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Biomedical subjects

G Deneffe

Publications and source records attributed to G Deneffe.

At least 55 records · Page 3Linked to original sources
PubMed1988

Surgical treatment of bronchogenic carcinoma: a retrospective study of 720 thoracotomies.

Seven hundred and twenty patients with primary bronchogenic carcinoma were operated on at the Pellenberg Clinic, K.U. Leuven, Belgium, between January 1, 1970, and January 1, 1985. Almost 45% of the resections were pneumonectomies and 47% were lobectomies. Mortality was 6.9% and 2.9%, respectively. Patients with squamous cell carcinoma (Stages I and II) who underwent lobectomy or pneumonectomy had an absolute 5-year survival rate of 52.8% (93/176); it was 21% (4/19) in the T3 N0/N1 subgroup. Patients with adenocarcinoma who underwent a lobectomy had a 5-year survival rate of 49% (26/53) in the T1/T2 N0 group and of 27% (3/11) in the T1/T2 N1 group. Only 13.6% (3/22) of patients survived 5 years if a pneumonectomy had to be performed. Only 1 in 22 N2 patients survived 5 years after resection.

Adult↗
PubMed1988

Preoperative CT examination for staging of mediastinal lymph-nodes in patients with (operable) non-small cell lung cancer.

In a prospective study of 100 and a retrospective study of 90 patients with non small cell lung cancer, the usefulness of CT in the preoperative staging of mediastinal lymph nodes was examined. The long-term prognostic value of CT was also investigated. Our results suggest that, using 1.5 cm as a criterion of size for malignancy, CT can be useful in the selection of patients for mediastinoscopy. CT can always help the surgeon in the mediastinal exploration but the long-term prognostic value is limited after the surgical-pathologic diagnosis has been made.

Carcinoma, Non-Small-Cell Lung↗
PubMed1988

Broncho-oesophageal fistula with vascular malformation.

We present a patient with a type III congenital broncho-oesophageal fistula and a connection between the systemic and the pulmonary circulation. The congenital fistula caused chronic bronchopulmonary suppuration with bronchiectasis which in turn was the cause of a left-to-right shunt, probably through multiple precapillary or capillary anastomoses.

Arterio-Arterial Fistula↗
PubMed1983

Cervical mediastinoscopy and anterior mediastinotomy in patients with lung cancer and radiologically normal mediastinum.

In the period 1975-1980, 1504 patients presented with lung cancer, 291 were presumably operable, and had no radiological evidence of mediastinal lymph node invasion. Two thirds (192 patients) underwent pre-operative surgical mediastinal exploration, and one third (99 patients) were operated right away. Of the 162 cervical mediastinoscopies, 16% had lymph node invasion (19.7% with right-sided, 10.6% with left-sided tumor); 28.9% of the 45 left-anterior mediastinotomies were positive. There was only one positive cervical mediastinoscopy of 46 cases with lower-lobe tumor, and no positive anterior mediastinotomy in 5 cases with left lower-lobe tumor. Mediastinal exploration yields, thus, a relatively higher percentage of positive results if the cervical mediastinoscopy is restricted to tumors affecting the right upper and middle lobes (25%), and if the anterior mediastinotomy is restricted to the left upper lobe (32.5%). A left anterior mediastinotomy should, thus, be recommended instead of cervical mediastinoscopy for tumors of the left upper lobe.

Adult↗
PubMed1979

Surgical treatment of adenoid cystic carcinoma of the left main bronchus and trachea by left pneumonectomy, resection of 7.5 cm of trachea, and direct reanastomosis of right lung.

A 23-year-old woman, who had suffered recurrent acute bronchitis, dyspnoea, and stridor, was found to have a tracheal stenosis and complete left main bronchus obstruction. Biopsy of the tumour showed an adenoid cystic carcinoma. After pneumonectomy the trachea was closed through tumour tissue. Two weeks later a right thoracotomy showed that a tumour had invaded the trachea from the carina up to 6 cm and the right stem bronchus for 1 cm. Under extracorporeal circulation 7.5 cm of the trachea and right bronchus were resected. A direct tracheal anastomosis was easy to perform. Spontaneous respiration with efficient coughing returned after five days. Unfortunately, one month later, high fever caused by a lung abscess developed, which provoked a massive haemoptysis with fatal outcome.

Adult↗
PubMedDate not supplied

Sleeve lobectomy for non-small cell lung cancer.

UNLABELLED: Sleeve lobectomy is a procedure in which the involved lobe with part of the main stembronchus is removed. The remaining lobe (s) is reimplanted on the main stembronchus. This procedure is indicated for central tumors of the lung as an alternative to pneumonectomy. It is the aim of this study to describe the technique of sleeve lobectomy and to analyse the early postoperative results and late results (survival-recurrence) after sleeve lobectomy for non-small-cell lung cancer. MATERIAL AND METHODS: Between 1985 and 1999, 77 sleeve lobectomies for bronchogenic carcinoma were performed at the University hospitals Leuven. The most common performed sleeve lobectomy is the right upper lobe sleeve lobectomy (67.5%). In 6 patients a combined sleeve resection of the pulmonary artery was performed. The operative mortality was 3.9%. Two patients developed a broncho-pleural fistula. The five-year survival rate was 45.6%. In 5 patients, an anastomotic suture developed which required a completion pneumonectomy in 2. Thirteen patients developed local tumor recurrence. CONCLUSION: We conclude that sleeve lobectomy can be performed with an acceptable mortality and morbidity. Long term survival rate and recurrence rate are as good as after pneumonectomy. The operative mortality is lower when compared to pneumonectomy, exercise tolerance and quality of life are much better after sleeve lobectomy compared to pneumonectomy. For central tumours we believe that sleeve resection is the procedure of choice.

