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M Hesseling

Publications and source records attributed to M Hesseling.

At least 19 recordsLinked to original sources
PubMed2003

Comparison of classic and endoscopic lymphadenectomy for staging breast cancer.

STUDY OBJECTIVE: To compare endoscopic and classic axillary lymphadenectomy staging of breast cancer with respect to operation-induced changes such as seroma formation, pain, neurologic sensations, lymphedema, infection, and reduction of shoulder-arm mobility. DESIGN: Prospective, randomized study (Canadian Task Force classification I). SETTING: University-affiliated hospital. PATIENTS: Eighty consecutive women with histopathologically confirmed invasive breast cancer who had clinically and sonographically negative axillary lymph nodes (<1 cm). INTERVENTION: Classic and endoscopic lymphadenectomies. MEASUREMENTS AND MAIN RESULTS: We attempted to obtain 10 axillary lymph nodes/patient. After 1, 3, 5, 7, 9, 42, and 84 days, clinical and ultrasonographic examinations were conducted to evaluate operation-induced changes. Short-term results showed that, with endoscopic technique, a representative number of axillary lymph nodes was removed, with reduced axillary infiltration and seroma induction, as well as less impaired shoulder-arm mobility. During the first month, postoperative infection, lymphedema, and neurologic complaints were comparable in both groups, with more stretching pain in the classic group and predominantly paresthesia in the endoscopic group. After 3 months no differences in postoperative complications were detected. CONCLUSIONS: Endoscopic axillary lymphadenectomy avoids short-term reduction of shoulder-arm mobility. Long-term studies are necessary to prove if this technique is as safe as the classic procedure with regard to local axillary recurrence. If so, endoscopy could become the method of choice for staging breast cancer in women with clinically negative lymph nodes.

Adult↗
PubMed2000

A novel peptide aldehyde with activity against human cytomegalovirus in two different in vivo models.

Novel peptide aldehydes (PAs) were identified as potent inhibitors of human cytomegalovirus (HCMV) in vitro. Although these compounds were highly effective against HCMV, they did not exhibit any activity against murine cytomegalovirus (MCMV). The purpose of this study was to test the antiviral activity of PA 8 as a representative of this novel class of inhibitors against HCMV in vivo. Because of the strict species specificity of HCMV we had to use two artificial animal models. In the first model, HCMV-infected human cells were entrapped into agarose plugs and transplanted into mice. In the second model, SCID mice were transplanted with human tissues that were subsequently infected with a clinical isolate of HCMV. In these two models the antiviral activity of PA 8 was clearly demonstrated, ganciclovir only being slightly superior in its in vivo antiviral activity.

Aldehydes↗
PubMed1997

[A preoperative diagnostic concept for determining the extent of laparoscopic surgery of the adnexa].

The operative laparoscopic therapy of pre- and postmenopausal adnexal tumors has become more and more important in routine gynecological surgery. Careful evaluation of malignancy criteria by preoperative diagnostics decides whether endosurgical treatment or laparotomy should be performed. Preoperative diagnostic measurements must secure a safe and efficient endosurgery without any negative financial impact due to unnecessary explorations. The proposed diagnostic concept offers maximal security with minimal investigations.

Adult↗
PubMed1994

[Safety and effectiveness of endosurgical management of benign adnexal tumors in the premenopausal period: a prospective study].

Between January 1985 and December 1989, a prospective laparoscopic study was performed in premenopausal women with pelvic cysts growing or persisting for at least three months or evoking acute abdominal complaints. The aim of this prospective study was the investigation of the functional/nonfunctional rate, the relapse and the malignancy rate. 372 women underwent a diagnostic-operative laparoscopy in the absence of irregular solid and cystic parts detectable by preoperative vaginal ultrasonography. The treatment consisted of non-randomised endosurgical ovarian cystostomy, cystectomy or ovarectomy. Histopathological assessment showed functional ovarian cysts in 268 women and non-functional benign ovarian tumours in 104. 2 cases were subsequently found to be malignant. After a mean follow-up-time of at least one year, we found an overall recurrence rate of 4.6% after cystostomy, 2% after cystectomy and 0% after ovarectomy in the group of functional ovarian cysts and a total of 1% after endosurgical therapy of the non-functional ovarian tumours. The diagnostic operative laparoscopy proved to be a safe and efficient treatment of pelvic cysts in women of reproductive age, provided a sufficient preoperative vaginal ultrasound examination had been performed.

Adolescent↗
PubMed1994

[Diagnosis and therapy of adnexal tumors in postmenopause. A prospective study].

The management of postmenopausal adnexal tumours is still controversially discussed. Approximately 30% of all postmenopausal tumours are malignant. The standard operative approach for these adnexal masses is still the exploratory laparotomy although the advantages of laparoscopic procedure are obvious, even in older patients. The aim of this prospective study was to find out to what extent diagnostic-operative laparoscopy is able to replace laparotomy in the therapy of postmenopausal adnexal masses. From January 1990 to August 1992, 169 postmenopausal patients entered the prospective study. After careful preoperative diagnostics, 63 patients underwent a laparotomy (group B) and 106 patients a laparoscopy (group A). 10 of these 106 cases underwent laparotomy after diagnostic laparoscopy (group Ab). The main operative procedure in group Aa was laparoscopic adnexectomy after Semm. Mean operative time and mean postoperative hospital stay were significantly lower in patients, who only underwent laparoscopic operation (group Aa). One case (0.9%) of the laparoscopically operated patients was subsequently found to be malignant (histologic assessment) and immediately treated by laparotomy with hysterectomy and contralateral adnexectomy. The combination of vaginal examination, vaginal/abdominal ultrasonography (tumor marker CA 125) and a sufficient preoperative diagnostic during endosurgery (no proliferations on the ovary or peritoneal surface, no ascites) reduces the risk of operating a malignant tumour by laparoscopy to a minimum. We believe that operative laparoscopy of postmenopausal adnexal masses is a safe and efficient method in carefully selected women.

