Biomedical subjects

G L Beets

Publications and source records attributed to G L Beets.

22 records · Page 2Linked to original sources

PubMed1996

Long-term results of giant prosthetic reinforcement of the visceral sac for complex recurrent inguinal hernia.

The results of recurrent inguinal hernia repair in a prospective cohort study were evaluated. From May 1986 to December 1990 75 patients with 150 hernias (24 primary, 126 recurrent) were operated using a technique based on Stoppa's preperitoneal mesh repair (giant prosthetic reinforcement of the visceral sac; GPRVS). All patients were at high risk for recurrence: they all had bilateral hernias, mostly bilateral recurrent and often repeatedly recurrent. All patients had a physical examination 1 week, 6 weeks and 1 year after operation. Sixty patients (94 per cent of surviving patients) had a physical examination after a mean follow-up of 5.7 (range 4-9) years. There were no major complications. There was one deep infection that healed without removing the mesh. One of the 75 patients (1 per cent) had a recurrence 2 months after the operation, due to a technical failure. Because of the excellent results, the ease of the procedure and the low complication rate, GPRVS is the authors' operation of choice for any recurrent inguinal hernia.

Aged↗

PubMed1996

Foreign body reactions to monofilament and braided polypropylene mesh used as preperitoneal implants in pigs.

OBJECTIVES: To compare the foreign body reaction of the monofilament polypropylene (Prolene) mesh, and the multifilament Surgipro mesh. Both types of mesh are widely used in laparoscopic inguinal hernia repair. DESIGN: Prospective experimental study. SETTING: University hospital, The Netherlands. MATERIAL: Six female Yorkshire & Dutch landway pigs. INTERVENTION: Laparoscopic transabdominal implantation of six Surgipro meshes and six Prolene meshes in 12 inguinal sites. MAIN OUTCOME MEASURES: At 3, 6, and 12 weeks after implantation the foreign body reaction was measured by counting multinucleated giant cells at the mesh-tissue interface. RESULTS: At all times the numbers of multinucleated giant cells at the mesh tissue interface were significantly larger with Surgipro than with Prolene (p < 0.001). CONCLUSIONS: There is significantly more foreign body reaction after implantation of Surgipro than Prolene mesh.

Animals↗

PubMedDate not supplied

Preoperative assessment of local tumor extent in advanced rectal cancer: CT or high-resolution MRI?

BACKGROUND: We compared high-resolution magnetic resonance imaging (MRI) with computed tomography (CT) in the assessment of tumor infiltration in surrounding structures for locally advanced primary and recurrent rectal cancer. METHODS: Twenty-six patients with operable, locally advanced rectal cancer (15 recurrent and 11 primary) were evaluated with conventional pelvic CT and 1.5-T high-resolution MRI with a quadrature phased-array coil. The images were scored for invasion of nine neighboring pelvic structures, and the results were compared with surgical and histologic findings. RESULTS: A total of 234 structures in 26 patients was evaluated for tumor invasion. For MRI the, sensitivity was 97% and the specificity 98%; for CT, the sensitivity was 70% and the specificity was 85%. The difference in performance was statistically significant (p<0.001). The failure most frequently made on CT was the false-positive prediction of pelvic floor and piriform muscle invasion (14), whereas MRI showed only four false-positive predictions. MRI correctly predicted all four cases of sacral bone invasion, three of which were missed by CT. MRI was accurate in 20 patients (80%) and CT in only five patients (19%). CONCLUSION: High-resolution MRI using a quadrature phased-array coil is highly accurate and superior to CT in predicting tumor infiltration in surrounding structures for locally advanced primary or recurrent rectal cancer and is recommended in the preoperative work-up of these tumors.

Adenocarcinoma↗

PubMedDate not supplied

High-resolution magnetic resonance imaging of the anorectal region without an endocoil.

BACKGROUND: To evaluate the feasibility of a high-resolution magnetic resonance imaging (MRI) technique in detailed imaging of the anal sphincter and lower pelvic region without the use of an endoluminal coil. METHODS: MRIs with an external phased array coil (T1- and T2-weighted turbo spin echo) were performed in 22 volunteers and 12 patients with an anal fistula, an anal sphincter defect, or a rectal tumor. The normal scans were evaluated by three independent observers. The scans of the patients were compared with surgical and/or histologic findings. RESULTS: The anal sphincter was visualized with detail. In the anal canal, hemorrhoidal tissue and the submucosae ani muscle could be seen. The MRI technique also allowed detailed imaging of anatomical structures above the pelvic floor. The MR findings in the 12 patients showed exact correlation with surgery and/or histology. CONCLUSIONS: High-resolution MRI of the anorectal region without an endoluminal coil is feasible. The MR technique with an external phased array coil allows detailed imaging of the anal sphincter at rest, the rectum, and the surrounding pelvic structures with one single investigation. The results are promising and suggest useful applications in the management of anorectal diseases.

Anal Canal↗