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G Kazemier

Publications and source records attributed to G Kazemier.

43 records · Page 3Linked to original sources
PubMed1997

Comparison of three techniques for adrenalectomy.

BACKGROUND: Conventional open adrenal surgery requires relatively large incisions and is associated with postoperative wound pain, intercostal neuralgia and pulmonary complications. Introduction of laparoscopic techniques has enabled development of minimally invasive adrenalectomy. METHODS: A case-control study of nine open, nine transperitoneal laparoscopic and 12 retroperitoneal endoscopic adrenalectomies was done in patients who were matched for Quetelet index, adrenal disorder and size of adrenal lesion; all tumours were less than 6 cm in diameter. RESULTS: Conversion to open adrenalectomy was necessary in two patients having transperitoneal laparoscopic adrenalectomy and in one having retroperitoneal endoscopic adrenalectomy. Operative time was longest in transperitoneal laparoscopic adrenalectomy (P = 0.004 and P = 0.005 versus open and retroperitoneal endoscopic adrenalectomy respectively). Blood loss was least in retroperitoneal endoscopic adrenalectomy (P = 0.01 versus both other groups). End-tidal carbon dioxide increase was greater in transperitoneal laparoscopic and retroperitoneal endoscopic than in open adrenalectomy (P = 0.014 and P = 0.01 respectively). After retroperitoneal endoscopic adrenalectomy, use of analgesia was least (P = 0.0003 versus other groups). Postoperative hospital stay was shortest after retroperitoneal endoscopic adrenalectomy (P = 0.024 and P = 0.027 versus open and transperitoneal laparoscopic procedures respectively). CONCLUSION: Retroperitoneal endoscopic adrenalectomy was optimal in patients with small adrenal tumours.

Adrenal Gland Neoplasms↗
PubMed1994

Proliferative response of hepatocytes transplanted into spleen or solid support.

Understanding the regenerative behavior of transplanted hepatocytes is of great importance for developing and improving such novel therapeutic strategies as hepatocellular transplantation and ex vivo gene therapy. In this study the proliferative responsiveness of transplanted syngeneic rat hepatocytes was examined in relation to the timing of the administration of a mitogenic stimulus. For this purpose nuclear bromodeoxyuridine incorporation after partial hepatectomy was investigated during the early post-transplant phase. The response of intrasplenically transplanted hepatocytes was compared to that of liver cells engrafted in polytetrafluoroethylene solid supports that had been implanted intraperitoneally 4 weeks prior to transplantation. Nonstimulated, engrafted hepatocytes exhibited a labeling index of approximately 0-1% independent of the transplantation technique used. This "spontaneous" labeling index did not change with time. Partial hepatectomy, executed simultaneously with hepatocyte transplantation through either technique, did not result in significant alteration of this proliferation index. Delayed kinetics were found not to be responsible for this lack of responsiveness. When the mitogenic stimulus was given between 2 and 6 weeks post-transplantation, a significant increase in labeling index was observed in comparison to sham-treated control animals. Maximal labeling indices of approximately 3-4% were found if the stimulus took place at 4 weeks post-transplantation. Both the pattern and the extent of the proliferative response seen in liver cells engrafted in solid supports were similar to the ones found in intrasplenic hepatocytes, indicating adequate vascularization of the supports. This data provides the first description of proliferative response in hepatocytes transplanted by the solid support technique, which may offer an attractive alternative to the intrasplenic route.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1990

Hepatic anatomy.

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Humans↗
PubMedDate not supplied

Radiofrequency ablation in patients with primary and secondary hepatic malignancies.

The aims of this study were to assess the technical effectiveness of radiofrequency (RF) ablation in patients with primary or secondary hepatic malignancies and to determine survival and complication rates. This was a retrospective analysis of prospectively collected data of patients treated with RF ablation and controlled for recurrence every 3 months by contrast-enhanced computed tomography (CT) or magnetic resonance imaging (MRI). The outcome is compared with a comprehensive review of data published in recent literature. Forty-seven patients underwent 50 RF sessions for the ablation of 73 tumors. Local tumor progression was observed in 11 patients (23%). A tumor sized larger than 30 mm, a tumor load larger than 14 cm3, and a percutaneous approach were associated with a faster time to local tumor progression. At the end of a mean (+/- SD) follow-up period of 11.4 +/- 7.5 months, 39 patients (83%) were alive, including eight patients with recurrent disease. The overall cumulative survival rates at 12 and 24 months were 87% and 70%, respectively. In our center, RF ablation can be safely performed to achieve adequate local control and survival rates. Time to local tumor progression was significantly related to initial size of the tumor and tumor load.

Adult↗