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Biomedical subjects

P Pattyn

Publications and source records attributed to P Pattyn.

52 records · Page 3Linked to original sources
PubMed1996

Laparoscopic and thoracoscopic surgery in infancy and childhood, the Münster/Gent experience.

Laparoscopic and thoracoscopic surgery have had a tremendous impact on adult surgery, but are still rarely used in children. In the past 3 years 168 children have been treated endoscopically in the three cooperating institutions. The course of all patients was documented prospectively in order to determine the value and prove the safety of endoscopic surgery in children. The operations performed endoscopically comprised appendectomy (n = 39), diagnostic procedures (24), adhesiolysis (n = 22), cholecystectomy (n = 13), bowel resection (n = 8), pyloromyotomy (n = 6), ovarial resection (n = 6), hiatus hernia repair (n = 22), splenectomy (n = 6), first stage of Fowler-Stephens operation for kryptorchidism (n = 3) and interruption of persistent botallic ducts (n = 6) in preterm infants. Apart from four wound infections (2.4%) following perforated appendicitis, one of which required laparotomy for perityphlitic abscess there were no serious complications. No patient died, and overall morbidity related to the procedure was 1.8% (i.e. incidence of uneventful minor intraoperative complications). Furthermore endoscopic surgery provides a better diagnostic survey of the abdomen or thorax so that missing of secondary pathology is unlikely. Pain and reflectory impairment of bowel-function or respiration were diminished, the aesthetic results were excellent and hospitalization could be reduced to a minimum. It is concluded that laparoscopic and thoracoscopic surgery are safe and reliable procedures for children and yield very encouraging results.

Adolescent↗
PubMed1996

[Results of liver transplantation in elderly patients (> 55 years of age)].

The results of orthotopic liver transplantation in patients > 55 years were compared to a group of patients aged < or = 55 years. Rates of 1- and 4-year patient survival were 88.5% and 73.1% vs. 88.0% and 70.7%, respectively. Morbidity and postoperative mortality were similar in both groups, suggesting that orthotopic liver transplantation can be safely performed in patients > 55 years of age with excellent improvement of quality of life.

Adult↗
PubMed1993

[Liver and liver segment transplantation in adults and children. Experiences with the first 50 cases].

The experience with 50 liver transplants performed in 42 patients within a 16 months period is reviewed. There were 15 transplantations in 12 children and 35 in 30 adults. The series was analysed regarding the source of transplant, i.e. living related (LR) n = 2 or cadaver (CAD) n = 48, graft size i.e. full size (FS) n = 34, reduced size (RED) n = 12 and split grafts (SG) n = 4. Regarding the preservation time or operating time there was no statistically significant difference between the groups. The overall function rate was 88%, 94% for FS and 73.4% for the remaining partial grafts (RED and SG). The difference was not significant (p = 0.062). Biliary leakage occurred in one (2%) reduced graft. Hepatic artery complications (kinking, intima dissection) were encountered in two (4%) patients receiving a FS. It is concluded that the use of partial liver grafts is a safe procedure to alleviate organ shortage while preservation time and operating time are not prolonged as compared to the transplantation of full size grafts.

Adolescent↗
PubMed1988

Serotyping and phage typing to identify Enterobacter cloacae contaminating total parenteral nutrition.

The origin of an outbreak of Enterobacter cloacae septicemia in six surgery patients was traced down to the total parenteral nutrition production line. While the endproduct of the production line was sterile, Enterobacter cloacae and other bacteria were detected on different tabs and tubings of the line. It is believed that the bacteria were transferred from the tabs to a few bags of the total parenteral nutrition in one batch by touch contamination. Serotyping and phage-typing of the clinical isolates revealed that five of the patients' strains were identical.

Bacteriophage Typing↗
PubMedDate not supplied

Jejunal arteriovenous malformation, diagnosed by angiography and treated by embolization and catheter-guided surgery: case report and review of literature.

A case of chronic gastrointestinal hemorrhage caused by a small jejunal arteriovenous malformation (AVM) is reported. Treatment by endovascular embolization was temporarily successful. Subsequently, the patient underwent laparoscopic resection, guided by intraoperative catheter localization with methylene blue. Histopathology confirmed a true AVM. Eighteen months after treatment, the patient is free of symptoms. Literature of jejunal AVMs is reviewed.