Aged↗
PubMed1994

[Breast saving or modified radical mastectomy in oncologic breast surgery?].

The bilateral subcutaneous reduction mastectomy is known as one of the methods in breast-saving cancer surgery, useful in patients with a malignant breast tumour showing multifocal lesions or combined with ptosis mammarum. In a retrospective study incorporating 160 patients after modified radical mastectomy or bilateral subcutaneous reduction mastectomy, we compared local recurrence rate, disease-free survival and mortality rate. A significant difference was found in local recurrence showing a higher rate in the non-radical group. The disease-free interval and the late mortality rate showed no statistical differences. The comparable disease-free interval of both groups added to the psychosocial benefits makes the bilateral subcutaneous reduction mastectomy a possible alternative surgical treatment of the breast carcinoma.

Adult↗
PubMed1993

[Management of gynecologic diseases within the scope of surgical pelviscopy].

Following the routine use of the diagnostic-operative laparoscopy in the surgical diagnosis and therapy of the lower abdominal pain, the surgeon is confronted with a plethora of gynecological diseases. Due to the unknown appearance, suboptimal therapy follows. Intra-operative consultation of a gynecologist does not necessarily bring the expected solution as there is a lack of gynecological anamnesis and preoperative examination. To avoid insufficient endosurgical diagnosis, therapeutical failures and iatrogenic infertility, the gynecological diagnosis scheme with subsequent therapy is described. Completing the preoperative diagnostics by a gynecological investigation can improve endosurgical treatment and avoid second-look surgery.

Abdominal Pain↗
PubMed1992

[Organ preserving endosurgery in pyosalpingitis].

Pyosalpinges are a difficult therapeutic problem in a complicated pelvic inflammatory disease. To avoid a diffuse peritonitis, often a laparotomy with salpingectomy is performed. 20 women of reproductive age with a uni- or bilateral pyosalpinx were incorporated in a prospective study to investigate the possibilities of a combined endosurgical/antibiotical treatment. After endoscopic confirmation, the patients were taken into study. During diagnostic laparoscopy, a salpingotomy with rinsing of the tubes and a drainage of the Douglas pouch took place. After one week of antibiotic treatment, a second-look laparoscopy was performed in all patients; no recurrence was documented. The combination of endosurgery and chemotherapy showed to be a safe and efficient therapy of tubal abscesses in women of reproductive age.

Adult↗
PubMed1989

[Recurrent functional ovarian cysts following laparoscopy fenestration].

The laparoscopic fenestration of functional ovarian cysts with a benign appearance is well known. After aspiration of the contents of the cyst, a window is cut in the cyst wall for an endocystic inspection. In this way, samples for cytology as well as histopathology are obtained. A laparoscopic fenestration was performed on 104 patients. During a mean follow-up time of 20 months, we found a recurrence of 8% in 91 patients. In the presence of pelvic adhesions, the functional cysts tend to reoccur. Corpus luteum cysts have a higher recurrence-rate than follicular cysts. In our study postoperative hormon-therapy recorded no protective effect.

Endometriosis↗
PubMed1989

Ovarian cystostomy.

Surgical treatment of follicle and luteal cysts by laparoscopic fenestration is an accepted procedure. After cyst aspiration, a "window" is cut in its wall. Thus, a tissue sample can be obtained for cytological and histopathological examination. Laparoscopic fenestration was performed in 104 patients. During a mean follow-up period of 20 months (N = 91) a recurrence rate of 8% was observed by vaginal examination and abdominal sonography. In the presence of pelvic adhesions, functional cysts tend to recur. Luteal cysts have a higher recurrence rate than follicle cysts.

Adult↗
PubMed1989

[Psychosocial aspects of bilateral subcutaneous reduction mastectomy in breast cancer].

The authors administered a questionnaire to 56 women with breast cancer who had bilateral subcutaneous mastectomies after Stroembeck/Beller since 1985. In this study, psychological aspects were investigated. There was no change in social behavior; isolation was not noticed. The negative effects on the body image were well accepted and discussed with relatives and friends. Psychological or emotional suffering was rare compared to patients with simple mastectomy. No change in sexual behavior was reported. The sexual function of the mamillae was significantly reduced. Although some cosmetic deformities were obvious, most patients would again choose the subcutaneous reduction mastectomy as operation of choice.

Adaptation, Psychological↗
PubMed1988

[Spontaneous rupture of the kidney pelvis in pregnancy].

A case of spontaneous rupture of the renal pelvis during pregnancy is presented. Diagnosis was made sonographically showing a perirenal extravasation. Early detection of this rare complication saved the kidney. After ureteral indwelling the extension of the extravasation and the clinical symptomatic improved rapidly. Further pregnancy was free of complications and the patient delivered two healthy infants without experiencing any problems during labour or delivery.

Adult↗
PubMed1988

[Traumatically-induced dermatofibrosarcoma protuberans of the breast].

Dermatofibrosarcoma protuberans is a rare, cutaneous-subcutaneous low grade malignancy. Despite the locally aggressive behaviour, metastases seldom occur. Evidence exists that trauma may be a predisposing factor. Treatment by wide tridimensional excision is recommended. One case of trauma-induced dermatofibrosarcoma protuberans in a 71-year old woman is reported.

Aged↗