Adult↗
PubMedDate not supplied

Reflections on three field lymphadenectomy in carcinoma of the esophagus and gastroesophageal junction.

BACKGROUND/AIMS: One of the most controversial questions in the surgical treatment of carcinoma of the esophagus and gastroesophageal junction (GEJ) is the extent of lymph node dissection, in particular the value of the cervical lymph node dissection (the so-called third field). METHODOLOGY: This study reflects a single institution's experience with this extensive lymphadenectomy, the technique of which is described in detail. RESULTS: Adding the third field to the lymph node dissection markedly improved accuracy of staging. Unforeseen involvement of lymph nodes in the neck was found in 30%. In T3N+ tumors of the GEJ, as much as 16.6% of positive lymph nodes were detected in the neck. Locoregional recurrence without distant metastasis was found in 6 patients (17.8%) out of a group of 37 patients with a minimum follow-up of 5 years. All 6 patients had stage IV disease because of distant lymph node metastasis (M+Ly). In 3 of these patients, locoregional recurrence occurred only after 3 years or more. In a subsequent series of 100 esophagectomies performed between 1992 and July 1993 no difference in outcome between radical versus standard resection was noticed for early stage I and II. However, there is a tendency towards a better estimated 5-year survival in favor of radical dissections (21%) versus standard resection (12%) in stage III and IV. CONCLUSIONS: Extensive three field lymphadenectomy can be safely performed without increasing hospital mortality (0%) and morbidity. Improved accuracy of staging, prolonged disease-free survival and potential increased cure rate are confirmed by our experience. Survival obtained with this technique has to be compared with survival obtained by other, multimodality treatment forms.

Adenocarcinoma↗
PubMedDate not supplied

[Surgical treatment of lungcancer five-year survival. Major surgical complications (author's transl)].

In the period 1961--1971, 41 patients with a squamous-cell carcinoma were operated upon. The absolute 5-year survival is 47.6% for the lobectomy and 20% for the pneumonectomy. In the period 1971--1976 (6 years), 211 resections for carcinoma (all types) were performed including 19 cases of squamous cell carcinoma, operated in 1971 and also studied in the first part of the work. They represent only 15.2% of all the hospitalized lungcancer patients. The lobectomy/pneumonectomy ratio is 60/40. The postoperative mortality is respectively 4% and 9.5% and the major surgical complications (bleeding, broncho-pleural fistula, empyema) are 0.8% and 3.6%. The causes of postoperative death are examined. Remarkable is the low incidence of bronchial fistulisation: 1 in 211 resections for malignant tumors, i.e. 0.47%. These results are discussed and compared with the literature.

Belgium↗
PubMedDate not supplied

Carcinoid tumour of the thymus: a case report.

A primary carcinoid tumour of the thymus is a very uncommon mediastinal tumour. Such a tumour weighing 83 g was incidentally discovered in an otherwise healthy man, aged 47 years. The histopathology is discussed.

Carcinoid Tumor↗
PubMedDate not supplied

Benign mesothelioma of the pleura.

A case of benign mesothelioma of the pleura that had been followed for 15 years and still retaining its benign character is presented. It had reached a remarkable size (4.0 kg).

Aged↗
PubMedDate not supplied

[Thymolipoma].

Thymolipoma is an uncommon mediastinal tumour composed of mixed thymic and adipose tissue. A tumour weighing 432 g was incidentally discovered in an otherwise healthy man (47 years), whose X-ray examination suggested a cardiomegally. The histopathology is discussed.

Humans↗
PubMedDate not supplied

Five-year survival in operated lung cancer.

A total of 1,001 patients with a confirmed diagnosis of lung cancer were treated at the University Hospital Pellenberg - Leuven in the five-year period 1970-1974. One hundred and sixty-four patients (16.4%) were operated and 152 underwent surgical resection of their pulmonary lung lesion. The influence of factors as histology, type of resection, age, staging, anatomic localization of the tumor on the five year survival are considered. The survival was 34.2% for all types of resected tumors, ranging from 42.0% for the lobectomies in squamous cell carcinoma to 0% in small cell carcinoma. The operative (30 days) mortality is included in the statistical follow-up. This mortality was 8.6% for the pneumonectomies and 4.3% for the lobectomies.

Adult↗
PubMedDate not supplied

Experience with 100 consecutive anterior mediastinotomies in lung cancer.

Between January 1978 and March 1981, 100 anterior mediastinotomies were performed in patients with proven or suspected lung cancer. It was done 72 times in patients with a tumor of the left lung, all presenting with a normal mediastinum. Of those 72 patients, 59 had a tumor in the left upper lobe: 30.5% of the latter were found to have involved mediastinal lymphnodes (our yield in this location was 15.1% when using the cervical mediastinoscopy); 16 patients with a left upper lobe tumor had both an anterior negative cervical mediastinoscopy followed by an anterior approach: 4 became positive (25%). The anterior mediastinotomy was performed two times in patients with a suspect mediastinum: the mediastinoscopy was once positive, and once negative. It was done 26 times in patients with a radiologically manifest enlarged mediastinum (7 on the right side, 19 on the left side); in 24 patients the histological diagnosis was unknown. The anterior mediastinotomy was positive in all 26 cases. For the whole group we found positive nodes in 10 of 26, i.e. 38.5% of the patients despite normal findings at cervical mediastinoscopy. We would therefore recommend an anterior mediastinotomy in every patient with a suspect or an enlarged superior mediastinum in order to establish an histological diagnosis or exceptionally to check the operability. If the mediastinum is radiologically normal, the anterior approach has much more chance to yield a positive result than the cervical one when the tumor is located in the left upper lobe.

Humans↗