Aged↗
PubMedDate not supplied

Surgery for gastrointestinal endometriosis: indications and results.

BACKGROUND: Although gastrointestinal endometriosis is an uncommon and often unexpected finding, the best treatment requires removal of all endometriotic lesions. The purpose of our study was to report our experience with the diagnosis and treatment of bowel endometriosis. MATERIAL AND METHODS: From January 1997 to January 2004, 13 patients (mean 35.7y ; range 21-55y) were operated for bowel endometriosis. We noted: age, history of endometriosis, previous pregnancies, preoperative investigations and symptoms, operative procedure and intraoperative findings. Follow-up varied between one month postoperative examination and seven years. RESULTS: Presenting symptoms of the cases were: acute appendicitis (3), dysmenorrhoea (7), constipation (6), pelvic pain (2), rectal bleeding (3) and dyspareunia (2). Operative management was performed in accordance with the anatomical distribution. Seven patients had a history of previous operations and multifocal involvement was present in 61.5% of cases. At a median follow-up of 12.2 months, 83.3% had complete relief of their initial complaints, with only one reoperation needed. The pregnancy rate after surgery was 66.6%. Preoperative tests were: ultrasound for ovarian endometriomas, coloscopy, barium enema, vaginal palpation for detecting rectovaginal involvement, MRI and CT scan. These tests predicted the extension of endometriotic process correctly in 50% of the cases. CONCLUSIONS: Endometriosis of the sigmoid and rectum is rare but can give rise to severe gastrointestinal and pelvic symptoms. Preoperative investigations are not infallible in predicting the extent of the disease, sometimes placing the surgeon before a dilemma, because it involves mostly young women in the reproductive phase of life. The colorectal surgeon, therefore, should seek the advice of an experienced gynaecologist and vice versa. Removal of all endometriotic lesions is mandatory for obtaining an optimal relief of symptoms.

Adult↗
PubMedDate not supplied

Total mesorectal excision in the treatment of rectal cancer: a review.

Despite the improvements in preoperative staging, surgical technique and adjuvant therapy, local recurrence remains a significant problem in rectal cancer surgery. Several patient- and tumour-related risk factors for the development of local recurrence have been identified and are being addressed by regimens of pre- or postoperative adjuvant therapy. Total mesorectal excision (TME) recently has been shown to result in a low recurrence rate even without the use of adjuvant therapy. Nevertheless, conclusive evidence in the form of a prospective randomized trial is to date not available. This paper describes the technique of TME and reviews the clinical and pathological data supporting its use in rectal cancer surgery.

Digestive System Surgical Procedures↗
PubMedDate not supplied

Metastatic follicular dendritic cell sarcoma of the stomach: a case report and review of the literature.

Follicular dendritic cell (FDC) sarcomas are rare tumours, typically seen in lymph nodes. However, in about one third of the reported cases, a FDC sarcoma presents as an extranodal mass. Involvement of the gastrointestinal tract is extremely rare, and only 3 cases have been described to date. We report on a 40-year-old female patient with a follicular dendritic cell sarcoma located in the stomach and the presence of a metastasis in the liver at the time of diagnosis. Severe asthenia, nausea, back pain and loss of weight were the presenting symptoms. A CT scan of the abdomen and an upper gastrointestinal endoscopy revealed a tumour mass in the stomach. The diagnosis of a FDC sarcoma was made on histological and immunohistochemical findings. We report the second case of a FDC sarcoma presenting in the stomach. Due to its rarity, a FDC sarcoma seldom enters the differential diagnosis of spindle cells neoplasms of the gastrointestinal tract. Complete surgical resection is the treatment of choice for FDC sarcoma.

Adult↗
PubMedDate not supplied

Peritoneal lavage after abdominal trauma: indications, technique, results.

This study represents our experience with 1461 patients who were seen in the Emergency Room of the University Hospital in Ghent with multiple traumatic lesions, between 1978 and 1982. In 43% of these polytraumata, we did an explorative peritoneal lavage in order to obtain a quick evaluation of intrabdominal haemorrhage. In 65% of the patients, the lavage was negative; 221 positive lavages (35%) underwent abdominal exploration; in 85% of these there were evident positive findings. The remaining 15% showed either no lesions, or minor lesions not involving risk of life. The overall accuracy-rate of the technique described above is at least 93%.

Abdominal Injuries↗