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J A Hooykaas

Publications and source records attributed to J A Hooykaas.

10 recordsLinked to original sources
PubMed1998

Pelvic exenteration for advanced primary rectal cancer in male patients.

Between November 1987 and January 1996 pelvic exenteration for primary rectal cancer was carried out in 11 male patients. Two underwent a primary resection with subtotal cystectomy. In the remaining nine patients, the treatment commenced with a staging laparotomy and the fashioning of an end colostomy of the descending colon, followed by preoperative radiotherapy (50-56 Gy in 5 weeks). Total exenteration with uretero-ileo-cutaneostomy was carried out 4-6 weeks later. In two patients, the exenteration was performed despite the detection of hepatic metastases during the second laparotomy. The pathological staging was T4 in six and T3 in five patients. The immediate postoperative course was uneventful in eight patients and their hospital stay averaged 20 days. Serious postoperative complications prolonged the hospital stay of three patients. Three died during the first 6 months. Recurrent disease caused the death of three of the eight remaining patients: one locoregional (7.5 years after surgery), one from pre-existing hepatic metastases (18 months after surgery) and one from the combination of locoregional and distant recurrence (15 months after surgery). Four patients are on follow-up without evidence of disease, 96, 43, 23 and 22 months after surgery. One patient is alive 20 months after exenteration, with two pulmonary metastases having been recently excised. We conclude that, notwithstanding the morbidity rate, total pelvic exenteration is an acceptable option for advanced primary rectal cancer in male patients. Preoperative radiotherapy should be administered for cancers seated in the lower two-thirds of the rectum and perioperative chemotherapy should be considered seriously.

Adult↗
PubMed1993

[Ultrasonographic diagnosis of polyorchidism].

In a 13-year-old boy echographic investigation of the scrotum was carried out because spermatocele was suspected. On the right side an extra testicle was observed. Polyorchism is a rare anomaly with, as far as we know, 74 cases reported in the literature. It may result from transverse splitting of the urogenital ridge in the 4th till the 6th week of the embryonal phase. The accompanying disorders include inguinal hernia, cryptorchism and torsion. Malignancy in the extra testicle has been reported in 4 cases only. In the absence of any accompanying disorder and if testicular tumor can be ruled out by ultrasonography, there is no need for surgical exploration.

Adolescent↗
PubMed1986

Vesicocalicostomy as ultimate solution for recurrent urological complications after cadaveric renal transplantation in a patient with poor bladder function.

We report a case of a neurogenic bladder in which hydronephrosis recurred early after renal transplantation. After 2 unsuccessful attempts at ureteroneovesicostomy of the donor ureter a vesicocalicostomy was performed, since reconstruction with the donor pelvis or ureter was impossible owing to the extended fibrosis and scar formation around the renal hilus and ureter. During the 23 months of followup renal function has been good without serious infectious sequela with a regimen of self-catheterization and no antibiotic maintenance therapy.

Adult↗
PubMed1984

[NMR imaging of the kidney].

NMR imaging was performed in 18 patients suffering from various renal disorders. 2 scanners were used, a 0.14T resistive prototype system and the superconducting Gyroscan S5. NMR imaging proved to be a very sensitive technique. Tumours as small as 5-10 mm were detected. Solid tumours and cysts could be distinguished. As a result of the excellent contrast resolution and tissue differentiation NMR imaging appears to be very accurate in the staging of renal cell carcinoma. Blood vessels within a tumour may be visible as little black dots. Because of their short T1 hemorrhagic cysts can be differentiated from simple cysts. Further prospective follow-up studies are required before a definite statement can be made as to the value of NMR imaging in diffuse parenchymal disease. Calcification were not detected. NMR imaging does not seem to be any more specific as to tissue characterisation than other imaging modalities.

Female↗
PubMed1982

Safe removal of failed transplanted kidneys.

The surgical removal of a transplanted kidney following rejection or failure can be hazardous. A total of 110 grafts were removed consecutively in 84 patients (in 21 cases a second graft and in 5 cases a third graft was removed). Two surgical techniques were applied: extracapsular and intracapsular removal. The extracapsular technique was associated with complications in 11 out of 69 cases (16 per cent) and the intracapsular technique, in 3 out of 36 cases (8 per cent). In 5 cases the operative technique could not be determined from the records. In the 14 cases developing complications, wound infection was observed in 7 cases, wound haematoma in 4 and mycotic aneurysm, pulmonary embolism and clotting in the bladder each in 1 case. One patient (1.2 per cent) died due to late complications after allograft nephrectomy following rupture of a mycotic aortic aneurysm. The technique of kidney transplant removal by either the intra- or extra-capsular route of the exact timing of the operation are important features for safe treatment of patients with end-stage graft failure.

Adolescent↗
PubMed1980

Management of rupture in allografted kidneys.

Allograft rupture is a rare but serious complication in renal transplantation, occurring in 3 to 8.5% of the transplanted kidneys. The consequences for the recipients are fatal in 6% of the cases and graft loss is the outcome in another 53%. Clinical features and treatment of renal allograft rupture are discussed and illustrated by a case history, in which successful management of this complication resulted in salvage of the graft and patient. A literature study with the purpose of determining the pathogenesis of graft rupture revealed that rejection plays a major role.

Adolescent↗