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Biomedical subjects

R J van Dongen

Publications and source records attributed to R J van Dongen.

At least 19 recordsLinked to original sources
PubMed1990

[Reconstructive procedures in chronic occlusive processes of the intestinal arteries].

Three approaches are considered: the left thoracoabdominal approach, the right-sided retro- or supracolic route and the transabdominal access. Aorto-common hepatic venous bypass grafting is the preferred procedure in singular occlusions of the celiac axis. Reimplantation and aorto-mesenteric venous bypass are the treatments of choice in singular occlusions of the mesenteric artery. Occlusions of both upper intestinal arteries can be treated with a venous bridge bypass graft or by transaortic end-arterectomy. Operative mortality is low (0.9%). Remaining occlusion and recurrent symptoms occurred in 12 of 92 patients.

Arterial Occlusive Diseases↗
PubMed1990

[Superior mesenteric artery compression syndrome].

Simultaneous compression of the celiac axis and superior mesenteric artery by the median arcuate ligament of the diaphragm is likewise uncommon. Only 2 patients have been reported in literature. Description of four patients with severe abdominal angina caused by this condition. All patients were cured by division of the arcuate ligament.

Angiography↗
PubMed1988

Surgical approaches for unresectable primary carcinoma of the hepatic hilus.

Thirteen patients with proximal malignant obstruction of the biliary tract secondary to primary cholangiocarcinoma are presented. Seven of these patients had bilateral involvement of the major vessels of the porta hepatis, and 12 had bilateral involvement of the main hepatic ducts up to the level of segmental bifurcation. Resection of the tumor was carried out in all of the patients. Extensive resection of the liver with resection of the regional vascular structures was done in six. Another six underwent resection of the liver without resection of the regional vascular structures. The remaining patient underwent resection of the tumor and of the regional revascular structures alone. Vascular resection included resection and reconstruction of both the portal vein and hepatic artery in four patients or only of the portal vein in three. Biliary drainage was carried out by intrahepatic cholangiojejunostomies between segmental hepatic ducts and a Roux-en-Y loop. Two patients died and ten are alive. The quality of postoperative life is satisfactory and the patients are free of sequelae and symptoms secondary to operation or disease. This approach is recommended for the management of a number of patients with bilateral vascular or biliary involvement secondary to primary cholangiocarcinoma of the porta hepatis. For those patients, this approach offers a promising alternative.

Adenoma, Bile Duct↗
PubMed1985

[The thoracic outlet compression syndrome and its vascular complications].

The costoclavicular compression syndrome and the cervical rib syndrome can cause arterial complications of the subclavian artery: mural thrombosis, occlusion and aneurysma. These complications can result in peripheral emboli or cerebrovascular insufficiency. Such sequelae can be avoided by timely surgical treatment of these compression syndromes. The therapy of choice is transaxillary rib resection. The same axillary approach can also be used for directly reconstructing the subclavian artery.

Aneurysm↗
PubMed1984

[Sexual function after vascular surgical interventions in the aortoiliac area--causes and the avoidance of impotence].

Neurogenic and vasculogenic impotence after aortoiliac reconstruction is an unpleasant problem in vascular surgery. The importance of maintaining or restoring intraoperatively a sufficient hypogastric artery blood flow is emphasized. Postoperative neurogenic sexual disabilities are irreversible and are due to interruption of sympathetic nerve fibers supplying the genital system. Dissecting the terminal aorta and the iliac arteries the hypogastric sympathetic plexus--which descends across the bifurcation--can be easily damaged. This is the cause of the high incidence of failure of ejaculation after aortoiliac surgery. In order to avoid this neurogenic sexual dysfunction a retromesenteric approach to the aortoiliac region is anatomically suggested by A. v. Hochstetter. It enables the exposure of the abdominal aorta and the iliac arteries without disrupting the superior hypogastric plexus and its variants. Respecting the integrity of the sympathetic plexus and a sufficient flow in the internal iliac artery the frequency of postoperative disturbances of erection was reduced from 17% (1199 patients) to 12.3% (570 patients). The incidence of postoperative loss of ejaculation in the same groups of patients decreased from 81% to 20%.

Aorta, Abdominal↗
PubMed1979

[Reconstructive procedure in aortoiliofemoral occlusive disease (author's transl)].

Based on experience with about 1,000 patients with operable aortoiliofemoral occlusive disease, the factors influencing the operative procedure are discussed. These include the angiographic picture, the severity of ischemia, general risks, accessibility of the operating field, and availability of reconstructive material. It is concluded that, in discussing the operative procedure in aortoiliofemoral occlusive disease, the central question must be, which procedure is best for this patient, in view of his special circumstances, and not, which procedure is technically possible.

Aortic Diseases↗