains to be determined. Veins stored at 4 degrees C or at -70 degrees C are not viable and only weakly antigenic. Their results are not better than those obtained with prosthetic material.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMedDate not supplied

Intraoperative identification of parathyroids by means of methylene blue.

In 134 cervical explorations for hyperparathyroidism, methylene blue was administered intraoperatively to stain parathyroid glands. Seventy-seven out of 79 adenomas (97.5%) and 199 out of 204 hyperplastic glands (97.6%) were clearly stained. The only recurrences were observed in patients undergoing surgery for hyperplasia of the parathyroid glands. The recurrences (12%) were mainly due either to initial wrong diagnosis of parathyroid adenoma, or they were graft dependent. Methylene blue is an effective, safe and easy way to localize and identify abnormal parathyroid glands, thereby improving the results and shortening the operating time.

Adenoma↗
PubMedDate not supplied

A case against parathyroid autotransplantation.

The authors report about a recurrence in a uremic patient who underwent a subtotal parathyroidectomy with autotransplantation in the sternocleidomastoid muscle for hyperparathyroidism. Reexploration revealed an enlarged parathyroid graft. This paper illustrates the potential complication of parathyroid autografts in patients with chronic renal failure.

Adult↗
PubMedDate not supplied

Treatment of alkaline reflux gastritis. A report of twenty cases.

The surgical treatment of twenty patients operated for postoperative alkaline reflux gastritis is discussed together with the pathogenesis of this syndrome as a late postoperative surgery syndrome. Diagnostic procedures and results of investigations and treatment were compared with data of the literature. Surgical treatment is of great benefit. The different surgical technics should be used according their own indication.

Adult↗